Running head: ORANGE COUNTY HEALTH NEED

Orange County Health Need Resolution Plan

Desiree Hartzell
University of South Florida
College of Nursing

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Orange County Health Need Resolution Plan

Every community has certain health needs and factors that could be improved upon. This
paper discusses health indicators of strength and weakness of Orange County, Florida, as well as
a health policy proposal to improve the outcomes of a crucial health need for the residents of this
county.
Local, State, and National Data
Orange County Florida is one of the larger counties in the state, boasting over 1.25 million
citizens (U.S. Census Bureau, 2014). The geographical placement of Orange County is directly
in central Florida covering 903.4 square miles (U.S. Census Bureau, 2014). The Countys square
mileage leaves the population at 1,269 people per square mile (U.S. Census Bureau, 2014).
Orange County is mostly all urban and suburban areas. Being the House of the Mouse, it is
only fitting the top employer of Orange County is Walt Disney World with over 69,000
employees (Major Employers, 2013). The second and third largest employers in Orange
County are Florida Hospital with over 25,700 employees and Universal Studios with over 17,300
employees (Major Employers, 2013). Being the second largest employer of Orange County,
Florida Hospital, owned by Adventist Health, along with Orlando Health are the two major
healthcare system companies in the county (Major Employers, 2013).
As Orange County is mostly an urban setting, age, education, income, and literacy are
major health factors for such a population dense area. The largest portion of the population in
Orange County are white people between the ages of 25 and 44 (Florida Charts, 2014). The
amount of Orange Countys total population below poverty level is higher than the states
average, and the percentage of citizens >25 years old with a high school diploma is higher than

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the state (Florida Charts, 2014). The percentage of people 5 years and older that do not speak
English is higher in Orange County than the states average (Florida Charts, 2014).
Analyze, Interpret, and Prioritize Data
Three Health Indicators of Strength
Education is a large indicator of health, therefore, as previously stated, Orange Countys
rate of high school diplomas is higher than the states average, at 86.9% versus 85.3%, which is a
health indicator of strength in Orange Countys population. The median household income in
Orange County is higher than the states average at $47,581 versus $46,956 (Florida Charts,
2014). With a higher median household income there is a correlation of access to healthcare,
therefore, the higher median household income is a health indicator of strength in Orange
County. The rate of prenatal care within the first trimester is higher than the states average at
84.6 versus 79.8, making this a health indication of strength (Florida Charts, 2014). Proper
prenatal care is an important health indicating factor, because prenatal care is the start of care for
that child in utero which can prevent long term health problems once the child is born.
Three Health Indicators of Weakness
Socioeconomic status is a large health indicator, in which case, Orange Countys
population below the poverty line as well as families below the poverty line are higher than the
states average at 17.0 and 12.8, these being health indicators of weakness (Florida Charts,
2014). Orange Countys STI and AIDS rates are more than a third higher than the states rate at
20.7% in Orange County and 14.8 for the states average, which make this a significant health
indicator of weakness (Florida Charts, 2014). Also, a major health indicator of weakness in
Orange County is access to healthcare, such as citizens with health insurance (73.8% in Orange
County and 77.1% states average), those who cannot afford to visit the doctor, or those who

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have seen the doctor in the last year (23.6% in Orange County and 20.8% states average), which
all of these rates are lower than the states average (Florida Charts, 2014).
Priority Health Issue
The priority health issue facing Orange County is the significant rates of STIs and AIDS
cases. The states incidence of STIs per 100,000 citizens in 2014 was 531.5, whereas the
incidence of STIs in Orange County is 728.6 (Florida Charts, 2014). The AIDS rate in Florida
per 100,000 citizens in 2014 was 14.8, and the rate in Orange County was 20.7 per 100,000 or
745 cases in total (Florida Charts, 2014). These numbers are extremely troubling and a huge
health concern in Orange County, considering these health issues are easily preventable with
proper education and protective devices. If the same people keep contracting STIs it can be
extremely harmful if left untreated and spread quickly throughout the community. The incidence
of AIDS is troubling because an AIDS or HIV diagnosis is extremely harmful to ones health and
a potential community health hazard if unmanaged. Without proper education or diagnosis of
HIV or AIDS people can spread the disease to a remarkable amount of people in a short time
span.
Discussion of Community Health Model
Determinate of Health Model
There are many determinates of health that need to be addressed in Orange County in
order to decrease the STI and AIDS rates. The community health nurse would need to consider
many outlets, such as the health system to address the issue of proper sexual education in schools
and healthcare institutions, and the environment and lifestyle of the countys residents, being an
urban area. The urban setting in itself presents issues for sexual health. In the urban Orange
County area, there is an overwhelming social atmosphere that encourages risky behaviors, such

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as drinking, drug use, and promiscuous unsafe sexual practices. Another lifestyle consideration
that could play a role in unsafe or promiscuous sexual practices could be Orange Countys lower
rate of religious affiliation amongst the residents. In 2012, 57.8% of Orange County residents
reported none in a questionnaire asking about religious affiliation (Orange County, 2012). As
solving the problem of higher STI and AIDS rates will mostly rely on proper education the
lifestyle in Orange County will need to be considered during the health teaching.
Population Diagnosis
The residents of Orange County have a higher incidence of STIs and AIDS, as well as a
risk for health complications related to risky behavior and lack of education as evidenced by
significantly high rates of STIs and AIDS compared to the states average.
Community Based Intervention
Primary Level of Prevention
As primary prevention for STIs and AIDS, the main focus would be education. A study
conducted by Leval, Sundstrom, Ploner, Dahlstrom, Widmark, and Sparen showed that proper
sexual education correlated with safer sexual practices, such as condom use for oral and vaginal
sex (2011). The study also found that more gender specific teaching was more useful in reducing
STI rates and encouraging safe sexual practices (Leval et al, 2011). A meta-analysis of 289
evidence based interventions to reduce STIs and AIDS in young people showed a 30% reduction
in STI and AIDS risk when appropriate sexual education was given to the participants, rather
than the promotion of abstinence alone (Petrova & Garcia-Retamero, 2015). An improvement in
proper sexual health education will need to be implemented in schools, provider visits, and
throughout the community. The education will need to take place for all of the residents of
Orange County regardless of age, race, etc. By improving the sexual education in schools we are

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catching the problem early, and by promoting sexual health in the community and healthcare
visits we are providing education to adults who may encounter a STI or HIV if they continue
unsafe sexual practices. The stakeholders involved in this change will consist of healthcare
providers, community members, school nurses, and county health departments. The community
health nurse will be involved in improving the education on STIs and AIDS, by holding seminars
around the county for provider and their staff to learn proper education on STI prevention and
appropriate patient education. The community health nurse could also encourage school nurses
in the county to spend more time educating students on safe sexual practices and the possible
complications if they do not adhere.
Secondary Level of Prevention
The main secondary level of prevention of STIs and AIDS is screening. Orange County
has many screening facilities that offer services for little or no cost throughout the area. The only
improvement that can be made for the screening techniques is to increase awareness of these
services. The community health nurse could work with local health departments and legislators
to release a PSA on the prevention and screening tactics for STIs and AIDS, as well as promote
funding for more free screenings throughout the county to catch and treat the STI and AIDS
cases before they are spread.
Tertiary Level of Prevention
The object of tertiary prevention for STIs and AIDS cases is to treat the existing
conditions as well as to prevent worsening or future infections. Since most STIs are curable with
treatment the focus for those clients would be education to prevent future infections, which
would fall under the primary prevention tactic. But, for the patients with permanent STIs such as
HIV, AIDS, Herpes, and HPV, the tertiary tactic would be management of the disease and

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preventing the spread of disease. The community health nurse would be involved in treating and
managing those with incurable STIs, by encouraging regular healthcare visits, antiviral therapy,
and safe sexual practices. Every county, including Orange County has a HIV/STD clinic that
provides long-term care for patients with HIV and AIDS. This clinic also provides long-term
care to those with other incurable, viral STDs, which is an important aspect of tertiary level of
prevention. While these resources exist currently in Orange County, involving community
members, legislators, and healthcare providers could provide more funding and awareness of
these resources.
Health Policy Proposal
The health policy proposal to decrease the incidence of STI and AIDS cases in Orange
County, Florida is to increase community education programs. Education is the main way to
improve STI and AIDS rates in Orange County. The stakeholders that will need to be involved in
this health policy improvement will be healthcare providers, school officials, county and state
health services, and state legislators. The key to this health policy improvement is having
everyone onboard with the importance of sexual health education and also an understanding of
what an impact sexual health is on an individual as well as an entire community. A potential
issue with this health policy proposal would be funding and improving sexual education in public
schools. States and counties are only allotted so much funding and legislators may or may not
see the importance of increasing funding for sexual education. Also, sexual health education in
public schools is already controversial, and this proposal is to heighten the education for the
adolescents to prevent STIs and AIDS, which may be problematic to some parents and school
officials. To combat the controversy and funding issues, community health nurses could present
statistics on teen pregnancy, STIs, and AIDS in Orange County to the school board, parents of

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students, and state officials arguing against more sexual education in schools. The intention in
providing the naysayers with the true statistics would be to obtain approval for the sexual
education program improvements, as well as additional funding from the states legislators.
Conclusion
Sexual health is extremely important for overall health of a population. Orange County,
Florida has a very high rate of STIs and AIDS, which is detrimental to the health of the
community population. By increasing awareness and education on proper sexual practices and
treatments Orange Countys incidence of STIs and AIDS will decrease dramatically.

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References

Florida Charts. (2014). Orange County, Florida 2014 County Health Profile. Retrieved from
http://www.floridacharts.com/charts/CountyHealthProfile.aspx?county=48&reportYear=
2014&tn=31
Leval, A., Sundstrm, K., Ploner, A., Dahlstrm, L., Widmark, C., & Sparn, P. (2011).
Assessing Perceived Risk and STI Prevention Behavior: A National Population-Based
Study with Special Reference to HPV. PLoS ONE, 6(6).
doi:10.1371/journal.pone.0020624
Major Employers Orlando MSA. (2013, December 13). Retrieved from
http://www.orangecountyfl.net/Portals/0/Library/County%20News/docs/Major%20Empl
oyers%20in%20Orange%20County.pdf
Orange County, Florida (FL) Religion Statistics Profile. (2012). Retrieved from http://www.citydata.com/county/religion/Orange-County-FL.html
Petrova, D., & Garcia-Retamero, R. (2015). Effective Evidence-Based Programs For Preventing
Sexually-Transmitted Infections: A Meta-Analysis. Current HIV Research, 13(5), 432438. doi:10.2174/1570162X13666150511143943
United States Census Bureau. (2014). Orange County, Florida. Retrieved from
http://quickfacts.census.gov/qfd/states/12/12095.htp