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Columbus city is located in county seat of Muscogee, Georgia, and lies 160 km south of Atlanta. It is one of the three Fall Line Cities of Georgia. The landscape of this city consists of rolling hills on the north side and flat plains on the south. The total area of the city is 221 square miles (Christer, 2011). Furthermore, it has a humid and subtropical climate. Founded as per the Georgia Legislature Act in 1828, the city was later named after Christopher Columbus. After the Civil War, industries in Columbus improved their operations and the city became one of the key centers of Confederate industry. It was among the major suppliers of ironworks and swords to the Confederate Army. Columbus State University, a comprehensive higher learning center, is located in this city. Today, various industries, such as Aflac, Synovus and Carmike Cinemas, can be found in the city as well. Several municipal projects have been done in this city, including the construction of a softball complex that hosted the 1996 Olympics, construction of the National Civil War Naval Museum located at the Port of Columbus and the Coca-Cola Space Science Centre. In addition to this, Columbus Museum has been expanded and a new bridge crossing Chattahoochee River to Phoenix City constructed (Christer, 2011). This city has also established itself as a centre for fine and performing arts. An example of such a centre is River Centre for the Performing Arts opened in 2002 and housing music department of Columbus State University. This has helped it preserve its culture. The city has five geographical areas. Downtown, the city’s central business district, has various religious centers, such as Church of the Holy family. East Columbus is the largest area where Bull Creek Golf Course is located. The third geographical area is Mid Town that is both a residential and commercial area. Peachtree, an indoor shopping mall, and the Landings, an outdoor shopping mall, are both located in this area too. It also has a number of nightclubs. North Columbus, the fourth area, is known for its upscale areas, such as Green Island Hills. The last area is South Columbus that is situated just below Mid Town. The National Infantry Museum is located in this area as well. The last census carried out in 2010 revealed that the city had a total population of about 189, 855. The population density of this area is 861.4 people per square mile. 50.42 % were White, 43.74 were African American, 4.49 % Hispanic or Latino 1.54% Asian, 0.38 Native American and 1.9% from other races. 26.8 % of the total population was under the age of 18, 11.9% from 18 years to 24 years, 29.8% from 25 to 44 years, 19.7 % from 45 to 64 years and 11.7 % above the age of 65 years (Grant, 2011). The per capita income for the city stood at $18, 262. People of Columbia practice Christianity, Islam, Jehovah Witness and Judaism. There are several types of health services available in the city. The Allergy Centre at Brookstone offers healthcare services to patients with asthma and other allergic diseases. Beltone Hearing Aid Centre provides medical services to patients with hearing complications. Columbus Clinic is a multi-specialty healthcare clinic that specializes in internal and family medicine. Columbus Diagnostic Centre offers patients an opportunity to receive accurate and prompt diagnosis without the need of visiting the hospital. Columbus Family Dentistry was formed to attend to the dental needs of the people living in Columbus. It treats dental and gum infections. Doctors Hospital has been in operation for about 25 years. It mainly handles baby delivery procedures. Eyeglass World was the first eye care facility in Columbus. It offers eye checkups at low prices (Grant, 2011). Furthermore, Eye Wear Unlimited, located in the center of Columbus, carries out eye examinations, retails lenses, glasses, frames and contact lenses. Free-IVF helps create awareness of the infertility problem that is facing the society. In addition to this, it offers treatment options and educates Columbus residents on methods of preventing it. Freedom Senior Care offers care for the aged people living in the area. Martin Army Hospital is located off 1-185 on Marne Road, and it offers medical services at Fort Benning. It was initially built to offer medical services to the Army in 1958. Muscogee Manor Centre is comprised of modern nursing care facilities with a rehab wing that provides counseling to drug addicts. River Town Pediatrics has skilled medical staff whose aim is to help children of this community enjoy healthier, longer and more productive lives. The Southeast Regional Pain Center has treated thousands of Columbus residents suffering from Pain disorders and chronic pain. All these health services are available in Columbus.

 

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The White people living in Columbus face a number of smoking-related health problems. This has led to a significant increase in health liabilities, which causes high risks of hypertension, noninsulin-dependent diabetes and ischemic heart disease. Unlike Hispanic women, White women in this area tend to smoke more cigarettes on a daily basis. This can be attributed to the fact that in Hispanic culture it is generally deemed socially unacceptable for a woman to smoke. A study carried out in Columbus revealed that Hispanics associated smoking with less pleasure as compared to the non-Hispanic Whites. In addition to this, Hispanic men believe that a woman who does not smoke is more friendly, sociable and attractive. Furthermore, there are people living in Columbus who do not trust physicians care and they believe that religion is the only factor that will heal them. The doctors attending to such patients are always advised to respect the beliefs of these patients and later establish a therapeutic relationship that is effective (Gardenswartz & Rowe, 1998). If they overlook this factor, the patient may never trust the physician again and, therefore, he may avoid seeking medical care when he needs it. Doctors have a responsibility of making the patient understand the consequences of refusing treatment that is supposed to be administered to them. If the patient persists in refusing treatment, the doctor should try and understand the reason for his refusal and address the misconceptions that the patient might be having. If he does not succeed, he should seek assistance from a hospital chaplain or religious leaders. Cigarette smokers in Columbus are mostly affected by cardiovascular diseases. These diseases affect their heart and blood vessels, leading to death in some instances. About 82% of people who die from coronary heart disease in this area are above 65 years of age (Sloan, 2004). Furthermore, the people who die from stroke are mostly above 55 years of age. This has been attributed to the fact that as the age increases, the serum cholesterol level in the body increases. In addition to this, the arterial walls lose their elasticity due to the change in their mechanical and structural properties. A type of cardiovascular disease that may affect cigarette smokers is Ischemic heart disease. It affects the heart muscles due to the reduced blood supply to myocardium. Hypertensive heart disease also affects smokers. It is caused by localized high blood pressure due to left ventricular hypertrophy and cardiac arrhythmias. Smoking also causes lung cancer. A number of Columbus residents have died from this disease due to smoking cigarettes. The disease is caused by uncontrolled growth of cells in the lung tissue (Sloan, 2004). If doctors do not treat the disease at early stages, the growth can spread to other body parts by means of metastasis. The symptoms of lung cancer are hemoptysis, chronic coughing and change in the coughing pattern, chest pain, weight loss, fatigue and appetite loss. Cigarette smoke contains about 60 known carcinogens, radioisotopes from the decay sequence of radon, benzopyrene and nitrosamine. Women who smoke and undergo a course of hormone therapy face a higher risk of dying from lung cancer. If a person quits smoking, his chances of lung cancer reduce since the body repairs the damaged tissues and removes the contaminated particles. Second-hand smoking can also cause lung cancer. The types of lung cancer affecting smokers in Columbus include non-small-cell lung carcinoma, small cell lung carcinoma, characinoid and sarcoma. Columbus residents also suffer from emphysema. This progressive disease affecting the lungs causes a person to experience shortness in breath. The tissues that support the physical shape and functions of the lungs are destroyed. It is sometimes referred to as obstructive lung disease since it destroys the lung tissues around the alveoli, making them unable to hold their functional shape upon exhalation. Two types of emphysema include pancinar emphysema and centriacinar emphysema. Panacinar emphysema affects mainly the lower lobes on the basal segments of the lungs while centriacinar emphysema affects the upper lobes of the lungs (Sloan, 2004). The symptoms of this disease include shortness of breath and expanded chest. There are health service programs which are designed to meet the needs people with lung cancer, cardiovascular diseases and emphysema. East Alabama Medical Centre performs chest radiographs to determine if a person suffers from lung cancer. It also carries palliative care, surgery and chemotherapy to help reduce the spread of cancer. Columbus Diagnostic Centre performs pulmonary function testing and radiography to diagnose if a patient has emphysema. If a patient suffers from this disease, it tries to advise the patient on the benefits and steps of quitting smoking. Several hospitals in the area have been encouraging people to exercise a lot so that they can avoid cardiovascular diseases.

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If I were to create an ideal system, I would ensure that there is a culturally competent health care for the cigarette smoking subculture in Columbus. I would achieve this by using ambulatory and preventive services. Ambulatory services are medical care services performed on an outpatient basis. This type of healthcare is common since it can be delivered without the need of expensive hospitalization. Examples of ambulatory care that I would incorporate in this ideal system include physician office visits, lab tests and radiology, outpatient surgical procedures and rehabilitation visits. In physician office visit, the patients with lung cancer and cardiovascular diseases would meet with the physician to get advice on diagnosis and methods they can adopt for successful treatment (Tablot & Rubenstein, 2003). This procedure takes far less time than if the patient went to a radiologist or neurologist. The patient begins by presenting his symptoms to the physician who later performs diagnostic procedures. He later carries out a system inquiry and the actual physical examination (Tablot & Rubenstein, 2003). Lastly, the physician will offer treatment to the patient and advise him on how to live a healthy life.

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I would also use lab tests and radiology to determine a rate of cancer spread in the bodies of patients suffering from lung cancer. I would also use vascular and intervention radiology to determine the heart condition of patients suffering from cardiovascular diseases. I would conduct X-ray scans to know if a patient is suffering from emphysema. I would also conduct biopsy procedures to know if cancer cells are present in the body of a cigarette smoker. I would also use outpatient surgical procedures on patients requiring them due to heart complications. This type of surgery does not require the patient to stay overnight in hospitals after undergoing a surgery procedure. This would help the patient to save time that would otherwise be wasted during hospitalization and spend less money due to lower hospital costs. I would also conduct cardiac rehabilitation visits that would ensure patients suffering from heart complications have adequate social support and that they understand the medication they are to take to improve their living conditions. I would carry out preventative services, such as cardiovascular screening. This would help all patients take care of their heart condition, thus preventing heart attacks and sudden strokes that could cause death (Zaza, Briss & Harris, 2005). The screening would be conducted after every 5 years to monitor cholesterol and body fat levels. The tests carried out would include total cholesterol tests, cholesterol test for high-density lipoproteins and triglycerides test. These tests would help detect and treat early cardiovascular diseases. Another preventive service that I would adopt is advising all the patients on how to observe a healthy diet (Zaza, Briss & Harris, 2005). This would help reduce heart complications by avoiding food with high cholesterol. Furthermore, I would advise them to engage in exercises that would keep their bodies fit and healthy. I would also advise the cigarette smokers to quit smoking since it causes lung cancer and cardiovascular diseases. I would further give them tips on how to quit the habit of smoking. Lastly, I would establish a nursing home in Columbus. This home would be staffed with skilled nurses that would offer constant medical care to the aged people in the society. In addition to this, the nurses would offer rehabilitative therapies for patients with drug addiction problems.

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In conclusion, it is evident that Columbus city is a good community to live in. This is because it has many health centers offering quality services, such as Martin Army Community Hospital. This community has people with a subculture of smoking. This practice has led them to develop health complications, such as lung cancer. However, an ideal system can be created by incorporating ambulatory and preventive services that will help improve the life and health care of the community.

 

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