Assignment 1: Community Assessment, Data Analysis, and Community Diagnosis Community Assessment of Diabetes Cases.
Recently, with the numerous changes in diets that individuals consume all over the world, there has been the development of diseases such as diabetes. Such conditions harm the quality of life for the infected individuals. Diabetes mellitus refers to a group of illnesses that are mainly characterized by the evidence of a rise in the levels of blood glucose. This disease is chronic and can have adverse effects such as mortality and high levels of morbidity. The increase in the cases of diabetes globally is fueled by the ever-rising number of obesity individuals, especially those with uncontrolled diet intake. The financial effect, reduced life expectancy, mortality, and premature morbidity that healthcare services, careers and diabetic patients undergo make this disease a severe health-threatening phenomenon. Like many cities, Harrisonburg, Virginia is one of the communities that have experienced a detrimental rise in the number of individuals diagnosed with diabetes. Although there are several strategies put in place to reduce the challenges that the patient undergoes due to diabetes, these individuals are still negatively affected by this disease. A Comprehensive assessment of Harrisonburg City is important based on their description, demographic makeup, reasons why diabetes affect them, and the risk and resilience factors that are present in the community.
Description
Harrisonburg is geographically located in Virginia’s Shenandoah Valley. As per the data from the United States Census Bureau (USCB), the city of Harrisonburg is about 46km2 with almost 0.3% of water and 99.7% of land (DeValpine & Trull, 2019). This city is located towards Rockingham County and is filled with numerous distinctive physical features that characterize its location in the valley. The climate of the area is generally cool to cold winters and hot, humid summers winters which can generally be described as the normal climate in most parts of the country. The city contains a good infrastructure with quality roads leading to every part of the city. There are well maintained clean buildings all over the country with the most popular business being the fast-food business since they are located in every corner of the city. As per the data provided by the National Center of Health Statistics (NCHS), there is also a recent rise of the businesses that partake in medical products (Stanhope & Lancaster, 2015). Most businesses are located towards the center of the city with facilities such as schools and hospitals located away from the city center.
Demographic makeup
Population
The population of this community lies at 55000 people as per the data provided by USCB as of July 2018 (Bendfeldt, 2017). Harrisonburg is one of the cities with the highest population density, which lies at 1100 people per kilometre square. Compared to the city’s population as of 2010, the rate of population growth is average as the percentage change is at around 10.3%. The rise in population in the city has been triggered by the numerous schools and business activities that people engage in throughout the city.
Age
Most of the community’s population is composed of the young population, with most individuals ages below 24years. This is specifically because of the two successful universities in the city that attract students from all over the world. Two thousand students are enrolled at Eastern Mennonite University while 22000 students are enrolled at James Madison University with Blue Ridge and Bridgewater also contributing to the high number of students. A small portion of the population is aged above 24 years, with only 7% aged above 70years (DeValpine & Trull, 2019). As per the data from the USCB, the city has a median age of 24, which is much lower from the 38 of Virginia State as a whole.
Gender
Both the female and the males are well represented in the town with their numbers slightly different. USCB gives the ration as 100 females to 87 males with their numbers at 27, 700 and 23,400 respectively (DeValpine & Trull, 2019). The ratio in gender in Harrisonburg has been influenced by the populations in the schools since the largest number of females are students at the universities.
Ethnicity
The Harrisonburg community is a diverse community filled with individuals from different races such as Asians, Latinos, African Americans, and whites. The diversity in races and ethnic groups is mainly because of the educational activities in the city that attract individuals from different parts of the world. According to the statistics from USCB, as in 2018, whites were the most abundant population across all ages in the community, followed by African Americans and least were the Pacific islanders.
Financial status
The financial status of individuals in this community varies depending on the age as which also causes the changes in their ability to work. The financial status of the city is average since the per capita income of the city is at $17,004 (Bendfeldt, 2017). With the average, financial status, there are some individuals below the poverty line, while others are above the poverty line. Since most of the individuals in the city are young, they make the largest percentage of the people living below the poverty line. The USCB statistics highlight that 32% of the population is below the poverty line, which includes 22% below the age of 20 and 10% above the age of 64 (Bendfeldt, 2017). Elderly individuals are below the poverty line because most of them are not physically able to work and earn an income.
Morbidity rates
Although there are health facilities in the city, the residents of the city still suffer high levels of morbidity specifically because most of the diseases that they face are either difficult to manage or expensive to manage. The major causes of morbidity in the city are diabetes mellitus, stroke, chronic lower respiratory diseases, cancer and heart disease. The symptoms that most of these chronic illnesses cause have caused most individuals to spend most of their time hospitalized, but still undergoing high levels of pain. The situation is even worse for the individuals that are under the poverty line as they cannot access adequate medical care, and thus suffer morbidity while at their homes. Also, some of the individuals in the community suffer morbidity due to these diseases because the hospitals in the city lack adequate facilities that can ensure the patients’ wellbeing.
Mortality rates
Mortality rates in the city have been rising over the years due to a rapid increase in population, which in turn leads to more people suffering from diseases that cause death. The higher mortality rate in the community has also contributed to the rise in the levels of obesity amongst the individuals. The major causes of mortality in the city as per the data provided by NCHS in 2018 were diabetes mellitus, cancer and heart disease, which caused 70% of the deaths. NCHS also states that in 2018, out of the 1,800 recorded in Harrisonburg, 60% were below the poverty line (Stanhope & Lancaster, 2015). This indicates that most individuals who live below the poverty line undergo higher mortality rates due to their inability to access quality medical care as they cannot afford.
Attitudes towards health and healthcare
As per the information from the windshield survey, the individuals in Harrisonburg city believe in the healthcare provided in the healthcare facility is more than the individual methods of maintaining personal health. This is depicted from the numerous hospitals and medical centers that offer medical services to the members of the society (DeValpine & Trull, 2019). It is also stated that the Virginia state government had set aside over 200 million dollars for the project of creating a hospital in Harrisonburg city. This depicts that not only the individuals but also the government have a positive attitude towards health and healthcare services. There is also a positive attitude towards the individual’s health depicted by the foods that are sold in some of the shopping centers. The survey shows the grocery part of the shopping center where many green foods and fruits are beneficial for protecting the members of the population from some of the illnesses.
However, although they depend on the healthcare facilities for their health, they do not give priority to health and wellbeing. They majorly focus on the food that they consume rather than issues that can boost their health. The city is filled with many fast foods stores that sell junk foods that can easily affect the health of the individual.
Information from the informants
From the survey, information from the informants on the health standards depicted how the individuals view the health services that are offered to them by the government. The issue on the creation of a 200million dollar hospital in the city that contains all the necessary equipment will be of a positive impact on the community’s health. This building will be beneficial in reducing the levels of mortality and morbidity caused by diabetes mellitus. It will also help reduce the costs that could have been incurred from the long-distance travels in search of medication.
The informants have also highlighted the numerous numbers of fast food stores that even surpass the number of health institutions in the area. This information is relevant in the assessment of the causes of diabetes in the community. With the significant causes being related to the high levels of obesity amongst the individuals, the fast foods stores play a role in the rise of diabetes cases in the city. This is because the food stores specifically base their business on the junk and fatty foods that contribute to obesity in most individuals.
Strengths and opportunities for the community.
Despite being at risk of having to undergo high morbidity and mortality rates due to diabetes, Harrisonburg has several strengths and opportunities that they could use to ensure their wellbeing. The primary strength of the city is the high level of awareness of some of the businesses. For instance, the individuals at the grocery section of the shopping center understand the dietary requirements for all individuals, both the affected and normal persons in the community. This availability of the dietary requirements for the individuals who want to prevent or control the levels of diabetes in society is of great strength to the community.
The availability of several health centers in different parts of the community is also a strength to the community in dealing with diabetes cases that affect them. Through these health centers, individuals that develop diabetes symptoms can easily receive early treatment without allowing the situation to worsen. Early management of diabetes saves the patient from morbidity and mortality rates that they would undergo if they had not received early treatment.
A state government that is willing to invest and support the improvement of health care services provided to the community is a great opportunity. As stated by one of the interviewees, the government was planning to set up a 200 million dollar hospital in the city. With such an opportunity, there will be an advancement in the quality of care services since such a costly hospital will have all the advanced equipment needed to manage diabetes mellitus.
A large number of schools in the area are an opportunity for fighting diabetes and ensuring the individuals live a healthy life. This can be done through the introduction of personal health-related courses in the schools that are specifically based on how individuals can prevent or live without the risk of developing diabetes. This will be effective in dealing with the rise in cases of diabetes in the community as the individuals will be aware of how to protect themselves from the risk of acquiring the disease.
Data description
The members of this community are vulnerable to being affected by diabetes because of their general lifestyle and the diet that the individuals consume. From the windshield survey, there are no signs of individuals walking down the street, which confirms the probability of the residents of this community living a sedentary lifestyle. With sedentary lifestyle being amongst the major causes of type 1 diabetes, this shows why this problem faces the members of this community. Also, having a significant population of students, they engage in less activities, such as reading which can be described as a sedentary lifestyle.
Also, judging from the blooming fast foods business in the city, there is a high level of consumption of junk and fatty foods that contribute to obesity in most of the individuals. From the statistics provided by NCHS, 30% of the population in Harrisonburg are obese with a higher percentage of female than male (Dobrosielski, Gibbs, & Stewart, 2016). Obesity is due to the foods that individuals consume in this community is also a significant cause of the ever-rising cases of diabetes in the city.
Risk factors
The risk of prevalence of diabetes amongst the members of the Harrisonburg community are highly related to the lifestyle that the individuals live in the city (Rashwani & Sattar, 2018). For instance, the increase in weight of most of the individuals in the city increases the risk of the development of diabetes amongst them. This is major because of the fatty diet that the individuals consume, which contributes to the deposition of fats in most tissues, thus making their cells insulin-resistant.
Age is also a significant risk factor for diabetes in the community since there is a substantial number older individuals amongst the population (Rashwani & Sattar, 2018). The risk of this disease affecting the aged portion of the city is mainly because of weight gaining, losing muscle mass, and fewer exercises. However, the cases of diabetes are also numerous among young individuals in the city.
Inactivity amongst the members of the community also puts the members of the city at a higher risk of developing diabetes. This is major because, without any physical activity, there will be gaining of weight, accumulation of glucose, and reduced sensitivity of the cells towards insulin. In Harrisonburg city, as per the windshield survey, there is inactivity as no one is seen in the streets of the town.
Resilience
The resilience factors for individuals with diabetes in Harrisonburg City are majorly the financial and medical support that individuals with diabetes receive from the family and other community members. For instance, the family members help individuals with diabetes adhere to the medication, thus enabling them to live a quality life. With a significant number of diabetes patients living lives below the poverty line, the community supports them by offering financial support for them to access adequate medication.
Effect
Diabetes not only affects the individuals and their families but also affects the community as a whole. NCHS reports that about 90% of the diabetes patients have permanent jobs in Harrisonburg (Stanhope & Lancaster, 2015). Due to morbidity and mortality caused by the disease, there is usually underperformance in most of the duties that they perform and in some cases, gaps are left in the job spaces that they initially occupied. This affects the community since there will be a reduction in the level of productivity, thus affecting the development of the city. Also, the financial support that the city provides leads to unexpected expenditure that can be regarded as a loss, since it could be invested in other development projects. Familywise, there will be a considerable loss, especially when the infected individual is the breadwinner since he or she can no longer earn income for the family.
Resources
Harrisonburg City has enough resources that can be used to resolve this problem, which include numerous health centers and educational institutions (Zimmet & Alberti, 2016). Through the health centers, the community can offer adequate medication that can be effective in reducing the rates of morbidity and mortality amongst the patients. Also, in educational institutions, courses can be introduced that educate the people on how they can avoid developing diabetes through proper dietary practices and engaging in activities that involve the whole body to prevent gaining weight.
Nursing Diagnosis
Diabetes among the members of the Harrisonburg City community related to obesity and inactivity as evidenced by the National Center of Health Statistics (NCHS).
Generally, diabetes can have a detrimental effect on not only an individual but also the economy of the country. Morbidity and Mortality rates due to this disease have been increasing rapidly over the years. With every individual being vigilant with their health, this disease can easily be dealt with in all parts of the world.
References
Bendfeldt, E. S. (2017). Everyone at the Table: A community Food Security assessment for Harrisonburg. VA . Virginia Cooperatve Extension , 11-26.
DeValpine, M. G., & Trull, L. H. (2019). Health Equity in Community Assessments: A Participatory approach in Rural Virginia. SAGE open, 21-39.
Dobrosielski, D. A., Gibbs, B. B., & Stewart, K. J. (2016). Examining Predictors of change in AIc with Exercise i Type 2 Diabetes Mellitus . Medicine and Science in Sports and Exercise , 536-544.
Rashwani, A., & Sattar, N. (2018). Risk factors, mortality, and cardiovascular outcomes in patients with type 2 diabetes . New England Journal of Medicine , 633-644.
Stanhope, M., & Lancaster, J. (2015). Public health nursing e-book: Population-centered health care in the community. Elsevier Health Sciences , 12-23.
Zimmet, P. Z., & Alberti, G. (2016). Epidemiology of Diabetes- status of a pandeic and issues around metabolic surgery. Diabetes care , 878-883.
Appendix
Population distribution in Harrisonburg City according to age
