Community Health Issues Responses

Community Health Issues Responses

Community Health Issues Responses

According to the County Health Rankings & Roadmaps website, Dorchester County, where I currently reside, is ranked 23rd out of 24 counties for overall health outcomes in the state of Maryland (Robert Wood Johnson Foundation Program, 2020). This ranking emphasizes the amount of health disparities within my community and the importance of public health nursing. After talking with a public health nurse (PHN), I discovered there are several health issues of concern, including adult obesity, adult smoking, and sexually transmitted infections (STIs). STIs are of particular concern in Dorchester County, with the rates of Chlamydia infection being consistently above the average of Maryland and the U.S. in all years from 2007 to 2017, with 2016 being the only year Dorchester fell below the state and national average (Robert Wood Johnson Foundation Program, 2020).



When attempting to tackle the STI problem in Dorchester County utilizing the Intervention Wheel, PHNs must consider the assumptions of the framework, including the impact of determinants of health (Stanhope & Lancaster, 2020). According to Stanhope & Lancaster (2020), one determinant of health is income. Dorchester County is regarded as a poor county in Maryland. This year, 27% of children in Dorchester County are living in poverty (Robert Wood Johnson Foundation Program, 2020). Much like chlamydia infection rates, childhood poverty rates in Dorchester County have remained consistently above the state and national averages from 2002 to 2018 (Robert Wood Johnson Foundation Program, 2020). PHNs in Dorchester County can consider the financial disparities of residents when implementing interventions to reduce STI transmission.

Screening, counseling, and teaching are all important interventions on the Intervention Wheel that can be used by PHNs to address the high STI rates in Dorchester County (Stanhope & Lancaster, 2020). After researching on the Dorchester County Health Department’s website, I found that the social determinant of income is considered in their STI program, as examination and screening services are offered to those under 21 years old free of charge (Dorchester County Health Department, n.d.). Surveillance is another important intervention PHNs can use to reduce STI rates (Stanhope & Lancaster, 2020). The Dorchester County Health Department’s STI Clinic also offers contact tracing services, to notify the sexual contacts of those infected with STIs so they can be tested and get treatment, ultimately reducing STI spread (Dorchester County Health Department, n.d.).

Dr. Attia’s overall TED Talk message of providing nonjudgmental care, and remaining open-minded to ever-evolving healthcare science is relevant when caring for client’s with STIs (TED, 2013). Instead of blaming those clients for their conditions or judging them by their personal choices, PHNs should consider the bigger picture. STI transmission is most likely not a result of a person’s negligence of safety in their sexual practices. High poverty rates in my community could result in children growing up in homes that lack the necessary means and education to teach their children about safe sex. It is the PHN’s role to consider these factors and develop interventions appropriate to the community situation.


Dorchester County Health Department. (n.d.). Communicable diseases. Retrieved September 1, 2020 from…

Robert Wood Johnson Foundation Program. (2020). Maryland: Dorchester (DO). County Health Rankings & Roadmaps. Retrieved from…

Stanhope, M., & Lancaster, J. (2020). Public health nursing: Population-centered health care in the community (10th ed.). St. Louis, MO: Elsevier.

TED. (2013). Is the obesity crisis hiding a bigger problem? [Video file]. Retrieved from…