Running head: HILLSBOROUGH COUNTY EVALUATION

Hillsborough County: Community Health Evaluation

Kailey M. Gay
NUR 4636
University of South Florida

HILLSBOROUGH COUNTY EVALUATION

Hillsborough County Community Health Evaluation

The physical location in which someone is born and raised in directly affects the kind of
life they will lead, the health habits they form and will therefore influence their health status. As
someone who has lived in Hillsborough County for my entire life, I recognize the impact the
society I live in has made on my family and I. Hillsborough County is located in west-central
Florida. It is a highly urban area and is approximately 1266 square miles (Profile of Hillsborough
County, n.d). Major employers in the area are the Hillsborough County School Board, University
of South Florida, and Verizon Communication Corp. Healthcare facilities in the area include
Florida Hospital located right next to USF, Tampa General Hospital, All Childrens outpatient
clinic and hospital, and the VA hospital (Profile of Hillsborough County, n.d).
Hillsborough Countys socioeconomic factors and population vary from the nations
averages. According to Florida Department of Health, the largest age group is from 25-44
(Newsroom,n.d.). The majority of people in Hillsborough County are white (78%) and in
Florida (79%) Hispanics represent 25% of Hillsborough Countys population and about 23% in
the state of Florida (n.d). The percent of families below the poverty line is 10.7% and about 9.9%
for the state. 14% of people age > 25 do not have a high school diploma in the state and county
(n.d.). 10.2% older than five do not speak English in the county and 11.8% in the state (n.d). This
paper will focus on the assessment of Hillsborough County health, prevention plans, and a health
policy proposal to improve the health concerns.
As a community, Hillsborough County has three strengths: a strong mental health level,
an above average median household income, and high health resource availability. According to
the Florida Department of Health, Hillsborough Countys suicide rate is 12.7%, while the state
average is 13.8% (Newsroom, n.d.). This suggests that Hillsborough County has a slightly higher

HILLSBOROUGH COUNTY EVALUATION

mental health level than the state of Florida. The median household income for Hillsborough
County is $49,536 and the state average is $47,660 (n.d). This suggests that the community is
slightly more prosperous than other counties in state of Florida. In addition, the health resource
availability is better in Hillsborough County than the state average. Physicians are more
predominant- 337.5 as opposed to 275 (n.d.). Pediatricians are 31.2 as opposed to the state
average of 23. This suggests that health resources are more readily available in the county than
the state average.
Three major weakness of the community include the most prevalent diseases in
Hillsborough County: heart disease, cancer, and sexually transmitted diseases. Heart disease for
all races in the county is 170.2, while the state is 153.4 (n.d). This suggests that heart disease is a
bigger problem in the community specifically than the state overall. There are higher rates of
cancer in Hillsborough County than the average of the state of Florida 166 in the community as
opposed to 159 in the state. In addition, Hillsborough County has the second highest rates of
STDs overall in the entire state of Florida (Sexually Transmitted Diseases, n.d.). My priority
health issue is the high rates of STDs in the county. This is an important issue to focus on as a
priority of health because it demonstrates the increased need for education and prevention.
The determinants-of-health model is comprised of different factors that influence an
individuals and populations health status. The different factors that comprise the health model
are social factors, policymaking, health services, individual behavior, and biology and genetics.
Use of the model would assist the development of intervention that address a population health
issue by allowing the community health nurse to look at the specific factors involved in the
health status of the community (Determinants of Health, n.d.).

HILLSBOROUGH COUNTY EVALUATION

Health system contributes to the transmission of STD prevalence. For example, someone
who is infected with an STD may not know that they are infected because they do not have
access to healthcare, cannot afford to be tested or cannot pay for the treatment (Jemmott,
Jemmott III & OLeary, 2007). Unfortunately, the majority of STIs do not cause noticeable
symptoms that would otherwise drive a person to be tested. Males who present with STDs are
most often asymptomatic as opposed to women who typically experience noticeable symptoms.
This is a leading factor of STDs spread to women and why women are more often diagnosed
(Sexually Transmitted Diseases, n.d.). Environment also contributes to the transmission of STDs
(Jemmott, Jemmott III & OLeary, 2007). The area in which someone lives directly influences
the kind of life they live, whom they associate with, and therefore correlates to behaviors or
habits the person may have (Marshall et al., 2009). In addition, the lifestyle someone leads
directly contributes to STD transmission. Lifestyle influences the choices one makes- both
positive and negative. One can choose to get involved in behaviors that lead to STD transmission
and disease (Uhrig, Friedman, Poehlman, Scales & Forsythe, 2014). The adolescent population
of Hillsborough County is at higher risk of contracting an STD due to a lack of
knowledge/education, and lifestyle behaviors as evidenced by the elevated cases of STDs as seen
on the Florida Health Department.
Primary STD prevention aims to prevent individuals from contracting a disease
altogether. The recipient of this prevention is adolescents of Hillsborough County from exposure
of STDs by both health promotion and risk factor modification. Health promotion will be
achieved through sex health education in Hillsborough County high schools with an emphasis on
various types of STDs, routes of transmission, and preventative measures such as abstinence and
condoms. In addition to high school students, the college population should also be reached. This

HILLSBOROUGH COUNTY EVALUATION

can be done so by educating the student body of free services offered through the school health
clinic through various forms of media. This will promote knowledge for safe sex practice and
available STD testing at no cost to the student. The stakeholders toward whom the intervention is
geared are the community members, health care providers, and the funding sources. The role of
the community health nurse would be to develop a sex and health education regimen that could
be adapted to be taught to various age groups.
The secondary level of prevention aims to treat adolescents who currently have an STD.
In addition to treatment this intervention will also focus on individual screening, counseling and
education. The patient will receive counseling of specific medication regimens for initial
treatment; will be informed about various support groups at initial diagnosis and as needed, and
how to prevent further STD transmission within themselves and others. The stakeholders include
the individuals affected, healthcare providers, and funding sources. The role of the community
health nurse would be to acquire a thorough history of the patient, teach the adolescent affected
with an STD about their treatment regimen, assess progress, and evaluate teaching. The goal of
this will be to increase the awareness of transmission of STDs and therefore decrease cases of
STDs transmitted to others in the community.
Tertiary level of prevention will place emphasis on maintenance and assessment of care
of those who are chronically affected by STDs or HIV to improve the quality of their life. This
will be achieved through several ways such as monitoring compliance, examining effectiveness
of treatment regimen, and preventing further health complications. Support groups have the
utmost importance in tertiary prevention because adolescents will need the support of peers and
others in the community in order to cope with a lifelong illness. The stakeholders for the tertiary
level of prevention are individuals affected, community members, healthcare providers, and

HILLSBOROUGH COUNTY EVALUATION

funding sources to aid in research and treatment clinics. Its important for the patient and their
parents/guardians to be referred to counseling and education concerning the disease, medication
regimen, and safety precautions. The community health nurse will follow up on the intervention
by assessing the patients treatment regimen effectiveness, assess coping, refer to counseling and
provide education.
Health policy works by regulating the standard health care that is provided in the
community setting- in this case the county. The main focus for the health policy proposal will be
a primary intervention of prevention for the most effective goal of decreasing rates of STDs. It
will be geared toward adolescents of high school and college-age in the Hillsborough County
community. This proposal will provide a coherent sex health education in both high schools and
college campuses with an extra emphasis on increasing awareness of safe sex practice on college
campuses in the area. In addition information will be provided about clinics on campus and areas
where students can be tested for free and where they can obtain condoms. The educational
proposal is for prevention, transmission routes, various available treatment options, and health
consequences of STDs. The goal of the health policy proposal is to have a significant decrease in
STDs in the adolescent population of Hillsborough County. The stakeholders that will be affected
are the community members, health care providers, and funding sources. The supporters of the
proposed health policy will be community members, public officials, and health care providers.
The positive influence behind the supporters will be for the community members to not be
affected by the growing rates of STDs in the county, health care providers congruent goal of
decreasing rates of STDs in their patients and the community, and the public officials similar
desire for Hillsborough County to no longer have the highest rate of sexually transmitted disease

HILLSBOROUGH COUNTY EVALUATION

and infections in the entire state of Florida. Opposing factors of the proposed policy might be
legislators whose priorities are funding for the county.
The first steps toward presenting the proposed health policy proposal would be to seek
out public officials who would be interested in making changes to assist in seeing the proposal to
fruition. There will be a PowerPoint presentation that will aim to interpret and analyze the
present issue in the county and the preventions and interventions put in place to aid in eradicating
it. The health policy proposal will influence Hillsborough County by addressing the rising health
problems and concerns in the population. This proposal focuses on the adolescent population by
adding to what they are already learning in school and adding to what they know about sexual
health in an age where it is the most vital to learn and hopefully prevent these diseases. This
health policy proposal will improve the adolescent and general community health of
Hillsborough County by decreasing the countys rate of STDs and improving the lives of people
who are affected.
Many things shape a persons health status, including the community in which they live.
This is why it is of the utmost importance for the community to make strides in promotion of
health. Hillsborough Countys rates of STDs are alarmingly high and show no sign of decreasing
in the near future. A preventative health policy proposal would drastically improve sex health
education, awareness of the disease, will help those affected cope, improve their quality of life
and ultimately improve the community as a whole.

HILLSBOROUGH COUNTY EVALUATION

References
Clinical Prevention Guidance. (n.d.). Retrieved July 1, 2015, from
http://www.cdc.gov/std/treatment/2010/clinical.htm
Determinants of Health. (n.d.). Retrieved July 1, 2015, from
http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-ofHealth#individual behavior
Jemmott, L. S., Jemmott III, J. B., & O'Leary, A. (2007). Effects on Sexual Risk Behavior
and STD Rate of Brief HIV/STD Prevention Interventions for African American Women in
Primary Care Settings. American Journal Of Public Health, 97(6), 1034-1040.
doi:10.2105/AJPH.2003.020271
Marshall, B. D., Kerr, T., Shoveller, J. A., Patterson, T. L., Buxton, J. A., & Wood, E.
(2009). Homelessness and unstable housing associated with an increased risk of HIV and STI
transmission among street-involved youth. Health And Place, 15783-790.
doi:10.1016/j.healthplace.2008.12.005
Newsroom.(n.d.).RetrievedJuly1,2015
Profile of Hillsborough County. (n.d.). Retrieved July 1, 2015, from
http://www.hillsboroughcounty.org/DocumentCenter/Home/View/1100
Sexually Transmitted Diseases. (n.d.). Retrieved July 1, 2015, from
http://www.floridahealth.gov/diseases-and-conditions/sexually-transmitted-diseases/std-statistics/
Uhrig, J. D., Friedman, A., Poehlman, J., Scales, M., & Forsythe, A. (2014). Knowledge,
beliefs and behaviours related to STD risk, prevention, and screening among a sample of African
American men and women. Health Education Journal, 73(3), 332-340.