Community Health and Population Focused Nursing Action Report

Sentinel City Action Report

Demographic Assessment

This paper takes place in Sentinel City, a virtual community, where information was obtained by touring the city via the website.  Sentinel City has a total population of 663,862 within four neighborhoods. (Sentinel City, 2019). They are Industrial Heights, Casper Park District, Acer Tech Center, and Nightingale Square.  Industrial Heights has the lowest population of 38,855, where as Casper Park District has the highest population of 352,643.  The Acer Tech area has a population of 168,390 and Nightingale Square has 103,974. (Sentinel City, 2019).  Sentinel City age breakdown per population is 7.4% are less then 5 years of age, 21.7% are less then 18 and 10.5% are greater than 65 years of age. The overall ethnicity of Sentinel City is 80.6% Caucasian, 31.5% Hispanic, 10.4% African American, 3.74% Asian, 2.0% Native American, 0.2% Pacific Islanders and 3.1% being of two or more races. (Sentinel City, 2019). Industrial Heights has the highest population of Hispanics at 46.8% and African Americans at 13.1% in the city. Casper Park District has 63% Caucasian and 24% being Hispanic. Acer Tech Center is primarily 70.2% Caucasian and 13.7% Hispanic, and Nightingale Square’s population primarily consists of 81.3% Caucasian and 3.7% Hispanic. (Sentinel City, 2019).

Sentinel City’s overall median income is $49,091.  Industrial Heights area has the lowest median income at $24,672, whereas Nightingale Square has the highest at $269,550. The Casper Park District median household income is $80,134, while the Acer Tech community is $166,300. (Sentinel City, 2019).  18.9% of Sentinel City residents live below the poverty level. The percentage of non-insured residents in Industrial Heights is 37.5%, Casper Park 22.7%, Acer Tech Center 1.5% and Nightingale Square 0.7%. (Sentinel City, 2019).

Neighborhood/Safety Assessment

Through traveling Sentinel City I noticed significant safety and health hazards. These were observed mostly in Industrial Heights. For example, I noticed a burning car and fire in a garbage can near the soup kitchen, which was polluting the air with smoke. Many of the buildings throughout the city had graffiti on them.  I also noticed that many areas in the city had garbage alongside their buildings with rats running through it. As you travel through the city you could see garbage across from the park, the school and the church. Many of the buildings were in need of repair or were abandoned. Streets in the city had sink holes and cracks in them.

Through collecting data I noticed there was a significant population using illicit drugs within the last year. The use of alcohol was at 26% and tobacco at 24% were the highest used substances in this population. Marijuana was the second highest at 12% of the cities population. Heroin use was at 7%, while cocaine and CNS depressants at 5%.  The lowest used drugs of the population were club drugs at 2% and methamphetamine at 0.5%. (Sentinel City, 2019).

The cities emergency response team included: Fire Response Team, EMS, and Advanced Life Support. The EMS response time for each are; Fire Response Team was approximately 6.5 minutes, and the EMS and Advanced Life Support approximately 7.5 minutes. Overall the response time of these individual teams is under 10 minutes per call.

Based on data from the police department the most common arrests in Sentinel City last year were due to warrants at 23%. Arrests for battery were at 17%, controlled substance arrests at 16%, while reckless conduct was at 9%.  Criminal trespass and public intoxication were at the lowest arrests made last year at 6%. (Sentinel City, 2019). Gang related violence plays a large role in crime rates in the city.  Aggravated assault was the highest and rates at 100 last year. Robbery and Simple Assault are at 40 for last year and Homicide was the lowest gang related crime. (Sentinel City, 2019).

Windshield Survey

The windshield survey of Sentinel City consisted of me riding the bus through the city and walking the streets, while taking note of what I observed.  First, I noticed that Sentinel City is more of an urban community, where the buildings are made of brick and mortar and are mostly joined together.  Areas like Industrial Heights and Casper Park District seemed to have more run-down and abandoned buildings. There were many buildings that had boarded up windows and graffiti on them. Trash was piled alongside the buildings with rats running out and through the alleys. I noticed prison work crew cleaning up a corner lot. There seemed to be more police presence in these two areas of town as well. I did not notice any houses, but there are a few apartment complexes in the city. As I progressed through the different areas of town, it was noticed that the buildings were becoming more modern and taken care of, although there is still significant amounts of graffiti in all neighborhoods.

As mentioned earlier, Sentinel City is very urban and doesn’t’t have many trees, even in the park areas. Through traveling the city there did not seem to be much open space for outdoor recreation.  However, I did note many people running and riding bikes.  While on the tour I did not notice any indicators of which area of town I was in.

Sentinel city is very active, in all four areas. I saw people playing tennis, children playing at the school, riding bikes, running, people talking in outdoor eateries, and many people just visiting on the sidewalks. I also noticed a few people in wheelchairs, walkers and using crutches, but I never a saw any accessibility ramps anywhere in the city. Touring the city it appeared that the population was mostly Caucasian, but I did see a Middle Eastern man walking near the City Hall, an African American woman walking down the street and I stop and spoke with an Asian family on the corner. 

Many of the cities residents utilize public transportation as it appeared to have multiple bus stops with people waiting for the bus. However it was noticed that there was a lot of foot traffic and those that traveled by bicycle. The streets have parked cars indicating that some of its population do use personal vehicles for transportation as well.  Sentinel City offers an array of places for people to socialize. For example, the tennis courts in Nightingale Square, there is an outdoor restaurant where residents can eat and socialize. Often there were small groups of people hanging out in front of stores like Joe’s market. 

The city offers a few centers, such as the Senior Center in Nightingale Center. The church has a soup kitchen with a very long line of residents. Throughout the city there were several medical and dental offices, and it was noticed to have a nursing home as well. There was a playground where children were playing, but it did not seem to have grass. Children going into the school wore a uniform. One park, which was being cleaned by the work crew had some nice big trees and but no grass. The people in the city have many options for shopping and dining.  There’s a fresh market, Joe’s Grocery, The Bodega, and a few small restaurants.

While traveling through the city you will see somewhat of an ethnic community.  I noticed multiple people with cultural head dresses and attire on.  It is unclear of the communities religion and political practices, but there is a Catholic church in Industrial Heights, which offers a soup kitchen for low income and homeless community members. I observed a protest outside the City Hall over taxes. There was a lot of police presence, but it seemed to be a peaceful protest.

Scavenger Hunt

Sentinel City has a vast of options for community resources.  For example, The Parks and Recreation Department offer educational programs, swimming lessons, food and gardening programs, adult fitness, kids summer camps and city sports.  The Health Care system especially for the elderly offer, transportation, medical care advocates, service animals, Meals on Wheels, a community center and multiple levels of living centers for the aging adult.  City hall offers resources for assault victims, shelters, legal aid, group treatment, therapy and emergency funds.  The Better Health Clinic offers contraception, STD services, women health screenings and preventative care.  The Soup Kitchen, a part of the Catholic church and Rescue Mission offers food for the low income, homeless and veteran population. Finally the Housing Project offers low income housing based on a person or families income.  Their rentals are studios, 1 bedroom or 2 bedroom units. (Sentinel City, 2019).

Data Analysis

As I toured the city and began collecting data, one of the first things I noticed was the the higher the median income, the nicer the area was, and the more insurance those residents had. For example, Nightingale Square had the highest income at $269,550 with the lowest of uninsured residents at 0.7%. On the other side of town in Industrial Heights, their median income was $24,672 with an uninsured rate of 37.5% of its residents. (Sentinel City, 2019). This part of town was the dirtiest of all four areas in Sentinel City.  I was very clear to me that Industrial Heights was the “poor” part of town. There were rat infested garbage next to buildings, cars and barrels on fire, run-down buildings, and an increase in Hispanic and African American residents.  Whereas the residents in Nightingale Square were primarily Caucasian, and the buildings and streets were clean and kept up.

As I continued collecting data for all four areas of Sentinel City there was evidence on how population health is affected by income or the lack thereof.  For example, with those living in Industrial Heights, who have no insurance, live in unhealthy conditions, and have little to no access to health care, it is easy for me to see the increase risks for more disease in this area compared to others in the city.

Top Three Problems in Sentinel City

Although there are many problems in Sentinel City, I will focus on the top three that stood out to me during my tour.  The top three problems I have chosen to focus on and compare to Healthy People 2020 are Sexually transmitted disease in younger adults, environmental health, and inactivity secondary to lack of outdoor recreational resources.

One of the first places I stopped in Sentinel City was the Better Health Clinic and I was shocked to see that 70% of those diagnoses with gonorrhea were 15-24 years of age. More alarming statistics were that 63% were diagnosed with Chlamydia and 40% diagnosed with HPV.  Healthy People 2020 states that “new cases of gonorrhea among females in 2015 were approximately 270,000 between the ages of 15-44 years of age.” (healthypeople.gov, 2019).  These numbers are frightening, it makes me question the underlying cause of these cases. Are these numbers high due to lack of safe sex education or is it a monetary concern for those in this community? 

Another health concern during my tour is the environmental health of the community. Mostly in Industrial Heights were we saw rat infested garbage all along the buildings, cars and barrels on fire, animals roaming the streets and feeding off the trash, and air quality and waste water are a major concern in these areas. As Healthy People 2020 has mentioned “poor air quality can be linked to premature death, cancer and long term damage to respiratory and cardiovascular systems.” (healthypeople.gov, 2019).  

The third health concern I noticed was the lack of outdoor recreation resources which inhibits daily activity.  Touring the city I noticed that there was one tennis court and basketball court and one park, which was run-down with weeds and garbage.  The city lacked any open space for outdoor activities, such as playing catch with your kids or a dog. There weren’t any open area play grounds for kids, and there were no bike or hiking trails that were noticed.  All of which lead to an inactive community. Healthy People 2020 states that an “improved quality of life can be increased with fitness and activity.” (healthypeople.gov, 2019). 

Discussion of Community Resources

Based on the information collected during the tour of the city, the Parks and Recreation have the best community resources in increasing activity in the community.  The focus could be on getting the word out to the inactive members about the resources that are offered through Parks and Rec. Such as their swimming lessons, outdoor gardening program, summer camps, city sports leagues, and adult fitness classes. 

Also the Parks and Recreation department revamp the tennis and basketball courts, making it more friendly for the entire family.  Perhaps tearing down some of the abandoned buildings and turning them into open space for activities would be an option.  The Parks and Rec. department could hire some of the low income or unemployed community members to help with the demolition and rebuilding process. Not only promoting income, but fitness as well.

Primary Prevention

Physical activity is the primary prevention I chose for Sentinel City. Personal and communal activity can boost moral as well as prolong life. According the American Heart Association, “regular physical activity can relieve tension, anxiety, depression and anger…and most people note an improvement in [their] general well-being.” (Physical activity, 2015). By renewing the outdoor recreational resources in  Sentinel City my goal is to increase activity within the community, thus increasing health and well-being.

Reflection

As I went through the simulation of the virtual city I learned how easy it is to not pay attention to the “bad stuff” in our own communities.  While rifling through all the data and statistics, it was an awakening experience for me to truly see the correlation between income and health and well-being of the community members. Or the lack of well-being.   I am currently not in a professional position in my community to make big changes but I can think of a few small areas that need attention to increase the well-being of my own hometown, and I feel like I now have the aptitude to dig through our local information and see what really needs some fixing.

References

• Centers for Disease Control and Prevention. (2017). Healthy People 2020. Retrieved from Center for disease control and prevention: https://www.cdc.gov/nchs/healthy_people/hp2020.htm
• Healthcare Learning Innovations. (2018). Sentinel City. Retrieved from WGU.ucertify: https://wgu.ucertify.com/?func=ebook&chapter_no=7#03tlb
• Physical activity improves quality of life. (2015). Retrieved January 27, 2019, from http://www.heart.org/HEARTORG/HealthyLiving/PhysicalActivity/StartWalking-Physical-activity-improves-quality-of-life_UCM_307977_Article.jsp