Little Havana: Health, Illness, Health Promotion and Disease Prevention in the Community

Introduction

Little Havana is the community that is considered to be a home for many Cuban immigrant residents. Approximately 98% of Hispanics live in Little Havana. The population of Little Havana is 76, 163 residents (The Health Foundation of South Florida, 2015). In the present time, Non-Hispanic White, African American, and Hispanic residents live here. Such mix of ethnicities can provoke a number of social dilemmas. People of Little Havana are involved in restaurant and tourism business since they live in the center of Cuban culture with many sights of interest. The median income of residents is $15, 213. Little Havana has many churches, parks, educational establishments, museums, and theaters that attract tourists worldwide (The Health Foundation of South Florida, 2015). Despite being a center of political, cultural, and social activity in Miami, Little Havana deals with many issues related to healthcare. Consequently, current research paper intends to describe the perspectives of health, illness, health promotion, and disease prevention in the community of Little Havana.

Review of Literature

The perspectives of health in Little Havana are related to the state of medicine, demographic situation, and the increase of cancer among the residents. Little Havana has no hospitals but several clinics including the Rafael Penalver Clinic. However, it is not enough taking into consideration the homelessness and poverty rates. Poverty level varies from 25 to 50% in Little Havana, and it is an alarming statistics for the community that is involved in the cultural development and tourism business (The Health Foundation of South Florida, 2015). In addition, Little Havana has several private clinics that provide services only to Hispanics. It is evident that ethnical division of population only worsens the situation in Miami neighborhood. There is also the Little Havana Activities and Nutrition Center that provides social and health-related services. It means that the perspectives of health should be based on such social issues as homelessness and poverty that are the reasons for many diseases (James, 2013).

The number of diseases is constantly increasing in Little Havana. The most widespread ones are cardiovascular disease, cancer, respiratory disease, injuries, diabetes, potentially disabled conditions, and HIV. The actual causes of diseases and deaths are related to nutrition, physical activity, weight status, substance abuse, and tobacco use. The research of Little Havana’s socioeconomic environment (poverty, racial segregation) is beneficial for the decrease of diseases. In Little Havana, adults who experience fair or poor general health include the following groups: Blacks (15, 9%) and Hispanics (24, 1%), residents having the low incomes (45%), those between the age of 40 and older (23%), and women (23, 3%) (The Health Foundation of South Florida, 2015). Moreover, the residents of Little Havana suffer from mental disorders that are caused by the low income, poverty, social issues, and inequalities. The number of diseases creates the necessity of determining the areas for community health improvements.

As the number of vulnerable people in Little Havana is increasing significantly, health promotion is a necessity for this area. Health promotion should be based on the following interventions: (1) financial availability of medical services, (2) opening more healthcare organizations, (3) the equal treatment of people of all ethnicities, (4) implementation of healthcare programs and treatment courses, and (5) improvement of social policy of Little Havana. Another way of promotion should be related to the increase of access to health services via improving the health insurance coverage, primary care services, and emergency rooms. Prior to improving the healthcare level, it is crucial to increase the general health status helping people to deal with the emotional and mental disorders (The Health Council of South Florida, 2013).

According to Beattie's model, health promotion in Little Havana should be based on community development, personal counseling, legislative actions, and health persuasion (Woolf, Johnson, Fryer, Rust, & Satcher, 2004). The aspects of Beattie's model can be used for disease prevention in Little Havana. Health persuasion can be based on the advertisement of healthcare services and medical programs. Consequently, the residents of Little Havana will be aware of the opportunities provided by healthcare organizations. Legislative actions presuppose the implementation of resources policy, laws, and regulations that control medicine. Every resident should receive personal counseling related to controls, plans, and personal objectives. In addition, community development is required to achieve socializing and empowerment of the community skills. It is evident that disease prevention has not only medical but also social, economic, political, and legal character (Hawkins, Catalano, & Arthur, 2002). However, medical response to diseases in Little Havana will be the most relevant and crucial.

Description of the Community of Little Havana

Health, Beliefs, Definition of Health, Illness, and Overall Status of the Community of Little Havana

Little Havana consists mostly of Hispanics (98%) (The Health Foundation of South Florida, 2015). Consequently, the community of Little Havana is interested in the improvement of their health status. The residents of Little Havana believe that the surroundings have an influence on their health. They consider Little Havana a safe place with a good transportation, housing, access to healthcare services as well as high quality and affordable food. However, these beliefs are not fully objective as the disease rate is constantly increasing. The overall health status of Little Havana community is normal since 50% of the population is healthy. “Compared to the county and state, the percentage of people aged 65 and older is higher” (Sylvester Comprehensive Cancer Center, 2015). Consequently, the community of Little Havana is in a need of better health services, increasing coordination, developing a plan of action, and bringing the community together. Health Foundation of South Florida provides the financial support of $3, 75 million to Little Havana. Moreover, they believe that government officials, donors, non-profit organizations, groups, and residents should be involved in the process of health status improvement of the Little Havana community.

The causes of illnesses in Little Havana are diverse. First, they are related to poor eating habits among population. Junk food is very popular in this community as it is cheap and does not require cooking. However, people ignore the fact that junk food can cause cancer and diabetes that are the leading reasons of death. Moreover, the wrong food combination, for example eating meat with fruits, can also provoke fatal diseases. It is obvious that eating should be healthy. Due to being religious people, Hispanics consider Alzheimer’s disease and cancer a punishment from God. According to the Health Foundation of South Florida (2015),18% of Hispanics suffer from diseases because of the enormous use of tobacco while 17% of Hispanics undergo illnesses because of passive lifestyle and failure to follow the healthy diet. In addition, 4% of Hispanics suffer from diseases because of the alcohol abuse that is the main cause of liver disease. However, it is evident that 30% of Hispanics suffer from cancer, diabetes, and cardiovascular diseases because of genetics (The Health Foundation of South Florida, 2015). Consequently, people cannot avoid them but should find the ways to overcome them.

Methods of Maintaining Health Used by Little Havana Community

Little Havana community is conscious of their health problems. As a result, they have their particular methods for restoring and protecting health. For supporting their health, Little Havana residents try to eat a healthful diet and maintain their weight to avoid cardiovascular diseases and cancer. Physical activity is another way to restore health as it can lower the risks of such diseases like diabetes, cancer, and depression. It is recommended to increase the level of activity at work and make the leisure time more active. Little Havana community tries to establish the interaction between health education and development and implementation of public policy as it is the way to healthcare improvements in general. Another method for maintaining health is supporting weight status. Little Havana is the place of many fast food restaurants. Consequently, overweighting is widespread among the residents. Little Havana community is interested in following diets and opening restaurants with the healthy meal. For restoring health, the residents of Little Havana use home remedies and visit health centers. However, the problem is that Little Havana has no enough hospitals.

Child Bearing/Rearing Beliefs and Practices

Child bearing beliefs and practices of the residents of Little Havana differ from those used in American. Hispanic people preserve their ethnic customs and traditions. First, they use preventive healthcare measures rarer comparing with other ethnicities. Hispanic women try to minimize breast examination. Consequently, many of them suffer from breast cancer. It is worth noting that they pass this practice to their children. In Little Havana, a mother is the only person who cares for children. Therefore, a father participates rarely in child’s upbringing. The practice of abortion is unacceptable for the Little Havana community as they believe that it is a sin. Moreover, Hispanics believe that wearing a bracelet or other magic things can protect them from illness. Hispanics suppose that birth abnormalities among children cannot be the result of parents’ alcohol or drug abuse but a divine punishment. In addition, these beliefs are passed from generation to generation in the community of Little Havana.

Rituals and Beliefs Surrounding Death and Dying

In the Little Havana community, rituals and beliefs surrounding death and dying differ from American ones. There are even such families that do not send their ill family members to hospitals. Hispanics believe that death is inevitable, and medicine cannot help to avoid it. For Hispanics, dying is the transferring to another phase of life. The residents of Little Havana try not to complain about pain and illness and regard them as the test of individuals. However, women express grief openly. Consequently, it becomes evident that rituals and beliefs are more persuasive for Hispanics that any healthcare practices. The residents of Little Havana accept the death as a part of their being. That is why healthcare employees should always take into consideration and respect rituals and beliefs surrounding death and dying in order to avoid cross-cultural conflicts.

Community Project

Current Healthcare Problems

Current healthcare problems in Little Havana are related to the constant increase of such diseases as septicaemia, influenza, pneumonia, kidney disease, Alzheimer’s disease, diabetes, unintentional diseases, respiratory diseases, stroke, cancer, and heart disease. The increase of diseases provokes the necessity of opening more clinics and hospitals since the existing ones cannot cope with the number of patients. There are the following public health dilemmas: economic (lack of money for healthcare programs and new healthcare establishments); social (poverty, homelessness, unemployment, poor conditions of living); political (legal interventions conflicts); environmental (water, air and land pollution). It should be mentioned that the level of access to health services in Little Havana is extremely low. “While the interdependence of health outcomes, insurance coverage and access to care is widely recognized, affordability is a major barrier for the uninsured” (The Health Council of Florida, 2013:207). First, the lack of health coverage and insurance instability makes people disappointed with medicine and its efficacy. The difficulties accessing healthcare services are related to lack of transportation, the problem of finding a physician, cost of clinics visit and prescriptions as well as inconvenient office hours. Second, the overall health status of the Little Havana community is a source of concerns.

Health Promotion and Disease Prevention in Little Havana

Health promotion and disease prevention in Little Havana are based on the following areas of impact: (1) nutrition and healthy eating; (2) primary healthcare; (3) mental healthcare; (4) prevention of alcohol and substance abuse; (5) physical activity. “Live Healthy Little Havana partners are committed to building a community that supports physical activity by reducing the barriers to physical activity and creating an environment in which every Little Havana resident can safely engage in physical activity” (The Health Foundation of South Florida, 2015).

Without doubt, the preventive measures are not limited to medical ones. Medical health promotion presupposes implementation of health programs and opening hospitals that are necessary for the improvement of healthcare policy, promotion of healthy lifestyle, and decrease of the disease rate in Little Havana. Another way of health promotion is to improve mental health status as depression and emotional disorders can be the reasons for many diseases. In Little Havana, 12,6% of residents have poor mental health. The statistics shows that Hispanic women with low incomes suffer the most from mental disorders. As a result, for mental health improvement, overcoming depression, stresses, and worries, residents of Little Havana have to do sports, follow diet, and avoid harmful habits. According to the Health Foundation of South Florida (2015), 40% of diseases are the result of lifestyle and behaviors. It is worth noting that practicing healthy lifestyle has become popular even in such a small community as Little Havana.

According to the Health Council of South Florida (2013), “Educational and community-based programs play a key role in preventing disease and injury, improving health, and enhancing quality of life.” It means that for health promotion and disease prevention, it is crucial to involve the whole community and make health status a key priority that is the result of healthcare, economic, political, social, and environmental activities in Little Havana.

The Implications for Nursing Science

The evolution of nursing science is another step for health promotion and overcoming the most dangerous diseases. First of all, there is the necessity in professionalization of healthcare establishment as the lack of hospitals hinders the necessary rehabilitation and treatment in the Little Havana community, thus provoking self-treatment that in most cases can be harmful. The standards of nursing education and practice are steadily increasing worldwide. Consequently, such community as Little Havana should also be more concerned with the state of affairs in nursing and healthcare practices. Quality and safety are the indicators of a good nursing science (Wachter, 2012). Another implication for the development of nursing science is quality medical education that helps to have the competent and qualified healthcare specialists. The state of affairs of medicine and healthcare in Little Havana proves that pharmacists, nurses, doctors, and other health professionals are not adequately prepared to provide the safest and the most qualitative medical care. Consequently, the following implications are necessary to change the situation: (1) using information technologies; (2) practicing evidence-based medicine; (3) focusing on quality improvement; (4) delivering patient-centered care (Herrman & Jane-Lopis, 2005). It is important to make the healthcare programs more effective in teaching humanities, technology, social science, natural sciences, and nursing science as they are the basement for the qualitative nursing.

Summary

After analyzing the Little Havana community, it becomes evident that its residents deal with many challenges related to the perspectives of health, illness, health promotion, and disease prevention. First, the residents of Little Havana can receive the innovative healthcare services if they attach higher importance to quality of medical services. Second, high health care standards are the result of favorable healthcare, political, social, economic, and environmental conditions. Third, disease prevention is another goal of the Little Havana community that can be achieved with the help of active lifestyle and healthy diet. Moreover, it is evident that ethnicity of the community is also the determinant of the health status. As the major population of Little Havana is Hispanics, sometimes, their cultural values and beliefs contradict to the established healthcare principles (the attitude to abortion, breast examination, the differences in child bearing, the attitude to death and dying). The methods of maintaining health are diverse, and they vary from person to person. Some residents believe in medicine and prefer their treatment techniques while others try to change their lifestyle to avoid stresses and depressions. The current healthcare priorities are related to nutrition and healthy eating, primary healthcare, mental healthcare, prevention of alcohol and substance abuse, and physical activity.

It is worth noting that effectiveness of health promotion and disease prevention can be achieved through collaboration of the healthcare, government and public organizations with the residents of Little Havana. The aim of the healthcare organizations is to provide the qualitative services. The healthcare specialists should be sensitive, respectful and tolerant to the ethnic peculiarities of every patient.

Recommendations

To improve the health status of the Little Havana community, it is recommended to elevate the general quality of life. Physical and mental illnesses are the major barriers to healthy life. Another step is to reduce the health disparities among the residents of Little Havana. In addition, it is recommended to increase the access to preventive services for all residents. Health promotion in Little Havana should be based on improvement of social policy, implementation of healthcare programs and treatment courses, the equal treatment of people of all ethnicities, opening more healthcare organizations, and financial availability of medical services. It is crucial to promote physical activity in Little Havana with the support of social interventions and fulfilling the community’s health needs and goals. In addition, crime prevention is essential for reducing physical violence that leads to the emotional and physical diseases. To improve the health status of the Little Havana community, it is recommended to prevent the alcohol and substance abuse with the help of social projects, trainings, and consultations. Moreover, it is obligatory to support mental healthcare with the help of screening risk factors that lead to psychic disorders. Additionally, Healthcare of Little Havana residents can be improved via delivering patient-centered care, focusing on quality improvement, practicing evidence-based medicine, and using information technologies.

It is also recommended to reform healthcare system and follow the severe equality policy in Little Havana. Only the complex of these actions, strategies and practices will bring positive results and increase the overall health status of the community. However, the recommendations have the following limitations: low income, cultural peculiarities, improper collaboration between healthcare institutions, government and social organizations.