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Peer reply DB 4 health pol 1-alberto alfonso           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 quali

Peer reply DB 4 health pol 

1-alberto alfonso 

          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%. 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, 2014). 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, 2015). 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. (2014): Primary care: Miami Dade advanced practice nursing.  Journal of Nursing in Primary Care; 71(18): 157-177.

McAllister, L.; Troy, S. (2015). Integrated Theory and Knowledge Development in Nursing (7th ed.) pp. 33–34.

2-yaima rosquete 

One of the groups I am concerned with in my community, City of Miami, are homeless youth.  This population is of interest to me because they are particularly vulnerable, affected by poverty, and receive inadequate medical care. Communication problems and fear of being deported; for homeless youth who are immigrants, serve as barriers to receiving medical care.

According to the County Health Rankings, youth homelessness remains a significant challenge in my community where approximately 18% of the nation’s homeless youth are located in the state (Florida Housing Coalition, 2018).  While the number of homeless youth increased by 80% between 2006 and 2013 on a national scale, it spiked by 150% in the state of Florida, and more specifically, by 170% in Miami (Florida Housing Coalition, 2018).  These statistics are scary and have aroused my interest because more than half of street youth and sheltered youth in my community do not have a regular source of health care and an approximate 35% of these youths reported serious health problems within the past year – 2015 (Florida Housing Coalition, 2018).

Nurses unquestionably represent the largest number of health care professionals and are faced with the responsibility of evaluating health concerns, and developing an aggregate plan of care to address those concerns.  Reaching out to populations who are vulnerable and marginalized presents unique challenges to nurses every day.  It is essential for community health centers to be created to address these gaps in access to care for the homeless population.  The creation of a community health center program would greatly help to address this public health problem as nurse practitioners can aid in implementing housing programs for the homeless youth.  The nurse practitioner can also advocate in the political realm by petitioning for funds for the homeless population; perhaps asking to create soup kitchens, open more shelters, and help with access to health care.


Centers for Disease Control and Prevention. CDC Health Disparities and Inequalities Report —

United States, 2013. MMWR 2013;62(Suppl 3):1?186. Retrieved on May 27, 2019 from


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