Running head: HEALTH IN PINELLAS COUNTY 1

Health in Pinellas County

Nashley Madera Galletti

University of South Florida

HEALTH IN PINELLAS COUNTY 2

Health in Pinellas County

The purpose of this paper is to describe the strengths and weaknesses of Pinellas County,

by evaluating current and relevant data. Identifying cultural, economic, and social factors that

can contribute to the overall health of the community. Also applying parts of the Public Health

Intervention wheel and other Public Health models to create a health policy to address the

current health of Pinellas County.

Overview of Pinellas County

Pinellas County is a peninsula located on Florida’s west coast, bordered by the Gulf of

Mexico and Tampa Bay. The county is 608 square miles and is 38 miles long and 15 miles wide.

The name Pinellas is from the Spanish words Punta Pinal, which means “point of pines”. Pinellas

was originally a part of Hillsborough County till they split in 1912. Pinellas County is now one

of the most densely populated counties in Florida. Pinellas County is considered an urban county

since 2010 by the Florida Department of Health ("Florida's Rural Counties", 2017). The

population of Pinellas Country as of July 1, 2016 was 960,730 people ("Population per square

mile, 2010", 2017), and will continue to rise consistently. Three major employers in the county

include Raymond James Financial, which employs 3,500 workers, Home Shopping Network

employs 2,800, and Bright House Networks employs 2,000. Two major healthcare networks in

the county are Hospital Corporation of America (HCA), and BayCare. All of this can affect the

community population in many ways.

Comparison of Local vs. State Populations

The population in Pinellas County is very diverse; some of the residents are locals for

generations and other are from around the state, country or world. In Pinellas County, 13.6%

compared to the state average of 15.7% of the population is below the poverty line. ("Persons in
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poverty, percent", 2017). According to the US Census, if the family’s total income is less than

the family’s total threshold, then the family and each individual is considered in poverty.

Pinellas country is above the state with 90.0% of the population age 25 or older with a high

school diploma, the states percentage is 86.9% ("High school graduate or higher, percent of

persons age 25 years+, 2011-2015", 2017). Since Pinellas County has a diverse population with

their residents with different cultural backgrounds, 13.7% of residents’ ages 5 or older speak

English less than well in the county, compared to the state, which is 28.1% ("Language other

than English spoken at home, percent of persons age 5 years+, 2011-2015", 2017). In Pinellas

County the access to a primary care providers is slightly higher than the state average, the

county’s rate is 19.8 per 100,000 versus 14.3 per 100,000 of the state average ("County Health

Profile", 2017).

Analysis and Interpretation of Data

In this section, the data that will be analyzed and interpreted will be from Florida Health charts,

which is a community health assessment resource that connected with the Florida’s Bureau of

Vital statistics.

Identified Strengths

Pinellas County’s health data has included some strengths that are worth mentioning. In

the County’s health status summary profile, includes data that 80.2% of the adults in the county

has some type of health insurance compared to the 77.1% of the state ("County Health Status

Summary Profile", 2017). The selection of this data indicates that the adults with some type of

health insurance will be more likely to get preventative care and go seek medical care when

needed. Also the congestive heart failure hospitalization rate is almost two-thirds less then the

state, 48.1 per 100,000 compared to 75.2 per 100,000 ("County Health Status Summary Profile",
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2017). Finally the last strength that stood out in the data analysis is the rate of HIV. The rate for

the county is less then the state average, 18.4 compared to 23.6 ("County Health Status Summary

Profile", 2017). The data from Pinellas County shows different areas where the strength of public

health shines.

Identified Weaknesses

Where there is strength there is always room for improvement in other areas, including

health in Pinellas County. One weakness in the country is the rate of acute hepatitis B. the rate in

the county is more than twice the average of the state, 5.0 per 100,000 compared to 2.2 per

100,000 as the state average ("County Health Status Summary Profile", 2017). Another

weakness that the county is enduring is the percentage of adults who currently smoke is 19.4% of

the population compared to the state average of 16.8% ("County Health Status Summary

Profile", 2017). Finally the rate of coronary heart disease death rate is 104.7 per 100,000 in the

county compared to the state average of 98.7 per 100,000 ("County Health Status Summary

Profile", 2017).

Identification of a Priority Health Issue

The priority health issue that will be focused on is the weakness of a high mortality rate

from coronary heart disease in Pinellas County. This is a priority health issue since the disease

can be very preventable with a series of steps the community can take to prevent it. According to

Li et al., 2015, coronary heart disease can be reduced with dietary modifications such as cutting

out fats from diets. Also as a part of Healthy People 2020, there is a goal set for the improvement

of cardiovascular health and the quality of life with detection of risk factors, prevention, and

finally treatment of coronary heart disease. The 2020 target rate for coronary heart disease deaths

is 103.4 per 100,000 population ("Heart Disease and Stroke | Healthy People 2020", 2017). This
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topic should be addressed because of the economic impact it can have if the rates lower.

Coronary heart disease leads up to multiple hospitalizations, primary care visits, medications and

overall care for a patient, which can come back to the community.

Discussion and Application of Community Health Models

In public health, it is important to incorporate community health models; they serve a

purpose for organization, health promotion, and also disease prevention. Community health

models also can be very individualized and different models can serve different purposes

depending on the communities needs. A model such as the Determinants of Health Model shows

that different factors combined together can affect the health of an individual in a community.

Those factors include genetics, individual behavior, social interactions or norms, physical

environment, and access to health services ("Determinants of Health | Healthy People 2020",

2017). Using this model develops the objective endpoints that would make the community

healthier and encourage health promotion and disease prevention. Factors that impact the priority

health issue of Pinellas County is individual behaviors and access to health services. One

contributing factor is social norms, which can include having activities that can hinder an

individual’s health, which can include eating at fast food restaurants or not exercising, this can

increase the chance of developing coronary heart disease. Another contributing factor is lack of

clinics in certain communities in Pinellas County, this makes certain community members have a

disadvantage in getting adequate health services since it might not be easily assessable.

According to Saito et al., 2016, it is possible to estimate the rate of coronary heart disease by the

mortality rate.

Population Diagnosis
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African American population in Pinellas county are at an increased rick of dying of

coronary heart disease due to lack of education of the disease and access to healthcare and

preventative measures. Some population characteristics that contribute to the increased risk of

coronary heart disease can include social norms, which include eating at fast food restaurants and

a lack of exercise during the week. Another characteristic can include lack of access to clinics

and preventative measures that can reduce the risk of developing coronary heart disease.

Community/Population-based Interventions

Evidence based interventions can be implemented to improve the current situation of

coronary heart disease death rates in Pinellas County. Three evidence-based interventions

include screenings that are recommended to community members that are at risk for the disease,

health education that includes coronary heart disease risk factors, diet modifications and life style

changes that can reduce the risk, and finally a team- based approach to care including care from

physicians, nurses, and nurse practitioners to improve communication and provide better quality

of care ("Cardiovascular Disease: Interventions Engaging Community Health Workers | Healthy

People 2020", 2017).

Primary Level of Prevention

The primary level of prevention of coronary heart disease in the at risk group in Pinellas

County is to start with education about the topic itself. The level of the recipient who is receiving

this education would be the individual in the community who are deemed at a higher risk for the

development of coronary heart disease ("Public Health Nursing: The Public Health Intervention

Wheel", 2017). The intervention would be a type of health promotion, since health care providers

and community health workers can educate about the risk factors that can lead to coronary heart

disease, including a change in diet ("Cardiovascular Disease: Interventions engaging Community

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workers", 2017). Stakeholders that this intervention is geared to are the community members,

and health care providers. The community members would be receiving the information while

the health care workers will be distributing the information in different forms such as verbally, in

printed form and even electronically online. There are some funding concerns including in this

prevention, the time and cost of creating materials to hand out to the public could cost the county

and spend money where it could be spend somewhere else. The community health nurse can

provide the education to the individuals that they deem at risk for developing the disease. The

community health nurse can also recommend different activities and ways to help lower the risk.

Secondary Level of Prevention

The secondary level of prevention of coronary heart disease is screening for people who

are at risk for the disease, the screenings can include blood pressure and cholesterol screenings to

individuals in the community ("Cardiovascular Disease:Interventions engaging Community

workers", 2017). The level of recipient would include the community members. The

stakeholders whom the intervention is geared to include the community members, public

officials, and health care providers. These stakeholders are important for this prevention method

to implement it county wide, especially public officials who have the power to create programs

that can give people in the community a way to see if they are at risk for this disease. Funding

can be an issue when it comes to screening, trying to make the cost as low as possible for

individuals can be a challenge. The community health nurse will be an essential part of this

prevention level; the nurse can help take blood pressures and blood for the cholesterol screening.

Tertiary Level of Prevention

The tertiary level of prevention for coronary heart disease would be team-based care. The

level of recipient would also include the community members. This would include physicians,
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nurse practitioners and nurses to be able to collaborate and see patients and work out a plan of

care that is individualized for each patient they see ("Cardiovascular Disease:Interventions

engaging Community workers", 2017). This intervention can monitor multiple things such as

compliance with the plan of care including compliance with medication that is prescribed to the

patient. Monitoring for the effects of the treatment, is the treatment effective for the patient? Will

there need to be an adjustment with medication or treatment to make it as effective for the patient

as possible. The team can also prevent any further negative impacts to the health of the patient by

starting treatment or medications right away. Stakeholders whom this intervention is geared to

would be the community members, and healthcare workers. They are considered stakeholders

since the healthcare workers will collaborate together and create a system where they can

effectively treat and manage their patients in a collaborative setting. Funding concerns would be

the concern of how the healthcare worker would be compensated for their work, which could be

hard to determine how to compensate that. The community health nurse can collaborate with

both the physician and the nurse practitioner to develop a care plan for the individual patient.

Development of Health Policy

In healthcare, a strong healthy policy can implement plans and actions for specific health

goals for a society. The level of prevention this health policy will focus on will be the secondary

level, which is prevention of coronary heart disease with screening for people who are at risk for

the development of the disease. Reducing risk factors in the African American population in

Pinellas county will be the focus of this health policy. The proposal will include screenings

performed at local health departments and clinics, host community health fairs in neighborhoods

that have a high risk of development of the disease, and educate the community of the disease
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when returning to their primary for annual visits. The desired goal for this health policy would be

for the rate of mortality from coronary heart disease in Pinellas county to reach the healthy

people 2020 goal of 103.4 deaths per 100,000, or even below that targeted number

("Cardiovascular Disease: Interventions Engaging Community Health Workers | Healthy People

2020", 2017). The stakeholders affected by the proposed health policy will include the

community members, which will be impacted by the policy the most, healthcare providers, who

will be able to conduct the screenings and later on educate the patient and start treatment for the

patient. And the final stakeholder would be finding funding for compensation of the healthcare

providers and funding for the screenings and events for the community. Supporters for the health

policy include the community members, who would benefit on the screenings for coronary heart

disease and the health care providers would benefit with more information for their patients and

to be able to create a more personalized care plan ("Cardiovascular Disease:Interventions

engaging Community workers", 2017). The influence for these supporters is crucial for the

health policy to be implemented, coronary heart disease is easily preventable with simple things

such as screenings of cholesterol and high blood pressure, and lifestyle changes such as a healthy

diet and exercise. These stakeholders can help implement the policy and help get Pinellas county

to the healthy people 2020 goal or even below it. Opposing stakeholders would be the public

officials and legislators for the reason of funding. Both stakeholders will see this health policy as

not necessary for the community so funding and approval can be an issue with both parties. The

first general step to put this policy into action is to speak to community health are providers and

speak to them about what will work while they go out and treat patients. Next, create a solid

health policy that can work with a budget that is appropriate. Later we can approach public

officials that can help move this policy forward within the community. This heath policy will not
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only reduce the rate of mortality with coronary heart disease but also increase the percentage of

people exercising and eating a healthier diet, which can improve other comorbidities such as

high blood pressure, blood sugar control in type 2 diabetes and more (Li et al., 2015), which

will improve Pinellas counties health. The potential impact of this health policy can be very

positive, especially towards the underserved communities. With events held in these underserved

communities, people will be able to get screened and know and importantly understand their risk

of coronary heart disease. After this health policy is implemented there is an increase chance of

increased health in the community, which include all members of the community.

Conclusion

For Pinellas county public health is important for the overall well being of the

community. An important aspect for Pinellas County to improve on is the death rates for

coronary heart disease. The health policy will help improve the rate in the county with screenings

for the community; this will improve lives and help people live longer in the county. There are

three levels of prevention that are essential to help reduce the death rates of coronary heart

disease, which include education about the disease, screenings, and finally a team-based

approach to care if diagnosed with the disease. Once these preventions can be implemented then

there will be a visible change in Pinellas County’s death rates of coronary heart disease.

This paper is relevant to me because I grew up in Pinellas County, and understood the

important of the healthcare providers and public health workers. I use to see people in my

community not be able to go tot the doctors for their illness simply because they couldn’t afford

it. Diseases such as diabetes and coronary heart disease can be easily preventable, so this health

policy can really help people improve their lives and stop the development of some illnesses.

This paper reminds me that as a nurse, even if I want to work in a hospital setting, I will always
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get people from the community and from all different backgrounds and situations. And that if

there isn’t anything preventative happening out in the community, the patients will always come

back to the hospital with the same problem.

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