A Community Health Needs Assessment (CHNA) is a technique that identifies and analyses community health needs that affect the whole community. The technique allows populations to prioritize health requirements and prepare for and respond to unfulfilled community health needs (Scoditti et al., 2019). A CHNA should help hospitals and other health care providers to identify community health needs and gaps. However, this paper will outline significant health needs facing the United States population concerning Chronic Obstructive Pulmonary Disease (COPD) and smoking. The paper will discuss the most affected population and explain the involvement of different stakeholders while articulating three specific high-priority health improvement needs of the population. Nonetheless, an explanation of how the wellness model is used to manage COPD will be outlined, and strategies used based on the treatment model.
Salient Characteristics Defining a Community
In the United States, smoking tobacco remains the most significant avoidable cause of a high mortality rate. The frequency of current smoking among adults in the US has decreased steadily in the last 20 years, reaching 13.7% in 2018 (Scoditti et al., 2019). However, a range of combustible, non-combustible, and e-cigarettes products are accessible in the US. Cornelius et al. (2020) used a CDC reviewed information from the 2019 National Health Interview Survey (NHIS) to assess the current national projection on utilization of tobacco products among US adults of 18 years and above. In 2019, a projected 50.6 million individuals in the US (20.8%) outline to be users of tobacco products, which comprises cigarettes (14.0%), e-cigarettes (4.5%), cigars (3.6%), and smokeless tobacco (2.4%), and pipes (1.0 percent ). Eighty-five percent of current tobacco products users confirm utilizing combustible items, and 18.6 percent claim to use more than one tobacco product. Males of 65 years and non-Hispanic American Indian/Alaska Native (AI/AN) adults had a greater frequency of current tobacco product usage.
Chronic obstructive pulmonary disease (COPD) is one of the significant diseases attributed to smoking. Zafari et al. (2021) posited that COPD is a main cause of death in the United States, imposing significant social health and economic cost. All stakeholders must understand the anticipated health burden with the predicted population increase.
Specific Health Improvement Needs of The Community
COPD is a principal cause of death and a significant burden on healthcare systems globally, affecting about 10% of adults aged 40 years and above. As provided by WHO estimates, 65 million individuals globally have moderate to severe COPD; however, many COPD victims may be underdiagnosed, particularly in economically challenged states. The problem of COPD is expected to significantly upsurge in the future because of chronic exposure to uncertainties and continuous changes in global population structure. COPD is projected to be the third foremost cause of death globally by 2030 (Scoditti et al., 2019). As a result, COPD prevention and treatment are now considered a severe public health concern with significant social and economic implications. Therefore, there is a need to articulate different aspects to improve and prevent more complications of COPD.
First, there is a need to develop effective surveillance and evaluation model to improve the collection, synthesis, dissemination, and reporting of COPD-related data. Proper health management data help achieve objectives such as reducing deaths and a new diagnosis of COPD through effective resource allocation (Matulewicz et al., 2021). secondly, there is a need to formulate effective programs and policies; this mainly increases prevention while upholding policy-related collaboration between different partners interested in COPD- related concerns such as smoking and tobacco use. There is also a need to develop an effective health communication system. It is necessary to heighten awareness of COPD among different groups, including people with COPD and their families, the smoking population, health professionals, system providers, decision-makers, policymakers, the media, and the public. The public need to be educated on the dangers and risk of smoking.
Engagement Of Community Stakeholders
The government is the major stakeholder in controlling tobacco usage as a major factor and cause of COPD. The CDC is the only federal agency that funds tobacco regulator activities in all 50 states, the District of Columbia, eight US territories, and 26 tribal organizations to control tobacco. Steliga (2018) outlined that public policy initiatives also employ a more socially responsible approach to smoking cessation, including more assertive leadership at the state and federal levels and via advocacy, public health, and professional groups.
Counseling smokers to stop and to offer them medication-assisted cessation are two of the most useful and cost-effective strategies doctors can provide patients. Nonetheless, support in quitting is neither generally covered by health insurance nor available from all specialists. Analyses of stakeholders’ views and interests may help identify impediments to more widespread provision of cessation services and offer solutions for advancing smoking cessation on the public policy agenda (Scoditti et al., 2019). Additionally, non-profit organizations such as Truth Initiative are dedicated to eradicating tobacco use by investing, exposing, and amplifying the truth concerning smoking and vaping through research studies.
There are barriers limiting the effective engagement of different stakeholders; for instance, Matulewicz et al. (2021) provided that despite the reference that individuals engage in therapy, urologists deem that this is outside the scope of specialists and hence not offered. On the other hand, counseling and smoking cessation are not incorporated in most healthcare plans limiting more involvement of specialists and health provider organizations.
Wellness and Treatment Model Used to Address Community Health Needs
COPD-specific chronic illness management strategies are based on the treatment model’s Chronic Care Model. This paradigm includes connections to community resources, health system assistance, and self-management. Although the style and delivery of these programs vary, they often give information about COPD, behavioral management coaching, and information about medication adherence and management (Kim & Hodgins, 2018). Wellness models such as quitting smoking and living a healthy life, on the other hand, aim at preventing the outcome of getting COPD.
The wellness model in tackling smoking issues is important as it strives at preventing individuals from catastrophic impacts of smoking such as COPD. However, the model fails to acknowledge and provide ways to improve the wellness of COPD victims (Model, 2019). On the other hand, the treatment model focuses immensely on the affected population by providing a theoretical framework for managing the illness or smoking addiction and fails to articulate the essential aspects of prevention. The model focuses mostly on mitigating the impact of the result rather than eradicating factors that cause the results.
In summary, health promotion programs for smoking reduction and cessation are believed to use a three-tiered strategy that articulates aspect needs of COPD. These strategies comprise; The need to have an effective data management system tracking the number of smokers and COPD victims, the importance of having effective policies and programs to handle smoking, and effective communication among the public. Communication, however, involves educating the public on the dangers of smoking and how to manage COPD. To handle these Community health needs in the USA, thus, need interventions from different stakeholders such as the federal government, the health care providers, clinicians, and the public. Both wellness and treatment model can be used to prevent more diagnoses of COPD and reduce the smoking population.
References
Cornelius, M. E., Wang, T. W., Jamal, A., Loretan, C. G., & Neff, L. J. (2020). Tobacco product use among adults—the United States, 2019. Morbidity and Mortality Weekly Report, 69(46), 1736. Cornelius, M. E., https://doi.org/10.15585/mmwr.mm6946a4.
Kim, H. S., & Hodgins, D. C. (2018). Component model of addiction treatment: A pragmatic transdiagnostic treatment model of behavioral and substance addictions. Frontiers in psychiatry, 9, 406. https://doi.org/10.3389/fpsyt.2018.00406
Matulewicz, R. S., Makarov, D. V., Sherman, S. E., Birken, S. A., & Bjurlin, M. A. (2021). Urologist-led smoking cessation: A way forward through implementation science. Translational Andrology and Urology, 10(1), 7. https://doi.org/10.21037/tau-20-1204
Model, A. H. (2019). Add-wellness. Annual Review of Addictions and Offender Counseling, Volume IV: Best Practices, 46.
Scoditti, E., Massaro, M., Garbarino, S., & Toraldo, D. M. (2019). Role of diet in chronic obstructive pulmonary disease prevention and treatment. Nutrients, 11(6), 1357. https://doi.org/10.3390/nu11061357
Steliga, M. A. (2018, March). Smoking cessation in clinical practice: How to get patients to stop. In Seminars an Thoracic and Cardiovascular Surgery (Vol. 30, No. 1, pp. 87-91). WB Saunders. https://doi.org/10.1053/j.semtcvs.2018.02.033
Zafari, Z., Li, S., Eakin, M. N., Bellanger, M., & Reed, R. M. (2021). Projecting long-term health and economic burden of COPD in the United States. Chest, 159(4), 1400-1410. https://doi.org/10.1016/j.chest.2020.09.255
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