RESPONSE TO DISCUSSION QUESTION

DISCUSSION QUESTION 1

 For community clinical, I will be at Sarah’s House. While specific Community Health Needs Assessment (CHNA) data is not readily available for preexisting studies online, we may, to a degree, discern much about the needs of this community by considering the services that Sarah’s House offers alongside the publicly available federal reports that compile current data and trends describing the status (local determinants of health, nature, and extent of community need) of Anne Arundel County. The point of a CHNA is to, essentially, give the community a voice about what members believe to be the highest priorities to address to support the wellbeing of their community. Therefore, although we may compare services offered by Sarah’s House with local county data, there is significant value in conducting a CHNA proper to initiate truly meaningful interventions that community members can buy into, partake in the development of, and benefit most fully from.

 

Sarah’s House participates in Anne Arundel County’s Continuum of Care Homelessness Partnership, which is a coalition that is “tasked with promoting community-wide commitment to ending homelessness, creation of and access to mainstream programs by people experiencing homelessness or at risk of homelessness, and optimizing self-sufficiency within our community (Breakstone, 2022). This is a federal coalition designated by the US Department of Housing and Urban Development. Notably, Sarah’s House is also one of only four of its kind that is supported by the U.S. Army, and appropriately is in the city/near the Military base Ft. Meade. Sarah’s House services, specifically, include housing (emergency Shelter, project-based supportive housing, rapid re-rousing services, daily meals, comprehensive employment services, skills for success classes, comprehensive case management, behavioral health services, employment & non-emergency medical appointment transportation, and referrals to community service providers for families, especially with children, in Anne Arundel County (Andrew, 2021).

 

According to the Maryland Annual Report on Homelessness, Anne Arundel County represents only 6% of Maryland’s population with the majority being children, adults, and families. Non-Hispanic and Non-Latino, White, and Black were the leading racial demographics experiencing homelessness in Anne Arundel County, and over half experience chronic homelessness. Of all homeless persons in Maryland, the report detailed that veteran made up 7.5% of the total (DHCD, 2021). There is also data from a CHNA done for Anne Arundel County (AAC), 2019. With regards to the services provided by Sarah’s House and our interest in this community’s health needs in particular, the report describes how there is a major issue with affordable housing in Anne Arundel County, and a diminishing amount of public and subsidized housing in the county. “The county served 1,684 homeless individuals in 2017,” which is a 13 percent increase since 2015.” This tells us that there 1. There is a need, 2. that is in a process of being addressed, but there is also a significant waiting list for “housing choice vouchers” (10,278 families total) with an average of 966 days of waiting (Brown, 2019). Finally, considering CHNA data compiled by UM BWMC for Anne Arundel County 2022, housing instability is a significant problem especially amongst extremely low income, families with children, and African American people. There is a major correlation between homelessness and health conditions such as heart disease, which is the leading cause of death nationally and in AAC. And lastly, rates of opioid overdose highest in Glen Burnie (17.28%), the city in which Sarah’s House is nestled in between with Ft. Meade (BWMC, 2023).

 

With all, clearly there is a need for homeless services in Anne Arundel County and Sarah’s House has positioned itself to fulfill the need. However, there are many other needs that also need to be addressed, and it will be very important to conduct a CHNA of the local community ourselves in order to best consider how we, as nursing students charged with this responsibility and practice, can leverage available resources and generate local support for interventions that will take the next step in addressing the needs for wellbeing in this community.

 

DISCUSSION QUESTION 2

I have my Practicum at Adventist Healthcare Shady Grove Hospital (AHC). AHC Shady Grove Hospital receives a lot of labor and delivery patients. Subsequently, they have a prenatal care program where patients can get prenatal care, routine laboratory tests, prenatal classes, and a dental screening (Adventist HealthCare Shady Grove Women’s Center, 2023). This programs’ services include mother and infant care, people without health insurance, pregnant women, and low income (Adventist HealthCare Shady Grove Women’s Center, 2023). Thus, pregnant women who are not U.S. citizens or legally living in the U.S. are eligible to apply.

A prenatal care program is especially beneficial for AHC’s population of expecting mothers because it reduces the amount of pregnancy complications and defects, ensures mothers have access to resources, and keeps the mother and baby healthy (U.S. Department of Health and Human Services, 2023). For example, making sure the mother controls “existing conditions, such as high blood pressure and diabetes, is important to prevent serious complications and their effects” (U.S. Department of Health and Human Services, 2023). Therefore, it is very important for mothers to receive prenatal care earlier, ideally the start of the first semester to ensure early diagnosis, intervention, and eliminate/reduce preventable maternal and infant morbidity and mortality (Montgomery County Maryland).

While I was unable to find specific statistics from Adventist Healthcare Shady Grove Hospital, Montgomery County had an overall decreasing trend for the percentage of births with late or no prenatal care. In 2017, the percent of births with delayed or no prenatal care was 7.1% (Montgomery County Maryland, 2023). Also, it was found that “the percentage of births with late or no prenatal care in the County has been consistently lower than that of Maryland” state (Montgomery County Maryland, 2023). In conclusion, the AHC Shady Grove Prenatal Care Program does a great job in meeting the needs of its patient population.