Running head: LITERATURE REVIEW

Literature Review
Sarah R. Hunt
Dixie State University

LITERATURE REVIEW

2
Literature Review

The United States Census Bureau reports nearly 32% of the residents in Provo, UT are
below poverty level and over 15% of the residents do not have insurance (2013). With these
statistics, annual check-ups are easily placed on the backburner. Education on the importance of
routine visits is important to eliminate the potential for chronic diseases, decrease medical costs,
and to prevent worsening injuries. The detrimental effects of eliminating preventative health care
appointments is exponential. Even with low income settings and families without insurance,
there are still ways of completing preventative health care screenings. Finding volunteer free
clinics and other methods to receive preventative care is crucial for members in these populations
to achieve the healthiest lives possible. The purpose of this paper is the review the published
literature on preventative health and to determine its significance in the under-served
populations.
Behavioral Ecology
The use of preventative health screenings is essential for individuals living under the
federal poverty level. Members in at-risk populations need the education and assistance to
prevent complications with their health before these complications arise. Daniel Nettle (2010)
explains how people of lower socioeconomic status typically have poorer health. He states these
individuals smoke more, participate in less physical activity, choose poorer diets, they are
characteristically non-compliant, they tend to ignore medical advice, and they are less healthconscious (para. 4). He continues to state in his behavioral observation, providing preventative
health education and voluntary screening services can actually increase social inequalities in
health.

LITERATURE REVIEW

Critical Analysis
Nettle provides great opinions on why preventative health is important, but that is as far
as it goes; his opinion. The article by this author had a lot of statistics which he used to infer
information about at-risk populations. His published article could have benefited from providing
more research information rather than opinion-based information. While his article takes a
theoretical approach with limited studies, his statement still rings true: health education and
voluntary screening services will improve health in poverty-stricken populations.
Oral Health
Oral care is a single, yet important, aspect to health. It is important for individuals to
recognize and understand their oral needs. Oral health is more important than having white teeth
and being aesthetically pleasing. When a person tends to their oral hygiene, they create positive
and healthy habits, select proper nutrition which affects more than the mouth, and take the
necessary steps to prevent tooth decay and other dental diseases.
Pediatric Oral Care
Taylor et al. (2014) makes the bold statement that dental care is the most common unmet
health care need. Their study explains a serious epidemic affecting children living in low-income
populations. Their article states the American Academy of Pediatrics is bringing awareness to the
most prevalent chronic disease in children as their research shows more than half of the 5 yearolds from low-income families have this disease. It is an infectious process that rapidly spreads
and causes tooth destruction. This disease is known as Early Childhood Caries (ECC). ECC has a
high rate of preschool children being untreated. This is important because serious dental
conditions can contribute to oral pain, difficulty chewing and inadequate nutrition, and in some

LITERATURE REVIEW

cases have been linked to failure to thrive. Dental decay and tooth loss can also lead to speechlanguage development issues, poor self-esteem, declining school performance and costly
emergency medical services and dental restorations (p. 5).
Fortunately, oral health is preventable. As with all preventative health care, early
detection is the primary key. Teaching correct habits of brushing and flossing teeth to children at
a young age is vital as it can affect the body systemically if left untreated. The use of fluoride
should also be considered to improve the health of the oral cavity in under-served populations.
Education is central in taking a step toward these highly preventable oral diseases.
Analysis
To the researcher, this article had more pros than cons. This article contained many
references, quotes, and information to educate their audience and readers. It also contained
information from a national dental association to give more credit to the article. One limitation to
this article is the direction toward children only. However, that is the primary topic for this article
and readers can see from the title it is an article about pediatric dental disease.
Preventative Social Work Programs
Hamilton and Rolf (2010) created an article to explain how critical it is to have
preventative social work programs in regards to mental health and suicide. Their article states
approximately 30,000 lives are lost to suicide and 650,000 people receive medical attention for
treatment from suicide attempts in the United States every year (p. 284). This is where
preventative care is essential. In fact, the Surgeon General has called for action to take a stand
against suicide. He asks for awareness and programs be created to educate the public in hopes of

LITERATURE REVIEW

preventing suicide. Encouraging those with thoughts of suicide to seek professional support
should be a major focus.
American Indian Youth Suicide Prevention
Hamilton and Rolf mention the suicide incidence rate for American Indians in 1.7 times
higher than the national average and as low as 10% of American Indians seek professional help.
Prevention programs are important as Hamilton and Rolf explained 70% of behavioral programs
focus on treatment rather than prevention (p. 285). With that said, there were several different
program implemented in this research study. These included: programs to raise awareness of
suicide, programs to encourage the involvement of tribal leaders, and a program titled the
American Indian Life Skills Development Curriculum which addresses key issues in adolescents
lives and how to combat difficulties. After their research of these programs, the authors were able
to see a positive results and noticeable improvement in suicide rates among American Indians.
Limitations
While this study had an appropriate timeline of 12 years, there were some limitations to
this study. The obvious limitation is how this study was conducted with the American Indian
population; a fraction of the ethnicities that make up the United States. The authors also noted
their own limitation of age groups. American Indians tend to have higher suicide rates in
adolescents whereas Caucasians suicide rates increase with age (p. 285). To apply this study to
the United States as a whole, it would be important to include racially appropriate information.
Elderly Preventative Care
Throughout this paper, the researcher has covered the pediatric and adolescent at-risk
populations, and now it is time to discuss the elderly population. Shenson, Anderson, Slonim,

LITERATURE REVIEW

and Benson (2012) explain the importance of preventative care for the elderly population
through screening and immunizations. Their article states By 2030, more than 81 million
Americans are expected to have multiple chronic conditions. If left unchecked, the aggregate
costs associated with treating these conditions will escalate sharply, from $1.3 trillion in 2003 to
$4.2 trillion by 2023 (p. 165). Those numbers are alarming high and do not help the current
status of the United States healthcare issues. Preventative care will decrease the medical costs by
identifying triggers for different diagnoses and prevent potential chronic conditions. One
imperative aspect to treat these problems before they occur is to complete primary prevention
screenings and vaccinate. Luckily, Medicare will cover preventative screenings and
immunizations. Completing these screenings and administering immunizations should remain the
focus as healthcare changes.
Analysis
This article also contains a lot of information with great statistical analysis. It also urges
the readers to think of their own preventative health patterns. One con to this paper is the lack of
information about immunizations. The topic of vaccinations can be a difficulty subject, so if the
author wanted to encourage immunizations, it would be important to provide data about why it is
important.
Learning Plan
The researcher is using the information from this literature review to create educational
pamphlets about preventative health to at-risk populations in Provo, UT. The information will be
passed to individuals seeking medical attention at the Volunteer Care Clinic, a free clinic to
people with income less than the federal poverty level and no insurance. The educational

LITERATURE REVIEW

pamphlets will be in English and Spanish as the clinic sees predominantly members in the
Hispanic population.
Conclusion
After the researcher completed a literature review of preventative care, it is clear
preventative health care is critical for low income and at-risk populations. Preventative screening
and immunizations assist individuals in poverty areas to receive the necessary care to lead
healthy lives. Complications from circumstantial issues in poverty areas are limited with regular
checkups and screenings. Access to resources such as free volunteer clinics increase the chances
of preventative screening for low income individuals and their families. As healthcare changes
and advances, providing preventative education and screenings will improve patient outcomes
and allow those individuals to take a stand for their own health.

References

LITERATURE REVIEW

Hamilton, S., Rolf, K. (2010). Suicide in adolescent American Indians: preventative social work
programs. Child & Adolescent Social Work Journal, 27(4), 283-290. doi:
10.1007/s10560-010-0204-y
Nettle, D. (2010). Why are there social gradients in preventative health behavior? A perspective
from behavioral ecology. PLos One, 5(10). http://dx.doi.org.libproxy.dixie.edu/10.1371/j
ournal.pone.0013371.
Shenson, D., Anderson, L., Slonim, A., Benson, W. (2012). Vaccinations and preventative
screening services for older adults: opportunities and challenges in the USA.
Perspectives in Public Health, 132(4), 165-170. Retrieved from
http://rsh.sagepub.com/content/132/4/165.abstract
Taylor, E., Marino, D., Thacker, S., DiMarco, M., Huff, M., Biori, D. (2014). Expanding oral
health preventative services for young children: a successful interprofessional model.
Allied Health, 43(1), 5-9. Retrieved from http://search.proquest.com.libproxy.dixie.edu/n
ursing/docview/ 1524323396/73FB39949D564E76PQ/1?accountid=27045
United States Census Bureau. (2013). Retrieved June 5, 2015 from http://www.census.gov/searc
hresults.html?q=Provo
%2C+UT+insurance&search.x=0&search.y=0&search=submit&page=1&stateGeo=&sea
rchtype=web.