Benjamín León School of Nursing
NUR 4636 Community Health Nursing
Community Assessment (20% of grade)
Upon completion of this assignment, the student will:
1. Examine concepts of community assessment.
2. Identify strengths, weaknesses and resources in the community.
3. Identify community diagnoses that describe the health situation of that community.
4. Provide suggestions for implementation of a plan to address the diagnoses.
1. Each individual will be assigned a community in Miami in which to perform a “windshield survey”. Traditionally, a windshield survey involves driving or walking around the community to observe and obtain first-hand a complete and accurate understanding of the community.
2. This should be a fun and informative activity. Each community is easily located either using google search or google maps. Identify location of the community geographically.
3. Please address each of the questions in each subsystem of the Windshield Survey. The expectation is that each individual will explore their assigned community.
4. After completing the survey, determine the strengths and weaknesses of the community.
5. Identify at least 2 community nursing diagnoses for your community.
6. Provide suggestions for a plan to address the diagnoses.
7. Write up your findings in one paper and present them to the class. If you would like to take pictures or record your trip, it would be fantastic! Your presentation should not be longer than 30 minutes. Please practice before you present!
8. Windshield Survey*
|Physical Environment||How does the community look?
What do you note about air quality, flora, housing, zoning, space, green areas, animals, people, human-made structures, natural beauty, water, and climate?
Can you find or develop a map of the area?
What is the size of the area?
|Health and Social Services||Is there evidence of acute or chronic health problems?
Are there shelters?
Is there evidence of “traditional” healers?
Are there clinics, hospitals, healthcare providers’ offices, public health services, home health agencies, emergency centers, nursing homes, social services facilities, mental health services, hospices? List them!
|Economics||Does the community appear to be” thriving” or does it appear to have fallen upon hard times?
Are there stores, places for employment, industries?
Where do people shop? Are there signs that food stamps are used/accepted?
What is the unemployment rate?
|Safety and Transportation||What types of protective services are there? (e.g. Police, fire, sanitation)
Are air and water quality monitored?
What are the number and types of crimes committed? Do people feel safe?
How do people get around?
What type of public and private transportation is available?
Do you see buses, bicycles, taxis?
Are there sidewalks, bike trails?
Is getting around in the community available for people with disabilities?
|Politics and Government||Are there signs of political activity? (e.g. posters, meetings?)
What party affiliation predominates?
What is the governmental jurisdiction of the community? (e.g. elected mayor, city council with single member districts?)
Are people involved in decision making in their local government?
|Communication||Are there “common areas” where people gather?
What newspapers do you see in the stands?
Do people have televisions and radios? What do they watch or listen to?
What are the formal and informal methods of communication?
|Education||Are there schools in the area?
How do they look?
What is the reputation of the schools?
What are the dropout/graduation rates?
Are extracurricular activities available? Are they used?
Is there a school health service? A school health nurse?
Is there a local board of education?
Are there libraries in the community?
What are the major educational issues?
|Resources||Where do children play? Where do families or adults play?
What are the major forms of recreation? Who participates?
What facilities for recreation do you see?
*Source: Adapted from E. T. Anderson and J. McFarlane, (2008), Community as Partner: Theory and Practice in Nursing (5th ed.) pp. 220-221. Philadelphia: Lippincott Williams and Wilkins.
Rubric for Community Assessment
1. Map or location of geographic area of community 5%
2. Windshield Survey (8 subsystems) 40%
3. Identification of strengths and weaknesses in Community 5%
4. Community nursing diagnoses and plan 5%
5. Class Presentation 20%
6. Paper summarizing findings (APA format) 20%
7. Group Member Evaluation 5%
cITY OF MIAMI GARDENS 4
City of Miami Gardens Windshield survey
City of Miami Gardens Windshield survey
Miami Gardens is a mid-sized city in Miami-Dade County, Florida. It has a population of 113,750, of which 70.8% are African-American (U.S. Census Bureau, 2017). Miami Gardens has a lack of public transportation, limited to county buses. This can present a challenge for those that do not have personal transportation. The low-density residential zoning over a range of 18 square miles renders walking impractical (Miami Gardens, 2017). This has the potential to increase dependence on automotive use, increasing obesity due to a sedentary lifestyle. There are several parks, that can mitigate this problem, including some that offer outdoor gyms free of service to the general public (Miami Gardens, 2019). Low-income and minority neighborhoods in the U.S. suffer from a disproportionately higher rate of sedentary lifestyles, which correlate with a higher rate of obesity (Shuval et al., 2013). A sedentary lifestyle related to lack of physical activity is a concern for this population. A healthier diet could improve the obesity rate of lower-income communities in the U.S., as fresh food options are limited in bodegas and corner stores prominent in lower income neighborhoods, creating ‘food deserts’ where the population is forced to commute to larger supermarkets that offer this selection, or choose lower quality foods from aforementioned corner stores or ubiquitous fast food restaurants (Institute of Medicine & National Research Council, 2009). A pilot program in Boston was launched in late 2015, where a food truck brought fresh produce to lower income communities at regular hourly intervals, partnering with a local non profit organization (Field, 2015).
Health and social services
There are several clinics in Miami Gardens, and private practices. There is also a psychiatric hospital and large hospitals nearby (Jackson Health System, 2019). The high poverty rate and low-income status of the city suppresses demand of available health services due to a large portion of the population being uninsured or under insured (U.S. Census Bureau, 2017). 19.4% of the population 65 years and under are uninsured in Miami Dade county (U.S. Census Bureau, 2016). This can lead to under utilization of services that are needed by the population, due to barriers in transportation, under utilization of resources that are available, and lack of knowledge regarding available services (May, Cunningham, & Hadley, 2004). Ineffective community therapeutic regimen management related to economic insecurity is a major risk for this population. Patient navigators and case managers may be able to offer services to populations with lower incomes and potentially improve health disparities in minority populations in the U.S., by serving as a resource role for the patient (Natale-Pereira, Enard, Nevarez, & Jones, 2011). Culturally competent care training employed by a health center in Chicago, catering to the Hispanic population, has lead to patients traveling all the way from Indiana, seeking care. Many of these patients report higher satisfaction with this facility than their local health practitioners, highlighting the strength of cultural competence and potential for remedying health disparities (Castellucci, 2018).
The community is a majority African-American city, with approximately 65% of the population living below 150% of the Federal Poverty Level (FPL) of $18,210 for a single individual (U.S. Census Bureau 2017). African American communities, regardless of income, suffer from a higher proportion of reported social isolation and weaker social relationships among its inhabitants (Wang, Phillips, Small, & Sampson, 2018). There are a significant number of retail establishments that serve the population, improving the economic status of the community (Miami Gardens, 2018). Social isolation related to absence of satisfying personal relationships can be a concern for more marginalized members of this community. Several interventions have been proposed to address social isolation in poor communities, including grass-roots organizations that address community advocacy and outreach, volunteering, and community service aimed at improving the physical appearance of the neighborhood (Samuel Centre for Social Connectedness, 2015). Increased social interaction within elderly members of the community has been shown to improve their long term health care outcomes (Siette, Cassidy, & Priebe, 2017).
Safety and Transportation
The Miami Gardens Police Department is responsible for seven neighborhoods: Andover, Bunche Park, Carol City, Lake Lucerne, Norland, Opa-Locka, and Scott Lake. The department also patrols Hard Rock Stadium, and the Calder Casino & Race Track. (Miami Gardens Police Department, 2018). Miami Gardens fire department includes four fire stations. Miami Gardens crime statistics report an overall downward trend in crime based on data from 13 years with violent and property crime decreasing. In 2016 total crime incidents in Miami Gardens was of 5,598. In 2019 is expected to be 4316. (“Miami Gardens crime,” 2019).
Miami Gardens air quality is 53, while the US air quality average is 58. Here health is ranked on a scale of 1 being the worst to 100 being the best. This analysis models respiratory illness and cancer risk down to the zip code level. (“Health in Miami Gardens,”2019). Miami tap water is safe to drink according to the Environmental Protection Agency (EPA) and international standards. (Bensadoun, 2018).
In Miami Gardens people get around by driving and those who don’t have private transportation have the options to get services from taxis & uber. They can also use Public transportation like Miami Dade County busses, and the Miami Gardens Trolley, which is a free service. People with handicap can use Special Transportation Service (STS) is a shared-ride public transportation service of Miami-Dade County. STS offers door-to-door transportation service, which operates 24 hours a day, 7 days a week. (Special transportation Service, 2019).
Weakness in Miami Gardens Community is the high crime rate. The city violent crime rate for Miami Gardens in 2016 was higher than the national violent crime rate average by 63.64% and the city property crime rate in Miami Gardens was higher than the national property crime rate average by 30.99%. (“Miami Gardens crime,” 2019).
Politics and Government
The city of Miami Gardens has the largest predominantly African-American municipality in the State of Florida with a mix of Caribbean population. It has a population estimate total of 105,414 (miamigardens-fl.gov). According to the office of Christina White, the Miami Dade County supervisor of elections. Each four district of Miami Gardens had a total 70,037 voters in the last 2018 elections. The highest category of voters were black females with age of 66 and up, and ages between 18-25 came in second largest bracket. The highest numbers of voters were under the Democratic party while the second highest went to Non-Affiliated party.
The City of Miami Gardens has a Mayor-Council-Manager form of government. The elected City Council sets the policies for the operation of the City. The City Council enacts Ordinances, the laws of the City, adopts Resolutions authorizing actions on behalf of the City, reviews plan for development, and establishes the policies by which the City is governed (Miamigardens-fl.gov). The City Council consists of seven members: A Mayor and two Councilmember’s elected citywide and four additional Councilmember’s elected by individual districts. The administrative responsibility of the City rests with the City Manager, who is appointed by the City Council (upon recommendation of the Mayor). Each Councilmember is elected to a four-year term (miamigardens-fl.gov).
One of the strengths of City of Miami Gardens when it comes to government is holding town hall meetings every week to reach to their constituents. The purpose of the meetings is to discuss the communities needs and hearing their concerns. The city of Miami Garden’s website has the updated schedule for the meetings months ahead for different topics. One of the weakness that Miami Gardens have are programs to cope with gun violence. The police department works extremely hard to decrease the gun violence but rare advertisement on projects about how to cope surviving gun violence.
As a city located towards north-central Miami-Dade County, the metropolitan area is awash with different common areas where people gather. The gathering points can be categorized into hotels, parks, and recreational areas. Some of the hotels situated at Miami Gardens include the Stadium Hotel, Holiday Inn Miami West Hotel, Rodeway Inn Miami, Hampton Inn & Suites Ft Lauderdale Hotel and Springhill Suites Fort Lauderdale Miramar (FindHotel, 2019). The hotels have dining and meeting areas where people can congregate for different social and executive reasons. On the same breath, the city holds such recreational areas as AJ King Park, Andover Park, Butterfly Garden, and the Auditorium among others. The parks and recreational centers form convergence points for people of different backgrounds. Therein, people pursue leisure by engaging in outdoor activities in a natural and semi-natural setting.
The residents at Miami Gardens get news, announcements, and entertainment from a variety of newspapers. Some of them include Tampa Bay Times, Orlando Sentinel, The Tampa Tribune, The Pensacola News Journal among others. Based on responses from a few randomly selected residents, the most read newspaper in the city is the Tampa Bay Times. Some of the citizens observed that the paper incredibly connects with them in case of any breaking news or any other valuable information. However, in terms of comprehensiveness of news, the Orlando Sentinel emerged most famous of all the newspapers.
The Miami Gardens residents are also television and radio owners. However, according to a survey conducted among a hundred Americans, more than 66% of the residents own televisions as compared to 20% that own and listen to radios. Interestingly, most of the residents have bundled their home phones, televisions and internet services using cables. Time Warner Cable is one of the popular choices that Miami residents have gone for. Regarding what the residents mostly watch and listen to, several different responses were given. Nevertheless, some of the popular responses that were common among the residents include the Roseanne Show, aired on ABC, and NFL Sunday Night Football. Additionally, most of the residents preferred Biography, comedy, drama and Musical genres.
Both formal and informal methods of communication are utilized by citizens living in the city. For the formally employed persons, vertical communication is mainly through legal and commercial notices. Some of the corporate centers ensure there is an audit trail to ascertain that everybody received the notice. Other formal ways of communication that are utilized at Miami Gardens include social media, publications, and mobile phones. It is plausible to appreciate that only official communication channels are identified as legit when formal information is passed on to a specific audience. Nevertheless, it was hard to establish the majorly utilized a formal method of communication.
Regarding informal communication, there were several instances when the residents of Miami Gardens find themselves sharing information in casual ways. Speaking to each other during social occasions, shaking hands of a colleague, talking to friends or family members during gatherings, talking to each other at a dinner table and waving to an acquittance when passing by them were some of the informal communication methods that were reported. Collectively, both formal and informal communication methods play a crucial role in passing on of information.
The city of Miami Gardens contains 37 schools (National Center for Education Statistics, n.d.). They include 21 public schools, 12 private schools and four colleges in which two colleges are for-profit and two are not-for-profit. The schools have been improving their school grades over the years. For example Barbara Hawkins Elementary was rated a “D” in 2015, today in 2019 the school has improved to be an “A” school. Although some schools in Miami Gardens have improved their grading scale, the city school board district has the highest percentage of poverty, measured by the amount of students receiving reduced-fee or free lunch. This is important because poor students were less probable to pass test standardized by the state (StateImpact, 2014).
In 2017, more than 79 percent of the population in the city of Miami Gardens is a high school graduate or has attained a higher academic degree (United Census Bureau, 2017). In 2017, an estimate of 29,415 people from 3-years-old and over were enrolled in school (United Census Bureau, 2017). Enrolled in a nursery or preschool 1,760 children. From kindergarten to 12th grade 19,592 students were enrolled. College or undergraduate students enrolled were 7,079 and graduate or professional school 984 people were enrolled (United Census Bureau, 2017). The dropout rate for high school students in Miami Dade County was 5.7 percent in 2017 (Florida Department of Education, 2017). The schools at Miami Gardens have afterschool programs. These programs vary from school to school and include assistance with homework, academic tutoring, music and art enrichment among other activities. Also, the city itself offers afterschool programs in different recreational parks such as; “Shining Star Afterschool Program” and “Future Stars afterschool Program” (Miami Gardens, n.d.).
School health programs are provided throughout the entire Miami Dade County, including the city of Miami Gardens from Pre-K through 12th grade. These health services include assessment, promotion and protection of the health of the students. Continuous, quality school health service is provided to the entire school community, public and not public (Florida Health, 2017). In addition, Miami Dade County Public School Department has a Mental Health program that delivers mental health services for students. Miami Gardens belongs to the Miami Dade School Board District 1. The community of Miami Gardens has a public library; the North Dade Regional Library. This public library is available for everyone and has its doors open the seven days of the week.
Many playgrounds are present for children residing in the city. The Bennett Lifter Park provides pavilions, playgrounds, tennis and basketball courts where children can play. Pavilions where families can rent for children’s parties. The Betty T. Ferguson Recreational Complex is one I see that stood out the most by its large football and soccer fields. It hosts multiple programs and activities year-round for both children and adults such as, martial arts, fitness classes, and Learn to Swim Program. The parents to children understood that exercises helped their children achieve a healthy weight, fostered growth, and development and boosted their cardiovascular health. On the other hand, adults worked out in search areas a Lake Stevens Park and North Glade Park.
Miami Gardens city is endowed with different recreational grounds on which different activities are carried out. Some of the major recreational activities include mountain biking, hiking, swimming, and outdoor picnics. Depending on the weather and type of recreational center, both children and adults are involved in the activities at different times.
One portion of the population that has benefitted from the different communication platforms is the children. Through connectivity on social media and televisions, the community can now receive as much information as possible on ways to contain lifestyle diseases like juvenile diabetes and childhood obesity. In the united states, children aged between 5-9 years mainly succumb to unintentional injuries, malignant neoplasms, heart diseases, homicides chronic low respiratory diseases and benign neoplasm as stated by (Clark, 2015). All this information has brought to the population owing to the improved communication in the city. Regarding resources, the city residents have had a chance to eliminate lifestyles diseases right from the young ages. The recreational centers and playgrounds in the city give children a chance to timely control their weight and reduce blood sugar. Subsequently, lifestyle-related chronic conditions among the children are significantly prevented.
Although communication has come with different advantages, social media is a platform notorious for cyberbullying. Consequently, suicide has continued to be among the causes of children mortalities in the city. On the other hand, children injure themselves in the playgrounds and recreational centers. As earlier alluded, unintentional injuries emerge as a significant factor in childhood mortality and morbidity as asserted by (Clark, 2015). In conclusion, communication and resources emerge as crucial sectors among the residents of Miami Gardens. There are designated areas where people gather for social and official reasons. It also arises that residents utilize both televisions and radios differently in receiving information. On the same note, the citizens enjoy different platforms that allow for formal and informal communication. However, both communication and resources have come with their advantages and disadvantages as abovementioned.
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