Running Head: Task 1 C228
Task 1 C228
Laura Orr
Western Governors University
Needs-Assessment
After observation, interviewing citizens, and reviewing statistical data of Sentinel City, I have concluded that there are several areas of need in the community that could use improvement. The areas that I will focus are on crime, accessibility for the disabled, teen pregnancy and sexually transmitted diseases. Using the demographics tool, neighborhood community and safety observations, performing a windshield survey of the area, and a scavenger hunt for information, I was able to compile information to support the areas the community could improve on.
An area that needs addressing is crime in the city. After speaking with a police officer, it was discovered that police receive anti-bias training for two days in the beginning of the job and then a possible refresher course every year. However, it is possible that some officers have not attended any training in three years. With crime rates increasing, more frequent training geared towards the crimes more prevalent within the city could be beneficial for everyone involved (Sentinel U, 2021).
A private store owner revealed that his store has issues with shoplifting, dark streets, and increased homelessness around the business. This issue ties in with more police training and presence in the areas of higher crime rates. Adding more streetlights to the area could also potentially decrease the incidents of crime due to the area being well lit (Sentinel U, 2021).
After speaking with a disabled citizen, it was noted that public transportation is not handicap accessible. This is very important since it appears most residents rely on public transportation to travel. Also adding ramps that allow disabled residents to be more independent can help decrease the risk for social isolation and let them feel included and important in the community (Sentinel U, 2021).
Using the demographics tool, it is concluded that there is a need for more education on prevention of teen pregnancy and STD’s. The Better Health Clinic data shows there was 418 teen pregnancies with 43 abortions and 375 births the past two years. The clinic offers prevention services to the community, but perhaps the clinic needs to have an outreach department to spread the word and have educational sessions at the local schools or within the community. With the number of teen pregnancies, it is clear that safe sex practices are not happening which also contributes to the number of STDs within the teenage population. Having informational sessions to promote the services offered by the clinic along with passing out free condoms could potentially help in this situation (Sentinel U, 2021).
Demographics
Using the demographics tool, I was able to see the statistical data regarding Sentinel City as a whole and the breakdown for each of the four neighborhoods: Nightingale Square, Acer Tech Center, Casper Park District, and Industrial Heights. Each neighborhood is quite diverse in population, ethnic group, age, median household, persons with disabilities, homeless persons, uninsured persons under 65 years of age, and more.
Sentinel City has 663,862 residents with 5,775 residents being homeless. The four neighborhoods total population, number of residents homeless, and percentage of persons with disabilities are as follows: Nightingale Square has 103,974 residents with 66 homeless and 3.5% disabled, Acer Tech Center has 168,390 residents with 199 homeless and 6.7% disabled, Casper Park District has 352,643 residents with 1,593 homeless and 6.8% disabled, and Industrial Heights has 38,855 residents with 3,917 homeless and 12.9% disabled. The median household income for the city is $49,091 and the primary ethnic group is mostly while alone at 80.6%. The median household income levels and primary ethnic groups for each neighborhood are as follows: Acer Tech Center $166,300 with the primary ethnic group being 70.2% white, Nightingale Square median income $269,550 with the primary ethnic group being 81.3% white, Industrial Heights has remarkably the lowest median income $24,672 with the primary ethnic group being Hispanic and Latino, making up almost half of the population at 46.8%, and Casper Park District $80,134 with a primary ethnic group being 63% white (Sentinel U, 2021).
When it comes to percentage of residents uninsured, Industrial Heights has the highest percentage at 37.5% followed by Casper Park District at 22.7%. Acer Tech Center has 1.5% uninsured residents and Nightingale Square has the lowest percentage at 0.7%. It is important to note that Industrial Heights has the lowest median household income, the greatest number of homeless residents, highest percentage of disabled residents, and the highest percentage of residents without insurance compared to Nightingale Square which is the complete opposite (Sentinel U, 2021).
Sentinel City is a diverse community with different ages, education levels, and ethnicities. Using the Sentinel City Community Health Simulation Demographics, residents under five years old make-up 7.4% of the population, residents under 18 years old make up 21.7%, and residents 65 years old and over make-up 10.5%. Education levels within the city for residents aged 25 and older are as follows: 85.1% of residents are a high school graduate or higher and 42.2% of residents have a bachelor’s degree or higher. The diversity within the city is also evident in the different ethnic backgrounds. The percentage of residents who are white alone is 80.6%, black or African American alone is 10.4%, American Indian and Alaska Native alone is 2.0%, Asian alone is 3.7%, Native Hawaiian and other Pacific Islander is 0.2%. Residents with two or more races make up 3.1%, Hispanic or Latino 31.5%, and white alone, not Hispanic or Latino is 52.7%. Education level (Sentinel U, 2021).
Neighborhood Safety Assessment
During my observations while driving around the city, I was able to assess the community for any safety hazards. The biggest thing I noticed was that each neighborhood had similar safety concerns, it was just a matter of to what degree. I noticed that the poorest neighborhood Industrial Heights and the richest neighborhood Nightingale Square both had graffiti on public buildings and doors, homeless people set up throughout the city, and trash on the sidewalks. All the neighborhoods have at least one or more building abandoned or in need of major repair. Industrial Heights was by far the community that needed most repair and attention.
The crime and drug use in Sentinel City are a concern just like in reality. 16% of arrests made are related to controlled substances. The percentage breakdown on drug use is as follows: 36% alcohol, 24% tobacco, 18% prescription drug use, 12% marijuana, 10% methamphetamines, 7% heroin, and 5% cocaine. After speaking with a police officer the most common crimes throughout the city are bicycle theft, property damage, shoplifting, or drunk and disorderly conduct. The number of more serious crime cases are as follows: 1231 aggravated assault, 559 robbery, 312 rape, and 20 murder cases. Gangs are prevalent in the area and the number of crimes related to their activity is as follows: 100 aggravated assault, 40 robbery, 38 simple assault, and 20 homicides. Emergency medical services available in Sentinel City are fire, ambulance, and police with response times of 10-15 minutes (Sentinel U, 2021).
Scavenger Hunt
Sentinel City has many community resources available to its residents. This section will discuss the services offered by parks and recreation, the healthcare system, social services, Better Health Clinic, the soup kitchen, and the Affordable Housing Project. Parks and recreation offer swimming lessons, nutrition, gardening, and adult fitness courses, city sports, summer programs for children, and after school programs. The budget for the park has been steadily declining over the last several years which is a major problem. Free public parks offer the community a free place to go and be outside, play, socialize, and be active. Public parks can also give citizens a feeling of belonging and decrease feelings of isolation, especially in the elderly. One citizen did vocalize a complaint that the location of the park was an issue due to unsolicited activities like prostitution, trespassing, public intoxication, and selling of drugs (Sentinel U, 2021).
The healthcare system elderly service offers a variety of resources that the elderly may need to help them continue to be as independent as possible. The common concerns with the elderly are driving, preparing meals, and transportation. This resource offers all those services, along with medical care advocates, elder abuse prevention advocates, government entitlement assistance, senior living options, and service animals (Sentinel U, 2021).
City Hall-Social Services offers a variety of victim assistance programs to include therapy and support groups, emergency financial assistance such a WIC and SNAP benefits, crisis counseling, legal support, and shelters and/or safe housing. These resources are very important for a community to have and important for the residents of the community to know they are available if needed (Sentinel U, 2021).
The Better Health Clinic offers a variety of services related to prevention and treatment. Services include contraceptives, pregnancy testing and counseling, infertility services, sexually transmitted disease services, breast and cervical cancer screenings, and other preventative health services. Even with a multitude of services offered, the number of teenage pregnancies and STDs continue to rise (Sentinel City, 2021).
The Interfaith church runs the soup kitchen for the community. They provide citizens with nourishment for free. They also have the commodity supplemental food program, and general food assistance. The soup kitchen provides 39,000-51,000 meals to community residents. This soup kitchen is in the neighborhood of Industrial Height where the median income is the lowest in the city and has the highest number of homeless residents (Sentinel U, 2021).
The Affordable Housing Project is a resource in the community that offers housing to low-income families. Unit studios, one bedroom, and two-bedroom units are available for tenants to choose from. The average income for tenants is $17,000-$33,000. Complaints from tenants include noise, dogs barking, and crime in the area (Sentinel U, 2021).
Windshield Survey
During my windshield survey I noticed that many aspects of Sentinel City are very similar, however, when you specifically look at each neighborhood, you can tell significant differences. Most of the buildings look very similar to one another no matter the neighborhood and are made of brick or stucco looking material. Industrial Park has more buildings with graffiti and run down or abandoned buildings while Nightingale Square had mostly all newer or updated looking buildings with minimal graffiti. Casper Park had inmates out in the community on a work release program cleaning up a park. I did not observe any windmills or solar panels. There were protestors in front of City Hall which leads me to believe the members of the community are willing to advocate for their city. I did not observe a lot of back yards or green space other than the city park (Sentinel U, 2021).
The appearance of the different neighborhoods did not go unnoticed. Nightingale Square has trees planted, landscaping, grass is well kept, minimal trash on sidewalks and in the road, minimal rodents present, and residents were walking their dogs on leashes. There were some public benches around all neighborhoods. Residents of the community were occasionally gathered outside in public space socializing. I did not notice any visible boundaries or neighborhood signs (Sentinel U, 2021).
There were children playing on the playground next to the school and some crossing the street where the crossing guard was. There were bus stops and many people riding bikes and walking down sidewalks. It should be noted that a citizen stated public bus transportation cannot currently transport wheelchair or disable persons. Residents were utilizing the park playing sports and there were groups of people in front of the barber shop and grocery store. It appeared there is not a specific place for people to gather, they are sporadic around the city (Sentinel U, 2021).
Primary transportation in the city seems to be walking or ridding the public bus that comes around. There are designated bus stops where people were gathered waiting for the bus to come around. I did not observe many cars on the road. I did observe a motorcycle rider. I did not notice any highly congested areas of traffic. There was one gas station that I noticed in the city. I did notice in Acer Tech Center there was a high-rise train track. There was a dental office, ophthalmologist office, Better Health Clinic, and community hospital. The residents shop at Joe’s Market and privately owned stores and boutiques. Because there were not many cars out and the residents utilize public transportation, bicycle riding, and walking, the sidewalks stay busy. There were quite a few residents moving about during the day. Someone was walking a dog, beat police patrolling, construction workers outside of a site working, people sitting on public benches socializing, protestors, and playing in the public park (Sentinel U, 2021).
In all neighborhoods, I observed billboards promoting health, screenings, and vaccinations. The community appears to be active, alive, and thriving. I observed different forms of culture expression; a man and woman with a turban on their heads and someone with dyed hair outside the barber shop. By the construction site, there were supplies and other things on the sidewalk that could potentially pose as a safety hazard to residents. The Interfaith City Church is used as a soup kitchen to provide meals on non-worship days. Several citizens stated they go to the church for not only food but for support groups that are available and counseling or advice from the priest. There were people outside both the hospital and clinic that appeared to be actively seeking medical treatment. The health clinic is in the Industrial Heights neighborhood which I think is a great idea due to it being a low-income area. Many people associate a health clinic with lower costs than a hospital and are more likely to seek medical treatment if necessary (Sentinel U, 2021).
Interpretation of Data
To better assess the health needs regarding sexually transmitted diseases, I visited the Better Health Clinic to gather data. There rate of STDs among teens is alarming. According to the epedemiology data, the precenntages of specifc STDs are as follows: Gonorrhea at 70% and Chlamydia at 63% among 15–24-year-olds. Teenage pregnancy has increased in the past 5 years, with reports of 475 teen pregnancies (Sentinel U, 2021).
After gathering information from the health department regarding immunizations, it is surprising to find that all four neighborhoods are below the national rate for immunization. Industrial Heights has the lowest overall immunization percentage, which is not surprising considering this neighborhood is they highest percentage of residents uninsured. The city does have an anti-smoking billboard posted, however, the 24% of the residents admit to smoking (Sentinel U, 2021).
Another observation I made when visiting the hospital is the high number of emergency department visits for non-emergency issues. 33% of visits were for pain related concerns. Many residents utilize the emergency room as their primary care physician, which can tie up resources and availability for true emergent concerns. If more resources and education were provided to residents on the benefits of going to a PCP instead of the emergency department, acute and chronic non emergent issues could be better managed, comorbidities potentially decreased, immunization rate increased, and the emergency department could be utilized what it is intended for; emergencies (Sentinel U, 2021).
Three Problem Areas
The three problem I have identified are the high percentage of sexually transmitted diseases, low immunization rates compared to the US average and the percentage of uninsured residents in the lowest income area of sentinel city Industrial Heights.
According to the epedemiology data, sexually transmitted disease among the community is a health issue. Healthy people 2020 goal is to promote healthy sexual behaviors, strengthen community capacity, and increase access to quality services to prevent sexually transmitted diseases (STDs) and their complications. This relates to Sentinel City because there is a high percentage of STDs within the community. If education sessions, promotion of services, and free condoms were offered, the percentage of STDs within the community could potentially decrease. Prevention is key (Office of Disease Prevention and Health Promotion, 2021).
Lower immunization rates are another health issue that the city faces. Healthy people 2020 Goal is to increase immunization rates and reduce preventable infectious diseases. It is important that all members of the community have access and can receive immunizations as needed. This will help prevent the spread of disease and increase efficacy of antibiotics. Providing education to residents on the benefits of immunizations will help them better understand the importance and hopefully encourage them to stay up to date on immunizations (Office of Disease Prevention and Health Promotion, 2021).
The large percentage of uninsured residents in the lower income areas of Sentinel city is another reason of concern. This may be correlated to the low percentage of residents that have not received proper immunizations. Without health insurance, cost of medical goods and services is a concern. Healthy people 2020 Goal is to improve access to comprehensive, quality health care services. The clinic and health department could offer education on how to apply for medical assistance or insurance for the residents who do not currently have insurance. Having a social worker at these education sessions could also help answer questions and assist residents in applying for aid (Office of Disease Prevention and Health Promotion, 2021).
Discussion of Community Resources
Sexually transmitted diseases in Sentinel City are a major concern. The Better Health Clinic is key in helping spread the word and provide education about STDs. They already offer STD services; they just need to reach the community better. One way to do that is to offer free educational classes and free condoms and dental dams. The community center already offers educational classes; however, it is possible that many people would not attend a class on STDs due to fear of embarrassment. The clinic and health department could reach out to the local schools to specifically target teenagers to provide education on abstinence, STD general education, and offer free condoms and dental dams to prevent STDs. There could also be a storage box at the Interfaith Church during the soup kitchen services to offer free condoms and dental dams to the residents that use this service. Once the community gets a plan in place and is successful at distributing education and prevention materials, the percentage of STDs should hopefully decrease.
Primary Prevention Topic
The primary topic I chose is preventing and reducing sexually transmitted diseases in Sentinel City.
Application of Assessment Strategies/Tools between Simulation and My Community
The relation between the simulation and my personal community is that every community has a part that is underprivileged. As with the simulation, Industrial Heights was the underprivileged neighborhood and therefore could use the most outreach from the community. The way I could address the number of reported STDs in my community is to reach out to the health department for the statistical information. Based off that, I could develop a plan as discussed earlier to address the specific needs of the community. Applying for grants, scholarships, or asking for donations to help prevent the spread of STDs could be useful in the community. My personal community already has a program with the health department that provides age-appropriate sex education at an early age and continues throughout high school. Perhaps working with my local health department to offer free screenings for STDs would be beneficial in treating and preventing the spread of STDs as well. It takes the community to encourage and support one another. Making sure that residents are educated and know where to find resources is another key factor in treating and preventing the spread of STDs.
References
Office of Disease Prevention and Health Promotion. (2021). Access to Health Services. U.S.
Department of Health and Human Services. https://www.healthypeople.gov/2020/topics-objectives/topic/Access-to-Health-Services
Office of Disease Prevention and Health Promotion. (2021). Immunization and Infectious
Diseases. U.S. Department of Health and Human Services.
https://www.healthypeople.gov/2020/topics-objectives/topic/immunization-and-infectious-diseases
Office of Disease Prevention and Health Promotion. (2021). Sexually transmitted diseases. U.S.
Department of Health and Human Services. https://www.healthypeople.gov/2020/topics-objectives/topic/sexually-transmitted-diseases
Sentinel U. (2021). Sentinel City (Version 3.1.3.1) [Computer software].
https://sentinelworld.healthcarelearninginnovations.com/Simulation/SentinelCity31/Start