Describe your role within the community?
My role is to provide nursing care to homebound patients
What are your responsibilities?
Responsibilities include skilled needs such as wound care, medication teaching, and disease process teaching as well as introducing different resources to patients so that they or their caregiver can manage their health needs.
How would you describe the community of Walnut Creek as far as people, their goals, values and interests and any barriers or challenges you meet in serving this area?
Walnut Creek is home to various retirement communities. These communities are meant to support the retirement life with social activities as well as provide resources for an aging community. Barriers include chronic diseases along with an older population who has depleted much of the finances while taking care of chronic disease. Many are unable to afford care givers and often family is not available in the retirement communities.
Describe your idea of what a healthy community is.
A healthy community is one that practices prevention and inspires its members to take an active role to maintain their own health.
Do you agree that Walnut Creek meets the description of a health community? If it doesn’t why doesn’t it?
Walnut Creek meets the description of a health community because of the vast resources it offers.
What would you use to maintain a healthy community?
Community activities that include all age groups.
Are there any identifiable major health risk factors and causes of illness within Walnut Creek?
The major cause of illness if chronic disease. The major risk factors include poor diet/nutrition due to lack of income, lack of regular activity and low socioeconomic status of a percentage of the elderly population. Chronic diseases account for 78% of the deaths in Contra Costa County, not just Walnut Creek. Heart disease had declined but other chronic diseases are increasing and present a health concern.
If yes, what are the recommendations or preventative measures that could be used to fix these issues?
Work within in the community and local government to support health behaviors through education. Increase the availability of preventative health care and screening for individuals with chronic diseases and provide more nutritious foods at food banks and through Meals on Wheels to name a few.
What are the health promotions available within the population of Walnut Creek and Contra Costa County?
Easy access to major hospitals, hospital run educational classes and activities, health fairs, and visiting doctors and nurses.
What is the predominate ethnic and cultural groups within this area?
23% of the population is foreign born of that 44% are from Latin America and 41% are from Asia.
Do their beliefs influence their health maintenance? If so how?
Yes, their cultural beliefs influence their health maintenance, for example there is a large percentage of our Latino population that use herbs and medications obtained from Mexico, along with their prescription medications. We do a lot of research of these medications, their interactions, and education on their compatibility with other medications.
What are the predominate health problems within the Walnut Creek area?
Chronic diseases such as diabetes, CHF, musculoskeletal diseases common with the aging process.
Are there prevention programs that address these health problems? If so what are they and are the programs sufficient?
Prevention programs begin at a much younger age that stress diet and exercise to prevent chronic disease. Programs are not sufficient in that lack of funds often make these programs vulnerable to cut backs.
What health resources are available in this area? Do you commonly make referrals to these resources? If not why not?
Rehabilitation centers, support groups, and pastoral care are available. Yes, we often make referrals to resources that allow the patient to maintain their health or improve it.
Are there indicators of nutritional deficiencies in this area? If so, what are they and how has community health been affected by these deficiencies?
There is evidence of nutritional deficiencies as much of the aging community is not actively involved in fresh food preparation. Many survive on cafeteria type foods which is generally high in sodium and cannot accommodate each person’s nutritional needs.
Has there been any impact on the community’s health with the increase in air pollution in the area over the past year? If so, what has the impact been, i.e. increased hospital admissions due to asthma or pneumonia?
Yes, COPD and asthma are on the rise. Even though California has strict air pollution regulations Contra Costa County (Walnut Creek) has five times the number of facilities that emit air pollutants per square mile than other cities in the area. There have been not only increased hospital admission but also re-admissions.
There are several oil refineries within this community. Is there an emergency notification system if there is a hazardous situation? If so what is it?
There are automated text messages and phone notifications, as well as triage levels, set up within the retirement communities. There is also an alarm system throughout the county that is implemented when a hazardous situation arises, instructing people to shelter in place.
Would you consider the individuals within the Walnut Creek area to be physically fit? If so, what activity do you see them participating in?
Compared to the national average, yes. Many outdoor activities are encouraged and available.
Any programs within the school system that promote physical fitness not only during school hours but also after school? Have these programs been effective in decreasing the obesity rate amongst children?
Yes, there are intramural sports and after school programs that provide physical activity. Even with activity options the obesity rate amongst children in the county rose 3.5% over the past 2 years. We feel it is due to the all the available fast food facilities in the lower income areas. There are several new programs in the area including NEW (Nutrition, Education and Wellness) that not only focuses education on the child but also the family.
As individual’s age within the community, are there programs to assist with maintaining fitness and decreasing home falls? If so, what are they and have they been effective?
There are exercise programs designed for the aging population. Retirement communities have many on premises. Their effectiveness is questionable. We continue to see a large percentage of individuals who experience falls due to gait instability and weakness.
What is the most common injuries in your senior population?
Fractures are most common, as a result of falls.
Within the Walnut Creek community, do you find that individuals appear to be focused more on work than on leisure activities and rest? If so why do you think this is?
The retirement communities are focused on leisure activities and rest. Younger communities are focused on work due to the high cost of living in the Walnut Creek community.
Would you describe Walnut Creek as a fast pace community? If so, have you seen an increase in individual consumption of coffee, nicotine and drugs to keep going?
Retirement communities are not considered fast paced and generally lean towards decreasing consumption of coffee and nicotine. Prescription drugs are common within this community but not illicit drugs. In areas other than the retirement communities, there continues to be a high percentage of individuals who smoke, men more so than woman and teens. It is uncertain if that is based on a fast paced lifestyle.
Are there a high percentage of shift workers in the area due to the type of employment that is available?
The major employers in the area are Chevron, Shell, Conoco Phillips and local hospitals. Shift work is very common.
What percentage of the population in the community is non-English speaking?
Approximately 12% are non-English speaking.
What is the predominate language spoken, if it is not English?
The predominant language is English. The next most prevalent language is Spanish, and accounts for approximately nine percent of the population.
How are communication barriers managed by the community health providers?
Translation services are provided through qualified interpreters and inclusion of family and friends provide an additional effective resource.
Within the community are there programs to assist those that are disabled whether it is cognitive or physical? If so, what are the programs and what is your involvement?
There are programs within the community to assist the disabled including the Developmentally Disabilities Council which provides information about community resources to families and advocates for the disabled. Regional centers provide care, housing, schools for the developmentally disabled. We also have many day programs for our fragile seniors and also those that are cognitively impaired. For our brain injured population we have outpatient cognitive skills training programs. There are also transportation programs available when needed. My involvement is to make referrals to these programs when there is a need.
How would you describe the people who reside within the community? Are they friendly, accepting of diversity and open to supporting the community either financially or by volunteering?
The aging population is friendly, but less accepting of diversity than the younger community. Volunteerism is encouraged to keep the community involved within the senior communities. Walnut Creek and other affluent areas do provide financial support for many of the programs.
Within the community of Walnut Creek, what would be considered the vulnerable population?
The elderly are the most vulnerable.
What makes them vulnerable and has this vulnerability impacted their health?
Lack of activity due to musculoskeletal pain is a major factor in making the elderly so vulnerable. This leads to increased muscle weakness, mobility limitations and more falls. Pain management is also an issue and can lead to increased narcotic consumption and an increased chance of overdose.
What percentage of the population within the community has health insurance and what percentage is uninsured?
Across Contra Costa County (CCC) one in three residents with incomes under 133% of FPL is uninsured. 20% of the population with income 133-300% of FPL were uninsured and 5% of the population with incomes over 300% of FPL were uninsured. As the community is relatively affluent, the overall percentage of uninsured is approximately 8%.
Are there programs within the community to assist individuals with obtaining health insurance (Medicaid) that can provide free or reduced rate health care? If so, what are these programs and are they easily accessible?
Coverage will change with the implementation of the Affordable Care Act in CCC. 154,000 individuals in CCC who are uninsured will be able to obtain Medicaid or private insurance. There are many facilities that can assist the individual with the application process, including community clinics and local emergency rooms. Until an individual or families insurance is in place, free medical care is provided by La Clinica La Raza for both the documented and undocumented. Low cost or free medical care is provided at county clinics for the documented only. These programs are easily accessible but the waiting time is long.
Are there issues with harassment and discrimination within the community? If so, how have they been dealt with?
I am sure there is harassment but it’s not visible. In this area there has been long term discriminatory practices in housing, health care and employment. Most discrimination is of racial or ethnic origins. There are several programs in the area of health care, including The Life Course Initiative which is designed to decrease the disparities in birth outcomes. The Homeless Program through CCC Health Services is also designed to assist with moving the homeless into supportive housing and link individuals to services to improve their health.
Are there issues with gangs, delinquency and violence within this community? If so, how is the community handling these issues? Are there programs available for victims of violence, domestic abuse, and crisis hot lines?
In the Walnut Creek area, gangs and gang violence are virtually unknown. You can still walk alone outside at night but you need to be cautious. In other parts of the county including Richmond, Bay Point and Pittsburgh gang violence is ever present and increasing. Delinquency crime has decreased in CCC mainly due to marijuana penalties being less harsh. The highest incidence of juvenile crime involves individuals with mental health issues. This is an area that continues to need increased advocacy. There are many programs available including STAND which provides a crisis hot line, housing and protection for individuals experiencing interpersonal violence. Mental Health and Probation Services are able to provide inpatient residential treatment, as well as individual and group therapy for adolescents.
Have these issues had an effect on the community as a whole? Has that effect been positive or negative?
These issues have definitely affected all areas of CCC but to different degrees. The more affluent areas are removed and somewhat unaware of what occurs outside their locked community’s. The middle income areas have become more observant, wary and cautious when they are out especially at night. The impoverished areas can be just as dangerous during the day as at night. Gunshot wounds are the major cause of death in young men in these areas.
Is there a high poverty rate within this community? What individual’s within the community experience the highest poverty rate? How has this affected the community?
Within the Walnut Creek area, poverty is not as visible as it is within other cities within CCC. But it is there and is seen mostly within the elderly population. With rising health care costs and increasing life expectancy, our seniors are becoming increasingly impoverished. In CCC, poverty is most visible amongst families with children especially single women with children. The community has come together to provide support for all impoverished persons, both financially and through volunteer programs.
Are there individuals within the community who have food insecurities? If so, what programs are available in the area and have you seen and increase or decrease in their usage?
Meals on Wheels and other meal delivery services are available within the community. Generally we’ve seen an increase in the use of the delivery services, but total dietary needs are not met due to the cost of the program.
Are there programs in the school system that meet the nutritional needs of the children within the community? If so, what are they and do you make referral to these programs?
School systems use some of the same type of meal services to provide nutritional meals. Most are private companies which can accept government subsidies. On occasion we need to set up patients with government subsidized services.
Do the meals within the school system meet the Federal standard as far as being health? Do the vending machines within schools in this area provide high sugar, high fat foods and drinks? If so, will that be changed to meet the Federal standard?
The meals meet the Federal Standard, but what the child consumes is not monitored. Vending machines are trending toward healthier choices.
Are the schools within the Walnut Creek are considered safe from bullying, drugs and alcohol consumption? If so, how is safely provided, i.e. on site law enforcement, locked campuses, preventative education.
The schools are considered among the safest in the state, still have their fair share of bullying, drugs and alcohol consumption. Preventative education programs exist and a no tolerance policy is enforced in all schools.
Is there any evidence of waste disposal or pest control issues? If so, what is your involvement in these types of situations as far as teaching, prevention, and/or reporting?
Within the Walnut Creek area, rarely is there an issue with waste disposal or pest control. In other communities within CCC there can be issues garbage accumulation, and overgrowth of vegetation, which can increase the breeding of pests. With increased foreclosure of homes in this area and with most of them having pools, the issues with stagnant water have increased. If I become involved in this type of situation, I forward the information to the public health department. I also provide education for individuals and families on the health dangers of living in this type of situation and prevention techniques.
Is the use of drugs and alcohol increasing or decreasing within the community? What has affected the change?
Binge drinking is being seen more amongst young persons within CCC. We are seeing older individuals who have been abusing alcohol for quite some time and have now developed long term health complications. We are also seeing more issues with alcohol and prescription medications especially narcotics within our senior communities. Home medication reconciliation has become one of our most important functions. Marijuana and methamphetamines are the most commonly abused with prescription drugs being the third most common. Baby boomers who are being seen in the local emergency departments with altered mental status are commonly showing positive lab results for marijuana and methamphetamine. Change has come in many directions but mostly we are seeing an increase in available detox programs for all individuals within the community.
How does the community deal with mental health issues? Are there resources available within the community to assist individuals, family, and partners with these issues?
Like most communities, persons with mental health issues continue to be stigmatized but attitudes are slowly changing. There continues to be those who live on the streets and don’t want any treatment. But for those that desire treatment, there are many programs within the county including Bridges to Home which offers wrap around services to those with mental illness.
Is sex education provided with the school system? If so, what is your role?
In California, sex education in the schools is not a requirement but most schools do provide some type of education. Schools are required to provide education on HIV/AIDS. I don’t have a role in this type of education.
Are there program and organizations available to provide education for individuals within the community on pregnancy, abortions, STD’s, contraception and AIDS? Are these programs easily accessible?
There are many programs within CCC available to provide education on these topics including Planned Parenthood, Draw the Line and Respect the Line for teens, Rainbow Community Center, CC Health STD Clinics and Counseling, Partner Counseling and Referral Services. All of these programs are easily accessible.
Are there programs within the community that can provide pre-post natal care, infant nutritional supplies, and breastfeeding instruction regardless of an individual’s financial status?
Yes. There are many programs available. For example, The Black Infant Health Project helps women gain access to pre-natal care and provides the infant with follow up care through their second year of life. The Pre-Natal Care and Guidance Program assists women in obtaining pre-natal care to promote healthy babies. Women Infant and Children (WIC), which provides nutritious food, breast feeding support and referral to other programs when needed.
Above is the interview derived from the community we are working on if that will help with my project
My portion of the slide are:
Slide 9:Common goals and interests( of people living in Contra Costa county)
Slide 10: Barriers and challenges (of people living in Contra Costa county)
Please see more instruction for the above order:
This is a CLC assignment. The instructor will assign you to a CLC group.
This assignment consists of both an interview and a PowerPoint (PPT) presentation.
Select a community of interest. It is important that the community selected be one in which a CLC group member currently resides. Students residing in the chosen community should be assigned to perform the physical assessment of the community.
Perform a direct assessment of a community of interest using the “Functional Health Patterns Community Assessment Guide.”
Interview a community health and public health provider regarding that person’s role and experiences within the community.
Interviews can take place in-person, by phone, or by Skype. Complete the “Provider Interview Acknowledgement Form” and submit with the group presentation.
Develop one set of interview questions to gather information about the role of the provider in the community and the health issues faced by the chosen community.
Compile key findings from the interview, including the interview questions used, and submit with the group presentation.
Within your group, create a PowerPoint presentation of 15-20 slides (slide count does not include title and reference slide) describing the chosen community interest.
Include the following in your presentation:
Description of community and community boundaries: the people and the geographic, geopolitical, financial, ethnic, and phenomenological features of the community as well as types of social interactions, common goals and interests, barriers, and challenges.
Summary of community assessment.
Summary of interview with community health/public health provider.
A conclusion summarizing your key findings and a discussion of your impressions of the general health of the community.
While APA format is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.
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