Needs Assessment of Sentinel City

Needs Assessment Demographics The totaling population number for Sentinel City is 663,862 people. The median household income for the city is $49,091 and 18.9% of the cities resident’s live below poverty level. The age group that accounts for most of the population is between the ages of 18 to 65 years old, they make up 60.4% of the residents. When looking at the different race’s that reside in this city, Caucasians make up 52.7%, Hispanics make up 31.5%, and African Americans make up 10.4% of the total population. The city is made up of four different neighborhoods: Nightingale Square, Acer Tech Center, Casper Park District, and Industrial Heights (Healthcare Learning Innovations, 2018). The neighborhood with the lowest population is Industrial Heights with a total of 38,855 residents, the lowest income for most families who reside here is reported to be $24, 672 and has the highest non-insured population at 37.5%. Casper Park District has a population totaling out to 352,643 people and their median household income is recorded at $80,134 with 22.7% of their residents being uninsured. In Acer Tech Center their population is 168,390, and their median household income is $166,300 and 1.5% of these residents do not have insurance. The last neighborhood is Nightingale Square, and 103,974 residents live here, the median household income is $269,550 and only 0.7% of their residents do not have insurance (Healthcare Learning Innovations, 2018). Neighborhood Safety Assessment One of the biggest concerns that is noted in all the neighborhoods in Sentinel City is the lack of cleanliness. The four neighborhoods had a noticeable amount of garbage on the streets, sewage and rats that that were getting into the garbage, there were also many walls that contained graffiti. At Casper Park there were stray dogs and cats that were seen, cars were broken into and appeared to be broken down in Industrial Heights. It was evident that the city would benefit from better sanitation. Garbage and rats running around were seen outside of Lily’s which does not meet sanitation regulations for the vicinity of the restaurant. A resource that Sentinel City offers to its community is alcoholics anonymous. This group is made up of 67% male and 33% female residents, their ages range from 31-60 years old. These members consist of 58% white people, 22% Hispanics and 15% African Americans. Arrests for controlled substances are made up of 16% of all arrest in the city, along with alcohol use within the community. Another drug that is very common in the city is tobacco, the population that purchases tobacco the most is Native Americans and Hawaiian or Pacific Islanders according to statistics. When comparing the graphs that provide the percentages of residents who used drugs in the last year, the leading drug was alcohol with a total of 30% of the residents using it. Less than 25% of the population were reported to be using tobacco and greater than 10% were using marijuana. Illicit drugs showed that 5% of the residents used cocaine, >5% used heroin and methamphetamine was reported at 10%. Prescription abuse accounted for 15% of the residents who used them (Healthcare Learning Innovations, 2018). The average response times in Sentinel City for emergencies such as medical services, advanced life services, and fires can average between 6 to 8 minutes. For shock to develop the average time is about 6 minutes, this is a good number for a response however it can be better (Healthcare Learning Innovations, 2018). Time is crucial, which means that the faster a medical service can reach that emergency the higher chance the patient has for a better outcome. Sentinel City has a hospital available on one side of town and a health clinic on the other, this allows for better access to a medical facility for when non-emergent situations occur making it close by no matter where the patient may reside in. Sentinel City, as many cities, has crimes that occur on the daily. Some of the most frequent arrests are arrests for residents who have outstanding warrants, battery and possession of controlled substances. The most violent crime that was reported last year was aggravated assault, when looking into statistics and genders, typically men tend to be more involved in violent crimes than women do. Another big issue in Sentinel City is gang violence, this is often connected to cases of aggravated assault. Gang violence, robbery and simple assaults were shown to be increasing in the last year while homicides showed to decline (Healthcare Learning Innovations, 2018). Scavenger Hunt There are many services that Sentinel City has to offer to the community. Parks and recreations fall under one of these services, they provide swimming lessons, nutrition courses gardening classes, summer programs for kids, fitness courses for adults, and many other services. Although they have increased the budget to help maintain the park, the budget for the park improvement has taken a hit and decreased (Healthcare Learning Innovations, 2018). Due to these services being available, it allows for the Sentinel City residents to have a place where they can remain active and learn healthy habits for a better lifestyle. Social services are another community resource in Sentinel City that is offered by City Hall. The social services provided are adoption assistance for families, head start and early start childcare, and youth independent living services. Healthcare assistance like Medicare and Medicaid is also another social service provided. WIC, which is mostly used by women who have children and infants is also a part of these services (Healthcare Learning Innovations, 2018). Sentinel City also offers help to the elder, they provide them with elderly healthcare services such as medical care advocates, government entitlement assistance and senior transportation to help ease their medical care (Healthcare Learning Innovations, 2018). The Better Healthcare Clinic is another facility that has many resources and services for the residents of sentinel city. Some of these services include contraception, pregnancy testing and counseling, services for screening and treatment of sexually transmitted diseases, cancer screenings for breast and cervical cancer, and many other sexual health services. Due to sexually transmitted diseases being prevalent in 15-year-old adolescents and high rates of teen pregnancy ranging from ages 15 to 17, the services provided at this medial facility are crucial. There has been a decline in numbers for teen pregnancy and pregnancy abortions in the last year due to the services provided by the clinic (Healthcare Learning Innovations, 2018) Another service that the city provides for the homeless population is the Soup kitchen. This service provides anywhere from 40,000 to 50,000 meals per month, with 64% of those meals being provided to homeless adults. Affordable housing is also provided in Sentinel City, statistics have proven that crime rate on this property is lower compared to the crime rate in the rest of the city. The main concern and complaint of the people who reside in his housing is the smoke due to the factories, pets and the mold in the building. The property offers studio, onebedroom, or two-bedroom apartments. The apartments with the least vacancies are the studios and the two-bedroom apartments have the most vacancies (Healthcare Learning Innovations, 2018). Windshield Survey In Sentinel City there is not much of an open area, it’s more of an urban city. There is no park in the city, however there are bushes, shrubs and trees noted along the sidewalks and there is playground available near the school. City Hall does have an area that has open grass, and the parks and recreation center also provides tennis courts that are available for those interested in outdoor activities. The housing in Sentinel City doesn’t consist of single-family homes, the housing market consist mainly of apartments and condos. Most of the apartments are made from brick and appear to be in good condition, in comparison to the apartments located in The Nightingale Square that have graffiti on the doors which makes them look run down and not appealing to the public. The apartments that are located above the laundromats have an AC unit outside of each window that is provided for those who reside in them. With the city having four neighborhoods the boundaries in place are economic since there are no clear lines of where one neighborhood ends and the other begins. Each city has their specific name, most of the buildings that are in these specific neighborhoods include their neighborhood name on them. A way that these neighborhoods set their boundaries is by making these names visible on their buildings notifying others of which neighborhood they are in. Of course, the nicer neighborhoods appear a lot nicer and well maintained than those that aren’t. The transportation is similar in all four neighborhoods because most residents either drive their own car, ride a bike, take the bus or walk by foot. Roads and sidewalks appear to be in good condition and gas stations are located within the city so that those who do drive a car can fuel up. As mentioned previously, the city is equipped with a hospital on one side of the city and a health clinic on other, this allows access to healthcare to be close for everyone no matter what part of the city they live in. Although the community looks good, there are improvements that can be made. There are areas of the city where piles of garbage are noted, along with rats running around and sewage in the gutters. The city can benefit from sanitation as it has a dirty appearance to it. This city has many services that it provides for its residents, City Hall has services that can assist those that need healthcare services, protective services, and WIC. Parks and recreation have many services and activities that can benefit children, these activities consist of swimming lessons and many other summer programs; they also offer nutritional and fitness courses for adults. There were many kids playing, walking and making use of the park that is provided by the school. Sentinel City also provides a hospital, health clinic and a dental office that help provide services for the members of the community. Residents can visit the Bodega Supermarket and Deli, here they can purchase a variety of foods from produce, meats, dairy, frozen and canned foods and tobacco products as well. Residents use the many modes of transportation available so that they can reach these services, whether its by car, foot, bike or bus. The city is made up of many different ethnicities that reside in it. Industrial Heights is made up mostly of Hispanics or Latinos making 48.6% of their population and 13.1% are African American, whereas Nightingale Square is made up mostly of white’s making 81.3% of their population and only 3.7% of it being Hispanic or Latino. Acer Tech Center is also mainly made up of whites at 70.2% and only 13.7% Hispanic or Latinos, same goes for Casper Park District with 63% of the population being white and 24% Hispanic or Latino (Healthcare Learning Innovations, 2018). Based off these statistics, it is obvious that Sentinels City’s population is mainly made-up of whites and Hispanics or Latinos being the secondary ethnicity. Religion is another part that makes up Sentinel City, with Interfaith Church being available for those who are religious. After having conversations with the members of the community, I found that these residents were either Catholic, Christina, Methodist, Muslim, Baptist, or Buddhist. With only one church noted in the city, it appears that it may cater to all these religions. Residents in Sentinel City are primarily heterosexual with a few who are bisexual or homosexual. When asked about drugs and alcohol the most common thing that people did was drink alcohol. A large population either own or rent the place that they reside in but there are still a few without homes who are homeless. When speaking to the residents, the drug that was used the most was marijuana, and those who used marijuana used tobacco as well. From the people that I spoke with regarding the use of marijuana two of them were homeless and the other was in prison. Interpretation of Data While I learned about the statistics related to the causes of death in the city, the number one cause of these deaths was due to cardiovascular problems followed by heart disease. When looking at the demographics of the city, having these two diseases sitting at the top of the list makes complete sense. 18.9% of the people who live in Sentinel City are currently living at a poverty level (Healthcare Learning Innovations, 2018) this means that because these people cannot afford nutritional food, they are most likely eating unhealthy diets and not getting the medical healthcare that they need. Two of the main health determinants that we see that people are missing are income and social status along with no healthcare services. A high population of the city also uses tobacco which in return causes in increase for cardiovascular diseases. People that have heart disease have a higher chance of having a heart attack or stroke, Healthy people 2020’s goal is to try and use prevention, detection and treatment of the risk factors for heart disease so that cardiovascular health can be improved as well as the persons overall quality of life (Office of Disease Prevention and Health Promotion, 2020b). As I drove around the city other issues that were noted was the cleanliness of certain areas that can affect the health determinant of the resident’s physical environments. It was concerning to see the garbage on the street, and the waste and sewage spill because these problems can eventually lead to bacterial growth that can result in illness for the residents of the city. Outside of Lily’s restaurant there was garbage and waste that can potentially lead to food contamination. When looking over the information about the restaurant, their main violation for food and safety was for their cleaning and washing. Exposure to the areas that are not clean or sanitary can lead to acute illness. When I stopped by and visited the Beter Health Clinic, it was apparent that teen pregnancy was an issue. Data shows that teen pregnancies were declining but over the last year they were back on the rise with over 200 teen pregnancies in females between the ages of 15 to 17. However, abortions in these pregnancies have decreased and been consistent at less than 50 per year. Based off the services and care that is being provided by the clinic and the high teen pregnancies it is clear that there is not much education on teen pregnancy. This problem can be caused by many different health determinants such as poor education and lack of health services. A second problem that was evident when visiting the Better Health clinic was the number of cases for sexually transmitted diseases. In the ages of 15 to 24 the most prevalent diseases were chlamydia and gonorrhea, while HIV and hepatitis B were more prevalent in people who were 25 years of age and older. The clinic does provide services for residents who have a sexually transmitted disease. What this information showed was that their may be a lack of education which is a health determinant. After learning this information, I visited the high school to see if education was provided regarding this problem, and unfortunately this was not provided for students who attended their school. Although there are treatment options and services provided by the clinic that can help cure most of these diseases, education is how we can prevent the transmission of them and would be the most beneficial. C1. Three Problem Areas One of the first problems that I found in Sentinel City was the use of tobacco in the community. One of the goals of Healthy People 2020 is that there be a lower number of illnesses, disabilities, and deaths that are caused by the use of tobacco as well as those who are being or have been exposed to secondhand smoke. The use of tobacco can eventually lead to or cause heart disease, in Sentinel City this is the second leading cause of death. Tobacco can lead to many diseases, including cancers and lung disease and has many negative and life-threatening effects on the human body. Healthy people 2020 has made a goal to “TU-3.1: reduce the initiation of the use of tobacco products among children and adolescents aged 12 to 17 years” (Office of Disease Prevention and Health Promotion, 2020b). Healthy people 2020 has advised people to try enacting smoke-free policies, having better control of who can access tobacco products, and trying to minimize the advertisements of tobacco while providing anti-tobacco media campaigns to the public (Office of Disease Prevention and Health Promotion, 2020b). Teenage pregnancies in Sentinel City are the second issue that I noticed. One of Healthy People goals is to “FP-8.1: reduce pregnancies among adolescent females aged 15 to 17 years” (Office of Disease Prevention and Health Promotion, 2020d). With an increase of teenage pregnancies, we tend to realize that it’s due to their lack of knowledge from their home life or within the school system. As teenagers become sexually active, sexual health is a topic that is crucial, and education needs to be provided. Once a teenager becomes sexually active and they happen to become pregnant, that tells us that protection was not used making them more susceptible to sexually transmitted diseases as well. Lack of sanitation was the third problem that I found within Sentinel City. In the streets there was noticeable trash piling up on the sidewalk with rats’ running around in it, there was also waste on the sides of the streets and a sewage pipe that was broken, and waste was spewing out of it everywhere. Healthy People 2020 has a goal that coincides with this issue “EH-11: reduce the number of toxic pollutants released into the environment” (Office of Disease Prevention and Health Promotion, 2020a). Due to the obvious lack of sanitation within the city, it led me to believe that toxic pollutants are likely being released into the environment. Toxic pollutants of this nature can cause serious health issues within the Sentinel City community. C2. Discussion of Community Resources Assessing the problem of tobacco use in Sentinel City, a change can be done and would be beneficial. A resource that is available for the residents in Sentinel City is the integrated services such as addiction counselors located at the hospital. The school district also has resources, for example at the middle school they offer special programs like drug awareness that can be beneficial in educating kids at a young age about the harm that tobacco can cause. At the higher education level, they also provide prevention programs for alcohol/drug abuse and tobacco awareness for students. It would benefit Sentinel City to provide more education to their residents on why tobacco can be harmful as well as having resources that can aid people to stop smoking. C3. Primary Prevention Topic The topic that I chose for primary prevention is “tobacco use in children and adolescents: primary care interventions” (Office of Disease Prevention and Health Promotion, 2020e). The main goal and purpose of this is to try and reduce the initiation of the use of tobacco products in children and adolescents between the ages of 12 to 17 years. Primary care providers suggest that we educate and counsel young adolescents to attempt preventing the initiation of tobacco use and to try and intervene if they are using it (Office of Disease Prevention and Health Promotion, 2020e). If we add additional education and use appropriate interventions, there is a higher chance that we stop or even prevent the use of tobacco products at an early age so that the individual can live with out the harm that tobacco may cause. D. Application of Assessment Strategies/Tools between Simulation and My Community After assessing the virtual community of Sentinel City, it has helped me identify issues and think critically on how these issues can affect the population of the community. Sanitation is not something new to me, I have come across it and typically just avoid those areas when it come to eating out at specific restaurants. After this assessment I didn’t realize that sometimes there are others who do not have this luxury and unfortunately have no choice but to eat at places like Lily’s because they cannot afford to go elsewhere. Moving forward, I will be more aware of the demographics, issues, and resources that are available to specific communities that I may travel to. This simulation has given be a better understanding as to why this type of information is important and it has taught me how I can use this to help initiate changes if I ever come across these types of issues in the future in my community.