Running head: SARASOTA COUNTY

Sarasota County: Evidence-Based Community Interventions

Liza McGill
University of South Florida
Community/Public Health Nursing: Population-Focused Nursing

SARASOTA COUNTY

Sarasota County: Evidence-Based Community Interventions

Geographic Location
Sarasota County, located in the state of Florida, was established in 1921 but adopted a
home rule charter in 1971. Situated approximately 60 miles south of Tampa, Sarasota lies
between Charlotte and Manatee counties (Sarasota County, 2015). Sarasota County is a rural and
semi-rural area. The land area of the county is 555.87 square miles. It includes the cities of
Venice, North Port, Sarasota and the Town of Longboat Key (Sarasota County, 2015). Its
population in 2014 was 396,962 compare to Floridas state population of 19,893,297 (United
States Census Bureau, 2015). However, in the winter months the population swells to over
480,000 (Sarasota County, 2015). Three major employers are School Board of Sarasota County,
Sarasota Memorial Healthcare System and The Sarasota County Government (Economic
Development Corporation, 2011). Sarasota County has a network of hospitals, pharmacies,
county health departments and private health care providers that make up their healthcare
systems.
Population and Socioeconomic Factors
The U.S Census Bureau reported that the percentage of families below poverty level in
Sarasota County from 2009-2013 was 12.2%, while the state percentage is higher at 16.3%.
During the same years, the population in Sarasota County over age 25 with a high school
diploma was 91.9% which is 5.8% higher than the states proportion of 86.1%. The population
of children greater than age 5 that does not speak English is 13.0%, which is 14.4% below the
states 27.4% (United States Census Bureau, 2015).

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The focus of this paper is to investigate hypertension cases in Sarasota County as

hypertension is a key contributor to the high rate of stroke and heart disease. Finally, a number of
evidence-based preventions will be recommended.
Strengths and Need-based Data
Sarasota County is ranked sixth overall in Florida in health outcomes (Florida Charts,
2015). This shows that the county is taking measures to prevent and teach the population on how
to live healthy. One indicator that demonstrates the strength of health is the percentage of adults
who have any type of health insurance coverage. Rationale is that having health insurance gives
you better and easier access to proper health care. In 2013, the countys insured population was
80.3% compared to the state with 77.1% (Florida Charts, 2015). Another strength is that 27.1%
of the population lives within a half mile radius of a healthy food source compared to that of the
state with 31.8%. Another good health indicator is that the rate of vaccine preventable pertussis
from 2012-2014 was 5.0 compared to 3.5 in the state (Florida Charts, 2015). The basis is that
pertussis vaccine has a significant impact on maintaining quality of life for adults and children.
As Sarasota has strengths, also have areas that need improvement. An area with room
for improvement is the quantity of adults diagnosed with high cholesterol. Having high
cholesterol increase the risk of heart disease and in Sarasota county the rate for high cholesterol
was 44.9% compare to the state with 33.4% (Florida Charts, 2015). Another area that needs
improvement is the number of adults who are current smokers. Smoking can lead to cancer and
other health issues. In 2013, the rate of smokers was 18.4% compare to the state with 16.8%
( Florida Charts, 2015). Further, the number of adults diagnosed with hypertension needs to be
lowered. Hypertension increases risk of stroke, heart disease and many more health-related

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issues. In Sarasota County, 37.5% of people were diagnosed with hypertension compared to the
state with 34.6%. (Florida Charts, 2015).
Choosing from the health indicators, hypertension will be the priority health issue focus
in this paper. Hypertension is most important to focus on because of its harmful effects on vital
organs. For example, it can decrease blood flow to the heart and cause a heart attack. Moreover,
high blood pressure can burst or block arteries that supply oxygen to the brain causing a stroke.
High blood pressure also can cause chronic kidney disease (Center for Disease Control, 2014).
According to CDC, about 70 million American adults (29%) have high blood pressure; thats one
out of every three adults. Only about half (52%) of people with high blood pressure have their
condition under control (2014). Also, according to Florida charts, hypertension is the main risk
factor for stroke (2015). For these reasons, hypertension is an essential topic of focus.
Community Health Models
Anything that influences health status is known as a determinant of health. The
determinants of health model shows that it is the interrelationship among factors such as policy
making, social factor, health services, individual behavior and biology and genetics that
determines an individual or a population health status (Healthy People 2020, 2015). For the
community health nurse to be able to develop appropriate interventions to address a population
based issue, she or he has to take into consideration the various factors that can influence health
outcomes.
The factors that contribute to the high percentage of older adult people with hypertension
in Sarasota County are individual behavior, biology and genetics. According to healthy people
2020, older adults are biologically prone to be in poorer health due to the cognitive and physical
effects of aging (2015). In Sarasota County, 31% of the population is over 65 years old compared

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to that of the state which is 17.8%. According to Cohen et al, there is a larger connection
between the onset of hypertension and age in people over 50 years old (2012). Individual
behaviors that directly relate to hypertension include diet, physical inactivity, and high alcohol
consumption (Healthy People 2020, 2015). The Florida Charts show that Sarasota County has a
higher percentage of elderly, alcohol consumption, smokers and high cholesterol by its people
than that of the whole state (2015). Other factors that contribute to hypertension are
environmental stress, lack of availability of healthy food and lack of insurance but these are not
the main issues for the high rate of hypertension.
For the negative nursing diagnose, the population subgroup is older adults with a risk
situation for hypertension. The population characteristic related to the risk of hypertension are
diet, smoking, drinking and age. These risk characteristics are supported by the determinants of
health categories individual behavior, such as substance abuse and diet, and biology and genetics,
such as aging.
Evidence Based Interventions
Primary preventions are services aimed to prevent diseases to health before they occur.
In the primary prevention of hypertension the recipient would be the community. The
interventions here would be to educate the community about various lifestyle changes.
According to Whelton, a combination of increased physical activity, moderation in alcohol
intake, and consumption of a diet that is lower in sodium content and higher in fruits, vegetables,
and low-fat dairy products represents the best approach for preventing high blood pressure in the
general population and in high-risk groups (2002). This could be accomplished by distributing
flyers, posters and pamphlets at doctors office, libraries, and schools with the information easy to
understand and read. The information for the interventions would be geared towards the

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stakeholders, the healthcare providers. The nurse would ensure that information gets to the
patient. Also, the nurse could work with the healthcare providers to provide teachings and
evaluations.
Secondary prevention is reducing the impact of a disease that has already occurred by
slowing or halting its progression. The recipient would be the individual. The intervention for
this would be to screen the individual by doing routine blood pressure check at the doctors office.
According to The Association of Faculties of Medicine of Canada (AFMC), screening
procedures (e.g., routine blood pressure checks) are often the first step, leading to early
interventions that are more cost effective than intervening once symptoms appear (2015). The
stakeholders would be community members and healthcare providers. The community nurses
role would be to help with the screening process and to work with the providers to follow up
with the patient to see how they are doing.
Tertiary prevention is helping those with ongoing illness to manage their illness longterm to help improve their ability to function. The recipient would be the individual. The
stakeholders would be the healthcare providers. The intervention would be to monitor effects of
the medication or treatment plan of the patient. According to AFMC, ensuring regular check-ups
to monitor patient condition for any adverse outcome is important (2015). The nurse would
encourage the patient to keep a dairy to help remember appointments and track their health
progress. The nurse could also do a follow up to reevaluate the progress.
Health Policy Proposal
According to world health organization, "Health policy refers to decisions, plans, and
actions that are undertaken to achieve specific health care goals within a society" (2015). Health
policy can have positive impact on the people of the community by allowing them to engage in

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healthier lifestyles. Hypertension is a serious concern in Sarasota, so secondary prevention would

be most beneficial. The health policy proposal would be to educate patients about medication
compliance as many patient stop taking their medication as soon as their blood pressure level
goes down or normalize thinking that they are cured. The desired goal is to prevent further
complications such as stroke or heart disease. Stakeholders that would be affected by the
proposal are community members and healthcare providers. One supporter of the proposed
health policy would be the healthcare providers. They are aware of how important it is for the
patient to get the necessary education about the risk of not being compliant with their
medications. They could speak on the money it would save insurance companies if patients are
educated on their illnesses and medications so that their health would not decline and lead to
hospitalization. One opposing force could come from the public officials. They might not want to
spend the money from the budget to educate the patient. To put the health policy plan into action
as a community health nurse I would do some research to see what is currently being offered and
then reach out to the community members and healthcare providers to see if they are willing to
participate in this matter.
The health policy proposal could address the needs of the underserved population by
giving them the opportunity to learn how to properly take their medications and about the high
risk for not been compliant. The information provided would be easy to comprehend making
them more willing to accept it. This will help to prevent further cases and complications of
hypertension in Sarasota County such as heart disease and stroke; therefore, the county rate of
these incidences would be reduced.
Conclusion

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From this paper one can see that the rate of hypertension in Sarasota County is higher
than that of the state. We see how primary, secondary and tertiary preventions can help these
individuals have healthier outcomes. Also, the paper explained some of the countys strengths
and weakness as well as the implementation of a proposed health policy detailing who will
support and who will oppose it. The personal relevance from this project for me is that it will
enable me in the future to better educate my patients with hypertension about the importance of
making healthy lifestyle choices so that they may live healthier.

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References

About High Blood Pressure. (2014, July 7). Retrieved June 30, 2015, from
http://www.cdc.gov/bloodpressure/about.htm
Cohen, L., Curhan, C, G., & Forman, P. J. (2012). Influence of age on the association between
lifestyle factors and risk of hypertension. Journal of the American Society of
hypertension, 6 (4). 284-290. Doi: 10.1016/j.jash.2012.06.002
Determinants of Health. (n.d.). Retrieved June 30, 2015, from
http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-ofHealth
Economic Development Corporation, Sarasota County. (n.d). Retrieved June 30, 2015, from
http://www.edcsarasotacounty.com/static/docs/user/communityprofile.pdf
Florida Department of Health (2015). County health profile. Retrieved from:
http://www.floridacharts.com/charts/CountyHealthProfile.aspx?county=29&reportYear=
2013&tn=31
Health policy. (n.d.). Retrieved June 30, 2015, from http://www.who.int/topics/health_policy/en/
National High Blood Pressure Education Program. (n.d). Retrieved June 30, 2015, from
https://www.nhlbi.nih.gov/files/docs/resources/heart/pphbp.pdf
Pages - Home. (n.d.). Retrieved June 30, 2015, from
https://www.scgov.net/AboutSarasota/Pages/default.aspx
The stages of prevention | Primer on Public Health Population. (n.d.). Retrieved July 29, 2015.
United States Census Bureau. (2015). State & County Quick Facts. Retrieved from
http://quickfacts.census.gov/qfd/states/12/12115.html
Whelton, P. (2002). Primary Prevention of Hypertension Clinical and Public Health Advisory

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From the National High Blood Pressure Education Program. JAMA, 1882-1882

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