| Course | NU713 Epidemiology and Social Determinants of Population Health |
|---|---|
| Unit | Unit 5 |
| Paper type | Seminar reflection |
| Length | About 830 words, 6 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | Doctor of Nursing Practice (DNP) |
| Updated | September 2026 |
Free sample paper for NU713 Unit 5
2.41, 1.88 or 4.37? A Seminar Reflection on Choosing the Reference Group for a Racial Disparity in Short-Term Diabetes Admissions Across Composite Brennard County
[Student Name]
Purdue University Global
NU713: Epidemiology and Social Determinants of Population Health
Unit 5 Seminar Reflection
[Instructor Name]
[Date]
Brennard County and its rates are composite; figures are bracketed placeholders for rates from the state discharge file.
The Claim I Brought
In my discussion post I wrote: "Black adults in Brennard County are admitted for short-term diabetes complications at 2.41 times the rate of white adults." I had calculated it from Prevention Quality Indicator 01 admissions in the state discharge file, pooled over [2022 to 2024] (Agency for Healthcare Research and Quality, 2024), and I thought of the number as a fact about the county.
What the Group Computed
During the seminar, the facilitator asked us to compute the same disparity in other ways. The rates, per 100,000 adult person-years, were [136.9] for Black adults, [87.5] for Hispanic adults, [56.8] for white adults, [31.3] for Asian adults and [72.7] for the county as a whole.
Against white adults, the Black rate ratio was [2.41] and the rate difference [80.1] per 100,000. Against the county total, the ratio was [1.88] and the difference [64.2]. Against Asian adults, the group with the lowest rate, the ratio was [4.37] and the difference [105.6].
A classmate pointed out a problem with the last comparison: the Asian rate rested on only [14] admissions over three years, so it was unstable and its confidence interval was wide. Another pointed out a problem with the county comparison: the county total includes Black adults, so comparing a group with a total that contains it understates the gap, and more so the larger the group's share of the population.
Why the Choice Matters
My first reaction was that one of these numbers must be right and the others wrong. By the end of the hour I saw that each answers a different question. The ratio against white adults asks how the largest group compares with the historically advantaged group. The ratio against the county total asks how far a group is from the average. The ratio against the lowest-rate group asks how far a group is from the best rate already achieved in the county, which some argue is the most relevant target.
The reference group is not a technical detail; it decides what the disparity is measured against, and so what the county is being asked to achieve.
This was the point I had missed. Harper and colleagues argued that choices such as the reference group, and whether to report absolute or relative measures, carry implicit value judgments that can change the size and even the direction of a reported inequality (Harper et al., 2010). A report from the National Center for Health Statistics had made a similar case, recommending that analysts state their reference group and consider both absolute and relative measures, since each can give a different picture of change over time (Keppel et al., 2005).
I also saw that the ratio alone had hidden something. My 2.41 said nothing about the number of admissions. The difference of [80.1] per 100,000 translates into roughly [43] extra admissions a year among the county's [54,000] Black adults compared with the rate white adults experience, a figure that means more to a hospital planning care than a ratio does.
What I Had Assumed
Looking back, I had assumed that a disparity is a property of the data, waiting to be measured, like a blood pressure. The seminar showed me that it is closer to a comparison I construct. Every disparity has three parts: the group, the reference and the scale, relative or absolute. I had chosen two of the three without thinking, the white reference because it was the one I had seen in published reports, and the ratio because it made the gap look large and clear.
The Rule I Adopted
I now follow a reporting rule for disparities in this project. First, I name the reference group in the same sentence as the number and explain why I chose it. For this project I will use white adults as the primary reference, because they are the county's largest group with a stable rate, and I will report the county total alongside it for context. Second, I report both the ratio and the difference, with confidence intervals, so the reader sees both relative and absolute size. Third, I do not use a group with fewer than [20] events as a reference, and I flag any rate based on so few events as unstable. My revised sentence reads: "Black adults were admitted at [136.9] per 100,000 person-years, [2.41] times the rate among white adults, a difference of [80.1] per 100,000."
The number I brought was not wrong, but it was incomplete. It hid a choice that I had made without noticing, and the seminar made that choice visible.
References
Agency for Healthcare Research and Quality. (2024). Prevention quality indicators technical specifications.
Harper, S., King, N. B., Meersman, S. C., Reichman, M. E., Breen, N., & Lynch, J. (2010). Implicit value judgments in the measurement of health inequalities. The Milbank Quarterly, 88(1), 4-29. https://doi.org/10.1111/j.1468-0009.2010.00587.x
Keppel, K., Pamuk, E., Lynch, J., Carter-Pokras, O., Kim, I., Mays, V., Pearcy, J., Schoenbach, V., & Weissman, J. S. (2005). Methodological issues in measuring health disparities. Vital and Health Statistics, 2(141), 1-16.
NU713 Unit 5 instructions, in plain terms
For Unit 5 you reflect on how a seminar discussion changed your understanding of a measurement or method. Most prompts ask you to state the view or claim you brought, describe what the seminar showed, explain why your thinking changed with reference to published work, and say how you will practice differently. Around 700 to 900 words, often with a small table, is standard. Faculty reward reflections that quote the original claim exactly, show the new calculations or arguments, connect the change to literature on measuring disparities, and end with a rule that can be applied again. If your seminar did no calculations, draw on the arguments made instead, and paraphrase classmates rather than quoting them at length.
How the NU 713 Unit 5 example is put together
The reflection opens with the writer's own sentence from a discussion post and its source. The seminar's rates follow for five groups and the county, with ratios and differences against three references. Two classmates' objections come next: one about the small count behind the lowest rate, one about comparing a group with a total that contains it. The central section explains what question each reference answers and carries the highlighted sentence about what the county is asked to achieve, citing work on implicit value judgments and a federal report on measuring disparities. A short section converts the difference into extra admissions a year. The writer then names three parts of any disparity measure and closes with a three-part reporting rule and a revised sentence.
Reading the NU713 Unit 5 grading rubric
Seminar reflections in this course tend to be assessed on the starting point, the learning described, connection to literature, application and writing. The starting point earns credit when the original claim is stated exactly. The learning criterion rewards specific calculations or arguments from the seminar rather than general impressions. Connection to literature is judged on whether published work explains why the change matters. Application is credited when the reflection ends with a rule or practice that could be used on the next analysis. Writing covers clarity, first-person voice and APA citation. Reflections that show numbers, even in a small table, often score better on the learning criterion because the reader can check them.
Common NU713 Unit 5 mistakes, and how to avoid them
A frequent weakness is summarizing the seminar without saying what the writer believed before it. Another is describing the new view without any calculation or example that shows why it is better. Some reflections declare one reference group correct, which misses the point that each answers a different question. Others ignore small counts, reporting unstable rates as if they were precise. Many never cite the literature on measuring disparities. And closing sections often promise to be more careful without stating what will change. Quote your original claim, show the alternative figures, explain what each means, and end with a reporting rule you could hand to a colleague.
Get an NU713 Unit 5 example written to your instructions
Jot down which disparity your Unit 5 group recomputed and what the numbers did, then attach the reflection prompt and rubric. From those notes the session is retold in the first person, free as the first custom sample and ready within 24-48h, or, where attending was not possible, built on your section's written alternative. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
More NU713 papers and DNP samples
- NU713 Unit 1: Discussion Post, Eviction and Diabetes
- NU713 Unit 2: Social Determinants Profile
- NU713 Unit 3: Measurement Critique, ADI and PRAPARE
- NU713 Unit 4: Fundamental Cause Paper, Colon Cancer
- NU713 Unit 6: Disparities Analysis
- NU713 Unit 7: Age-adjusted Rate Comparison
- NU713 Unit 8: Secondary Data Appraisal
- NU713 Unit 9: Structural Framework Application
- NU713 Unit 10: Population Health Brief
- NU703 Unit 5: Literature Synthesis, DNP Role Use
NU713 Unit 5 questions, answered
Which reference group is correct for a disparity ratio?
None is correct in general; each answers a different question. A historically advantaged group shows the gap against a familiar comparison, the total population shows departure from the average, and the most favorable group shows distance from what is already achieved. Healthy People reports have used the best group rate. Whatever you choose, name it and say why in one sentence.
Why report the absolute difference if the ratio already shows the gap?
Because the two can move in opposite directions and describe different things. The ratio tells you how many times more common an outcome is; the difference tells you how many extra events per 100,000 people that means. A planner sizing a program needs the second. Reporting both, with a line on why they diverge, is standard practice in this course.
What if the seminar did no calculation at all?
Then the reflection draws on what was argued instead: the claim you brought, the classmate point that tested it and the position you hold now. Paraphrase exchanges without naming classmates in full. A reflection on a discussion-only session can still quote a figure from your own earlier work if that figure is what the conversation changed.
Where can I find a free NU713 Unit 5 sample paper?
The complete NU713 Unit 5 seminar reflection sits on this page, covering the original claim, the seminar's recalculations, two classmates' objections, why the reference group matters, a count of extra admissions and a reporting rule, with three references. Support for a reflection on your own seminar discussion can be arranged.
What reporting rule does NU713 Unit 5 adopt?
Name the reference group in the same sentence as the number and say why it was chosen; report both the ratio and the difference with confidence intervals; and never use a group with fewer than 20 events as a reference, flagging any such rate as unstable.