| Course | NR 550 Population Health Disparities: Local, National, and Global Perspectives |
|---|---|
| Week | 7 |
| Paper type | Multilevel policy analysis |
| Length | About 1,130 words, 2 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | MSN, Population Health |
| Updated | September 2026 |
Free sample paper for NR 550 Week 7
Multilevel Policy Analysis: Seven Levels That Could Act on the East Side's Childhood Asthma Emergency Gap, What Each Body Can Change, and How Much of the Gap Each Could Reasonably Reach
Student Name
College of Nursing, Chamberlain University
NR 550: Population Health Disparities: Local, National, and Global Perspectives
Instructor Name
Month Day, Year
Multilevel Policy Analysis: Seven Levels That Could Act on the East Side's Childhood Asthma Emergency Gap, What Each Body Can Change, and How Much of the Gap Each Could Reasonably Reach
The Gap
Compared with the state rate, children on the east side have about 203 more asthma emergency visits per 10,000 children per year, or about 158 excess visits a year in total, and about 221 per 10,000 more than their peers elsewhere in the county. The structural causes brief attributed a substantial share of the gap to features of the place: old, damp rental housing, diesel exposure near the rail yard and truck route, and the absence of evening primary care. It attributed part to the circumstances of families, including income and smoking. This analysis lists every level of government and organization that could act on the gap, names the body at each level and the thing it can change, and estimates how much of the gap each could reach. The estimates are rough, but stating them as portions of the gap lets options be compared.
The Levels
Table 1 lists each level, including levels that appear to have little to offer, because an empty row is part of the evidence.
Levels, bodies, the object each can change and estimated reach
Table 1
| Level | Body | What it can change | Estimated reach of the gap |
|---|---|---|---|
| Household | Families | Smoking indoors, trigger reduction, medication use | Small to moderate, limited by housing |
| Health system | Hospital and federally qualified health center | Evening pediatric clinic on the east side; asthma action plans at discharge | Moderate, perhaps one quarter |
| Landlords | Private owners of pre-1960 rentals | Repairs for moisture, mold and pests | Moderate, if enforced |
| City | Code enforcement office | Inspection frequency and enforcement of rental standards | Moderate, through landlords |
| County | Health department | Home asthma visits with trigger assessment; data monitoring | Small to moderate |
| State | Medicaid agency; environmental agency; transportation department | Coverage of home visits and remediation supplies; diesel emissions; truck routing | Potentially large, slow |
| Federal | Housing and environmental agencies | Healthy homes grants; locomotive emissions standards | Indirect; funds and rules others use |
Power and the Thing It Can Change
Each level has a body and an object. A level with a body but no object cannot be recommended to.
Household. Families can reduce indoor smoking and some triggers and use controller medications. But a family cannot fix a leaking roof it does not own. Household education reaches the part of the gap that households control, which the structural brief suggested is the smaller part.
Health system. The hospital and the federally qualified health center could open an evening pediatric clinic on the east side and give every child seen for asthma in the emergency department an action plan and a follow-up appointment. This acts directly on the access gap. If a quarter of east side emergency visits occur in the evening for exacerbations that planned care could address, the clinic could reach something like a quarter of the gap.
Landlords and the city. Landlords own the housing; the city's code enforcement office has the power to require repairs. The object is inspection and enforcement. The local evidence from families moving into renovated housing suggests that housing repair can reduce visits substantially, but repairs happen only if enforcement is active.
County. The health department can offer home visits in which a nurse or community health worker assesses triggers, supplies mattress covers and pest control, and teaches families. Home-based, multi-trigger interventions for children with asthma have evidence of reducing symptoms and urgent care use, and they combine the household and housing levels (Krieger & Higgins, 2002). The county's reach is limited by staff: at current funding, it can visit perhaps 80 families a year.
State. The state Medicaid agency could cover home asthma visits and remediation supplies, which would pay for the county's program at scale. The state environmental agency and transportation department have power over diesel emissions and truck routing. These changes could reach a large part of the gap but take years.
Federal. Federal agencies set locomotive emissions standards and fund healthy homes programs. They cannot act on the east side directly but supply the rules and money that other levels use.
Matching Levels to Causes
The mismatch is the finding. The level with the most direct contact with families, the health system and county nurses, has the least power over the largest cause, which is housing and air. The levels with power over housing and air, the city, the state and federal agencies, have the least contact with the families and the least information about the east side's rate. Frieden (2010) described a health impact pyramid in which interventions that change the context in which people make decisions reach more people with less individual effort than counseling and education. The east side's gap is concentrated at the base of that pyramid.
Recommendation
Three actions, in order. First, the health system should open an evening pediatric clinic on the east side, since it is within one organization's power and reaches the access part of the gap within a year. Second, the county should present the tract-level data to the city council with a request for proactive rental inspections on the east side, prioritizing tracts E1 to E5; this acts on housing through the one local body with enforcement power. Third, the county and hospital together should ask the state Medicaid agency to cover home asthma visits and remediation supplies, which would turn a small county program into a service that could reach every east side child with frequent emergency visits.
Diesel exposure near the rail yard is the hardest cause to reach locally. It is noted here so that it is not lost, and the county should raise it with the state environmental agency, but it is not the first recommendation because no local body can change it.
Limits of the Estimates
The reach estimates are judgments based on the local evidence, not modeled projections. They could be too optimistic if families do not use an evening clinic or if enforcement leads landlords to raise rents or sell. They could be too pessimistic if the interventions reinforce each other. Rose (1985) cautioned that population strategies often produce modest benefits for each individual but large benefits across a population, which suggests that even small reductions per household may add up to a meaningful share of the gap.
These limits will be revisited when the first year of data is in.
References
Frieden, T. R. (2010). A framework for public health action: The health impact pyramid. American Journal of Public Health, 100(4), 590-595. https://doi.org/10.2105/AJPH.2009.185652
Krieger, J., & Higgins, D. L. (2002). Housing and health: Time again for public health action. American Journal of Public Health, 92(5), 758-768. https://doi.org/10.2105/AJPH.92.5.758
Rose, G. (1985). Sick individuals and sick populations. International Journal of Epidemiology, 14(1), 32-38. https://doi.org/10.1093/ije/14.1.32
What the NR 550 Week 7 assignment asks for
The seventh week asks you to analyze policy options for a health disparity across levels of government and society. The prompt typically requests the levels involved, the actors and their authority, possible policies, their likely impact and a recommendation. List every relevant level in a table, including levels that seem to have little to offer, since empty rows are evidence. For each level, name the body and the specific thing it can change, such as a rule, a service, a schedule or funding. Estimate how much of the gap each could reach, as a portion rather than an intention, and say how the estimate was made. Identify mismatches between who has contact with the problem and who has power over its causes. Recommend actions in order. State the limits of your estimates. Cite public health frameworks in APA 7.
How the NR 550 Week 7 example is put together
The analysis opens by restating the gap in rates and excess visits and linking it to the causes identified earlier. Table 1 lists seven levels with their bodies, objects and estimated reach. A section discusses each level's power and object, from household trigger reduction to state Medicaid coverage of home visits, federal healthy homes grants and emissions standards, citing housing intervention evidence. A section names the mismatch and links it to a framework in which changing context reaches more people than counseling. The recommendation orders an evening clinic, proactive rental inspection and state coverage of home asthma services, and notes diesel exposure as a harder problem. A section states the limits of the reach estimates.
Where the points sit in the NR 550 Week 7 rubric
Multilevel policy analyses are generally judged on completeness across levels, accurate identification of authority, realistic estimates of impact, insight into how levels interact and a well-supported recommendation. Keeping every level in the table, including weak ones, shows the analysis is complete. Naming a body and an object for each level makes recommendations actionable. Estimating reach as a share of the gap allows options to be compared rather than simply listed. Identifying the mismatch between contact and power shows structural insight. An ordered recommendation that begins with what is within reach demonstrates practicality. Stated limits and public health frameworks cited in APA 7 complete the analysis.
NR 550 Week 7 help: mistakes that cost points
Policy analyses often recommend actions without saying who has the power to take them. Name the body and what it can change. Another weakness is omitting levels that seem unhelpful; include them, since their absence of power is part of the finding. Some students describe impact as intentions, such as will improve outcomes, rather than estimating a share of the gap. Make an estimate and explain it. Avoid recommending only the most ambitious policy; order actions by what can happen first. Consider unintended effects, such as rent increases after enforcement. Keep the causes identified earlier in view, so recommendations match them. State how the estimates were made and how they could be checked.
Get a NR 550 Week 7 example written to your instructions
Send the gap you have been given and the levels your classroom expects in the table, or say the prompt leaves them open and a defensible set gets chosen and justified. A custom analysis is written to your instructions and returned inside 24 to 48 hours, the first one free, with a named body and means at every level.
More NR 550 papers and MSN samples
- NR 550 Week 1: Disparity Statement Discussion
- NR 550 Week 2: Local Disparity Profile
- NR 550 Week 3: Comparator Analysis
- NR 550 Week 4: National Data Review
- NR 550 Week 5: Structural Causes Brief
- NR 550 Week 6: Global Comparison Write-Up
- NR 550 Week 8: Synthesis Paper
- NR 540 Week 7: Sustainability Plan
- NR 539 Week 7: Outcome Evaluation Plan
- NR 538 Week 7: Priority Ranking Matrix
- NR 530 Week 7: Framework Comparison Paper
NR 550 Week 7 questions, answered
How many levels should the analysis cover?
Every level that touches the gap, including the ones you expect to come out empty. A table showing that the city has no relevant power and the state has all of it is a result, and it only becomes visible because the city row was written out and left honest. Papers that include only the promising levels tend to conclude that the promising level should act.
What counts as a means?
Something specific that a named body can actually change: a rule, a purchasing decision, a license condition, an opening time, a formula that moves money. Should prioritize is not a means, and neither is raise awareness. If you cannot write the sentence a person at that level would put their name to, the level does not yet belong in your recommendation.
What if the level that could act is far above me?
That is a legitimate finding and a common one. Report it plainly, then add what somebody at your own level can do toward it, which is usually supplying the evidence, documenting the gap in a form that body accepts, or joining whoever already petitions it. The paper stays honest by keeping that contribution separate from the decision itself.
Where can I find a free NR 550 Week 7 sample paper?
The seven-level asthma policy analysis appears above as the NR 550 Week 7 sample, readable from start to finish. If your disparity sits in a different policy setting, share it with our team and an analysis of levels and reach can be prepared.
What mismatch does the NR 550 Week 7 sample find?
That the bodies closest to families, clinics and county nurses, have the least power over the largest causes, housing and air, while the bodies with that power have least contact with the families.