Section B: Summary of Findings from Needs-Assessment Tools
The demographic assessment was used to process available data concerning varying aspects of the Sentinel City population. Sentinel City is a relative city comprising four district neighborhoods. The districts include Industrial Heights, Acer Tech Center, Casper Park District, and Nightingale Square (American Sentinel University, 2020). As of 2020, Sentinel’s population was estimated at 663,862. This was an increase from 600,024 to 663 862 two years ago, which represents a 9.6% population growth rate. In terms of the four districts, Casper Park District is the most populous 352,643. The leading ethnicity is white 63%, followed by Latino or Hispanic 24%. Acer Tech Center is the second populous district with a population of 168,390. Primary ethnicity is white 70.2%, while secondary ethnicity is Hispanic or Latino 13.7%. The third populous district is Nightingale Square, with a population of 103,974. A majority of the residents are from White ethnicity 81.3% and Hispanic or Latino 3.7%. Industrial Heights is the least populated district with a total of 38,855 residents. Unlike the other three communities, Industrial Heights’ primary ethnicity is Hispanic or Latino, 46.8%, while secondary ethnicity is Africa American (Black) 13.1% (American Sentinel University, 2020).
Most (39.6%) of Sentinel City residents are under the 18-64 age bracket. Individuals under 18 years are the second largest group (21.7%) of the Sentinel population, followed by persons aged 65 years and older (10.5%), and then children below five years (7.4%). In 2020, a majority (80.6%) of the population were White, followed at a distance by Black or African American at 10.4%. Asians, American Indians, and Alaska Native, and Native Hawaiian, and Other Pacific Islander are the minority groups representing 3.7%, 2.0, and 02%, respectively. Nonetheless, 3.1% of the residents identified as two or more races. Genders are almost nearly even. The female population at Sentinel City is estimated at 49.9%, while that of the male at 51.1% (American Sentinel University, 2020). Gender distribution in Sentinel is almost consistent with the rest of America. In some states, the gender ratio favored men in 2018 (Statista Research Department, 2021).
The primary language in Sentinel City is English. Foreign-born residents represent 16.1% of the entire population. About 85.1% of the residents are high school graduates or higher, while 42.2% of the residents have bachelor’s degrees or higher and are aged 25 years and above. There has been a slight increase in the average income per household in the past few years. The annual per capita income is estimated at $32,597, and the average household income is reported at $49,091. About 18.9% of the residents live below the poverty level. In 2020, private nonfarm establishments stood at 21,961 and private nonfarm employment at 373,970, which increased by 1.5% compared to 2019. There are a total of 55,830 non-employer establishments, and in total, there are 67,500 firms. These firms’ ownership is as follows: black community 10%, Asian 7%, Hispanic 12%, and Native Hawaiian and Pacific Islander 0.2%. Women own 35.8% and Men 64.2% of the firms in Sentinel City. In addition, veterans make up 14,157 (2.1%) of the city’s residents (American Sentinel University, 2020).
Neighborhood /Community Safety Inventory
I used the neighborhood/community inventory to provide an overview of Sentinel City’s safety. The crime rate has significantly reduced in the Acer Tech Center neighborhood of Sentinel City. In particular, fewer men are involved in violent-related crimes. The opposite is witnessed in Nightingale Square, where there are elevated issues associated with violent crime and public intoxications. In addition, while walking through Sentinel City’s four neighborhoods, both on foot and public transport systems, there were various forms of health safety concerns. First, it was observed there are increased cases of violations linked with cleaning and washing. There were also violations related to food storage. This exposes residents of Sentinel City to possible food supplies contamination, especially in Nightingale Square. Secondly, the rate of homelessness at Sentinel City is worrying (Healthcare Learning Innovations, 2021).
The number of homeless in the city is 5,775 (Acer Tech Center 199, Casper Park District 1,593, Industrial Heights 3,917, and Nightingale Square 66). It was observed crowds of homeless residents near bus stops, and business entrances caused fear of potential robbery with violence or assault. Moreover, the level of increased public intoxications witnessed in Nightingale Square might cause a high rate of violent crimes committed in this particular neighborhood. Issues with trespassing were also observed, which also raises safety concerns among the residents of Sentinel City. Additionally, factory smoke, pestes, and noise are some complaints raised by the residence. I observed that both factory smoke or air pollution and noise pollution threaten residents’ health safety (Healthcare Learning Innovations, 2021).
The windshield survey was utilized to offer a summary of Sentinel City regarding the physical and environmental areas. Sentinel City is a standard urban city comprising four central neighborhoods, including Casper Park District, Acer Tech Center, Nightingale Square, and Industrial Heights. However, I observed that no physical boundaries or signs are identifying the four neighborhoods. There are 288,188 housing units, and the homeownership rate stands at 50.4%. Approximately 76.8% of the Sentinel’s population lives in the same house for one year and over. A majority of the homes across Sentinel City are multi-level, old brick/concrete buildings. Under Sentinel City Affordable House Project, new apartments are being built. I observed that most of the residents live in one-bedroom apartments, commonly referred to as studios (Healthcare Learning Innovations, 2021).
I observed ABC daycare at Casper Park. Other for-profit daycares were mainly spread throughout Casper Park and Acer Tech Center neighborhoods, while publicly financed ones are partially distributed across the four districts of Sentinel City. In addition, there is a public transport system, which is under the Sentinel City Department of Transportation. I observed that women from Black, Asian, and Latino communities are the primary public transport users. I observed that bus stations are closely located to all main buildings as well as intersections, and all appeared to be in good shape since most of the city’s transport budget goes to resurfacing and reconstructions of roads (Healthcare Learning Innovations, 2021).
I further saw a local radio station going by the name Radio Buzz at Acer Tech Center. The majority of the audience are residents aged 45 and above, while most announcements are related to health and politics. I only saw one church, Interfaith Church, and one school in Industrial heights throughout my walk (Healthcare Learning Innovations, 2021). I also observed a soup kitchen, primarily services homes residents of Sentinel City throughout July, August, and September. I further observed a grocery (Joe’s Grocery) in Nightingale Square. I noted that residents have considerably embraced organic food consumption, which is higher than in average America’s population. Moreover, I observed one health clinic (Better Health Clinic) and one supermarket situated in Industrial Heights.
Population Scavenger Hunt
Population Scavenger Hunt was employed to help identify primary resources available within Sentinel City. Main resources are distributed across Sentinel City. First, I observed that affordable housing offers approximately 30% of the shelter residents since 18.9% of persons in Sentinel City live below the poverty level. Another significant resource in this city is parks and recreation services. I observed that Nightingale’s parks and recreation department provide various services, including swimming, health-related cooking sessions, and gardening lessons. The department further offers adult fitness programs, and sports facilities, and after-school programs. Nevertheless, the department faces a significant challenge due to trespassing among homeless citizens. As a result, the department receives a considerably high number of complaints.
There is one soup kitchen located at Industrial Heights, which primarily serves homeless persons in the city. The Interfaith Church welcomes the homeless for free meals (Healthcare Learning Innovations, 2021). The kitchen also offers meals to residents in need, especially those from low-income households. About 5% of care services are done through charity. Furthermore, Sentinel City Healthcare System offers services to the residents. Services provided focus on ensuring that the community is healthy and that all residents access quality and affordable care. Notably, Sentinel City Healthcare System offers subsidized care services for those from low-income households. As a result, there has been a significant increase in preventive dentistry. Another crucial resource for Sentinel City residents is social services offered at City hall. Primarily, I observed that the City hall provides residents with healthcare assistance. For instance, through social services, up to 200,000 residents are enrolled on Medicaid. This guarantees the health of citizens from low-income households. Other Sentinel City resources include supplemental nutrition assistance, where communities in Casper Park and Industrial Heights are the primary beneficiaries (Healthcare Learning Innovations, 2021).
B1: Analysis of Collected Data
Through assessment of Sentinel City utilizing the above tools, there are changes as well as improvements needed. However, based on the provided information, health concerns vary slightly based on different factors. One essential piece of data gathered in Sentinel City is that syphilis, HIV, and Gonorrhea are the primary sexually transmitted diseases (STDs) among adults 25 years and older (Healthcare Learning Innovations, 2021). The spread of STDs among adults is as follows: HIV 3%, Gonorrhea 30%, and syphilis 24%. STDs at Sentinel City are primarily attributed to lack of timely healthcare access, sexuality and secrecy, and substance abuse. More importantly, lack of access to quality healthcare hinders early detection and treatment of STDs among Sentinel City residents, contributing to the further spread of these diseases. Similarly, the Center for Disease Control and Prevention (CDC) highlighted syphilis, HIV, and Gonorrhea as the leading forms of STDs and attributed the increase to risk behaviors, such as substance abuse (CDC, 2021).
Accidents and injuries are the primary causes of emergency room (ER) visits in the city (Healthcare Learning Innovations, 2021). I observed that accidents and injuries were widespread throughout the four districts of Sentinel City. The main contributing factors of accidents and related injuries are the lack of designated pedestrian walkways in some streets and intoxicated driving. Accidents and injuries significantly contribute to the overall disability rate, which currently stands at 6.7% Acer Tech Centre, 6.8% Casper Park District, 12% industrial heights, and 3.5% Nightingale Square. In 2020, a total of 65 people were killed in road accidents, representing a crude death rate of 10.2.
The obtained information indicates that alcohol, tobacco, and prescription drug abuse are the primary addiction issues in Sentinel City (Healthcare Learning Innovations, 2021). Smoking is also a significant health concern among Native Americans, non-Hispanic, and multi-racial groups. The most worrying data was smoking during pregnancy (402), increasing the risk of preterm birth, congenital disabilities, and low birth weight. Similarly, CDC (2020) indicated that smoking during pregnancy tends to increase the risk of health issues, such as preterm birth, defects, and low birth weight. Another primary health concern in Sentinel City is cardiovascular diseases. In 2020, 1238 deaths were linked with cardiovascular diseases, representing a crude death rate of 195.1. Despite the residents consuming more organic products, I observed their diet intake includes foods with high cholesterol, resulting in obesity and overweight. Another significant risk in Sentinel is smoking and the use of other forms of tobacco. This increases the risk of complications related to cardiovascular diseases.
C1: Top three Health Concerns in Sentinel City
The three main health concerns within Sentinel City based on Healthy People Goals are STDs, substance abuse (tobacco, prescription drugs, and alcohol), and accidents and injuries (Healthcare Learning Innovations, 2021). The three health concerns are prevalent throughout the four neighborhoods. Besides, these health issues affect all ethnicities in the city.
The prevalence of sexually transmitted diseases (HIV, Gonorrhea, and syphilis) among adults aged 25 years and older in Sentinel City is worrying. In spite of their associated cost burdens, complications, and being largely preventable, STDs remain a considerable public health problem in Sentinel City. The issues seem unrecognized mainly by healthcare professionals and the public. The Healthy People 2020 goal aligns with this health concern experienced in Sentinel. Healthy People 2002 goal involves promoting healthy and safe sexual behaviors and strengthening society’s capacity. The other goal is to enhance access to quality services to prevent STDs as well as their accompanying complications (HealthyPeople.gov, 2014).
Healthy People 2020 goal concerning accidents and injuries is to reduce emergency department or room visits for nonfatal injuries. Another Healthy People 2020 goal concerning this particular public health concern is to minimize the rate of fatal injuries, targeting 10% improvement. The third goal is to reduce hospitalization due to nonfatal injuries. The final goal of Healthy People 2020 in relation to accidents and injuries, as public health issues, is to mitigate nonfatal and fatal spinal cord and traumatic brain injuries (HealthyPeople.gov, 2020). Accidents and injuries remain a significant concern in Sentinel City. The accidents and injuries are spread out in the four districts. Most of these accidents result in fatal injuries, further contributing to the worrying trend of disability incidences in Sentinel City. This necessitates the city administration to align their prevention measures with Healthy People 2020 goal to address this issue.
The ultimate goal of Healthy People 2020 in regard to substance abuse is to reduce substance abuse to safeguard health, ensure safety and quality of life for all persons, particularly children (HealthyPeople.gov, 2020b). Sentinel City continues to struggle with drug, alcohol, and tobacco problem. Substance abuse in Sentinel City has a profound effect on persons, families, and the community at large. One notable effect of the substance abuse problem is its contribution to the already existing health concerns related to STDs. Moreover, substance abuse issues contribute to increased motor vehicle accidents and related injuries in Sentinel City. Thus, Sentinel City needs to adopt some of the Healthy People 2020 prevention resources.
C2: Available Community Resources
The primary health concern across Sentinel City, in my opinion, is increased substance abuse, leading to high rates of the addiction problem. Notably, more residents of the Acer Tech Center district are abusing alcohol and tobacco. Besides, there are increased cases of prescription drug abuse among the residents. According to HealthyPeople.gov (2020b), it is essential to work on prevention efforts to reduce substance abuse and related public health concerns, such as motor vehicle crashes and STDs. There are various community resources available at Sentinel City that could be used to address substance abuse. One of the critical community resources available is Sentinel City Healthcare System. The other community resource is social health services offered through charity programs, especially in Acer Tech Center. The Sentinel City Healthcare System provides vital health services to the community. This presents increased opportunities for residents struggling with addictions due to substance abuse with access to and coverage of the needed treatment and prevention services.
Social health services primarily offered through charity programs in Acer Tech Center represent a crucial community resource in efforts to address the drug abuse menace at Sentinel City. Through these programs, residents battling addictions can access need care and support throughout their recovery journey. The parks and recreations also represent an essential community resource in response to the substance abuse issue in Sentinel City. The parks and recreation provide numerous programs for adolescents and adults, including sports, swimming lessons, fitness, and summer events. In return, this gets the residents engaged, reducing idle time, which might worsen the issue of drug abuse in the four districts of Sentinel City. Additionally, social services offered at parks and recreation facilities effectively prevent exposure to alcohol, drugs, and tobacco, which is likely to reduce the number of residents involved in drug abuse.
C3: Primary Prevention Topic
Based on the health concern discussed in the previous section, the primary prevention topic of interest would be substance abuse prevention. Sentinel City ought to offer evidence-based substance abuse prevention interventions. The new interventions could involve the family and community to enhance the overall success of the fight against substance abuse among the residents of Sentinel City.
Section D: Lessons from Assessment Strategies
Applying demographics assessment, neighborhood/community safety inventory, windshield survey, and population health scavenger hunt as assessment strategies in a simulation community offered me an opportunity to learn more about effectively identifying public health concerns at a community level. For instance, I realized that identifying health concerns require a multi-level approach to ensure that all relevant data is obtaining regarding prevalence, individuals mainly affected, and available resources to address the issues. Moreover, I learned that the four assessments tools effectively provide comprehensive and unbiased data needed to identify a health issue and possible contributing factors. I also learned that applying these assessment strategies facilitates the identification of resources available and which ones might be missing to address the health concern of interest. Lastly, I realized that once relevant data is obtained, it is possible to identify some of the weaker areas within the society that should be prioritized using available resources. In return, this would help address health concerns affecting individuals and communities within the given area.
American Sentinel University. (2020). Community health simulation demographics. Health Learning Innovations, 1-6.
Center for Disease Control and Prevention. (2020). Substance use during pregnancy. https://www.cdc.gov/reproductivehealth/maternalinfanthealth/substance-abuse/substance-abuse-during-pregnancy.htm#:~:text=Smoking%20during%20pregnancy%20increases%20the,infant%20death%20syndrome%20(SIDS).
Center for Disease Control and Prevention. (2021). Sexually transmitted disease surveillance, 2019. https://www.cdc.gov/std/statistics/default.htm
HealthyPeople.gov. (2014). Sexually Transmitted Diseases. https://www.healthypeople.gov/2020/topics-objectives/topic/sexually-transmitted-diseases#three
HealthyPeople.gov. (2020a). Injury and violence prevention. https://www.healthypeople.gov/2020/topics-objectives/topic/injury-and-violence-prevention/objectives
HealthyPeople.gov. (2020b). Substance abuse. https://www.healthypeople.gov/2020/topics-objectives/topic/substance-abuse
Healthcare Learning Innovations (2021). Sentinel City. Photo Journal, 1-13.
Statista Research Department. (2021). Total population in the United States by gender from 2010 to 2025. https://www.statista.com/statistics/737923/us-population-by-gender/