| Course | NUR-4430 Public Health Nursing |
|---|---|
| Module | Module 5 |
| Paper type | Health equity analysis |
| Length | About 1,000 words, 6 pages |
| Format | APA 7 student paper |
| School | Thomas Edison State University |
| Program | Bachelor of Science in Nursing |
| Updated | October 2026 |
Free sample paper for NUR 4430 Module 5
Same County, Different Odds: Health Equity, Social Determinants and the Numbers Behind Disparity in Cumberland County
Student Name
Bachelor of Science in Nursing, Thomas Edison State University
NUR-4430: Public Health Nursing
Mentor Name
Month Day, Year
Same County, Different Odds: Health Equity, Social Determinants and the Numbers Behind Disparity in Cumberland County
Earlier modules showed that Cumberland County, New Jersey, has the highest estimated rates of adult diabetes, obesity and smoking among the state's twenty-one counties. County averages, however, hide differences inside the county. This paper looks at those differences in figures, explains them through the social determinants of health, identifies the groups most affected, and proposes how a public health nurse can act on equity rather than only describe it. Income, poverty and schooling figures are the Census Bureau's five-year survey estimates covering 2020 through 2024 (U.S. Census Bureau, 2025), and all health figures from model-based estimates for 2023 (Centers for Disease Control and Prevention, 2025).
What Equity Means Here
Braveman et al. (2017) define health equity as everyone having a fair and just opportunity to be as healthy as possible, which requires removing obstacles such as poverty and discrimination and their consequences, including powerlessness and lack of access to good jobs, education, housing, safe environments and health care. The definition matters because it turns attention from individual behavior to conditions. A higher diabetes rate in one group is not, by itself, evidence of inequity; it becomes an equity concern when it follows from differences in opportunity that are avoidable and unfair. Marmot (2005) made the same point at a global scale, arguing that the social conditions in which people live and work drive much of the gradient in health between groups, and that those conditions can be changed by policy.
The Disparities in Figures
The table compares Cumberland County with New Jersey as a whole on income, poverty and education, and shows differences by race and ethnicity within the county. Three patterns stand out. First, the county as a whole is poorer and less educated than the state: fewer than one in five adults aged twenty-five and over holds a bachelor's degree, compared with more than two in five statewide. Second, within the county, poverty among Black and Hispanic residents is far higher than among White non-Hispanic residents. Third, the gap between groups in Cumberland is smaller than the statewide gap in income, mainly because White non-Hispanic residents of Cumberland earn much less than their counterparts elsewhere in New Jersey. Cumberland is a place where almost every group has less than its statewide peers, and some groups have much less.
| Measure, five-year survey estimates | Cumberland County | New Jersey |
|---|---|---|
| Poverty, Hispanic or Latino residents | 18.1% | 16.2% |
| Poverty, Black residents | 19.8% | 15.5% |
| Poverty, White non-Hispanic residents | 11.1% | 6.4% |
| Median household income, Hispanic or Latino households | $64,303 | $76,364 |
| Median household income, Black households | $47,446 | $71,115 |
| Median household income, White non-Hispanic households | $78,131 | $115,459 |
| Adults 25 and over with a bachelor's degree or higher | 18.9% | 43.6% |
From Social Conditions to Health
The health estimates follow the social ones. The county leads the state in estimated food insecurity at 24.7 percent of adults and in transportation barriers at 12.3 percent, and it is second in the share of working-age adults without health insurance at 18.9 percent. Each of these is a social determinant with a direct path to chronic disease. Food insecurity makes a diabetic diet hard to follow and is associated with cheaper, calorie-dense food. Lack of transportation makes routine visits and laboratory monitoring harder to keep. Lack of insurance delays diagnosis, which helps explain why diagnosed diabetes may still understate the true burden in the groups with least access.
The county's large Hispanic population, more than a third of residents, includes many seasonal agricultural workers and families with mixed immigration status. Fear of immigration consequences, limited English proficiency and irregular work schedules can each keep people from preventive care even when it is offered. Black residents, with the county's lowest median household income, face the combination of low wages and the long history of discrimination that Braveman and colleagues name as an obstacle to equity. These are the populations a county health department would identify as most vulnerable to the chronic disease burden described in earlier modules. It is worth adding what the numbers cannot show. Survey estimates undercount people who move with the harvest, live in employer housing or avoid government surveys, so the true gaps for seasonal workers are probably wider than any table here suggests. Nurses who work in the county's clinics and mobile vans often know this from experience, and their observations belong in the community assessment alongside the published figures.
An Equity Response for Public Health Nursing
Describing disparities is an assessment task; acting on them is assurance and policy development. The choice of response matters, because a program designed for the average resident tends to reach the residents who already have the most resources first. The evidence suggests that one effective response is to change who delivers support. Kangovi et al. (2018) randomized 592 low-income patients with chronic disease in Philadelphia primary care practices to support from community health workers or usual care and found that patients paired with a community health worker rated their care more highly, logged far fewer inpatient days at the six- and nine-month marks, and were less likely to bounce back into the hospital. The workers in that trial were hired from the neighborhoods their patients lived in, and much of their time went to rent, groceries, rides and paperwork rather than to blood pressure readings.
For Cumberland County, a public health nurse could build on that evidence in three ways: by pressing for bilingual outreach workers, fluent in the Spanish and Haitian Creole that many farm families speak, to be built into the county's chronic disease programs; by mapping where transportation barriers and food insecurity cluster and placing screenings there rather than at the health department; and by presenting disaggregated data to the county's health coalition so that progress is measured for each group, not only for the county average. Equity work succeeds only when the gap between groups narrows, and that cannot be seen unless the data are broken out in the first place.
References
Braveman, P., Arkin, E., Orleans, T., Proctor, D., & Plough, A. (2017). What is health equity? And what difference does a definition make? Robert Wood Johnson Foundation. https://www.rwjf.org/en/insights/our-research/2017/05/what-is-health-equity-.html
Centers for Disease Control and Prevention. (2025). PLACES: Local data for better health, county data, 2025 release [Data set]. https://data.cdc.gov/500-Cities-Places/PLACES-Local-Data-for-Better-Health-County-Data-20/swc5-untb
Kangovi, S., Mitra, N., Norton, L., Harte, R., Zhao, X., Carter, T., Grande, D., & Long, J. A. (2018). Effect of community health worker support on clinical outcomes of low-income patients across primary care facilities: A randomized clinical trial. JAMA Internal Medicine, 178(12), 1635-1643. https://doi.org/10.1001/jamainternmed.2018.4630
Marmot, M. (2005). Social determinants of health inequalities. The Lancet, 365(9464), 1099-1104. https://doi.org/10.1016/S0140-6736(05)71146-6
U.S. Census Bureau. (2025). American Community Survey 2020-2024 5-year estimates, tables B17001B, B17001H, B17001I, B19013B, B19013H, B19013I and B15003 [Data set]. https://data.census.gov/
Reading the NUR 4430 Module 5 assignment instructions
In most terms the fifth module of NUR-4430 focuses on health equity, social determinants and vulnerable populations. The written assignment often asks you to identify a vulnerable population in a community, describe the disparities it faces with data, explain the social determinants that produce them, and propose public health nursing interventions to reduce them. Some sections ask you to use Healthy People 2030 objectives or a named equity framework, and others ask for a windshield survey or interview. The TESU course site has the exact wording, so check whether county data are required, whether you must compare groups within the community, and how many scholarly sources you need. Use data broken down by group wherever you can find them.
How the NUR 4430 Module 5 example is put together
The paper opens by explaining why county averages hide differences and names its data sources and years at once. A definition section uses two scholars to separate a difference from an inequity. The disparities section presents a seven-row table comparing groups within the county and the county with the state, followed by three patterns in plain language. The next section connects food insecurity, transportation and insurance to chronic disease and describes the groups most affected without stereotyping them. The response section uses a randomized trial of community health workers to justify three local actions and ends by arguing that equity progress requires data broken down by group.
Reading the NUR 4430 Module 5 grading rubric
Equity papers in a public health nursing course tend to be graded on a clear definition of equity and the population, accurate data showing disparities, analysis of social determinants, evidence-based interventions, the nursing role, and writing. The data row is where many papers lose points, by describing a population as vulnerable without numbers or by using national figures when local ones exist. Analysis is rewarded when it explains how specific conditions produce specific health outcomes. Interventions should be supported by evidence and fit the population and setting. Mentors also notice respectful language: describe groups by their circumstances and avoid implying that disparities come from individual choices alone.
Common NUR 4430 Module 5 mistakes, and how to avoid them
Equity drafts most often stall at a catalog of gaps, each reported and none explained. For each gap, name the social condition that drives it. Another common problem is mixing data sources and years without saying so, which makes comparisons unreliable; label every figure. Students also propose interventions aimed only at individual behavior, such as education, when the obstacle is cost, transportation or language. Use evidence for interventions that change conditions or who delivers care. Keep language respectful and specific. Census tables broken down by race and ethnicity are free and current. A desk writer can draft an equity paper on your own county from the directions and data you share.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Thomas Edison State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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NUR 4430 Module 5 questions, answered
Where can I find a free NUR 4430 Module 5 sample paper?
The full equity paper is on this page, with its disparities table, references and margin notes. It uses current Census and CDC figures for Cumberland County, New Jersey; repeat the method with data for the community your directions name.
What is the difference between a health disparity and a health inequity?
A disparity is any difference in health between groups. An inequity is a difference that is avoidable and unfair because it comes from unequal opportunity, such as poverty, discrimination or lack of access. Equity papers should explain why a disparity is also an inequity.
Where can I find data by race and ethnicity for my county?
The American Community Survey publishes income, poverty, education and insurance tables broken down by race and ethnicity for every county. State health departments and county health rankings also report some health measures by group. Always note the data year and whether figures are one-year or five-year estimates.
What interventions count as equity interventions in NUR-4430?
Interventions that reduce obstacles or change who delivers care, such as community health workers, mobile services in underserved areas, interpretation, transportation support and policy changes. Education alone rarely closes a gap caused by cost or access, so pair it with structural changes.
How should I describe vulnerable populations respectfully?
Describe the conditions people face rather than labeling the people themselves, use the terms communities use for themselves, and avoid implying that disparities result only from behavior. Precise data and specific circumstances help keep the language respectful and accurate.