Sample Essay on Community Health Needs Assessment

Community Health Needs Assessment

Introduction

This report will provide information and summary of Chester County community health needs assessment of children with dental health care needs. Quantitative information from the US census and Chester county department of health will provide the required statistics for the report, which will be compared to the Healthy people 2020 goals and objectives to determine the state of dental health care for children.

 

Information Background of the Community

Background information for the community is vital for the assessment, as it will provide in details the defining boundaries of the community to be studied. The climatic factors and features that may affect the health and well-being of the community; environmental and climatic factors, can lead to poor dental health. It is asserted that unhealthy diet could lead to dental problems, which may be determined by missing, unfilled, and decayed teeth of children (McGeehin and Mirabelli, 2001).  Business activities in the community also have an indicator on dental health of children because it points to the economic status of the community.

The community to be studied is around Chester County hospital in West Chester, PA. The hospital serves the community, and it is at the level of national hospital with over 220 beds, admitting more than 13,500 patients in a year in addition to performing both in-patient and out-patient services. This region is served well by the different transport network and facilities comprising the Thorndale regional rail and the bus routes that ensure access to the medical facility and the services it offers. The transport network defines the boundaries with the routes providing service in and around West Chester, Exton mall through to the West Chester roundabout.

It is asserted that Climatic occurrences have an effect on the health of the community and their capability to access services (Cooley et al, 2012). The climatic condition of the community is constantly fluctuating with high temperatures in the summer coupled with high storms. This poses a threat of certain diseases to the community, especially those carried by bugs (Centers for Disease Control and Prevention, 2013, June 6). This region experiences an annual high temperature of 63.8°F and low temperature of 40.2°F translating to an average of 52°F. The average annual rainfall-precipitation is averagely 47.82 inches with an annual snowfall of 27 inch (National Center for Environmental Health, 2014, January 23). The climate can affect the health of the people, for example, climate change would increase pollen concentration drastically affecting individuals with asthma, and mosquitoes will increase and attack the community. Increased precipitation leads to floods threatening the quality of drinking water (Grisé, 2011).

 

The region around Chester county hospital is endowed with natural resources as it is served with the water catchment of Ontario, Chester creeks and the Schuylkill River (U.S. Global Climate Change Research Program, 2009, June 11). Agriculture has been the backbone of the economy in this community with mushroom growing being famous on the southern portion of the region (New York City Panel on Climate Change, 2009). In respect to the surrounding regions, the terrain can be described based on the elevation in feet; the high point is Honeybrook with an estimated 1020 feet with the Schuylkill River having the lowest height estimation of about 66 feet (Nowak and Heisler, 2010).  Being a low elevation between other counties, it experiences a subtropical kind of climate.

Chester County is well-thought-out to have a collection and a variety of business that have had immense contributions in promoting and prospering the economy. In this region, one will find entrepreneurial businesses and companies making them possess a whopping 25% of the nation’s purchasing power. This is an indicator that the economy and living standards of the people is good and will permit access of better dental and other healthcare services.

In the manufacturing sector companies such as Dopaco and Reynolds Metals among other companies offers employment and jobs to about 23.1% of the workforce population. This region has been considered the state’s richest farmland with rich fertile loan soils that has the flourishing of tobacco, corn, grain poultry, and livestock farming. The economic council of the region works closer with the farmers to contribute noteworthy agricultural revenue of about $333 million per annum. This affirms the position that the communities has improved income translating to better living standards making the population access and afford better health care services.

Based on the background information presented it is evident that the general living standards of the people is good and that a smaller percentage of around 20 percent of the children under the age of 5 have decayed, discolored, missing or filled teeth.  The need that the assessment would look into is on how to create awareness on the importance of good diet to the community through campaigns so that the different household families can embrace a well-balanced diet that will not cause dental problem to the children (Sheiham and Watt, 2000).

 

Analysis of population Demographics

 

Information on demographic characteristics of the community is important, as it will help identify certain issues during assessment. Dental care for children is often considered an expensive venture, which cannot be afforded by the entire population. This for instance will determine whether the household families will be in a position to provide the basic amenities to their children. The nature of the population and the size of household families will determine whether some families are overburdened to the extent of abandoning their children with dental problems (Pimentel et al, 2005).  Education level of the population is also significant during dental healthcare assessment for children, as it will show whether the population are actually well informed of the good diet for their children.

According to the information from Census data of 2010, the total population of people who were living in the region were about 29,972 out of which 17.2 percent were whites, 74.7 were black, 0.4 percent Native America, 0.6 percent Asians, 0.1 percent Native Hawaiian, 3.9 percent from other races (U.S. Census Bureau, 2015, November 7).  In these households 24.8 percent were married and lived together, 32.1 percent were single women with households but no husbands present, 36.6 percent had no families.

The average income for this population was estimated to be around 23,703 dollars while that of families was 29,436 dollars (U.S. Census Bureau, 2015, November 7). In this, the male gender had a considerable average income of 29,528 dollars compared to that of women that was 21,005. The capita income of the population under study is estimated to be about 9,052 dollars where about 22.8 percent of the families and a corresponding 27.2 percent of the population are living below the poverty line. In this population, a considerable 36.9 percent are children under the age of 18 while 65 years and above comprise 21.8 percent. Information sourced from census statistics indicate that about 11 percent of the population with the age of 18 and above graduated from high school while 55 percent completed Bachelors degree and above.

It is estimated that almost half of the adult population, which is 47.8 percent, graduated from a 4-year college compared to that of 28.2 percent nationwide. It estimated that in Chester County an estimated 29 percent of the population have graduated with a Bachelors degree, those with Masters Degree stand at 14 percent (U.S. Census Bureau, 2015, November 7). Those children enrolled in private preschools stands at 71 percent of the total, it also boasts of the best student to teacher ratio in the state (U.S. Census Bureau, 2015, November 7). The 12 district schools have an estimated 65,567 students population where the low-income students have been steadily growing by around 33 percent for the past four years. A third of the young population attends full day kindergarten with a graduation rate of about 93 percent.

From the statistics, it is evident that the population is not so big and that the dependency ratio is small, the need here would just to find a way to provide in-house dental programs and services to the population since they can afford as it is proclaimed that dental disease is one of the most expensive disease to treat.

 

Analysis and indicators of Health Status

It is acknowledged that dental health problems for children may cause a considerable suffering to the victim as it changes what people eat affecting the quality of life lived. It is in respect to this that there is need to incorporate dental health promotions to those who suffer from dental problems. Dental health problems, may lead to a number of chronic diseases, injuries and stress prompting the need for improved methods to prevent dental problems (Petersen , 2003).Dental problems diseases may affect both the physical psychological of the child influencing growth, chewing, speaking and socialization (Sheiham and  Steele, 2001). The morbidity and mortality rates that are caused by the chronic diseases may also have an influence on the dental health of the children.

 

Data from the US department of health affirms that information on morbidity and mortality rates will assist in establishing the linkages that are brought about by the social determining factors of health and outcomes. For example, it is essential to provide comparison of how a chronic disease leads to a specific health outcome and highlight on the causing factors and their relationships (Earl, 2001).  Infant mortality is the rate of deaths of children under the age of 1 year per 1000 births, this information is important for health service providers as it will identify an existing issues causing deaths that should be addressed. In Chester County, PA the total births translates to 30,215 while the total infant deaths is 157 translating to the infant mortality rate of 5.20. Morbidity rate ascertains how often a disease occurs in region, for instance, morbidity can be the number of people who have cancer or asthma. Some examples of diseases and their morbidity in the county include HIV with a total occurrence of 74 translating to a morbidity rate of 4.9 percent, Syphilis is 14 translating to a 0.9 percent, Tuberculosis 23 translating to a percentage of 1.5, gonorrhea an occurrence of 539 translating to a massive 35.9 percent.

It has been pointed out that the incidences of death are caused by certain chronic diseases from the statistics; there is the need for awareness on the relationships between other diseases and dental health diseases so that children are provided with the care that may prevent the occurrence of other diseases leading to high mortality.

 

Stakeholder/Key Informant Data

 

Questionnaires are prepared to be given to the key informants to provide responses on various issues that needed to be determined. The individuals were chosen since they were experts in the various medical and health areas in addition to possibility of providing expert knowledge and information. They were identified and recruited using appropriate, acceptable, and competitive exercise. These individuals have direct knowledge on the behavioral characteristics of the people in the county and include the following;

 

Ann Marie Siegal, M.D.

Chairperson, Breast Health Task Force

The Chester County Hospital

701 East Marshall Street

West Chester, PA 19380

610-431-5530

Fax: 610-431-5144

 

Anne Lamb

Dentist West Chester

194 Exton Square Mall

Exton, PA 19341

 

Barry Kliger

Dentist West Chester

1 Britton Pl, Ste 5

Voorhees, NJ 08043

 

Maureen Tomoschuk

President and CEO

Community Volunteers in medicine

610-836-5990 ext. 102

mtomoschuk@cvim.org

 

Mark Flanders

Borough Manager

Pottstown, PA

 

Kurt Zwikl

Executive Director

Schuylkill River Greenways Association

Pottstown, PA

 

Kay Dougherty

Former Board Member

Tri-County Area Health and Wellness Foundation

Pottstown, PA

 

 

Questionnaire

Introduction

I am conducting a community health needs assessment on children Dental health care in Chester County, PA. You have been identified and noted as an individual with valuable knowledge and information in such an activity, I appreciate your willingness to cooperate in the venture. Please note that all the information will go to the research and will strictly be kept confidential.

 

Key Health Issues

In the below list Please rank from 1-5 where 1 is most significant, the most vital health issue in Chester, County region.

Cancer                                                                                                1 2 3 4 5

Sexually Transmitted Diseases                                                          1 2 3 4 5

Dental health                                                                                      1 2 3 4 5

Stroke                                                                                                 1 2 3 4 5

Diabetes                                                                                             1 2 3 4 5

Substance Abuse                                                                                1 2 3 4 5

Herat Disease                                                                                     1 2 3 4 5

Tobacco                                                                                              1 2 3 4 5

Maternal/Infant Health                                                                       1 2 3 4 5

Unintentional injuries                                                                        1 2 3 4 5

 

As a matter of convenience share any additional knowledge concerning the above health issues on why you ranked them that way_____________________________________________

 

Access to Health Care

On the scale of 1-strongly disagree to 5-strongly agree, kindly rate each of the statements on the healthcare access in Chester County.

Most of the residents in the county are able to access primary health care giver      1 2 3 4 5

Majority of the population are able to access a medical specialist                                1 2 3 4 5

Most of the population in the county are able to access the services of a dentist  1 2 3 4 5

Transport to residents is available to meet medical appointments                                 1 2 3 4 5

The number of those providing medical assistance is sufficient in the region       1 2 3 4 5

Identify any two vital resources that may be required to improve healthcare access in the county. 1____________________________

2____________________________

 

Please rank from 1-5 where 1 is most significant. The barriers to accessing health care services in the region

Availability of health providers                                                         1 2 3 4 5

Unmet basic needs                                                                             1 2 3 4 5

Difficulty in navigating the health care system                                 1 2 3 4 5

Expensive services                                                                             1 2 3 4 5

Lack of child Dental health care programs                                        1 2 3 4 5

Lack of medical insurance                                                                 1 2 3 4 5

Transport problem                                                                             1 2 3 4 5

Language and cultural barriers                                                           1 2 3 4 5

Time constraints                                                                                 1 2 3 4 5

 

Share any additional knowledge concerning the barriers above and why you ranked them in that way_____________________________________________

 

Others

Based on your opinion is there any specific population that is inadequately being served by the health care system? Yes or No

Explain why?

 

Community Aspirations and Capacity

Based on your opinion, what are the activities that are being well done in terms of health care?

What would you recommend should be done to improve the quality of health in the county?

What are some of the encouragements that would motivate more community involvement in the health issues? (Tick all that apply)

Increased Communication and awareness

Community Forums and workshops

Engaging diverse leaders

Providing opportunities for the community

Collaboration with other stakeholders

 

The assessment will be a holistic technique that would collect and analyze vital data while incorporating critical thinking on the issues to be addressed.

Analysis of the community’s Social System

Political landscape of a region may determine the healthcare legislations that are put in place, the social status of the population based on religion and cultural beliefs may determine the behaviors exhibited in adoption of certain programs and procedures in diseases prevention and control. The well-fare programs provided by the socio-political structures are considered building stones in eradicating and managing certain diseases.

This county has originally been known to be a Republican stronghold though it is gradually incorporating Democrats. The commissioners are in involved in formulation and selection of policies to provide the vital resources and facilities; in addition, they are also responsible for managing financial transactions and other administrative tasks. There are varieties of social religious institutions in the region including the Orthodox Churches, Catholic Mission Churches, and United Methodist church.

The system of education is structured in a way that the early childhood education is followed by the elementary level, high school follows suit and then the tertiary level of education.  Post-secondary education includes programs of certificates, diplomas, Bachelors and Masters Degree (U.S. Census Bureau, 2015, November 7).  The education system of the county provides the students with opportunities to help prepare them to be productive citizens. Apart from education, the system provides for other extra-curriculum activities like athletics, music, and theatre.

The social environment in the region is that of cultural competency that ensures that the systems are able to provide effective and efficient health services to the population that is characterized by different values, beliefs, and behaviors. Fortunately, the social environment is responsive and conducive supporting the health care system services provision (Wenzel, 2003).

There are several community welfare and health care program in the region that is assisting the population with various services such as credit counseling services to offer counseling on foreclosure proceedings, free health care provided by volunteers through provision of both free medical and dental services especially if a household has no health insurance (Yee and Sheiham, 2002). The dentistry volunteers also offers preventive and restoration services for those who need them. Chester county food bank provide food assistance to the population and information to ensure food security to the people of the region. Other welfare programs include human services supporting housing and emergency rent deposit to the population, providing grants to pay rent to avoid people from being homeless. Medicare and Medicaid services programs offered comprise physician’s services, emergency evacuation services, home healthcare services, ambulance services, and home rehabilitation services.

 

References

 

Centers for Disease Control and Prevention. (2013, June 6). CDC urges everyone: Get ready to

stay cool before temperatures soar. Retrieved from Centers for Disease Control and Prevention: www.cdc.gov/media/releases/2013/p0606‐extreme‐heat.html.

 

Cooley, H., Moore, E., Heberger, M., & Allen, L. (2012). Social Vulnerability to Climate

Change in California. Oakland: California Energy Commission.

 

Earl, M. L. (2001). Improved rates of compliance with hand antisepsis guidelines: A three-phase

observational study. American Journal of Nursing, 101(3), 26–33.

 

Grisé, S. N. (2011). Evaluating the risk of non‐native aquatic species range expansions in a

changing climate in Pennsylvania. Shippensburg University, Department of Biology. Shippensburg: Shippensburg University.

 

McGeehin, M., & Mirabelli, M. (2001). The Potential Impacts of Climate Variability and

Change on Temperature‐Related Morbidity and Mortality in the United States. Environmental Health Perspectives, 185‐189.

 

National Center for Environmental Health. (2014, January 23). Natural Disasters and Severe

Weather. Retrieved from Centers for Disease Control and Prevention: http://www.bt.cdc.gov/disasters.

 

New York City Panel on Climate Change. (2009). Climate Risk Information. New York.

 

Nowak, D. J., & Heisler, G. M. (2010). Air Quality Effects of Urban Trees and Parks. Ashburn:

National Recreation and Park Association.

 

Petersen PE.(2003).The World Oral Health Report: continuous improvement of oral health in the

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Pimentel, D., Zuniga, R., & Morrison, D. (2005). Update on the environmental and economic

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Sheiham A, & Steele J.(2001). Does the condition of the mouth and teeth affect the ability to eat

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Sheiham A., & Watt R. (2000). The common risk factor approach: a rational basis for promoting

oral health. Community Dentistry and Oral Epidemiology; 28:399-406.

 

U.S. Census Bureau. (2015, November 7). USA: State and County QuickFacts . Retrieved from

United States Census Bureau: http://quickfacts.census.gov/qfd/states/00000.html.

 

U.S. Global Climate Change Research Program. (2009, June 11). National Climate Change.

Retrieved from Global Climate Change Impacts in the United States: http://nca2009.globalchange.gov/national‐climate‐change.

 

Wenzel, R. P. (2003). Prevention and control of nosocomial infections (4th ed.). Philadelphia:

Lippincott Williams & Wilkins.

 

Yee R, Sheiham A. (2002).The burden of restorative dental treatment for children in Third

World countries. International Dental Journal;52:7-10.