Disease Control and Prevention (Www.Cdc.Gov)

¶ … Disease Control and Prevention (www.cdc.gov) reports that about 50 million people (that is one in five Americans) are living with "at least one disability." Moreover, the CDC claims that "most Americans" at some time in their lives will suffer a disability. As to how the CDC reached the average of one in five, the United States Healthy People 2010 Plan ("Objective 6-1") used two standardized questions to identify those who are disabled. Those who answered "yes" to the question, "Are you limited in any way in any activities because of physical, mental, or emotional problems?" And the question, "Do you now have any health problem that requires you to use special equipment…a cane, a wheelchair, a special bed or a special telephone?" were determined to be disabled (CDC). The "yes" answers received during surveys conducted across all 50 states ranged from 11.4% to 25.8%, and the average was 20%. And so it is clear that millions of Americans are disabled. The two salient questions for this paper are, what are the specific challenges that disabled people face in communities and how can nurses intervene to aid disabled people vis-a-vis Watson's Theory of Human Caring?

Community health issue described using Healthy People 2010 data:

The U.S. Government's "Healthy People 2010" (HP2010) has put forward information including indicators and objectives for people with disabilities in communities. The ten "leading health indicators" published by the government are: physical activity; overweight and obesity; tobacco use; substance abuse; responsible sexual behavior, mental health, injury and violence; environmental quality; immunization; and access to health care (HP2010).

Of course, just knowing what the indicators are isn't enough for healthcare professionals -- there is a compelling need to know what to do about the indicators. The HP2010 information pages online (www.healthypeople.gov) suggest that by the fact of presenting the indicators it is hoped that citizens and communities will be "motivated" to "take actions to improve the health of individuals." There is something every citizen can do to help improve the health of individuals and families: one, everyone should "adopt the 10 leading health indicators" in order to make good healthy living choices; two, public health professionals and public officials should be encouraged (lobbied) to embrace those 10 indicators as "the basis for public health priority-setting and decision-making"; and three, the progress toward success in the community should be measured against the leading health indicators (in other words, the ten can be a kind of barometer for the community to follow in terms of success in confronting the health issues).

Reason for choosing this topic: Upon looking at the statistics (one in five people in the United States is disabled) and giving serious thought to each of these issues, a person who is planning for a career in healthcare cannot help but be impacted on several levels. For one, it seems that everywhere one looks these days -- the malls, the grocery stores, and restaurants, at church or walking down Main Street -- there are grossly overweight people. It is obvious that obesity is a plague, and that goes back to education about healthy eating. Probably many young people grow up in urban environments and develop the fast-food habit at a young age. That is just one of the Leading Health Indicators, but it is crucial to the healthcare issue, because obesity can be a cause of diabetes, high blood pressure, and even stroke. Link that with the statistics that show few people get enough exercise, and you have a very serious national health problem. This alone is a good reason for choosing the topic "People with Disabilities."

Description of the problem: People with disabilities suffer pain, depression, and a "greater risk" for developing certain illnesses, the CDC explains. And as noted earlier in this paper, one in five persons in America has a disability -- and that statistic alone is a red flag for the healthcare community. Among the problems specifically, according to the CDC ("Disability and Health") are: 30% of women and men with disabilities are "obese"; only 12% of adults (18 and over) are "physically active 30 minutes five days a week"); 32% of disabled adults smoke cigarettes (a serious health problem by itself); and moreover, only 23% of adults who have serious depression are actually receiving treatment. Depression can be a warning sign that there are more serious potential consequences unless the depression is treated.

Background factors that contribute to the issue: The HP2010 offers ten leading health indicators, and within those are sub-categories that add up to "467 science-based objectives" (HP2010). All the objectives are designed to eliminate or reduce some of the pivotal problems relating to the following background issues.

Too many disabled people are "limited by environmental factors" (they don't have access to buildings, recreational activities or transportation); there are too many people with "negative attitudes" about disabilities (this affects the social climate for those who are disabled); many disabled people are either limited in their access to educational opportunities or have no access at all; persons who are disabled too often have limited access to "career development, career opportunities, job placement and job satisfaction"; many disabled people have "limited or no participation in governmental decision-making on issues that directly affect their lives, voting activity, and opportunities to run for public office" (www.cdc.gov).

Local data available: Thanks to good coordination with CDC, Healthy People 2010, the Surgeon General's Office and other federal agencies, every state has the ability to "identify and access" the health status of disabled people because all states have a "Behavior Risk Factor Surveillance System" (BRFSS). In Missouri, for example, local officials are providing preventative measures for children attending camps this summer; any child that has a cough or otherwise appears to have flu symptoms, should be sent home since the "swine flu" -- Novel Influenza A (H1N1) Virus -- is highly contagious. In "Healthy Kentucky" one of the local goals is keeping one's weight under control by exercising and making good meal decisions. Solid information is made available in Missouri. And in Delaware ("Be Healthy Delaware") there are four "broad-based" goals set in terms of avoiding disabilities: a) promoting healthy behaviors; b) promoting healthy communities; c) "preventing and reducing diseases and disorders"; and d) "improving health systems."