Running head: CHILDREN LIVING IN POVERTY IN BROWARD COUNTY 1

Children Living in Poverty in Broward County

Kimone K. Wright

University of South Florida College of Nursing

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Children Living in Poverty in Broward County

The community intervention will take place in Broward County, Florida, United States of

America, where there is a major issue with children living in poverty. The purpose of this paper

is to examine the population and socioeconomic factors of Broward County, and compare these

to the state of Florida. The weaknesses and strengths of the county will be examined, analyzed,

and interpreted, and a priority health issue will be chosen. The contributing factors to the chosen

priority health issue will then be discussed. Also, evidence-based interventions will be developed

and discussed according to community health models. For each community and population-based

intervention, principles of the Intervention Wheel Model, and Levels of Prevention Model, will

be applied. Furthermore, a health policy proposal will be discussed in response to the population

diagnosis, and the first steps toward presenting this health policy will be described.

Geographic Location and Employment

Broward County was created in 1915 and has an area of 1, 557 square miles (Florida

Department of Transportation, 2013). In 2012-2014, the population size of Broward County was

1,778,964, making it the second most populous county in the state of Florida with a population

growth rate is 25.5% (Florida Department of Health, 2016). The largest cities of Broward County

are Fort Lauderdale, the county seat, with a population size of 170,065, Pembroke Pines with a

population size of 155,565, and Hollywood with a population size of 143,935 (Broward.org,

2012). The three major industry sectors for employment in Broward County are: trade,

transportation, and utilities with 23.0% of workforce, professional and business services with

15.9% workforce, and education and health services with 13.8% workforce (Florida Department

of Transportation, 2013). However, the three major employers are American Express with 4, 846

employees, Nova Southeastern University with 3,919 employees, and PRC, along with Kaplan
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Higher Education, with 3,000 employees (Florida Department of Transportation, 2013). There

are numerous healthcare systems in Florida. However, Broward 2-1-1 Healthcare Services

Program serves as a single access point information and referral system for Broward County,

connecting residents to available health services in a timely, compassionate and efficient manner

(Broward 211, 2016).

Population and Socioeconomic Factors

The socioeconomic factors of Broward county vary with that of other counties, and

hence, the state of Florida as a whole. The percentage of families below the poverty level in

Broward County is 14.6%, while the percentage in the state of Florida is 16.7% (Florida

Department of Health, 2016). Although this may seem like a small difference, it shows that

members of Broward county, compared to Florida as a while, have more access to basic

necessities of life. Also, the population in Broward County, age 25 or older, with a high school

diploma is 87.1%, while this population in the state of Florida is 85.3% (Florida Department of

Health, 2016). Therefore, Broward County has more adults with a high school diploma than the

average counties in the state Florida. The population, ages 5 or older, in Broward County, that

speaks a language other than English at home is 37.8%, compared to Floridas rate of 27.4%

(Florida Department of Health, 2016). Therefore, approximately 37.8% of Broward Countys

residents may have some difficulty communicating with English-speaking residents of that

county or may be able to speak at least two languages comfortably. This is an advantage for

these residents since many companies prefer to hire individuals that are multilingual.

Additionally, access to healthcare centers or primary care providers may depend on a number of

factors, which includes insurance availability, health care workers availability, and monetary

needs. In Broward County, the ratio of physicians to patients is 1,360:1, while that of the state of
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Florida is 1,390:1. This means that, on average, one physician in the state of Florida cares for 30

more patients than one physician in Broward County. This is an advantage to this county.

Analysis and Interpretation of Data

Each county has its strengths and weaknesses. Broward County has a number of strengths

that are very important in its development. For example, the percentage of adults who are obese

is 24%, while the national benchmark is 25% (County Health Rankings and Road Maps, 2013).

Although these percentages are close, Broward county is managing obesity better than the state

of Florida in general. This is a strength because obesity increases a persons risk of chronic

diseases, such as cancer and cardiovascular diseases. Also, in Broward County, 100% of the

population has access to exercise opportunities, while in the state of Florida, an average of 92%

of residents have this opportunity (County Health Rankings and Road Maps, 2016). Therefore,

each member of Broward County has the opportunity to remain physically fit through exercise.

Exercise is important as it contributes to physical and mental wellbeing. Another advantage that

Broward County has over the average states is that 86% of residents engage in diabetic

monitoring, while on average, 85% of Florida residents engage in this activity (County Health

Rankings and Road Maps, 2016). This too, is important as it prevents the worsening of diabetes

and the risk of other chronic diseases.

On the other hand, Broward County requires improvement in a number of areas. For

example, the county can improve on the percentage of students who attend college. In Broward

county, only 67% of students attend college, while the national benchmark is 70% (Florida

Department of Health, 2016). Improving this health indicator would help to increase the level of

education achieved by the people of Broward County. Higher levels of education would also

help citizens of Broward county to obtain better jobs and improve the levels of unemployment
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and insurance coverage. Also, Broward county can work on decreasing the percentage of people

who smoke. 15% of the residents of Broward county smoke, while the national benchmark is

13% (County Health Rankings and Road Maps, 2016). Improving this health indicator is

important because smokers are more likely than nonsmokers to develop lung cancer,

cardiovascular disease, and stroke. Additionally, people who smoke are more likely to drink

alcohol. The county can also improve on the percentage of children who are living in poverty.

Broward county is at 20%, while the national benchmark is 14% (County Health Rankings and

Road Maps, 2016). Improving this health indicator is important because living in poverty

increases the childs risk of health problems in childhood and later in life. Also, these are the

future adults of Broward County and a healthy adult population contributes to a more productive

county.

Priority Health Issue and Community Health Models

Many factors are taken into consideration when determining the health of individuals and

communities. These factors include personal, social, economic and environmental factors. The

range of these factors that influence health status are known as determinants of health (Office of

Disease Prevention and Health Promotion, 2016). These determinants fall under several broad

categories. These include policymaking, social factors, health services, individual behavior,

biology and genetics (Office of Disease Prevention and Health Promotion, 2016). The

interrelationships between these factors determine the overall health of an individual and the

population at large. Sectors such as education, housing, transportation, agriculture, and

environment can be an important combination in improving population health. However, many

people believe that the access and use of healthcare services have the greatest impact on their
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healthcare, but other factors such as relationships with families and friends, state of the

environment, and income and education level, all have a large impact ones health.

Children living in poverty is a priority health issue in Broward County since at least 2 out

of every 10 children in this county is living in poverty. Many factors may contribute to this issue.

The lifestyle of parents has a huge impact on their childrens wellbeing. For example, many

adults in Broward County are smokers and alcoholics, and some are unemployed. Also, the

percentage of alcohol-impaired driving deaths, 22%, is very high (County Health Rankings and

Road Maps, 2016). This means that there is a possibility that children may lose their guardians

through death, and this could leave them in poverty. Also, environmental factors such as safe

houses and communities, clean, fresh air, and employment and working conditions contribute to

good health. Unfortunately, many residents of Broward County are not exposed to these. When

parents are healthy, they are better able to provide for their family. Furthermore, in Broward

County, 26% of the population is uninsured (County Health Rankings and Road Maps, 2016).

This means that 26% of individuals will have to pay for medical care for themselves and their

children without the help of a health insurance company. Because health care is so expensive,

many adults are unable to afford this and so they are less likely to participate in preventive care

and are more likely to delay medical treatment, unless they have a serious medical emergency.

This lack of access, or limited access, to health services greatly impacts an individuals health

status. Also, uninsured individuals may visit the doctors and end up having to pay a great deal of

medical bills. This puts them and their children at risk for poverty.

Many genetics and biological factors may put children at risk for living in poverty. For

example, age, sex, and inherited conditions such as sickle-cell anemia, cystic fibrosis, and

hemophilia may put children at risk of living in poverty. This is because many times, parents
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with these conditions are unable to perform certain jobs, and hence, are unable to adequately

provide for the children. For instance, a father or mother with sickle-cell anemia is unable to

perform strenuous activities, or even participate in many physical activities because this illness

makes them easily become short of breath. Additionally, the Broward County population also

has a risk for an increase in poor or fair health related to a number of population characteristics.

The County Health Rankings and Roadmaps for Florida shows some examples of this. These

examples include, premature death, which is 5,900, low birth rate which is 9% of the population,

and children in poverty which is 20% (2016). This may cause health risks for newborn babies, as

well as older children, which may affect them in the future. Also, 15% of adults in this county

smokes, 24% are obese, 18% engage in excessive drinking. In addition, 26% of the population is

uninsured. This means that 26% of the population may have to cover their medical expenses

without the help of an insurance company (County Health Rankings and Road Maps, 2016).

These activities put them at risk for development of preventable diseases.

Community/Population-based Interventions

According to Multimedia Educational Resource for Learning and Online Teaching

(MERLOT), The Intervention Wheel, first introduced in 1998 by the Minnesota Department of

Health, under the section Public Nursing, it is a population-based practice model that integrates

three levels of practice (community, systems, and individual/family) and 17 public health

interventions. Each of these levels contributes to improving population health (2016). On the

other hand, according to the Institute of Work and Health, The Levels of Prevention Model

consists of three levels of prevention: primary, secondary, and tertiary level (2015). This model

explains the range of interventions to promote health available to health care workers. Primary

prevention prevents a disease or injury, secondary prevention reduces the impact of an existing
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disease or injury, while tertiary prevention reduces the impact of an ongoing illness or injury by

delaying complications (Institute of Work and Health, 2015).

Primary Level of Prevention

Community members, public officials, legislators, and health care providers should

contribute to the prevention of poverty in children in Broward County. In order to prevent

poverty, public officials could work on increasing the number of jobs available to members of

the county, implement measures that will encourage individuals to get at least a college degree,

and make health care more accessible as this will ensure health and wellness. Financial security,

which provides families with a consistent family income, could also be encouraged to improve

poverty in Broward County. Community members, could also do fundraising activities that will

raise funds for children at risk of living in poverty. If officials are unable to provide funding to

improve the wellbeing of these children, they could seek donations and help from individuals

who are willing to donate, along with agencies. For example, the US Environmental Protection

Agencys (US EPAs) environmental justice grant programs, whose primary purpose is to

support communities as they develop and implement solutions that significantly address

environmental and/or public health concerns at the local level (US Environmental Protection

Agency, 2016). The EPS also provides funding for eligible applicants for projects that address

local, environmental and public health issues within an affected community. The program assists

recipients in building collaborative partnerships to help them understand and address

environmental and public health concerns in their communities (US Environmental Protection

Agency (2016).

In developing, carrying out or following up on ways to prevent poverty in children, a

community health nurse must first be a part of the community. Along with nursing practice, the
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nurse must combine public health sciences, including the enforcement of federal, state, or local

laws, in order to make these interventions effective (Truglio-Londrigan & Lewenson, 2013).

The public health nurse must also be able to apply and perform the 17 intervention strategies of

the intervention wheel at the 3 various levels of practice. Also, they must be able to apply those

skills and initiate change at the individual/family, community, and system level of community

health practice. These actions will give community health nurses an idea of the concerns in

Broward County, which allows them to implement measures to prevent poverty in children.

Secondary Level of Prevention

Unfortunately, since a large percentage of children in Broward County are living in

poverty, parents and public officials, such as nurses and other public health practitioners, must

find ways to reduce the impact of poverty on these children. These public health practitioners are

responsible for using various strategies, such as outreach and surveillance, to engage in case

findings. They should reach out in the community, locate those living in poverty, provide

information about the nature of the concern to public officials, explain what can be done to fix

the situation, and how services can be obtained (Truglio-Londrigan & Lewenson, 2013).

Additionally, surveillance allows for close observation of families living in poverty. Nurses may

observe these families when they do their follow-up visits. They should keep a log of the

progress made by each family. Public officials are also involved in the secondary prevention of

poverty in children since they too can donate tools required for health care workers to carry out

these interventions. They can also provide jobs for parents or guardians living in poverty that are

fit to work, provide workshops for families living in poverty, and implement free education and

food in the schools so that more children living in poverty may become educated.

Tertiary Level of Prevention

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In order to reduce the impact of poverty in children, family members living in poverty

need to understand ways to improve their lives and become better individuals. They can learn

this by becoming involved in community activities or groups where they interact with others that

share the same concern. This will give them the opportunity to share ideas. They may learn

methods that their group members used to improve their living situations. In order to know if

these interventions are working as planned, officials must find ways to monitor compliance of

these individuals and monitor how individual treat the situation. They could monitor the

treatment of the situation by using outreach and surveillance strategies. They could do this by

sending out social workers and public health nurses to homes. Here, these individuals will do

frequent assessment of the situations and decide if improvements are being made. Again, the

community health nurse is responsible for doing frequent assessments in order to keep track of

the progress of this intervention. If there is a concern with funding and resources, the county can

ask for donations from various individuals and organizations, or they could plan activities that

will help them raise funds. These activities include, but are not limited to, 5K charity runs,

concerts and street carnivals, and raffle selling.

Health Policy

A well-developed health policy can cause great improvement in Broward County. The

health policy proposal that could positively impact Broward Countys poverty issue is a

secondary level intervention. This is because poverty is an existing issue that can be resolved, for

example, with strategies such as outreach and surveillance. In Brevard County, the primary focus

in decreasing the level of poverty is to provide adults or guardians with more jobs, encourage

education, make health care more accessible, and provide workshops for families of children

living in poverty. The goal of this intervention is to provide more money in households which
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will allow members to get better healthcare and provide for their families. This will contribute to

a healthier and safer environment. This intervention is geared toward community members,

public officials, legislators, and health care providers. If everyone works together, this problem

can be resolved. There are many businesses and organizations willing to donate funding to help

counties. For example, the US Environments Protection Agency.

For a health policy to be in place, there must first be a plan. The process begins with an

analysis of poverty within the county, taking into account both quantitative and qualitative data.

This analysis should indicate the priority issues. These issues are then brought to public officials.

Unfortunately, if public officials and legislators are not in agreement with the proposal, this issue

may not be resolved. For approval from officials in resolving this issue, individuals must get

accurate information from the residents of the county. With strong proof of this issue,

government officials are more likely to grant the wishes of the public. If there are less children in

Broward County living in poverty, the population will have a brighter future as more individuals

will be healthier and more productive.

Conclusion

20% of children in Broward County are living in poverty (County Health Rankings and

Road Maps, 2016). However, if the correct stakeholders are contacted, this issue can be resolved.

There are many factors that impacts the population, which include personal, social, economic

and environmental factors, and the interrelationships between these factors determine the overall

health of an individual and the population at large. Therefore, residents of Broward County

should learn more about these factors and use their knowledge appropriately to improve their

lives and the lives of other members of the county. This paper is very important to my nursing

career as it gives me a wider knowledge of the many health issues presented in the state of
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Florida, including Broward County. It also supplements my previous knowledge, and provide me

with information on ways to prevent or control issues to improve the overall health of the

community. This paper also gave me an opportunity to think about how the different factors that

impact a population interrelate to determine the overall health of that population. After the health

policy mentioned is put in place, more children will be provided with the tools needed to

improve their lifestyle. For example, more children will be able to attend colleges, get a job

when they graduate from college, and be able to monitor their health status. This will not only

have a positive impact on individuals, but it will have an impact on the county in general. More

people will be happier and safer in their environments.

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