Community Assessment and Analysis

Functional Health Patterns

Questions

Responses

Hetal

• Predominant ethnic and cultural groups along with beliefs related to health.
• There is a strong attachment to indigenous cultures. The community still believes in traditional treatment methods that uses hers and plants.
• The advancement of modern healthcare techniques has been promoted by Christianity
• Predominant spiritual beliefs in the community that may influence health.
• The community has great respect for natural healers or “santeros” who claim to posses spiritual powers.
• Availability of spiritual resources within or near the community (churches/chapels, synagogues, chaplains, Bible studies, sacraments, self-help groups, support groups, etc.).
• The community is in close proximity of both churches and spiritual shrines. The Roman Catholic church has however made great achievements in converting most of the Hispanics to Christianity.
• Do the community members value health promotion measures? What is the evidence that they do or do not (e.g., involvement in education, fundraising events, etc.)?

• What does the community value? How is this evident?

• On what do the community members spend their money? Are funds adequate?

Hetal

• Predominant health problems: Compare at least one health problem to a credible statistic (CDC, county, or state).
• The major health issues include a predisposition to diabetes, asthma and HIV / AIDS. For example, Latinos accounted for 20% of new HIV / aids infections on the US. The number of Hispanic adults having asthma contributes to around 26% of he US population
• Immunization rates (age appropriate).
• Very low immunization rates among  Hipanic children. Around 77 percent of Hispanic children aged 19-35 months of age have received the recommended 4 doses of DTaP, 3 doses of polio, 1 dose of measles-containing vaccine, and 3 doses of Hib vaccine
• Appropriate death rates and causes, if applicable.
• The age bracket with the highest death rates was 60-69 years. The main causes of these deaths were heart diseases, cancer and accidents.
• Prevention programs (dental, fire, fitness, safety, etc.): Does the community think these are sufficient?
• The main prevention program that assists this community is PCP. PCP provides advice on healthy living with a focus on supportive communities and leadership skills.
• Available health professionals, health resources within the community, and usage.
• Most of the communities do not have access to health facilities. The existing facilities are over-utilized and understaffed.
• Common referrals to outside agencies.
• The United Nations programs also operate in these areas for example WHO.

Hetal

• Indicators of nutrient deficiencies.
• Obesity rates or percentages:
• The highest obesity rates are found among the black Hispanics (44.1%). This mainly caused by poor dietary behavior as well as a lack of nutrition education
• Compare to CDC statistics.

• Affordability of food/available discounts or food programs and usage (e.g., WIC, food boxes, soup kitchens, meals-on-wheels, food stamps, senior discounts, employee discounts, etc.).
• The Food banks and WIC have attempted to substitute food shortages and nutrition deficiencies by introducing food stamps and relief food distribution.
• Availability of water (e.g., number and quality of drinking fountains).
• The availability of safe drinking water is a difficulty for most white and black Hispanics
• Fast food and junk food accessibility (vending machines).
• Children and adults prefer junk food that is easily accessible in street-side vending machines and in school grounds.
• Evidence of healthy food consumption or unhealthy food consumption (trash, long lines, observations, etc.).
• Most of the populations scramble in fast food joints for junk food. There are also large volumes of littering in dumpsites that displayed the huge consumption of fast foods.
• Provisions for special diets, if applicable.
• There are no special diets for the Hispanic masses.
• For schools (in addition to above):
• Nutritional content of food in cafeteria and vending machines: Compare to ARS 15-242/The Arizona Nutrition Standards (or other state standards based on residence)
• Amount of free or reduced lunch
• Most states have regulations on the content but Hispanic-inhabited regions have lax or sometimes, no regulations on nutrition levels. Schools do not actively participate in regulating the type of food their students consume.

Hetal

• Common air contaminants’ impact on the community.
• Air has been polluted due to the smoking cars, fire smoke, dust and pesticides. The pollution contributes to deaths by asthma and other respiratory complications like pneumonia.
• Noise.
• Increased usage of cars and trucks contributes to noise pollution.
• Waste disposal.
• The sewage systems are not properly designed therefore raw sewage is left to run on the surface.
• Pest control: Is the community notified of pesticides usage?
• The communities are ignorant of the proper methods of handling, usage and disposal of pesticides.
• Hygiene practices (laundry services, hand washing, etc.).
• Their hygiene routine is low because of water scarcity and lack of education in the area
• Bathrooms: Number of bathrooms; inspect for  cleanliness, supplies, if possible.
• The Hispanic population have low personal cleanliness levels
• Universal precaution practices of health providers, teachers, members (if applicable).

• Temperature controls (e.g., within buildings, outside shade structures).
• There are no air conditioners to stabilize the temperature within buildings.
• Safety (committee, security guards, crossing guards, badges, locked campuses).

• The unemployed youth engage in petty crime as well as organized violent activities. The local police and private security officers are not enough to contain these criminals.

Jessica

• Community fitness programs (gym discounts, P.E., recess, sports, access to YMCA, etc.).

CULPEPPER, Q. (2012, July 17). Program aims to keep Hispanic community healthy, fit. Kvue.com. Retrieved May 22, 2012, from http://www.kvue.com/news/local/Program-aims-to-keep-Hispanic-community-healthy-fit-98667134.html

• Recreational facilities and usage (gym, playgrounds, bike paths, hiking trails, courts, pools, etc.).

Moore, L. V., Diez Roux, A. V., Evenson, K. R., & McGinn, A. P. (2008, February 25). Availability of Recreational Resources. National Institute of Health. Retrieved May 22, 2012, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2254179/

• Safety programs (rules and regulations, safety training, incentives, athletic trainers, etc.).

Construction Safety: Best Practices in Training Hispanic Workers. (n.d.). Construction Safety: Best Practices in Training Hispanic Workers. Retrieved May 22, 2012, from http://ehstoday.com/construction/news/ehs_imp_36851/

• Injury statistics or most common injuries.

Acosta, D. (2008, November 29). Unintentional Injuries in the Hispanic/Latino Population. Unintentional Injuries Content. Retrieved May 22, 2012, from http://faculty.washington.edu/dacosta/HHP/module6/content.html

• Evidence of sedentary leisure activities (amount of time watching TV, videos, and computer).

The President’s Council on Physical Fitness and Sports – E-Newsletter. (2007). The President’s Council on Physical Fitness and Sports – E-Newsletter. Retrieved May 22, 2012, from http://www.fitness.gov/enewsletter/Summer07_featurearticle.htm

• Means of transportation.

American Community Survey. (n.d.). 5-Year Release Details. Retrieved May 22, 2012, from http://www.census.gov/acs/www/data_documentation/2009_5yr_data/

Jessica

• Sleep routines/hours of your community: Compare with sleep hour standards (from National Institutes of Health [NIH]).

SLEEP – Sleep Health in U.S. Hispanic Population. (n.d.). SLEEP – Sleep Health in U.S. Hispanic Population. Retrieved May 22, 2012, from http://www.journalsleep.org/ViewAbstract.aspx?pid=27848

• Factors affecting sleep:
• Shift work prevalence of community members
• Environment (noise, lights, crowding, etc.)
• Consumption of caffeine, nicotine, alcohol, and drugs
• Homework/Extracurricular activities
• Health issues

SLEEP – Sleep Health in U.S. Hispanic Population. (n.d.). SLEEP – Sleep Health in U.S. Hispanic Population. Retrieved May 22, 2012, from http://www.journalsleep.org/ViewAbstract.aspx?pid=27848

Jessica

• Primary language: Is this a communication barrier?

• Educational levels: For geopolitical communities, use http://www.census.gov and compare the city in which your community belongs with the national statistics.

Regarding education, the proportion of Hispanics 25 years old and over with high school diplomas increased from 45.7 percent in 1983 to 53.1 percent in 1993. Despite that improvement, in 1993 Hispanics were still much less likely to be high school graduates than were non-Hispanic Whites. About 9.0 percent of Hispanic young adults reported that they had a bachelor’s degree, compared with about 26.8 percent of non-Hispanic White adults.

The Hispanic Population. (n.d.). The Hispanic Population. Retrieved May 22, 2012, from http://www.census.gov/population/www/pop-profile/hisppop.html

• Opportunities/Programs:
• Educational offerings (in-services, continuing education, GED, etc.)
• Educational mandates (yearly in-services, continuing education, English learners, etc.)
• Special education programs (e.g., learning disabled, emotionally disabled, physically disabled, and gifted)

White House Initiative on Educational Excellence for Hispanics. (2011, December 30). U.S. Department of Education. Retrieved May 22, 2012, from http://www2.ed.gov/about/inits/list/hispanic-initiative/index.html

• Funding resources (tuition reimbursement, scholarships, etc.).

• Without a doubt the Hispanic Scholarship Fund is one of the largest and most well recognized resources for Latino scholarships. The HSF is a clearinghouse for educational information related to Hispanic students and has built enough influence and respect to draw millions of dollars in funding from large corporate sponsors like McDonalds and Wal-Mart.
• The Hispanic Heritage Foundation has taken on a mission to inspire Hispanic students of all heritages to become extraordinary civic leaders. The organization specifically offers a number of annual Hispanic Heritage student scholarship awards.
• The Hispanic Association of Colleges and Universities (HACU) delivers droves of information relative to the institutions most invested in Hispanic students. HACU’s list of scholarships is regularly updated. Corporate partners such as Gap, General Motors, and Home Depot fund these awards. All HACU scholarship recipients demonstrate a balance of academic motivation and financial need. Monetary awards range from $1,000 to $2,800.
• For Hispanic students interested in journalism or broadcast media, the National Association of Hispanic Journalists (NAHJ) scholarships run between $1,000 and $5,000. All offer specific relevancy for Latinos who are sadly invisible in mainstream journalism.

Scholarships for Hispanics. (n.d.). Hispanic Scholarship Programs and College Opportunities for Hispanic Students. Retrieved May 22, 2012, from http://www.collegescholarships.org/minority2.htm

Trish

• Age levels.
• Most of the young Latinos view themselves as being in the middle of two cultures and struggle with understanding their identity. The older population of Latinos still has low self-perception.
• Programs and activities related to community building (strengthening the community).
• The Latinos have community-based coalitions to provide capacity building. They mobilize each other through health organizations as well as churches and schools to build their communities.
• Community history.
• Pride indicators: Self-esteem or caring behaviors.
• The adolescents have higher self esteem than any other social group because of their education levels, business links and exposure to other cultures
• Published description (pamphlets, Web sites, etc.).

• Journal of Adolescent Research that contained the issue “Ethnic Identity and Self-Esteem of Latino Adolescents: Distinctions Among The Latino Populations”

Trish

• Interaction of community members (e.g., friendliness, openness, bullying, prejudices, etc.).
• Latino Americans tended to avoid competition or activities that would set them apart from their own group. The aspect of machismo influences cross gender interaction. There is a general hatred of the European Americans
• Vulnerable populations:
• Why are they vulnerable?
• How does this impact health?
• The black Hispanics are the most vulnerable populations. This is because they are predisposed to catching very many diseases through their low health status. Most of them are also poor and this makes it difficult to afford treatment.
• Power groups (church council, student council, administration, PTA, and gangs):
• How do they hold power?
• Positive or negative influence on community?
• The church and the school are the two groups that influence most of the Latino Americans. These two groups contribute to national building, poverty alleviation and resource allocation among other activities that make them influential. They both have positive impact on the society by imparting skills and good morals on the Latinos.
• Harassment policies/discrimination policies.
• The Northern European police are cited as the worst terrorists of the Latino community. Police from North America harass Hispanics during random raids, drug raids or other police programmes. The central US government has however targeted Latinos I the healthcare scheme that was launched by the Obama regime.
• Relationship with broader community:
• Police
• Fire/EMS (response time)
• Other (food drives, blood drives, missions, etc.)
• Hispanics are generally welcomed in other communities. Their relationship with other law enforcing agencies both local and international has not been very cordial. The Latinos also cooperate with NGOs

Trish

• Relationships and behavior among community members.
• Early sexual activity among adolescents exposes young people to health-related consequences, particularly sexually transmitted diseases (STDs). The older age bracket from around 45 also has a higher sexual activity.
• Educational offerings/programs (e.g., growth and development, STD/AIDS education, contraception, abstinence, etc.).
• The fight against HIV/AIDS and other predisposing behavior is mainly spearheaded by NGOs like CDC. CDC has programmes to counter the spread of HIV by transsexuals and prostitutes. CDC also engages in CBO mobilization to provide awareness on the different contraceptives, diseases and other information on STIs
• Access to birth control.
• Most families cannot access birth control due to unavailability, cost of ignorance on such methods.
• Birth rates, abortions, and miscarriages (if applicable).
• The current birth rate for Latinos in this area was 80.3 births per 1000. The number of miscarriages also went down to 26% from 34%.
• Access to maternal child health programs and services (crisis pregnancy center, support groups, prenatal care, maternity leave, etc.).

• Most pregnant females cannot access healthcare for their babies, as it is unavailable and expensive. The teenage pregnancy rate is almost twice as high compared to other females globally. Therefore, many groups have come up to form crisis centers to support them like the Florida Pregnancy Support Services Program

Trish

• Delinquency/violence issues.
• A large number of youth drop out of primary and secondary levels of education to join street gangs or peddle drugs in the hope of achieving income stability.
• Crime issues/indicators.
• There is an increase in gang activity in San Antonio. The youth in these gangs engage in drug peddling and petty crime around the neighborhood.
• Poverty issues/indicators.
• Around a quarter of the Hispanic population, live in poverty. About 32.4 percent of Hispanic males and 31.1 percent of Hispanic females were unemployed in 2010 and the number is bound to increase over this economically harsh period. Generally, Hispanics also earn way less than non-Hispanic whites. All these factors coupled with high rates of school dropouts leads to more poverty among Latinos.
• CPS or APS abuse referrals: Compare with previous years.
• The rate of domestic abuse in Latino families has gone down compared to previous years. In 2002, 64% of all families had either experienced a violent incident or been a victim. This number has since dropped to about 55%. The Hispanic culture encourages wives to bear their abusive husbands and vice versa.
• Drug abuse rates, alcohol use, and abuse: Compare with previous years.
• The number of Latinos abusing drugs has increased as compared with previous years. 6,713 adults in Texas were included in a survey that investigated the prevalence of drug abuse among Hispanics of which 1,690 persons admitted to either abusing drugs or formerly taking drugs. This was an 11% rise in drug abusers from the previous year.
• Stressors.

• Stress management resources (e.g., hotlines, support groups, etc.).
• Most of the chronically ill Latinos receive stress management therapy in their hospitals. The rest of the masses are supported by government counselors who are easily reached.
• Prevalent mental health issues/concerns:
• How does the community deal with mental health issues
• Mental health professionals within community and usage
• Rates for most mental disorders among Latinos are similar to that of the overall population. However, rates vary among Latino sub‐groups, and rates for most mental disorders are higher for US‐born Latinos than for Latino immigrants. The community has a general stigma against such disadvantaged individuals. There are mental health professionals around the Hispanic-inhabited areas that assist mentally ill people. They include American Society of Hispanic Psychiatry (ASHP), Hispanic Medical Professionals and National Alliance on Mental Illness (NAMI) among others.

• Disaster planning:
• Past disasters
• Drills (what, how often)
• Planning committee (members, roles)
• Policies
• Crisis intervention plan
• Latino states have been hit by many disasters such as hurricanes and earthquakes. Low-income immigrant Latinos are particularly vulnerable to disasters because they are both ill prepared and disproportionately affected. A large population of Latinos cannot be accessed by the Emergency Management Systems.