C228 Task 1 sentinel city Community Health Stimulation

1. Needs Assessment

The increasing demand for healthcare today requires hospitals and primary care teams to develop services that match the needs of their local populations. Factors like the rise in chronic diseases have led to an increased focus on preventive healthcare to allow individuals to make choices about their health. To better provide the most appropriate care, a community health assessment serves as a tool to inform providers of the specific needs of certain populations. The assessment gives the healthcare provider information about the current health status of the people, issues of greater concern, and the services available to address the identified needs. This discussion focuses on the virtual community of Sentinel City to identify the health needs of the people and ways to address these health concerns.

Demographics

The four neighborhoods that makeup Sentinel City include Nightingale square, Acer tech Center, Casper Park District, and Industrial Heights. The city has a total population of 663,862 people (Sentinel U, 2021). The population can be broken down according to the area lived, race occupied, and age. For instance, children under the age of 5 years make up 7.4% of the population, under 18 years occupy 21.7%, and those above 65 years represent 10.5%. Racially, the population is made up of Whites, Black/African American, American Indian and Alaska Natives, Asians, and the Hispanic or Latino. The race percentage breakdown is as follows: White alone 80.6%; Black/African American 10.4%; American Indian & Alaska Native 2.0%; Asian 3.7%; Native Hawaiian & other Pacific Islander 0.2%; Two or more races 3.1%; Hispanic or Latino 31.5%; White alone, not Hispanic or Latino 52.7% (Sentinel U, 2021). Economically, the city’s median household income is $49, 091. Because of the diversity observed, about 18.9% of the people live below the poverty line.

The four neighborhoods display different characteristics regarding the total population of people, racial composition, and socioeconomic status. Casper Park District is the largest neighborhood with a population of 352, 643 people. Because of the large population, the median household income is $80,134, a figure that is less than other similar neighborhoods (Sentinel U, 2021). Acer tech Center is the second-largest neighborhood with a population of 168,390 and a median household income of $166,300. The third-largest neighborhood is Nightingale Square with a population of 103,974 people. The socioeconomic status of this area is fairly better than the other regions. The median household income in Nightingale Square is $269,550 and is the highest among the four neighborhoods (Sentinel U, 2021). The smallest area in the city is called Industrial Heights. This region has a population of 38,855 people and a median household income of $24,672.

The socioeconomic status of a community greatly affects health-seeking behavior including access to healthcare. The four neighborhoods display diversity in the number of non-insured residents that is an important determinant of health. Nightingale Square has 0.7% of the population without health insurance. As the second most stable neighborhood, Acer Tech has 1.5% of the population without health insurance while Casper Park District has 22.7% (Sentinel U, 2021). The highest number of people without health insurance is observed in Industrial Heights with 37.1% (Sentinel U, 2021).

Neighborhood Safety Assessment

The city experiences differences in the aspects of safety depending on the region one lives. As one goes through the towns, trash can e seen in the streets, especially in low-income regions like Industrial Heights. More litter bins can be observed in developed areas like Nightingale Square. Stray dogs and cats are seen in the streets and rats running from the trash indicating challenges with waste disposal. Additionally, the neighborhood has boarded-up windows on buildings, graffiti on buildings, abandoned broken down cars on the street, and dirty grocery stores. The air quality in areas like Industrial Heights is poor because of the garbage that causes pollution. Water safety is another concern in the area whereby overflows from septic tanks are observed to pollute water sources. High-income areas have water tanks on the roofs and their drainage systems are well-built to prevent flooding.

Drug use is a common phenomenon in the city. Statistics indicate that 36% of the population report drinking alcohol, 24% smoke tobacco, 12% marijuana, and 5% cocaine. Apart from these common drugs, about 10% of the population abuse methamphetamines while 18% are observed to abuse prescription drugs (Sentinel U, 2021). Emergency medical care is an important feature in Sentinel City because of the large population and safety events observed. The emergency medical services (EMS) response time is 7.46 minutes. For those seeking help due to fires, the response time is 6.33 minutes while the advanced life support response time is 7.54 minutes (Sentinel U, 2021). The increased use of drugs in the region means a lot of crimes occur. The most commonly observed crimes include aggravated assault, robbery, rape, ad murder. Gang-related violence is observed in the city with crimes including 20 homicides, 100 aggravated assaults, 38 simple assaults, and 40 robberies (Sentinel U, 2021).

Scavenger Hunt

The population health scavenger allows for the assessment of a community to determine the services provided and how they affect the health of the people. The services offered to the community can be divided into six groups including parks and recreation, healthcare system, city hall social services, better health clinic, soup kitchen, and affordable housing project. The parks and recreational centers are well-distributed across the city. They provide services like swimming lessons, nutrition and gardening courses, kids’ summer programs, city sports leagues, adult fitness courses, and after-school programs. A common problem observed is the poor quality of the parks in low-income areas whereby there is a lack of maintenance including cleanliness and safety in the parks at night.

The healthcare system in the city mainly focuses on the elderly population that makes up 10.5% of the total population (Sentinel U, 2021). The system provides elderly services like senior transportation, meals on wheels, medical care advocates, and long-term care beds for those with chronic illnesses among many others. Home health services are available to take care of the disadvantaged, especially in regions like Industrial Heights where health insurance is challenging. The city hall is available to provide social services like assistance with adoption, independent living, child care providers, and subsidy benefits to the people (Sentinel U, 2021). The centralization of these services makes it easier for the community to access important information.

Healthcare services are delivered through the Better Health Clinic. This center provides a variety of services including contraceptive services, basic fertility services, STI prevention, screening for breast and cervical cancer, and preconception health among many others (Sentinel U, 2021). The clinic mainly provides preventive healthcare services to help people in determining and shaping their health status. Despite the availability of these services, those from low-income areas find it difficult to access them due to challenges with health insurance. The soup kitchen provides over 40,000 meals per month to the city population with the majority being the homeless. The affordable housing project assists individuals with an average income below $40,000 (Sentinel U, 2021). The project also sees solutions to issues like property disputes, tenant complaints, and regulation of housing charges.

Windshield Survey

A windshield survey is a tool that helps in assessing the environment, how people live, and the services available to address the health concerns of the people. Sentinel city is a fairly large city with six neighborhoods containing different population distributions. The first aspect observed is the housing and commercial buildings whereby the majority are multi-level containing different residents. There are no visible solar panels or windmills in the city. Most of the graffiti can be observed in Industrial Heights while those in Casper Park District run down the sidewalks. There are nice, high-rise Palace Condos in Nightingale Square with various redevelopment projects going on in the city. It is evident from the simulated drive that Sentinel City is an urban environment. Numerous trees line the sidewalks with limited green spaces across all neighborhoods. Open spaces are mostly concrete including free areas in the parks and playgrounds.

Walking through the city does not leave clear boundaries of the neighborhoods. The only noticeable feature is the state of the buildings as well as the quality of sidewalks when moving into less developed areas. There are a few parks in each neighborhood for recreation and exercise. Infrastructure to support public transportation is inadequate and bus lines are accessible from different neighborhoods. Apart from the use of vehicles, several people are observed traveling on foot or using bicycles to move around. The presence of sidewalks in almost every main road in the city indicates the use of personal means to move around. Regarding the quality of healthcare services, each neighborhood is observed to have a service center. For example, Sentinel City Healthcare System is located in Nightingale Square while Acer Tech has a community center. The city is well-supplied with groceries and different stores can be seen across all neighborhoods.

B1. Data Analysis: Interpretation of Data

Various challenges affect the people in Sentinel City. I learned that there are a lot of wastes in the city both in high and low-income areas. These wastes contribute to air and water pollution that could lead to diseases. Areas like Industrial Park have wastes all over the roads with rats and other rodents running into buildings (Sentinel U, 2021). The other crucial aspect noticed that affects the people is the high rate of insecurity across the city. The only places that are fairly safe include Nightingale Square and Acer tech Center. Crimes in the region range from simple robbery and aggravated assault to rape and murder. There is evidence of a burning vehicle in the streets and combined with the 200 assault reports from the police department demonstrates the state of violence in the city (Sentinel U, 2021).

The second aspect that I found important is the health status of the people in Sentinel City. Better Health Clinic is available to offer several services to the community with a greater focus on preventive healthcare. I noticed that most individuals in the region suffer from chronic conditions like cancer, heart disease, and diabetes. The demographics of Sentinel City indicate a crude death rate of 693.9 of which 195.1 represents cardiovascular disease burden while 154.2 represents cancer including malignant neoplasms and lung cancer (Sentinel U, 2021). Apart from the chronic conditions, there is low adherence to vaccination especially to children aged 18 to 35 months. High-income areas like Nightingale Square have a vaccination rate of 94% compared to low-income areas like Industrial Park with 78% (Sentinel U, 2021).

Another area of concern is the increasing number of STIs. I observed that Hepatitis B diagnosis for people over the age of 25 was at a rate of 92% and Chlamydia among the 15-24-year-old demographic was at 71% (Sentinel U, 2021). Additionally, the rate of teen pregnancies was high due to irresponsible sexual behavior among the adolescents alongside contributing factors like alcohol and drug use.

C1. Three Problem Areas

One of the problems which need to be addressed in the city relates to immunizations to prevent infectious diseases. The Healthy People 2020 goal for this area is to increase immunization rates and reduce preventable infectious diseases (Office of Disease Prevention and Health Promotion, 2021c). Although the immunization rates for elementary school children are within the required limit, regions like Industrial Heights could benefit from increased immunization for DTap, Hep B, and polio. The second problem area that should be addressed in the city is the increasing rate of sexually transmitted diseases. The healthy People 2020 goal for this issue is to promote healthy sexual behaviors, strengthen community capacity, and increase access to quality services to prevent sexually transmitted diseases and their complications (Office of Disease Prevention and Health Promotion, 2021a). It is observed that most colleges do not provide school health programs regarding sexuality. About 67% of higher-level institutions do not have any student health service available.

The third problem area that should be addressed is teen pregnancy. The Healthy people 2020 goal is to reduce pregnancies among adolescents aged 15 to 17 years and those between 18 to 19 years (Office of Disease Prevention and Health Promotion, 2021b). Addressing these challenges can greatly improve the health of the population across all age groups.

C2. Discussion of Community Resources

Resources in the community to help with the increasing rate of STIs in the city includes services offered at Better Health Clinic. The clinic provides testing and counseling services for youths and the elderly (Sentinel U, 2021). Sexually transmitted disease services are provided in the clinic to help guide the adolescents n responsible sexual behaviors. Additionally, the schools in the community can be utilized to improve health education on sexuality and the use of drugs that contributes to irresponsible sex.

C3. Primary Prevention Topic

The primary prevention topic that relates to the identified problems is reproductive and sexual health. This topic deals with sexually transmitted diseases, sexual transmission, and the prevention of STDs including HIV/AIDS. Untreated STDs can lead to long-term health benefits to the youths including infertility, fetal complications, and increased transmission of HIV. Improving healthcare access to the youths, regular screening, and school health programs can help address this challenge in the community.

1. Application of Assessment Strategies

A complete and accurate assessment is the foundation of good nursing care. I learned during the simulation that in-depth assessment includes examining aspects of the community that influence an individual’s health. I realized that using the four assessment tools provides an opportunity to identify a variety of health concerns f a community that helps in picking out the most important topics that can be addressed. During the simulation, I realized that engaging the community members is an active assessment strategy that enables the gathering of more information about the health problems of a community. Engaging key sectors of the community like schools, health centers, and the police department helped in gathering specific data that pointed out actual health problems in the community. In my community, I will use these approaches to understand the health needs of the people and the available resources to address the identified problems.

References

Office of Disease Prevention and Health Promotion. (2021a). Sexually transmitted diseases. U.S. Department of Health and Human Services. https://www.healthypeople.gov/2020/topics-objectives/topic/sexually-transmitted-diseases

Office of Disease Prevention and Health Promotion. (2021b). Family planning. U.S. Department of Health and Human Services.

https://www.healthypeople.gov/2020/topics-objectives/topic/family-planning/objectives

Office of Disease Prevention and Health Promotion. (2021c). Immunization and infectious diseases. U.S. Department of Health and Human Services. https://www.healthypeople.gov/2020/topics-objectives/topic/immunization-and-infectious-diseases

Sentinel U. (2021). Sentinel City (Version 3.1.3.1) [Computer software]. https://sentinelworld.healthcarelearninginnovations.com/Simulation/SentinelCity31/Start