While completing my windshield survey I had many revelations about the community I have lived near all my life. They will be discussed along with three aspects of community life that could affect health, each with two nursing interventions that would produce a positive effect on the health indicator. It will list community health partnerships, while identifying cultural diversity and its role in community health. All my life I have lived near the city of Watertown population thirty thousand. The economy has been affected for the worse along with many job losses locally over the last twenty years. My impression of the area has always been that is consisted of mostly middle- income to upper- income standard of living with minimal low income. After completing the windshield survey “the equivalent of a community head to toe assessment.” (Stanhope, & Lancaster, 2012, p. 420) then re-driving the same route again was a real eye opener. The whole city is so complex the idea of boundaries that aren’t fences was foreign to me at first but is now so obvious.
Looking closely at the homes and the condition the houses, yards, sidewalks were in gives an idea of the prosperity of the people living there. It can be easy to drive through residential areas occasionally and not really see the condition the community is in. It takes a trained eye to readily identify concerns. The area has a large military base within twenty miles so there is a diverse ethnic population with a large portion being young single males. The first nursing diagnosis of alcohol and drug use is concerning for many areas of the population. From the solider home on leave many with PTSD, to the many other people in the community that abuse alcohol and drugs. The two interventions would be rehabilitating the individual and counseling to prevent backslide condition by providing the person with effective coping skills. The military community has a large Post Traumatic Stress Rehabilitation center on base for the soldiers to seek care. The local community has Credo Foundation that has in patient care for those in need of rehabilitation services, and outpatient counseling services to help improve behaviors and progress during the rehabilitation process.
Many other community services exist to provide support for the addicted person, such as in-patient mental health department at the local hospital. The second intervention would be to create community support for proper nutrition and health intervention related to increased health issues due to alcohol and drug abuse. This could be provided through public health screening clinics, health fair information, Red Cross soup kitchens. The second health concern would be the high rate of teen pregnancy. A diagnosis could be anxiety related to lack of income and medical care during pregnancy due to lack of education and family support. The interventions would be to seek assistance from the community WIC, PCAP and social service office for immediate financial assistance so medical care would not be delayed. The second would be to provide community support and education, parenting classes, etc., to the vulnerable population on teen pregnancy while creating groups within the community to continue providing support for those in need. The third health concern is the level of illiteracy in the community much of it related to the high rate of teen pregnancy.
The first intervention would be decreasing the number of high school drop outs while increasing the levels of reading skills in school. This could be done by creating community support that will increase the availability of tutors, support groups, in school and the community, to assist childcare (BOCES provides in school day care) that will keep young parents in school. The second would be increasing the availability financial support so the teenage parents can afford to stay in school, community support and public agencies (Catholic Charities, Church food pantries) could provide the assistance that may be needed to complete the proper forms allowing for assistance. The culturally diverse populations in the community still face the same issues with alcohol and drug abuse, along with teenage pregnancy and illiteracy. Often this is due to language barriers and a poor understanding of the cultural norms for the specific population. Bilingual providers, and written information provided in native languages is the first step in improving communications and understanding of the populations diverse needs. Communications provided in the media via TV, radio, internet and written word is a routine process.
The role of the community is to promote public health to improve the health of each individual that will in turn improve the health of the whole community. The national partnership for action, is an “inclusive health and social system that treats people equitably and creates conditions in which all people can achieve optimal health reflects an educated society and a strong economy.” (Minority health, 2012) It is so important for the members of a community to have medical care available along with community support so all communities can thrive. A role of nurses in the Healthy people 2020 is to be a patient advocate and help bridge the communication gap between the medical community and the community’s population. Nurses can provide information on teen pregnancy in the school setting and the community setting through schools, clinics and local hospitals; also in home support through Cornell cooperative extension and public health. These processes should always recognize the cultural diversity of the local community.
Stanhope, M. & Lancaster, J., (2012). Public health nursing: Population-centered health care in the community (8th ed,). St. Louis, MO: Mosby Elsevier