C228 Sentinel City Community Health Needs Assessment

Sentinel City

Sentinel City Action Report PDF see PDF attachments (Sentinel City, d.).
Sentinel City Community Health Needs Assessment:

In this simulation city, I will be exploring and compiling data to understand better what the community provides and what needs improvement. This paper will explore the four induvial neighborhoods of Sentinel City in the demographics portion. And will include statistics including population, gender, age, income and community resources already in place. Next are the neighborhood and community safety inventory. This will include the induvial neighborhood breakdown of crime, gang violence, drug use, safety hazards and EMS and fire rescue response times. Lastly, The windshield survey will provide a physical description of what the community looks like.

Demographics Assessment

Population of Sentinel City 634,265
Age Percentage breakdown of the population of Sentinel City is 4% under five yrs, 21.7% under 18, 10.5% over 65 Yrs. (sees table below for neighborhood breakdown.)

	Age <5	Age 5-18	Age >65	Age 18-65	Total
Nightingale Square	2.4%	5.9%	13.9%	77.8%	103,974
Acer Tech Center	4.1%	7%	19.8%	69.1%	168,390
Casper Park District	10.9%	33.8%	6.5%	48.8%	352,643
Industrial Heights	10.9%	20.8%	0.9%	67.4%	38,885

Race Percentage breakdown of the population of Sentinel City 6% white, 31.5% Hispanic, 10.4% Black/African American, 3.7% Asian, 52.7% nonwhite Hispanic/Latino, and 2 or more races make up 3.1% of the population. (Sentinel City, n.d. C228 Sentinel City Community Health Needs Assessment).

Nightingale Square: Primary White 81.3% Secondary Hispanic 3.7%

Acer Tech Center: Primary White 70.2% Secondary Hispanic 13.7% Casper Park District: Primary White 63% Secondary Hispanic 24%

Industrial Heights: Primary Hispanic 46.8% Secondary Black/African American 13.1%

Median Household Income of Sentinel City 49,091

Percentage of Sentinel City residents living below the poverty level 18.9%.

According to City Hall of Sentinel City, 36% of SNAP recipients last year were low income, but the total number of SNAP recipients were not reported. The definition of low income as defined by Sentinel City was not disclosed. (If the city was not virtual the data would be found in a national data base.) If one could assume a person is uninsured due to finances not due to one of a multitude of other reasons and all are under 65 years of age, the rate is 25.6%. (Sentinel City, n.d.)

However, this is a big assumption; I could not find a clear total number of people living below the poverty level. According to US Department of Health & Human Services, The poverty line is based on the number of people living in a family. (Stanhope & Lancaster, 2014)

2017 POVERTY GUIDELINES FOR THE 48 CONTIGUOUSSTATES AND THE DISTRICT OF COLUMBIA
PERSONS IN FAMILY/HOUSEHOLD	POVERTY GUIDELINE
1	$12,060
2	$16,240
3	$20,4204
4	$24,600
5	$28,780
6	$32,960
7	$37,140
8	$41,320

For families/households with more than eight persons, add $4,180 for each additional person.

(U.S. Department of Health & Human Services, 2016)

The population of each of the four neighborhoods: Nightingale Square: 103,974

Acer Tech Center: 168,390

Casper Park District: 352,643 Industrial Heights: 38,855

Median Household Income of the four neighborhoods: Nightingale Square: 269,550

Acer Tech Center: 166,300 Casper Park District: 80,134 Industrial Heights: 24,672

Percentage of non-insured residents in each of the four neighborhoods: Nightingale Square: 7%

Acer Tech Center: 1.5% Casper Park District: 22.7% Industrial Heights: 37.5%

Neighborhood and community Safety Inventory

Describe any safety hazards seen (i.e. pollution, stray animals, buildings in disrepair, ):

There were several safety concerns noted in the different neighborhoods.

Across the street, from ABC Day Care (Casper Park District) there were multiple stray dogs and cats noted as well as rodents around piles of trash. A garbage can was on fire in the park indicating potential homeless activity. In the same neighborhood, there were multiple buildings noted that were rundown with boarded up windows and graffiti. The industrial heights neighborhood has a large plant secreting toxic waste that could potentially infect the water supply. There is also a tall chimney with smoke and pollutants going into the air. Nightingale square and Acer tech center appear to have less safety hazard concerns. These areas are cleaner and the buildings and landscape are well kept.

There are no stray animals or rodents seen and looks like a safer neighborhood to be in.

Summarize data related to drug use in the city:

According to City Hall and the police department arrest records for the past year, 23% of all arrests were related to cannabis use/possession and 16% for other controlled substances making a total drug use 49% of all arrests.

What are the EMS response times:

In the event of an emergency, EMS response time in Sentinel city is approximately seven and a half minutes. Fire rescue is just over 6 minutes and Advanced life support just over 8 minutes. Comparison city #1 response time is a little over 8 minutes. Comparison city #2 has a 12-minute EMS response time. And comparison city # 3 is a little over 5-minute response time. C228 Sentinel City Community Health Needs Assessment

What types of crime are occurring in the area:

According to city hall data, Cannabis use and or position is the single highest offense citizens are arrested for. Other crimes occurring in the area include; open warrants for a multitude of offenses such as failure to appear in court, assault and battery, possession of a controlled substance, criminal trespassing, reckless conduct, and public intoxication.

Is there gang violence? Describe:

It was noted that at ABC day care there was a hostage situation conducted by a gang of armed men.

According to the police department, most gang violence involves robbery, aggravated assault, simple assault, and homicide. Data suggests Aggravated gang violence has decreased in the last year.

Windshield survey

Driving through Sentinel City, my observations are that it is a large community with a population of 634,265 (Sentinel City, n.d). The housing is made up of mostly large apartment buildings constructed by brick and concrete. The lower income area is noted to have older run down buildings that have boarded up broken windows and graffiti. In comparison to the more affluent community that has newer and better-maintained buildings.

The city blocks are tightly packed together without much open space noted throughout the city. There is only one park that is not very well maintained. The city does have a community center that looks well maintained from the outside. A soup kitchen is located in Industrial Heights to help those in need. The Casper Park District holds the city park. It is not inviting, It is run down with overflowing trash cans, graffiti and bordered up buildings nearby. The City Hall is located in Acer Tech Center. It was noted when walking through this area there was a protest going on with a group of people.

Nightingale Square is the nicest area in the city. It is clean and well maintained. It feels safer when walking around with coffee shops, nice looking store fronts, and the

community recreational center.

Modes of transportation noted throughout the city is the city bus, personal cars, bicycles and walking. The bus line is very user-friendly with stops at every neighborhood and near every popular building. The bus runs frequently and appears to be well maintained and clean. The road ways are well maintained and traffic flow safely and without delay. Railway tracks were noted, although I did not see a train or station. For those with a private vehicle a large freeway was seen and a gas station located in Nightingale square. This area is more affluent, where more people may have a private vehicle.

Service Centers in Sentinel City throughout each four neighborhoods include the community recreational center located in Nightingale square. This center offers activities and educational programs to the people. It is on the bus route making it easily accessible to everyone. Industrial Heights has a park and school yard for children to play in. Nightingale Square has services for the community including Smile Dental, and Sentinel City Hospital. Casper Park district has ABC Day Care. Nightingale Square feels the safest and most clean. This neighborhood has many thriving businesses such as donut time, bean coffee, and Joe’s grocery. C228 Sentinel City Community Health Needs Assessment

The Senior living center is also located here. There is a large hospital seen in Acer Center and a farmer’s market where people are buying fresh produce.

People seen within Sentinel City are Police officers walking on the sidewalks.

Construction workers near developing and renovating buildings. Couples are holding hands are walking on the sidewalk. People sitting outside on benches, At Joe’s Grocery, there was a street performer juggling with people watching. In Nightingale square, there are people walking their

dogs.

Overall, Sentinel City has a lot to offer its community. Some areas like Nightingale

Square and Acer Tech Center that are more affluent and feel safer to walk through. The community and buildings are well kept. There are more Local business and restaurants, and there are more pedestrians seen walking in these neighborhoods. The lower income neighborhoods, Industrial Heights and Caper Park District neighborhoods are noted to be less maintained with boarded up buildings, graffiti, trash on the ground, and stray cats and dogs as well as rodents running around.

There is one nondenominational Interfaith church where the soup kitchen is also run out

The building has spray painted crosses on it.

The Hospital located in Acer Tech center offers services such as ED, inpatient, mental health, neuro, cardio, ortho, urology, and surgery. (Sentinel City, n,d.)

There are signs noted throughout the community promoting smoking cessation, immunizations, and safe driving. There is a billboard advertising not to text and drive. No political signs are noted other than the protestors outside city hall holding picket signs that read

“tax the rich”.

The radio station and newspaper stands provide communication for what’s going on in the city.

Population Health Scavenger Hunt

Parks and Recreation:

The Parks and Recreation Department offers a rec center that has a variety of programs i.e., swimming lessons, nutrition courses, gardening courses, kids summer programs, city sports leagues, adult fitness courses, and after school programs. An interesting incidental finding regarding the budget for Parks and Recreation has significantly decreased from 60% to 35% over the past four years. Although, the number of homeless that has moved in the park has significantly increased as well.

Healthcare System:

Elder Services provided by the healthcare system provides services including medical care advocating, government entitlement assistance, community center outreach, elder abuse prevention and advocating, meals on wheels, as well as assisting with and providing service animals. Only 8.3% of the more elderly population use medical care advocates, 7.6 % use government entitlement assistance, 2.9% use community centers, 1.3% use meals on wheels and 0.9% use elder abuse prevention advocates.

City Hall-Social Services:

City Hall, social services department, provides a great deal of assistance. Adoption assistance ranking # 1 which appears to be about 425 cases, followed by head start and early head start at just over 100 cases, Youth independent living services at 90 cases. Stay at home program coming in at about 30 cases, and Child care providers accepting subsidy benefits at about 40 cases.

Some of the programs that are provided through healthcare assistance include applying for Medicare, Medicaid, and charitable healthcare. They also assist with obtaining (WIC) a federally funded short term program that provides food, healthcare referrals and nutritional education for low-income women, infants, and children up to age 5. They also assist in obtaining (SNAP) which provides a monthly supplement for purchasing nutritious food to qualifying people such as the elderly, disabled, or anyone in a training program who meets the financial requirement of low income. C228 Sentinel City Community Health Needs Assessment

Community Health Center:

The Community Health Center, Better Health clinic provides a wide range of healthcare services from counseling, preventative services, and health screenings, to pregnancy testing/ counseling, achieving pregnancy, infertility services, STD services, breast cancer, and cervical cancer screenings

Soup Kitchen:

The interfaith church of Sentinel city provides a soup kitchen to those in need. It appears to have long lines throughout the entire day and evening. Indicating a great need for additional food programs. The main clientele utilizing the soup kitchen are homeless adults. Those utilizing the soup kitchen are 64% homeless adults, 12% are veterans, 7% disabled adults, 6% elderly, 3% are homeless children, and 6% are healthy adults. The church also offers food assistance, emergency food programs, USDA commodity and supplemental food programs. Data shows 18.9% of Sentinel City residents are living below the poverty level.

Affordable Housing Project:

The Affordable Housing project was set up to help those in need. According to the affordable housing project, there are three main types of units available for rent in Sentinel city. Studio apartments, one-bedroom apartments, and two-bedroom apartments. According to the data provided from the graphs, there are vacancies in all three units.

Nearly 50% of the one-bedroom apartments are vacant. Approximately 5% of the studio apartments are vacant, and approximately 7% of the two-bedroom units hold vacancies. There is evidence provided between income levels and the number of bedrooms available. A studio apartment which holds the most vacancy is reflected to house a person with the average income of over $45,000 a year. As the people renting the two-bedroom apartment have a combined income of just over $28,000 a year.

According to the data provided by the affordable housing project over the past four years, crime rates are highest within the city limits. This year reported crimes totaling 2,118 offenses. The Second highest crime rate is in neighborhoods at 420 crimes this year, followed by the lowest crime rate located on the property with only 14 reported crimes.

C1. Top three health concerns/ problems about Healthy People 2020 goals:

After performing a detailed analysis of Sentinel city based on the Healthy People 2020 three major problems that need to be addressed are Nutrition, Maternal, infant, and child health. And Health related quality of life and wellbeing.

Nutrition appears to be a major issue in Sentinel City as evidenced by the soup kitchens long lines day and night serving between 40,000 to 50,000 meals per month. It is evident that there are a great number of people in the community that require free meals. Another underserved area is the local elementary school system needing to either provide free lunch or discounted lunch for approximately 27% of That’s an astonishing one out of every four students. By raising awareness and providing better services and finances for theses assistive programs, it will reduce hunger, malnutrition, chronic diseases, and reduce the risk of diabetes, obesity and other health issues related to unhealthy diets in turn educating and providing for a healthier lifestyle and body weight.
Maternal, Infant, and Child Health

Sentinel city hospital/healthcare system provides a broad range of services. However, other than WIC there does not appear to provide any maternity services, OBGYN services, and pediatric clinics. The “Better Health Clinic” provides infertility and conception services, but once conception occurs, no further services are provided. The goal of this outcome is the help improve the health and well-being of women, infants, children, and families. Per Healthy People 2020 (Maternal-Infant-and-Child-Health, 2017 C228 Sentinel City Community Health Needs Assessment).

Health-Related Quality of Life & Well-Being

After riding through Sentinel city on the public transportation system, I only noticed one park and one recreation center located at Nightingale Square located in the most affluent part of the community. The Park and recreations offered a broad range of services. However, there appeared to be a diverse spectrum of residents utilizing the park. The first group being the more affluent, where residents were using the park for play, tennis, leisure and physical activities.

The 2nd group being the homeless, utilizing the park as temporary living. And the 3^rd group made up of delinquents causing crime, prostitution and drug dealing according to the police records. It does appear that there are efforts in place to keep the park clean and safe helping the law-abiding residents of Sentinel city to feel safe in the park. Promoting a healthier community by Increasing physical activity will improve the health and well-being for the residents of Sentinel City. This is directly related to a physical activity which is also part of healthy people 2020. (Healthy People 2020 Health-related-quality-of-life-well-being, 2020).

A Community resource that addresses one of the problems as mentioned above is to create a more nutritious meal program for the elementary school and providing at risk kids with healthy meals at home. The school’s social worker and nurse can make up a plan of care that identify the students at risk of hunger or malnutrition. Next, the student’s parents will receive help to sign up for WIC, SNAP or food stamps if qualified. While in school there could be government paid breakfast and lunch programs free of charge or discounted to those who qualify as low income.

The primary prevention topic based on the problem selected is hunger, malnutrition, and healthy eating. This is part of “Nutrition and Weight Status” according to Healthy People 2020. (Healthy People 2020 Nutrition-and-weight-status, 2017)

Community Assessment Strategies:

The virtual world of Sentinel City Simulation has helped me to learn more about my community and what could be offered to our residents. I am now more aware of how to analyze data and compile information to create a demographic assessment. The research performed included data collecting of the population in age, race, income status, and gender. Assessing the safety of the community led me to uncover hazards and safety concerns. The Windshield survey allowed for an overall physical assessment of the city from conditions of the land and buildings and what the city had to offer in each neighborhood to the type of people walking around.

The population scavenger hunt allowed me to see what resources are available to the people in Sentinel City. After gathering all the data, I could distinguish the top three health concerns in the City and what could be done to help. Completing the assessment of Sentinel City, I now feel like I have the knowledge and confidence to research and compile data to help in my community. I will be able to apply the assessment strategies I have learned from the simulation environment of Sentinel city to my community and have a better understanding of community resources, knowing what programs are available in the community, and how to compile data and facts.