Introduction
It is important to note that identifying health inequities requires a thorough analysis of the key metrics, including social determinants of health. The assessment of health trends in Nassau, Suffolk, and Kings Counties of New York State allowed an in-depth overview of major points of interest in this regard. Despite the fact that NA is the top performing county in NY compared to Suffolk or Kings, it still has problems with low birth weight, obesity, and long commute.
Health Inequities
The identified health inequities are low birth weight, obesity, and long commute. In the case of the latter, the state average is equal to 39%, whereas Nassau has 47% (County Health Rankings & Roadmaps, 2022). It is stated that there is a link between long commute and obesity since more time a person spend in his or her car, higher the sedentary lifestyle duration (King & Jacobson, 2017). Sedentary lifestyle and obesity are significant contributors to physical health of an individual (Mason et al., 2021). Low birth weight is specific to African American communities of the county only.
Social Determinants
The key social determinants of health, which are the underlying reasons behind the health inequities, include poor maternal nutrition during pregnancy, geographical specificities, and poor physical activity. Physical inactivity contributes to obesity to the point that “physical inactivity is a primary contributor to the obesity epidemic, but may be promoted or hindered by environmental factors” (Gray et al., 2018, p. 1). Poor maternal nutrition during pregnancy is linked to low birth weight. It is reported that “improving women’s nutritional status positively affected LBW, SGA, and PTB,” where LBW, SGA, and PTB stand for low birth weight, small-for-gestational-age, and preterm birth, respectively (Da Silva Lopes et al., 2017, p. 1). The long commute is caused by the country geographical specificities, which cannot be changed.
Root Cause Analysis
The Root Cause Analysis revealed that Nassau (NA) is the healthiest region in the New York, and the top three health inequities are low birth weight (LBW), obesity, and long commute. Potential underlying reasons are poor maternal nutrition during pregnancy, geographical specificities, and poor physical activity. The relationship between health inequities and reasons are based on the data obtained or evidence from external scholarly sources.
Specific Populations Affected by the Inequities
It should be noted that obesity uniformly affects all members of the Nassau community, whereas the long commute primarily impacts people who drive, such as working adults. However, low birth weight is a problem mostly for African Americans of the Nassau county. For example, the Black population has 12% of LBW, but the state average is around 8% (County Health Rankings & Roadmaps, 2022). Therefore, the identified specific populations are working adults and African Americans.
Main Commonalities and Differences
The core commonality in health of three counties can be seen between Nassau and Suffolk. Both regions are ranked in the top 25% of the healthiest counties in NY (County Health Rankings & Roadmaps, 2022). However, the difference can be observed in regards to Kings county, which significantly lags behind Nassau and Suffolk. In all metric values, Kings is behind the other two neighboring regions, which indicates a major health disparity tied to the county.
Impact of County-Specific Policies
The data demonstrates that the county-specific policies are clearly perpetuating positive health outcomes for the Nassau population. The table shows that the availability of primary care physicians and mental health providers is high, which is likely the reason why there is no major mental health or physical health problem stemming from poor healthcare. However, for LBW, a study suggests that low birth weight is not as effective of a metric as a measurement of gestational age through ultrasound (Hughes et al., 2017, p. 289). The nutritional intervention is primarily achieved with the use of nutritional education as well as oral supplementation of multiple micronutrients, zinc, low-dose calcium, and vitamin A (Da Silva Lopes et al., 2017). Thus, LBW among African Americans need to be addressed through a policy, which would increase access to ultrasound and nutritional interventions.
Resource Disparities
There are clear and evident resource disparities between the counties. Specifically, such a difference can be observed in the availability of primary care physicians and mental health providers. Nassau has twice as many primary care physicians compared to Suffolk and Kings, and they both lag behind the state average values (County Health Rankings & Roadmaps, 2022). In addition, the unemployment is significantly higher is Kings than Nassau, which affects the resources available for the former community to be healthier.
Conclusion
In conclusion, the analysis of health trends in Nassau, Suffolk, and Kings Counties of New York State identified key disparity points. Nassau is the healthiest region in the New York, but it still has problems with low birth weight (LBW), obesity, and long commute. It is important to note that evidence-based underlying reasons include poor maternal nutrition during pregnancy, geographical specificities, and poor physical activity.
References
County Health Rankings & Roadmaps. (2022). How healthy is your community? Web.
Da Silva Lopes, K., Ota, E., Shakya, P., Dagvadorj, A., Balogun, O. O., Peña-Rosas, J. P., De-Regil, L. M., & Mori, R. (2017). Effects of nutrition interventions during pregnancy on low birth weight: An overview of systematic reviews. BMJ Global Health, 2(3), 1-12. Web.
Gray, C. L., Messer, L. C., Rappazzo, K. M., Jagai, J. S., Grabich, S. C., & Lobdell, D. T. (2018). The association between physical inactivity and obesity is modified by five domains of environmental quality in U.S. adults: A cross-sectional study. PLoS ONE, 13(8), 1-14. Web.
Hughes, M. M., Black, R. E., & Katz, J. (2017). 2500-g low birth weight cutoff: history and implications for future research and policy. Maternal and Child Health Journal, 21(2), 283–289. Web.
King, D. M., & Jacobson, S. H. (2017). What is driving obesity? A Review on the connections between obesity and motorized transportation. Current Obesity Reports, 6, 3-7. Web.
Mason, D. J., Perez, A., McLemore, M. R., & Dickson, E. (2021). Policy & politics in nursing and health care (8th ed.). Elsevier.
Appendix
Health Trends in Nassau, Suffolk, and Kings Counties of New York (County Health Rankings & Roadmaps, 2022)
Health Outcomes: Length of Life
Health Outcomes: Quality of Life
Health Factors: Health Behaviors
Health Factors: Clinical Care
Health Factors: Social and Economic Factors
Health Factors: Physical Environment
Nassau (NA) – is the healthiest region in the New York.
Top three health inequities – low birth weight (LBW), obesity, and long commute.
Underlying reasons – poor maternal nutrition during pregnancy, geographical specificities, and poor physical activity.