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Poverty as a Socio-Economic Determinant to Health in Fremont Community, Bay Area

Poverty presents as a key socio-economic determinant in health in Fremont Community located in Bay Area, Alameda County, California. In terms of history, Fremont Area was first occupied in 1797, after the Spaniard Father Fermin de Lasuen founded the 14^th California Mission known as Mission San Jose. American settlers arrived in the area in 1846, when John C. Fremont developed a map for the Mission pass (City of Fremont California₁, par. 1-2). In this reflection, poverty is argued as a key contributing factor as to why obesity, healthy eating/active living and diabetes top the health needs list.

In 2009, Alameda County was inhabited by 1,491,482 people. The population is composed of African Americans (27.4%), White (27.1%), Latino (25.5%), Asian (15.1%), and other ethnic groups (5%) (Center on Human Needs, 12).  People of color in Alameda County are historically disadvantaged populations who are segregated and isolated with cycles of hardships due to limited employment employments opportunities and housing. As such African Americans are most affected by health issues including obesity, unhealthy eating habits due to limited access to healthy foods, and diabetes (Center on Human Needs, 12). Together, obesity, healthy eating/active living and diabetes are rated at the highest health needs in Fremont Community. They come first before other health needs such as mental health, economic security, cardiovascular disease/stroke, substance abuse, violence/injury prevention, healthcare access and delivery, cancer, asthma, infectious diseases, and maternal and child health, in the order of decreasing health needs (Kaiser Foundation Hospital Fremont, 3).

The goal of this reflection is to promote community empowerment through public education and increased access to healthcare services. Collaboration is fundamental so as to engage all so as to have a positive impact in resolving community health needs. Community input facilitates community engagement. Through engagement, a deeper understanding of health care needs/issue within the community’s perspective can be developed. Further, it results in increased level of collaboration, sustainability, and potential positive impact (Kaiser Foundation Hospital Fremont, 4).

The risk of chronic diseases can be reduced through maintenance of health body weights and consumption of healthy diets. Chronic diseases such as obesity and diabetes are attributed to high body weight and consumption of unhealthy foods. Efforts must be directed to behavior change in different settings such as worksites, schools, communities, and healthcare organizations (Kaiser Foundation Hospital Fremont, 6). It implies that healthcare staff including community nurses need to work with community-based groups to address community health needs.

Obesity, healthy eating/active living and diabetes pose significant healthcare costs. In part, healthcare cost is gathered by individuals, families, Alameda County, California State, and the Federal Government. Some individuals including undocumented immigrants are not eligible for Medicaid and Medicare healthcare insurance; hence, can only access care through out-of-pocket expenses (CMS.gov, par. 1). Lack of health insurance coverage is a major disparity that contributes to worse health community health outcomes (Center on Human Needs, 5). Lack of health care coverage can be complicated further by poverty since individuals may not be able to access healthy foods or may be forced to forego health care and services. 

            Collaboration and engagement of Fremont Community to address mentioned health needs involves leveraging of existing local community assets and partnerships (Kaiser Foundation Hospital Fremont, 5). Key leaders at Kaiser Foundation Hospital Fremont include Continuing Care Service Director, Area Finance Officer, Director of Public Affairs, Assistant Medical Group Administrator, and Director of Health Education (3). These leaders stand at the foreground of addressing Fremont Community health needs.  Besides, the Alameda County Public Health Department has established the Fremont Family Resource Center in which community members are provided with nurses who can manage cases, provide public education, outreach and referral services, and counseling services (City of Fremont California₂, 1).  Public education programs should focus on helping community members make healthy food choices. Other important, stakeholders such as community leaders, community-based organizations, Department of Public Health, local clinicians, elected officials, and safety-net clinics should be involved in community engagement events as done by Kaiser Foundation Hospital Fremont (4) on 20 October 2016 at Silliman Center in Newark, California. These leaders and stakeholders must be involved in a community engagement initiative to addressing health needs in Fremont Area.

In conclusion, health needs including obesity, healthy eating/active living and diabetes should be prioritized when developing strategies and interventions measures to increase access and availability of health care services and information to Fremont Community. All relevant stakeholders should be included in the community engagement initiatives that aims to address community health needs. Apart from increasing healthcare access and availability, the Federal, State, and County government as well as non-governmental agencies need to collaborate to better the welfare of the Fremont Community such as provision of affordable housing and creation of employment opportunities for all, since it can help improve community health in the long run.