Community Health and Population-Focused Nursing in Sentinel City, Thesis of Advanced Accounting

Download Community Health and Population-Focused Nursing in Sentinel City and more Thesis Advanced Accounting in PDF only on Docsity! Running head: Community Health and Population-Focused Nursing C228: Task 1 C228 Task 1 C228 V3 Western Governors University A. Action Report: See Attached photo journal B. Needs Assessment: Demographics Sentinel City has a population of 663,862. 7.4% of the population is <5 years old. 21.7% is <18 years, and 10.5% are 65+years. White alone makes up 80.6% of the population. White alone/not Hispanic 52.7%, Hispanic 31.5%. African American alone 10.4%, Asian alone 3.7%, 2 or more races 3.1%, American Indian/Alaska Native alone 2%, and Hawaiian/Pacific Islander alone 0.2%. The median household income of the city is $49,091 with 18.9% of the residents living below the poverty level. The percentage of homeless people is 0>87%. 50.4% are homeowners and 45.8% housing units in multi-unit structures. 42.2% of people > 25 have a bachelor’s degree or higher. The highest death rate is from cardiovascular and heart disease. Sentinel City consists of 4 neighborhoods, including Nightingale Square, Acer Tech Center, Casper Park District, and Industrial Heights, within 153 square miles, with 3922.6 people per square mile. Nightingale Square has a population of 103,974 of which 5326 are veterans. It has a primarily white population, 81.3% followed by Hispanic or Latino 3.7%. Persons <5 years old make up 2.4% of the population, <18 make up 5.9% and 65+ make up 13.9%. The median Figures title: 2 household income was $269,550. The percentage of its residents that are < 65 years old and uninsured is 0.7%. 3.5% of the population under 65 is disabled. Acer Tech Center’s population is 168,390 with 6208 veterans. It is also predominantly white, 70.2% followed by 13.7% being Hispanic or Latino. 4.1% are <5 years old. 7% is <18 years and 19.8% is 65+ years old. The median income is $166.300 with 1.5% of people <65 years old being uninsured. 6.7% of the population under 65 is disabled. Casper Park District’s population is 352,643 with 2016 veterans. The primary ethnicity is white at 63% followed by 24% Hispanic or Latino. 10.9% are < 5 years old. 33.8% are < 18 years and 6.5% are 65+ years old. The median household income is $80,134 with 22.7% of people < 65 years old being uninsured. 6.8% of persons under 65 are disabled. Industrial Height’s population is 38,855 with 607 veterans. The primary ethnicity is African American at 46.8% followed by 13.1 % Hispanic or Latino. The median household income is $24,672 with 37.5% of its residents <65 years old being uninsured. 12.9% of its residents under 65 are disabled. Nightingale Square has the highest income and the lowest proportion of uninsured people. Acer Tech Center has the highest percentage of people > 65 and the highest number of veterans. Casper Park District has the largest population, the highest percentage of people <18 and < 5 years. Industrial Heights is the only neighborhood that is not the primary or secondary ethnicity. It has the lowest median income and the highest proportion of people without insurance. It matches Casper Park for the percentage of children <5, and it has the largest percentage of people <65 with disabilities. It also has the highest homeless rate in the city at 0.59% followed by 0.24% in Casper Park District. Neighborhood Safety Assessment Figures title: 5 clients fed at the soup kitchen are homeless adults, but also serve veterans, disabled, elderly, and homeless children. Sentinel City has an Affordable Housing Project located in Casper Park District. They offer studio apartments, one- and two-bedroom apartments. Last year, compared to citywide and neighborhood crime, property crime is relatively low. The most occupied units are studio apartments. Sentinel City’s Department of Parks and Recreation is located in Nightingale Square. It offers educational programs like swimming, nutrition, gardening, kids summer programs, city sports leagues, adult fitness, and after school programs. It is well maintained with 40-50% of its budget spent on maintenance and 10-20% on improvements. Windshield Survey The Windshield Survey is a tool used to assess a community’s needs while driving through. I kept notes on my impression of each neighborhood making up this community. I began my visit to Sentinel City in Nightingale Square. I noticed how well maintained this neighborhood was. There were upscale condos, a gym, and tennis courts which were in use by some adults. Street performers were entertaining families that were out and about. There were a few small areas with nicely cut grass and trimmed trees. People were chatting in front of the store with their grocery carts filled with food. Bus stops were clean and there were a lot of nice cars parked around. As I entered Acer Tech Center, I came to the Sentinel City Hospital. The hospital grounds were well kept. Most of the health care services were close to the hospital. There were a dentist and a pharmacy within walking distance. Across from the hospital was a museum opening soon. A handful of restaurants had outdoor seating, the most popular seemed to be the Figures title: 6 Lily’s Restaurant near the hospital. There were a few people riding bikes and others out walking around. Some were playing tennis and basketball at the Sentinel City Parks and Recreation tennis/basketball courts in Nightingale Square, but these were the only people exercising. Only a few of them had children with them. Some had dogs on leashes. There were people of many ethnic backgrounds, mostly Caucasian, but also African American, Indian, Vietnamese, Hispanic, Jewish, and Indo-Aryan. The mayor of Sentinel City was African American. As I approached City Hall, I could hear the voices of some people protesting taxes. They seemed peaceful and remained behind a fence. The mayor, a Representative of District 3, and the Director of Health were also out-front speaking to citizens and answering questions. Just past City Hall, there was a Farmer’s Market with fresh fruits and vegetables and a few other street vendors. Sentinel City had an Art Gallery, a radio station, a barbershop, a bookstore, and dress stores. Sentinel City had many Italian restaurants throughout the city along with a doughnut shop, coffee shops, a deli, and a sushi restaurant. I only saw one laundromat but there were many neighborhood grocery stores. I passed a few check cashing services as I went through Casper Park and Industrial Heights. Continuing through Casper Park and Industrial Heights, the amount of litter and trash bags sitting on the sidewalks increased, along with the number of stray cats and dogs, and rats living in the trash. The older buildings had exterior furnaces/air conditioners. Some large abandoned buildings had windows boarded up and covered up with graffiti. There were old rusted barrels and wood left around. The Interfaith Church was located at the far end of Industrial Heights. It provided a soup kitchen and there was a rescue mission behind it. There were not many parks other than the one by the school district, but there were many places fenced off with ‘no trespassing’ signs. There appeared to be an elevated railway running through the Figures title: 7 center of town, but I did not see any stations for boarding, and I did not see any major highways. The bus route seemed to pass through most of the city. The parts of Sentinel City I visited did not have any single-family houses with yards for children and animals to run around. The only park I saw was by the Sentinel City School District in Industrial Heights. Although at first glance it looked clean and well kept, the Department of Parks and Recreation report complaints about the presence of homeless people, stray animals, drugs, prostitution, and crime as well as cleanliness and location. There were many large brick apartment buildings in each neighborhood and a few condos. ‘Green Living’ was advertised in all four neighborhoods either on billboards or on the apartment building signs. The city had a couple of senior living centers. The one in Nightingale Square had a conveniently located bus stop while the one in Casper Park did not. B1. Data Analysis While I made my way around Sentinel City, I began to see some trends. Most notably, Nightingale Square not only has a higher median income and more insured residents, but the neighborhood overall was newer and cleaner than the others. There were less trash and debris on the sidewalks and buildings were in better condition. It seemed like people felt safer and free to casually spend more time outdoors as a family or playing basketball with friends. As I got closer to Industrial Heights, the median income decreased, and the upkeep diminished. There was more trash with rats running through it, more stray animals, and more of a police presence. Living in these unhealthy conditions greatly increases the overall health risks of the population. It is easy to see the relationship between the components of the epidemiologic triangle and how changes in any one area or its interactions with each other can affect an environment and a community’s risk Figures title: 10 impede physical exercise in the community, especially for children. There are many complaints about park location, cleanliness, and safety, hindering their use. Complaints include the number of homeless people and stray animals, public intoxication, drug use, and crime including prostitution arrests. Sentinel City has a gym, but it is located in Nightingale Square making it difficult for people in other neighborhoods to utilize. The alcohol and drug use in Sentinel City add to the problem. 2. Sexually transmitted diseases Healthy People 2020 Goal: Promote healthy sexual behaviors, strengthen community capacity, and increase access to quality services to prevent sexually transmitted diseases (STDs) and their complications. Healthy People 2020 Objective: STD-1 Reduce the proportion of adolescents and young adults with Chlamydia trachomatis infections. Sentinel City’s rate of all Sexually Transmitted Diseases is concerning; however, chlamydia alone has affected 3,214 citizens with a rate/100,000 being 484. Alarmingly, 71% of these cases are in the 15-24 age group. Untreated STDs can lead to long-term health problems, especially for adolescent girls and young women. According to Healthy People 2020, the CDC estimates that undiagnosed and untreated STDs cause at least 24,000 women in the United States each year to become infertile. 3. Injury and Violence Prevention Healthy People 2020 Goal: Prevent unintentional injuries and violence and reduce their consequences. Figures title: 11 Healthy People 2020 Objective: IVP-33 Reduce physical assaults. In addition to the immediate health consequences, injuries and violence have a significant impact on the well-being of the people in the community. The effects extend beyond the victim to family members, friends, coworkers, employers, and the community as a whole. Sentinel City, reported violent crimes to include murder, rape, robbery, and aggravated assault. Last year 1,231 aggravated assaults were reported compared to 559 robberies, 312 rapes, and 20 murders. C2. Discussion of Community Resources Sentinel City has many resources already available to its citizens that focus on the modifiable risks of cardiovascular disease. Sentinel City Health Care System offers weight management services at both clinics. The Department of Parks and Recreation offers nutrition and adult fitness classes. There is at least one Farmers Market in town offering fresh fruits and vegetables, and the schools offer healthy meal options with high amounts of protein, vitamin C, calcium, and iron while limiting total and saturated fats. The colleges in Sentinel City have tobacco awareness groups. The EMS, advanced life support, and time to shock response times are adequate as seen in the comparison with three other cities; however, the number of full-time paramedics was the least of the three cities. Also, civilian responder training was low. This can be seen when looking at the percentage of the population trained in CPR and AED use and the percentage of cardiac arrests with CPR performed by citizens. Julie Benjamin, the District 3 Representative is trying to decrease homelessness by raising funds to convert abandoned buildings into shelters and with job training courses and counseling, which will help decrease the number of homeless in the parks. She also wants to increase the number of after school programs and recreational facilities Figures title: 12 which will help increase exercise and physical activity of citizens of all ages. Sentinel City has a great opportunity to improve on these resources. C3. Primary Prevention Topic Nutrition, Physical Activity, and Obesity Increasing physical activity and improving nutrition helps to decrease the incidence of heart disease by improving modifiable risk factors and may help prevent other health problems like Type 2 Diabetes and obesity leading to a better quality of health and well-being. The city can institute community-wide campaigns focusing on ways to improve nutrition and increasing physical activity. Schools and health care providers can teach easy ways to improve activity levels like walking to school/work. Restaurants and grocery stores can be encouraged to offer healthier options. The community can focus on cleaning up the parks and making them safer places for children and families. D. Application of Assessment Strategies /Tools between Simulation and My Community This simulation taught me new assessment skills and tools that I can use in my community, like the windshield survey, the scavenger hunt, and the neighborhood safety assessment. I found new places to go to gather community information, like the health department, community centers, and churches, and soup kitchens, and to find health information, like Healthy People 2020. It motivated me to think of creative ways to improve the health and well-being of my community and to get involved in making my community a better place for all of its citizens.