3-4 page essay on a selected community
Conduct a Windshield Survey in a section of your community. Take notes about what you observe.
It requires actually taking a look at the selected area of the community. This survey should be focused on the problem and population you have selected for your practicum project. If you choose, for example, obesity among Hispanic schoolchildren, you might want to locate a section of the community where many Hispanic children live, or you might want to conduct the Windshield Survey around where Hispanic children attend school. If Hispanic children are not found in a specific section of your community (e.g., Chinatown in San Francisco or Harlem in New York), then you may select the section of the community where you live or work but pay particular attention to your practicum population and practicum problem as you conduct a survey of the community as viewed through the eyes of the public health nurse.
Submit a 3- to 4-page paper including:
Introduction to the community, including the name of the community and any interesting or historical facts you would like to add about where you live
Photographs of the selected area of the community that serve as evidence of your observations and hypotheses
Windshield Survey findings, including a description of the section of your community that you chose to survey
Description of the Vulnerable Population and Available Resources
Demographics of the vulnerable population
What social determinants create their vulnerable status?
What community strengths exist to assist this population?
Conclusions based on Nursing Assessment of the Community
Based on what you have found, what conclusions can you draw about your community and your selected population for your practicum? (Renal failure)
Select at least 5 scholarly resources to support your assessment. Websites may be included but the paper must include scholarly resources in its development. 11
Windshield Survey/Community Assessment
Name:
School:
Community Introduction and facts
The community I have chosen to conduct the windshield survey is Richmond City, in Fort Bend County, Texas. The city of Richmond was incorporated in 1837 and named after Richmond’s town in England. The city was among one of 19 cities to be incorporated by the Republic of Texas and witnessed the Battle of Richmond on August 16, 1889, which was the result of a violent feud over control of Fort Bend County (Wikipedia, 2020). Richmond is referred to as the county seat and located within the Houston/Sugarland/Rosenberg/The Woodlands metropolitan area. The location of the city is on the southwest side of the Brazos river, with a small portion on the northeast side, and connected by U.S Highway 90A which leads east 8 miles to the city of Sugarland, and bordered approximately 19 miles to the southwest by the City of Rosenberg (Wikipedia, 2020). The Population of Richmond was 11,679 based on the 2010 U.S census. Richmond consists of 51.20% of whites, 10.55% of African Americans, 0.63% of Native Americans, 3.53% Asians, 0.07% Pacific Islanders, 31.00% from other races, and 58.71% of them Hispanics or Latino population (Wikipedia, 2020).
Fort Bend County is one of the counties in Texas history. Fort Bend County was created from portions of Austin, Harris, and Brazoria Counties in 1837 after the incorporation of Richmond when the county was then seen as a suitable area for crops and livestock by the early settlers (Fort Bend County History, [n.d.]). Fort Bend has a rich heritage and historical value that has formed the bedrock of developments going on in the county presently and will help in positively shaping the future of the county. In the early 1920s, the discovery of oil and gas at Blueridge, Orchard, Thompsons, and later at Katy marked the beginning of Fort Bend’s petroleum industry. Presently, oil production continues in several areas of the county. Fort Bend had a sizeable black population, mostly slaves, after the end of the civil war. During Reconstruction, after the civil war, many black men were elected to County offices and were influential in Fort Bend County until the 1950s. Due to the high expansion rate noted in Houston in the early 70s, parts of Fort Bend county witnessed marked developments. New residential areas emerged. Places like: New Territory, Great wood, Cinco Ranch, Quail Valley, First Colony, Pecan Grove, Sienna Plantation, River Park East and West, Canyon Gate, Bridlewood, and Texana emerged and are now among the cities under the fort bend county (Fort Bend County History, [n.d.]). The estimated population for Fort Bend County in Texas was 811,688, which 55.1% represents Caucasians, Hispanics/Latinos are 24.7%, Blacks or African Americans accounted for 21.1%, and Asians represent 20.8% (U.S Census Bureau, 2019).
In the City of Richmond, there are several government agencies, private companies, and nonprofit organizations. The facility for my practice setting is one of the facilities in the City of Richmond; it is owned and funded by the State of Texas. The facility, established in 1968, occupies about 241 acres of land. The facility accommodates a diverse group of residents with different health issues. There are residents with an intellectual and developmental disability, medically fragile residents, residents with acute and chronic medical problems, and those that can function with limited assistance (Texas Health and Human Services, n.d.). The City of Richmond has numerous restaurants, malls, grocery stores, major stores like Wal-Mart, HEB, Kroger, Randall, Car dealerships, Clinics, Check-Cashing businesses, and strip-center sprawls. The city of Richmond is also known as the city of contradiction and transition due to being a part of Houston’s bustle and at the same time remaining a slow-paced farm and ranch town in Fort bend County and has several schools, public libraries, churches, recreational parks, museums, health centers, and notable medical center (Wikipedia, 2020).
Vulnerable Populations
Research data shows that the State of Texas had 10.9% – 11.9% adults diagnosed with diabetes with an age range of 18 and upward, 11.3% -12.8% represents the male population in 2018 (CDC, 2019). Also, there was a conclusion that about 7.4%- 10.5% of total residents of Fort-Bend County aged 20 and above had a diagnosis of diabetes, 7.7% -11-2% are African American males age 20 and above (CDC, 2019). Out of the 811,688 reported population in Fort Bend County, African Americans residing in Richmond, Texas, represents 15.2% out of 21.1% in Fort Bend County (U.S Census Bureau, 2019). Between 2016 and 2017, the percentage of uninsured residents in Richmond, TX average to 20.5% (DATA USA. [n.d.]). The poverty level at Fort Bend County, Texas, in 2019 was estimated at 7.9%, with about 5% African Americans among those living below the poverty rate in Richmond, Texas (U.S Census Bureau, 2019). In 2017, Diabetes mellitus was the contributing cause of death in Fort Bend County, with 315 deaths reported; the total number of men representing 84.7 deaths per 100,000 people, out of 97.7 deaths per 100,000 people in Texas, and 89.2 deaths per 100,000 people in the whole of United States (Texas health data. [n.d.]).
The determinant of health in the Community (City of Richmond, TX)
Biological and Genetics More males, Median age 45-54 as of 2016 (DATA USA, [n.d.]).
Individual Behavior Congestive heart failure, Pneumonia, UTI, Sepsis, and Diabetes (Type 1 and Type 2) are the primary diagnosis for hospitalization (DATA USA, [n.d.]).
Social Environment- Male and Female, which consists of Hispanics/Latinos, whites, Asians, and African Americans, with median Household income reported as $92,224 in 2017 (DATA USA, [n.d.]).
Physical Environment The Homeownership rate approximately 54.6%; most residents commute averagely 27.2 minutes to work by driving (DATA USA, [n.d.]).
Health Services In Fort Bend County, 1 PCP sees an average of 1,245 patients per year. Also, in the City of Richmond, 1 PCP sees about 1,245 patients per year. Only 79.5% of the population of Richmond TX, has health coverage with 41% on employee plans, 20.2% on Medicaid, 10.3% on Medicare, 0.714% on military or VA plan, and 7.25% on non-group plans (DATA USA, [n.d.]). The five leading hospitals are less than 5 to 10 miles from the surrounding cities in Fort Bend County, one of the hospitals (OakBend Medical Center) is located in Richmond, TX. Due to these several determinants in this community, the cost of treatment of diabetes and other comorbidity conditions often pose a high burden on the individuals and families, which can be a barrier for individuals to adhere to regular treatment regimens and also stands as a barrier to consistent monitoring of the disease (Bernard, Banthin, and Encinosa, 2006).
Conclusion
Due to its nearness to Mexico, the State of Texas has a high concentration of both legal and illegal immigrants from Mexico. With this challenge comes a high level of Diabetes mellitus cases, most notably among the immigrant population. Due to the high number of Hispanics/Latinos and African American residents in Fort Bend County, the City of Richmond, just as other cities in Texas, has a high rate of diabetes cases. It is, therefore, challenging to provide adequate health care for this population with or without health insurance. Legislation Between 1986 and 2013 made it an existing challenge for the State of Texas to provide appropriate and cost-effective care to the 1.6million undocumented immigrants, despite the continued growth of this vulnerable population (Kuruvilla, and Raghavan, 2014).
To fully reach this vulnerable population group, it is essential for the Public Health Nurse to pay attention to areas where this population group lives and also works. The nurse should strive to build trust with the group; nurses should provide education if possible in languages the immigrants can easily understand. Teaching should be on how to prevent and manage the disease very well. Nurses should educate immigrants on how to have access to healthcare with or without insurance. Without adequate education for this vulnerable group, Diabetes mellitus Type 1 and Type 2 cases will continue to rise within the community with complications from Cardiovascular diseases being the primary cause of death. It also exposes the population to risks of having cardiovascular diseases such as Myocardial infarction, stroke, and peripheral vascular disease (Morrish, Wang, Stevens, Fuller, and Keen, 2001).
Historical Pictures
OakBend Medical Center located in Richmond TX.
Fort Bend Museum Built in 1883 located in Richmond, TX.
Fort Bend County Court House located in Richmond, TX.
Shopping Malls in downtown Richmond, TX.
St. John’s United Methodist Church, designated as a Recorded Texas Historic Landmark in 1983 located in Richmond, TX.
Richmond City Hall located in Richmond, TX
Richmond Police Department is in the old jail located in Richmond, TX.
State of Texas owned health Care facility (Richmond State Supported Living Center, established in 1968).
Facility entrance and housing area of the Residents
Healthcare Center located near the Richmond State School in Richmond, TX.
A community with predominantly African American residents near Richmond State School in Richmond, TX.
Rail Road freight train heads west through Richmond
George Memorial Library in Richmond, Tx
The three Elementary schools within the Richmond city limits include: Jane Long, Pink, and Smith.
Jane Long Elementary School T. L. Pink Elementary School Deaf Smith Elementary School
The middle/junior/high schools within the Richmond city limits include: Wessendorff Middle School, Lamar Junior High School, and Lamar Consolidated High School are serving the student living within the Richmond city.
Wessendorff Middle School Lamar Junior High School Lamar Consolidated High School
References
Bernard, D., Banthin, J., & Encinosa, W. (2006). Health Care Expenditure Burdened among Adults with Diabetes in 2001. Medical Care, 44(3), 210-215. Retrieved June 17, 2020, from www.jstor.org/stable/3768154
DATA USA (n.d.). Richmond, TX. Retrieved from https://www.datausa.io/profile/geo/richmond-tx#health
Fort Bend County, Texas (n.d.). History | Fort Bend. Retrieved from https://www.fortbendcountytx.gov/your-county/about-us
Kuruvilla, R., & Raghavan, R. (2014). Health care for undocumented immigrants in Texas: past, present, and future. Texas Medicine. Retrieved from https://www.europepmc.org/abstract/med/25147984
Morrish, N. J., Wang, S. L., Stevens, L. K., Fuller, J. H., & Keen, H. (2001). Mortality and causes of death in the WHO Multinational Study of Vascular Disease in Diabetes. Diabetologia, 44 Suppl 2, S14S21. https://doi.org/10.1007/pl00002934
Texas Health and Human Services. (n.d). Learn about our facility. Retrieved from https://www.hhsc.state.gov
Texas Health Data. (n.d.) Fort Bend County Diabetes Death Statistics. Retrieved from https://www.healthdata.dshs.texas.gov/statistics/texas/fort-bend-county-diabetes-deaths-mortality
U.S Census Bureau (2019). Richmond City Quick Facts. Retrieved from https://www.census.gov/quickfacts/fact/table/richmondcitytexas/RHI225218
U.S Census Bureau (2019). Quick facts Fort Bend County, Texas; United States. Retrieved from https://www.census.gov/quickfacts/fact/table/fortbendcountytexas,US/PST045219
U.S. Department of Health and Human Services. (2016a). Determinants of Health. Retrieved from https://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-health.
Wikipedia (June 17, 2020). Facts About the City of Richmond, Texas. Retrieved from https://www.wikipedia.gov/Richmond_Texas
