N4465 Care of Vulnerable Populations

N4465Care of Vulnerable Populations

COMMUNITYASSESSMENT, ANALYSIS, and NURSING INTERVENTION

Modules1-3 (Weeks 1 – 3) Assignment Template

Student ___Dates: _

Nameof Community or Zip Code: 77004

ModuleOne (Week One): Part One Windshield Survey and Key InformantInterviews

Pleasecomplete the following information on this template about thecommunity you have selected. If you do not use thistemplate there will be a 30 pts penalty and you will be required toresubmit within 48 hrs. You may increase the size of the block bycontinuing to type. Use as much space as necessary to provide youranswers

Elements

Descriptors

Physical Environment

Make sure you address fully what you observed and NOTE if something was not found within your community area.

● Boundaries

What defines the boundaries? Roads, water, railroads. Is the area known for a particular name? What area is this community located in?

Boundaries of zip code 77004 are defined by railway lines, streets, and roads. The southern boundary is defined by Truxillo Street and extends from the Gulf Freeway to Southwest Freeway, while the main streets form its western boundaries. All other boundaries are defined by roads, such as Texas State Highway (Wood, 2013). This zip code lies within the area known as Houston, TX, or the Third Ward.

● Housing and Zoning

What is the age of the houses? Describe type of construction material, appearance, and general condition. Do you see single family housing? Multi-family housing?

The oldest houses in Zip Code 77004 were constructed in eighteen thirty seven, which means that they are about a hundred and seventy eight years old, although some of them are being replaced with modern houses. However, most of the houses are less than fifty years old because zip code 77004 is recorded as the region with the highest number of new houses being constructed per year in the U.S. For example, about fifty thousand new residential houses were constructed in twenty fourteen, without counting the real estate buildings (Bivins, 2014). Nearly all houses are in good condition while the old ones are being replaced with new ones. The most common type of materials beings used include tendered bricks and blocks. Most of these materials are either red or gray in color. The largest proportion of the residential houses is single family, but there is substantial number of multi-family houses.

● Common Meeting Places

Where do people in the neighborhood hang out? Who hangs out there and what hours of the day?

Many people hang out in coffee houses and pubs. It is difficult to state precisely the type of people who hang out because it depends on the time and days of the week. For an instant, the retirees hang out any time of the day (including the working hours) while the working class hang out in the evening, weekends, and holidays.

● Indicators of Growth or Decline

Is this a “thriving” community or does it look “run down?” Is there new or ongoing construction? Businesses and Industries coming to the area? Are buildings, roadways, and public areas clean and well-kept? Do you see dirt, trash, or graffiti?

The zip code 77004 is composed of a thriving community, which can be confirmed by the fact that over fifty thousand new houses are being constructed per year. Currently, there is no evidence of new manufacturing companies, but the companies operating the services industries (including banks and insurance firms) are expanding tremendously in the region. Roads that connect the zip code to its neighborhood are clean and well maintained, but there are few roads that have trash. For example, the Down Town Roads have heaps of trash by the road side.

● Employment Opportunities

What places for employment are there is this area? Name the businesses and industries in this area.

Employment opportunities can be found in the service industry, manufacturing firms, and construction companies, and in small business operating in zip code 77004. The manufacturing firms include KMCO, PL, Royal Baths, ad Canyon Manufacturing Incorporation among others. Service firms include Prosperity Bank and AI United Insurance among others.

● Transportation

How do people get from one place to another? Is public transportation available? How timely is it? Personal autos? Bikes? Walking?

Many people use the public means of transport, which include the Houston Metro and public buses. However, there are some people who use personal cars, bikes, taxis, and walking to move from one place to another.

People

Make sure you address fully what you observed and NOTE if something was not found within your community area.

● Race and Ethnicity

What is the majority racial group represented? What is the majority ethnic group represented? Describe the distribution of gender, approximate ages, single families, multiple families, generational families?

The majority racial group is the White followed by the Black, Asians, and the native Americans. The European American is the most popular ethnic group in the zip code 77004. Gender distribution is quite fair with a male female ratio of about one is to one. More than half of the population is between eighteen and sixty five years, and live in single families. However, there are a few multiple families, but generational families are quite rare.

● Cultural Characteristics

What cultural similarities or differences do you observe? Languages spoken? Clothing? Ethnic eating places? Culturally-based celebrations? Signs in languages other than English?

Dreaming big is one of the cultures that are shared by nearly all demographic groups living in zip code 77004. However, most of the Latinos preserve their traditional believes and songs (such s Las Mananitas) that are not used by other cultural groups. Although most of the cultural groups use English in communication, adopt the white clothing styles, and eat in usual places, Latino and Native Indians have their own styles and facilities. For example, some Indians women wear saris and patronize Indian restaurants. Latinos have preserved their ceremonies such as Quince Anos. Each of the cultural groups uses signs when communicating, but it all depends on the individual person.

● Lifestyle Healthy Behaviors

What healthy lifestyle behaviors do you observe? Do you see people exercising, wearing helmets when biking, seat belt usage, using trash cans for garbage disposal, healthy eating practices?

There are quite a large number of residents who visit gyms for physical exercise. However, some bike riders do not use helmets when riding bikes and many people throw trash besides the trash cans, which is a sign of irresponsibility. Safety belts are mostly used by drivers of personal cars, but users of public buses rarely use the belts, especially those who are travelling over a short distance. The zip code has many fast food restaurants, which indicates unhealthy eating practices.

● Lifestyle Risk Behaviors

What unhealthy lifestyle behaviors do you observe? Do you see people practicing risky lifestyle behaviors such as drinking alcoholic beverages, smoking, fighting? Do you see signs of violence, gang activity, drug use, criminal activity, and bars on doors and/or windows? Do you see overweight/underweight persons? Do you see children unattended playing out in the streets? Do you see any signs of homelessness? Street people? Describe gender, age, and race/ethnicity of persons observed.

Excessive drinking of alcohol is common among the youths, especially on Fridays evening and weekends. More than half the streets have gangs that engage in drug selling and other violent activities, such as fighting. There are many overweight people, but most of them are women and children. There are also a few children who play along the streets unattended. The zip code 77004 has a large number of homeless people who increase security threats in the region. The homeless people end up forming street families and gangs that threaten the lives of residents. Most of the street people are the male youths and a mixture of Blacks and Hispanic, and a few whites.

● Poverty Indications

Do you see any signs of homelessness? Street people? Describe gender, age, and race/ethnicity of persons observed.

People sleeping on cartons along the streets can be seen early mornings, which indicates of homelessness and the existence of street people. The majority of homeless and street people are male youths from the Black and Hispanic communities.

Services in the Community

Make sure you address fully what you observed and NOTE if something was not found within your community area, how far away it is and how people will access it.

● Social Services

Do you see evidence of recreation centers, parks, and social services? For services that are not available, how far must persons travel to access these services?Describe each.

The zip code 77004 has several recreation facilities (such as the DS Recreation Center) and parks (such as Dodson Lake Park). People living within the zip code have access to several social services, such as health care insurance programs for children and disabled persons, subsidized food programs, and perinatal programs. Zip code has several agencies (such as the Social Service Outreach) that help residents to access social services that are provided by the state as well as the federal government, but are not available within the zip code. This reduces the distance that residents have to travel to access these social services.

● Health Services

Do you see evidence of health (Hospitals, Dr’s Offices, and Clinics) and mental health services? Describe each. Are there any signs of alternative services in the area, such as healers (curanderos), herbalists, herbal stores, palm readers, acupunctures, and chiropractors? For services that are not available, how far must persons travel to access these services?

The zip code has private and public hospitals (such as Memorial Herman Hospital), numerous doctors’ offices (such as Cypress Physicians), clinics (including Texas Wellness Health Clinic), and mental health services (such as Menninger Clinic). These types of facilities exist within the zip code in large numbers, which reduce the distance that residents need to travel to get health care services. In addition, the zip code has a large number of herbalists (such as the Axelrad Clinic and the Joint Oak), but palm readers, chiropractors, and acupunctures are limited.

● Fire and Police Services

Do you see any fire and police services/equipment/officers? Where are the closest fire and/or police stations?

The zip code 77004 has about a hundred and eight fire stations that are strategically located to deal with fire outbreaks. The zip code has more than fifty police stations. The closeness of the fire or police station depends on where one is standing. However, the distribution of these stations is higher along the busy streets and densely populated residential areas.

● Educational Resources

Where is the nearest public library? Discuss the Schools and Universities/Community colleges?

The zip code 77004 has several public libraries, including Aldine Brach Library. These libraries are closed to residential areas. In addition, nearly every street has at least a college, university, or other kind of learning facility. The availability of institutions of learning has helped residents enroll in full time or part-time courses.

● Religions

What signs of religion do you see? Discuss the types of churches, mosques, temples? What services are offered by these churches, e.g., Day Care, Mother’s Day Out, Summer Camps, Languages Classes, Citizenship Classes, Food Banks, Clothing, other.

Churches, mosques, and temples are the major signs of religions of the people. Most of the churches are Pentecostal and offer different services that include summers camps, citizenship education classes, and mother’s day out. There are a few mosques and temples in the zip cope.

Business &amp Industry

Describe stores and shops available in the community, e.g., grocery stores, gas stations, department stores. What type of business climate exists? Manufactures? Light or heavy industry? Large employers? Small business owners? Retail? Hospitality industry? Do people have to seek employment elsewhere? Is this considered a “bedroom community”- where people work outside this community but live here? Make sure you address fully what you observed and NOTE if something was not found within your community area.

Zip code 77004 has all types of business stores, including grocery (such as Kroger), retail stores (such as West Marine), discount stores (such as Citi Trends), and gas station stores, such as Valero. Business climate in the zip code 77004 can be described as both macro and micro. Some businesses operate locally and are only influenced by the local factors while the large businesses are influenced by both internal and external factors. The zip code has light and heavy industries, large and small employers. The hospitality industry is also on the rise. Although the zip code 77004 has many companies that provide employment opportunities, people who need to change working environment can look for jobs outside the zip code region. Most of the people working within the zip code live in this region, which means that the place cannot be regarded as the bedroom. This is confirmed by the existence of many residential houses in the zip code.

Politics

What indicators do you see about politics? Posters? Headquarters? Make sure you address fully what you observed and NOTE if something was not found within your community area.

The existence of political party offices and headquarters are the major indicators of politics in the zip code 77004, but posters are rare. For example, the Democratic Party in Harris is strategically located for anyone to notice.

Media

Do you see indicators of what people read? Listen to the radio? Watch TV? Are there any signs of media language other than English? Make sure you address fully what you observed and NOTE if something was not found within your community area.

There is nom evidence of non-English radio and TV station in Zip code 77004, but its neighborhood has them. There are many TV and radio stations based in Houston and one can see news papers being sold along the streets. The location of TV de Houston Spanish in within Houston confirms that residents watch programs broadcasted in Spanish.

Key Informants

Interview a fireman or police office.

Also interview a librarian, school teacher, school nurse or administrator.

Ask each person interviewed to share their perceptions of

the following and cite personal communication as appropriate:

  1. Interview with fireman or police officer

˃ Community’s Health issues

All people interviewed gave similar community health issues. The chief of Houston Police Department, Charles McClelland, stated that substance abuse is the major health issue in the zip code 77004 (personal communication July 3, 2015).

˃ Community’s Safety issues

The chief of police at Houston Police Department , Charles McClelland, stated that reckless driving was the major safety issue that affects the community living within the zip code 77004 (personal communication July 3, 2015).

˃ Strengths of the Community

The strengths of community living in the zip code 77004 are based on the availability of adequate facilities, such as police stations, fire stations, health care facilities, and experts who operate these facilities. In addition, the ability of the community to neglect cultural diversity and focus on common enemies (such as poverty, insecurity, and health challenges) has helped the residents keep going.

  1. Interview with librarian, school teacher, school nurse or administrator

˃ Community’s Health issues

The director of guidance and counseling at Nimtz High School, Charlotte Davis, stated that overweight, substance abuse, and HIV/AIDs are the major health issues in the zip code 77004 (personal communication July 3, 2015). The issue of substance abuse is made worse by the people who sell drugs to students and the large number of gangs in the streets.

˃ Community’s Safety issues

Director of guidance and counseling at Nimtz High School, Charlotte Davis, asserted that kidnapping and extortion by street boys are key safety issues affecting people living within the zip code 77004 (personal communication July 3, 2015).

˃ Strengths of the Community

Leaders and residents from different racial backgrounds share a common vision of developing the region and join hands to address social issues affecting them. This has kept the community going in spite of the health and safety challenges they face.

Analysis of Windshield Survey

Analyze and summarize your observations and the input from key informants. Write a 3 paragraph summary of community health (2) and safety (1) issues for this community and strengthens of the community. Remember to cite personal communication as appropriate:

Zip code 77004 has several health issues, but they are common to all developing cities and urban areas in the world. Substance abuse and the spread of HIV / AIDS affect the street people and the homeless persons who live in the streets within the zip code 77004 (Charlotte, D. April 3, 2015). The rapid growth of Houston and its neighborhood indicates that cases of HIV / AIDs infection and substance abuse will continue increasing.

In addition, obesity and overweight are major health issues that the stakeholders in the health care sector should watch (Charlotte, D. April 3, 2015). Trends indicate that cases of overweight are quite common among women and children. Although there are many gym facilities and other sports facilities in the zip code, it is evident that not many people utilize them to keep their bodies fit.

The existence of street families is a security threat that makes people living within the zip code 77004 feel unsafe, especially during the nights (Charles, M. April 3, 2015). The street people are accused of kidnapping people and engaging in burglary in the busy streets and residential areas. However, the leadership of Houston has managed to establish adequate facilities (such as the health care facilities and police stations) to handles the safety and health issues in zip code 77004.

Reference

Bivins,R. (2014). Boom on Houston notching more new home starts than theentire state of California. CultureMap LLC.Retrieved July 3, 2015, fromhttp://houston.culturemap.com/news/real-estate/04-02-14-boom-on-houston-notches-more-housing-starts-than-the-entire-state-of-california/

CharlesMcClelland, The chief of police at Houston Police Department,(personal communication July 3, 2015).

CharlotteDavis, The director of guidance and counseling at Nimtz High School,(personal communication July 3, 2015).

Wood,R (2013). Downin Houston: Bayou City Blues. Austin:Universityof Texas Press.RetrievedJuly 12, 2015, from http://stateofobesity.org/states/tx/

Module2 (Week2) Part Two: Statistical Analysis of Community Health Problem

Pleasecomplete the following information on this template. Ifyou do notuse this template there will be a 30 pts penalty and you will berequired to resubmit within 48 hrs. You may increase the size of theblock by continuing to type. Use as much space as necessary toprovide your answers

Nameof Community or Zip Code: 77004

Instructions: Enter your response in each category marked below. Provideobjective, statistical support for your subjective findings.

Includeall the data listed in the Objective Data Criteria listed below.

Addsupplemental data as needed for your community.

Allstatistical data must be reported in NARRATIVE form only.Tables and graphs will not be accepted.&nbsp

Compareobjective data for your community with local(city), state, and national data.

Youmay increase the size of the block by continuing to type. Use asmuch space as necessary to provide your answers

GeneralObjective Data Criteria for the Community-at-Large

  1. Demographics: Total population age distribution gender distribution family characteristics (single parent, multi-family, etc.). Remember compare objective data for your community with local (city), state, and national data. Remember to cite sources as appropriate.

The zip code 77004 has a total population of 30,379 people compared to the U.S. population of 308 million and the state’s (Texas) population of 26 million (Zip Atlas, 2014). About 28.74 % of the people living within the zip code 77004 are aged 19years and below, 26.11 % are aged between 20 and 34, 46.44 % are aged between 35 years and 64 years, and 13.16 % are aged 65 years and above. At the state (Texas) level, about 31.39 % of the people are aged 19 years and below, 22.55 % are between 20 and 34 years, 51.28 % are between 35 and 64 years, and 9.94 % are 65 years and above. At the national level, about 28.64 % are aged 19 years and below, 20.92 % are between 20 and 34 years, 38.01 % are between 35 and 64 years, and 12.41 % are 65 years and above (Zip Atlas, 2014). About 48.73 % of the total population in zip code 77004 is composed of male and 51.27 % female residents. About 49.65 % of the population Texas is composed of male and 50.35 % female citizens. At the national level, 49.04 % of the total population is composed of male and 50.96 % female citizens (Zip Atlas, 2014). More than 50 % of the total number of total population lives in a single family set up at regional, state, and the national levels.

  1. Racial/Ethnic Characteristics: Remember compare objective data for your community with local (city), state, and national data. Remember to cite sources as appropriate.

About 16.73 % of the people living within zip code 77004 are white, 72.42 % black, 0.3 % Native Indians, 2.84 % Asians, 0.03 % Native Hawaiian, and 5.3 % other races. At the state level, 70.97 % of the people are white, 11.54 % black, 0.57 % Native Indians, 2.7 Asians, 0.07 % Native Hawaiians, and 11.69 % other races. At the national level, 75 % of the people are white, 12.26 % black, 0.87 % Native Indians, 3.59 % Asians, 0.14 % Native Hawaiians, and 5.48 % other races (Zip Atlas, 2014).

  1. Economy: poverty rate, unemployment rates, median income. Remember compare objective data for your community with local (city), state, and national data. Remember to cite sources as appropriate.

About 49.08 % of the people in zip cope 77004 live below the poverty line (Zip Atlas, 2014) compared to seven point six percent in the state of Texas, and 15.4 % percent at the national level (United States Census Bureau, 2015). The zip code 77004 has unemployment rate of 23.18 % compared to the state average rate of six percent and the national average rate of five point eight four percent (Zip Atlas, 2014). People living in the zip code 77004 have a median income of $ 20,840, compared to the state value of $ 37,718.88, and the national value of $ 39,349.33 per annum (Zip Atlas, 2014).

  1. Education: High school completion rates higher education statistics. Remember compare objective data for your community with local (city), state, and national data. Remember to cite sources as appropriate.

The zip code 77004 has a high school completion rate of 21.49 %, compared to the state’s (Texas) average rate of 24.84 %, and the national average rate of 28.63 % (Zip Atlas, 2014). About 14 % of the people have at least a Bachelor’s degree compared to the state’s average of 15.61 %, and the national value of 15.54 % (Zip Atlas, 2014).

  1. Identify two Morbidity and Mortality/Risk Problems: (Based on your observations from Week 1 subjective assignment, windshield survey and key informants provide Morbidity, Mortality (M&ampM) and risk data for your community… Example 1: if you observed obesity in your community then present obesity rates and health conditions associated with obesity [i.e. CVD, HD, Depression, etc.). Example 2: smoking/drinking rates and health conditions associated with smoking [i.e. Lung Cancer, COPD, etc]. These variables may include the following: gender (who does this problem affect the most, men or women) age distribution ethnicity or racial group(s) mostly-affected morbidity and mortality rates any data related to life-expectancy in light of the health issues is there a geographic area where the health problems mainly exist is there a relationship between the health issue(s) and environmental health hazards are these life-threatening health issues? Remember compare objective data for your community with local (city), state, and national data. Remember to cite sources as appropriate.

The major problems affecting people living within the zip code 77004 include obesity and the abuse of alcohol. About 23.2 % of the people living within zip code 77004 are obese compared to the state rate of about 30.9 %, and the national rate of 35.7 % (Wood, 2015). Obesity is closely associated with the high blood pressure and heart diseases. Currently, there are no statistics showing the prevalence of HBP in zip code 77004, but the Texas prevalence rate is 24.6 %, where 41.4 % of those who are affected are Black Americans, 29.1 % white, and 21.7 % Hispanic, and the rest come from minor races. About 58 % of those who are affected by HBP are 65 years and above, 36.9 % are between 45-64 years, 16.3 % are between 30-34 years, and seven point eight percent are between 18-29 years (Texas Department of State Health Service, 2014). At the national level, about 29 % of the total population suffers from HBP, where 43 % and 45.7 % black American men and women are affected respectively, 27.8 % and 28.9 % Hispanic men and women are affected respectively, and 33.9 % and 31.3 % of while men and women are affected respectively (Center for Disease Control, 2014). In addition, 11.1 % men and 6.8 women aged 20-34 years are affected, 25.1 % men and 19 % women aged between 35 and 44 years are affected, 37.1 % men and 35.2 % women aged 45-54 years are affected, 54 % men and 53.3 % women aged 55-64 years are affected, and 66.7 % men and 78.5 % women aged 64 years and above are affected (CDC, 2014).

Currently, there are no statistics showing the exact number of people affected by substance addition in zip code 77004. At the state level, 49 % of those affected by drug addition are male, 51 % are black Americans, 19 % Hispanic, and the rest are white Americans (TDSHS, 2014). The average age of those who are affected is 38 yeas. At the national level, 30.74 % white male and 23.73 % white female 25 % black male and 19.02 % black female, 29.34 % native male and 27.20 % native female, 18.84 % Asian male and 19.77 % Asian female, and 40.48 % Hispanic male and 24.19 % Hispanic female are at the risk of alcohol addiction (Chartier &amp Caetano, 2014). About 41 % of all those at the risk of addiction are aged between 15 and 54 years (Chartier &amp Caetano, 2014).

  1. Other data as needed (air, water quality, crimes rates). Remember compare objective data for your community with local (city), state, and national data. Remember to cite sources as appropriate.

Air quality of the zip code 77004 is measured using the scale of 0-100. Currently, the air quality is estimated to be 0, compared to a value of 67, and 93.9 in the state of Texas and the United States respectively (Sperlings, 2015). The water quality is estimated to be 37 on the scale of 100, compared to the state’s value of 97, and the national value of 55 (Sperlings, 2015).

People living within the zip code 77004 are affected by four major types of crime, which include theft (87.52 %), violence (11.58 %), sexual abuse (0.69 %), and homicide (0.21 %) (Citizens Information Association LLC, 2015). Violent crimes affecting the residents of Texas are measured on the per 1,000 residents, where murder cases account for 0.04, rape 0.37, robbery 1.2, and assaults 2.37 compared to the national values of 0.04 for murder, 0.34 rape, 1.09 robbery, and 2.29 assaults (Tyson, 2015). Property crimes per 1,000 residents in Texas are 7.22 for robbery, 22.88 thefts, and 2.49 vehicle theft compared to the national values of 6.10 for burglary, 18.99 for theft, and 2.21 vehicle theft (Tyson, 2015).

Analysisof Data

  1. Based on your subjective and objective review of your findings what conclusions have you arrived at? Remember to cite sources as appropriate.

  • What impressions from your subjective observations were unfounded / invalid?

The subjective observation indicated that there are many employment opportunities in the zone code 77004, but the objective data shows that the region has a very high unemployment rate (23.18 %) compared to state’s average rate of six percent and the national average rate of five percent (Zip Atlas, 2014). In addition, subjective observation indicated that zip code 77004 is a progressive zone where businesses are flourishing faster, but objective data shows that it has a high rate (49.08 %) of people living below the poverty live compared to the state’s rate of six percent and the national rate of 15.4 % (USCB, 2015). The subjective observation indicated that the whites are the majority in the zip code 77004, but the objective data shows that about 72.42 are black while the whites are 16.73 % (Zip Atlas, 2014).

  • Given the objective data, what impressions were validated/substantiated?

The subjective observation indicated that zip code 77004 has a high crime rate because of the existence of street gangs, which was confirmed by objective data that shows that residents are affected by theft crimes (87.52 %), violence (11.58 %), sexual abuse (0.69 %), and homicide (0.21 %) (CDC, 2014). In addition, the subjective observation shows that there are many people who are affected by obesity and substance addition. These facts have been confirmed by objective data showing that about 23.2 % of the residents are obese (Wood, 2015). Moreover, subjective observation indicates that people in zip code 77004 dispose trash besides the roads, which is consisted with the facts that the air and water qualities are law (Sperlings, 2015).

  • What cause-and-effect relationships did you discover/identify?

The fact that the most those suffering from obesity are blacks indicates that there is cause and effect relationship between race (being a black American) and obesity. In addition, there is a cause and effect relationship between the large number of fast food restaurants and cases of obesity. Moreover, the fact that the residents of zip code 77004 deposit trash on the road sides indicates that there is a cause and effect relationship between environmental consciousness and the quality of waiter and air.

  1. Problem Analysis for Community/Zip Code:

Problem:List two problems within your community (i.e.Infant Malnutrition, CVD, Lung Cancer, Obesity, Alcoholism, Violence)NOTE: Theseproblems need to be something the Community Health Nurse can impact(i.e.A CHN cannot build a sidewalk, repair a street, implement a new busroute, etc.). Rememberto cite sources as appropriate.

  1. Obesity ___

  2. Substance addiction

Selectone of these problems and complete the Problem Analysis chart(substance abuse)

Problem Correlates*

Relationship of Correlate to Problem

Data Supportive of Relationship +

Ex. Inadequate diet

Ex. Diets lacking in required nutrients contribute to malnutrition

Ex. All infants and children seen at the local Public Health Clinic are referred to the nutritionist because of poor diets (X.Y. personal communication, May 15, 2014). Of infants measured, 60% were in the lower percent for their weight/height (X report, 2014).

Poverty

Poor people spend more time idling, which increases the risk of being influenced to abuse substances.

About 49.08 % of the people living within the zone code 77004 live below the poverty line, which increase the risk of being influenced to use substances (USCB, 2015).

Unemployment

The jobless people get stressed and use substances to forget their troubles.

The zip code 77004 has unemployment rate of 23.18 %, which increases the risk of stressful conditions that lead to substance abuse (Zip Atlas, 2014).

Environment

Urban and crowded residential areas expose the youths to too many things, some of them being addictive substances, before there are mature enough to determine whether they are good or not.

More than 68 % of the people in zip code 77004 live in crowded residential place, which increase the risk of early exposure to addictive substances (Advameg Inc, 2015).

Drugs availability

When drugs are readily available, the youths are tempted to test them and end up being hooked.

Objective data shows that the majority of drug gangs call zip code 77004 homes (Schiller, 2010).

*Theseare factors that contribute to problem and outcomes.

+Refer to appropriate sections of the database and relevant researchof the findings in current literature. Data in the third columncould be local, state, or national statistics.

Referto text (pg. 420-423) for additional examples.

  1. Community Health Nursing Diagnoses:

Basedon your subjective and objective assessment findings above for bothWeeks 1 and 2, write TWOpriority community health nursing diagnoses.

Youmustuse this format as outlined in your text page413(do NOTuse NANDA):

HealthRisk/problem of (specific injury, illness, or potential of,complication of, etc) among (specific population) related to(supporting evidence from your assessment findings).

  • Your CHN Dx MUST be something that a community/public health nurse can do something about. See example below.

  • Note: Poverty is NOT a CHN dx!

  • Remember do NOT use NANDA Nursing Dx

Forexample:Riskof asthma complications among children in SE Dallas County related toobservations of overcrowded living conditions, lack of publictransportation (may result in inability to access health care), highnumber of animals observed living in homes, poverty indications (mayresult in lack of access to medications).

Community Health Nursing Diagnoses #1

The high risk of obesity among the black Americans living within zip code 77004 is related to over-consumption of fast foods, genetic predisposition, physical inactivity, and old age as evidenced by the availability of many fast food restaurants, a high prevalence of obesity among the black Americans, underutilization of gym facilities, and the fact that the majority of affected people are 65 years and above.

Community Health Nursing Diagnoses #2

The risk of substance addiction among the black and Hispanic youths living within the zip code 77004 is related to ready availability and environmental exposure as confirmed by the high rate of unemployment, existence of drug gangs, and a large number of black Americans and Hispanic youths.

Reference

AdvamegInc (2015). 77004 zip code detailed profile. AdvamegInc.Retrieved July 5, 2015, from http://www.city-data.com/zips/77004.html

Centerfor Disease Control (2014). Highblood pressure facts.Washington, DC: CDC. Retrieved July 12, 2015, fromhttp://www.cdc.gov/bloodpressure/facts.htm

Chartier,K. &amp Caetano, R. (2014). Ethnicityand health disparities in alcohol research.Washington, DC: NIAAA. Retrieved July 12, 2015, fromhttp://pubs.niaaa.nih.gov/publications/arh40/152-160.htm

CitizensInformation Association LLC (2015). 77004 crime maps. CrimeMaps.Retrieved July 5, 2015, fromhttp://www.bustedmaps.com/incidents/texas/77004

Maxwell,C. (2012). Substanceabuse trends in Texas: June 2012.Austin: Gulf Coast Addiction Technology Transfer Center. RetrievedJuly 12, 2015, from www.utexas.edu/…/CurrentTrends2012.pdf

Schiller,D. (2010). Most gangs in Texas call Houston region home. StreetGang.Retrieved July 5, 2015, fromhttp://www.streetgangs.com/contacts#sthash.rvniHGEt.dpbs

Sperlings(2015). Health in Houston (zip 77004), Texas. Sperlings.Retrieved July 5, 2015, fromhttp://www.bestplaces.net/health/zip-code/texas/houston/77004

TexasDepartment of State Health Service (2014). Highblood pressure prevalence in Texas.Austin: TDSHS. Retrieved July 12, 2015, fromhttps://www.dshs.state.tx.us

Tyson,E. (2015). Crime rates for Texas. LocationInc.Retrieved July 5, 2015, fromhttp://www.neighborhoodscout.com/tx/crime/

UnitedStates Census Bureau (2015). Stateand county quick facts.Washington, DC: USCB. Retrieved July 12, 2015, fromhttp://quickfacts.census.gov/qfd/states/48000.html

Wood,R. (2015). Thestate of obesity in Texas: The State of Obesity.Washington, DC: America’s Health and Robert Wood Foundation.Retrieved July 12, 2015, from http://stateofobesity.org/states/tx/

ZipAtlas (2014). 77004 zip code map and detailed profile. ZipAtlas.Retrieved July 5, 2015, fromhttp://zipatlas.com/us/tx/houston/zip-77004.htm#demographics

Module3 (Week3) Part Three: Community Health Nursing Intervention

Directions:Please complete the following information on this template. Ifyou do notuse this template there will be a 30 pts penalty and you will berequired to resubmit within 48 hrs.Youmay increase the size of the block by continuing to type. Use asmuch space as necessary to provide your answers

Introduction:Purpose of the paper, synopsis of community, two CHN dx withsupporting evidence (i.e. Observations, reports from Key Informantsand Statistical data). Remember to cite sources as appropriate.

The purpose of this paper is to develop suitable community health nursing intervention for obesity and substance addition for the communities living within the zip code 77004. The zip code 77004 community is comprised of about 30,379 people, who include the majority Black Americans (70.97 %), white Americans (11.54 %) zero point five seven Native Indians, two point seven Asians, and 11.69 % minor races (Zip Atlas, 2014). Gender disparity is quite fair because 49.04 of the people are men and 50.96 female citizens. However, the community is affected by a high rate of poverty where about 49.08 % (close to half the population) of the people live below the poverty line and about 23.18 % are unemployed (USCB, 2015).

It is estimated that about 23.2 % of the people living within the zip code 77004 obese, but most of them are the black Americans (Wood, 2015). In addition, about 49 % of the people are at the risk of abusing substances because of their availability and the presence of drug gangs (Maxwell, 2012). Similar to obesity, substance addiction affect the black Americans and the Hispanic communities more than other races.

Basedon the 2 CHN Dx you developed in Assignment 2 or modified, select ONEproblem and develop a CH Nursing intervention. Rememberto cite sources as appropriate.

  1. CHN Dx/Problem you selected:

Obesity:

Obesity is one of the key health challenges affecting people living within the zip code 77004. WHO defines obesity as abnormal fat accumulation, which measured by a BMI of 30 and above (WHO, 2014). This challenge affects about 23.2 % of the people living within the zip code 77004 (Wood, 2015).

  1. Why did you select this problem? Provide rational for selecting these problems in 1-2 comprehensive paragraphs (Consider the problem priority criterion on page 415 Box 18-7). Provide supporting community and scientific/authority evidence (i.e. Healthy People 2020, CFC, AHA, etc.) for this Dx. Remember to cite sources as appropriate.

Obesity was selected because it affected a significant proportion of the population in zip code 77004. The 23.2 % of the people affected translated to about 7,052 people are suffering from obesity (Wood, 2015). It is estimated that about 25 % of the people suffering from obesity are at the risk of dying prematurely (WHO, 2015). This translates to about 1,706 people dying of obesity each year within the region. In addition, obesity is more likely to continue increasing than reducing. Moreover, obesity affects the Black Americans than any other racial group. Currently, there are no interventions proven to be effective in addressing the menace of obesity in the zip code 77004. Therefore, it is evident that obesity is serious health challenge in zip code 77004.

  1. Two Goals (i.e. goals are where you want to go) and two to three Objectives (i.e. how you will get there) per goal of Community Health Nursing Intervention

Goal 1: To increases the awareness of obesity and its causes

  1. Objective: To reach about 50 % of the residents in zip code 77004 by June 2016 through educational seminars.

  1. Objective: To distribute educational materials on obesity and preventive strategies to about 70 % of the residents of zip code 77004 by April 2016.

Goal 2: Promote physical activities, especially among youths within zip code 77004

  1. Objective: To initiate a community football league that will include about 10 teams by December 2015.

  2. Objective: To offer physical education program to about 10 high schools in zip code 77004 by March 2016.

  1. Intervention Objectives Timeline

Present Date

Objective( Number and Statement)

Anticipated Completion Date

Ex. August 2014

Ex. Eighty-percent (80%) of infants seen by health department, neighborhood health center, and private physicians will have developmental levels assessed.

Ex. August 2015

July 2015

To reach about 50 % of the residents in zip code 77004 by June 2016 through educational seminars.

June 2016

July 2015

To distribute educational materials on obesity and preventive strategies to about 70 % of the residents of zip code 77004.

April 2016

July 2015

To initiate a community football league that will include about 10 teams by December 2015.

December 2015

July 2015

To offer physical education program to about 10 high schools in zip code 77004 by March 2016.

March 2016

Referto text (pg. 420-423) for additional examples.

  1. Plan of Intervention and Evaluation

Intervention Activities

Responsible Agency/Person

Evaluation Measures

Target Date of Completion

Ex. 8/11/14

Ex. Community Health Nurse identifies and trains lay advisors in community as case finders

Ex. Community Health Nurse

(CHN)

Ex. • Lay advisors will be able to verbally describe case-finding methods to CHN

Number of new WIC cases will be tracked by CHN on monthly basis for 1 year to determine if goal of 80% has been met

Ex. Lay advisor training completed by

10/17/2014

July 6, 2015

Identify knowledge gaps about obesity and organize educational programs for people living in zip code 77004

Community health nurse

Participants of the educational programs will be able to define obesity and name at least three causes and two prevention measures

June 1, 2016

July 6, 2015

Develop and distribute educational materials on effective methods of avoiding obesity

Community health nurse

At least 70 % of the residents of zip code 77004 should be having at least one copy of educational material

April 1, 2016

July 6, 2015

Organize students in local schools into teams and plan how they will be competing for a tournament

Community health nurse

At least 10 should be taking part in the inter-schools tournament

December 31, 2015

July 6, 2015

Develop a physical education program and deliver its content to local schools

Community health nurse

Students in at least 10 local schools should be able to describe the relationship between physical activities and obesity

March 20, 2015

Referto text (pg. 420-423) for additional examples.

Summary/Conclusion:Summarize your assessment findings, your proposedcommunity health nursing intervention, and the community publichealth outcomes that you anticipate as a result of the intervention. This can be one or two brief paragraphs. Remember to cite sourcesas appropriate.

The zip code 77004 is a multiracial community that faces different types of challenges. Economic challenges include the high rate of unemployment (23.18 %) and a large number of people living below the poverty line (USCB, 2015). Health challenges include substance abuse and a large number of people suffering from obesity (23.2 %) (Wood, 2015). Most of these problems affect the black American living in the region more than other racial groups. The community health nurse can addresses the health challenges (including obesity) through educational programs and promoting physical activity programs for youths.

Reference

Maxwell,C. (2012). Substanceabuse trends in Texas: June 2012.Austin: Gulf Coast Addiction Technology Transfer Center. RetrievedJuly 12, 2015, from www.utexas.edu/…/CurrentTrends2012.pdf

UnitedStates Census Bureau (2015). Stateand county quick facts.Washington, DC: USCB.

WHO(2014). Obesity. WHO.Retrieved July 5, 2015, from http://www.who.int/topics/obesity/en/

WHO(2015). Media center: Obesity and overweight. WHO.Retrieved July 5, 2015, fromhttp://www.who.int/mediacentre/factsheets/fs311/en/

Wood,R. (2015). Thestate of obesity in Texas: The State of Obesity.Washington, DC: America’s Health and Robert Wood Foundation.Retrieved July 12, 2015 from http://stateofobesity.org/states/tx/

ZipAtlas (2014). 77004 zip code map and detailed profile. ZipAtlas.Retrieved July 5, 2015, fromhttp://zipatlas.com/us/tx/houston/zip-77004.htm#demographics