Sentinel City Task One - community health PDF

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Running head: TASK ONE

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Sentinel City: Task One LAZ WGU

TASK ONE

2 Sentinel City: Task One B. Needs Assessment Summary

Demographic Assessment A demographic assessment was performed by taking data related to Sentinel City’s residents including population, median household income, ages, ethnicities, and number of people non-insured. Sentinel City has a population of 663,862 people (Healthcare Learning Innovations, 2018). The city makes up four neighborhoods. Nightingale Square has a population of 103,974 people, Acer Tech has 168,390 people, Casper Park District has 352,643, and Industrial Heights has 38,855 people (Healthcare Learning Innovations, 2018). Most of the residents of this city as a whole are between the ages of 18-64 years old. Residents under 5 years old make up 7.4%, under 18 years old are 21.7%, and 65 years and older make up 10.5%. Most of the community is white, while 31.5% are Hispanic or Latino, and less than 6% is made up of Asian, Native Hawaiian/other Pacific Islander, and Black/African American ethnicities (Healthcare Learning Innovations, 2018). The median household income for Nightingale Square is 269,550 dollars, while Acer Tech Center’s median household income is 166,300 dollars, Casper Park District’s is 80,134 dollars, and Industrial Height’s is 24,672 dollars (Healthcare Learning Innovations, 2018). The neighborhood with the most non-insured residents is Industrial Heights, at 35.7% reporting that they do not have insurance, whereas Casper Park District sits at 22.7% of non-insured residents, Acer Tech Center at 1.5%, and figures show Nightingale Square has the most insured residents as 0.7% reported being non-insured (Healthcare Learning Innovations, 2018). Neighborhood/Safety Assessment

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A Neighborhood Safety Assessment was made by looking closer at each neighborhood in Sentinel City and assessing for public safety risks in the community. In all four neighborhoods trash can be seen in bags along buildings accompanied by stray animals and rodents. Additionally, every neighborhood has graffiti; most noticeably in Industrial Heights. Also, more evident in Industrial Heights than the other neighborhoods is an increase in trash, stray animals/rodents, and abandoned buildings/cars. Of the sexually transmitted infections diagnosed in individuals 15-24 years old, most notable are Chlamydia at 71%, Gonorrhea at 58%, HPV at 49%, trichomoniasis at 41%, and HSV-2 at 37% (Healthcare Learning Innovations, 2018). STIs diagnosed in individuals 25 years and older are notable for Hepatitis B at a whopping 92%, HIV at 80%, Syphilis at 77%, HSV-2 at 63%, and trichomoniasis at 59% (Healthcare Learning Innovations, 2018). Last year there were 219 teen pregnancies (Healthcare Learning Innovations, 2018). Common arrest charges in Sentinel City are public intoxication and controlled substances (Healthcare Learning Innovations, 2018). EMS response times are 10-15 minutes (Healthcare Learning Innovations, 2018). Common types of crime in the area include bicycle theft, property damage, shoplifting, and drunk/disorderly conduct (Healthcare Learning Innovations, 2018). There is also gang-related violence including homicide, aggravated assault, simple assault, and robbery (Healthcare Learning Innovations, 2018). Population Health Scavenger Hunt A Population Health Scavenger Hunt was completed to assess the different programs offered by community resources in Sentinel City. The Parks and Recreation Department educational programs include swimming lessons, nutrition courses, gardening courses, kids summer program, city sport leagues, adult fitness courses, and after school programs. The department spends their budget on park maintenance, park improvements, personnel & administration,

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programs, and “other” (Healthcare Learning Innovations, 2018). Last year, the highest of the most common park complaints were homelessness, cleanliness, and stray animals. Common park citations most notable include violent crimes at 24%, intoxication or public drug abuse at 16%, trespassing after hours at 31% (Healthcare Learning Innovations, 2018). The Healthcare System, specifically in regard to Elderly Services, provides seniors with medical care advocates, transportation, service animals, meals on wheels, elder abuse prevention advocates, community centers, and government entitlement assistance (Healthcare Learning Innovations, 2018). Most popular services are medical care advocates, government entitlement assistance, and senior transportation (Healthcare Learning Innovations, 2018). Senior living unit options in Sentinel City include senior living center units, nursing home units, independent senior apartments, assisted living units, skilled nursing care beds, long-term care beds, and swing beds (Healthcare Learning Innovations, 2018). Most fall under the categories of senior living center at 3,472 units, nursing home at 2,874 units, and independent senior apartment at 1,048 units (Healthcare Learning Innovations, 2018). Social Services are offered at City Hall. Adult and child service programs included are adoption assistance, head start/early head start programs, youth independent living services, stay at home program, and care providers accepting subsidy benefits (Healthcare Learning Innovations, 2018). The Social Services Department has data on the number of citizens using healthcare assistance. Most of Sentinel City residents utilizing healthcare assistance are using Medicaid at 200,036 citizens, followed by Medicare at 104,240 citizens, ACA at 38,771 citizens, and Charitable Healthcare at 4,116 citizens (Healthcare Learning Innovations, 2018). Additionally, the Social Services Department shares that citizens receiving benefits of the SNAP

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program include low-income citizens, those that are disabled, people in training programs, and those that are 60 years and older (Healthcare Learning Innovations, 2018). The Better Health Clinic is another community resource. Its programs include contraceptive services, pregnancy testing/counseling, achieving pregnancy, basic infertility services, preconception health, STD services, breast cancer screening, cervical cancer screening, and other preventative health services (Healthcare Learning Innovations, 2018). Another community resource is the Soup Kitchen. This institution serves meals to the elderly, veterans, disabled adults, homeless children & adults, as well as healthy adults & children (Healthcare Learning Innovations, 2018). Sources of funds include commodity supplemental food, emergency food, food assistance, and USDA commodity (Healthcare Learning Innovations, 2018). Lastly, the Affordable Housing Project serves it community by finding housing for individuals with low income (Healthcare Learning Innovations, 2018). Affordable housing is offered in studio, one-bedroom, and two-bedroom apartments (Healthcare Learning Innovations, 2018). Windshield Survey A Windshield Survey was performed from the bus in the Sentinel City, as observations were made about the city at large. Sentinel City is an urban area where most of the buildings are sturdy, made out of brick, and are several stories high. Some however take on a more modern look like the condominiums in the Nightingale Square neighborhood, and some reflect an older time period like the Historic Hotel in the Acer Tech neighborhood. Housing consists of condominiums and apartments, most of which are in good standing. There are signs of building disrepair in Industrial Heights where it looks like there is a construction/housing project underway. Sentinel City has a decent amount of landscaping, including grass, trees, and shrubs.

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All landscaped areas are well cared for and not overgrown. There is one area in Casper Heights, however, where inmates are cleaning up what looks like a small park. Public sidewalks are well kept, walkable, and feature benches. Between neighborhoods, you can see a divide as each has its unique characteristics respective to its economic differences. Nightingale Square is home to people that are making more money than the other neighborhoods and it is well kept, clean, and has minimal trash, graffiti, and stray animals. As the median household income decreases from Nightingale Square to Acer Tech to Casper Park District to Industrial Heights, there is an increase in homelessness, trash, graffiti, abandoned buildings/cars, stray animals, and rodents. In the daytime, the common social spots in Sentinel City seem to be Lily’s Restaurant and the City Center Historic Hotel. Additionally, the bulk of individuals seen while touring Sentinel City were at Joe’s Grocery and the Soup Kitchen. Many individuals are seen walking on the sidewalks, and some are in cars and biking on the streets. Very few seem to use the bus system, which runs regularly for $3.06 (Healthcare Learning Innovations, 2018). Accessibility for those in wheelchairs seems to be in good standing, as a few people using wheelchairs can be seen in a couple different places in Sentinel City. There is access to healthcare including the hospital, health clinic, and dentist. People are friendly as you walk down the street and are happy to answer any questions. At the City Hall, there was a peaceful protest related to taxing those holding higher economic standing and several police officers were around observing and seemed to be respecting space. Most folks around town seemed to be dressed conservatively, however there were some that had brighter colored hair and a vibrant sense of style. Children were dressed in uniforms in the schoolyard. As far as music and the arts go, near the radio station was a Jazz billboard, and the city also is home to a fine arts storefront. Other billboards in the area

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advertise driving safety, anti-smoking, pro-vaccinations, and encourage recycling. There are several stands selling what appears to be food including a fruit/vegetable stand, as well as convenience stores, liquor stores, and coffee shops. B1. Epidemiology and Health Determinant Analysis Sentinel City hosts several health concerns. One of particular concern is safe sexual intercourse. As previously stated, STIs diagnosed in individuals 25 years and older are notable for Hepatitis B at 92%, HIV at 80%, Syphilis at 77%, HSV-2 at 63%, trichomoniasis at 59%, and there were 219 teen pregnancies last year (Healthcare Learning Innovations, 2018). Additionally, in ages 15 to 24 years old, chlamydia makes up 71% of the STIs diagnosed, and gonorrhea makes up 58% (Health Learning Innovations, 2018). Assuming these pregnancies were unplanned, there seems to be a public health issue related to birth control, as well as a problem with safe sex practices in regard to Sentinel City’s STI numbers. There is a sex education program in middle school, however not in high school (Healthcare Learning Innovations, 2018). Another issue that was evident from all the anti-smoking billboards, is tobacco use. According to data, 402 babies were born to mothers that smoked during pregnancy (Healthcare Learning Innovations, 2018). Additionally, information provided by the Bodega shows that individuals identifying as Native Hawaiian/Other Pacific Islanders from the ages of 21 to 35 years old and 46 to 55 years old, as well as American Indian/Native Alaskans from the ages of 21 to 35 years old are smoking more packs of cigarettes per week than any other race (Healthcare Learning Innovations, 2018). Between all races, an average cigarette buyer in Sentinel City is smoking about 3.7 packs a week. Interestingly enough, lung cancer accounts for the cause of 161 of the 4,401 deaths reported in Sentinel City (Healthcare Learning Innovations, 2018).

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Crime is another issue in Sentinel City. As discussed before, gang-related crimes in Sentinel City include homicide, aggravated assault, simple assault, and robbery (Healthcare Learning Innovations, 2018). Violent crimes are one of the most common park citations in Sentinel City, and now there is an imposed city curfew on those under 18 years old from 11pm to 6am unless accompanied by an adult 21 years and older (Healthcare Learning Innovations, 2018). According to Rodney Cooper, the highest crime indexes, or the lowest crime rates, are in Nightingale Square at 93/100, followed by Acer Tech Center at 89/100, Casper Park at 57/100, and Industrial Heights at 42 (Healthcare Learning Innovations, 2018). Industrial Heights is also the neighborhood with the most vandalism/graffiti. Another concern is regarding air pollution. It seems that the college-aged students are far more concerned with getting upper respiratory problems than others. This data in combination with the fact that among housing complaints, the most common complaint is factory smoke related makes it seem like there is cause for concern. Mayor Franklin also stated that there is need for air pollution control when he mentioned that there is a plan for city council and local factories to work together to better air quality (Health Learning Innovations, 2018). C1. Sentinel City Health Concerns I feel that the biggest health concern is related to the high STI rate in Sentinel City. To be specific, the high rate of chlamydia infections, 71%, in individual ages 15 to 24 is particularly alarming (Health Learning Innovations, 2018). This relates to the Healthy People 2020 objective, STD-1, that states, “reduce the proportion of adolescents and young adults with Chlamydia trachomatis infections” (Office of Disease Prevention and Health Promotion, 2020-g). According to Healthy People 2020, it is important to make STI prevention a priority because it can cause

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infertility in women and it is costly to the healthcare system (Office of Disease Prevention and Health Promotion, 2020-f). Another concern is cigarette smoking. The average cigarette smoker in Sentinel city is smoking about 3.7 packs per week, and 402 deaths have been caused by lung cancer (Health Learning Innovations, 2018). According to Healthy People 2020, decreasing the population’s use of tobacco is important because, “Tobacco use is the largest preventable cause of death and disease in the United States” and smoking-related illnesses are costly to the healthcare system (Office of Disease Prevention and Health Promotion, 2020-c). An objective taken from the Healthy People 2020 objectives than can address the problem related to tobacco use in Sentinel City is objective TU-1 which states, “reduce tobacco use by adults” (Office of Disease Prevention and Health Promotion, 2020-d). Lastly, air pollution caused by the local factories in Sentinel City. Reducing air pollution is important to address because it lengthens life expectancy and increases “quality of life” (Office of Disease Prevention and Health Promotion, 2020-a). An objective from Healthy People 2020 that addresses this health concern is EH-3, which states, “reduce air toxic emissions to decrease the risk of adverse health effects caused by mobile, area, and major sources of airborne toxics” (Office of Disease Prevention and Health Promotion, 2020-b). C2. Sexually Transmitted Infections- Chlamydia Due to the nature of the current health concern, it is my opinion that Sentinel City address reducing the number of diagnosed chlamydia infections in people ages 15-24. The Better Health Clinic would need to step in and become more involved educating safe sex practices to adolescents and ensuring that they have access to safe sex barriers like condoms. I also think that

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the high school should build on the foundation of sex education started in middle school to increase rates of safe sex and reduce STIs. C3. Prevention of Sexually Transmitted Infections According to Healthy People 2020, one way to reduce the spread of chlamydia and to reduce the risk of complications from undiagnosed chlamydia is by rigorous screening (Office of Disease Prevention and Health Promotion, 2020-e). Additionally, evidence from a study in Denmark shows that this was particularly helpful in preventing chlamydia-related pelvic inflammatory disease in women (Office of Disease Prevention and Health Promotion, 2020-e). D. Application of Needs Assessment to the Community Through using the Demographics Assessment, Neighborhood/ Safety Assessment, Population Health Scavenger Hunt, and the Windshield survey in Sentinel City I had the opportunity to look closer into Sentinel City and look for areas of potential community health concerns. I think doing these exercises will assist me as I look closer into my community and assess its population statistical data, physical environment, community resources, and safety hazards. In doing this I will be able to better address the health and safety needs of my community.

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Healthcare Learning Innovations (Sentinel City) [Computer Software]. (2018). Aurora, Co. Retrieved from http://wgu.ucertify.com/ Office of Disease Prevention and Health Promotion. (2020-a). Environmental health. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/environmental-health Office of Disease Prevention and Health Promotion. (2020-b). Outdoor air quality. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/environmentalhealth/objectives Office of Disease Prevention and Health Promotion. (2020-c). Tobacco use. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/tobacco-use Office of Disease Prevention and Health Promotion. (2020-d). Tobacco use. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/tobacco-use/objectives Office of Disease Prevention and Health Promotion. (2020-e). Screening for genital chlamydia infection. Retrieved from https://www.healthypeople.gov/2020/tools-resources/evidencebased-resource/screening-for-genital-chlamydia-infection Office of Disease Prevention and Health Promotion. (2020-f). Sexually transmitted diseases. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/sexuallytransmitted-diseases Office of Disease Prevention and Health Promotion. (2020-g). Sexually transmitted diseases. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/sexuallytransmitted-diseases/objectives...