Community Health And Population-focused Nursing
WGU -C228 Task 1
Demographics Assessment
Sentinel City, with a total population of 663,862 comprises four different neighborhoods - the newer and better maintained Acer Tech and Nightingale Square as well as the older, industrial Casper Park District and Industrial Heights. The demographics assessment of Sentinel City provides more depth to the characteristics of its population. Casper Park district has the highest population (352643), and industrial Heights has the lowest (38855). 103974 people reside in Nightingale Square and the remaining 168390 in Acer Tech Center. 7.4% of the total population comprises children under the age of 5 years, and 21.7% are those between 5-18 years of age.10.5% of the community is above the age of 65 and the remaining are adults between 19-64 years of age.
The city comprises different race and ethnic groups. Most of the population, around 80.6%, is White. African American make up 10.4% of the people, Asians 3.7%, Hawaiians and other Pacific Islander 0.2% and 3.1% of the population are two or more races.
Median household income distributions in the four neighborhoods are as follows: Nightingale Square -$269,550, Acer Tech Center - $166,300, Casper Park District - $80,134, Industrial Heights - $24,672. While the median household income for the entirety of the city comes to roughly $49,091.
People without health insurance, under age 65, is at its highest in Industrial heights (37.5%) followed by Casper Park District (22.7%), Acer Tech Center 1.5% and Nightingale Square 0.7%. Thus, it is very evident from the data that median household income is inversely proportional to the percentage of non-insured people in a neighborhood.
Neighborhood/community safety assessment
The neighborhood/community safety assessment tool helps to identify safety hazards within the city. The neighborhoods of Acer Tech and Nightingale Square gave clean and well-maintained buildings and streets with no pollution. There are more safety concerns and hazards in Casper Park and Industrial Heights. These include old, dirty and unrepaired buildings with graffiti on the walls. There is garbage outside buildings and bins are turned over with trash all around. An abandoned car was seen in Industrial Heights while another was set on fire. Rats and stray dogs are recognized around the city. The statistics also show that there have been 10-20% of strays observed in the last 4 years. 90%of the animals entering shelter were not spayed/neutered. Dog biting needing hospitalization is excessive in Industrial Heights, at 43%.
According to the statistics released by City Hall, the average EMS response time of Sentinel City is 7.46 minutes, which is a little behind comparison city 3 (5.43 minutes). Comparison city 2 has the highest time of 12.14 minutes and town 1 reports 8.32 minutes.
Sentinel City crime rate is reported to be 3,605 per 100,000. The violent crimes reported in the previous year were murder (20 incidents), rape (312), robbery (559) and aggravated assault (1231). Frequent charges included public intoxication (6%), reckless conduct (6%), criminal trespassing (9%), possession of a controlled substance (16%), battery (17%), warrants (23%) among others. As per a statement from officer Cooper, Nightingale Square has the lowest crime rate, while Industrial Heights and Casper Park District have greater crime rates. Gang violence is also present in the city. Last year there were 100 cases of gang-related aggravated assault, 20 cases of murder, 38 cases of rape and 40 robberies linked to gangs. More males than females have been victims of violent crimes, in general.
Scavenger hunt tool
The scavenger hunt tool provides us information about the services offered by community resources available to the residents of Sentinel City. The Department of Parks & Recreation offer informative lessons such as swimming classes, nutrition classes, gardening classes, kids summer programs, city sports leagues, adult fitness programs, and after-school programs. Frequent park complaints revolve around things such as park hygiene and upkeep, the excessive number of home-less individuals, and crime. The park and recreations budget has gone down from 60% in the year 1 to 35% last year.
The Healthcare System provides a variety of services for the elderly population. The portion of the elderly implementing the service in the last 12 months are as follows: elderly transportation - 6.8%, service animals-2.5%, meals on wheels – 1.3%, senior exploitation prevention advocates – 0.9%, community centers - 2.9%, government welfare – 7.6% and medicinal advocates – 8.3%. Living units for the elderly in the city include senior apartments, nursing home units, assisted living units, skilled nursing care beds, swing beds, and senior centers.
The social services provided by the city leadership include adult as well as child protective services like help with adoption, independent living services for young people, stay at home programs and nutrition programs like WIC for women who are pregnant, breastfeeding, postpartum or those with infants and SNAP for low income, disabled or elderly.
Better Health Clinic, formerly known as Community Health Center, provides services similar to Planned Parenthood such as but not limited to birth control, counseling, infertility services, sexually transmitted disease treatments, breast cancer as well as cervical cancer screenings, and other preventive services. They also keep a record of all the sexually transmitted diseases like hepatitis B, HIV, syphilis, HSV2, gonorrhea, Trichomoniasis, and chlamydia last year by age distribution. In addition to that, they provide information about teenage pregnancies, birth, and death rates over the previous 5 years.
There is a soup kitchen operated by the Interfaith Church of Sentinel city that caters to mostly homeless adults (64%). Other people that benefit from the kitchen are elderly, veterans, disabled people, homeless children, and some healthy adults and children too. Their sources for supplemental nutrition are emergency, food assistance, and USDA commodity programs. Father Eudaro Martinez is a priest and manages the church, where homeless residents like Dwyane Thomas gets 2 meals every day.
The Affordable Housing Project operates out of Casper Park district. They compile statistics regarding crime reported on property, neighborhoods, and citywide, vacant/occupied property units, average income by unit types and common tenant complaints. Frequent tenant complaints include factory smoke, dogs barking, noise, police activity, high rent and loitering among others. Of all the 2-bedroom units in the city, 44%are occupied. Among the 1-bedroom units 26%, and 44% of studios are currently filled.
Windshield survey
Driving through Sentinel city allows us to conduct a windshield survey of the community. Most buildings are made of bricks and concrete and mostly connected to each other. The buildings in Acer Tech and Nightingale Square seem to be newer and well maintained as well as similar in height and structure. There is also more sense of pride in these neighborhoods with big billboards advertising the community. There is also grass and well-maintained trees and benches along the streets. The buildings in Casper Park and Industrial Heights are much older and worn out and dissimilar with broken doors/windows, boarded up windows, graffiti and disrepair in general.
The city is more urbanized and has very few open spaces. The common areas in Acer Tech and Nightingale Square are well-kept. There are tennis courts in Nightingale Square. There is also a small children’s park in Industrial Heights and green open space in Casper Park. According to the mayor, they have the intention to create more open areas to incentivize more outdoor physical activity as he feels there are many benefits some of which would be environmental, in the building of eco-friendly urban settings.
There are no hard and fast boundaries between the four distinct neighborhoods. The Industrial Heights and Casper Park looks more streamlined and economical, whereas the other two are better maintained.
The majority of people uses buses for their daily commute, followed by bicycles and cars. The city roads are well maintained and are safe for bicyclists, cars, and pedestrians. The city itself does not have any big highways. One gas station was spotted in Nightingale Square. There are also some rail tracks that pass-through Casper Park District as well as Acer tech center; however, I didn't locate any train station. The mayor believes that there should be convenient public transit. There ought to be adjustments for various groups such as bicyclists, pedestrians, and differently abled individuals. The mayor intends to start hosting car-share and bike-share programs for Sentinel City.
The city has a variety of service centers. There is a recreation center with tennis courts in nightingale square, and people are seen actively playing on the courts. There are parks and playgrounds. There is a small playground in industrial heights where children are seen dancing. There are medical and dental offices as well with patients seen entering and leaving the buildings.
There are many stores in sentinel city for residents to shop. Bodega supermarket and deli is located in industrial heights where they have information about tobacco sales and nutrition. Joe’s Grocery is another store which found in Nightingale square where customers are seen walking in and out of it. Another outdoor market is seen in the Acer tech center.
Traveling through sentinel city during the day gives a glimpse of the vibrant community, and most of the people are out and about. I spotted people walking their dogs on leashes, groups engaging in different parts of the city, joggers, people playing tennis, children in the parks, protesters outside city hall. I also spotted people in prisoners on the ground in Casper park district. This is where I stopped to speak to Fabio Kamaka who was on a prison work release. Other people are also dressed as expected. There are officers on duty in uniforms as well as children going to school in school uniform. Pet dogs on leash, stray dogs, and cats are seen. The older neighborhoods also seem to be infected with rats. There is plenty of activity on the streets during the day which shows the vibrancy of the community of Sentinel city.
White/Caucasian make up most of the population. Other races like African American, American Indians, and Asians are also spotted in the city. I spotted a sushi place in Casper Park and a Mexican restaurant in Nightingale square. There are also different ethnicities in the town.
Better health clinics are in Industrial heights, and a car is seen on fire outside the clinic. The clinic provides information about sexually transmitted diseases. There seems to be a problem of alcohol addiction in the city as evident from billboards everywhere. There is a big billboard outside Joe’s grocery that talks about fighting addiction. Some of the billboards advertising about "don’t text and drive," e-cigarette promotion in industrial heights and one in Acer tech that says "save your lungs."
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A political protest for tax reforms is seen outside the city hall. There are posters around that ask you to vote, but I didn’t observe anything linked to a particular political party. Radio seems to be the most important source of media for the community. Radio buzz 96.5FM is in Acer Tech Center. There are no signs of television use in the city. There is also print media like magazines that are sold in stores like Bodega. English seems to be the primary language of media communication.
Analysis of Collected Data
It is evident that there are several issues in the city. Cleanliness is a big concern. There is trash everywhere around the town, along with stray dogs and cats, rats running around and pollution. The citizens also have endorsed that cleanliness is a problem.
People have raised a lot of concern about rising crime in the city. According to statistics, Industrial Heights is leading to criminal activity. The mayor has also mentioned that he is trying to identify solutions that will help decrease crime in the neighborhoods.
There is a lack of adequate spaces in the city to have a physical activity. The only place with space to play is in the parks of the city. I didn't find any front or backyard around the houses of Sentinel city, where kids or even adults can play with their kids. The residents also expressed concerns about the growing population of homeless.
C1. Top Three Health Problems based on Healthy People goals:
This assessment has clearly conveyed that Sentinel City has wellbeing differences that arise from social, monetary or natural burdens. These influence the population in Sentinel city with more impediments to wellbeing dependent on their socio-economic situation, age, sex, personal, physical handicaps, and/or mental wellness.
The following are the top three problems identified in the city:
Pollution & environmental issues: A milestone of the Healthy People is to develop social and physical environments that promote health and equally. Healthy People 2020 highlights the importance of addressing the social determinants to “Create social and physical environments that promote good health for all” as one of the four overarching goals for the decade. Physical determinants include natural environments, such as green space as well as the built environment, such as buildings, sidewalks, bike lanes, and roads, schools, and recreational settings. Sentinel city has several environmental safety concerns that affect the wellbeing of the residents. These include old, dirty and unrepaired buildings with graffiti on the walls, garbage outside, fewer green spaces and air pollution.
Access to healthcare and STD prevalence: The community evaluation of Sentinel City shows that sexually transmitted diseases are common in the city among students. Gonorrhea and Chlamydia are the most common ones among ages 15-24. Another objective of Healthy People 2020 is to advocate for safe sexual behaviors and enlarge access to exceptional services to lower rates of sexually transmitted diseases (STDs) as well as combating their complications.
Teen pregnancy: Teenage pregnancy rates in Sentinel City have gone up in the last year compared to the 3 previous years. One of the goals of Healthy People 2020 is to improve the healthy development, health, safety, and well-being of adolescents and young. The leading causes of the issues among adolescents and young adults are mostly preventable. Adolescents who have excellent communication and are bonded with a caring adult are less likely to engage in risky behaviors. Parents who supervise and are involved with their adolescents’ activities are promoting a safe environment for them to explore opportunities. The children of families living in poverty are more likely to have health conditions and poorer health status, as well as lower access to and use of health care services.
C2. Community resources available to address one of the problems identified in part C1.
There are a few resources available in Sentinel City to deal with healthcare issues. Better Health Clinic provides services and information to deal with sexually transmitted diseases among other health issues. Information and statistics about different diseases and vaccinations can be obtained from the Public Health Department in Nightingale Square. Acer Tech has some information about Sentinel City’s health care services such as orthodontic and medicinal programs for the senior citizens.
C3. Identify a primary prevention topic based on the problem you selected in part C2.
I believe that Sentinel City should focus on improving the quality of life for the teens and provide more education on STDs as well as on protective sex. In addition to that, they need to advertise about the disease itself, and the consequences of it can have on one's health if not get treated. They need to have this conversation started in middle and high schools and how and where to find the help if needed. The city needs to provide the public health department with more resources and the public with more education so that STDs can be prevented.
- Discuss how you will apply the assessment strategies you have learned from the simulation environment to your community assessment strategies in your community.
Walking through the simulation has been extremely useful in giving me an idea of how to conduct an actual community assessment. It gives me a sense of the spots to get essential data while surveying my locale. I know where to go to get information on health services that a community has access to, resources for homeless, statistics about issues like crime and diseases, food safety issues, resources for recreation and computer and English classes among others. The simulation exercise also helped me appreciate the importance of talking to city residents to get their perspective of the services provided by the city and with local business owners to understand the market issues. Speaking to the mayor gives an idea about plans for the city’s development. Overall, this simulation has been a very valued tool to get some practical experiences of how to go about a community assessment in a real-world care setting.
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