Community Dynamics and Health Problem

Community Dynamics and Health Problem Order Instructions: PURPOSE

Community Dynamics and Health Problem
Community Dynamics and Health Problem

The purpose of this paper is to provide an opportunity to utilize community assessment strategies, uncover a community health problem, and identify the components of the problem related to the community dynamics.

Community Dynamics and Health Problem Directions

This paper is expected to be no more than four pages in length (not including the title page and reference list). Typical papers are usually three pages. Below are the requirements for successful completion of this paper.
• Introduction: This should catch the reader’s attention with interesting facts and supporting sources and include the purpose statement of the paper. This should be no more than one or two paragraphs.
• Community: Identify the community by name that you will be using for this paper and provide a brief, general description of the community. Your community should be the area where you live or work. This should be one or two paragraphs.
• Demographic and epidemiological data: Compile a range of demographic (population description) and epidemiological (causes of health problems and death) data for your community by examining census reports, vital statistic reports, city records, morbidity and mortality reports, and other agency sources. Using this data, describe the community and the problem. Compare your community data to state or national data. This comparison will help to identify a community health problem specific to your community. A summary of these data should be no more than one page.
• Windshield survey: Provide a brief summary of the findings from your first assignment. Make sure to discuss elements that link your observations to your identified problem. This should be no more than one or two paragraphs.
• Problem: Using the assessment data, identify the problem that you consider to be a priority concern. Provide a rationale for your choice and relate your choice to one of the Healthy People 2020 specific numbered objectives. Healthy People objectives are located within a topic area under the Objectives page. Your rationale should also include why this is specifically a problem in your community. This should be no more than three paragraphs. Include support of your rationale with at least two scholarly sources such as professional journal articles related to your problem.
• Summary: The summary paragraph of your paper should include a statement about the problem, the population at risk for this problem, and the major direct or indirect factors that contribute to this problem. This information should be no more than one or two paragraphs.
• Reference page: All references cited within the paper should be included on a separate References page.

Community Dynamics and Health Problem Guidelines

• Application: Use Microsoft Word 2010™ to create this assignment.
• Use the categories above as APA headings for the sections of your paper.
• Length: This paper is expected to be no more than four pages in length (not including the title page and reference list). Typical papers are three pages.
• Submission: Submit your file via the basket in the Dropbox: Caring for Populations: Assessment and Diagnosis by 11:59 p.m. MT Sunday of Week 4.
• Technical writing: APA format is required. Review APA tutorials in Doc Sharing and use the resources of Smarthinking for writing tutors.
• Do not use first person (I, me, my, our) in this paper. Make the community the subject even in your windshield survey summary.
• Save your paper with your last name in the document title (e.g., “Smith Assessment and Diagnosis”).
• Late submission: See the course policy on late submissions.
The following are best practices in preparing this project.
• Complete the demographic, epidemiologic, and windshield survey prior to choosing a problem to focus on.
• Choose a nursing problem specific to your community.
• Make sure all elements of the paper are addressed and headings for each category are included.
• Review directions thoroughly.
• Cite all sources within the paper as well as on the References page.
• Proofread prior to final submission.
• Check for spelling and grammar errors prior to final submission.
• Use the A column of the rubric below to ensure that you have included all the needed elements.
• Abide by the CCN academic integrity policy.

Criteria A
Outstanding or highest level of performance B
Very good or high level of performance C
Competent or satisfactory level of performance F
Poor or failing or unsatisfactory level of performance Pts
10 points Catches the reader’s attention with interesting facts and supporting sources; includes the purpose of the paper
(9–10 points) No purpose provided but “hook” is present
(8 points) Purpose of paper discussed; hook to get reader interested is missing
(7 points) No purpose provided and no attention-getting hook
(0–6 points) /10
Community Data
25 points Community identified and briefly described
(23–25 points) Community identified but description missing
(21–22 points) Community not identified and/or not described
(19–20 points) Community not identified and not described
(0–18 points) /25
Demographic and Epidemiological Data
50 points A range of demographic and epidemiological data for your community examined by census reports, vital statistic reports, city records, morbidity, and/or mortality rates and other agency sources, and compared to state or national data
(46–50 points) Some demographic and epidemiological data described or missing state or national comparison
( 42–45 points) Little demographic and epidemiological data and missing state or national comparisons
( 38–41 points) Lacking demographic and epidemiological data and missing state or national comparisons
(0–37points) / 50
Windshield Survey
10 points Community windshield survey findings briefly described; findings relate to the identified problem
(9–10 points) Windshield survey findings described but not clearly related to the identified problem
(8 points) Windshield survey lacks sufficient assessment and relation to the identified problem
(7 points) Windshield survey findings not described
(0–6 points) /10
50 points Assessment data used to identify the problem; rationale provided for your choice and related to one of the Healthy People objectives; supportive data provided to validate this as a problem in your community
(46–50 points) Problem not related to Healthy People objective or lacks rationale or lacks supportive data
(42–45 points) Problem not related to Healthy People objective and lacks rationale or lacks supportive data
(38–41 points) Problem not related to Healthy People objective, lacks rationale, and lacks supportive data
(0–37 points) /50
Application of Evidence-Based Literature
30 points Two or more quality references from professional literature cited that clearly support your rationale
( 28–30 points) Two references cited, but the information in reference may be biased or not directly relevant to your rationale
( 25–27 points) Only one reference cited that is directly relevant to the rationale
( 23–24 points) No references cited or one reference cited that is not relevant to the rationale
(0–22 points) / 30

Community Dynamics and Health Problem Summary

10 points Includes a statement about the problem, the population at risk for this problem, and the major factors that contribute to the problem
(9–10 points) Summary lacks reiteration of identified problem or population at risk or contributing factors
(8 points) Summary lacks two or more of the following: reiteration of identified problem, population at risk, and contributing factors
(7 points) Summary unsatisfactory or not completed
(0–6 points) /10
20 points Discussion well organized and logically supports analysis and reasoning; structure clear and compelling to reader; easy to follow author’s reasoning; paragraphs linked together in logical ways; main ideas stand out
(19–20 points) Discussion accurate but limited; some attempt at organization apparent, but in general paper does not flow well
(17–18 points) Paper comes across as disjointed or rambling; flow of paper difficult to follow
(15–16 points) Discussion has errors in content; no discernible attempt at organization; paper is chaotic
(0–14 points) /20
20 points • Title page, running head, and page numbers (3)
• Grammar, punctuation, and sentence structure correct (5)
• References properly cited within paper (5)
• Reference page includes all citations (2)
• Evidence of spelling and grammar checks (5)
(19–20 points) • Minimal errors in APA title page noted
• Minimal errors in grammar, punctuation, and/or sentence structure noted
• Citations present but not in correct format
• References present, with minimal errors in format
• Minimal red or green wavy lines within document
(17–18 points) • Multiple errors in APA format
• Several grammar and punctuation errors noted
(15–16 points) • Citations missing
• References missing or incomplete
• No evidence of proofreading prior to submitting paper
(0–14 points) /20
Total Points /225

My initial windshield survey assignment:

Community Dynamics and Health Problem Criteria Your response

1. Community introduction:
Identify the community you will be using for this assignment. It should be the area where you live or the area surrounding your work setting. The community I will be using for this assignment is the community in which I live, Staten Island New York. Staten Island is one of the five boroughs of New York City and has a population exceeding over 450,000 residents. Staten Island is known as the forgotten borough of New York City and is not often a tourist attraction. Staten Island is the most suburban and least populated of the five boroughs. It is a culturally rich community and a melting pot for many different kinds of races and cultures. There are many historic landmarks in Staten Island including the Staten Island Ferry, Snug Harbor Cultural Center, The Alice Austin House, Historic Richmond Town, The Staten Island Zoo to name a few as well as the future home of the worlds largest Ferris wheel which is set to begin construction within the next year. Staten Island is also known for being the home of the world’s largest garbage dump, the Freshkills Landfill, which has been closed. Thanks to reality television Staten Islanders have recently been on the receiving end of many stereotypes thanks to shows like Jersey Shore in which Staten Islanders have been looked upon poorly. What many people do not realize about Staten Island is that we are a close-knit community that comes together in times of need. In recent history, events such as the September 11th attacks and Hurricane Sandy really pulled Staten Islanders together to help those in need. Volunteers pulled together to help others get there lives back in order following these disasters but unfortunately Staten Islanders are depicted in the media has being loud, obnoxious, uneducated and spoiled thanks to these inaccurate depictions of us on television shows. Staten Island has a rich culture with many exciting experiences and beautiful landscapes to offer residents and visitors alike.
2. Windshield survey
a. vitality People are very visible and outspoken in the community. Staten Islanders are active in the community and hold many events for its residents. Most recently the Richmond County Fair was held on Staten Island and raised money for many important causes. A breast cancer walk was also held in order to help raise money and awareness for Staten Islanders affected by breast cancer. The residents of Staten Island vary in age, race and culture. The predominate age group consists of middle age individuals; the ratio of male to female is about equal with a slightly higher number of females on the island. The predominate race on Staten Island is white, Italians make up a large percent of the nationality on the island which is the reason Staten Island has been given the nickname “Staten Italy” on many television and social media settings. The general appearance of the people I observed appeared to be healthy. There seems to be a trend in extremes, I noticed many very physically fit individuals along with many obese individuals. The younger females were for the most part very clean, kempt and well dressed many wearing designer clothing. Their clothes also tended to be very tight fitting and revealing for the most part. I also observed many well-dressed individuals waiting on express bus stops on their way to work in the city as well as many mothers walking their young children to school and the bus stops. I saw a number of pregnant women walking around two parks as well as the Staten Island mall. As I was driving I also came across a few homeless people asking for change when cars were stopped at lights so the conditions vary as I drive from area to area. I noticed there to be tourists around the Staten Island Ferry terminal and surrounding area but other then that section tourists do not often travel to Staten Island, they prefer to stay in Manhattan and the other boroughs. Staten Island has a very big drug problem; currently the drug of choice within the community is heroin. Many parts of the community such as Port Richmond, Saint George and Mariners Harbor to name a few are drug neighborhoods, in my drive I witnessed a few people obviously intoxicated standing right on the street corners and witnessed an exchange of drugs out in the open next to a deli while I was waiting at a stoplight. There is also a high occurrence of emotional and mental disabilities within the community especially within the neighborhoods I mentioned with the drug problems. The South Shore of Staten Island also has a high occurrence of mental illness which lead to a prescription drug abuse problem a few years ago. New laws have prevented abusers from being able to obtain the prescriptions as easily as they used to. This has helped the issue but has not put an end to it.
b. Indicators of social and economic conditions In general the homes I observed are well kept with manicured lawns in the majority of the community. This varies from neighborhood to neighborhood for example Todt Hill has million dollar mansions where as other neighborhoods are more run down and abandoned. The majorities though have nice, well kept housing. A trend I noticed was the elimination of single-family homes and building multi family townhouses in its place. This is common in every single area of Staten island and the occurrence has been increasing dramatically over the last few years. Staten Island also has a vast array of transportation methods available including buses, a train system, the Staten island ferry and cabs to name a few. These transportation methods are greatly utilized by the residents and there always seems to be multiple people waiting on bus stops at all times of the day and night. Many school children and adolescents utilize the public transportation system to get to school each day as well. Staten Island has a large number of public and private schools as well as day care centers, preschools and programs for childcare run within the many churches of the community. I noticed a trend of high school students tending to hang out outside of school during school hours mostly sitting in groups, many of which were smoking cigarettes. There has been a wide spread campaign to help people quit smoking with many anti smoking billboards and advertisements on buses and bus stops. The pharmacy CVS has even banned selling any kind of tobacco products in their stores and have been placing public advertisements in regards to quitting smoking and information to help individuals quit. Election day just passed and I noticed many campaign signs in people’s yards in favor of candidates that they will be voting for. The community is very outspoken and political and many Staten Islanders tend to run for community offices. I also noticed many seasonal workers in my observation, many lawn care services cleaning people’s yards or leaves and taking care of the yard. This is a common daily occurrence and a very typical sight in your travels around the community.
c. Health resources Staten Island has three major hospitals as well as many clinics, rehab centers, nursing homes, doctors offices and outpatient care centers. The hospitals are Staten Island University Hospital North campus in Ocean Breeze, Staten Island University Hospital South campus in Princes Bay and Richmond University Medical Center in Randell Manor. We also have a Veterans Center in St. George that is conveniently located near the ferry Terminal and many bus stops so it is easily accessible. There are many sub-acute and long-term rehab centers located all over Staten Island, most of which are hospital affiliated. There is also numerous long term care facilities and nursing homes. There are many doctors offices located all over the community ranging in all kinds of specialties. I do not exaggerate when I say there are doctors and dentist offices in every neighbored many times multiple within the same building on nearly every street. I also passed a 24 hour walk in clinic that was located next to a housing project and I know there is another clinic like this located on the other side of the island. Staten island also has a large substance abuse and methadone clinic that is affiliated with Staten island University Hospital which is located next to the north campus. There is also a large Staten Island University Psychiatric hospital located right next to the north campus that offers in and outpatient psychiatric care. There are so many available healthcare options including free clinics like planned parenthood available to the community all of which are conveniently located for the residents of Staten Island.
d. Environmental conditions related to health Staten Island is home to the world’s largest landfill. It has been closed for a few years now but it still causes a large amount of air and water pollution to the neighborhood. Besides the poor air quality Staten Island also has a high amount of ground pollution from people littering. In my observation I noticed a few people throwing trash and cigarette butts out of their cars as well as large amounts of trash and debris on the side of the roads. Staten Island has also become very overcrowded in the last ten years and the addition of so many multi family homes has only made this worse. There are twice as many cars on the road now then I remember growing up and this has raised the air pollution significantly. There is barely a time where there is not traffic in the streets and expressways and it is about to get worse now that they have reduced the speed limit to twenty-five miles per hour on all roads. There have also been many new stop signs and traffic lights with cameras; some roads have them at almost every intersection. Being a part of a large city the entire community is very well lit, in my opinion overly lit and to bright. There is also handicap access at every public building. Community buildings, offices and restaurants need to be handicap accessible in order to pass inspections. There are also two YMCA centers within the community and numerous public parks with playgrounds, beaches, boardwalks and sports fields that are utilized all times of the year. These areas are kept clean by the city sanitation department. Most public and private schools also have playgrounds on the campus that are open to the public after school hours. There is also an abundance of restaurants all over the community, easily hundreds of all different types of cuisines. Staten Island is a melting pot of cultures and it is definitely seen in the many different kinds of restaurants in the community. A new trend that has started in the last two years is the appearance of food trucks on the street. The city is trying to make Staten Island more like Manhattan where they have all different kind of food carts on every street. The occurrence of food carts has increased all over the community especially this past summer. This also unfortunately increases the rodent problem. There are many rats, mice, raccoons and other kinds of pest all over the community and in the hotter months mosquitos are a huge problem. New York City is known for its rat problem and Staten Island is not exempt from this problem.
e. Social functioning Staten Island is a very family oriented community. On Sunday I observed many families going to church together. There are many different kinds of churches, chapels and synagogues all over the community due to the diverse cultures living within the community. A large part of the community is Roman Catholic and there are a large amount of catholic churches and schools located all over the island. Neighborhoods are very family oriented, this past Halloween I observed many groups of families and friends trick or treating with their children. Many neighbors also have neighbor watch programs as well as community councils that meet numerous times a year. A big group in my neighborhood is the Westerleigh Improvement Society and is a large group of community members that meet monthly in order to work on and discuss issues within the community. They are always have fundraisers and drives to help improve and clean up the community. This sense of community is not everywhere unfortunately. There is areas of Staten Island that have a high incidence of gang related activity especially in the Port Richmond, Mariners Harbor and St. George areas. There have been a few incidences that made the nationwide news recently in regards to the issues that occurred between gang members and the police in these areas. One particular incident results in a march Al Sharpton held in the St. George section of Staten Island which was very disruptive and ended up dividing the community rather then bringing it together.
f. Attitude toward healthcare I believe that health resources are well utilized in my community. Especially with the recent Ebola scare there has been a definite increase in people utilizing public healthcare options. The emergency departments are being utilized more then normal due to the fear people have of Ebola. There are man free health clinics and government funded healthcare available to the community. Staten Island has a high utilization of government provided healthcare and it is very often utilized. Besides healthcare being readily available to residents there are many out of hospital options as well. Local pharmacies often advertise many wellness and preventive care options. CVS pharmacy have what is called a minute clinic where individuals can go and ask questions, get healthcare advice as well as a check up and preventive medications and vaccines right within the pharmacy. The local hospitals are frequently advertising health related events that they hold in order to increase awareness on healthcare issues and trends. I have also volunteered at health fairs that are held in area high schools for the public to go and get simple health screens and flu shots in order to increase their awareness on health issues. Overall the community has many opportunities for its residents to receive healthcare, wellness visits and preventative treatment in order for the community to remain healthy as a whole. This is especially important with flu season just starting and the advertisements have been more frequent the last few weeks then they were in the summer. The advertisements are sure to raise awareness for the community.

3. Community Dynamics and Health Problem Conclusion

Provide a summary of your findings and your conclusion. What problems did you identify? I have found in my observations that Staten Island is a very diverse community. The different neighborhoods within the community all have their pros and cons. Since we are one of the five boroughs of New York City this diversity is to be expected. It is an interesting occurrence how on a simple drive you can go through so many different types of neighborhoods. A major issue I observed has to do with overpopulation. Single-family homes are things of the past and more multi-family townhouses are being built every day. This is leading to overpopulation of Staten Island. There are more people and more cars on the road, which are all within the same amount of space. This is increasing traffic and pollution of the community as a whole leading to the decline in people’s health overtime. There is also a huge drug issue within the entire community. Many people assume that drug issues tend to be within the lower classes, which is not true in this community. People of all classes and ages are abusing drugs. The biggest drug issues right now are heroin addiction and abusing prescription medications. Driving around I actually observed a drug exchange outside of a deli in the middle of the day. Besides drug abuse alcohol abuse is another big issue within the community. Daily we read about people being caught with and injuring themselves and others driving under the influence of drugs and alcohol. It is a huge problem that is being overlooked in my opinion. Lately there has been an increase in drunk driving checkpoints throughout the community that has brought awareness to and helped the issue. The problem does not discriminate and is an issue all over the community. People are being critically injured and losing their lives over these issues and it is getting out of control. Besides the drug issues there is also a big gang presence on certain parts of the Island that seems to be spreading to new areas each and everyday. The police have been receiving a high amount of scrutiny over a recent issue that occurred during the summer that resulted in the death of a man that was resisting arrest. Since that time the police have been under so much scrutiny it has been preventing them from doing their job due to the large amount of constant criticism they are receiving. It is interfering with them being able to do their jobs efficiently and the crime rate has risen. The majority of Staten Island is a close-knit community but these issues are slowly making the community suffer and break apart. I find more and more people moving off of the island, a move which I myself am planning to make next year. Overall Staten Island has some serious issues but it is the community in which I was born and raised. The majority of my family still live here and it will forever be my home.

Community Dynamics and Health Problem Sample Answer


Caring for populations’ assessment is an essential step in ensuring complete patient satisfaction in a population. Assessment of patient progress in health may occur after or during treatment. Diagnosis is part of the population care process which aims at identifying the disease or infection of a community. There are many and different assessment strategies and diagnostic procedures which are employed by a community to uncover its problem so as to provide the best intervention for each of the components of the identified problem.  The interventions provided consider any related community dynamics. In this paper, I discuss the how different assessment strategies to identify the health problem of Staten Island, the possible components of the problem associated with family dynamics and diagnosis for the problem


North Shore of Richmond County is one two major communities in Staten Island. It is served by Richmond University Medical Center. It is divided into smaller areas which include George, Port Richmond, Mariner’s Harbour, Stapleton and West Brighton.  . North Shore is historically known to be poorer, less literate and subject to cultural and linguistic barriers as a result of a considerable proportion of foreign born residents. These factors have been limiting factors to the community’s access of better health care. According to released by Richmond County Medical Society (RCMS) in 2008 commission, infant mortality in this community was recently approximated to be 60 % higher than the over rate of the entire New York City and almost three times above what was reported in South Shore.

The report commissioned by RCMS identified poverty as a major hindrance to access to health care and has a great impact North Shore’s health status. The sub-regions in North Shore are the leading in poverty levels in Staten Island. For instance, Stapleton (21%), Port Richmond (17.5%), Mariner’s Harbor (17.4%) and West Brighton (15.4%) carry the highest levels of poverty rates.  Other regions have lower lover levels poverty levels such as South Shore of Staten Island with a rate of 4.6% in 2007. The community also faces the most serious challenges in terms of healthcare resources, besides poor health status and high poverty levels. Majority of the 2,000 individuals known with HIV/AIDS in RUM come from North Shore.

Demographic and epidemiological data

According to the census carried out in 2,000, persons below 18-years old were represented by 23.7 % while that of the state 23.6%. Those at the age of 65 and over comprised of 15.5% against the state’s 13.8%. In a research carried out by the Massachusetts Department of Public Health for 1995-2013, the demographic data obtained collected indicated great levels of inadequacy in all aspect of the community’s well being. The population below 100 % and 200% of the poverty level is 8.9% and 20.7% of 24,412 and 56, 868 respectively and that of the state is 9.3% and 21.7%.  Children under the age of 18 years of age leading a life  below 100% of the poverty line is  for the community and the state are 20.7 %  and 21.7% while the unemployed people who are 16–years-old and above is 8.3% of 12, 536. The population of the state Births to women aging 15 to 44 is 58% of 3,256. Infant mortality is 3.1% out of a count of 10. Birth to adolescent mothers is 6.4 % of 210 and those benefitting from publicly funded prenatal care 44.7 in a count of 1,450. On infectious diseases, the community recorded an HIV/AIDS prevalence of in terms of a crude rate of 208.1 in a count of 598, tuberculosis crude rate 5.2 out 15, pertussis 5.6  out of 16, hepatitis-B 80 out of 23. In terms of injury indicators, the crude rates in suicide, homicide, and injury deaths related to a motor vehicle is 4.9(of 14 counts), 10.9 (31 counts) and  2.5 (2.5 of 7). Last, chronic disease indicators, total deaths recorded is 687.3 out of 2,651 counts. The area adjusted rate of cancer, 175.5(of 651 counts), breast cancer deaths 57.6 out of 208 and cardiovascular disease deaths 196.1 out of 794 area counts (Richmond University Medical Center, 2013).

Windshield survey

Community assessment plays an essential role in community nursing. It is important to understand various categories of the residents in the community is fundamental to clarifying the process of assessment.  The first category of residents described were the HIV/AIDS young people between the age of 18 and 30 years old. The most of the women were already married while fewer men had spouses. A few of HIV/AIDS positive patients were low income earners while a majority were unemployed and depending on farm produce and small business for survival.  Those who suffered from HIV/AIDS related complications received medical attention from a nearby health center.  The second category identified was old people aged 75 years and above. Most of them lived in abject poverty and received inadequate attention from their caregivers. Most of them nursed chronic problems such as diabetes and blood pressure. Besides the little support from family members, there no other support system ( Wilkinson  & Leuven, 2010).


The main problem this community is facing is a hindrance to accessing the right health care as well as the availability of healthcare facilities. Statistics show that only 8.7% community members have the AFDC Medicaid Recipients and are 8.7% and 1.1%.  As a result of poor health care, infant mortality in the community and the state are 3.1% and 4.4 % respectively. Multiple Assistance Unit Medicaid Recipients   Poverty arises from inadequate education of the residents of this community. It was discovered that most members of this community and health care centers had no access to electronic health records. Different age groups showed varying levels of poverty and rationale. Most young people are poor because of unemployment, poor education and substance abuse. Closely associated with this problem is poor medical care to the people. Ability to access proper medical attention depends on one‘s level of education, access to a medical facility and other social-economic facts (Cornelius & Price, 2013).

Community Dynamics and Health Problem Summary

North shore is and its sub-regions are the poorest when it comes to Per Capita Income, the prevalence of disease and access to the diagnostic center. The rates of poverty and disease prevalence are high with poverty as the main underlying problem. Most youths are unemployed. This community has poor access to health care despite a wide range of health related issues it faces. From the windshield survey carried out, it was seen that most people were in abject poverty and help was not soon coming. In conclusion, serious interventions are needed in order to help the community initiate and implement its health programs.

Community Dynamics and Health Problem References

Cornelius, F., & Price, R. (2013). Community health nursing test success an unfolding case study review. New York, NY: Springer Pub.

Richmond University Medical Center Community Health Needs Assessment & Implementation Plan 2013. (2013, January 1). Retrieved November 22, 2014, from

Wilkinson, J., & Leuven, K. (2010). Fundamentals of Nursing Theory, Concepts, and Applications. (2nd ed.). Philadelphia: F.A. Davis.

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