# Module 2 (Week 2) Part Two: Statistical Analysis of Community Health Problem

Module 2 (Week 2) Part Two: Statistical Analysis of Community Health Problem

Please complete the following information on this template. If you do not use this template there will be a 10-point grade penalty per assignment, and you will be requiredto resubmit within 48 hrs. You may increase the size of the blocks on the template by continuing to type within each section.  Use as much space as necessary to provide your answers.

Name of Community or Zip Code: Kyle, 78640

Instructions:Enter your response in each category marked below.  Provide objective, statistical support for your subjective findings.

• Include all the data listed in the Objective Data Criteria listed below.
• All statistical data must be reported in NARRATIVE form only. Tables and graphs will not be accepted.
• Compare objective data for your community with local (city), state, and national data.

You may increase the size of the block by continuing to type.  Use as much space as necessary to provide your answers

General Objective Data Criteria for the Community-at-Large

1. Demographics: Total population; age distribution; gender distribution; family characteristics (single parent, multi-family, etc.). Remember compare objective data for your community with local (city), state, and national data.Remember to cite sources as appropriate.
 Kyle is one of the most populated cities in Texas being at number 89 out of the 1712 cities. It has a population of 39, 060 with Lancaster following it closely at 388767 people and Texarkana at 37679 people. Texashas a population of 26, 092,033 while the national statistics stand at 314,107,084.The male female ration is 1.0:1 across, Kyle, Texas and the national data. Kyle has a median age of 30.1 with Texas being at 33.9 and37.4 nationally. Kyle age breakdown include 9.5% males and 19.8 females for less than 5 years, 18.6males and 19.8% females for ages between 5 to 14, 9.3% males and 5.8% female for ages between 15 to 19 years, 5% male and 5.35 female for ages between 20 to 24 years. 17.1% male and 19.4% female in the bracket between 25 to 34 years.19.1% male and 17.2% female for ages between 35 to 44 years old. Between 45 to 54 years old, the male constitute of 12.4% and female consisting of 10%. Between 55 to 64 years old, 6.1% are male and 6.9% are female. 2.5% males and 5.2% females are between the ages 65 to 84 years old. Above 84 years old, the males consist of 0.4% while the female constitute of 0.2%. The family types in Kyle constitute of 83% of married couples, 13% of common-law couples and 4 percent female lone parent. In

1. Racial/Ethnic Characteristics: Remember compare objective data for your community with local (city), state, and national data. Remember to cite sources as appropriate.
 It terms of racial distribution, the Caucasians form 76.21% of Kyle population, 74.73% in Texas and 73.815 nationally. The African Americansform 7.02% of Kyle population, 11.86% for Texas and 12.60% nationally. The Asians are at 0.85% in Kyle, 4.09% for Texas and 5.00% in the national population. American Indian in Kyle are at 0.25%, 0.49% in Texas and 0.82 on the national population (Davis,Roscigno& Wilson, 2016).There are 0.00% native Hawaiian in Kyle but stand at 0.085 in Texas and 0.17% for the national population. The mixed race form 2.42% of Kyle population, 2.38% in Texas and 2.91% for the entire national population. Other races stand at 13.24% in Kyle, 6.37% in Texas and 4.705 for the national population.46.6% of the Kyle population constitute of Hispanics who may be of various races and could be applicable in various racial categories.

1. Economy: poverty rate, unemployment rates, median income. Remember compare objective data for your community with local (city), state, and national data.Remember to cite sources as appropriate.
 The median household income of the residents of Kyle in 2016 was \$72, 191. This was relatively higher compared to other residents from Grey Forest at \$72, 083 and Terlingua at \$72,188.Thehousehold income in the united states stand at \$ 53,482. Despite these raised figures, 6.8% of the Kyle population live in poverty hence the city is ranked number 38 in terms oflevels of poverty. The children are ranked number 37 at a poverty level of 22.7%, working age women at number 31 with 16.1% and working age men at number 24 with 11.5%. The unemployment rate is at 2.60% in Kyle and at 5.20% in the united states.

1. Education: High school completion rates; higher education statistics. Remember compare objective data for your community with local (city), state, and national data. Remember to cite sources as appropriate.
 The highs school completion rate in Kyle is at 86.6% of the population while the higher education remains at 29.5%.

1. Identify two Morbidity and Mortality/Risk Problems: (Based on your observations from Week 1 subjective assignment, windshield survey and key informants provide Morbidity, Mortality (M&M) and risk data for your community… Example 1: if you observed obesity in your community then present obesity rates and health conditions associated with obesity [i.e. CVD, HD, Depression, etc.). Example 2: smoking/drinking rates and health conditions associated with smoking [i.e. Lung Cancer, COPD, etc]. These variables may include the following: gender (who does this problem affect the most, men or women); age distribution; ethnicity or racial group(s) mostly-affected; morbidity and mortality rates; any data related to life-expectancy in light of the health issues; is there a geographic area where the health problems mainly exist; is there a relationship between the health issue(s) and environmental health hazards; are these life-threatening health issues? Remember compare objective data for your community with local (city), state, and national data. Remember to cite sources as appropriate.
 In Kyle, the rates of childhood obesity has risen in the last three decades raising the risks for other accompanying condition such diabetes mellitus, cardiovascular conditions, early puberty, mental illness, low self-esteem, negative body image, elevated levels of blood cholesterol as well as kidney conditions. In the last ten years, the number of children and the adolescents with type two diabetes have increased from 5% to 20%. According to American heart association, the childhood obesity graph have been rising constantly. The united states have a childhood obesity rate of 175 affecting about 12.7% millions of children and adolescents (CDC, 2017).

1. Other data as needed (air, water quality, crimes rates). Remember compare objective data for your community with local (city), state, and national data. Remember to cite sources as appropriate.
 Kyle has a crime rate of 16.76% per 1000 residents having a report of 599 crimes in total. The violent crimes constitute of 1.74% totaling to 62 crimes while property crime encompasses 537 crimes with a percentage of 15.03(Fischer et al., 2017).The property crime rate in Texas is at 28.31 % and the violent crime rate at 4.12%.In 2015, the crime rate in the united states change with the overall violent crime increased to 4.i percent while the property crime reduced by 1.3 percent. The staff responsible of safety and quality of water in Kyle is the city of Kyle Public Works staff as they ensure the water meets the standards of Safe Drinking Water Act. The water in Kyle city was safe for use according to the report by Customer Confidence Report delivered in July 2017 to the customers.Despite the fact that the customer confidence report also indicated safe and quality water for Texas, the state had experienced various water quality problems from several public water supply bodies. These bodies are affected by contaminants ranging from pesticides, nitrates from and phosphorus from animal feeding operations and waste water treatment plants, petrol products from storage tanks and mercury from manufacturing companies. The drinking water quality levels of the united states if generally good since more than 905 of the nation’s community water system is in line with the standards set by the Environmental Protection Agency. Air quality index of Kyle city is moderate and at 52 percent.Similarly, Texas has a moderate air quality index save for other parts of the country due to pollution from vehicles. Without the pollution, the state experience good air quality. The Texas Commission on Environmental Quality monitors the air quality on an hourly basis for the metropolitan cities.

Analysis of Data

1. Based on your subjective and objective review of your findings, what conclusions have you arrived at? Remember to cite sources as appropriate.
• What impressions from your subjective observations were unfounded/invalid?
 Despite the fact that there were no occurrences of most-like appearances on the air and majority of the population going to work by commuting, the air pollution is still significant hence at moderate level of 52% instead of good or excellent.

• Given the objective data, what impressions were validated/substantiated?
 Following a high number of children with obesity, it validated the existence of the condition among adults. This so because the childhood obesity is a reflection of the lifestyle in the city and cuts across to the adult population.

• What cause-and-effect relationships did you discover/identify?
 The rising population has led to various changes in the city including increased poverty rate, increased crime rate and pressure on the social facilities such as academic institutions.

1. Problem Analysis for Community/Zip Code:

Problem: List two (2) problems within your community (for example, Infant Malnutrition, CVD, Lung Cancer, Obesity, Alcoholism, Violence)NOTE: These problems need to be something the Community Health Nurse can impact(for example, a CHN cannot build a sidewalk, repair a street, implement a new bus route, etc.). Remember to cite sources as appropriate.

1. Obesity____________________________________________
2. ________________________________________

Select one of these problems and complete the Problem Analysis chart

 Problem Correlates* Relationship of Correlate to Problem Data Supportive of Relationship + Ex. Inadequate diet Ex. Diets lacking in required nutrients contribute to malnutrition Ex. All infants and children seen at the local Public Health Clinic are referred to the nutritionist because of poor diets (X.Y. personal communication, date). Of infants measured, 60% were in the lower percent for their weight/height (X report, date). Increased amount of food intake and inappropriate composition of food consumed as well as inactivity leads to obesity. Excess food intake and constant intake of fortified food leads to over nutrition. Inactivity also leads to accumulation of fats hence obesity. Only 30% of children and adolescents were active for at least 60 minutes per day on a weekly basis. Hence 15.6% were overweight and 15.7% obese (Cunningham, Kramer & Narayan, 2014).

*These are factors that contribute to problem and outcomes.

+ Refer to appropriate sections of the database and relevant research of the findings in current literature.  Data in the third column could be local, state, or national statistics.

Refer to text (pg. 420-423) for additional examples.

1. Community Health Nursing Diagnoses:

Based on your subjective and objective assessment findings above for both Weeks 1 and 2, write TWO priority community health nursing diagnoses.

You must use this format as outlined in your text page 413(do NOT use NANDA):

Health Risk/problem of (specific injury, illness, or potential of, complication of, etc) among (specific population) related to (supporting evidence from your assessment findings).

• Your CHN DiagnosesMUST be something that a community/public health nurse can do something about. See example below.
• Note: Poverty is NOT a CHN diagnosis.
• Remember do NOT use NANDA Nursing Diagnoses.

For example:Risk of asthma complications among children in SE Dallas County related to observations of overcrowded living conditions, lack of public transportation (may result in inability to access health care), high number of animals observed living in homes, poverty indications (may result in lack of access to medications).

Community Health Nursing Diagnosis #1

 Risk for lifestyle conditions among children in Kyle, Texas related to inactivity and poor dieting from the observation of in adequate number of playing field and recreational centers, taking of junk food and using buses to go to school (Skinner et al., 2016).

Community Health Nursing Diagnosis #2

 Risk for insecurity related to high poverty levels and relatively lower employment rate (Fischer et al., 2017). This can also be related to the idleness among the employed which might have increased the violent crime rate.

Module 3 (Week 3) Part Three: Community Health Nursing Intervention

Directions: Please complete the following information on this template. If you do not use this template there will be a 10- point grade penalty per assignment, and you will be required toresubmit within 48 hrs.You may increase the size of the blocks on the template by continuing to type within each section.  Use as much space as necessary to provide your answers.

Introduction: Purpose of the paper, synopsis of community, two CHN diagnoses with supporting evidence, for example, observations, reports from Key Informants and Statistical data. Remember to cite sources as appropriate.

 This paper aims to explore the health problems of population in Kyle city and come up with a solution towards curbing the identified problemsKyleis one of the cities located in central Texas. It is between Austin and San Antonio.

Based on the 2 CHN Diagnoses you developed in Assignment 2or modified, select ONE problem and develop a CH Nursing intervention.Remember to cite sources as appropriate.

1. CHN Diagnosis/Problem you selected:
 Risk for lifestyle conditions related to inactivity and poor dieting among children Kyle as observed by taking of unhealthy diets, absence of playing fields for children as well as children using buses, public transport and lifts for their transport to and within the schools they learn in. In order to curb this risk, there is need to create awareness among the care providers of this children towards the health problem. This can be done by running the remedy programs in the media, use of bill boards and introduction of the health topics into the children program. In addition, lobby can be conducted to introduce policies that are geared towards providing playing field for children to play and also making it mandatoryfor school programs to honor the breaks and playing periods in the school programs. At the same time, farmers can be taught on food production to increase the farm produce of food that is healthy and enable embrace of fresh farm products rather than the processed foods(Crixell et al., 2014). This will see adequate farm production to serve the entire Kyle city population hence feeding on healthy diet.

1. Why did you select this problem? Provide your rational for selecting this problem in 1-2 comprehensive paragraphs (Consider the problem priority criterion on page 415 Box 18-7). Provide supporting community and scientific/authoritative evidence, for example,Healthy People2020, CDC, AHA, other. Remember to cite sources as appropriate.

 Risk for lifestyle conditions was of priority to this population based on the health problems that they are already facing according. Already Kyle experiencing not only the childhood obesity but also adult obesity this is an indicator of other eminent conditions that may develop with time. According to CDC, all other cities including Kyle failed to meet the healthy people 2020 goal of 15% prevalence of obesity with the least obesity rates of Colorado at 20.7%, Hawaii at 21.8% and Massachusetts at 22.7 %( Dietz, 2015).These statistics together with observations from the practices by the residents of Kyle, there exist a great risk of developing lifestyle diseases other than obesity which will cut across all ages. Through this study, the causative factors will be determined and addressed appropriately.

1. Identify two (2) Goals. For example,goals indicate where you want to go.

Then, identifytwo to three (2-3) objectives per goal. For example,objectives should indicate how you plan to get there, or how you plan to accomplish the goal(s).

 Goal 1:Increase the childhood obesity awareness in September which is considered National Childhood Obesity Awareness Month.   1.      Objective: Increase awareness that lack of physical activity can lead to obesity and other lifestyle conditions.   2.      Objective:To reach all the care giver of children and adolescent concerning the issues of childhood obesity.   3.  Objective: To distribute various fliers and air various programs that would reach the parents, teachers, farmers children and adolescent who are all stakeholders in childhood health.     Goal 2:Lobby for policy change towards keeping children healthy as well as advising the policy, makers on matters pertaining to the health children and the adolescent.   1.      Objective: To reach out to the policy makers in spearheading bill amendments pertain to food production, physical; activities in school and playing grounds for children.   2.      Objective: To rally the community and other stakeholders to form a strong base in spearheading the changes of laws in schools, community and the agricultural center.   3.      Objective: to seek for contributions in the drafting of bill pertaining to the children and adolescent health.

1. Intervention Objectives Timeline
 Present Date Objective( Number and Statement) Anticipated Completion Date Enter Date Ex.  Eighty-percent (80%)of infants seen by health department, neighborhood health center, and private physicians will have developmental levels assessed. Enter Date 16/01/2018 70% of children in preschool and primary classes per school will enter in a nutrition program.  The school physician will record their weight monthly, guide their physical activities as well as diet for a whole year and then record the weight after 16/01/2019 14/02/2018 All teachers for both preschools and primary classes will undergo seminar to equip them with knowledge and modified programs to teach children and their parents. The community health nurse in conjunctionwith the school pediatrician will spearhead the program. 03/03/2018 27/02/2018 Two teaching sessions will be conducted per week in the local media stations and channels concerning healthy leaving among children and the adolescent. 27/08/2018

Refer to text (pg. 420-423) for additional examples.

1. Plan of Intervention and Evaluation
 Date Intervention Activities Responsible  Agency/Person Evaluation Measures Target Date of Completion Enter start date.         16/01/2018 Ex. Community Health Nurse identifies and trains lay advisors in community as case finders            The school nurse and pediatricians will enroll pupils into a nutritional assessment program where the activity and diet of the participants will be monitored. The nutritional assessment will also be carried out to determine the progress of the report. Ex. Community Health Nurse (CHN)         School nurses and school pediatricians. Ex. • Lay advisors will be able to verbally describe case-finding methods to CHN • Number of new WIC cases will be tracked by CHN on monthly basis for 1 year to determine if goal of 80% has been met   Running nutritional programs will be established and continuous get assessed during the period allocated for the programs. Ex. Lay advisor training completed by enter date of estimated completion.       The program will run up to 16/01/2019 14/02/2018 The community health nurse will organize with various school administration for training seminars to their teachers on modification of teaching programs to accommodate health education to the pupils. Community health nurse, school pediatrician and school nurse. The teachers will be able to make a lesson plan accommodating the health education plan. The teachers will also be able to verbalize the expected areas of concern in the teaching program. The teachers will demonstrate various ways in which they will convey the health education and activities to their learners. The teachers seminar will come to a closure by 03/03/2018 27/02/2018 Community health nurse organizes and teaches the general public on healthy leaving among the adolescents and children on radio stations and local channels. Community health nurse. The public will be able to ask questions and verbalize understanding of the proposed practices through calls and text messages to the stations. The teaching sessions will be completed by 27/08/2018

Refer to text (pg. 420-423) for additional examples.

Summary/Conclusion: Summarize your assessment findings, your proposed community health nursing intervention, and the community public health outcomes that you anticipate as a result of the intervention.  This can be one or two brief paragraphs. Remember to cite sources as appropriate.

 The urban nature of Kyle city has predisposed it to various health risks. Its high population has forced the residents to compete for various resources while at the same time exposing them to health hazards. The childhood obesity is high not only in Kyle but also in the Texas state and united states in general(Skinner et al., 2016). This can related to the poor diet and inactivity from the entire population which have embraced the capitalist culture with few playing fields for children and common use of fast foods. This has put the children a greater risk of lifestyle conditions which will extend to their adulthood. In order to curb the risk, lobbying to change policies on agricultural production and children physical activity, creating awareness among the care providers of both children and the adolescent as well as incorporating health education in the children education program will be of benefit (Dietz, 2015). This will lead to combined forces directed towards physical activity and dieting among the children and adolescents hence change in lifestyle. In the long haul, the children and the adolescent will be fit hence giving hope for healthy adulthood to the Kyle population.

References:

Cunningham, S. A., Kramer, M. R., & Narayan, K. V. (2014). Incidence of childhood obesity in

the United States. New England Journal of Medicine, 370(5), 403-411.

Crixell, S. H., Friedman, B. J., Fisher, D. T., &Biediger-Friedman, L. (2014). Peer Reviewed:

Improving Children’s Menus in Community Restaurants: Best Food for Families, Infants,

and Toddlers (Best Food FITS) Intervention, South Central Texas, 2010–2014.

Preventing chronic disease, 11.

Davis, J. J., Roscigno, V. J., & Wilson, G. (March 01, 2016). American Indian Poverty in the

Contemporary United States. Sociological Forum, 31, 1, 5-28.

Dietz, W. H. (2015). The response of the US Centers for Disease Control and Prevention to the

obesity epidemic. Annual review of public health, 36, 575-596.

Fischer, K. R., Schwimmer, H., Purtle, J., Roman, D., Cosgrove, S., Current, J. J., & Greene, M.

1. (2017). A Content Analysis of Hospitals’ Community Health Needs Assessments in

the Most Violent US Cities. Journal of community health, 1-4.

Skinner, A. C., Perrin, E. M., & Skelton, J. A. (May 01, 2016). Prevalence of obesity and severe

obesity in US children, 1999-2014. Obesity, 24, 5, 1116-1123.

Walker, K. E., &Crotty, S. M. (2015). Classifying high-prevalence neighborhoods for

cardiovascular disease in Texas. Applied Geography, 57, 22-31.