APA formatting and proofreading – Community Nursing

Community health and poplulation focused nursing 4

A. Photo Journal: Sentinel City Photo Journal submitted.

B. Needs Assessment:

Demographics. The demographic assessment tool helps to compile information about the population in question. It helps to gather information such as race, ethnicity, and income level. The total population of Sentinel City is 663,862. Of the total population 7.4% are under the age of 5 years old, 21.7% are under 18 years old, and 10.5% are 65 years or over. Sentinel City is comprised of the following ethnicities: Caucasian 52.7, : African American, 10.4%, American Indian/Native Alaskan 2%, Asian, 3.7%, Hispanic/Latino 31.5%, Native Hawaiian/Pacific Islander, 0.2%, and finally two or more races 3.1% (Healthcare Learning Innovations, 2018). Sentinel City is broken down into 4 regions: Nightingale Square, Acer Tech Center, Casper Park District and Industrial Heights. Nightingale Square has a population of 103,974 with highest median household income of $269,550 and the lowest uninsured resident rate of 0.7%. Acer Tech Center has a population of 168,390 with a median income of $166,300 and the second lowest uninsured resident rate of 1.5%. Casper Park District has the highest population of the regions with a total of 352,643 residents, a median household income of $80,134 and uninsured rate of 22.7%. The last region Industrial heights has a population of 38,855, the lowest median income of $24,672 and the highest uninsured resident rate of 37.5%. In Sentinel City, 18.9% of the population lives below the poverty level.

Neighborhood/Community Safety Assessment. This tool helps to identify physical and social risk factors within a community. After touring the city it is apparent that the poor environmental conditions can be contributing to a disruption of community health in Sentinel City. The Industrial Heights region present with the most concern, this may largely be due to the poverty this region of the community faces. In Industrial Heights you see graffiti, trash pilings along the sidewalks, rundown buildings, and even a car fire. There is a playground in this region of the city but it near the soup kitchen which serves 64% of the homeless adults. With such a large homeless population visiting the soup kitchen it is most likely this affects the ability of the children in the neighborhood to visit the park safely. In addition, there are a lot of factory buildings in this area with minimal greenery. The residents in this area do not have access to a nearby grocery store in which they can purchase healthy and nutritious food options, making this a food dessert. According to the USDA, “Low-income residents of these neighborhoods and those who lack transportation rely more on smaller neighborhood stores that may not carry healthy foods or may offer them only at higher prices.” Casper Park is also noted to have areas with graffiti with rodents and trash pilings visible in the area. Joe’s grocery is also in Casper park and according to data there were approximately ninety cases of foodborne illness from fish and shellfish and over fifty cases caused by poultry products last year (Healthcare Learning Innovations, 2018). The Acer Tech region includes City Hall, the Sentinel City Healthcare System, and Community Center. There are some areas of graffiti but not as prevalent as in Casper park and Industrial Heights. The only area of apparent concern is Lily’s restaurant which over the past 5 years has had an influx of food and safety violations. Nightingale Square presents as the best of 4 regions of Sentinel City with a lot of greenspace, clean streets, parks and recreation.

According to the Sentinel City Police Department data, there has been an increase in robbery and aggravated assault over the past 5 years (Healthcare Learning Innovations, 2018). The incidence of homicide increased slightly to 23 as compared to 20 in the past year. To make improvements as it relates to crime in the area policing efforts and strategies would need to be implemented to support a positive change. According to the Sentinel City Healthcare System, Alcohol and Tobacco use are the most prevalent in the city with 25% alcohol use and 24% tobacco use. Sentinel City’s EMS response time is average when compared to most other cities in similar size.

Windshield Survey. A windshield survey helps the surveyor collect data regarding what they observe visually in the community. As you explore Sentinel City it is not quite obvious what streets you may be traveling on due to a lack of signage that you are in a new region. The Industrial Heights region is impoverished. There are trash pilings on the streets, rodents were visible, and graffiti vandalism. There is a bodega but no other grocery store in which residents can get healthy and affordable meal options. The streets in industrial heights appear dirty and the buildings appear rundown. Casper Heights also has some graffiti vandalism and garbage pilings but not as much as the Industrial Heights region. Construction workers are present on the street and there are prisoners seen on a work release program picking up trash in a greenspace. There are billboard signs in this region advertising for the citizens to get vaccinated and don’t text and drive. In observation in appears the city is trying to improve the Casper Heights region of Sentinel City. Acer tech includes City Hall, the radio station, hospital, museum, and Lily’s restaurant. People are seen outside of city hall protesting about taxes. The Mayor and Director of Health are also present in front of City Hall. Acer Tech Center feels like Sentinel City’s downtown area as it encompasses some of the most important business and government in Sentinel city. Lastly Nightingale square offers the only grocery store in Sentinel City. The buildings in Nightingale square appear to be newer. The streets in Nightingale square are clean and there are trees present along with streets. Nightingale square also has billboard advertising vaccination, drug rehabilitation, and recycling. The only gas station in Sentinel City is also in Nightingale Square. Sentinel City in general offers public transportation in the form of bus. Several cars are seen along the streets of Sentinel City and residents are walking.

Scavenger Hunt. Parks and Recreation. Sentinel City Parks and Recreation Department offer a plethora of services and activities which includes swimming, gardening, nutrition, summer programs for children, fitness, city sports leagues, and after school programs.

Healthcare System, Elderly Services. Sentinel City offers services for the Elderly population such as senior living options. Over the past 12 months 6.8% of the elderly population used senior transportation, 8.3% used Medical care advocates, and 7,6% used government assistance (Healthcare Learning Innovations, 2018).

City Hall, Social Services encompasses protective services, healthcare assistance, WIC, and SNAP. Within the city, the highest number of SNAP receipts in the past year are low-income persons and the disabled and 200,036 residents of Sentinel City are receiving Medicaid (Healthcare Learning Innovations, 2018).

Better Health Clinic provides a multitude of services including contraceptive services, pregnancy testing/counseling, infertility services, sexually transmitted disease service, and presentative screenings and services. Within the past year teen pregnancies and birth rate has increased slightly. The abortion rate in the city has remained consistent over a 5 year period. In regards to sexually transmitted infections Chlamydia and Gonorrhea are the highest amongst the 15-24 age group while Hepatitis and HIV are most prevalent in ages 25 and over (Healthcare Learning Innovations, 2018).

Soup Kitchen. The soup kitchen serves a various citizens in Sentinel City however more than half of the person’s it serves is in the homeless adult population. The Soup Kitchen receives it nutritional resources from 4 different programs that provide nutritional assistance. In the past 12 months the soup kitchen has served an average of 45,000 meals per month.

Affordable Housing Project. The average income of the tenants has increased slightly over a 5 year period in all the unit types. The most common tenant complaint within the housing project is factory smoke. The two bedroom units have the most vacancy at 10% (Healthcare Learning Innovations, 2018).

B1. Data Analysis

The assessment tools have helped me to gather much information about some of the health determinants in Sentinel City. Some of the most prevalent issues is the number of homeless citizens within the city, cleanliness, and sexually transmitted infections (STI’s). After speaking with the citizen’s in the city Gary Johnson story was the most notable. Gary is a 17 year old male who is homeless. He was sexually abused at a young age by his stepfather and foster parents. To make money he prostitutes himself to men and women. The money he does make he uses to buy weed and he admits to shoplifting, alcohol abuse, and marijuana use. Gary declined to answer if he has any sexually transmitted infections. Gary could be inadvertently contributing to the high number of STI’s within the city as well as the complaints in the city regarding the homeless population in the parks. According to the Better Health amongst 15-24 year old’s Gonorrhea and Chlamydia are the highest.

C. Sentinel City Health community diagnosis

C1. Three problems based on Healthy People 2020 goals

After completing the assessment of Sentinel City three problems I identified are Adolescent Health, Sexually Transmitted disease and Environmental Health.

As discussed previously, the story of Gary Johnson is important in understanding just how at risk the adolescent population is. Gary is homeless, only has a 10th grade education, is a smoker, and uses illegal substances. He could also be contributing to teenage or unintended pregnancies and sexually transmitted infections due to his history of prostitution. According to Healthy People 2020, the goal is to improve the overall well-being of adolescents and ensuring healthy development, health, and safety.

Sexually transmitted disease within the 15-24 population is also concerning as 71% with Chlamydia and 58% with Gonorrhea are in this age group. For 25+ persons in Sentinel City, Hepatitis B and HIV are the two highest STI’s. In order to make an impact on the community health as it relates to STI’s we must identify the social, economic, and behavioral factors that could be contributing to the problem and what resources are within the community that. Healthy people 2020’s goal for STD’s is “Promote healthy sexual behaviors, strengthen community capacity, and increase access to quality services to prevent sexually transmitted diseases (STDs) and their complications.”

The final problem I have identified is poor environmental health. In Sentinel City it is apparent that trash pilings, rodents, cleanliness and poor air quality is an issue with the most prevalent concerns being found in Industrial Heights and Casper Park. Healthy People 2020 states, “Maintaining a healthy environment is central to increasing quality of life and years of healthy life.” Implementing a plan to improve environmental health within Sentinel City will help to prevent chronic conditions such as asthma and prevent disease caused by hazardous waste.

C2, C3. Community Resources and Primary Prevention Topic

The Office of Disease Prevention and Health Promotion, offers a range of interventions and resources to help achieve the goal of Healthy People 2020 in preventing the incidence of sexually transmitted diseases. The Better Health Clinic with Sentinel City offers sexually transmitted disease services. Generally sexually transmitted disease services includes screening, treatment, education, and prevention of such infections and diseases. For primary prevention, Sentinel City does not have enough resources available to effectively prevent sexually transmitted infections. With such a large population of citizens there is only one health clinic in Sentinel City. While Sentinel Hospital is also available it is not appropriate setting to receive the care needed and it can be a financial burden especially to those who are lower income without health insurance. Education regarding sexually transmitted infections needs to start early and continue throughout. Sentinel City School district offers sexual education as a special program in Middle schools it does not offer it in High Schools. Promotion that these resources are available and are free is vital. Sentinel City needs to make the citizen’s aware of the available services by using Billboards, signs in local business, and radio advertisements. They may be able to partner with the local Buzz radio station to have guest on air to speak about the clinic and services that are available.

D. Application of Assessment Strategies in my Community

Touring Sentinel City and using the assessment tools has helped me to realize how diverse communities are. When I drive around my community I become more observant of my surroundings and the needs of the population. Within the simulation I learned a lot by speaking to the citizens of Sentinel City. I can translate this to my work life when working with patients and family member’s. I have realized that although we may live in the same city our experiences can be very different depending on socioeconomic and environmental factors within each region of the city. I also think by observing my community I will find what resources are available and I can also help to relay this information to my patients.

References

Healthcare Learning Innovations (Sentinel City) [Computer Software]. (2018). Aurora, Co.

Retrieved from http://wgu.ucertify.com/

Access to Affordable, Nutritious Food Is Limited in “Food Deserts”. (n.d.). Retrieved June 17,

2020, from https://www.ers.usda.gov/amber-waves/2010/march/access-to-affordable-

nutritious-food-is-limited-in-food-deserts/

Community Health Needs Assessment information from the Center for Rural Health. (n.d.).

Retrieved May 12, 2020, from https://ruralhealth.und.edu/projects/community-health-needs-assessment

Access to Affordable, Nutritious Food Is Limited in “Food Deserts”. (n.d.). Retrieved May 12,

2020, from https://www.ers.usda.gov/amber-waves/2010/march/access-to-affordable-nutritious-food-is-limited-in-food-deserts/

Sexually Transmitted Diseases. Healthy People 2020. (2020). Retrieved May 23, 2020 from

https://www.healthypeople.gov/2020/topics-objectives/topic/sexually-transmitted-diseases

Adolescent Health. Healthy People 2020. (2020). Retrieved May 23, 2020 from

https://www.healthypeople.gov/2020/topics-objectives/topic/Adolescent-Health

Environmental Health. Healthy People 2020. (2020). Retrieved May 23, 2020, from

https://www.healthypeople.gov/2020/topics-objectives/topic/environmental-health