COMMUNITY HEALTH SIMULATION

The demographic assessment of different parts of the Sentinel City reveals varied health needs and risks in the different community zones. The community facing the highest risk is the Industrial Heights, which has a median income household of $ 24,672 and a population totaling to 38,855 people. This region can be described as the lowest income zone and also least populated. Out of the population in this area, the proportion of the non-insured population stood at 37.5%., which implies that most -people may not have the ability to cater for their healthcare expenses. On the other hand, the Nightingale Square is the most endowed community in the city with a median household of $ 269,550 and a total population of 103,974. In this particular community, only 0.7% of the population is uninsured. 

Acer Tech Center can be considered as the second best well-off community with a median household income of $ 166,300 and a population of 168,390. The portion of its population that is not insured was 1.5%. Casper District Park is the community whose members live just above the poverty line with its median household income of $ 80,134 and a population of 352,642. Out of this population, 22.7% are uninsured. It can be noted that in the entire Sentinel City, approximately 18.9% of the people live below the poverty line. This population may be unable to cater for their healthcare services.

It can also be observed that cardiovascular factors are the major causes of deaths in Sentinel City. This is a likely indicator of unhealthy lifestyle practices such as poor diets mainly characterized by fast foods and soft drinks and also lack of exercises. Heart diseases are the other major cause of deaths in the city. The third major cause of death among the population in the Sentinel city is the Malignant Neoplasms. 

Neighborhood/Community Safety Inventory 

An assessment of the Neighborhood/Community Safety Inventory reveals that some neighborhoods are cleaner and safer than others. Some of the evidence indicating this include walls with graffiti that is common in low-income neighborhoods that are unsafe, people outside smoking and drinking, trash piled up against building walls, dilapidated buildings, stray dogs loitering across the streets, and a car burning on the roadside. 

Data from the Sentinel City Pharmacy level reveals that approximately 24% of the population in the city smoke tobacco, 26% consume alcohol, 13% marijuana, and 8% take heroin. This portrays a major health risk of drug-induced diseases. The use of these drugs is a risk factor in triggering other lifestyle-based diseases such as brain damage, lung cancer, throat cancer, and liver cirrhosis among others. Neighborhoods characterized by high intake of drugs are largely unsafe with high crime rates. This assertion can be confirmed from the Police department that indicates that most arrests in the city are related to warrants, cannabis, and use of controlled substances. This indicates that drug use is a major factor influencing the safety of the city. 

The City Hall indicates that the EMS response time is 7.46 minutes, which in comparison to three other cities, is the second best. The crimes reported in the city include simple assault, acts of homicide, aggravated assault, and robbery. Data from police indicated a high prevalence of gang-related crimes with a steady increase in aggravated assault, simple assault, and robbery being noted in the recent years. The roads appear to be quite unsafe for riders due to the lack of specialized lanes for bicycle riders. 

Windshield Survey

Through the Windshield Survey, it was clear that the Sentinel City enjoys a diversity in the population make-up. The outlook of the houses in the city reveals the differences between different regions in the city. The high-income areas are characterized by more upscale and nicely maintained houses as compared to the low-income neighborhood where the houses appear to be more run-down and dirty. Neighborhoods with higher income levels have better-maintained lawns and landscaping compared to areas of lower income dwellers. During the ride on the bus, these differences were evident as one moved from one economic endowed region to another. As one travels from high-end regions signage of health promotion and maintenance are clear compared to the low-income region where only one sign is evident but lacking clear and complete information. This is a likely indicator that residents in the higher income regions have better access to health care services including healthcare information. The city has essential services such as a hospital, clinic, and a rescue center serving the less fortunate in the society. The protests at the City hall are indicators of uneven distribution of resources where it is evident that the poor are more oppressed with taxes unlike the rich.

Population Health Scavenger Hunt

The scavenger hunt reveals the services provided throughout the communities in the city. It is clear that the city has recreational parks that can be used for fitness such as tennis courts, swimming lessons, nutrition diets, and adult fitness course. There are healthcare services provided for the senior citizens. There are also apartments, living centers units, nursing home units, assisted living facilities, and skilled nursing beds for the aged population. City Hall provides services such as healthcare assistance, supplemental nutrition for women, infants, and children. There is a center offering healthcare services on reproductive health. In the interfaith church, there is a rescue facility that takes care of the less-privileged people in the society. The Affordable Housing Project will be highly relevant to making housing more affordable to the low-income families.

Analysis of Data Using Concepts of Epidemiology and Health Determinants. 

From the data presented in the above discussion, it is apparent that Sentinel City faces Social Inequality across its different communities. The protests at the City Hall calling for taxes for the rich indicate that the poor were bearing a heavier burden in terms of taxes relative to the rich. Social inequality is highlighted through unequal distribution of goods, services, and opportunities in a society. It is evident that there is a social gradient between the different communities in the city, with Industrial Heights being the least endowed while Nightingale Square is most resource endowed section of the community (Knesebeck, 2015). The situation can be interpreted that Industrial Heights may have worse health status due to its low socioeconomic position.

Another epidemiology concept that can be figured out from the data presented above is on health-related states, more specifically on the distribution of the uninsured population in the community. From the Demographics Assessment, it can be established that approximately 62.4% of the population in the city’s communities is uninsured. This number is quite high compared to the 11.7% uninsured Americans in 2017 and 10.9% in 2016 (Auter, 2018). In the city, it is indicated that approximately 100,000 people are enrolled under the Medicare scheme that caters for the senior citizens above 65 years and the disabled. This implies that the more youthful population in the middle-class are exposed to high premiums for health insurance. It can, therefore, be identified that in this city, the major health determinants are the income level, socioeconomic status, and status of the neighborhoods. 

Community Diagnosis

Problems Based on Healthy People 2020 Goals

One of the problems facing Sentinel City is the high rate of tobacco consumption. This can be a likely cause of lung cancer that was noted to be the fourth leading cause of death in Sentinel City. Evidence indicates that about 24% of the population in the City uses tobacco. The Healthy People 2020 proposes a framework for action required to reduce the tobacco use to an extent that it does not become a public health problem to the community(Office of Disease Prevention and Health Promotion, 2015). To achieve this, the framework proposes different initiatives such as raising the price of tobacco products, coming up with comprehensive smoke-free policies, offering cessation treatment in healthcare facilities, use of anti-tobacco media campaigns, total funding of tobacco control programs, enact access to tobacco products, and minimizing any form of tobacco advertising and promotion directed at children. Such frameworks may be utilized at Sentinel City to reduce the negative impact to health in the city. 

Another problem that can be identified in Sentinel City is on food safety and hygiene. This is a problem prevalent at the grocery store where large numbers of foodborne illness were noted, with highest figures being recorded for fish and shellfish products. Healthy people 2020 seeks to reduce the foodborne illness in the USA by improving food-safety behaviors and practices (Office of Disease Prevention and Health Promotion, 2015). Food illness is described as a preventable and also underreported public health problem. At Sentinel City, it was observed that there was poor waste disposal at the Grocery Store which is a likely cause of the contamination of the food. This indicates that food illness in the city may be influenced by the behaviors and activities of the community members. 

Another problem evident in Sentinel city is the high prevalence of violence. Data from Police Department revealed a high prevalence of gang-related crimes with a steady increase in aggravated assault, simple assault, and robbery being noted in the recent years. Violence is also among the major crimes reported in the city. This is related to the Healthy people 2020 goal on injury and violence prevention, which targets the prevention of unintentional injuries and reduction in their consequences (Howard, 2014). Violence affects the health status of the people in the community as it inflicts fatal and non-fatal injuries. Other health impacts of violence may include years of potential life lost, disability, poor mental health, high medical costs, and reduction in productivity. 

Community Resources 

Sentinel City has enough resources that can be used to address the problems identified above. In addressing the problem of tobacco use, the resources that may be utilized include the health clinic and radio station. The health clinic may be used to assist the smokers access cessation treatment and other appropriate therapies. The health clinic may also be used as a resource center to provide information to the people on the effects of the use of tobacco to both active and passive smokers. The radio station may be used to broadcast the anti-tobacco campaigns and adverts. The use of radio is an effective means of communication that can reach many people at the same time. It offers a broad option on how to package the information on tobacco use, including informative ads or running of health-based shows. 

Primary Prevention Topic 

To address the problem identified, the primary prevention topic would be, “Tobacco-Smoking Cessation.” This topic would seek to capture the attention of smokers, both active and passive, and highlight to them that it is possible to quit smoking. This topic would seek to prevent the use of tobacco by raising awareness on the effects of smoking. Under the topic, different therapies available to assist those willing to quit smoking tobacco would be addressed. To make this topic more appealing, there would be an analysis of case studies of smokers who have successfully quit smoking as a means of providing testimony to the tobacco users to encourage them on their cessation journey.

Application of Learnt Assessment Strategies

The tools learned in this simulation exercise include Demographics Assessment, Neighborhood/Community Safety Inventory, Windshield Survey, and Population Health Scavenger Hunt. The Demographics Assessment tool will be essential in carrying out an assessment to point out to the informed, understanding of the gaps or needs that are available within a community, and their impacts upon the members of the community. This will seek to evaluate the health needs of different demographic groups such as youths, and senior citizens, families, parents, and infants (Laberge & Shachak, 2013). 

As a Community Health Nurse, Windshield Survey Tool will be essential in learning more about the community through direct observation. This will be essential in pointing out to the health-related resources that would be key to addressing different health problems. The tool involves collecting visual data from a care to provide a background and context of the community (Hunt, 2013).

References

Auter, Z. (2018). US Uninsured Rate Steady at 12.2% in Fourth Quarter of 2017. Washington, DC: Gallup, January, 16.

Howard, K. (2014). Prevention of Foodborne Illness and Medical Product Adverse Events: A Healthy People 2020 Progress Review.HealthyPeople.gov. Retrieved from https://www.healthypeople.gov/sites/default/files/Food%20and%20Medical%20Product%20Safety%20Slides%20.pdf

Hunt, R. (2013). Introduction to community-based nursing. Lippincott Williams & Wilkins.

Laberge, M., and A. Shachak. “Developing a Tool to Assess the Quality of Socio-Demographic Data in Community Health Centres.” Applied Clinical Informatics 4.1 (2013): 1–11. 

Office of Disease Prevention and Health Promotion. (2015). Food Safety. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/food-safety

Office of Disease Prevention and Health Promotion. (2015). Injury and Violence Prevention. Retrieved from: https://www.healthypeople.gov/2020/topics-objectives/topic/injury-and-violence-prevention

Von dem Knesebeck, O. (2015). Concepts of social epidemiology in health services research. BMC Health Services Research, 15, 357.