Overview
The health problem identified in the Miami-Dade County (MDC) community is cardiovascular disease. A survey by PRC (2013) attributed the elevated cardiovascular risk to overweight (62%), sedentary lifestyle (30%), hypertension (33%), and smoking.
Description of the Community
History
Miami-Dade County (MDC) was split from St. Johns County in 1836. Its cosmopolitan history is linked to the arrival of railroads in the 1890s, the construction of canals, and unrest in Latin America that brought in earlier Cuban and Spanish settlers.
Type of community
The MDC community is highly heterogeneous; it includes urban, suburban, and rural communities. It comprises over 35 cities, including the City of Miami (Cedar Lake Ventures, 2015). Over one million residents occupy the unincorporated suburban regions in the East. Rural communities inhabit the Southern agricultural areas, such as Redlands.
Physical Environmental Considerations: The Community as a Place
Description: General Identifying Data
Location
MDC lies in the Southeastern part of the Floridian peninsula. It is located between the Atlantic Ocean and the Gulf of Mexico.
Topographical features
MDC has a maximum elevation of10ft above mean sea level (msl). Most of the areas have a flat, low-lying topography. In particular, regions in the west and east of the County are largely marshlands lying at five feet above msl (Cedar Lake Ventures, 2015).
Climate
MDC has a semi-tropical marine climate. The key characteristics of this climate include warm and wet summers, low diurnal range due to oceanic influences, and dry winters (Cedar Lake Ventures, 2015). Summer humidity levels are amongst the highest in this County (89% during daytime). It receives an average annual rainfall of 1570 mm. Its average diurnal temperature range is 10oF.
Boundaries, Area in Square Miles
MDC has a total landmass of over 2,000 square miles. It is Florida’s biggest metropolitan region. In the eastern border of the County lies the Biscayne Bay and Atlantic Ocean. The Everglades National Park, Florida Keys and Broward County lie towards the western, southern, and northern sides of the County, respectively (Cedar Lake Ventures, 2015).
Environment
Sanitation
The Water and Sewer Department (WASD) supplies quality drinking water sourced from the Biscayne aquifer to Miami-Dade’s 35 municipalities. WASD runs over ten water and wastewater treatment plants that offer water services and sewer services to 13 and 12 cities, respectively (Cedar Lake Ventures, 2015).
Pollutants
Air pollutants – methane, particulate matter, CO, and NO – in MDC are linked to incineration. Mitigation measures involve an integrated waste management plan, waste-to-energy plants, and rock mining permits. Miami-Dade’s flatland ecosystems contain diverse fauna and flora, including prairie plant communities and scrubs inhabited by foxes, frogs, salamanders, and deer. Local animal reservoirs of diseases include pets.
Air quality
Miami-Dade records moderate-to-good air quality index of up to 99% (Cedar Lake Ventures, 2015). This figure implies that air quality in terms of color, odor, and particulate matter is excellent due to Miami-Dade’s flat topography and absence of major industries.
Food sources
Miami-Dade has a vibrant agricultural sector due to the tropical climate. Fresh local produce from the southern Redlands are supplied to the municipalities. Food preparation includes Redland recipes, such as Cuban and Spanish cuisines.
Potential disaster in the population
Miami-Dade is prone to hurricanes and tropical storms during the months of June through November. Another potential disaster in coastal cities is the rising sea level due to climate change.
Extent of disaster preparation in the population
Residents move into evacuation centers during disasters for easier transportation. They also know the disaster kit contents and supplies required during hurricane preparations.
Housing
Types of housing
Miami-Dade’s housing sector is predominantly private. Private developers construct and sell luxury residential houses and condominiums to individuals and families.
Condition of housing
The supply of quality housing units – multifamily homes, single-family houses, and mobile structures – is adequate. Most of the houses (21.3%) were built between 1970 and 1979, but are in a good condition for habitation.
Percent owned, rented
The occupancy rate in the County stands at 86%. The proportion of owner-occupied and renter-occupied housing units is 60% and 40%, respectively (Cedar Lake Ventures, 2015).
Housing for special populations
Near homeless
The County, through the State Housing Initiative Partnership, supports affordable public housing projects for low-income households in urban neighborhoods. The Homeless Prevention and Rapid Re-housing Program also offers rental support to near homeless residents.
Homeless
The County’s Homeless Trust funds the construction of permanent structures for homeless locals. It has constructed 145 units for formerly homeless people.
Frail elders
An estimated 67.7% of the elderly population (>65 years) in Miami-Dade own houses. The remainder pays rent or lives in senior centers.
Leading Industries and Occupations
The major industries in MDC include trade, transportation, and utilities, leisure and hospitality, professional and business services, and financial activities. The predominant occupations include accountants and auditors, nurses, cargo agents, travel agents, construction workers, etc.
The People of the Community
Population Profile
Total population of Miami-Dade
The County has a total population of 2,496,457 people (based on the 2010 Census).
Population density
Miami-Dade is the most populous county in Florida with 13.4% of the State’s population (Florida Legislature, 2017). The estimated population density is 1,371 individuals per square mile.
Population changes in past 10 years
The 2000-2010 percentage change in population was 10.8%. Since the last census (2010), the population has grown by 8.2%.
Population per square miles
According to Florida Legislature’s (2017) latest report, there are 1,371 persons per square mile in MDC.
Mobility
Geographical mobility is low with over 87.6% of the people living in the same house for over a year.
Types of families
Family household types in the County encompass married (44.1%), single female (18.1%), single male (6%), and one-person households (25.9%).
Biological Considerations/Vital and Demographic Population Characteristics
Age composition
Miami-Dade’s population comprises the following age cohorts: 21.9% children and teens (<18 years), 14.4% senior citizens (65 years and over), 5.6% college-age persons (18-21 years), 25.1% young adults (22-39 years), and 33.4% older adults (40-64 years) (Florida Legislature, 2017).
Sex distribution
In MDC, females constitute 51.49% of the population.
Race distribution
Miami-Dade’s population is 68% Hispanic, 16% African American, 14% Caucasian, and 2% Asian American (Florida Legislature, 2017).
Ethnic group composition and distribution
The ethnic groups represented in this County are Hispanics, Whites, Blacks, Asians, and others – Indian and Hawaiian. Hispanics occupy areas like Fisher Island and Sweetwater, while Blacks are the main inhabitants of Gladeview and Westview (Cedar Lake Ventures, 2015). Whites predominantly live in Surfside and Miami Beach, among others.
Mortality characteristics
Annual birth and crude death rates
Miami-Dade has an annual birth rate of 11.76 per 1000 persons. Its crude death rate is 7.92 per 1000 persons per annum.
Age-specific death rate
It stands at 20.6 deaths per 100,000 (diabetes).
Infant mortality rate
It is estimated to be 4.6 deaths per 1,000 live births.
Maternal mortality rate
It averages about 9.7 deaths per 100,000 live births.
Cause-specific death rate
It stands at 1.0 (birth defects), 0.7 (sudden unexpected infant death, 0.57 (low birth weight), and 0.1 (unintentional injury) deaths per 1,000 live births.
Leading causes of morbidity
Incidence rates
The incidence rates of heart disease, cancer, and diabetes are 5.5%, 5.3%, and 3%, respectively.
Prevalence rates
Heart disease, cancer, and diabetes have a prevalence of 6.1%, 4.8%, and 10.8%, respectively (PRC, 2013).
Psychological Considerations
Significant historical events
They include the arrival of railroad in 1896, Cuban immigration of the 1960s, and Hurricane Andrew (1992).
Future economic prospects
Future job growth of 37.9% is expected in real estate and tourism industries.
Formal and informal communication network
It includes public media, newspapers, and informal community events and contests.
Rates of suicide and homicides for specific subgroups within the population
According to the PRC (2013) report, the suicide rate is highest among male teens (62% of adolescent suicides) and Hispanic male teens (0.9/100,000).
Adequacy of protective services
There are adequate government and community efforts to combat depression, domestic violence, and drug abuse.
Common sources of stress
They include unemployment, unaffordable housing, and legal problems (immigration).
Sociocultural Considerations: The Community as a Social System
Socioeconomic status
Income of family
It averages $49,264 +/- $569 p.a.
Major occupations
They include accountants, auditors, nurses, and cargo agents.
Estimated level of unemployment
It stands at 5.4%.
Percentage below poverty level
Those in poverty are estimated to be 20%.
People retired
They constitute 14.4% of the population.
Educational level
High school graduates constitute 80.1% +/- 0.3% of the population.
Religious distribution
About 40.9% are religious – 22.5% Catholic, 1.15% Jewish, and 5.95% other religions.
Marriage and divorce rates
They stand at 7.4 and 4.3 per 1,000 people, respectively.
Language
Residents speak English, Spanish (72%), and Haitian Creole.
Government and Leadership
Type of government
It includes a mayor and board of commissioners.
City offices
The Stephen P. Clark Center houses the County administration. It operates from eight to four, five days a week.
Education
Public educational facilities
They include elementary (474), middle (215), senior high (105) schools, and college.
Private educational facilities
They comprise private schools and colleges.
Libraries
Public libraries include West Dade library and Richter library.
Services for special populations
Pregnant teens
The Teenage Parent program supports pregnant teenagers to continue schooling.
Adults with special problems
It provides mental health services and affordable homes for seniors.
Children and adults who are developmentally disabled
Available services include Leisure Access Centers and Medicaid waiver.
Children and adults who are blind and/or deaf
The services include Blind Babies Program for toddlers and Miami Lighthouse for the elderly.
Transportation
Transportation is through highways, roadways, and bike lanes. Mobility involves the Metrorail system, cars, and bicycles.
Behavioral Considerations
Consumption patterns
Most residents consume fresh produce from the Redlands, Spanish cuisines, and processed food.
Leisure pursuit
Residents on vacation frequent Miami Beach resorts and other places.
Other health-related behaviors
Residents engage in jogging in city recreational parks.
Health System Considerations
Identify Existing Services
MDC has many hospitals, community health centers, and mental facilities, e.g., Jackson Behavioral Health Hospital.
Assessing Current Level of Performance
The prevention quality indicators (PQIs) show inequalities and gaps in healthcare provision and access attributed to high poverty rates (19.4%) and uninsured population (18.3%) in MDC. There is also a high burden of disease for CHF, high blood pressure, and T2DM in most areas.
Healthcare Availability and Accessibility
Essential healthcare, mental healthcare services, and maternal care are available in hospitals and community-based facilities spread across MDC.
Health Needs Lacking Services
Behavioral and mental health needs lack adequate culturally sensitive services in MDC.
Extent to Which Health Care Services are Overused and Underused
Health care services are underused in Miami-Dade because of the large number of the uninsured.
Financing Health Care
Health care financing in Miami-Dade primarily involves Medicaid and Medicare programs for eligible persons.
References
Cedar Lake Ventures. (2015). Overview of Miami-Dade county, Florida. Web.
Florida Legislature. (2017). Miami-Dade county. Web.
Professional Research Consultants [PRC]. (2013). 2013 PRC Miami-Dade County community health needs assessment household survey report. Omaha, NE: PRC.