respond to classmates from an fnp perspective

Please respond to your peer’s posts, from an FNP perspective. To ensure that your responses are substantive, use at least two of these prompts:

Do you agree with your peers’ assessment?
Take an opposing view to a peer and present a logical argument supporting an alternate opinion.
Share your thoughts on how you support their opinion and explain why.
Present new references that support your opinions.

Please be sure to validate your opinions and ideas with in text-citations and references in APA format. Substantive means that you add something new to the discussion, you aren’t just agreeing. Be respectful and thoughtful.This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion and should be correlated to the literature.Minimum of 100 words.
Tracie’s post
The effects of income inequality on her health and ability to be an active participant in her care
Based on Ms. Miller’s presentation and current situation, I am highly concerned about her inability to care for herself due to her working two jobs, awful work hours, and multiple children along with her unemployed partner. According to a recent article, the American Health-Care System increases income inequality (Chokshi, 2018). For most people, going to the doctor once a year is a financial burden. People are faced with high insurance premiums, deductibles, and copays. This is an even bigger burden for someone who has three children and an unemployed significant other. It’s easy to put self-care last when you have so many other people depending upon you. Prescriptions are a whole other financial burden upon itself. This is just for basic primary care for one person. Repeat the process for an entire family; labs, referrals, specialists, emergency-room visits, and surgeries. I am hoping Ms. Miller has some type of government health insurance for her children.
These series of expenditures before, during, and after care is indirectly called having “skin in the game.” A study done by the American Journal of Public Health sheds a light on just how all that “skin in the game” affects the material conditions of patients. This research indicates that household spending on health care is a significant contributor to income inequality in the United States. It also indicates that medical expenses push millions of Americans below the federal poverty line, including 7 million people who make more than 150 percent of the poverty line (Chokshi, 2018). Four million of these Americans are pushed into ranks of extreme poverty (Chokshi, 2018). Studies on inequality and mortality may acquire the most attention, but disparities in morbidity and quality of life are also evident. Low-income adults are more than three times likely to have limitations with routine activities like eating, bathing, and dressing due to chronic illness, compared with more affluent individuals (Chokshi, 2018). Ms. Miller’s case is quite complicated and she really needs help in the sense that her partner should get a job and contribute to the bills. She would be an ideal candidate for future birth control. She needs a lot of education on health, safe sexual practices, and self-care. She would also benefit from some government assistance programs such as WIC and food stamps to help decrease some of the burden of buying food for her family.
Reference
Chokshi, D. (2018, April). Income, Poverty, and Health Inequality. Retrieved from https://jamanetwork.com/journals/jama/fullarticle/2677433 (Links to an external site.)
Charli’s Post
Health disparities she may experience related to her pregnancy, such as the risk for preterm labor and the high rate of infant mortality in low-income women.
There are many factors that play a role in contributing to the increased risk of infant mortality for this current pregnancy for Miss Miller. Diabetes and obesity are two health conditions that create increased risks during pregnancy. The fact that Miss Miller does not have time to follow-up with her health conditions, works two jobs, and has other children to take care of does not help her chance of changing her diet or habits to improve her health outcomes. A person with elevated blood sugars prior to pregnancy that are uncontrolled are at risk for causing birth defects (NIH, 2018).
Women that are of lower incomes have higher risks of giving birth to a baby that is preterm and low-birthweight. They are more likely to experience higher stress levels compared to higher income families which then contributes to inadequate nutritional intake, higher levels of smoking during pregnancy, unhealthy mental health, and poorer access to adequate prenatal care (Brownell et al., 2018). Miss Miller has access to health care, but her busy schedule makes it difficult to make it to her appointments and also find time to go home and be with her children in between jobs. Being she is the only provider for the household, she has higher stress levels than most women in making sure she is able to provide for her family. The other children have responsibilities and needs that the mother will need to meet, but again it is difficult with such a busy schedule of working two jobs.
Lower income families do not always have the money to buy healthy meals unless they get money from the government for food. Eating unhealthy and not on a routine schedule will make it difficult for Miss Miller to control her blood sugars and make sure they are under control during her pregnancy to prevent birth defects in this pregnancy. Unfortunately, this is real life for many women and there are not always a simple fix for these women or an easy change that can be given to them. Providers should try to find resources in their community to help these women if they are willing to receive the help.
References
Brownell, M., Nickel, N. C., Chartier, M., Enns, J. E., Chateau, D., Sarkar, J., . . . Katz, A. (2018). An unconditional prenatal income supplement reduces population inequities in birth outcomes. Health Affairs, 37(3), 447-455,455A-455K. doi:http://dx.doi.org/10.1377/hlthaff.2017.1290

What are some factors that make a pregnancy high risk? (2018). NIH. Retrieved from https://www.nichd.nih.gov/health/topics/high-risk/…
 
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