Running head: HEALTH POLICY 1

Health Policy Paper

Vanessa Rushing

University of South Florida

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Health Policy Paper

Pinellas County is one of the most popular destinations in the state of Florida for tourists

and state natives alike. Beaches, theme parks, and extravagant adventures await those who

choose to swing by. Although this county may have it all when it comes to health and the status

of its citizens there are still problems that lay beneath the surface. This paper tackles the health

issues that Pinellas County faces daily and includes ideas on how to make them better.

Overview of Pinellas County

Pinellas County, Florida, located on the states West Coast, is a 280-square mile peninsula that

is bordered by the Gulf of Mexico and Tampa Bay. Pinellas County has 24 incorporated

municipalities all governed by elected officials that provide services to the people. Cities that are

included in Pinellas County are Saint Petersburg, Saint Pete Beach, Treasure Island, Tarpon

Springs, Clearwater, Pinellas Park and many more. Pinellas County is the most densely

populated county in Florida with 3,347 people per square mile with the next closest county being

Broward County with 1,445 people per square mile.

Pinellas County is classified as an urban county versus being a rural county. As of the 2010

census, Pinellas County’s population is 916,542 people with the majority of this population

being in the 45-64 year old age range. The population of Pinellas County is 82.14% white,

10.34% black or African American, and 2.96% Asian. Pinellas county has many major

employers but the top three include Raymond James Financial, The Home Shopping Network,

and Bright House Networks. The major health care systems in Pinellas County include BayCare

which is a locally-based system with 8 hospitals and also HCA healthcare incorporated which

owns 12 local hospitals. Pinellas County’s statistics and population rates vary from the state and

national statistics and rates.

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Comparison of Local vs. State Populations

According to the United States Census Bureau, the United States population of families living

below the poverty line is 15.7% versus 14.0% in Pinellas County, Florida. Percentages of

families living below the poverty levels has declined in recent years across the United States and

impacting Florida in a beneficial way. Florida’s population of people over the age of 25 with a

high school diploma is only 20.6% while Pinellas County, Florida’s population of people with a

high school diploma is 90%. According to the Associated Press, Florida is tied with four other

states for the lowest graduation rate in the United States. In the state of Florida about 28.1% of

the population above the age of five do not speak English while in Pinellas County 13.7% of this

specific population do not speak English (United States Census Bureau). The second most

spoken language in Florida and Pinellas County is Spanish. Access to health care and primary

care physicians by way of health insurance is vastly different in the state and Pinellas County.

14.3% of the population of the state of Florida is uninsured while Pinellas County’s population

percentage is 16.2% of uninsured people.

Analysis and Interpretation of Data

Identified Strengths

In Pinellas County, Florida one of the strengths of this county versus the state is the 3-year

death rate (2013-2016) from stroke. In Pinellas County, the rate of stroke induced deaths is 26.6

per 100,000 people while in the state of Florida the rate is 34.5 per 100,000 people according to

the County Health Profile on Florida Health Charts. These charts show that survival rates of

people who do suffer from strokes are much better in Pinellas County versus the entire state of

Florida. This can suggest that Pinellas County has excellent emergency care systems in place to

prevent deaths from strokes.

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Another strength of Pinellas County, Florida is the 3-year incidence rate of cervical

cancer in all women. Per 100,000 women the rate of cervical cancer in the state of Florida is 8.6

versus in Pinellas County the rate is 8.1 according to the County Health Profile. These low rates

in Pinellas County can be linked to The Breast and Cervical Cancer Early Detection Program

(BCCEDP) at the Florida Department of Health in Pinellas County which provides no cost

cervical cancer screenings allowing for early detection according to Florida Health Department.

According to the Florida Health Charts the number of AIDS cases in Pinellas County,

Florida is lower than the amount of state cases. In Pinellas County, there are 12.0 cases per

100,000 people versus 12.7 cases in the state of Florida. Pinellas County offers a full-service

HIV/AIDS clinic which also offers HIV counseling, case management, and testing which could

account for the lower rates in Pinellas County.

Identified Weaknesses

In Pinellas County, total tobacco-related cancer deaths to people aged 35 and over is higher

than the state of Florida as a whole. The rate for total tobacco-related cancer deaths in Pinellas

County is 198.5 per 100,000 versus 172.0 for the state of Florida as a whole. The higher rates of

tobacco-related deaths could be linked to the higher population of older people in Pinellas

County aged 45-64 years of age according to Pinellas County Statistics.

Unintentional injuries in Pinellas County are higher than the state of Florida according to

the County Health Profile. In the state of Florida, the rate per 100,000 people is 42.1 while in

Pinellas County it is 50.0 thus making unintentional injuries a more common event in Pinellas

County.

Another area of weakness for Pinellas County is the death rate of coronary artery disease

versus the state of Florida. In Pinellas County, the death rate for coronary artery disease is 104.7
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per 100,000 people while the state of Florida’s rate is 98.7 shown by the County Health Profile.

This shows that Pinellas County is lacking in treatment and prevention of coronary artery disease

while the state of Florida is improving.

Identification of a Priority Health Issue

In Pinellas County, Florida there is a vast difference between the rates of tobacco-related

cancer deaths in this specific county and the state of Florida. This is a priority health issue due to

the dangerous and lasting effects of tobacco and the complications that can arise from second-

hand smoke. In Pinellas County, some of the top causes of death include cancer (22.8%), heart

disease (22.7%), chronic lower respiratory disease (5.7%) and stroke (3.7%) which are all made

worse and more complicated by tobacco and smoking (Florida Health, 2012). According to

Florida Health, 19.3% of the adult population in Pinellas County smoke tobacco which is higher

than the state percentage of 17.1% and extremely higher than the Healthy People 2020 goal of no

more than 12% of tobacco using adults. These statistics show that tobacco use in Pinellas

County is a major problem and is causing a myriad of health problems in the adult population

which then impacts the younger generations who are left.

Discussion and Application of Community Health Models

Community health models are an important aspect of health care and treatment of

patients in divergent types of communities and populations. These models can set the standard

for proper treatment of patients and in turn create more positive outcomes. The Detriments of

Health Model studies the influence that personal, social, economic and environmental factors

have on a person’s health status and how they can actually be detrimental to one’s health as a

whole. This model aids in the developing interventions for specific population based health

issues because it targets the four distinct factors of a population and studies how each factor
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plays a role so it can better aim at interventions that will actually work and be beneficial. For the

priority health issue in Pinellas County, Florida there are many factors that influence its

expansion including lifestyle factors like smoking, environmental factors like being surrounded

by tobacco companies and other people who are using tobacco products, and finally the impact

of the health system where people are continuously getting ill due to tobacco.

Population Diagnoses

Citizens of Pinellas County are at increased risk of suffering from a tobacco-related

illness or death due to low rates of smoking cessation in the county by all citizens.

Community/Population-Based Interventions

Primary Level of Prevention

In the community of Pinellas County, the main intervention for the priority health

problem would be to participate in smoking cessation and to stop the use of all tobacco products.

Stakeholders for this intervention include the community members because they will be the ones

who will no longer engage in the usage of tobacco products like smoking cigarettes or using

chewing tobacco. Public officials may also be a stakeholder in this intervention by making it a

community initiative for everyone to participate in the cessation of tobacco usage through

campaigns and meetings. Some concerns that may arise can come from the tobacco companies

and the loss of money at local businesses due to people no longer spending money on tobacco

products. The role of the community nurse would be a crucial part of this intervention in carrying

it all out. People would turn to the community nurse for advice and other ways of smoking

cessation like nicotine patches and gums or other techniques or products to try and make it

easier. The community nurse will also be able to follow up with patients to see how they are

coping with their new, healthier lifestyles and see if the interventions are working.
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Secondary Level of Prevention

The recipients of this level of prevention would be individuals who are taking on the

initiative of smoking and tobacco product usage. The intervention for this level would include

treatments to help ease the strain of smoking cessation and help individuals who are particularly

struggling with their new lifestyle. Treatments would include forms other than pharmacological

ways, like attending smoking cessation classes where patients are taught on how to deal with

cravings, the physical and emotional symptoms that may arise, and to create a quitting plan that

the patient will be able to follow if they feel they are getting off track. Health care providers

would be a major stakeholder in this level of intervention because they would be providing the

intervention treatment whether it was in the form of classes or prescriptions for nicotine patches.

Funding concerns may be a problem as with any new formation of intervention programs but

since Florida has already begun to participate in programs like Tobacco Free Florida it wouldn’t

seem to be a problem to raise the proper amount for this cause. The community health nurse

would be a great resource to those individuals who are participating in treatment courses for

smoking cessation as the community nurse can be their go-to for questions or problems.

Tertiary Level of Prevention

In this level of prevention, the recipient would be individuals who were participating in

the past two levels of prevention. Monitoring compliance would be a major part of this level or

prevention to ensure that people are actually following through with not using tobacco products

and maintaining their healthy lifestyle. If people do not cooperate then things cannot get better

for the community as a whole. Monitoring treatment effects would be another aspect of this level

of prevention to make certain that the patients are feeling well and are not experiencing too many

side effects of smoking cessation. Some consequences of smoking cessation would be irritability,
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restlessness, and anxiety and it would be the community’s duty to deal with these consequences

and aid their fellow citizen through their recovery. Stakeholders for this intervention include

health care providers and community members because both of these populations would be front

line in helping the patients out through this. The community health nurse would be a vital

character in following up with the participants and making sure they have all they need and are

keeping on track with their quit plans.

Development of Health Policy

Health policy can have a major impact on communities, no matter how different they

may be from one another. Health policy is the set guide to how we should be striving to be our

healthiest and set examples for future generations to come. The health policy proposal for

Pinellas County will come from the secondary prevention level where individuals will be offered

different forms of treatment for smoking and tobacco product usage cessation. Individuals who

participate in this intervention will be able to attend classes where they are taught about how to

deal with cravings, any side effects or changes in their bodies from not smoking, and also how to

create a quit plan and sticking to it to ensure success. Other forms include pharmacological ways

like nicotine patches or other medications to ease the transition. The goal for this proposed health

policy is to dramatically reduce the amount of smokers and tobacco users in Pinellas County,

Florida and to decrease the rates of tobacco-related deaths. The proposed health policy will affect

different stakeholders like community members who will be participants in this policy, public

officials who will support the policy, health care providers who will carry out the interventions,

and legislators who will act to enhance the policy if need be. Supporters of the proposed health

policy would include health care providers and funding sources who are tired of treating

preventable illnesses caused by smoking or picking up the bill for these treatments. These
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supporters will have a major influence on how far this policy can go. Opposing forces could

include some community members who do not wish to stop smoking or cut tobacco out of their

lives. This health policy would greatly improve the health of the citizens of Pinellas County,

Florida because it would reduce the amount of tobacco-related deaths drastically. Pinellas

County would no longer see such high rates of heart disease, respiratory disease, or cancers

which are all exacerbated by smoking and tobacco usage.

Conclusion

All in all, Pinellas County, Florida does have its good and bad. Although this county may

struggle with tobacco usage and tobacco-related deaths, different forms of intervention can be

put in place to aid in the recuperation of the county’s citizens. By giving the citizens access to

classes and other forms of pharmacotherapy, Pinellas County could drop its tobacco use rates

and in turn reduce the amount of deaths and illnesses caused by smoking.

This paper is extremely relevant to my nursing career because every day as nursing students

we are told to help our patients stop smoking as much as possible due to the dangerous and fatal

effects they can have on a person’s body. This paper offered me a lot of knowledge about my

home county that I will now be able to use when caring for patients.
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References

County-State Profile 2015. Department of Health State of Florida. Retrieved June 17, 2017 from

http://www.flhealthcharts.com/ChartsReports/rdPage.aspx?rdReport=ChartsProfiles.CountyState

Profile

About Pinellas. Retrieved June 17, 2017 from http://www.pinellascounty.org/about_pinellas.htm

Pinellas County Community Health Assessment (2012). Florida Department of Health in

Pinellas County. Retrieved June 17, 2017 from http://www.floridahealth.gov/provider-and-

partner-resources/community-partnerships/floridamapp/state-and-community-reports/pinellas-

county/_documents/pinellas-cha.pdf

Erickson, Chris. 2012. Tampa Bay’s largest healthcare systems. Tampa Bay Business Journal.

Retrieved June 17, 2017 from http://www.bizjournals.com/tampabay/blog/2012/08/top-7-of-

the-list-largest-healthcare.html

Quick Facts. United States Census Bureau. Retrieved June 17, 2017 from

https://www.census.gov/quickfacts/fact/table/pinellascountyflorida,FL,US/PST045216

Associated Press. 2014. Florida’s high school graduation rate among lowest in nation. ABC

News. Retrieved June 17, 2017 from https://www.local10.com/news/florida/floridas-high-

school-graduation-rate-among-lowest-in-nation-
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