Introduction
The aim of this paper is to use a combination of demographic, epidemiological and windshield survey assessment data to discuss one community health nursing problem affecting the Country Walk community and also to identify the underlying factors that cause the problem within the population. Although Country Walk suffered deadly consequences in the wake of Hurricane Andrew, the community has demonstrated resiliency by rebuilding the area to standards that have facilitated the health and wellbeing of its members.
As is the case in other communities, incidences of obesity, overweight adults, poor diet and physical activity, low consumption of fruits and vegetables, diabetes, hypertension, and asthma have been reported in Country Walk. Although the rate of uninsured people in Miami-Dade County (MDC) is higher than the state’s rate, available literature demonstrates that the standards of the county’s drinking water meets or surpasses those set by state and federal agencies (Health, n.d.).
Community Overview
The community to be assessed is Country Walk, an urban neighborhood located in Miami-Dade County (MDC), Florida. The community contains a unique mix of occupational and cultural groups, though a substantial proportion of the population works in the military and the neighborhood has more people of South American and Cuban descent than any other neighborhood in the U.S.
Although the community has a higher percentage of residents born outside the U.S. compared to other neighborhoods in the country, it has a high level of cohesiveness, deep rootedness, purpose, and drive. The community is a great option for families as demonstrated by the combination of top public educational institutions, low levels of crime, high sense of community, family-friendly neighborhoods, and owner-occupied single family homes (About Country Walk, 2016).
Demographic Data
Country Walk had a population of 16, 276 in 2015 and its racial/ethnic composition was 26.4% South American, 26.1% Cuban, 4.7% Mexican, and 3.0% Spanish (About Country Walk, 2016). The racial composition is comparable to that of MDC at 64% Hispanic (Miami-Dade County, 2014) Most people residing in the area are in the upper-middle income bracket (45% in management and professional occupations) as demonstrated by the fact that the community has a higher income than 74.3% of the neighborhoods in America (About Country Walk, 2016).
The average family in Country Walk has 3.2 persons, which is comparable to that of MDC at 3.7 persons. The median age of the neighborhood population is 37.2 years according to 2012 statistics, while that of MDC is 38.6 years; however, married couples account for two-thirds of all families in Country Walk and MDC. Available figures demonstrate that foreign born residents account for 51% and 44.1% of the population in MDC and Country Walk, respectively, and that Spanish is the most popular language (About Country Walk, 2016; Miami-Dade County, 2014).
Epidemiological Data
The population diagnosed with diabetes in Country Walk in 2013 was 8.6%, compared to 10% in Florida and 9.1% nationally. Those with high blood pressure were 24.2% of the population compared to 28.8% in Florida and 30.3% nationally. Obesity is also prevalent within the community, with figures showing that two in every ten people within the community (23.9%) are obese compared to 29.8% in Florida and 30.3% nationally. The average life expectancy rate for individuals in Country Walk is 77.6 years compared to 76.19 years in Florida and 76.32 years nationally (Country Walk, 2013).
Infant and child mortality rate in Country Walk is low (601 infants and 54 children per 100,000) compared to state (775 infants and 68 children per 100,000) and national (763 infants and 68 children per 100,000) figures (Country Walk, 2013). Adult smoking within the community is at 12% compared to 18% in Florida, while physical inactivity is at 21% compared to 23% in Florida (County Health Rankings, 2016). Around 33% of the population within the community is uninsured compared to 24% in Florida.
Available literature demonstrates that the consumption of fruits and vegetables within the neighborhood is low compared to state and national figures as only 22.1% of adults in the community “meet the Federal government’s guidelines for fruit and vegetable consumption” (Community Profile, 2013, para. 2). Although asthma and sexually transmitted diseases have also been reported within the community, the priority health areas seem to be diabetes, high blood pressure, and obesity.
Windshield Survey
The observations of the windshield survey demonstrate that Country Walk is an ethnically diverse urban neighborhood, though a significant percentage of the population is of Hispanic descent. Most families are comprised of young working-class couples and most of the homes are single owner-owned located in gated and well manicured environments. The community is served by three fully-fledged hospitals, three nursing homes and several dental clinics. However, diabetes has been reported as a serious health issue within the community due to the vast population of Hispanic descents, diet choices, and lifestyle behaviors.
Problem Diagnosis
From the assessment, it is evident that diabetes is a serious health nursing problem within the community that warrants to be prioritized. One of the goals of Healthy People 2020 is to “reduce the disease and economic burden of diabetes mellitus (DM) and improve the quality of life for all persons who have, or are at risk for, DM” (HealthyPeople.gov, 2016). Objective D-1 of the Healthy People 2020 initiative targets to reduce the yearly number of new cases of diagnosed diabetes in the population to 7.2 new cases per 1,000 people aged between 18 and 84 years (HealthyPeople.gov, 2016).
Diabetes is considered a major health problem within the community due to its ethnic/racial composition which shows that most people are of Hispanic or Latino origin. Available scholarship demonstrates that the “prevalence of type 2 diabetes in the U.S. Hispanic population is nearly double the rate in non-Hispanic Whites” (Solorio, Bansal, Constock, Ulatowski, & Barker, 2015, p. 730).To achieve the Healthy 2020 objective discussed above, it is important to prioritize the reduction of diabetes in this community as Hispanics are the fastest growing minority population in the U.S.
It is also important to prioritize diabetes as Hispanic adults not only suffer higher rates of morbidity and mortality related to diabetes than non-Hispanic white people, but are more likely to develop diabetic-related complications (e.g., retinopathy, kidney disease, and lower limb amputation) than their peers in the population (Hatcher & Whitemore, 2007). The factors that contribute to high incidences of diabetes in this community include racial beliefs (most Hispanics associate diabetes with folk beliefs such as susto), obesity (23.9% are obese), poor diet choices (low intake of fruits and vegetables, lack of physical activity (21% are inactive), high blood pressure (24.2% have the disease), and high cholesterol (Alexandria, 2014; Aponte, 2009; Community Profile, 2013).
Summary
This paper aimed to use demographic, epidemiological and windshield survey assessment data to discuss one community health nursing problem affecting the Country Walk community and also to identify the factors that are known to cause this problem within the population. Demographic and epidemiological assessment data has demonstrated that most people in Country Walk are Hispanic and that the community is faced by lifestyle-related complications including obesity, diabetes, and high blood pressure. Diabetes has been considered as the most serious community health problem that needs to be prioritized due to its tendency to affect more Hispanics and also due to associated risk factors that include obesity, high blood pressure, poor health choices, and ethnic beliefs.
References
About Country Walk. (2016). Web.
Alexandria, V. (2014). Diabetes among Hispanics: All are not equal. Web.
Aponte, J. (2009). Diabetes-risk factors across Hispanic subgroups in the Hispanic health and nutritional examination survey (1982-1984). Public Health Nursing, 26(1), 23-28.
Community profile: Miami-Dade County, Florida. (2013). Web.
Country Walk, Florida – Health concerns. (2013). Web.
County health rankings & roadmaps. (2016). Web.
Hatcher, E., & Whitemore, R. (2007). Hispanic adults’ beliefs about type 2 diabetes: clinical implications. Journal of the American Academy of Nurse Practitioners, 19(10), 536-545.
Health. (n.d.).Web.
HealthyPeople.gov. (2020). Web.
Miami-Dade County economic & demographic profile 2014. (2014). Web.
Solorio, R., Bansal, A., Constock, B., Ulatowski, K., & Barker, S. (2015). Impact of a chronic care condition intervention on diabetes quality of care in a community health center. Health Services Research, 50(3), 730-749.