Community Health Nursing involves the promotion and preservation of health of population groups in a community (Kozier et al. , 2006). A community is a collection of people who share common aspects of their lives. It is a “social system in which the members interact formally or informally and form networks that operate for the benefit of all people in the community (Kozier et al. , 2006). ” In terms of health, a community may be viewed as a group of people living together in a certain locality having a common health problem, such as high incidence of infant mortality, tuberculosis, HIV/AIDS, obesity and others (Kozier et al. 2006).
Thus, Community Health Nursing involves the synthesis of public health practices and nursing principles in the application of means to promote and preserve the health of communities (Kozier et al. , 2006). Community Health Nursing is an important area of the nursing profession that ensures the health and productivity of individuals, families and societies. Hence, this paper will be dwelling on the application of Community Health Nursing principles on the assessment and analysis of the health status of a community: the county of Stanislaus, California, United States of America (USA). Community/Geographical Area
Stanislaus is a county in the Central Valley of California, USA. It covers an approximate area of 1,494 square miles of land mass and 21 square miles of water (Stanislaus County, 2009). The county was named after the the Stanislaus River, now Estanislao River, that snaked through the rich vineyards of the county. The area was first discovered by the European explorer Gabriel Moraga in 1806. Later, the Stanislaus river was renamed to Rio Estanislao, in honor of the Native-American chief Estanislao, who fought for the Indian’s liberation from the Mexicans until his defeat in 1826 (Santos, 2002).
In terms of politics, Stanislaus is primarily a Republican county. However, in the 2008 elections, Barack Obama, a Democrat, received perhaps the largest number of votes for the county (Moran, 2008). As for the county’s economy, majority of the county’s population works in sales and offices. However, the county is also well known as an agricultural county, producing primarily grapes used for the creation of wines (Sperling, 2008). Demographic and Epidemiological Data According to the 2008 Stanislaus County Community Health Assessment Report, there are around 525,903 individuals residing in the county.
Population reports show that this population has greatly increased, especially when compared to 2004’s overall population of 494,747 residents (Public Health Services, 2008). In general, there are more females (50. 5%) than males. Also, there are approximately 145,146 families residing in the county, with each household earning a median income of $50,094 (U. S. Census Bureau, 2009). In terms of age groups, majority (54%) of the residents of Stanislaus County are aged 20 to 59 years. When compared to the ages of the general population of California, Stanislaus has a younger population (Public Health Services, 2008).
In terms of race/ethnicity, the population of Stanislaus is composed of 87% White, 7% Blacks, 3% Asians, and the remaining percentage includes other races (Public Health Services, 2008). However, in the same report, it was projected that by 2015, “Whites will comprise 43% of the county’s population, Hispanics 46%, Asians 5%, and Blacks 3% (Public Health Services, 2008). ” From the 2009 County Health Status Profiles Report/Update of the California Department of Public Health, it was found that Stanislaus county had a crude death rate of 3. 57 (2004-2007), had 22 cases of AIDS (2005-5007), had 14 cases of tuberculosis, and had an infant mortality rate of 6. 7 (2004-2006) (California Department of Public Health, 2009).
The important thing to note in all these statistics is that not one of them was able to achieve the objectives and rates set by the Healthy People 2010. Health Concern Infant Mortality Rate has been considerd by most as the main indicator for a nation or area’s health status (Congressional Budget Office, 1992). Given this fact, the county’s infant mortality rate sadly reflects a rather poor community health status.
The county gathered an infant mortality rate of 6. 7 – a value way above California’s infant mortality rate of 5. 3 and much more higher than the Healthy People 2010 objective of 4. 5 infant mortality rate (California Department of Public Health, 2009). Healthy People 2010 is a set of health objectives that provides a framework for health promotion for the the nation. “It is a statement of national health objectives designed to identify the most significant preventable threats to health and to establish national goals to reduce these threats (Healthy People, 2010). In the Healthy People Objectives, a major objective included for maternal and child health is: “Reduce fetal and infant deaths (Healthy People, 2010). ” The Stanislaus County Community Health Report for 2006 highlighted the problem on infant mortality rates for the county. According to the report, of the 58 counties in California, Stanislaus county ranked as the 10th worst for overall infant death (Public Health Administration, 2006).
The same report revealed that “an average of one to two babies die every week in Stanislaus County (Public Health Administration, 2006). These figures emphasize the severity of the infant mortality in the county. Unfortunately, the definite reasons for the high infant mortality rate are still unknown. Even until now, the Stanislaus County Government and Public Health Services Department is trying to research the definite reasons for the said mortality rate. However, some possible reasons and factors pointed out include living conditions, lack of prenatal care and visits, past medical history, health habits, and life changes/social support (Public Health Administration, 2006).
A primary resource center for the community would be the county’s Health Services Agency (HSA). The HSA offers health care services for the community through a network with health centers that are qualified by the state. The HSA conducts activities and programs to chieve its missions: a) promote wellness and healthy lifestyles; b) prevent illness and injury; c) provide quality care and treatment; and d) preserve access to health care for the underserved; through leadership, continuous improvement and teamwork. Most especially, the HSA lives and works around its vision of “Healthy People in a Healthy Stanislaus! (Health Services Agency, 2010)”
An important program of the HSA is the Maternal Child Adolescent Health [MCAH] Program. This program “facilitates the assessment of health status of women, infants, children and adolescents, the identification of gaps/barriers to services, the coordination with community programs, and the advocacy for development of services to meet identified needs (HSA, 2010). ” However, even with all its efforts, infant mortality remains an area of health not being addressed/solved despite the entire partners’ involvements. Recommendations In all these, it is comforting to know that nurses can help in dealing with this problem.
Nursing professionals can participate in the MCAH’s programs for mothers and infants. Among these programs inlude: Comprehensive Perinatal Services Program (CPSP), Healthy Birth Outcomes (HBO), Perinatal Outreach and Education (POE), and Prenatal Care Guidance (PCG) (Health Services Agency, 2010). In the CPSP, nurses can provide assessments, nursing interventions, referrals to obstetricians, and follow-ups. In the HBO, nursing professionals can provide intensive case management services through voluntary home visits, in coordination with the other members of the health care team.
In POE, Public and Community Health Nurses can provide education and outreach in order to promote healthy pregnancies and healthy children. Finally, in PCG, nurses provide guidance and counselling on nutrition, family planning, prenatal care, insurance, and all other related aspects of pregnancy (Health Services Agency, 2010). Throug the participation in these activities and through partnerships with agencies like the HSA, nurses facilitate the advancement toward a healthier target population.
At the end of the day, even after all the efforts that people exert and will exert, health problems, including Stanislaus’s high infant mortality rate, will perhaps still remain. But despite this, it is important for health care professionals to continue their efforts to help the community. It is important for nurses, especially, to support and participate in the community’s, nation’s, and state’s efforts toward a healthier population. However, ultimately, the overall objective the nurse should aim for is to enable the population to be indpendent and effective decision makers for their health and health care.