Task 1: Community Health Simulation Introduction: More emphasis is being placed on healthier communities as changes are occurring in the fields of healthcare financing, policy, and focus. One of the primary roles of a community health nurse is to assess the community or population in order to determine its health status in relation to its assets and needs. In this task, you will engage in a Community Health simulation for a total of 20 hours to gather information about a virtual community. Sentinel City™ Community Health Simulation is a virtual city developed by Healthcare Learning Innovations to represent what you may find in any real United States city. You will be able to take a virtual bus trip and/or walk around the city while observing the environment and people of Sentinel City™. Through your observations, you will gather information to assess potential health issues and risks within this online virtual learning environment. You will assess different factors that may contribute to or detract from the health and wellness of the community and its citizens. During your trips through the city, you may be asked to describe the people you see and any expected or unexpected findings related to the citizens of Sentinel City™. Your keen observations will be the foundation to successfully completing assignments within your course. The simulation website will automatically log your hours and produce a special report at the end of each session. Be sure to have a notepad to record your observations of Sentinel City™ in preparation for this task. The link to Sentinel City™ is located in the Community Care and Collaboration section of the Course of Study. Please review the Sentinel City Quick Start Guide, Student Guide, and Troubleshooting and FAQs Guide prior to engaging in the Sentinel City™. You may also want to download the Demographics Assessment, Neighborhood/Community Safety Inventory, Windshield Survey and Population Health Scavenger Hunt tools located in the attachment section to complete section B of this task. Requirements: Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. Use the Turnitin Originality Report available in Taskstream as a guide for this measure of originality. You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course. Within Sentinel City™ you will notice a camera icon. Use the camera to take pictures within the simulation. Use the "enter text" feature to add your observations to the pictures. Submit a PDF of your action report from Sentinel City™ that includes the following completed activities from Industrial Heights, Casper Park District, Acer Tech Center, and Nightingale Square: Interfaith Church Sentinel City School District Sentinel City Department of Transportation Better Health Clinic ABC Daycare Sentinel City Affordable Housing Project City Hall Radio Buzz 96.5FM Sentinel City Healthcare System Lilly’s Joe’s Grocery Sentinel City Department of Parks and Recreation Complete a needs-assessment summary to determine the health needs and risks of the virtual community in Sentinel City™ by using eachof the following tools: Note: These tools can be found either in the web links section or as an attachment to this task. Demographics Assessment Neighborhood/Community Safety Inventory Windshield Survey Population Health Scavenger Hunt Note: The name of each of the four tools should be identified in the needs-assessment summary, along with a brief summary of how each of the four tools were used in the needs assessment. Analyze the collected data using concepts of epidemiology and health determinants. Note: Refer to these three sections of your COS for additional information: Epidemiology and Environmental Health, Epidemiological Data, and Application of Epidemiology. Formulate a community diagnosis for Sentinel City™ by doing the following: Discuss the threeproblems for Sentinel City™ based on the Healthy People goals. Discuss community resources (e.g., Sentinel City™ Affordable Housing Project, Better Health Clinic) that are available to address oneof the problems identified in part C1. Identify a primary prevention topic based on the problem you selected in part C2. Note: See the attached “Approved Activities List” for guidance in formulating your topic. Discuss how you will apply the assessment strategies you have learned from the simulation environment to your community assessment strategies in your community. Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized. Demonstrate Professional communication in the content and presentation of your submission.
Task 1
Eshawna Herrington
Western Governors University
The Demographic Assessment showed the Sentinel City had health needs and risk in different communities within the city. The community most at risk was Industrial Heights. This community had a median income household of $24,672 with a population of 38,855. It is the lowest income community and the least populated community in Sentinel City. Industrial Heights also has the most insured population in the city at 37.5 percent. The community Nightingale Square which has a median household income of $269,550, with a population of
103,974, and a non-insured percentage of 0.7 percent is the most well off community in the city. The community ranking in the second most well of spot is Acer Tech Center where the median household income is $166, 300, with a population of 168,390, and a non-insured percentage of
1.5 percent. The community that is just above the poverty line of living is Casper District Park where the median household income is $80,134, with a population of 352,642 which shows that more people live just above the poverty line than below yet they do not fall into the wealthy category either. This community of people would be considered middle income with a 22.7 percent of uninsured residents in their community. There are 18.9 percent of the people in Sentinel City living below the poverty level. These people more than likely to do not have the funds or access to resources needed to promote and maintain their health.
(Sentinel City (n.d.)) • Neighborhood/Community Safety Inventory
The Neighborhood/Community Safety Inventory showed certain communities seemed safer and cleaner than others. Some of the things seen in the community were graffiti on buildings, rats running in the streets, people outside drinking and smoking, trash stacked outside against buildings, abandoned buildings across the street from the school, stray dogs running around and barking, and even a burning car on the side of the street.
There are also according the the Sentinel City Pharmacy about 24 percent of the city’s population using tobacco, 26 percent using alcohol, 13 percent using marijuana , and 8 percent using heroin. This is a large percentage of the city population using drugs and other unhealthy substances. According to the police city data more people are arrested for warrants, cannabis, and controlled substances which alludes to the city having an issues with drug use.
The EMS response time according to City Hall is 7.46 minutes which is the second fastest time compared to three other cities. The crime in the city consists of simple assault, homicide, aggravated assault, and robbery. These crimes based on the police date of Sentinel City are gang related and show an increase in aggravated assault, simple assault, and robbery compared to the previous years. There may need to be more of a police presence in more party of the city to decrease the crime.
(Sentinel City (n.d.))
The Windshield Survey showed the Sentinel City is a community that has a mix of culture and population. The houses vary in the city from some being more upscale and nicely kept to some being run down and dirty. The landscaping in the communities where the household median income is higher have a better kept community than the ones with the lower household income median. While riding the bus you can see the economic changes as you leave from a clean well kept neighborhood that has signs about health promotion and maintenance to a more run now neighborhood with dogs running around and one sign about becoming vaccinated not telling who should or where to get it done. This shows how the communities that have more money have better access to healthcare and safety.
The school has age appropriate activities for the children and seems to be in a bad part of the city because there are abandoned buildings across the street from it. The city does have essential service centers like a hospital, health clinic which could be compared to Planned Parenthood, and even an elderly living center. There are people out in front of City Hall protesting taxes with signs stating “Tax the rich” which shows that the city may have more people living in middle class and poverty than the amount of people living “rich”.
Based on the city demographics there are more white and hispanic people than there are any other race in the city. Most of the population is middle age with only 21.7 percent of the population being under the age of eighteen and 10.5 percent being age 65 and older. This would make the city more than likely more of a modern living city. The city also has a church that is not only there to serve people with religious preference but to also serve the less fortunate community as a soup kitchen.
(Sentinel City (n.d.))
The Population Health Scavenger Hunt showed some of the services offered throughout the Sentinel City communities. In the Parks and Recreation department there are swimming lessons, nutrition courses, and even adult fitness courses. These are great things that can help the people of the city stay fit and healthy. The Healthcare System offers services for the elderly. These services are senior transportation, meals on wheels, community centers to keep them active and engaged, and service animals. There are also independent senior apartments, senior living center units, nursing home units, assisted living units, and skilled nursing care beds. This shows that the elderly community has a lot of reliable resources so they should not have too many risk as long as they are informed of these services. City Hall offers social services that include healthcare assistance such as medicaid, adoption assistance, supplemental nutrition assistance program better known as SNAP or Food Stamps, and WIC for women, infants, and children. These programs help to assist those who may need resources when it comes to purchasing food and healthy eating items along with adopting children for those who choose to.
All of these can be costly but City Hall makes the effort to help cut those cost for the people. The Community Health Center offers contraceptive services, pregnancy testing and counseling, sexually transmitted disease services, cervical cancer screening, and other preventative health services. The center’s data shows there has been a decline in teen pregnancy, birth, and abortions within the past year. The Soup Kitchen which is at the church offers meals to the homeless, veterans, children, and disabled. The largest population of clients served are homeless adults and then veterans. The most meals are served during the summer months of June to August. The
Soup Kitchen gets most of its resources from the Commodity Supplemental Food Program and Food Assistance. The Affordable Housing Project offers affordable housing to low income individuals and families. The average income of the tenant within the last year has ranged between about $18,000 and $32,000 which is mainly below poverty. The people of this community are at risk due to the complaints of the factory smoke and stray dogs roaming the streets which are the top two complaints.
1. Analyze the collected data using concepts of epidemiology and health determinants.
The Sentinel City community lacks sufficient health care coverage for a large portion of their population. The Demographics Assessment shows that overall the city has an uninsured population representing 62.4 percent of the city’s communities which is significantly larger than the 27.8 percent that the National Center for Health Statistics reported in 2015 for America. Then 67 percent of the higher institutes have no student health services. Over 100,000 people in the city receive medicare which is a large number, however medicare is only for those who are 65 years and older and the disabled (medicare.gov) which leaves the younger and middle class generations with no insurance if they cannot afford to pay high premiums and make too much to qualify under low income. In this instance the health determinants are the population’s income and social status, the health services available, the physical environments in which they live, and their levels of education in regards to learning about preventative, secondary, and tertiary prevention measures.
C. Formulate a community diagnosis for Sentinel City™ by doing the following:
One of the problems for Sentinel City is the high rate of use with tobacco. The Healthy People 2020 objective based on tobacco states “Establishing policies to reduce exposure to secondhand smoke, increase the cost of tobacco, restrict tobacco advertising, and reduce illegal sales to minors.”(HP2020). This objective would be a way for Sentinel City to start lowering the percent of its population using tobacco which is currently about twenty-four percent of the city population. Another problem the city has is the safety of the food being sold at the grocery store. There were a high number of foodborne illness reported at the community grocery store the highest being fish and shellfish products. The Healthy People 2020 goal is to “Reduce foodborne illnesses in the United States by improving food safety-related behaviors and practices.”(HP2020). The city could benefit from aiming to reach this goal which would help reduce the cases of foodborne illnesses. The last problem the city is facing is having a high rate of violence throughout the city. The Healthy People 2020 goal is to “Prevent unintentional injuries and violence, and reduce their consequences.” ( HP2020). This goal would help to reduce the the high crime rate within the city making it a safer place for the people of the city to live.
Community resources that could help address the city problem involving tobacco use would be the health clinic and the radio station. The use of tobacco alone cause so many other health problems for people so reducing the use would make people healthier and prevent other health complications. The people of the city could go to the health clinic to get more information on what the use of tobacco does to their bodies and those around them who inhale second hand smoke. Educating them would be one of the main preventative measures taken to start the decline in the population using tobacco. The radio station could help by running ads relating to tobacco use and how it affects the body and how it makes people’s bodies unhealthy. The radio could even do giveaways to people who are choosing to become tobacco free.
The primary prevention topic that would relate to the city’s population using tobacco would be the topic “Tobacco”. This topic aims at preventing the use of any tobacco and preventing the use of smoking.
I would apply these assessment strategies in my community by being sure to investigate what areas my community is lacking in. I would look into what is available for the elderly and people living below poverty level. I would then look into what resources are available aid in better development of my community and different ways that we could bring the resources about. This would also include looking into ways to keep these resources funded so that they would be able to continue to serve the community.
References
Healthy People 2020
https://www.healthypeople.gov/2020/topics-objectives
Medicare Eligibility. Retrieved May 17, 2017, from
https://www.medicare.gov/eligibilitypremiumcalc/
National Center for Health Statistics. Retrieved May 17, 2017, from
https://www.cdc.gov/nchs/fastats/health-insurance.htm
Sentinel City. (n.d.). Retrieved April 10, 2017, from
http://citl.americansentinel.edu/twine/SC2.3_Healthcare System – Storyline
output/story.htm
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