Running head: IMPROVING HEALTH DISPARITIES IN COLLIER COUNTY- SMOKING

CESSATION

Improving Health Disparities In Collier County

Smoking Cessation
Marieta Perino SBN - Student
University of South Florida

Improving Health Disparities In Collier County

Smoking Cessation
In 2013 Collier County was ranked second healthiest county in the US. This was
determined by study conducted by University of Wisconsin. The health of the community is
based not only on what happens in the doctors office, but also what is the overall activity level
of the population, what are their eating habits, education level; are most people insured;
smoking, consuming alcohol, using drugs, crime levels and more. The two most prevalent and
preventable health problems leading to death are tobacco use and overweight and obesity levels.
Another problem in this county is overconsumption of alcohol heavy binge drinking. Research
shows that individuals with income of $50,000 or more are more likely to engage in this kind of
activity (Community Health Planning and Statistics, 2013). Over 13% of the population in

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Collier County is 65 years old and older and they are more likely to consume alcohol and to get
involved in motor vehicle accidents.
Collier County was founded in May 1923. It is located in Southwest Florida at the
southern end of Floridas Gulf Coast, south of Hendry County. The total County area is 2,305 sq
miles that makes it the largest county in Florida by land area. There are two primary designations
in the area Urban and Rural/Agricultural. The communities with urban planning are: Naples,
Marco Island, Golden Gate, Urban Estates and Immokalee. The rural once include: Royal
Fakapalm, Big Cypress, Rural Estates, and Corkscrew.
The population is 251, 377 people, with 76% white people, 4% African American, 19%
Hispanic, 1% other. The diversity and growth of the population is increasing continuously. The
top three employers in the county are Collier County Public Schools, NCH Naples Hospitals,
and Publix Super Markets. That comes to show that the education, health care and healthy eating
are priority in this are and thats what makes the county very successful in maintaining healthy
population. The major health care systems include NCH, Physicians Regional, and Health Care
Network of Southwest Florida (The Health Planning Council of Southwest Florida, Inc., 2013).
The ratio of household income in Florida at the 80 th percentile to the 20th is 3.8 6.3 (overall
4.6), where Collier County stands with 4.4. Unfortunately the number of people living in poverty
has increased by 56% for the last 20 years. Overall it remains one of the wealthiest counties in
the country with per capital income of $37,335 for 2013, which is 1.4 times that of the state. The
majority of the population is educated, showing that 78% has at least high school education
where the overall percentage for Florida is 75%. About 30% or more have Bachelors degree.
Those at age 5 and older speak English with the small exception of less than 7%. Overall in
Florida residents age 5 and older 26.64% spoke a mother language other than English.
Being ranked as second healthiest county in the US, Collier County shows a lot of strengths
in the health care system. Just to mention a few: the infant mortality declined by 31% for the last

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20 years 5 deaths to 1000 life births. Mothers are receiving good education and prenatal care.
They continue to improve their health only 3.8% reported smoking during pregnancy. For the
last 10 years the number of women between the ages of 15 35 with STD has declined by 4%,
where it increased by 24% for the state of Florida. The statistics show a decline of 75% of
teenage pregnancies. Which comes to show that better education is provided to the population in
relation to birth control and prevention of SDTs (Community Health Planning and Statistics,
2013).
With all the positive outcomes that the health care in Collier County has accomplished,
some areas still need improvement. Accidental injuries remain one of the leading causes of death
in the area as well as the whole state of Florida. For the older population 75 85 years old, the
main reason is falls, and motor vehicle accidents throughout all ages. The County needs to find
ways to educate the elderly population on falls prevention and adjustments that need to be done
for their living habitat to improve their safety. Every other adult in Collier County suffers from
chronic disease. They account for 7 out of 10 deaths of residents every year. Most of those
diseases are caused by modifiable factors tobacco use, excess alcohol consumption, lack of
physical activity and poor diet control. For example lung cancer is the leading cause of death in
the area absolutely preventable in a lot of the cases (18% of all deaths) (Community Health
Planning and Statistics, 2013). Better community teaching is necessary in order to help the
population avoid engaging in habits (like tobacco smoking) that can impact live negatively and
lead to diseases and death.
The rate of infectious diseases in the County has increased in the last 10 years by 20%. The
diseases are enteric and gastrointestinal salmonella, campylobacter and more. Good hand
hygiene and well-cooked food would help with prevention.
The priority health issues in Collier County are modifiable risk factors - overconsumption of
alcohol, excess use of tobacco products, and physical inactivity that lead to diseases, motor

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vehicle accidents, obesity and deaths. Increasing smoking cessation in adult smokers is one of
the main goals to be accomplished in order to significantly decrease the mortality in the area, as
mentioned earlier 18% account for lung cancer victims. The mortality rates are key indicators
for the overall health in the community. Regular health visits in conjunction with better everyday
food choices, avoiding alcohol and tobacco products, and increasing physical activity can
prevent a lot of premature deaths caused by lunch cancer, diabetes, heart disease and motor
vehicle accidents. Cancer accounts for 779 deaths in 2012 in Collier County 26.7% of all deaths.
Its immediately followed by hearth disease with 673 deaths (Menvielle, Boshuizen, Kunst,
Dalton, Vineis, Bergmann, Kaaks, 2013).
The determinants of health model include the range of social, economic, environmental, and
personal factors that influence someones health status. The emphasis is on ecological approach
in order to promote heath and prevent diseases. In order for the interventions used to be
successful they need to target multiple determinants education, transport, access to health care,
resources available. Policies can be implemented in order to improve the populations health
for example increase of sales tax on tobacco products. This can lead to reduction of tobacco
products use. It can improve overall heath and help people modify their behavior.
The factors that greatly contribute to the tobacco use and binge drinking in Collier County
are lifestyle choices. They go hand in hand with poor diet and low physical activity levels. It may
sound very simple to educate people and help them make changes in their every day life but
there is a need for good plan in order to achieve success. Find out what they know about their
problem and are they willing to make the change in order to improve their health outcomes. As a
community nurse we can use different approaches to implement our goals (Menvielle et al.,
2013).

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One of the primary nursing diagnosis for the population of Collier County is: Population at
risk for developing lung cancer, related to tobacco use, evidenced by 18% lung cancer mortality
in the area.
Primary health care prevention is associated with preventing a disease from occurring. We
apply interventions before there is an evidence for the disease or injury. Lung cancer is occurring
in people who smoke cigarettes or have recently quit. By quitting people reduce their chance in
having lung disease in half. There is many ways we can approach this situation. Implement
teaching in high schools and colleges on how bad tobacco use is for your health and explain the
consequences of cigarette smoking. Primary prevention can be implemented in the doctors
offices buy simply asking people if they use tobacco and if they need help to find recourses on
how to quit. Commercials on TV or billboards on the road are great way to reach out to the
community and give them that important piece of information on preventive care. The
community health nurse has a viable role in health education, community organizing and
collaborating with agencies and members in order to achieve these goals (Community Health
Planning and Statistics, 2013).
Secondary prevention is aimed to decrease the impact of the disease that has already
occurred. If we know that a lot of people in Collier County are smokers we need to and make
them aware of programs that help with smoking cessation and encourage people to take
advantage of them. For example Tobacco Free Florida offers free of charge and easy to achieve
ways to quit smoking. They know its hard but not impossible. They offer resources and support
to give people the chance to quit for good. For each person overcoming nicotine addiction is
different so they promote different tools that can help. Today we are showing progress. In 2007,
43% of current adult smokers have tried to quit smoking at least one in the past year. The statistic
shows that this percentage has increased to 50% and 60% respectively for 2010 and 2013. As

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community nurses we would set up educational meetings twice a year to evaluate peoples
knowledge, assess their readiness to quit, and provide valuable information on how to quit
smoking. When the next meeting comes we will be able to assess and see how everyone has
progressed, how many people have successfully quit, and how many are still trying and what we
can do to help them. Another way to provide support and encouragement is when people go for
their annual physical. The nurse can screen the patients and find out who is smoking and who
needs help to quit for good

(Nelson, Pederson, Mowery, Bailey, Sevilimedu, London &

Pechacek, 2015).
With tertiary prevention the disease is ongoing and the goal is to help people manage longterm health diseases and injury. If you have already been a smoker for many years, you have
caused damage to your lungs and other body systems. We are going to implement actions that
will help people improve their quality of life and their ability to function. When someone is
diagnosed with respiratory distress, or even worse - lung cancer, we are going to monitor the
patience compliance to the prescribed regimen. Prevent further damage from happening. Making
sure that they are no longer using any tobacco products, looking to see progress in long-term
health evaluation. We as nurses are with the patients every day and when we are doing our
assessment we should ask how they are doing and if they are remaining tobacco free. Assess how
they are tolerating their treatment plan (Smith, Niederdeppe, Blake & Cappella, 2013).
The health policy targets people that are at risk for developing lung cancer as secondary to
tobacco use. The goal is to collaborate with those individuals on one to one bases. With every
office visit the nurse will assess their knowledge on the matter, provide patient education and
assess readiness to quit today. Give them guidance and helpful tools to make their smoking
cessation successful. Reevaluate the patient with each visit; apply therapeutic communication,
active listening and teaching. It can be really hard for people to quit if their family members and

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friends smoke, advice them to avoid places and situations that can lead to tobacco use. Second
hand smoking and is also very harmful because the same chemicals are inhaled, provide your
patient with information. Explain that if they continue to use tobacco, their chances of
developing lung cancer and dying are very high. If more people quit smoking today that will
improve the overall health of the community and the population, we will see less cancer, less
cardiovascular diseases, anxiety and depression.
As a future nurse I would like to be more involved in the community health and to provide
valuable information and educate people in order to help them improve their quality of life and
prevent diseases from occurring. Teaching on smoking cessation among adults and the risks of
smoking among adolescence is a fantastic opportunity to deliver desirable outcomes in overall
peoples health. It is not always easy to make the right choices and to get rid of bad habits, but
we are only humans and we deserve a chance for a better tomorrow. Providing support and care
for the community will make the difference.

References:

Community Health Planning and Statistics. (2013). Retrieved March 09, 2016, from
http://collier.floridahealth.gov/programs-and-services/community-health-

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planningand-statistics/public-health-information/index.html
Menvielle, G., Boshuizen, H., Kunst, A. E., Dalton, S. O., Vineis, P., Bergmann, M. M., ... &
Kaaks, R. (2013). The role of smoking and diet in explaining educational inequalities in
lung cancer incidence. Journal of the National Cancer Institute, 101(5), 321-330.
Nelson, D. E., Pederson, L. L., Mowery, P., Bailey, S., Sevilimedu, V., London, J., ... &
Pechacek, T. (2015). Trends in US newspaper and television coverage of tobacco. Tobacco
control, 24(1), 94-99
Smith, K. C., Niederdeppe, J., Blake, K. D., & Cappella, J. N. (2013). Advancing cancer control
research in an emerging news media environment. J Natl Cancer Inst Monogr, 2013(47),
175-181.
The Health Planning Council of Southwest Florida, Inc. (2013, January 15). Collier County
Florida Health Assessment. Retrieved March 9, 2016, from http://www.hpcswf.com/wpcontent/uploads/2011/12/Collier-County-Health-Assessment-2013.pdf