The focus of healthcare provision is shifting towards the health of collective communities. A community health nurse therefore must be able to assess the healthcare needs of people from a particular community by carrying out a study, which will uncover information about their communal well being.
Population Economic Status Assessment
The population of the surveyed area is fairly multi ethnic and multiracial. Therefore, the health needs of this community are diverse because of the differences in economic status and health indicators. Even a small difference in income has a direct influence on the accessibility of healthcare services within the community. The African American racial group is likely to experience high incidents of community health problems because of the barriers that exist within it, which are related to their inability to afford healthcare. Maternal health and limited access to medical insurance are some of the common issues that affect the African American population. The white racial group also experiences severe health conditions because a large number of Whites are among the aged.
Neighborhood Community Safety Inventory
Neighborhood or community assessed
Safety Hazards in the Natural Environment
The safety hazards within the community were found to be diverse and spread out. There were low levels of air pollution but the level of water pollution was found to be significant. The extent of natural radiation was estimated to be less than 5% and the most common forms of pollutants consisted of discharged waste from homes. The hot weather conditions were found to cause skin problems even though wild animals did not pose a big risk as disease carriers. Sun burn is a real danger to the people especially those that have most of their activities outdoors (Berenson, 2011, p. 21).
Safety Hazards in the Built Environment
In the built environment, storied buildings posed a safety hazard, although the extent of disrepair caused healthy hazards for many. The building codes were effective even if old buildings had cracks that posed a danger of collapsing. Sanitation and waste disposal systems were found to be in a good condition but the threat of a lead exposure in the area existed. The access to sanitation was encouraging and majority of residents in the community could access toilets though the sewage systems needed some improvements.
Garbage posed a health risk especially to those households that did not dispose it regularly. The community was prone to fire incidences as only a third of them hard serviceable alarms and extinguisher systems. The fire insurance rates were affordable to the other segments of the population though they were out of reach for most low income earners. The response time for the fire and other emergency personnel was roughly 10 to 20 minutes and more than a half of the residents carried fire insurance. Traffic accidents’ rates were low and they mainly occurred in crowded places though many residents had vehicle insurance. Noise from local restaurants and hotels also posed a great hazard to the residents.
Safety Hazards in the Socio-cultural Environment
Crime rates were found to be low and the crimes that occurred were mainly muggings and drug abuse. Police reaction to reported crimes was fair and there was less tension between the various groups that make up the community. Gang conflict and other forms of organized crime and violence were extremely minimal. Drug dealers posed also posed danger to the community, even though it was not a matter of great concern. There is a danger of users getting mental health conditions as a result of drug abuse (Andrews & Boyle, 1999, p. 142).
Disaster Potential
The potential for flooding and the probability of an earthquake were low, although bush and forest fires posed a big risk. Severe weather events posed a moderate risk and the residents in the community were well aware of a disaster plan. A warning system for natural disasters and fire exists and a good number of residents are aware of it.
Nursing Interventions to Address Safety Problems
More people should be encouraged go for preventive medical services to ensure that they boost their immunity levels against some common diseases. There should be more family planning initiatives to improve on the maternal health of the residents of this community. More information should be provided to all the households to help them get prepared for health related challenges. There should be community programs that help those residents who are not well versed in disaster prevention and management, to acquire the necessary skills.
Expected Outcomes of Nursing Interventions
The residents can be given the necessary information on how to prepare for undesirable health situations. In this way, the residents can be well placed to adequately deal with various health problems that surround them.
Evaluation of Intervention Outcomes
The feedback the community gives regarding the interventions offered and the extent to which the interventions are helpful (Andrews & Boyle, 1999, p. 143-145).
Cultural Assessment Tool
Biophysical Considerations
What is the age composition of the cultural group?
The median age was 32 within the community and within the native Hawaiian community, aging was taken as a form of wisdom and the young are expected to respect the old. An adult is someone who is 21 years and above, and the gender composition of the community was 50.7% female and 49.3% male. Gender had an influence in access to healthcare service and the skin color differences exposed some residents to high or low risks of getting cancer. Community members displayed positive attitudes towards a lean body frame but had negative attitudes towards overweight people. The physical health problems that were common in the community were arthritis, cancer and obesity (Weber & Kelly, 2009, p. 125).
Disaster Assessment and Planning Guide
Biophysical Considerations
People over the age of 55 were most likely to be affected by a disaster because of their body weaknesses. Black and native Hawaiians were at risk of being affected by disasters especially fire disasters. Maternal health was still a challenge and the most communicable disease which could be spread in case of a disaster was tuberculosis. The communicable disease was found to be highly prevalent in areas with crowded populations and it could spread in case of a disaster because of people being placed close to each other (Veenema 2007, pp. 234-249).
Psychological Considerations
Community members were alert in preparedness for disasters especially fires and their response to disaster was positive and swift. There is availability of public information and there was a moderate chance of destruction if a disaster was to occur. Mentally challenged individuals have a high risk of not being alert to disasters and can be at risk of succumbing to the effects of these disasters. Psychological effects of a disaster in the community were likely to be negative.
Physical Environmental Considerations
Flooding, earthquakes and severe weather conditions can all create the potential for disasters. Community structures were not well equipped to withstand the effects of a disaster and schools and sports arenas were likely to be the assembling places for people affected by disasters. Rainy weather likely to slow down rescue efforts and windy weather likely to cause rapid spread of bushfires. Water supplies can be affected in case of floods and bush fires are likely to cause human and wildlife conflicts. Structural damage of buildings and infrastructure create risks for evacuation for victims of disasters within the community. Rescuers can also be in danger of the structural damage because it can create problems for them in the way they do their work. Persons displaced by a disaster require shelter (Penuel, Statler & Golson, 2010, pp.150-170).
Epidemiological issues that have a lot of impact on community health are varied. Autism is a problem in some sections of the population and affects children more. The children affected by this are mostly boys and girls are not likely to suffer from it. Mental health is also aspect that needs to be addressed by community health programs. Water quality in some areas is not of the desired safety standards and has some contaminants that may contribute to bacterial infections in case of ingestion. Water borne diseases are likely to affect a segment of the population living here.
This information reveals that Waimanalo needs more community health support in addressing disaster preparedness, pollution, water borne diseases and social factors. There should be strengthening of the mental health programs in the community which the study has found to be inadequate. Facilities which are supposed to serve the health needs of the community are inadequate and there is a lack of specialization within them, which can provide remedies to the health needs in the community.
The following genogram shows the information about the health situation in the community and the factors that contribute to these health factors. The genogram highlights the relationships between the various factors that the community is exposed to and their contribution to the health situation in the community
There is a high relationship that was found to exist between youth unemployment and the prevalence of drug abuse in the community. Pollution of water and air was likely to contribute to poor environmental health in form of water and air pollution. The community members therefore were at risk of having their drinking water getting contaminated which can cause water borne diseases. The usage of drugs within the community brings about the possibility of poor mental health being experienced by the users. This is made worse by inadequate specialized facilities that can treat this disease in the community.
References
Andrews, M. M., & Boyle, J. S. (1999). Trans-cultural concepts in nursing Care (3rd ed.). Philadelphia: Williams and Wilkins.
Berenson L. (2011). Cultural competencies for nurses: Impact on health and illness. Sudbury, MA: Jones & Bartlett.
Penuel, K., Statler, M., & Golson, G. (2010). Encyclopedia of disaster relief. New York, NY: Sage.
Veenema, T. (2007). Disaster nursing and emergency preparedness. New York, NY: Springer.
Weber, J., & Kelly, J. (2009). Health assessment in nursing. New York, NY: Lippincott, Williams & Wilkins.