Nursing Health and Research Problems in Urban Areas

Urban Areas and Nursing Research Problems

 Whats are Urban Communities,Health Issues in Urban Areas,Urban Areas and Nursing Care,Process of Urbanization,Health Outcomes and Disparities in Urban Areas,Chronic Illnesses In Urban Population,Focus of Urban Health Research,Nursing Responsibilities,Nursing Challenges,Innovative Research Projects,Responsibilities of Nursing Researchers In Urban Areas.

Whats are Urban Communities

    Urban communities are home to heterogeneous ethnic, age, and socioeconomic groups, populations that make up a large share of the underserved in this county. These underserved populations face daunting hurdles that challenge their ability to maintain healthy lifestyles. 

    Furthermore, urban environments may provide limited or inaccessible support for individuals seeking health promotion and disease prevention information and services. 

    Many urban environments are marred by poverty, strained school systems, crowded housing, unemployment, a pervasive drug culture, periodic street violence, and high levels of stress. 

    Some health issues resulting from the urban environment include high rates of HIV infections and AIDS, increased morbidity and mortality due to violence, increased morbidity and mortality secondary to substance abuse, the resurgence of infectious diseases (tuberculosis and hepatitis B), chronic illness, and maternal/child health problems.

Health Issues in Urban Areas

    Many of the health problems experienced by residents in urban neighborhoods are preventable, at least in part, through lifestyle changes. Steps also can be taken to reduce health disparities through early identification and treatment. 

    Unfortunately, statistics demonstrate that urban populations do not routinely receive early screening and preventive health care.

Urban Areas and Nursing Care

    When thinking about what urban means, nurses are confronted with a number of images, ranging from shining tall buildings, greater opportunities for employment, upscale housing, and community parks to dilapidated buildings, vacant lots sewn with rubble, high rates of unemployment, congested expressways. , youth gangs, drug dealers and drug addicts, and, most of all, people. 

    Perhaps the images include the stark difference between African, Asian, Caribbean, European, Hispanic, Middle Eastern cultures expressing the diversity and cosmopolitan atmosphere of everyday life in big cities. 

    In some cases, the images are those of opportunity; in others, of despair. Historically, urban images in the United States have tended to oscillate between the positive (cities as innovative, progressive, and modern) and the negative (cities as alienated, pathological, and decadent). 

    Today, popularly depicted urban images include culture, arts, and music; recreation and leisure; and the hustle and bustle of commerce, as well as violent crime, rampant drug abuse, crumbling infrastructure, transportation gridlock, and pollution. 

    These images not only depict sharp contrasts between rich and poor but suggest that the worst states of health are found among urban dwellers exposed to substandard housing, poverty, unemployment, and drug abuse.

Process of Urbanization

    The process of attaching meaning to these images is multifaceted. However, there is no consensus on a common definition of urban. 

    Most definitions include an interrelationship between people (demography) and space: political and administrative boundaries, social and cultural arrangements, economic and technological restructuring. 

    The process of urbanization in the United States has resulted in political, social, economic, environmental, and health changes; At the same time, political, social, economic, environmental, and health changes have influenced the process of urbanization. 

    Urbanization is a dynamic process, and its effects on health are seen and felt in different ways within particular cities and across the nation.

Health Outcomes and Disparities in Urban Areas

       Striking disparities in health outcomes among urban populations provide compelling evidence of the significant health risk these groups experience. 

    The health outcomes described below are observed in non urban populations but are disproportionately seen in urban populations and leisure; and the hustle and bustle of commerce, as well as violent crime, rampant drug abuse, crumbling infrastructure, transportation gridlock, and pollution. 

    These images not only depict sharp contrasts between rich and poor but suggest that the worst states of health are found among urban dwellers exposed to substandard housing, poverty, unemployment, and drug abuse.

    The process of attaching meaning to these images is multifaceted. However, there is no consensus on a common definition of urban. Most definitions include an interrelationship between people (demography) and space: political and administrative boundaries, social and cultural arrangements, economic and technological restructuring. 

    The process of urbanization in the United States has resulted in political, social, economic, environmental, and health changes; At the same time, political, social, economic, environmental, and health changes have influenced the process of urbanization. 

    Urbanization is a dynamic process, and its effects on health are seen and felt in different ways within particular cities and across the nation.

    Striking disparities in health outcomes among urban populations provide compelling evidence of the significant health risk these groups experience. The health outcomes described below are observed in non-urban populations but are disproportionately seen in urban populations.

Chronic Illnesses In Urban Population

Hypertension and heart disease: Thirty-eight percent of Blacks suffer from hypertension; of those, only 25% are managing their disease.

    Obesity: Forty-four percent of Black and Latino women ages 20 and older are obese, compared to 27% for all women and 37% for low-income women.

    Diabetes: The disease is 33% more common among Blacks than among the general population. Latino and Native American populations report elevated morbidity rates from diabetes, often exacerbated by poor nutrition and exercise habits.

    Cancer: Major disparity in cancer rates exist among Blacks, Latinos, Native Americans, the elderly, and poor Americans. Failure to screen is often due to fatalism, lack of knowledge, or limited access.

    General health habits: Poor nutrition, smoking, alcohol and drug abuse, minimal exercise and stress management, along with other risk factors, appear to be more common among people with low incomes, who tend to be urban residents.

      Violence: Men, young adults, and teenagers within minority populations, particularly Blacks and Latinos, are mostlikely to be murder victims. Domestic violence accounts for one of six homicides, particularly among young adults and Blacks.

    Child abuse cases make up a significant portion of urban violence, affecting mostly poor families. Maternal and Child Health Black, Native American, and Latino infants have the highest morbidity and mortality rates in the United States. 

    Low-birthweight Black babies account for most of these deaths, but even normal weight Black babies have a greater risk of death.

    Asthma risk is increased for poor, minority urban residents, both initial attacks and exacerbations. Environmental factors such as air pollution and cockroach allergens have been correlated with emergency room visits for asthma.

 Teen pregnancy has risen for all girls, particularly among poor and ethnic minority groups, with significant social, economic, and health consequences . HIV and AIDS The rates of AIDS among Blacks and Latinos are more than triple that of the general population. 

    Women and their children are one of the largest groups infected. Sexually active teens are a fast growing population at risk for HIV infection. 

Focus of Urban Health Research

    Urban Health Research focuses on the following processes, which form a circular link:

    Identifying methodologies and models for developing culturally sensitive research approaches, data collection instruments, and program evaluation instruments.

  Building partnerships with community members, nurses, and other health professionals who have community-based practices and with transdisciplinary researchers to identify and prioritize urban health issues that need investigating.

    Determining the most effective, culturally sensitive health promotion and disease prevention intervention strategies and best practice models for the targeted urban setting.

    Implementing the most effective health promotion and disease prevention intervention strategies and best-practice models within the targeted urban community while simultaneously collecting evaluation data that will be used to modify the implementation process as needed.

Nursing Responsibilities

    As nurses we must be concerned about how the issues of urbanization affect the health of urban communities. Residents of such communities are the most reliable sources for this information. 

    However, they are not likely to volunteer this information either because of distrust of researchers or the perception that their opinions or facts are not valued by nurses or researchers. 

    Hence, one of the early steps in the urban health research process is to empower and recruit urban community members, especially minorities, to become active research partners, not just participants, in research programs. 

    The overall goal of urban-related nursing research is to integrate scientific knowledge, professional skill, community input and support, and political advocacy of health promotion and disease prevention in an effort to create and maintain healthy urban communities. 

    To achieve this goal, nurse researchers in urban settings, with community input, must seek to develop, test, and disseminate health care interventions, tailored to address the major urban health care issues, that are found to be scientifically sound, culturally relevant, and effective. 

    Once identified, the urban related nursing research process continues with the implementation of effective interventions and best practices within the community while maintaining overall health care costs. 

    When logistically feasible, it is advisable to take the programs or practices to the target populations because this approach tends to foster participant.

Nursing Challenges 

    Nurses can meet the challenges of addressing the needs of urban community residents by using a multidimensional approach that focuses on their social, psychological, biological, and environmental needs. 

    Historically, nurses have viewed the recipients of their care in a holistic manner, taking into account all domains that have an impact on their lives. This approach is particularly useful with urban minority populations, who tend to experience many different stressors and who also tend to value the interpersonal process.

Innovative Research Projects

    Through innovative research projects, innovative educational programs, and new strategies for providing services, we can meet their needs. For today, urban health is a priority. 

    With the recent economic trend that is moving health care from hospitals to the community, current nursing students are being prepared to shift their work setting to the community and to interact with clients in their “home environment.” 

    This educational preparation should result in better health care as well as stronger client advocacy, another important aspect in the process. Nurses in the future will increasingly work in community-based settings such as homeless shelters, community clinics, small independent practices, schools, and church clinics. 

Responsibilities of Nursing Researchers In Urban Areas

    To summarize, for programs of nursing research to be effective in urban communities the researcher must do the following:

    Design programs that are based on a comprehensive needs assessment, including an identification of the target population. Make programs accessible and affordable to the target population. 

    Ensure that the programs are culturally competent and relevant to the target population (ie, consistent with norms, attitudes, beliefs, and attitudes). Members of the target populations should be included in program design, implications, and evaluation.

    Ensure that the programs are consistent with the social and community norms of the target population so that program participants will receive consistent messages and reinforcement for the prescribed health behavior plan.

    Address the linguistic needs of the target population (ie., with translators and health and education reading materials in the community's native language and at the appropriate reading levels).

    When applicable, ensure that programs meet the needs of the deaf and hearing impaired members of the target population, as well as those with developmental disabilities.

    Residents of urban communities have numerous health care challenges. Fortunately, nurses with the proper education and training can emerge to provide excellent compassionate and innovative care and to design culturally competent and theory driven intervention that will produce positive healthy outcomes. 

    One advantage of meeting this need is the fact that most schools of nursing are located in urban communities, which enhances the interaction between and among nurses, community members, and researchers. 

    Nurse researchers are not the only ones who benefit from such interaction; students and the people in the community also benefit. Nursing research projects designed and implemented by building bridges with the community can provide the most effective and cost-effective community-based health care.