Sentinel City Community Health and Population Focused Nursing

1. Needs Assessment: Demographics

Sentinel City is made up of four neighborhoods namely Nightingale Square, Acer Tech Center, Casper District, and Industrial Heights. These neighborhoods demonstrate variations in the total population, racial and ethnic groups, and income levels. Overall, Sentinel City is a fairly large city with a total population of 663,862 people. The distribution of people according to age in the city is as follows: Under 5 yrs old 7.4%; Under 18 yrs old 21.7%; 65 yrs old and over 10.5% (Healthcare Learning Innovations, 2020). Variations can also be in terms of racial distribution in the city whereby the majority are Whites (80.6%). The Black/African Americans make up 10.4%, American Indians and Alaska Natives 2.0%, while Asians account for 3.7%. Other significant groups in the city include native Hawaiian and other Pacific Islanders (0.2%), and Hispanic or Latino (31.5%). Reports indicate that the median household income level for the city is $49,091 and about 18.9% of the people live below the poverty level (Healthcare Learning Innovations, 2020).

Demographics of the city can be broken down according to the neighborhood occupied. The largest neighborhood is Casper Park District with a population of 352,643 people followed by Acer Tech Center, Nightingale Square, and Industrial Heights with a population of 168, 390,352,643, and 38,855 people respectively (Healthcare Learning Innovations, 2020). Differences can also be observed in terms of the income levels across the four neighborhoods. For example, Nightingale Square has the highest median household income ($269,550) followed by Acer Tech Center, Casper Park District, and Industrial Heights with $166,300, $80,134, and $24,672 respectively (Healthcare Learning Innovations, 2020). The last aspect that can be compared across these neighborhoods is the percentage of non-insured residents. There is no surprise that Nightingale Square, with the highest median household income, has the lowest percentage (0.7%) of non-insured individuals (Healthcare Learning Innovations, 2020). Acer Tech Center has the second-lowest level with 1.5% followed by Casper Park District and Industrial Heights with 22.7% and 37.5% respectively.

Neighborhood/Safety Assessment

High income and low-income areas often display huge differences in the level of safety and living standards that is an outcome of income levels. As one goes through the neighborhoods, there is a significant amount of trash in the streets with low-income areas like Industrial Heights having huge amounts of garbage. Stray dogs and cats can be seen on the streets with rats from trash running into buildings. The quality of housing is another observation made whereby low-income areas have poor buildings that appear to be old. There are more boarded-up buildings in Industrial Heights with graffiti and trash outside compared to high-income areas like Nightingale Square. There are abandoned broken cars down the street and a car on fire with police and fire track can be seen in Industrial Heights. The quality of air in the four neighborhoods varies in low-income areas where industries and other means of pollution are observed to affect the quality of air. For example, Industries in Industrial heights are a source of air and water pollution. There are no diversions to control spillages and overflows from septic tanks are a source of water pollution.

The second aspect of the neighborhood/ safety assessment conducted is drug use in the city. The rate of alcohol intake is high in the city with 36% of the people reporting drinking alcohol, 24% smoking tobacco, 12% marijuana, 10% methamphetamines use, and 18% abusing prescription drugs. Emergencies are common in areas with many people like Sentinel city. During the assessment, I realized that the EMS response time is approximately 7.46 minutes, the fire department 6.33 minutes, and advanced support 7.54 minutes (Healthcare Learning Innovations, 2020). Most emergencies are a result of accidents and violence, especially in low-income areas. For instance, aggravated assault is the most common crime reported followed by robbery, rape, and gang-related murder (20 incidences of murder reported). According to the city reports gang-related violence and crime are high whereby there are 20 homicides, 100 aggravated assaults, 38 simple assaults, and 40 robberies. Officer Cooper rates the four neighborhoods according to the level of crime as follows: Nightingale Square 93%, Acer Tech Center 89%, Casper Park District 57%, and Industrial Heights 42%.

Scavenger Hunt

The majority of the population in the city are youths that benefit from community resources like parks and recreational facilities. These resources offer services like swimming lessons, City Sports League, adult fitness courses, and after-school programs. The majority of these services are offered in Nightingale Square because of factors like affordability. However, a few challenges experienced include cleanliness, stray animals, and crime rates in some areas that make it difficult to utilize the services. The second area assessed was the health sector to determine the services provided in different areas and resources available to address the community needs. The city has incorporated health services for the elderly who make up 10.5% of the total population. Services utilized by this group include senior transportation (6.8%), government entitlement assistance (7.6%), meals on wheels 91.3%), and elderly abuse prevention services (Healthcare Learning Innovations, 2020). The healthcare system also provides skilled care beds, long-term care beds, swing beds, and senior living center units.

To gain further insight into the health of the community and the services available, a visit was made to Better Health Clinic. The healthcare facility offers a wide range of services including contraceptive services, pregnancy testing/counseling, achieving pregnancy, basic infertility services, preconception health, sexually transmitted disease services, breast cancer screening, cervical cancer screening, and other preventative health services. To effectively deliver these services, the clinic is divided into various departments that include an emergency department, inpatient departments, pharmacy, ambulatory care, dentistry unit, and the pediatric unit. Services not directly related to the health and illness offered in the clinic include English language learning, computer classes, basic parenting 101, and alcoholic anonymous. A visit to the City Hall-Social Services revealed the availability of services like adoption assistance, subsidy benefits, stay-at-home program, and independent living services. Lastly, the Soup Kitchen provides over 40,000 meals per month to the homeless and those in need (Healthcare Learning Innovations, 2020). Additionally, programs like USDA commodity, emergency food, and commodity supplemental food are available to address food-related issues.

Windshield Survey

A generalized overview of Sentinel City can be described using the aspects of the population observed, lifestyle, housing, environment, transportation, and politics. As one moves around the city, buildings made of bricks and mortar are most dominant. High-income areas like Nightingale Square have multilevel buildings probably used to contain the large population in the city. Although graffiti is observed across all the neighborhoods, Industrial Heights and Casper Park have more. There are limited green spaces noted in all neighborhoods including less space between buildings because of the high population. As one walks around the towns, numerous tree linings are observed with concrete open spaces in the playgrounds. The Community Center and City Hall are both surrounded by grassy areas. Regarding the aspect of boundaries, there are noticeable differences in the state of the facade of buildings including sidewalks that have not been repaired.

The movement of people in the city is through various means including public transport. The presence of cars parked on the sidewalks indicates that many people move around using personal vehicles. A great number of people are seen traveling on foot while others are using bicycles to move around. While observing the people in the city, they are of varied races and ethnicity representing diversity. There are signs of community vibrancy where people are seen interacting in the city, children paying, and families walking freely. Police are observed mingling with people in the city and a prisoner with an orange jumpsuit can be seen cleaning up a lawn. Regarding the aspect of healthcare, Better Health Clinic is available to offer numerous health services to the people. The public health department is located in Nightingale Square and ABC Daycare Center in Casper Park District both offer healthcare services to populations served.

B1. Data Analysis: Interpretation of Data

Various factors combine to affect the health of people in the community. During the health assessment, I observed many factors that affect the health of the people in Sentinel City. For instance, there is a challenge with air and water pollution in the city as a result of industrial activities. I observed poor waste disposal practices in the city, especially in Industrial Heights where garbage was scattered all over. Spillages from septic tanks contributed to water pollution while fumes from industries were a potential source of air pollution in the city. Secondly, the level of violence in the city is high, especially in low-income areas. There are alarming incidences of rape and murder, homicides, and aggravated assaults that make safety an issue in most parts of the city.

Drug and substance abuse are common in Sentinel city with the majority of the people drinking alcohol (36%). There are significant incidences of tobacco and marijuana use that are potentially the cause of heart disease which is the leading cause of death in the city (Healthcare Learning Innovations, 2020). Low-income areas like Industrial Heights are faced with problems with healthcare access due to a lack of insurance. Statistics indicate that 37.5% of the population in the area are non-insured while 22.7% in Casper Park District are faced with the same challenge. Lack of health insurance and other factors like education can be the potential reasons why there is a challenge with immunizations for children aged 18 to 35 months. Statistics indicate that 78% of children get immunized in low-income areas compared to 94% in Nightingale Square (Healthcare Learning Innovations, 2020). At Better Health Clinic, epidemiological data shows an increasing rate of teen pregnancies for those aged 15 to 17 years. A total of 475 teens were recorded and 179 abortions on the board indicate problems with sex life. Additionally, the rate of STIs like Chlamydia, gonorrhea, and syphilis is high.

C1. Three Problem Areas

Sexually transmitted infections (STIs). There is a huge challenge with the STIs in the city. Reports indicate that syphilis, chlamydia, and gonorrhea affect most individuals aged 15 to 24 years. The Healthy People 2020 goal for STIs is to promote healthy sexual behaviors, strengthen community capacity, and increase access to quality services to prevent sexually transmitted diseases (STDs) and their complications (Office of Disease Prevention and Health Promotion (ODPHP), 2022a).

Immunization. Challenges with immunization for children aged 18 to 35 months are observed in low-income areas. Only 78% of children in low-income areas receive all immunizations compared to 94% in high-income areas. The Healthy People 2020 goal for this problem is to increase immunization rates and reduce preventable infectious diseases (ODPHP, 2022b).

Teen pregnancy. Data from Better Health Clinic indicates 475 teen pregnancies and 179 abortions. There is a lack of adequate school health programs to address the health issues of teenagers and the increasing rate of drug use can be a contributing factor. The healthy People 2020 goal for this issue is to improve the healthy development, safety, and well-being of adolescent girls including a reduction in teen and unintended pregnancies (ODPHP, 2022c).

C2. Discussion of Community Resources

The selected issue to be addressed using community resources in this area is sexually transmitted diseases among adolescents. Available community resources include:

The Public Health Department

Sentinel City Healthcare System Hospital in Nightingale Square

Better Health Clinic in Industrial Heights

City Hall

Media- WSEN News 4U and Radio Buzz 96.5

The public health department is an important community resource that can help in designing programs to increase awareness of the increasing rate of STIs in the city. Collaboration between the public health department and media stations like WSEN News 4U and Radio Buzz 96.5 will ensure a large population is aware of the STI burden in the city. City Hall can be utilized to organize education programs for the youths regarding STI transmission and prevention strategies. Apart from these resources, healthcare facilities like Better Health Clinic can help to provide treatment and counseling for the youths to help reduce the burden of the disease in the community. Nurses and other healthcare providers can also organize outreach programs to increase awareness of the disease and perform screening for deadly STIs like syphilis and gonorrhea.

C3. Primary Prevention Topic

The primary prevention topic that relates to the prevention of STIs in the city is Reproductive and Sexual Health. This topic deals with the prevention of common STIs like Syphilis and Chlamydia using various interventions.

1. Application of Assessment Strategies/Tools Between Simulation and My Community

The assessment tools utilized in this simulation include a demographic assessment tool, neighborhood/safety assessment, scavenger hunt, and windshield survey. Throughout the survey, I have realized that these tools serve to identify specific health concerns of the community while focusing on several areas. I have also learned that obtaining health information is important to identify crucial aspects of care like health disparities among minority groups that influence health outcomes. In my future assessments, I will utilize these tools to identify resources in that community that can be used to address the health concerns of special groups. I will use the windshield survey to identify public and private resources that can be pooled to address the health needs of the community. I will the scavenger hunt to identify health patterns of the community like healthy eating habits, recreational facilities, and affordable housing that affect the health of populations.

References

Healthcare Learning Innovations. (2020). Sentinel City 2.3 [Computer software].
Retrieved from https://wgu.ucertify.com/?func=ebook&chapter_no=7#03tlb

Office of Disease Prevention and Health Promotion. (2022a). Sexually transmitted diseases. https://www.healthypeople.gov/2020/topics-objectives/topic/sexually-transmitted-diseases

Office of Disease Prevention and Health Promotion. (2022b). Immunization and infectious diseases. https://www.healthypeople.gov/2020/topics-objectives/topic/immunization-and-infectious-diseases

Office of Disease Prevention and Health Promotion. (2022c). Adolescent health. https://www.healthypeople.gov/2020/topics-objectives/topic/Adolescent-Health