Community Leader Perspective on Major Health and Socioeconomic Disparities
The Chairman of the Ethics committee at Lawrence Memorial Hospital raised a number of major health and social economic disparities within local community. The health and social-economic disparities that were raised are not limited to suboptimal insurance, the need for multiple but low paying jobs and lack of access to reliable transportation. Additionally, the chairman of the Ethics committee in this facility has also stipulated key initiatives which should be embraced in order to address these major health and social-economic disparities. This paper describes these recommendations and how they may be incorporated into the delivery of care by the Advanced Practice Registered Nurse.
Enhancing access to public transportation
Accessibility to health care facility is a major factor that most governments, both the developing and the developed ones focus on in as far as ensuring that every citizen can access quality health care services. Apparently, in our community, the health care facilities are located at a far distance and, therefore, most individuals find it challenging to seek for health care services whenever they are unwell. Besides this, the access and cost of public transportation system is high, and this means that majority of the community members cannot afford it. Precisely, due to the lower accessibility and high cost of transport, most individuals opt to stay at home when they are sick, and only visit the health facility when the situation has worsened. This leads to poor health, high mortality and morbidity rates since they only opt to struggle in seeking health care services when the disease that they are suffering from progresses to advanced levels. Additionally, the community members cannot embrace healthy behaviors such as visiting the health care facilities for disease screening as well as family planning methods due to the limitation of distance and cost.
In order to increase access of public transportation in the community, there are a number of measures that can be embraced. For example, the national government in collaboration with the local government should not only increase the number of public vehicles transporting people to and from the health facility, but also subsidize the cost of transportation. Additionally, the number of ambulances should be increased in order for them to be ready to go for patients who might be in need of health care services within the community. By so doing, majority of the locals will manage to access quality health care services whenever they need them. This recommendation can be incorporated into the delivery of care by the Advanced Practice Registered nurse in numerous ways. For example, the Advanced Practice Registered nurse should in the forefront in pushing for the increase of the number of ambulances in their respective health care facilities.
In addition to this, the Advanced Practice Registered nurse should distribute a call number to the health consumers every time they visit the health facility in order for them to call for ambulance whenever they feel they are unwell and cannot manage to access or afford a public transportation system. Additionally, the Advanced Practice Registered nurse should collaborate with the other health care professionals and support systems in order to ensure that individuals who call for ambulances are assisted adequately and in a timely manner. Moreover, after attending and discharging patients, it is the role of the Advanced Practice Registered nurse to conduct follow-ups in order to ensure that the patient are recovering well and adhering to the prescription (Birks et al., 2016). This is important since majority of the patients may fail to honor doctor`s appointment dates due to the prevailing challenge of inaccessibility and unaffordability of public transport system.
Employers sympathizing or pardoning employees who fail to report to work in a timely manner after they seek for access of health care services
It is unfortunate that most employers focus more on the flow of operations within their organizations than the health of the employees. Additionally, the employers should at least take time to listen to the reasons that employees give concerning why they are late to work or absent from the working stations the whole day or week. It is unfortunate for some employers of the casinos to terminate their contracts with the employees even without considering the reasons why the employee has been late or absent from work. Though, there are some unethical characters such as some employees faking stories in order to convince the employer why they are late, there are mechanisms which the latter can embrace into to establish whether the reasons given by the former are genuine or not. This recommendation can be incorporated into the delivery of care by the Advanced Practice Registered nurse by signing the medical leave out that the employee may be having in order to serve as a confirmation of indeed the latter had visited the health care facility.
Optimizing the health insurance cover
In order to optimize the health insurance cover, there is need to set up specialty offices for major specialties next to their respective health care facilities and these facilities must be mandated to accept State insurance. It is unfortunate that most of the local specialists in our community do not accept Medicaid cover for most of the health consumers even when they have a referral from an ER. This recommendation can be incorporated in the delivery of care by the Advanced Practice Registered nurse through ensuring that the latter sets the pace to the other nurses, orthopedics and dermatologists in accepting the insurance cover of the local patients. If the Advanced Practice Registered nurse can be in the forefront of accepting Medicaid covers of the locals, the other specialists, especially the orthopedics and dermatologists whom the Chairman of the Ethics committee at the Lawrence Memorial Hospital has pointed out as the most offenders, then the others will follow suit. Additionally, the Advanced Practice Registered nurse should advocate for the establishment of specialty offices near major health care facilities in order to reduce the burden of most locals being forced to travel for long distances in order for them for their health care services to be covered by the Medicaid insurance policy (Pellegrini et al., 2015). It is unfortunate that at the moment, most locals are forced to travel to either New haven or Hartford in order for their medical costs to be covered by the insurance. Considering that most of the locals are low income earners coupled with the lower accessibility and affordability of the public transportation system, most patients rarely manage to travel to these two health facilities. Additionally, the Advanced Practice Registered nurse should be in the forefront in advocating for the reduction of waiting times not only at Yale and UConn, but in all health facilities.
Enhancing educational levels among the locals
Low education among the locals is a major factor which have been contributing to unhealthy behaviors among them, which in the long run contributes to the development of numerous communicable and non-communicable diseases. Despite the fact that most of the locals are the adults and going back to school is close to impossible, there is need for enhancing health education in this population in order to raise awareness concerning how to keep themselves free from lifestyle diseases. Years of completed education as well as educational experiences influences the health of an individual (Adler et al., 2016). For example, individuals who are educated shun themselves from unhealthy behaviors such as smoking, sedentary lifestyles, and taking uncontrolled diets and this is due to the fact that these individuals tend to be aware of the dangers that these practices may have to their health. Instead, individuals with education embrace healthy behaviors such as taking balanced diets, regular physical exercises, and regular screening of various non-communicable diseases (Pellegrini et al., 2015). This can be incorporated in the delivery of care by the Advanced Practice Registered nurse by ensuring that regular health education campaigns are conducted within the community. The Advanced Practice Registered nurse should be in the forefront in as far as running of these programs is concerned. Additionally, within the health care setting, the Advanced Practice Registered nurse should also try to enlighten the patients concerning the importance of embracing healthy behaviors such as disease screening and regular exercises.

References
Adler, N. E., Cutler, D. M., Jonathan, J. E., Galea, S., Glymour, M., Koh, H. K., & Satcher, D. (2016). Addressing social determinants of health and health disparities. Vital Directions for Health and Health Care Initiative: National Academy of Medicine Perspectives.
Birks, M., Davis, J., Smithson, J., & Cant, R. (2016). Registered nurse scope of practice in Australia: an integrative review of the literature. Contemporary Nurse, 52(5), 522-543.
Pellegrini Filho, A., Solar, O., Rígoli, F., de Salazar, L. M., de Andrade, L. O. M., Serrate, P. C. F., … & Atun, R. (2015). Social determinants of health, universal health coverage, and sustainable development: case studies from Latin American countries. The Lancet, 385(9975), 1343-1351.