Abstract
This intervention plan intends to act as a catalyst to the promotion of health policies that are to see the African-Americans lives free from Coronary Heart diseases. This plan has got the following six sections. First, the rationale section which describes the need for intervention in the African–American issue. Second, the objectives section which describes the objectives of this plan. Third, target Community section which describes the African-American community that is affected by Coronary Heart Disease. Fourth, is the method section which explains how this intervention plan will achieve its’ objectives. Fifth, the evaluation plan section which describes the process and methods that will be used to measure the outcomes of this intervention plan. The last section is the reference section which contains documented materials used in this intervention plan.
Introduction
This intervention plan for Coronary Heart Disease (CHD) in African Americans is calling for the attention of the United State government to implement health measures that protect the African Americans from CHD. This is because the African-Americans are more affected than any other race in the United States. CHD is a chronic disease in the world including the United States. This disease is a threat to many lives concerning the fact that there is no known etiology of CHD. There are many factors linked to the cause of CHD. These factors include smoking, heredity factors, lifestyles, age, and obesity (Gillum, Mussolino, & Madans, 1998).
Interestingly, from different researches CHD has shown a relationship with different racial groups. There are races highly affected by CHD than other races. In the United States the African Americans is a race that is affected by CHD more than any other race. This relationship that is seen to exist between CHD and different racial groups requires the government and health stakeholders to strongly put this into consideration when dealing with CHD. The Africa-Americans are more subjected to Traditional factors that cause CHD than the white race in. Therefore, it is important to understand the interesting racial differences that can predict the presence of CHD in a person. This prediction will help understand the origin of CHD and be important in describing best intervention methods and procedures (Jones et al., 2002).
Coronary Heart Disease (CHD) in African–Americans
This intervention plan recognizes effects of CHD on African-Americans. In America, there are enough evidences to prove that the African-American race is the most affected race with CHD. The race has the highest mortality rate resulting from CHD. The death occur mostly out-of–hospital, affecting the young age. The African-American race is prevalent to some CHD risk factors. The race is also affected with recognition and the treatment of the affected or individuals at risk. Last, the African-Americans are limited to the access to the cardiovascular care. The African- Americans have a high sudden cardiac arrest than the white race (Clark et al., 2001). This explains some of the reasons why the African-Americans are more affected when attacked by CHD than the White-Americans.
The increased effect of CHD on the black Americans needs a quick intervention in the issue. Approaches used to handle the disease tend to work better on other races but when used on these African-Americans they do not yield the same results. The black Americans when compared to the White Non–Hispanic, it is found that they have a higher rate of hypertension which contributes to developing of coronary disease in a person. Over years, there has been a reduction in the hypertension level in different races in the United States, but there has been no significant reduction in the African-American race. For example, “study shows that between 1990 to 1998 death rate of the white Non-Hispanics with cardiovascular disease reduced by 15% and only 11% to the Africa-Americans” (Martins & Norris, 2004, p.735).
The level of exposure of the African–Americans to the factors that lead to coronary disease is high. For example, the African-American are highly prevalent to hypertension. In this intervention plan, it is important to intervene in the CHD affecting the African Americans. This is because of there exposure to risk factors It includes: stroke, hypertension heart related disease, and hypertensive nephropathy (Martins & Norris, 2004). The table below compares the level of hypertension in the Non-Hispanic white and Non-Hispanic African-Americans between 1999 and 2000.
A table showing blood pressure prevalence and control in the United States Adult Population, 1999- 2000:
The vulnerability of the African-Americans to CHD than any other race, calls for the intervention the issue to help reduce the mortality rate of African-Americans affected by CHD. In addition, CHD is a burden in terms of costs of treatment; it is also a major cause of mortality in African-Americans than any other diseases. For example, between 2004 and 2006 39% of African–Americans aged 85 and above died of cardiovascular diseases. From our experience with various intervention plans to different health organizations, we hope that this plan will provide appropriate interventions in this issue affecting the African-Americans.
Objectives
In rescuing the African-Americans from the threats of CHD and reducing the mortality rate caused by CHD among the African Americans we have got the following objectives in this intervention plan:
- By 31st December 2015 the ratio of African-Americans affected by CHD should be 1:1 compared with the Non-Hispanic whites.
- At January 2014 70% of the African-Americans should be able to lead health lifestyles to help reduce the risk of CHD.
- Motivate use of walk therapy to treat leg impairment in the CHD Africa- America patients by more than 85% of the patients in public and private hospitals by end of March 2013.
- Prevent CHD risk factors by 60% by December 2013.
- Reduce the percentage of the African-American people aged above 85 who die from CHD by 50% by December 2014.
Target community
This intervention plan for CHD targets the Africa-American black people living in the United States. This section describes the people of these of community in relation to CHD. This is a one of the largest small races in the United States. The group makes the 12.8% of the United States population and more than 50% of this group occupies the southern part of the United States. This ethnic group shows different results concerning the coronary diseases. The group emerges to be more subjected to risk factors that contribute to CHD in comparison with other ethnic groups. For example, taking a risk factor like Hypertension which contributes to CHD we find that the African-American is more prone to this risk. African-American are likely to develop a severe hypertension than the white. Hypertension makes more than 70% of patients not to control their blood pressure leading to CHD (The Health Authority, 2006).
Cases of premature death as a result of CHD in Africa-Americans are high indicating earlier existence of the disease at the young age. There other factors that risk this community to CHD. They include the ability to access healthcare, eating styles, general lifestyles (for example smoking), socioeconomic status, attitude toward diseases, racial discrimination, and genetically explanations account for high number of CHD among the Africa-Americans (Winham & Jones, 2011).
Methods
This section describes the action to be undertaken in order to achieve the desired objectives mentioned in section 2 of this plan. Our strategy affects CHD intervention plan direction dealing with areas that are to manage the following specific areas:
- Reducing the death rate among the Africa-American as a result of ChH
- Promote health lifestyles among the African-American people
- Identify the use of walking therapy by the CHD patients and also by the Africa-Americans who are not affected by CHD to prevent the spread of this disease.
- Prevent CHD risk factors among the Africa-American people
Description of the intervention
The goal of this intervention plan is to develop policies that will help the Ministry of Health in the United States to manage and control the CHD among the Africa-America people in the United States. The strategies of this plan involve the entire population of the African-American people and the ministry of Health. There is a strategy to achieve each objective mentioned in this plan.
Strategy for reducing death rate of African-Americans
This strategy needs use of financial aid to help the affected Africa-Americans access treatment. Many of them are unable to pay for treatment of CHD because it is normally expensive. The team of this plan will negotiate with the United States government to subsidize CHD treatment to relieve this ethnic group from the burden of payment.
The team will ensure mandatory test of the children below the age of 5 for test of CHD and CHD risk factors. When detected there will be free treatment and follow up procedures made to ensure safety and healing of the patient.
Strategy to promote Health lifestyles
Health lifestyle is vital in prevention of CHD. From the beginning of February 2013, the plan team will educate the Africa-American people on the importance of leading health lifestyles. They will be educated through all the local public television in the United States on Sunday from 4:00 p.m. every week beginning October 2012 up to 14th January 2015. There will be annual workshops on health lifestyles to prevent CHD held every first weekend of December every year until 2015 held in a selected town of Southern America every year.
Strategy to promote use of walking therapy to prevent CHD
Waking therapy helps to improve blood circulation in individuals reducing the level of exposure to CHD. The team plan team will promote this strategy through integration with heath experts and offering free guiding and counseling services. The guiding and counseling session will be held in mobile offices used by the team members.
Strategy to prevent CHD risk factors among the Africa-American people
CHD has got no well known etiology. Therefore, health prevention of the factors associated with it will help save the Africa–Americans from the ravages of CHD. The team will identify these factors like smoking, hypertension, and heredity factor. Through careful observation and survey, we will identify the section of the population affected by this risk factor. For example, if the young people are affected by the risk factor of smoking, the team will educate them on the effect of smoking and propose other better recreational activities like swimming and playing football.
Collaborating Partners
For the successes of this intervention plan, there are partners who will be part of this plan to give feedback, financial support, and direction. The partners are as follows:
- The government of United States
- The Africa- Americans
- The ministry of Health
- The World Health Organization
- Private and public healthcare providers.
Intervention plan model
Below is a description of the model to be followed during the intervention period. The model contain the following: The key activities in each stage, specific intervention activities, person responsible, expected outcome, outcome indicator, and deadline date.
Evaluation Plan
The evaluation plan is going to help see the effectiveness of the strategies of this plan. This plan will evaluate the progress through use of survey, focus groups and observations.
Observation will be made on the way the African-Americans are responding to access of medical care. At the end of December 2012, there should be an increase in the percentage of those accessing medical treatments.
The plan team will use a focus group to measure the effectiveness of the strategy in the long run. The focus group shall give the results concerning the performance of the strategies on July 2013 and December 2015. The focus group will give value on the lifestyles of Africa–Americans and also use of walking therapy to prevent CHD.
Last, there will be survey done on the Africa-Americans in the Southern America continually during the process to help determine if the ratio of this group that has CHD is equivalent to the white race. We hope the plan will help control and manage the effects of CHD on Africa-Americans.
References
Clark, L. T., Ferdinand, K. C., Flack, J. M., Hall, W. D., Kumanyika, S. K., Garvin, J.R., Saunders, E., Reed, J. W., Valentine, H. A., Watson, K., Wenger, N. K., & Wright, J. T. (2001). Coronary heart disease in African Americans. Heart Disease, 3(2), 97-108.
Gillum, R. F., Mussolino, M. E., & Madans, J. H. (1998). Coronary heart disease risk factors and attributable risks in African-American women and men: NHANES I epidemiologic follow-up study. Am J Public Health, 88(6), 913–917.
Jones, D. W., Chambless, L. E., Folsom, A. R., Heiss, G., Hutchinson, R. G., Sharrett, A. R., Szklo, M., & Taylor, H. A. (2002). Risk factors for coronary heart disease in African Americans: the atherosclerosis risk in communities study, 1987-1997. Arch Intern Med, 162 (22), 2565-2571.
Martins, D., & Norris, K. (2004). Hypertension treatment in African Americans: Physiology is less important than sociology. Cleveland Clinic Journal of Medicine, 71(9), 735-743.
The Health Authority. (2006). Cardiovascular Risk Factors. Web.
Winham, D. M., & Jones, K. M. (2011). Knowledge of young African American adults about heart disease: a cross-sectional survey. BMC Public Health, 11, 248.