Health Care Policy

I live in Miami Dade County in the State of Florida where clinical care has taken a hard hit in recent years. Clinical care and quality care are at its worst state compared to the other leading counties in the State of Florida. Miami-Dade ranks 40 out of the 67 counties in quality care and has the worst clinical care access and attention. These issues are highlighted by the uninsured clinical care which has 23%, poor diabetes care and monitoring of 85%, delays and prolonged stays for the patients in the hospital which has a 70% compared to the best ranked at 54% (Drader, 2020). The state also has low access to mammography and x-ray screening to the patients which is at 55%, which means the screening systems is not easily accessible to the patients (Drader, 2020). It also lacks enough health and clinical care personnel ranging from primary care, dentists, and mental health providers. These parameters imply that the system is poor and needs improvements.

As a nurse practitioner I would recommend immediate intervention from the federal government and state government to strategize in improving the clinical care situations of Miami Dade County to better conditions (McAllister & Troy, 2018). This can be done through the creation of a community health center that offers screening tools such as mammography and x-ray screening to reduce the unattended cases, employing more clinical care, mental health and dentists to minimize the ratio for which every personnel serves many patients which causes delayed treatment and prolonged stays for the patients in the hospital wards. Doing so, the clinical care access and delivery will be efficient for the patients and thus Miami Dade County will be a better place for everyone. The nurse practitioner can help advocate for this change by petitioning political figures to address the issue.


Drader, M. (2020). Primary care: Miami Dade advanced practice nursing. Journal of Nursing in Primary Care; 71(18): 157-177.

McAllister, L.; Troy, S. (2018). Integrated Theory and Knowledge Development in Nursing (7th ed.) pp. 33–34.

Yanet Garrido Coutin

Briefly list the general statistics pertaining to a specific health concern that is on the rise in selected the city/county.

New York city is the city I would like to practice as a FNP. Inactivity is the leading cause of early death in the United States, accounting for more than 5.3 million of the 57 million deaths globally in 2008. The general statistics regarding this issue in New York City showed a percentage of adults age 20 and over reporting no leisure-time physical activity. The 3 most affected counties with the highest percent of people with lack of physical activity are Orleans, with a 32%, followed by Genesee with a 31% and Wayne with 31% of physical inactivity as well. Statistics also reported that the county with the lowest percent is Tompkins with a 15%.

How can the creation of a community health center program help to address this public health problem?

In the United States, the community health center (CHC) is the most common model for providing integrated primary care and public health services to low-income and uninsured people, and it is one of the ways that federal grant money is used as part of the country’s health-care safety net. Community health center program includes a variety of opportunities to promote physical activity within the population. Fitness programs can be found in a variety of public places, such as community, senior, fitness, and community wellness facilities, as well as parks. Exercise activities such as aerobic dance classes, Zumba, Pilates, yoga, Tai Chi, and spinning/indoor cycling are commonly included in program offerings, which vary by location. The creation of community-based social support for physical activity and activity programs for older adults are some of these measurements taken by the state to address this public problem.

What can you as a nurse practitioner and/or nurse leader do to influence policy innovation to resolve the problem?

As a nurse practitioner, I can help to minimize this health issue by providing exercise prescriptions that represent a personalized care plan to fulfill the specific needs of individuals based on the different physical condition and the recommended daily Physical Activity Guidelines for Americans. Educating and setting goals as well as follow-up via phone, internet, or mail. Individuals at high risk of injury with complex health conditions must be referred to certified exercise professionals such as physical and occupational therapists to receive individually tailored plans. As a family nurse practitioner I must also educate about the different diseases resuming from the lack of activity and exercise. Education on other preventive programs that go along with physical activity such as nutrition is also fundamental for increase the consciousness of the individuals about their health.


County Health Rankins & Roadmaps (2021). Building a culture of health, County by County.

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