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Nursing Assessment of Napa Community

Napa County has unmet health needs. About 13 percent lack medical insurance and pay cash. In addition, not all members of the community have Medicare or Medi-cal. Only 4% of the community is healthy while others are in low-income category. There are environmental risks from Lake Berryessa since more than 60 people have drowned in it. Children and elderly are prone to health risks. There are wild animals in the area, which pose health risks to the community. Pollution from pesticide is a concern for many residents. Air pollution has increased in the past few years, but water remains safe.

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Hot, dry summer conditions pose threats of fire while some places have limited water. Wells and private water are expensive. The place has the feared poisonous oak and other poisonous plants.

Residential units could be health hazards in Napa County. There are fears of carbon monoxide poisoning, lead-based paints, faulty gas lines, and deviations from building codes. However, Napa has well maintained housing units with safe sidewalks and effective responses from authorities. All homeowners and developers observe building codes. There is public awareness about lead-based paints, which are common in pre-1978 homes. Hence, most families understand how to manage cases of lead poisoning.

The County has no waste disposal problems, but the demand for waste management has increased. There are low cases of residential fire in Napa County, but the responses have been immediate from the fire department. Any residential homes, which are five miles away, are under high alerts of fire. Swimming pools are safe to residents and vulnerable people.

Disasters are likely to have negative impacts on children and the elderly at Napa County. Any disaster could result in psychological trauma among children and disruption of care to senior citizens and children who have special health needs.

The racial composition of Napa County could lead to response challenges in case of a disaster. For instance, whites would rely on external assistance. On the other hand, Hispanics have close family ties and live together. Hence, they can manage a disaster as a team. Language barriers could also be a threat to effective response during a disaster. In case of illegal immigrants, they may decide not to seek for help to avoid detection. A disaster could also negatively affect low-income households, which may lack adequate supplies during emergencies. Still, most Hispanics in the area have high rates of poor health than Caucasians.

Low flooding and threats of fire are common in the entire County. However, these are not major concerns compared to risks from a potential earthquake due to the geographical nature of the County. The entire California could experience an earthquake and many residents of Napa County could sustain injuries or deaths from falling objects, debris, furniture, auto accidents, fire, or even from toxic chemicals. Injuries may include “dislocations, fractures, wound infections, head, and brain injuries” (Napa County, 2010). California has prepared its residents adequately for any potential earthquakes or other emergencies.

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A disaster is likely to have severe impacts on low-income Hispanic communities and other immigrant agricultural workers. This part of the community is prone to health risks due to poverty, infectious diseases, traumatic injuries, sun stress, and exposure to chemicals, musculo-skeletal disorder, and lack of health care access among other risk factors.

A disaster may also cause an outbreak of communicable diseases, which are classified as person-to-person, food borne, and waterborne communicable diseases. Displacement of populations can cause strain on available, limited resources, such as water, shelter, sanitation facilities, and other supplies. Conditions common in most disaster zones could facilitate the spread of diarrheal diseases, hepatitis, and leptospirosis. These diseases and bacteria are associated with water contamination after disasters. In addition, overcrowding could lead to the spread of missiles, acute respiratory infections, and meningitis, as well as tetanus and fungal infections.

Any disaster that takes place during cold seasons may aggravate respiratory conditions in the community. The situation can also affect the existing pregnancies.

Napa County is a well-prepared community for any disaster. Both public and private stakeholders conduct public awareness about disaster preparedness. In the past few years, responses for three disasters caused by fire, earthquake, and the flood have been effective. The County has coordinators to assist with any emergency needs during disasters.

Most disasters have occurred unexpectedly in the community. Hence, it is difficult to ascertain the community’s responses to warning. Nevertheless, past responses to emergencies have been effective.

There are possibilities that poor responses to disasters could occur in Napa County due to challenges in communications and transportation. Communities living in far places may not receive immediate help during emergencies. Moreover, language barriers and age could also affect responses to disasters. Still, mental health conditions could hamper responses to disasters. Overall, Napa County has an organized disaster management program, including plans for handling effects of disasters.

Napa County is culturally conservative. The community tends to respect old age and aging. The community associates old age with diseases, but health promotions and support centers for the elderly are common in Napa. Gender does not play a significant role in health care provisions. No known genetic conditions affect the community, but physiological health conditions associated with heart disease, obesity, diabetes, asthma, most cancers, liver disease, and cirrhosis and effects resulting from alcoholism are common.

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Stress is common in the community due to high costs of living, a lack of health care insurance, under insurance, substance abuse in teenagers, and inadequate resources. Overall, Napa community cultural perspectives promote good community health and coping mechanisms through public education.

Interpretation of data collected

Napa community has a population size of 139,045, which consists of 49,179 households. There are 31,002 children aged below 17 years as per 2013, which represents 23% of the entire population. People aged over 65 years account for 16% of the population. This exceeds the California state percentage of 12.1%. The majorities in Napa County are mainly whites (55%) and Hispanic (33%). The rest of the populations (12%) consist of other races, such as Asian, African-American, Native Indian and others. The high rates of poverty are rampant among Hispanic (58%) and whites (40%) while the rest of the populations account for insignificant rates. The percentage of children below poverty line is 12.8% while 12% of the households are below the poverty line. More than 26% of the residents are living below 200% of the Federal poverty line (FPL).

The Community Health Status Indicator (CHSI) for Napa County covers some specific areas in the study (National Institutes of Health, 2010). The leading causes of death in Napa County include heart diseases, cancer, and stroke (Napa County, 2010). The most affected are whites and Hispanics. Most cases of these deaths relate to risk factors like smoking, high blood pressure, high blood cholesterol, binge drinking, obesity, or lack of physical activities. Most deaths are common among male senior citizens.

Relative Health Importance remains close to the county’s health importance. For instance, Napa County has “the highest number of elderly in California” (Napa County, 2010). As a result, there are many community homes for the elderly. A three-year trend analysis of coronary heart conditions showed that Napa performed better than the state of California (Napa County, 2010).

Vulnerable populations consist of children, the elderly and pregnant women. Cases of emergencies could worsen their conditions in the community because they become prone to health related challenges. However, Napa County has adequate disaster response and mitigating strategies for all members of the community.

Environmental health measure and community safety are critical for Napa County. Water remains safe, but air pollution has increased in the past few years. Wild animals and poisonous plants, as well as lead-based paints used in pre-1978 homes and potential disasters are threats to community health.

Generally, access to health care in the community is good. There are facilities to cater for old persons. However, there are uninsured community members (13%) and others who pay for their own medical bills. Poverty in some parts of the community, especially among the vulnerable Hispanic community hinders access to health care.

The community’s cultural aspects do not restrict seeking treatment. Moreover, public awareness and education have reduced cases of stigma.

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There is a slight increment in cases of mental health in Napa County. About 6.49% have mental health problems. From this number, 10.9% adults are below the FPL while 10% children are also below the FPL. The community does not discriminate individuals based on their mental status because of public awareness and education.

A community genogram

A community genogram

A short interpretation of the genogram

  • All white boxes are health indicators assessed
  • Yellow boxes are potential health risks to the community
  • Red boxes show factors that have caused deaths to the community
  • Green boxes show community safety, level of preparedness, and best practices

A community diagnosis

Napa County has unmet health needs, specifically under population factors and demographic characteristics. Poverty and lack of health insurance continue to affect some members of the Napa community. This creates health care access disparities in the community (World Health Organization, 2001). Moreover, vulnerable populations, especially mentally ill and the elderly, have increased in the community. As a result, health services should focus on such vulnerable groups. There is a need to improve the community health on major causes of deaths and health risk factors associated with deaths. Behavior-related health issues and potential disasters pose serious health challenges to the community. Napa community should continue with public education and awareness campaigns, which have positive health outcomes in the community.


Napa County. (2010). Leading Causes of Death: Stroke Fact Sheet. Web.

National Institutes of Health. (2010). Community Health Status Indicators (CHSI) Transcript. Web.

World Health Organization. (2001). Community health needs assessment.

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