community health assessment (module 1)

what is a community according to WHO?

A group of people, often living in a defined geographical area, who may share a common culture, values and norms, and are arranged in a social structure according to relationships with the community- has developed over time.

what is a community most common definition?

 “community of place” or geographic boundaries. A cluster of people that share at least one common characteristic (i.e. geographic location).

community health

the meeting of collective needs by identifying problems and managing interactions within the community itself and between the community and the larger society

why is the health of a community so important esp to nuring?

if someone is in unhealthy community with poor health outcomes (increased mortality/morbidity rates), your community has a shorter lifespan, higher prevalence of disease

what does a healthy community look like to you?

Low crime rate

Quality schools 

Supportive family life

Robust economy, low unemployment and average income rate 

High environmental quality (clean air, water)

Accessible and quality health services

Civic involvement

Accessible transportation

Wide variety of leisure activities

healthy people 2030 goals

1. Attain healthy, thriving lives and well-being free of preventable disease, disability, injury, and premature death

2. Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all. 

3. Create social, physical, and economic environments that promote attaining the full potential for health and well-being for all. 

4. Promote healthy development, healthy behaviors, and well-being across all life stages.

5. Engage leadership, key constituents, and the public across multiple sectors to take action and design policies that improve the health and well-being of all.

what is a community health assessment?

It is a logical, systematic approach to identify community needs, clarify problems, and identify community strengths and resources.

The act of becoming acquainted with a community

• Health status, needs, and resources

• Goal: to describe the needs = develop strategies to address the needs

• Identify where better information is needed (i.e health disparities among various subpopulations and quality of life) to achieve health equity

Motivations to complete CHA?

law, drives funding, allows allocation of limited resources and mandated for each county to complete ever 3-4 years, Affordable care act and non-profit hospitals

what is the principle challenge for nurses performing CHAs?

gaining entry and acceptnce into a community: TRUST

what are the community subsystems for Anderson and McFarlane’s wheel?

1. recreation

2. physical environment

3. education

4. safety and transportation

5. politics and government

6. health and social services

7. communication

8. economics

what is subjective data at the community level?

everything uses ur senses doing the windshield survey

what is objective data at the community level?

numbers, stats, community rates

what is the community core for Anderson and McFarlane’s wheel?

history

demographics

ethnicity

values and beliefs

what do you assess first the subsystems or the core?

the core first then the 8 subsystems

subjective core examples

What do you see that illustrates the area’s history?

What sorts of people do you see?  

Do you see people that may be affected  by your project’s topic?

Are there churches, temples, mosques or other religious adornments?

Does the population look homogeneous?

objective core examples

Data regarding…

Household Types

Marital Status

Religious denominations

Vital Statistics (birth rates, morbidity & mortality rates, perinatal mortality rates…)

physical environment subjective examples

How does the envionment look?  

What does the landscape look like?  

What do you note about air quality,  flora, housing, zoning, space, green areas, animals, people, human made structures, natural beauty,  water, climate?
Are the houses old?  What condition are they in? What about sidewalks? 

physical environment objective examples

Data regarding…

Map of the area

Size and location within the region

Waste disposal

Water supply

Type of housing

Average temperature

Average rain/snowfall

Pollution

education subjective examples

Data regarding…

Map of the area

Size and location within the region

Waste disposal

Water supply

Type of housing

Average temperature

Average rain/snowfall

Pollution

education objective examples

Data regarding…

Graduation rates

Drop out rates

Level of education

Number and types of schools including higher education

Extracurricular activities

safety and transportation subjective

Do you see buses, taxis, bicycles?

Are there sidewalks, bike trails?

Is getting around the area possible for people with disabilities?

What are the roads like?

Do people feel safe?

Do you see protective service personnel around (i.e., police, fire, EMS)?

safety and transportation objective

Data regarding…

Use of transportation

Commute times

Types of crimes committed

Crime rates

Water source and treatment

Air quality monitoring

politics and gov subjective

Are there signs of political activity?

What party affiliation predominates?

Do you see evidence of people protesting?

What do the billboards tell you in terms of politics and gov’t?

Are there flags flying? 

politics and gov objective

Political parties (who predominates and how are they split?)

Top political issues

Governmental jurisdiction of the community (i.e., elected mayor, city council with single member districts)

health and social services subjective

What health care services are visible?

Are these services overused and/or busy?

What do the emergency departments look like?

evidence of acute or chronic conditions?

health and social services objective

Stats regarding your project’s health-related topic…

Stats about who is affected by your project’s topic:

Who is affected?

What are those stats?

Hospitals and other health care services

communication

Info to consider for both subjective and objective:

Formal communication→ newspapers, radio, TV, mail delivery, cable TV

Informal communication→ bulletin boards, posters, billboards, newsletters

communication subjective examples

Are there “common areas” where people gather?

What newspapers do you see in the stands? cell phones, texting, etc

Do you see billboards, posters, etc. around?  What do they display in terms of your topic? advertisements?

communication objective examples

Number and types of communication available

How does the area communicate the types of resources available?

economics subjective

Is it a “thriving” or “deteriorating” community?

Who are the major employers?

Where do people shop?

Are there signs that supplemental nutrition assistance program (SNAP) are accepted/used?

economics objective

Unemployment rates

Income

# of households below the federal poverty level

Occupations

recreation subjective

Where do children play?

What are the major forms of recreation?  Are they costly?  Are they well maintained?

What recreational facilities do you see?

Are there natural resources for recreation (trails, etc.)

recreation objective

Drug and alcohol use

Number and types of recreational facilities available

Funding

Organization of recreational activities

community health diagnosis includes:

1. the problem

2. affected group and location

3. the etiology

4. the S/S

primary prevention

prevention of disease

ex. immunizations, education to the general population

secondary prevention

early detection and treatment

s/s early disease or risk factors

ex. screenings

tertiary prevention

halt or delay the disease process

reduce disability and restore functionality

interventions geared at restoration or rehabillitation to max possible capacity

Where are objectives derived from?

The community dx

Behavioral Risk Factor Surveillance System (BRFSS)

collects state data about U.S. residents regarding their health-related risk behaviors, chronic health conditions, and use of preventative services