Physical Environment
Although available data shows that the Kiryas Joel community has a total area of 1.1 square miles (2.8 km2), physical observations do not reveal any boundaries within the community apart from the fact that it is located close to the neighboring towns of Blooming Grove and Woodbury. There are no commercial streets in the community, though the neighborhood has an identity as a Jews community. In housing, much of the area is given over to residential property although new construction is ongoing throughout as demonstrated by upcoming modern townhouse-style condominiums mostly used for multi-family dwellings due to the large size of families. However, zoning of the housing developments in the community has not been effectively coordinated, and it is evident that the developers do not rely on any plan during construction.
People
Most of the residents in the community comprising 18,300 people are Hasidic Jews, who passionately observe the Torah and its teachings. The community is not homogenous when racial or ethnic variables are considered due to the sizeable proportion of immigrants of Hungarian ancestry. There are a few African Americans and Asians noted, though there are no overt indicators of ethnicity observed within the community. Most of the people in the community engage in healthy eating habits as demonstrated by the high number of sheds selling a wide variety of fruits and vegetables, as well as parlors selling natural honey and milk. Similarly, the central pillar of religion in the community ensures that most people do not engage in risk behaviors such as alcoholism or drug abuse. Poverty is high in the community due to high population growth and the fact that the area has the lowest per capita income (approximately $4,355) of any community with over 10,000 people in the United States.
Services
Health services are provided by two health facilities owned by the town council and one private health institution with religious underpinnings. These facilities have no capacity to provide mental health services and are inconveniently located within the peripheries of the community. The two schools built and operated by the town council are inadequate and overcrowded, hence unable to meet the needs of the community especially in light of the fact the community has one of the youngest median age (13.2 years) in the United States.
Additionally, although there is a tarmac road traversing through the community, hence easing public transport, other road networks linking vital facilities within the community (e.g., schools, healthcare facilities) are in a deplorable state. There is a police post within the community, but fire services are non-existent. There are many open spaces available in the community that children normally use to play; however, these open spaces have not been well maintained and therefore cannot pass as recreational facilities or parks. There is a main synagogue in the community and several other temples that show the predominantly Jewish religious orientation within the area.
Summary of Key Community Issues
From the narration, it is clear that poverty is one of the main issues that negatively influence effective healthcare delivery within the community. Available data shows that the area has one of the lowest per capita incomes in the United States, and hence it is clear why there are only two public health facilities and one private hospital to provide services to over 18,300 people. The high poverty level in the area needs to be addressed for people to leverage better access to healthcare services.
The other issue that needs to be addressed immediately is the high population growth within the community. This issue has been demonstrated by large families living in multi-family dwellings in the area, and also by overcrowding of schools and other social amenities owing to the fact that a considerable proportion of the population is made up of young people. Religion may also have a role to play in fueling the high population rate. The task for community nurses, therefore, is to come up with strategies that could be used to encourage community members to plan their families.