Assessment Focus
The focus of the assessment is the city of Houston, Texas, and the MD Anderson Cancer Center.
Population Characteristics
Houston, TX is currently one of the most populated cities in the United States, with 2,151,475 residents. As of 2010, 199,906 residents were 25-29 years old. The median age of males was 31 and females – 33 years. Among 1,612,930 residents 16 years and over, almost half were male and another half – female; by the age of 65, only 80,397 of the 189,942 residents would be male, which means that men in Houston face higher mortality and lower life expectancy than women. Almost 920 thousand residents in 2010 were Hispanic or Latino. 537,000 residents were Caucasian white (The Houston City, 2012). Compared to the U.S., high school graduation rates in Houston are lower (77% compared to 85%, accordingly) (The University of Texas, 2009). Education attainment indicators vary significantly, depending on race and ethnicity. The civilian labor force in Texas accounted for only 5.1% against the U.S.-based 6.4%, with the median household income being $40,856 (University of Texas, 2009). Compared to 1980, when Houston had 1,595,138 residents, the city population had increased by almost 30% (The City of Houston, 2012).
Neighborhood Environment
The main features affecting the population’s health are socioeconomic and demographic, mainly the level of income, immigration status, language proficiency, and environmental factors, such as pollution, recreation, and access to health care. Of the total 782,643 households in Houston in 2010, 481,570 were comprised by family households with their own children under 18 years (The City of Houston, 2012). Non-family households represented only 301,073, 242,380 householders living alone at that time (The City of Houston, 2012). Energy has historically been Houston’s main industry, and thousands of energy-related companies are currently located in this area. Houston has a well-developed system of sanitation and environmental protection: the city’s Parks and Recreation Department monitors 366 parks and 200 greenspaces within the Houston territory (The City of Houston, 2012). At the same time, numerous land inequities in Houston continue to persist: lead poisoning, Toxics Release Inventory facilities, hazardous waste sites, and landfills have serious negative impacts on public health (Houston Department of Health and Human Services, 2008). Educational opportunities are vast, and the Houston Independent School District includes 288 schools, 210,000 students, and 13,000 teachers (The City of Houston, 2012). Local residents have access to all major means of communication, and the city’s Mayor Annise D. Parker is also the community’s main leader.
Health Information
In 2012, mortality in the Houston area was 7,099 compared to 5,466 at the national level. 19% of residents died due to poor health. 17% of residents were found to be obese, 29% were smoking, and 23% claimed to be physically inactive. 14 cases of motor vehicle crash deaths were registered. 34% of children lived in single-parent households, and 25% of residents did not receive adequate social support (County Health Rankings, 2013). One of the most problematic aspects was the low rate of cancer screening among adults; in the meantime, one of the most frequently cited neighborhood problems was the presence of stray animals affecting 40% of households (University of Texas School of Public Health, 2011). Cancer is the second most prevalent cause of mortality in Houston (University of Texas, 2009). Most health issues are related to income disparities, immigration status, and the insurance status of Houston residents.
Health Resources
1,189 primary care physicians operate in the Houston area in 2012; 63 preventable hospital stays were registered (County Health Rankings, 2013). Local residents have access to a number of health programs and resources, including the Children’s Health Insurance Program and Medicaid. The lack of insurance is the biggest problem, and the ratio of primary care physicians per 100,000 population steadily decreases (University of Texas, 2009; University of Texas, 2011b).
Diagnoses
Based on the information presented above, two community diagnoses can be developed:
- The risk of cancer in low-income Houston residents is related to the presence of industrial landfills and waste processing sites.
- The risk of cancer among uninsured Houston residents is related to low screening levels, the absence of the required insurance status, and poor access to health screening resources.
Plan
The problem of social status, landfills, and cancer risks has been abundantly documented. King et al. (2006) analyzed the relation between cancer and perceptions of environmental health among Fresno residents, Texas, while Trumbo, McComas and Kannaovakun (2007) explored the level of cancer anxiety in alarmed communities living not far from hazardous sites. The plan will be to calculate the number and percentage of low-income residents living in close proximity to landfills and dangerous sites and analyze the health risks they are facing due to their location.
The role of community screening for cancer prevention was explored by Elmore et al. (2005) and Briss et al. (2004). To solve the problem, nurses will organize community screenings for cancer to engage low-income and uninsured Houston residents and provide them with an opportunity to make informed health decisions. Nurses will also explore the main motives behind the low rates of cancer screening in Houston to develop alternative health promotion strategies.
Summary
This paper presents the results of a brief community assessment. The focus area is Houston, Texas. Houston is facing numerous health disparities and environmental complexities. Nurses should develop complex plans to address these problems.
References
Briss, P., Rimer, B., Reilley, B., Coates, R.C., Lee, N.C., Mullen, P., Corso, P. […] Lawrence, R. (2004). Promoting informed decisions about cancer screening in communities and healthcare systems. American Journal of Preventive Medicine, 26(1), 67-80.
County Health Rankings. (2013). Texas: Health outcomes. County Health Rankings & Roadmaps. Web.
Elmore, J.G., Armstrong, K., Lehman, C.D., & Fletcher, S.W. (2005). Screening for breast cancer. Journal of American Medical Association, 293(10), 1245-1256.
Houston Department of Health and Human Services. (2008). The City of Houston health disparities data report. The City of Houston. Web.
King, D.W., Hernandez-Valero, M.A., Chukelu, P.C. & Jones, L.A. (2006). An initial assessment of a forgotten minority community: Key informant’s perceptions of environmental health in Fresno, Texas. Californian Journal of Health Promotion, 4(1), 22-31.
The City of Houston. (2012). Demographic data. The City of Houston. Web.
Trumbo, C.W., McComas, K.A. & Kannaovakun, P. (2007). Cancer anxiety and the perception of risk in alarmed communities. Risk Analysis, 27(2), 337-350.
The University of Texas. (2009). The state of health Houston/Harris County, Texas. The University of Texas. Web.
University of Texas School of Public Health. (2011a). The health of Houston survey 2010. The University of Texas. Web.
The University of Texas. (2011b). The largest Houston health survey reveals the unmet needs of both adults and children. The University of Texas. Web.