MMHA 6200 Week 3 Priority Population Rationale Paper Example

Choosing a Priority Population: Children With Asthma in the East-Side Rental Corridor

Student Name

Walden University

MMHA 6200: Creating Healthy Communities

Instructor Name

Month Day, Year

Choosing a Priority Population: Children With Asthma in the East-Side Rental Corridor

Introduction

Lakeshore Community Hospital, a composite nonprofit hospital on the east side of Port Harmon, an invented Great Lakes city, cannot address every population health problem on the east side at once. Three candidate populations were proposed for its next community health effort: children with asthma living in the rental corridor along the old streetcar line; older adults living near the supermarket that closed two years ago; and working-age adults without cars. This rationale chooses the first and explains in writing why the other two were set aside for now. All local figures are illustrative, drawn from the composite county's published tables and the hospital's own records.

Criteria

Five criteria were set before the candidates were compared. Size: how many people are affected. Severity: how serious the health burden is. Gap: how far the group's outcomes sit from the county's, following Kindig and Stoddart's emphasis on the distribution of health within a population (Kindig & Stoddart, 2003). Reach: what the hospital can actually do, given its services, partners and resources. Measurability: whether change could be measured within two years using data that already exist. Each criterion is scored high, medium or low.

The Comparison

Table 1 compares the three candidates.

Table 1

Three Candidate Populations Compared on Five Criteria (Illustrative)

The Chosen Population

Children with asthma in the corridor score high on four of five criteria. The hospital's own emergency records, sorted by ZIP code, show children from the three corridor ZIP codes returning for asthma far more often than children elsewhere, and the gap from the county is large enough to be visible even in a single year's data. The burden is severe: each emergency visit means a frightening night, a missed school day and often a parent's missed shift. The hospital can reach these children through its pediatric emergency department and clinic, and evidence-based interventions exist: home-based interventions that address multiple asthma triggers have been found effective in cutting children's symptom days, school absences and urgent visits for asthma (Crocker et al., 2011). And change could be measured within two years, because emergency visit records are already collected.

The corridor also connects the health problem to its upstream causes. Most corridor children live in older rental housing, where moisture, mold and pests are common and code enforcement acts only on complaints. Housing quality is a well-documented contributor to asthma (Krieger & Higgins, 2002), and the corridor offers a defined place where a housing-focused effort could be tested.

Why the Older Adults Were Set Aside

Older adults near the closed supermarket face a real problem: the county's senior services waiting list shows rising demand for home-delivered meals in the surrounding ZIP codes since the closure. But the hospital has little reach over food retail, and the outcomes most likely to change, nutrition and chronic disease control, would take longer than two years to measure with existing data. The hospital's dietitians and social workers can continue to refer these residents to existing programs, and the population should be reconsidered if a partner, such as a food bank or the county aging office, proposes a joint effort in which the hospital's role is clear.

Why Working Adults Without Cars Were Set Aside

Working adults without cars miss appointments and lose work because the east side's bus routes are slow and infrequent; census commuting tables show a high share of east-side workers relying on public transit. But the hospital has no role in transit planning, and the health effects of transportation barriers are hard to measure separately from other causes. The hospital can reduce one part of the barrier, missed appointments, through its existing ride assistance program, but a population health effort centered on this group would depend on decisions the hospital does not make.

How the Community Was Consulted

The choice was not made from data alone. Before the committee met, the hospital's community health staff held two listening sessions on the east side, one at a school family resource center and one at a tenants' association meeting, and asked residents which of the three problems they would want the hospital to work on first. Parents at the school session spoke about children's asthma and about landlords who did not fix leaks; residents at the tenants' meeting raised both asthma and the closed supermarket. The sessions did not decide the question, since they were small and not representative, but they confirmed that the corridor's families saw asthma and housing as connected and as urgent. Collaborative partnerships in community health tend to work best when community members help define the problem rather than being consulted after it has been chosen (Roussos & Fawcett, 2000), and the listening sessions were a first step toward that.

Limits of the Choice

Selecting the corridor's children does not mean the other two populations matter less. It means the hospital can do more for them now, with evidence, and can show within two years whether it has. Braveman and Gottlieb argue that the most powerful levers on health often lie outside health care (Braveman & Gottlieb, 2014); the corridor is the place where a hospital's own services and a housing lever meet. The next steps are to measure the corridor's disparity carefully, assess its needs in layers from the child to the rental rules and build a coalition that includes the people who own and live in its housing.

References

Braveman, P., & Gottlieb, L. (2014). The social determinants of health: It's time to consider the causes of the causes. Public Health Reports, 129(Suppl. 2), 19-31. https://doi.org/10.1177/00333549141291S206

Crocker, D. D., Kinyota, S., Dumitru, G. G., Ligon, C. B., Herman, E. J., Ferdinands, J. M., Hopkins, D. P., Lawrence, B. M., & Sipe, T. A. (2011). Effectiveness of home-based, multi-trigger, multicomponent interventions with an environmental focus for reducing asthma morbidity: A Community Guide systematic review. American Journal of Preventive Medicine, 41(2 Suppl. 1), S5-S32. https://doi.org/10.1016/j.amepre.2011.05.012

Kindig, D., & Stoddart, G. (2003). What is population health? American Journal of Public Health, 93(3), 380-383. https://doi.org/10.2105/AJPH.93.3.380

Krieger, J., & Higgins, D. L. (2002). Housing and health: Time again for public health action. American Journal of Public Health, 92(5), 758-768. https://doi.org/10.2105/AJPH.92.5.758

Roussos, S. T., & Fawcett, S. B. (2000). A review of collaborative partnerships as a strategy for improving community health. Annual Review of Public Health, 21, 369-402. https://doi.org/10.1146/annurev.publhealth.21.1.369