Final Project

Posted: January 4th, 2023

Final Project

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Final Project

The coronavirus pandemic continues to ravage Americans across the nation, with no end in sight. So far, over 150,000 people have died from Covid-19, with over 4.4 million having tested positive (Worldometers, 2020). While the disease has predominantly affected adults with preexisting conditions, it has also afflicted children, especially those below the age of 12 years in unique but concerning ways. Moreover, the pandemic has exposed the perennial health disparities in the country by afflicting minority groups that are in the low socioeconomic status more than the rest of the citizenry (Azar et al. 2020). In this project report, the Mothers Children Health (MCH) population is school-age children aged between 5 and 12 years.

Knowledge Base

Children from underprivileged circumstances are likely to experience worse health outcomes than their more privileged counterparts. The ongoing coronavirus pandemic worsens the health wellbeing of this segment of children, with new information emerging frequently as researchers learn more about the SARS-CoV-2 virus. In addition, the health disparities are reflected in children in the same manner they afflict adults.

According to The Centers for Disease Control and Prevention (CDC) (2020), 2 % of people in the United States confirmed to have contracted the virus are aged below 18 years, which is higher than that in Italy (1.2 %) and Spain (0.8 %), and lower than that in China (2.2 %). Although, this prevalence is much lower than that in adults, children aged between 5 and 12 years are being afflicted by Covid-19 differently from adults, because they are displaying conditions similar to those of Kawasaki disease (Bialek et al., 2020). In this regard, although many of the diseased children are asymptomatic, some have displayed heart complications leading to cardiac arrests, which are unlike the typical cause of death in adults, which involved respiratory failure (UC Davis Health, 2020). Moreover, children from low socioeconomic status families are experiencing more detriments compared to those from affluent families (Sparks, 2020).

The detrimental health outcomes in the children with Covid-19 are caused by the inability of their immune system to fend off the virus, which facilitates to attack the internal organs, including the heart. In the same vein, the health disparities across the families of these children are aggravated by those on the lower socioeconomic status having weaker immune systems due to poor nutrition, thus increasing their likelihood of overcome by the virus. About 20 % of the households with children aged 12 years and below were food insecure in the country by the end of April of 2020 (Bauer, 2020). In this regard, childhood, socioeconomic status, and nutrition are precursors to the detrimental health outcomes in this population segment. However, it is not clear how the coronavirus causes the Kawasaki-like disease among the positive cases in children. Similarly, it is not known why children are usually asymptomatic regardless of the socioeconomic status or display different symptoms from those of adults and infants.  

The strength of policy planning knowledge included the well-defined procedures for identifying the health problem, assessing the need, and formulating the objectives for addressing the problem that focus on the identified need. Moreover, the planning process is pragmatic and grounded in theory. In this case, the formulation of a program hypothesis along with a logic model to conceptually ground the intervention, are pertinent considerations during the program planning process.  However, existing knowledge does not direct on how to accommodate rapidly changing problems and their circumstances into the planning process. In this regard, programs that have been developed using specific parameters may turn to be inappropriate a changed version of the problem that emerges before the planning process is complete. In this regard, although the planning process is part of the program development process, it is linear and therefore, lacks the pertinent feedback loops that would make it responsive to rapidly changing circumstances or morphing problems. Consequently, the planned program may lack specificity because of being vaguely targeted, or may suffer from obsolescence quickly as the targeted problem changes within the lifetime of the planning process. The ongoing coronavirus pandemic is a typical example of a problem that would challenge the planning of an effective intervention program. Its state, vagaries, and outcomes are changing rapidly amidst minimal etiological and pathophysiological knowledge about the disease, thus making intervention programs to either be ineffective or lose their efficacy quickly.    

Social Strategies

The social strategy being used to bolster the immune system of children is to provide children from financially disempowered families with assistance to access nutritional foods, which are usually beyond their regular means. This is a federal program that targets low-income Americans that cannot afford nutritional diets for themselves and their families. This strategy is implemented as the Supplemental Nutrition Assistance Program (SNAP) and helped 40 million Americans access nutritional food in 2018 (Center on Budget and Policy Priorities, 2019). It has helped children access fruits and vegetables that often lack in their regular meals, thus facilitating their growth and development (Adler, Glymour, & Fielding, 2016). Although the program aimed at providing nutritional assistance during economic downturns, it has been instrumental in cushioning many American families against the vagaries of joblessness that became rampant during the ongoing pandemic. Considering that many afflicted families have children aged below 12 years, this program has helped the children access nutritional diets that strengthen their immune system, in turn making them more resilient against Covid-19.

This program was formerly known as the food stamps program, which was initiated in 1939 to address the food insecurity of Americans following the great depression. However it was inscribed in law in 1964 through the Food Stamp Act. After several legal amendments and program reforms, the food stamp program was renamed SNAP in 2008 through the Food, Conservation, and Energy Act. Since then, families with no or low incomes have accessed financial assistance ranging between $668 and $189 to purchase food from stores across the country (Center on Budget and Policy Priorities, 2019). Currently, it targets many American families with breadwinners that have lost their jobs due to Covid-19.

This program is effective for households that gross a monthly income below $2,252 for a family of three (Center on Budget and Policy Priorities, 2019). It favors families with children as those without can only access the benefits for three months. In addition, it benefits American citizens and documented immigrants, as undocumented ones are ineligible. In this regard, the program has been effective to the section of Americans that are likely to be ravaged by income disparities that often lead to health disparities, especially among the cohort of children in this report.   

Action Plan

The proposed program is a wholesome child-centered initiative covering the entire country. It would resemble the stimulus package being availed to struggling businesses in the United States that has been approved by the Congress, only that it targets all American children instead.  This program would be appropriate during this period of the ongoing pandemic in which school-going children are at home together with their parents, who have lost their incomes due to unemployment, amidst increasing food insecurity in homes (Bauer, 2020). The objectives of the program would be to i) provide the children with access to nutritious meals at least twice a day, ii) test the immunity status of the children every 6 months, and iii) recommend and avail nutritional supplement for children with weak immune systems. 

The program would target children aged between 6 and 12 years specifically. Therefore, the unit of intervention would be the individual child, to accommodate the children not in a family setup. The eligible children should have food insecurity by taking less than two meals a day. Besides, the children should have demonstrated weak immune systems that are determined through a medical examination. While the program would target children of both genders and from all races, it is expected to benefit those experiencing poor health outcomes due to the health disparities in the country.

The program activities include identifying nutritionally-deficient children through data on their daily meal intakes, preparation and serving of at least 2 hot meals for the participating children, blood tests to confirm the state of their immune systems, and provision of supplements for children with compromised immune indicators. 

The expected health outcomes would be a regular and healthy immune system in the children, which can be confirmed through a blood test. It is already established that the immune system of children is developed through proper nutrition, and the program would ensure that such diets are available to the targeted children regularly. Therefore, the program is linked to nutrition and socioeconomic status as the precursors to the health problem. To achieve these outcomes, collaboration with the private sector to provide healthy meals, the medical fraternity to test the children regularly, community leaders to help identify and enlist the children to the program, and the federal and state governments to fund the initiative.  

References

Adler, N. E., Glymour, M. M., & Fielding, J. (2016). Addressing social determinants of health and health inequalities. JAMA, 316(16), 1641-1642.

Azar, K. M., Shen, Z., Romanelli, R. J., Lockhart, S. H., Smits, K., Robinson, S., … & Pressman, A. R. (2020). Disparities in outcomes among COVID-19 patients in a large health care system in California: Study examines disparities in access and outcomes for COVID-19 patients who are members of racial and ethnic minorities and socioeconomically disadvantaged groups. Health Affairs, 39(7), 1253-1262. https://dx.doi.org/10.1377/ hlthaff.2020.00598.

Bauer, L. (2020). The covid-19 crisis has already left too many children hungry in America. Retrieved from https://www.brookings.edu/blog/up-front/2020/05/06/the-covid-19-crisis-has-already-left-too-many-children-hungry-in-america/.

Bialek, S., Gierke, R., Hughes, M., … & Skoff, T. (2020). Coronavirus Disease 2019 in Children—United States, February 12–April 2, 2020. Morbidity and Mortality Weekly Report, 69(14), 422-426. https://dx.doi.org/10.15585%2Fmmwr.mm6914e4.

Center on Budget and Policy Priorities (2019). Policy basics: The supplemental nutrition assistance program (SNAP). Retrieved from https://www.cbpp.org/research/food-assistance/policy-basics-the-supplemental-nutrition-assistance-program-snap.

Centers for Disease Control and Prevention (CDC) (2020). Information for pediatric healthcare providers. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/hcp/pediatric-hcp.html.

Sparks, S. D. (2020). How is Covid-19 affecting children’s’ health? 4 questions answered. Education Week. Retrieved from https://www.edweek.org/ew/articles/2020/05/26/how-is-covid-19-affecting-childrens-health-4.html.

UC Davis Health (2020). Troubling covid-19 syndrome identified in children. Retrieved from https://health.ucdavis.edu/health-news/newsroom/troubling-covid-19-syndrome-identified-in-children/2020/05.

Worldometers (2020). United States. Retrieved from https://www.worldometers.info/coronavirus/country/us/.