Jewish Population and History in Miami

• The Jewish population is ethnically diverse and steadily increasing.
• Miami was initially a Spanish colony without Jews.
• A significant immigration wave occurred in the 1930s
• High living standards attracted people from California.
• As the population aged, the community began to decline.
• The recent growth of the young adult Jewish population

Reasons for Choosing the Population

• Jewish young adults in downtown Miami
• The growing population of ~7000 impacting demographics
• Minority cultural background defines healthcare challenges.
• Limited resources may not support population needs.
• Diverse community from various backgrounds and cultural beliefs
• No information regarding the culturally competent approach
• Miami healthcare system unprepared to serve the Jewish community

Aggregate Description

• Life expectancy averaging between 81-85 years old (Central Bureau of Statistics, 2015).
• The low fertility rate of 1.5 children per adult
• High-risk social behavior such as smoking
• Cultural dietary habits lean towards fats and carbohydrates.
• Less than 50% practice leisurely physical activity (Benderly et al., 2017).
• Miami Jewish Health systems primary healthcare facility
• Approximately 30% live below the poverty level

Aggregate Health Risks and Treatment

• Leading causes of death: cardiovascular disorders and cancer
• High-risk factors for diabetes, hypertension, dyslipidemia
• Noticeable prevalence of higher weight amongst the population
• 20% are carriers of genetic disorders common to Jews (Warsch et al., 2014)
• Religion may impact attitudes and treatment choices
• Lack of competent cultural training to treat population

Analyzing Aggregate Strengths and Weaknesses

• Community assessment is necessary to develop strategies
• Culture affects an individual’s physical and psychological health
• Presence of cultural identity through Jewish institutions
• High life expectancy but significant percentage aging
• A sedentary lifestyle and smoking prevalence in the community
• Over 40% encountered anti-Semitic attitudes (Labgold, 2014)
• Socio-economic inequality limits access to health care

Family Description

• Family is historically and currently practicing Judaism
• Traditional family structure, three generations in the household
• Large house in a primarily Jewish neighborhood
• Cohesive familial ties and emotional relationship
• Open discussions are held about family issues
• Maintains access to health care services regularly

Risk Assessment

• Friedman Family Assessment Model utilized
• Occupations may cause elevated levels of stress
• Cardiovascular system disorders are prevalent
• History of cancer, diabetes, and liver issues
• Family predisposed to rapid progression of conditions
• Seek support to cope with stressful situations

Developing a Care Plan

• Using the Healthy People 2020 objective as guidance
• Vision To develop an intervention plan for aggregate
• The plan focuses on behavioral intervention and education
• Diagnosis of family includes imbalanced nutrition
• Occupational stress and exposure to physical activity
• Lifestyle can be targeted with behavioral intervention

Intervention Strategies

• Education promotes home-based self-care of family members
• Diet and activity addressed through instruction
• Instruction on health risks and proven strategies
• The intervention lasts eight weeks combining methods of education
• The practitioner provides access to community resources (Philis-Tsimikas & Gallo, 2014)
• Goal to direct family towards sustainable health

Education about Health Risks

• Intervention in health beliefs, attitudes, perceptions
• Disease-specific health risks and behaviors
• Critical to modify the diet to prevent chronic conditions
• Introducing moderate activity and strength training
• Activity and nutrition reduces disease risks
• Hypertension and dust allergy common noncommunicable conditions
• Disorders result in lower quality of life

Disaster Management Plan

• Necessary for cities to manage natural disasters
• An emergency preparedness plan limits adverse consequences
• Minimizes trauma and health risks during disasters
• Develops adaptation by promoting appropriate social behaviors
• Risk awareness ensures survival and individual resilience
• Timely resource preparation is critical for disaster situations

Family Disaster Education

• Management plan to create a fundamental knowledge base
• Acquisition of skills and acceptance of potential dangers
• Miami susceptible to hurricanes during certain seasons
• Health practitioner educates and helps to create a plan
• Evacuation routes, precaution measures, and checking contacts
• Preparing a disaster survival kit with supplies
• First aid training and psychological coping practices

Evaluation and Barriers to Implementation

• Tracking progress – fifth step MAP-IT model
• The assessment helps identify shortfalls and make corrections
• Environmental risks in relation to aggregate population
• Costs may discourage family member participation
• Costs include resources, materials, and consultations
• Costs are justified with long-term health benefits

Measurable Signs of Success

• Project realization is monitored and evaluated
• Recorded results identified and plan adjusted
• Subjective perceptions and objective data are analyzed
• BMI and physiological indexes are compared over time
• Weight loss, normalized blood pressure, and lipid content
• Monitoring cardiovascular risk factors and diabetes

Overview of the Aggregate Health Situation

• Currently, aggregate maintains access to health care
• Population growth and shortage of competent professionals
• Nurses require cultural training to treat the Jewish community
• Genetic predisposition, occupational stress, unhealthy diet
• Community-based prevention in disaster management plans
• The preliminary assessment helps manage environmental barriers
• Data evaluated to modify education and new interventions

References

Benderly, M., Chetrit, A., Murad, H., Abu-Saad, K., Gillon-Keren, M., Rogowski, O., …Kalter-Leibovici, O. (2017). Cardiovascular health among two ethnic groups living in the same region: A population-based study. International Journal of Cardiology, 228, 23-30.

Central Bureau of Statistics. (2015). Life expectancy, by sex, religion and population group. Web.

Labgold, M. (2014). Summary report of the 2014 Greater Miami Jewish Federation Population study: A portrait of the Miami Jewish Community. Web.

Philis-Tsimikas, A., & Gallo, L. C. (2014). Implementing community-based diabetes programs: The Scripps Whittier Diabetes Institute experience. Current Diabetes Reports, 14(2), 462.

Warsch, J., Warsch, S., Herman, E., Zakarin, L., Schneider, A., & Hoffman, J., …Barbouth, D. (2014). Knowledge, attitudes, and barriers to carrier screening for the Ashkenazi Jewish panel: A Florida experience. Journal of Community Genetics, 5(3), 223-231.