Professor and Classmates

Case Study: Maternal Child/Development and Mental Illness

1. Discuss several risk factors that may impact health outcomes for the vulnerable population in your case study.

2. Identify one agency in your community that can assist this vulnerable group and assess this agency in terms of the 4 A’s (see the lesson). Discuss each of the A’s separately to assess accessibility, acceptability, affordability and availability for this population.

After reviewing Mary’s case, I found many resources in my community of St. Augustine, Fl that she could take advantage of. Services like pregnancy screening, eligibility screening for and assistance to obtain 45- day temporary Medicaid, pregnancy risk assessment, WIC, education and how to maintain a healthy pregnancy. After searching my area, I also found one clinic best known as Assures Best Care (ABC) that I felt met all of Mary’s needs in terms of accessibility, acceptability, affordability, and availability. This clinic qualifies under accessibility because Mary would be able to take advantage of another organization called Grace United Methodist Church, that provides free transportation to those in need of a ride to doctor’s appointment or for job opportunities. In terms of acceptability, this is designed for males and females who fall on the sliding scale of family household and income size. This program is affordable for Mary’s situation. Availability of resources are from Monday-Friday from 8:00 am-5:00 pm, by appointment only.


The City of St. Augustine seems to have adequate resources for other vulnerable population that I observe as well. St. Gerard Campus is another facility that is designed to assist young pregnant teenagers and unwed mothers. They help with medical care; educational services need and obstetrics services to all women. These services include, free pregnancy testing, personal/pregnancy counselling, free sonograms, adoption/adoption counselling, food, clothing, furniture, High School with onsite daycare, allowing young mothers to reside and go to school while having daycare service onsite and not having to worry about their child. The local welfare office WIC, a nutrition program provides women with low to moderate income who are pregnant or breastfeeding or recently become pregnant, infants and children under 5 years of age. Services provided such as healthy foods, nutrition counselling, breastfeeding support, immunizations, etc.
In terms of the vulnerable population, such as the mentally disabled, there are some services available in the community that aid. One such organization is The Arc of St. Johns, that aids people with developmental disabilities so that they can participate as full members of their communities. Services provides are but are not limited to behavioral training, companion services, mental health services, supported, employment, and living and transportation. The risk factors that I see impacting the health outcome for the vulnerable population in this case study is Mary’s medical history, history of child neglect, poverty, stress level and her low social support from family and friend.


Catholic Charities. Putting Compassion into Action, (Links to an external site.)

Florida Health St. Johns County Women’s Health. services/clinical-and-nutrition-services/wic/index.html

Grace United Methodist Church. Transportation Ministry. (Links to an external site.)

St. Gerard Campus.
The Arc of St. Johns.

#2 Derrick Haile

The case that I have chosen is the senior with dementia.

There are multiple risk factors that might impact a senior citizens health outcomes like Mr. Johnson. For one, his income has a direct impact on how he will live the rest of his life and what resources are available to him and his family. Nies and McEwen (2019) tell us that the older a person gets, the more money they will spend on healthcare. Another important thing to consider in this case is that Mr. Johnson’s wife is his sole provider and if she were to get injured or passed away, he would be on his own and if he is left alone in his house, that would be very problematic. When it comes to direct impact to health, nutrition is also very important. Nies and McEwen (2019) state that “poor nutrition in the elderly population is common.”

One agency that I have located in my community that services senior citizens with and without dementia is called ElderCare of Alachua County.

Acceptability: It is clear that Mr. and Mrs. Johnson need help and have many needs when it comes to caring for Mr. Johnson because it seems that his body is deteriorating. Mrs. Johnson has already expressed that she needs help and would like to send him to a nursing home but would not be able to afford it. Also it is important to note that Mrs. Johnson can easily fall into depression due to caregiver burnout. In fact, “One study showed that as many as 75% of caregivers struggle with symptoms characteristic of anxiety and depression. (Staloff, Diop, Matuk, Riese, & White, 2018)” ElderCare of Alachua County provides services that include transportation to and from activities, provides respite care, homemaking, and adult daycare for Alzheimer’s patients. These services are all provided for free to the patients.

Accessibility: Mr. Johnson might be in a wheelchair or is physically disabled in some way so it might be very difficult to get him in and out of his house due to stairs or lack of strength or it might take too much effort to get inside of a vehicle or there might not be a ramp.

Availability: These services are all provided by volunteers who volunteer their time to help with the care of these citizens. If there are a decrease in the number of volunteers then there might not be enough for all of the patients to get a chance to have these services done.

Affordability: Like I stated before, this program is completely free to the users and operates on donations given and from people volunteering their time and services so Mr. Johnson would not have to use any of his own money or insurance.


Nies, M. A., & McEwen, M. (2019). Community/Public health nursing: Promoting the health of populations (7th ed.). St. Louis, MO: Saunders/Elsevier

Staloff, J., Diop, M., Matuk, R., Riese, A., & White, J. (2018). Caring for Caregivers: Burnout and Resources for Caregivers in Rhode Island. Rhode Island Medical Journal (2013), 101(9), 10–11. Retrieved from

UF Health. (2019). ElderCare of alachua county. Retrieved from