Community Health Nursing Assessment

Introduction
In an effort to promote the health needs within a community, a successful community health nurse (CHN) must focus on the entire population. In order to accomplish this task, the CHN utilizes a scientific approach to determine the priority population focused health needs for the community. According to Nies & McEwen (2011), a population focus involving an assessment of the community is a primary tool utilized in order to develop planning, interventions, and evaluations for the community at large. The purpose of this paper is to determine a priority health problem of a specific community based on demographic data, epidemiological data, and a windshield survey of the community. Rockport is a Texas Gulf Coast community located on the Live Oak Peninsula between Copano and Aransas Bay on State Highway 35. Named for the rock ledge that lies underneath the coastal shore, Rockport was founded after the Civil War as a cattle slaughtering, packing, and shipping port. This industry continued until the late 1800s when boatbuilding and fishing began to develop into important industries. After the railroad came to Rockport, tourism and the resort business began to thrive. After the turn of the century, a major hurricane almost destroyed the entire community.
Recovery from this devastating natural disaster was slow but by the late 1920s, the community once again began to thrive. At that time, shrimping became a major industry within the community. Throughout the next four decades, the community continued to grow with the main sources of commerce remaining in the areas of fishing, shrimping, and tourism. Today Rockport is a favorite vacation spot known as the Texas Riviera. Major sources of commercial life today in Rockport are the restaurant and motel industries. Demographic and Epidemiological Data.

The estimated population of Rockport is 8,846 compared to 25,674,681 for the state of Texas. The age breakdown for the population is 5% under the age of 5, 17. 9% under the age of 18, 28. 3% over the age of 65 and 51. 7% female. The state of Texas is 7. 7% under the age of 5, 27. 3% under the age of 18, 10. 3% over the age of 65 and 50. 4% female. Caucasian is the largest ethnic group in Rockport at 88. 7%, African-American at 1. 5%, American Indians at 0. 7%, Asian at 2. 4%, Native Hawaiian at 0. 1%, and Hipics at 20. 8%. The state of Texas lists Caucasians at 70. %, African-Americans at 11. 8%, American Indians at 0. 7%, Native Hawaiian at 0. 1%, and Hipics at 45. 3%. Currently, 14. 7% of the population over the age of five in Rockport does not speak English in the home setting, 87% of the population over the age of 25 is a high school graduate, and 32. 3% over the age of 25 has a bachelor’s degree. In comparison, the state of Texas lists 34. 2% over the age of five that do not speak English in the home, 80% over the age of 25 with a high school diploma, and 25. 8% over the age of 25 with a bachelor’s degree.
Per capita income in Rockport is $30,513 compared to $24,870 for the state of Texas. The median income per household is $44,487 and the state of Texas is $49,646. Individuals living below the poverty level in Rockport are 17. 6% of the population compared to 16. 89% for the state of Texas. Current infant mortality in Rockport is 4. 2 per 1000 live births compared to six per 1000 live births for the state of Texas. Adult obesity is 26. 6% of the population in Rockport and 10. 7% of the population is diabetic. Childhood obesity is 23. 3% of the Rockport population compared to 32. % in the state of Texas. In 2002, Aransas County was listed as one of the top 10 dirtiest counties in Texas due to air pollution from a local chemical plant. Windshield Survey Within the community, a large number of individuals are visible. Many are entering convenience stores and some are standing in the parking lot areas talking. A variety of ages is noted and the two major ethnic groups in the community, Caucasian and Hipic, are the two that are the most visible. Many of the individuals are overweight or obese. Some are well dressed while others are disheveled in appearance.
Pregnant women are visible as well as women with small children. The general condition of the homes in Rockport is diverse. Many of the homes are multi-million dollar structures while others are dilapidated and in need of serious repair. People seen in the downtown area are walking but away from that area, most people are traveling in cars. Some people are traveling on bicycles or golf carts in designated areas. Three areas of public housing are noted but there are no visible signs of public transportation. Numerous campaign signs are visible throughout the entire community. One adult daycare and two child day centers are noted during the survey. Two grade schools, one middle school, two private church schools, and one high school are seen during the survey. Many of the homes in the neighborhoods in the area are dirty and in need of repair. The yards are full of garbage and items such as old appliances, empty beer cans, and cars on blocks. Some of the roads are in need of repair and almost too narrow for two cars to traverse safely. Most of the business buildings have handicapped ramps leading up the sidewalks. Parking lots have handicapped parking and the doors have handicapped buttons.
One large park is noted during the survey but the park was sparsely populated during the survey. Very few children are visible during the survey. Numerous full-service restaurants as well as fast food facilities are seen throughout the community. Rockport has no hospital but there is one emergency care clinic. Two dialysis centers, one assisted living facility, and three long-term care centers are noted. Two physical therapy facilities are also seen during the survey as well as three dentist offices. While driving throughout the neighborhoods, very few children are seen outside playing. No neighborhood watch signs are visible in any of the neighborhoods. Numerous churches are seen throughout the entire community. No evidence of gang activity, drug abuse, or alcohol abuse is visible during the survey. One herbal shop is located in the downtown area. Next door to the herbal store, there is an advertisement for massage therapy sessions. Signs advertising health clinics, lectures, or health fairs are not visible during the survey. Problem Assessment data clearly defines obesity as a focus health area. The combined percentage totals for the adults and children within the Rockport community that suffer from obesity is 49. %. According to the Center for Disease Control and Prevention obesity is one of the most common and most expensive health problems facing the United States. One of the objectives of Healthy People 2020 is to improve nutritional status and promote weight loss. When individuals are overweight or obese, they are also at high risk for numerous other medical complications such as hypertension, Type II diabetes, cardiovascular disease, dyslipidemia, osteoporosis, and many more diseases.
Historical Significance
Before the 1900s being overweight was considered a hallmark symbol of wealth and health. The additional weight indicated that the individual had the financial resources to obtain a vast amount of food. Today, however, obesity is indicative of current and future medical problems. Prior to the many modern-day conveniences that most individuals use today, people toiled at intense labor to make a living. Meals were prepared from scratch and microwave meals were not available. In addition, food was expensive and difficult to acquire. Walking was common and until the late 1980s, obesity was not a problem in the United States.
Summary Obesity is a medical health problem that has become an increasing health care dilemma for minorities, low-income populations, and immigrants. These populations are vulnerable to these health care issues due to a variety of factors such as cultural diet choices, genetics, lack of funds to resource more nutritious foods, and lifestyle choices. Throughout the United States, obesity and diabetes are reaching epidemic levels. Individuals today live a more sedentary lifestyle. They eat more fast foods, fried food, and consume drinks high in sugar content. Children in the public school system consume meals high in carbohydrates and often engage in little or no physical activity. Lack of income reduces the consumption of fresh fruits and vegetables and parents often purchase cheaper luncheon meats such as hot dogs rather than the more expensive cuts of meat. When the fast-food giants introduced the supersizing concept to the world, thus began the supersizing of the population.
Reference

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Candib, L. (2007) Obesity and diabetes in vulnerable populations: Reflections on proximal and distal causes.
http://annfammed.org/content/5/6/547.ull Centers for Disease Control and Prevention (2012).
http://www.cdc.gov/obesity Kaiser Health News (2012) Texas.
http://www.statehealthfacts.org Nies, M. A., & McEwen, M. (2011).
http://www.city-data.com/county/Aransas-County-Tx.html Scorecard (2012).
http://scorecard.goodguide.com Shukalo, A. 2005).
http://tshaonline.org/handbook/online/articles/hgr05 U. S. Census Bureau (2012).
http://www.census.gov/U.S. Department of Health and Human Services (2012).
http://www.healthypeople.gov/2020/topicobjectives2020/overview.aspx? topicid=29 Wiley, S. (2012).
http://www.livestrong.com/article/359624-obesity-in-america.

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