Community Nursing



Q.1: Affordable Health Care Act: Fee for being uninsured

Althoughtaking an insurance cover is in most cases considered as optional andleft at the discretion of individual citizens, the government usesdifferent measures to pressure people to buy health insurance cover.One of these measures is to charge citizens who can afford the cover,but decide to ignore it some fee. According to (2015)a penalty known as “individual shared responsibility payment” wasintroduced to target citizens who deliberately choose to be covered,yet they have adequate income to buy their personal health insurancecover and their dependants. Affected individuals pay the penalty forthe months in which they, their spouses, or their dependants did nothave an insurance covered. The payment is made when making federaltax returns at the end of the year.

Theamount to be paid is reviewed annually. For example, the fee will becalculated either as a percentage of income or per person who was notcovered in a given time starting from the year 2016 (,2015). For example, uninsured households will pay about 2.5 % oftheir annual income up to a maximum of the total annual premium forthe average price of the Bronze insurance plan that is sold in themarketplace. Charges for per person basis will be $ 695 for eachadult and $ 347.50 for each uninsured child. The main objective ofthese charges is to encourage people to buy insurance cover forthemselves and their dependants.

Althoughstatistics show that the number of uninsured people have dropped from12.0 % to 7.8 % in the state of Maryland (Gantz, 2015), the penaltycalls upon the community, especially those who are yet to be insuredto buy health insurance programs. This is because they still have topay some fees that cannot help them in times of sickness.

Q.2: Environmental health

FortWashington, similar to other townships experiences differentchallenges as a result of environmental pollution. Some of the keypollutants affecting the residents of Fort Washington and the entirecounty of Prince George are associated with chemicals used infactories. These pollutants include formaldehyde (45.6 %), benzene(15.97 %), acetaldehyde (6.1 %), naphthalene (5.7 %), and polycyclicorganic matter (5.43 %), 1, 3-Butadiene (4.94 %), carbontetrachloride (4.48 %) and Arsenic compound (2.29 %) among others(EPA, 2015). The presence of these pollutants in the air, water, andthe soil has increased the risk of suffering from different diseases,including cancer. For example, Prince George’s county has adisproportionately higher prevalence of cancer, low birth weight, andmortality compared to both the national and the state average.

Onething that one can learn from (EPA, 2015) is that most of thepollutants affecting the residents of Fort Washington are secondary,which accounts for 40.08 % of all pollutants. Secondary pollutantsresult from a reaction between primary pollutants that are releasedin the industries and different components of the atmosphere. Thisimplies that innocent residents are subjected to the risk ofcontracting cancer and other diseases industries.

Acommunity health nurse can contribute towards finding a solution tothe issue of risk of diseases that result from secondary pollutantsthrough advocacy and research. Empirical studies on the relationshipbetween secondary pollutants and an increase in the prevalence ofnon-communicable diseases (such as cancer) can help a communityhealth nurse approach any government agencies and local industry andpresent concerns of the residents. This forms the basis ofevidence-based practices and advocacy.


EnvironmentalProtection Agency (2015). My environment.EPA.Retrieved December 1, 2015, from,38.75041,-76.99512&ampcLat=&ampcLon=&amppSearch=20744,%20MD

Gantz,S. (2015). Uninsured rate in Maryland improves by 5 % points.BaltimoreBusiness Journal.Retrieved December 1, 015, from Health coverage options if you’re December 1, 2015, from