Community Health Nursing HW 2

Discuss aspects of a health concern not being addressed despite the efforts of services and partnerships involved and describe the ultimate outcome(s) or goal(s) from Healthy People 2020 relating to that specific health concern.

Answer the following questions to assist in data interpretation:

What similarities are apparent between the data that were gathered and the data that were generated?
What differences are apparent between the data that were gathered and the data that were generated?
What are the weakness and strengths of this community?
In what areas is improvement needed in this community?

The assignment should be written in an APA-formatted essay. The essay should be between 1500 and 2000 words in length and include at least two scholarly sources other than provided materials.

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Defining the Community

The community under study in this paper is Queens. Queens is classified as one of the five boroughs of the New York City. It is part of the larger New York City indicating that it is urban based. It is coextensive with a respective county of New York State thus considered a county too. It was consolidated in the New York City in 1898. Its neighbors Brooklyn at the Western end of Long Island, and Nassau County to the East. Around 47% of its population is foreign born and it serves as one of the most ethnically diverse counties in US. It is also highly diverse in linguistics. The county has an estimated 2.28 million people with the Asians (Non-Hispanic) having the largest population Community Health Nursing HW 2

The county has a total area of 178 square miles, 109 square miles being on land and 70 square miles being in the sea. On the West, it is bordered by Brooklyn, and the Newton Creek. Northwest it is bordered by Newton Creek, and far west by Manhattan. To the North, it is bordered by Bronx. Flushing Bay and Flushing River are also North of Queens. To the South, it is Rockaway Peninsula. Jamaica Bay is also located in this area too.

The County comprises of several neighborhoods. Many residents of Queens identify themselves with these neighborhoods rather with the county or New York City at large. The major neighborhoods in the city include Flushing, Whitestone, Middle Village, Ozone Park, Astoria, Rockaway Beach, Richmond Hill, Jamaica, Bellerose, Corona Heights, Rego Park among others.

On literacy levels, around 81.5% of the population are high school graduates or have a higher level of education compared to the country percentage at 88.8% (US Census Bureau, 2018). Around 31.5% have tertiary level education that is a bachelor’s degree or like national percentage. 10.1% of the population under 65 years in the county lack health insurance services compared to national’s 9.5%. The birth rate for the past 12 months stands at 4% and the infant mortality rate is 3.9 per 1000 live births (TownCharts, 2020)

This community health assessment is being conducted to determine the current health status and needs in Queens County. In future, the data collected may help in designing a health improvement plan for the County and inform how best resources should be allocated to satisfy the existing needs. Harboring a large number of foreign-born citizens and non-citizens too, they assessment will also be used to research on their access to healthcare especially the undocumented immigrants. The assessments will also help increase knowledge about public health and how different activities are interconnected in relation to health.

This information to be used in the community assessment has been collected through online data gathering from accredited and reliable sources. Onsite data was also generated by visiting different neighborhoods in the county. The data was generated through participant observation, windshield survey, engaging in focus groups, and a KAP survey. All ethical procedures and also protocols offered in curbing the COVID19 pandemic where be adhered to in the process.

Assessment

Diversity of Population

Queens is distinct from other communities in the country due to its highly diverse population. It has people from different races. The interesting concept is that most of this racial groups are highly clustered in specific locations in the neighborhood (TownCharts, 2018). The population of the County is estimated to be around 2,278,906 as per the Statistics released by the United States Census Bureau in 2018. It was estimated to have 865,578 housing units with a total of 777, 904 households (US Census Bureau, 2018). There was an estimate of 2.97 persons per household. The median value in each household was estimated at$481,300. The owner occupancy is rated at 44.5. The age based demographics are as follows; 6.2% are under the age of 5, 13.9% are between the ages of 6-18, 64.2% are between the ages of 19-64, and 15.7% are over the ages of 65 (US Census Bureau, 2018). Females had the highest percentage of the population at 51.5%. 47.5% of the residents are foreign-born. The Median household is estimated at $62, 006 and per capita income at $28,814 (US Census Bureau, 2018). Around 12.2% of the residents live below the poverty line in the country.

The county has different ethnic groups and is very racially diverse which is attributed to the higher number of foreign-born populations. The three largest ethnic groups in the county are Asian (Non-Hispanic), White (Non-Hispanic), and African American. Around 49.5% of these were born in Latin America, 33.5% in Asia, 14.8% In Europe, 1.8% in Africa and 0.4% in North America. 44. % of the population speak English at home, 23.8% Spanish, and 16.8% Indo-European language among other languages. The three most foreign spoken languages are Spanish (505,010 speakers), Chinese (Incl Mandarin, Cantonese, 208,114 speakers), and Bengali (76,812 speakers) (US Census Bureau, 2018). As of 2018, there were 1.04 more Asian residents than any other race in the County. Chinese community comprise the highest percentage of the Asian community while Puerto Ricans comprise of the largest percentage of the Hispanic population.

With many of the foreign-born population already naturalized, there are many undocumented immigrants in Queens. According to a report by Migration Policy Institute, Queens County is home to around 246,000 of the 643,000 undocumented immigrants living in New York (Migration Policy Institute, 2018). Due to their status, many of them lack access to healthcare services. Due to the fear of being deported, many of them are not able to access tertiary level education and have to grapple with low paying menial jobs throughout their stay in the County (Hayduk et al., 2017). Many are not able to afford quality housing and live in illegal basements with poor conditions (Stewart et al., 2019). These areas have poor hygiene and sanitation which expose the occupants to infectious diseases. The basements structures have weak walls, poor wiring, poor lighting, and lack emergency outlets. In case of an emergency, the occupants have no alternative escape route except the entrance.

According to a field article by the New York Times (Stewart et al., 2019), many of them arrive at the country illegally and they migrate to Queens which is more a convenient settling place. Many already have relatives or friends from their local countries in the County and come in hope of earning to help back at home. Most of their earnings are sent to families back at home and many are left with so little for their own use (Wyrick et al., 2017). Many of them conduct menial jobs thus cannot afford a quality lifestyle. There is need to improve the lives of these immigrants through better access to health and other process that provide them with legality to be in the country. There should be programs to cater for the innocent children who arrive at the country while young or those born to undocumented immigrants. Community Health Nursing HW 2

Data Generation

Windshield Survey and Personal Observation

The survey was conducted in three days in different neighborhoods in the county checking out for various health indicators. The areas covered were Jamaica, Corona Heights, Richmond Hill, Flushing, Astoria, and Bellerose. In two of the days, the survey was done by driving around the County to cover many areas comprehensively and the last day through public transport to have obtain first-hand experience. This was combined with personal observation which involved parking the car at strategic places and assessing the population.

The community has diverse architectural designs in the houses present. This can be attributed to the diverse cultures residing in the County. Interestingly, many of these houses seem to have been built around 10-25 years ago especially in the estates. The houses are congested, and others are even attached. Some have backyards, or parking spaces. This can be attributed to the high population in such a small area.

Deep in the low end-suburbs the situation was different, there were many apartments. There were many posters advertising houses with cheap renting costs. The posters were in different languages with the majority being English Spanish, and Chinese. A visit was made to one of the houses to obtain a clearer picture of the situation at hand. It was poorly constructed and was divided into small rooms like a dormitory. The lighting and ventilation were poor, and all residents shared a bathroom and a toilet.

7 parks were identified in Queens during the survey. However, many of them were located a bit far from the residential places. Many of them were spacious and very green such as Flashing Meadows Corona Park, and Forest Park. The parks had fewer people which may be attributed to the current pandemic. A quick observation on the walking behavior of many residents in Jamaica’s public streets indicated urgency and precaution No criminal activity was noted, however, there was a sense of insecurity and fright which indicated gaps in the security.

Around 20 clinics were observed during the survey. 12 of them are in high end areas of the County. 14 community clinics were also observed. The community clinics seemed to have an influx of patients than the private ones. There are also several hospitals in the community. In Jamaica, 2 hospitals were identified, Jamaica Hospital Medical Centre and Queens Hospital Centre. Other hospitals identified were Flushing Hospital Medical Centre and New York Presbyterian in Flushing, Elmhurst Hospital Center in Elmhurst, Mount Sinai Queens in Astoria, and ST. Mary’s Children Hospital in Bayside. From the survey, the County has a good number of health facilities. However, quality of services offered was determined through feedback from a focus group.

Focus groups

Data from the community was also collected by organizing a focus group. The focus group had 10 members. Recruitment of members was done with the assistance of various contact people within the county (friends, colleagues, and relatives). The group members were diverse in terms of economic status, geographical location, ethnic background, gender, citizenship status, and age. All members were of the group were above 18 years. There was representation of different ages (0-5 years, 6-18 years, 19-64 years, and over 65 years). Ages 0-5 years, and 6-18 years were represented by parents with children at those levels. Each participated signed a consent form and a Non-Disclosure Agreement on everything shared within the group setting. The discussion took place in a park for a duration of 3 hours.Community Health Nursing HW 2

APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.