HSCI710 Essay Vulnerable Populations

Name

Liberty University

HSCI710

David Irving

13/11/2022 

Introduction

Numerous studies over the last few decades have shown that racial and ethnic minorities, as well as low-income adult groups, in the United States have a disproportionately high prevalence of diabetes, complications from diabetes, and mortality outcomes from diabetes (Johnson et al., 2022). The present COVID-19 pandemic has brought to light the unequal risks that vulnerable groups and people face. To ensure that everyone reaps the benefits of the recent shift in healthcare toward emphasizing the health of populations and placing a higher value on the quality of care provided rather than the number of services offered, social determinants of health (SDOH) have emerged as a priority area for intervention.

Due to the high incidence, high expense, and disproportionate population burden of diabetes, it is vital to understand and reduce the effects of SDOH. The American Diabetes Association (ADA) released a scientific statement to improve our knowledge of the connection between social and environmental risk factors for developing prediabetes and type 2 diabetes. Before the pandemic hit, the American Diabetes Association (ADA) formed the present SDOH and diabetes writing committee to compile research on the links between

SDOH and diabetes risk and outcomes, as well as the results of therapies aimed at reducing SDOH. This was done with an eye on better comprehending and advancing SDOH-related prospects for improved health among the diabetic community (Eton et.al., 2022).

Economic status; neighborhood and physical environment (housing, built environment, toxic environmental exposures); food environment (food insecurity, food access); health care and social context are the primary focus of research involving adult Americans and the five determinants of health (SDOHs) (social cohesion, social capital, social support). We briefly discuss the concepts and theoretical foundations of SDOH. There are proposals for more studies on diabetes and recommendations for further research to enhance practice in this paper, which was compiled with the help of national advisory organizations (Kern et.al., 2022).

Fully describe the population at risk. Include a thorough analysis of the social

determinants of health

Diabetes patients' health variations have been connected to social, economic, and environmental deprivation. Knowing the social and environmental elements that together account for between 50 and 60 percent of health outcomes is crucial for tackling the problem of health equality (Kern et.al., 2022). Equality in health is achieved when there are no variations in health that can be traced to avoidable, unjust, or easily rectified factors or variables. The phrase “health equality” has been used in medicine to describe eliminating disparities in care based on factors such as a person’s socioeconomic status. When we speak about “health equality,” we are referring to the concept that everyone should have the same access to the highest quality healthcare available (Kern et.al., 2022).

Health outcomes are affected by a person’s “social determinants,” which include their environment throughout infancy, youth, adulthood, and old age. These structures are formed partly by how money, power, and resources are distributed at the global, national, and local levels (Kern et.al., 2022). A global agreement on what constitutes SDOH is necessary, although some conceptual frameworks give more weight to economic and social factors. The World Health Organization’s (WHO) Healthy People 2020 and County Health Rankings models for SDOH prioritize access to care (WHO) (Johnson et.al., 2022). This is true regardless of whether or not the needs of the service’s quality are considered. The shelter may be divided into the community, the built environment, and the natural environment. Every day, we face potential environmental dangers from various sources, including toxins, air pollution, and water quality. Possible environmental risks also include some others.

Describe the healthcare challenges in terms of access, quality, and cost

The phrase “digital health” describes the collaboration between the medical and technological communities. Mainly related to diabetes, it denotes the use of data gathered by networked devices and processed by applications and software. The Diabetes IoT, to put it another way. An estimated 29.1 million persons in the United States had diabetes in 2012.

Forecasts put the number at 33.1 million by 2050 (Johnson et.al., 2022).

Cloud-connected diabetic devices are not yet widely used; even when they are, patients and doctors may feel overwhelmed by the volume of data they generate. Approximately 140,000 people in the United States are hospitalized every year due to diabetic ketoacidosis, a life-threatening complication of diabetes (Johnson et.al., 2022). Healthcare professionals already have a lot on their plates without having to guess at their patients' blood glucose levels, which is a problem made worse by the chronic nature of diabetes. Recent research indicated that people with diabetes devote an average of 58 minutes daily to self-care.

The $322 billion cost to the U.S. economy from diabetes in 2012 was a 48 percent increase from 2007. This sum includes the $244 billion spent on healthcare and the $78 billion in lost output. Prediabetes costs 74% more than it did five years ago. In comparison, the cost of untreated diabetes is 82% higher—people with diabetes pay around 2.3% more for healthcare than individuals who do not have diabetes (Johnson et.al., 2022).

Identify and evaluate two current solutions.

The Current Situation with Regards to Cloud-Based Glucose Monitors Readings from continuous glucose monitors (CGMs) and glucose meters that are linked to the cloud may be sent directly to a user’s smartphone or computer (“the iCloud”) (Johnson et.al., 2022). Through mobile and web-based applications made possible by the types mentioned above, data may be moved to and viewed on other devices such as smartphones, smartwatches, and tablets.

Although just a few linked glucose monitoring devices have been introduced to the market throughout the last few years, this situation is anticipated to change swiftly. Even though only a tiny number of patients use them at the moment, it is anticipated that this will alter as their price continues to reduce and their usefulness continues to grow. By sending the data over a wireless or cellular network, they make it feasible to send and receive data without needing cables or software to facilitate the process. With the assistance of these technologies, visits to the doctor may be more productive and effective (Beran et al., 2021)

Diabetes is an information-driven disease, and practitioners may find that the data generated by cloud-connected medical devices is beneficial. The essential purposes served by such devices are the uploading of data, the performing of automated statistical analysis, and the creation of graphical representations. Automated algorithms will, over the next few years, assist providers in discovering patterns that, with their assistance, might be noticed and easier to locate. Because of the seamless transmission to applications and internet software, there is significantly less of a chance that glucose data will be ignored in the meter or lost at home.

As data collection and intervention have traditionally been two sides of the same coin in treating diabetes, these devices offer the potential to assist complete the loop. With the assistance of these decision-support algorithms, interpreting glucose readings and adjusting insulin dosages may become more manageable (Beran et al., 2021). It also gives suggestion to the treatment and assist make the sessions more productive. However, there are only a few studies that are of a sufficiently high quality to demonstrate a connection between better patient outcomes and medical devices linked to the cloud. In principle, patients would benefit from modifications in their treatment that were more precisely focused if the information provided by such devices was better. This may provide better outcomes.

No clinical studies to verify actual savings have yet been carried out, the possibility of preventive treatment of diabetes is already garnering attention. Connected cloud-based systems can provide remote population management, potentially eliminating the need for expensive in-patient stays and outpatient clinic visits. Systems such as this one may be used by clinicians, for example, in order to maintain remote tabs on their patients (Spicer et al., 2022). Medical machines are designed to notify medical professionals if a patient’s blood sugar levels begin to display concerning patterns, whether they be high or low. Patients can remotely submit their blood glucose levels to the platform hosted in the cloud by using the firm’s smartphone app. After that, the Population Tracker will compile all of the information into a single, consistent user interface. This method were utilized to assist payers and health systems in identifying individuals at risk before a severe event, significant cost savings in the healthcare industry would likely be realized. The provision of glucose data by patients and the monitoring of the dashboard by care managers are both necessary components of the success of such remote population management. Glucose monitors linked to the cloud make both of these tasks far more straightforward (Beran et al., 2021).

Propose two solutions that may mitigate the chronic disease among the

vulnerable population

Asummary of Telehealth services enable patients and medical professionals to communicate and share health information through audio or video links established via the internet (e.g., via video calls or text messaging).Patients are often cared for in the comfort of their own homes or at local medical facilities. Patients sometimes have to travel significant distances to see a healthcare provider, yet HCPs are often located in remote, and frequently metropolitan areas. After these quick visits, which usually last less than 15 minutes, medicines may be administered over the internet by medical team members. With a few notable exceptions, such as psychotherapy consultations, telehealth services' primary focus is on acute care. Telehealth is a sector of the healthcare industry that is expanding rapidly. It is anticipated that by the year 2018, the size of the telehealth market will have increased by a factor of ten, and that this sector’s revenue will have increased to as much as $4.5 billion, up from just $440 million in 2013. There has yet to be a conclusive response available to whether companies would expand their product lines to treat chronic illnesses remotely (Green et al., 2022).

Telehealth has significant potential for enhancing patient care in various ways, especially for patients with chronic conditions like diabetes (Green et al., 2022). At any moment, over 58% of Americans have access to a mobile phone, and 87% have established internet connections. These services can lower healthcare costs across the board, including those associated with readmissions, medical supplies, and patient meals. Because patients do not have to miss work or travel far to get to a medical facility, telehealth services can save money and time on travel and lost productivity (Green et al., 2022).

Researchers compared the outcomes of patients with chronic illnesses who were allocated to the Health Buddy Program through telemedicine to those who received standard care in a matched control group trial. A different research found that if all nursing homes used telehealth technology, the United States could save $479 million per year on transportation expenditures. Telehealth can potentially address 33 percent of all ambulatory care visits in the United States (Green et al., 2022). Though still in its infancy, research suggests that telehealth therapy may have a poor cost-benefit effectiveness. Despite these findings, it is hard to deny that telehealth has the potential to save costs if used to its fullest. Patients of endocrinologists often wait an average of 37 days for their first non-urgent appointment, but patients of cardiologists might get a consultation in as little as 15 days (Green et al., 2022).

Patients now have more access to specialists who may not be in their primary care network because of the expansion of accessible healthcare providers made possible by telehealth, regardless of their location. Numerous studies have indicated that patients are satisfied with their telehealth services. In a recent online Harris study, people were asked whether they would be comfortable having video meetings with their providers. Sixty-four percent of those surveyed indicated they would be. Despite concerns that consumers will not be pleased with telehealth consultations, several studies have shown that individuals are satisfied with the care they get from doctors using this method. People living in rural locations may face obstacles when trying to get specialist medical treatment, such as that of an endocrinologist. Telemedicine allows patients to get in touch with the professionals they need for treatment as soon as possible. People from underprivileged neighborhoods with complicated requirements may benefit significantly from these services since they provide them with additional options when choosing a healthcare practitioner (Papanas et al., 2022).

The use of telehealth can lessen the paperwork medical professionals have to do (Papanas et al., 2022). Thanks to telehealth services, doctors no longer have to deal with the paperwork and insurance claims that are part and parcel of providing medical care to patients. Telemedicine allows physicians to visit patients while their offices are closed. Because of this, they can increase their time spent with patients whenever it is most practical for them to do so.

Biblical perspective on leadership response

A significant number of African Americans think that churches should also take responsibility for meeting the medical needs of their congregations. African Americans who have type 2 diabetes or are at risk for developing the condition are under the mistaken impression that the preventative measures they take in this area positively impact their overall health. Diabetes management is complex for many individuals since they do not trust the people who are supposed to help them and do not take their medication. Traditional outreach initiatives, which include screening, education, and clinical treatment, have contributed to improving the health of underserved areas by medical professionals (Leonard et al., 2022).

Community-based initiatives could be an excellent choice if you want to reach out to African Americans with diabetes prevention programs and you want to do so.

The literature suggests that care professionals' cultural knowledge is often deficient, suggesting a need for more attention on this topic in educational programs. There has been much use of multi-participant pedagogies, and the results have been positive most of the time. Studies in recent years suggest that seeking religious leaders' help may boost engagement and recruitment. This qualitative research contributes to a larger project exploring community members' perspectives on and reactions to diabetes self-management and prevention education. The inquiry-group technique was used for this longitudinal study’s descriptive purposes (Papanas et al., 2022) .

Christians spoke on how their faith in God and commitment to Jesus had changed their lives. One of the women said she could pull herself out of her depression thanks to her renewed faith. He rescued me from four wheels to three-inch heels," she exclaimed after five years of wheelchair usage. A pastor said he put his faith in God after doctors told him his “low blood count.” Members of the congregation then gave praise to God for the miraculous recoveries. Unfair research practices were purportedly catalysts for the Black community’s mistrust of the medical sector.

The survey respondents felt they required more information before making informed decisions about medical procedures. The biological approach limited healthcare providers' and patients' ability to have open conversations about patients' religious choices. Some accounts claim that believers disregard their medical needs and live in unhealthy conditions. When asked how they handled having to make life-or-death medical choices, participants in the book “Vigilance” mentioned praying to God. One male respondent claimed he prayed about his brother’s choice to get a colostomy.

Another pneumonia patient who had been hospitalized was unwilling to undergo diagnostic testing, dietary counseling, or blood transfusions. At least one participant said they took care of their own diabetic treatment without consulting a doctor. According to the survey’s respondents, a healthier lifestyle, including better eating habits and more frequent exercise, may significantly impact a diabetes patient’s health (Newman et al., 2022). Experts generally believe that self-control underpins all other aspects of a healthy lifestyle, including regular exercise and a balanced diet. One commenter suggested getting “spiritual advice” before “going off pharmaceuticals” since “the devil” may be “trying his best to persuade you what to do.

Participants expressed interest in improving their diet and physical activity levels, but also mentioned facing challenges in doing so. Many people believe that if they just took the time to read food labels, they would make healthier decisions. Numerous well-intentioned churchgoers had their efforts thwarted due to the sheer volume of additional tasks placed on their shoulders. People with diabetes may find spiritual solace in churches if churches participate in campaigns against diabetes. 53% of African Americans regularly attend religious services, and another 76% say they pray at least once daily (Papanas et al., 2022).

Faith-healing communities and people of African descent share many commonalities, including a disproportionately high prevalence of the latter belief. African Americans are much less likely than Whites to trust medical professionals. The findings indicate an increase in “hyper-vigilance” due to distrust, decreasing care-seeking, doctor-patient communication, and treatment plan adherence. Some African Americans may find relief from their mistrust of humanity in a Christian’s faith in God’s ultimate sovereignty. They made all of their healthrelated decisions with God’s Word and prayer as their guides.

African Americans who place a high value on their religious beliefs may pray or meditate for direction before making decisions about their health or the medications they use.

The study found that African Americans may need more time to achieve their health goals due to nutritional knowledge gaps, challenges, and ambiguity in implementing dietary recommendations. Health programs at religious institutions may be helpful for people with diabetes because they provide a social network and a sense of duty. The longitudinal study aimed to reduce error by encouraging triangulation of sources through continuous evaluation of results by the church community throughout the inquiry group process. The results helped guide the design and delivery of self-management and education programs for people with diabetes in faith communities (Papanas et al., 2022) .

Discussions about diabetes management typically exclude the patient’s religious beliefs and the treatment options that arise from them. African American diabetics' faith can be restored with treatment that respects their religious values, unique healthcare requirements, and preferred approaches. Helping patients identify where they are deficient in knowledge or ability, SDM would increase the likelihood that they will engage in preventive and self-management practices. The value-based payment system made possible by the Affordable Care Act (ACA) would help speed up the adoption of evidence-based recommendations into clinical practice, which could otherwise take more than a decade.

Conclusion

Continuous glucose monitoring (CGM) devices and glucose meters linked to the cloud can transfer readings to mobile applications or internet platforms automatically. Mobile devices such as smartphones, smartwatches, and tablets can receive data from these devices. They enable data transmission across cellular networks or wireless networks, hence reducing the need for cables and software to download data. Remote population control employing cloud-connected technology might help reduce the need for expensive hospitalizations and pointless clinic visits. With the help of such a gadget, medical professionals may do remote patient monitoring (Beran et al., 2021). The use of telehealth may be beneficial in many

ways, especially for patients with chronic conditions such as diabetes. Patients do not need to take time out of work or travel a significant distance to see a physician. Clinicians can now treat patients outside of regular business hours thanks to telehealth services, which also help minimize the amount of administrative work. Telehealth services take care of the paperwork and money associated with medical visits, allowing doctors to concentrate on their patients instead. African Americans who have diabetes need special treatment that takes into consideration their various religious beliefs and pharmaceutical options in order to reestablish trust. 

References

Beran, D., Perone, S. A., Perolini, M. C., Chappuis, F., Chopard, P., Haller, D. M., … & Gastaldi, G. (2021). Beyond the virus: Ensuring continuity of care for people with diabetes during COVID-19. Primary Care Diabetes, 15(1), 16-17.

Chen, M., Surbhi, S., & Bailey, J. E. (2022). Association of Weight Loss With Type 2 Diabetes Remission Among Adults in Medically Underserved Areas: A Retrospective

Cohort Study. American Journal of Health Promotion, 36(1), 29–37.

Eton, E. A., & Newman-Casey, P. A. (2022). JAMA ophthalmology. A Call for Health

Equity in Diabetic Care to Improve Eye Health.

Petrakis, V., Panagopoulos, P., Papazoglou, D., & Papanas, N. (2022). Diabetes mellitus and hypertension as significant risk factors for mortality from Covid-19 pneumonia.

Experimental and Clinical Endocrinology & Diabetes, 130(03), 205-206.

Pinheiro, L. C., Soroka, O., Kern, L. M., Higgason, N., Leonard, J. P., & Safford, M. M. (2022). Racial disparities in diabetes care among incident breast, prostate, and colorectal cancer survivors: a seer Medicare study. Journal of Cancer

Survivorship, 16(1), 52–60.

Pop-Busui, R., Januzzi, J. L., Bruemmer, D., Butalia, S., Green, J. B., Horton, W. B., … & Richardson, C. R. (2022). Heart failure: An underappreciated complication of diabetes. A consensus report of the American Diabetes Association. Diabetes

Care, 45(7), 1670–1690.

Spicer, J. G., Zhao, P., Resnick, N., Larkin, N., & Barber, M. M. (2022). Engaging Asian Patients with Diabetes in an Intensive 12-Week Pulsed Intervention: Mixed Method Research Study. Nursing Economics, 40(2), 87–97.

Vaughan, E. M., Johnson, E., Naik, A. D., Amspoker, A. B., Balasubramanyam, A., Virani,

S. S., … & Foreyt, J. P. (2022). Long-Term Effectiveness of the TIME Intervention to Improve Diabetes Outcomes in Low-Income Settings: a 2-Year Follow-Up. Journal of General Internal Medicine, 1–8.