What is the response of protective services personnel to episodes of family violence?

PLEASE READ ALL INFORMATION THROUGHLY
This is the third revision for this paper. This paper is good but still needs the below adjustments. Just add on to it. Please refer to the previous submissions. Do not change this paper just expand in the lacking areas
Below is a list of the tools used and the corrections needed .Thank you for all your time and effort

Corrections needed:as follows
12/2/15: Four of the tools are identified and discussed. The Windshield Survey and Population Health Scavenger Hunt are not found. Please identify and discuss how these tools were used/

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12/2/15: Once all six assessment tools are utilized, please provide an overall interpretation of the data using the concepts of epidemiology.

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12/2/15: Healthy People 2020 initiatives are mentioned in general; however, specific goals are not found. Please discuss each of the three problems in relation to specifically corresponding Healthy People 2020 goals.

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TOOLS USED
Windshield Survey
Directions:
This assessment is a foundational exercise for you to learn about your environment and
explore where you live. Take some time to intentionally explore your county. Look at your
county as the home and the place of work for the county residents.
While driving through your community, stop for coffee or have lunch in a neighborhood.
Find a place to eat where you can sit down as part of the community. You may want to walk
around your community as well so that you can explore it from both a driving perspective
and a walking perspective.
Once you have observed the area, write about your impressions of the county in your notes.
Reflect on any surprises and whether the county looks different to you now after taking the
time to note the various elements. What would you like to learn more about related to your
topic and population of interest? You may want to sketch a map related to your topic area
for future reference when writing your community description.
Take notes on the county using the following questions as a guide. These questions are only
to provide guidance; you may discover other areas that you want to note. Include your
findings in the community description section of your paper. You will use this information to
complete task 1 for your “Community Health and Population-Focused Nursing” course.
Collecting this data will help you define your population of interest and prepare for your
practicum experience. You may also want to reference these results in the resources and
partners section of your paper.
ELEMENT DESCRIPTION:
Housing and Commercial Buildings:
•How old are the houses and buildings in the community?
•What materials are the homes and buildings constructed from?
•Are all the houses similar in age and architecture?
•How would you characterize their differences?
•Are the houses detached or connected to each other?
•Are there solar panels? Windmills?
•Do the houses have space in front or behind them?
•What is the general condition of the houses and buildings?
•Are there signs of disrepair (e.g., broken doors or windows, leaks, missing locks)?
•Are there signs of neighborhood pride, such as well-tended yards?
•Is there central heating, modern plumbing, air conditioning?
Open space:
•Is the county primarily rural, suburban, urban, or a mix? How much open space is
there?
•What is the quality of the space (i.e., lush green parks or rubble-filled lots)?
•What is the lot size of the houses, lawns, and flower boxes?
•Do you see trees on the streets or a green island in the center of the streets?
•Is the open space public or private? Who uses this space?
Boundaries:
•What signs are there of where neighborhoods begin and end?
•Are the boundaries natural (a river, a different terrain); physical (a highway, a
railroad); or economic (differences in real estate or presence of industrial or
commercial units along with residential)?
•Do the neighborhoods have an identity or a name? Do you see them displayed? Are
there unofficial names?
“Commons”:
•What are the neighborhood hangouts (e.g., schoolyard, convenience store, bar,
restaurant, park, 24-hour drugstore)?
•What groups of people tend to gather at these hangouts?
•At what time do they typically meet?
•Does the commons area have a sense of territoriality, or is it open to everyone?
Transportation:
•How do people get in and out of the neighborhoods (e.g., car, bus, bike, walking)?
•Are the streets and roads conducive to good transportation and bicycle use and also
to community life?
•Are there major highways running through the county? Who do these highways
serve?
•How frequently is public transportation available?
•Are gas stations available?
•Are there train stations or light rail stations?
Service centers:
•Do you see social agencies, clients, recreation centers, signs of activity at the
schools?
•Are there offices of doctors, dentists, and other such services?
•Are there parks? Are these parks in use?
Stores:
•Where do residents shop (e.g., shopping centers, neighborhood stores, outdoor
markets)?
•How do they travel?
People out and about:
•If you are traveling during the day, who do you see on the street (e.g., an occasional
passerby, a father with a baby)?
•Do you see anyone you would not expect?
•Can you spot the purpose of those that you see, such as a door-to-door salesperson
or a postal worker?
•Is the dress of those you see representative or unexpected?
•What animals do you see (e.g., stray cats, pedigreed pets, watchdogs, birds, wild
life)?
Signs of community vibrancy:
•Is this neighborhood on the way up or down?
•Is it alive?
•How would you decide?
•Do you see any of the following: street vendors, trash, abandoned cars, political
posters, neighborhood-meeting posters, real estate signs, abandoned houses, mixed
zoning usage, people tending their yards, sidewalks in good repair?
Race:
•Are the residents primarily Caucasian, African-American, Asian, of another group, or
is the area integrated?
Ethnicity:
•Are there indications of ethnicity (e.g., food stores, churches, private schools,
information or signs in a language other than English)?
Religion:
•Of what religion are the residents?
•Do you see evidence of heterogeneity or homogeneity?
•What denominations are the churches, temples, and mosques?
•Do you see evidence of these religious facilities being used other than on days of
worship?
Health:
•Do you see evidence of acute or of chronic diseases or conditions?
•Do you see evidence of accidents, communicable morbidity diseases, alcoholism,
drug addiction, mental illness, etc.?
•How far it is to the nearest hospital? To the nearest clinic?
Politics:
•Do you see any political campaign posters?
•Is there a headquarters present?
•Do you see evidence of a predominant party affiliation?
Media:
•Do you see indications of television use such as satellite dishes?
•What magazines and newspapers do residents read?
•What media do you see being sold in the stores?
•What form of media seems most important to the residents (e.g., radio, television,
print, online)?
•What languages are represented in the various forms of media?
Physical Environment:
•Are there indications of an excess of certain types of activities, such as stores that
sell alcohol or fast food restaurants?
•What sorts of billboards are displayed and what do they indicate?
•Are there many cell phone towers or is cell phone access limited?
Adapted from Anderson, E.T., & McFarlane J.M. (1988). Community as client: Application of
the nursing process. Philadelphia, PA: Lippincott.
Community and Population Health Scavenger Hunt
Explore your community and choose six of the following facilities (within your
city/county or just outside of your county):
Women, Infants, and Children office (WIC)
Health department
Food pantry
Department of human/social services
Fire department
Police department
Substance abuse .facility
Ymca
Senior center
Community center
Domestic violence center/shelter
Crisis child care center
Homeless shelter
Emergency management department(e.g., NAMI: National Alliance on Mental Illness)
American red cross
Mental health association
Boys and girls club
Planned parenthood
Chamber of commerce
Consider the following questions while interacting with these service providers in you
1. What is the organization’s target population?
2. How does the organization advertise its services to the community or target population?
3. Are there any barriers to service?
4. What written information do they have available (e.g., pamphlets, brochures)?
5. What is the appearance, both internal and external, of the facility?
6. How do staff members present themselves (e.g., appearance, attitude, knowledge of
services, diversity)?
7. What language capabilities do staff members have?
8. Does the organization have a referral process or does it operate on self-referrals?
9. Are there fees for the services provided? Are payment options available?
10. Does the organization have a presence on the Internet?
11. Is the organization’s facility accessible from various types of transportation (e.g., bus,
train)?
12. What specific services does the organization provide?
13. (Your Choice) Community and Population Health Scavenger Hunt

CULTURAL ASSESSMENT TOOL
Biophysical Considerations
What is the age composition of the cultural group?
Age Group Population Size
0–1 year
1–5 years
6–12 years
13–19 years
20–29 years
30–49 years
50–64 years
65–74 years
75–84 years
Over 85 years
What attitudes toward age and aging are prevalent in the culture? ________________________
_____________________________________________________________________________________
How do attitudes toward aging affect health? _________________________________________
At what age are members of the culture considered adults? ________________________________________________
Are there cultural rituals associated with coming of age? _______ What are the health effects of these rituals and practices, if any? __________________________________________________
What is the gender composition of the cultural group? ____________________________
Does gender play a role in the acceptability of health care providers? If so, how? _________
_____________________________________________________________________________________
Do members of the cultural group display genetically determined physical features or physiologic differences? If so, what are they and how do they influence health? _______________________
_____________________________________________________________________________________
Do group members display differences in normal physiologic values? If so, what are they? _________
_____________________________________________________________________________________
What genetically determined illnesses, if any, are prevalent in the cultural group? _______
_____________________________________________________________________________________
What are the cultural attitudes toward body parts and physiologic functions? ___________________________
_____________________________________________________________________________________
What physical health problems are common in the cultural group? ________________
_____________________________________________________________________________________
Psychological Considerations
Does the cultural group have an individualist or collectivist perspective? _______________
How do members of the cultural group prioritize individual, family, and group welfare and goals? ___________
_____________________________________________________________________________________
What is the extent of stress experienced by members of the cultural group? _______________________________
_____________________________________________________________________________________
What are the usual sources of stress? ________________________________________________________________
How do group members typically cope with stress? ___________________________________________________
_____________________________________________________________________________________
Is there intergenerational conflict within the cultural group that contributes to stress? ______________________
_____________________________________________________________________________________
How do members of the cultural group perceive change? _______________________________________________
_____________________________________________________________________________________
How do they adapt to change? ______________________________________________________________________
_____________________________________________________________________________________
Do members of the cultural group exhibit attitudes of resignation and fatalism? If so, what effect does this have on the use of health care services? ______________________________________________________________________
________________________________________________________________________________________
What attitudes toward mental health and illness are held by members of the cultural group? ___________________
________________________________________________________________________________________
Is there stigma attached to mental illness for the individual? _______ For the family? _________________________
How does stigma affect health and willingness to seek health care services? _________________________________
________________________________________________________________________________________
Physical Environmental Considerations
How do members of the cultural group perceive their relationship to the environment? ____________________
_____________________________________________________________________________________
How do members of the cultural group perceive personal space? ________________________________________
What is the orientation of the cultural group to time? __________________________________________________
What changes in their physical environment have members of the cultural group experienced? ______________
_____________________________________________________________________________________
What influence do these changes have on the health status of the group? _________________________________
_____________________________________________________________________________________
Sociocultural Considerations
Relationships
What are the perceptions of members of the cultural group with respect to supernatural forces? _________________
________________________________________________________________________________________
What roles, if any, do supernatural forces have in health and illness? ________________________________________
________________________________________________________________________________________
What are the religious affiliations of members of the cultural group? ________________________________________
________________________________________________________________________________________
What are the major tenets of the religion(s)? _____________________________________________________________
________________________________________________________________________________________
What influence does religious affiliation or spirituality have, if any, on health care beliefs and practices? _________
________________________________________________________________________________________
Do religious leaders have a role with respect to health and illness within the cultural group? _______ If so, what is that role? _________________________________________________________________________________________
Are religious beliefs and practices incorporated in health care? If so, how? ___________________________________
________________________________________________________________________________________
Do magical influences play a part in health and illness within the cultural group? _______ If so, how? ___________
________________________________________________________________________________________
How is marriage perceived within the cultural group? ____________________________________________________
________________________________________________________________________________________
At what age does marriage usually occur? _______________________________________________________________
Who is considered an appropriate spouse for a member of the cultural group? _______________________________
________________________________________________________________________________________
What is the typical family structure within the culture? ___________________________________________________
What gender roles are expected within the cultural group? ________________________________________________
________________________________________________________________________________________
What are the expected roles and responsibilities of couples? _______________________________________________
________________________________________________________________________________________
How are couples expected to interact with other family members? ____________________________________________
What roles are typically performed by family members? __________________________________________________
________________________________________________________________________________________
How interchangeable are these roles? ___________________________________________________________________
How congruent are family roles with those of the dominant culture? ________________________________________
________________________________________________________________________________________
Who is responsible for decisions within the family? _______________________________________________________
Within the larger cultural group? _______________________________________________________________________

DISASTER ASSESSMENT AND PLANNING GUIDE
Description: This tool is intended to assist community health nurses and other community members to assess the level of disaster preparedness in the community and to plan for effective disaster response. The assessment component of the tool is based on the six dimensions of health in the dimensions model and reflects biophysical, psychological, physical environmental, sociocultural, behavioral, and health system factors influencing disasters and community response to them. Community health nurses and others assessing community disaster preparedness may want to begin the assessment with the Community Disaster Preparedness Checklist (p. 121) to identify areas in which more in-depth assessment is required and then use this tool to direct that in-depth assessment.
Appropriate populations: May be used to assess and plan for disaster preparedness at the community level. May also be used to develop disaster plans for specific health care agencies and institutions or other groups within the community (e.g., schools). Some of the questions also address assessment after a disaster event has occurred.
Data sources and data collection strategies: Sources of data for community disaster assessment and planning may include community historical records, official government documents, existing disaster plans of community agencies and organizations, and interviews with key individuals within the community. Additional sources of data may include local businesses and industries, schools, health departments, civil defense/disaster agencies, and the local chapter of the American Red Cross. Information on community resources may also be available from social and civic organizations and clubs. Area maps and personal observation by the community health nurse and others may also provide important information. Because disaster planning should be a community-wide endeavor, community health nurses will be only one group involved in obtaining assessment data and developing a community disaster plan. Community health nurses, however, may create the impetus for disaster planning and/or coordinate data collection and interpretation and disaster response planning.
Use of information: Data obtained using the tool will be used to identify community disaster potential and to plan means of preventing disasters from occurring or mitigating their adverse effects on the community. Assessment data should be used to develop a general plan of community disaster response that would fit many types of disaster events. Assessment data may also serve as an impetus for educating the general public regarding disaster preparedness.
DISASTER ASSESSMENT AND PLANNING GUIDE
Assessment
Biophysical Considerations
What is the age composition of the population(s) most likely to be affected by a disaster? ___________________
________________________________________________________________________________________
Are there special health needs present in the age group(s) identified? ____________________________________
________________________________________________________________________________________
What is the ethnic/racial composition of the population(s) most likely to be affected by a disaster? What effects, if any, will ethnicity have on response to a disaster? _____________________________________________________
________________________________________________________________________________________
What is the extent of injury anticipated as a result of a disaster? What types of injuries are most likely to occur? ________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
What chronic health problems are prevalent among the population(s) most likely to be affected by a disaster? ____
________________________________________________________________________________________
________________________________________________________________________________________
What communicable disease problems are anticipated as a result of a disaster? ____________________________
________________________________________________________________________________________ POPULATION ECONOMIC STATUS ASSESSMENT
Population size _______
Average household income _______
Percentage of households at or below poverty level _______
Composition of the low-income group:
Racial/Ethnic Group Percentage of Poor Age Group Percentage of Poor
African American Birth–1 year
Asian 1–12 years
Hispanic 13–20 years
Native American 21–30 years
White 31–50 years
Other 51–65 years
66–84 years
Over 85 years
Proportion of families eligible for public assistance _______
Proportion receiving assistance _______
Population unemployment rate _______
Proportion of the population with employment-based health insurance benefits _______
Annual public health funding allocation _______
Per capita personal health care expenditures _______
Percentage of people with unmet health needs due to financial constraints _______
Percentage of the population that is homeless _______
Source of payment for health care services:
Payment Source Percent of Expenditures
Private insurance
Medicare
Medicaid
Military
Other government
Out of pocket
Uncompensated
NEIGHBORHOOD/COMMUNITY SAFETY INVENTORY
Description: This tool can be used to assess physical and psychosocial safety hazards in a given client’s neighborhood or in a community at large. The tool assesses elements of the physical environmental, psychological, and social dimensions of health in the dimensions model. The inventory promotes identification of safety problems in the neighborhood or community and planning of nursing interventions to resolve identified problems.
Appropriate populations: Any neighborhood or community. May also be used to assess the neighborhood in which a specific individual client or family lives.
Data sources and data collection strategies: Personal observation of the neighborhood and interviews with residents and key informants are excellent means of obtaining information about neighborhood or community safety. Examples of key informants include local police and fire personnel, business and industry leaders, community officials, local disaster planning groups, department of transportation officials, and insurance company representatives. Review of police, fire, and insurance records may also be a source of important environmental safety information.
Use of information: Information derived using the tool can be used to educate individual clients regarding elimination or avoidance of safety hazards. Information may also be helpful in planning community safety education programs, in initiating disaster planning efforts, or to support political activity to enhance neighborhood or community safety. Finally, neighborhood safety information may assist the nurse to take precautions to promote his or her own safety while working in the area. Using information derived from the inventory, the community health nurse develops nursing diagnoses related to safety problems and plans interventions for those problems. Frequently, the interventions needed will require collaboration with other agencies and individuals, but may be initiated by the nurse.
NEIGHBORHOOD/COMMUNITY SAFETY INVENTORY
Neighborhood or community assessed: ______________________________________________________________
Safety Hazards in the Natural Environment
What is the extent of air pollution? What pollutants are involved? _______________________________________
_____________________________________________________________________________________
What is the extent of water pollution? What pollutants are involved? _______________________________________ ________________________________________________________________________________________
What is the extent of natural radiation in the area? ________________________________________________________
________________________________________________________________________________________
Are there other environmental pollutants in the area? _____________________________________________________
________________________________________________________________________________________
Do local weather conditions pose health hazards? ________________________________________________________
Are there drowning hazards (e.g., lakes, rivers) in the area? ___________________________________________________
Do wild animals in the area serve as reservoirs for disease? ________________________________________________
Do stray animals pose a safety or health hazard in the neighborhood? _______________________________________
What poisonous plants or plant allergens grow in the area? ________________________________________________
________________________________________________________________________________________
Safety Hazards in the Built Environment
Do residential units pose safety hazards? ________________________________________________________________
________________________________________________________________________________________
What is the extent of disrepair in housing units? _________________________________________________________
Are there structural defects in area buildings, roads, and so on that pose safety hazards? ______________________
________________________________________________________________________________________
Do local building codes effectively address safety issues? __________________________________________________
Are building safety codes enforced? ____________________________________________________________________
Are there broken sidewalks (or lack of sidewalks) or other external safety hazards in the neighborhood that pose health risks? ________________________________________________________________________________________
Is there a lead exposure hazard in the area? ______________________________________________________________
How adequate is sanitation and waste disposal? _________________________________________________________
Is there a problem with trash or garbage that poses a health risk? ___________________________________________
What is the prevalence of residential fires? ______________________________________________________________
What proportion of homes in the area have functional smoke alarms or sprinkler systems? ____________________
What are the local fire insurance rates? _______________________________________________________________
To what extent do residents (home owners and renters) carry fire insurance? ______________________________
What is the response time for fire personnel? _________________________________________________________
Are area swimming pools adequately fenced? ________________________________________________________
What is the prevalence of traffic accidents? ______________________________________________________________
Do traffic accidents tend to occur in specific areas? _______ If so, where and why? ____________________________
________________________________________________________________________________________
What are the local car insurance rates? __________________________________________________________________
To what extent do residents carry automobile insurance? __________________________________________________
What is the response time for emergency personnel? ______________________________________________________
Are there significant noise hazards in the area? ___________________________________________________________
What safety hazards are posed by local industry? ________________________________________________________
________________________________________________________________________________________
To what extent do local industries adhere to safety standards? _____________________________________________
________________________________________________________________________________________
Safety Hazards in the Psychological Environment
How secure do area residents feel? __________________________________________________________________
To what extent do environmental conditions contribute to stress? ________________________________________ _____________________________________________________________________________________
Safety Hazards in the Sociocultural Environment
What is the extent of crime in the area? _______________________________________________________________
What types of crime are involved? __________________________________________________________________
_____________________________________________________________________________________
What is the response time for police personnel? _______________________________________________________
Do area residents take an active part in crime prevention? ______________________________________________
What is the extent of intergroup conflict in the area? ___________________________________________________
_____________________________________________________________________________________
Is there tension between racial or ethnic groups in the area? ____________________________________________
Is there gang violence in the area? ___________________________________________________________________
What is the extent of family violence in the area? ______________________________________________________
What is the response of protective services personnel to episodes of family violence? _______________________
_____________________________________________________________________________________
What is the extent of drug and alcohol use/abuse in the area? ___________________________________________
_____________________________________________________________________________________
Are drug dealers a problem in the area? ______________________________________________________________
What is the extent of drug-related crime in the area? ___________________________________________________
Disaster Potential
What is the potential for flooding? __________________________________________________________________
What is the potential for earthquakes? _______________________________________________________________

_________________________________________________________________________________________
________________________________________________________________________________________

Paper for correction

Community health
Introduction
Healthy people 2020 goals are a futuristic oriented strategy that is aimed at improving people’s health and livelihood by 2020. Healthy people, 2020 goals are community oriented, and its success greatly depends on positive health gains from the grass roots. Community health workers have on their shoulders a great responsibility to assess the community health environment to establish community needs that require attention (Healthypeople.gov, 2015).
Community needs are the gaps in health care that need to be taken of as priority to improve general community health. Health people 2020 is primarily based on four pillars, its mandate is to identify community needs, increase community awareness and understanding on health and the existing opportunities, provide for measurable strategies and objectives that are easily realizable from a national to a community level and identify community health needs that need research and evaluation (Healthypeople.gov, 2015).
Its key objectives are high-quality health services that will improve the life expectancy of individuals, achievement of equity in health care provision, the creation of conducive environment both socially and environmentally that promote good health and promotion of healthy practices and behaviors across the state.
Study area
This study is aimed at assessing the health needs of Queens County; it is one of the boroughs of New York, and it is highly populated and still posting population increase in the county. This assessment is aimed at assessing the health needs of the people in Queen County in alignment with the healthy people 2020 initiative. A need assessment is critical and imperative to create a health strategy and budget for the people of Queens County.
The county is home to a multi-cultured community, the indigenous people in this county amount only to the 60% of the total population whereas the rest are from other parts of the world. The Chinese people are the highest in some the Asian community in Queens County. The Chinese people are more cultural and traditional which calls for extensive cultural assessment to establish their needs and perspectives to health.
Queen county health needs are affected by three major forces; economic, environmental and cultural forces. The county is a melting pot of different communities living together; each community has different cultural practices and health needs. The county has some environmental hazards that pose danger to the community. On the economic front, the amount of resources will determine the ability of the county to get quality medical equipment and health products (Scorecard pollution information cite, 2015).
Need assessment
A need assessment is the establishment of the society health requirements and gaps that need attention from health providers and regulators. It is the initial stage to the attainment of healthy people 2020 goals. A need assessment tool varies from one region to another depending on the size of the community and resource endowment.
Need assessment approach
To conduct a need assessment study of a community, it is important to have a variety of information. This information is primarily sourced from the community using different apparatus, the choice of apparatus is imperative to quality, accuracy and credibility of the results.
The study used four major assessment tools;
1. Economic assessment tool
This tool was used to report on the financial ability of the population in Queens County; it assesses the economic power ability to get health products and medical equipment. This can be achieved by assessing the per-capita income, employment rate and the number of the population in the county. The total population of Queen County was found to be 2.2million people. Most of the adults in the county were insured i.e. 82% whereas 93% were employed. However, the population that was said to be below poverty level posted a 16% of the total population. The birth rate recorded a 13.5% in every 1000 people whereas mortality rate was 611 in every 100,000 born (Department of health, 2015).
2. Safety inventory assessment tool
This was used to determine the safety of the neighborhoods for the populations. This was carried out through direct observation and interviewing. Also, the local disaster planning groups and community officials provided important information. The study found out that the population health safety was faced by three major pollutants; chemical release, lead hazards and Superfund. These pose the great health danger to the health of the community through an outbreak of respiratory and other diseases. Another health safety scare in Queen Community is out of assault and accidents. The neighbor hoods are congested risking social crimes and accidents (Scorecard pollution information cite, 2015).

3. Disaster and planning guide assessment
This aims at providing information on how well the community is prepared for disasters. In Queens County most disaster management strategies are primarily focused on securing business, and it lacks measure to secure the people from health-oriented disasters like a disease outbreak. The county housing set up is too congested which is risky in case of a disease outbreak, the level of pollution deposits in the county also is a loaming disaster threat to the people’s health. Healthy people 2020 goals are aimed at preventing disease occurrence in which measure should be put in place to protect the people’s health (Healthypeople.gov, 2015).
4. Cultural assessment tool
A cultural assessment tool assesses the cultural makeup of a community. Different cultures have different practices and beliefs this greatly affects health care providers and planners approach and strategies on health. Queens County is made of people of different cultures that call for a great deal of studies on their beliefs and practices to provide good healthcare to the community (Department of health, 2015).
Problems identified
Three major diseases affecting the community of Queens County were established these diseases are; asthma, obesity and HIV aids. Asthma cases in the county were from the high number of toxic waste from industries and smoking that was a big vice in the County (Department of health, 2015).
Asthma is caused by allergies or increased hypersensitivity, high chemical pollutants and smoking in the county increases the chance and is reason for high number of asthma cases in the county.
There was high childhood obesity in the city; this was blamed on the poor life styles of the people in the county and poor diets. There were less than enough spaces for outdoor activities for children to work out which would help burn calories.
Human immune deficiency virus was prevalent because of great moral permissiveness in the community and congestion. Testing centers for early diagnosis were not immediately available to the people. Some diseases like HIV and AIDS can be difficult to cure but can be managed and reduced. People should be encouraged to go for testing regularly for early diagnosis and treatment. More health facilities should be established to increase counseling services and education to the people on wellbeing and healthy living.
Conclusion
The study found Queens County much populated with health hazards which greatly increases the rate of infection in the population. The contaminated superfunds and other pollutants not only cause danger to the people of Queen County but also the environment and ecosystem which supports the people. These hazardous wastes also increase the risk of cancerous diseases and respiratory diseases. For instance, industrial lead and mercury.
Healthy people 2020 greatly emphasizes on the importance of preventing prevalence of diseases. In this case there is need to sensitize the population on the dangers posed by these polluted environments. Asthma and cancer are difficult diseases to cure but can be prevented through healthy living styles and ensuring a clean environment.
Queen County has a lot to be done to achieve the healthy people 2020 initiative; more strategies need to be put in place to control respiratory disease prevalence in the county. The county should create more awareness to the population to control smoking and littering, more recreation outdoor facilities should be established to provide children an avenue to play and grow healthy. More awareness should also provide concerning lifestyle change and counseling for those who have contracted HIV and AIDS. Testing and counseling facilities should be set up in the county for the same purpose.

The diagnosis of Queen Community health calls for community involvement in creating and establishing healthy lifestyles in the society. Health care organizations can hardly achieve healthy people 2020 goals if the communities are not involved. Health care organizations working in the regions should however initiate home based asthma and HIV assessment; this will help to educate the community on the dangers of smoking, pollution and late diagnosis.

Reference list
Department of health (2015). Socio-economic status and general health indicators – Queens County. New York State. Retrieved 11/2/2015 from: https://www.health.ny.gov/statistics/chac/chai/docs/ses_61.htm
Healthypeople.gov (2015). 2020 Topics and objectives-objectives A-Z\Healthy people 2020.
Retrieved11/3/2015: https://www.healthypeople.gov/2020/topicsobjectives
Scorecard pollution information cite (2015). Pollution locator: USA. Retrieved: 11/3/2015 https://scorecard.goodguide.com/env-releases/us-map.tcl

Is there central heating, modern plumbing, air conditioning?

•Is there central heating, modern plumbing, air conditioning?
Open space:
•Is the county primarily rural, suburban, urban, or a mix? How much open space is
there?
•What is the quality of the space (i.e., lush green parks or rubble-filled lots)?
•What is the lot size of the houses, lawns, and flower boxes?
•Do you see trees on the streets or a green island in the center of the streets?
•Is the open space public or private? Who uses this space?
Boundaries:
•What signs are there of where neighborhoods begin and end?
•Are the boundaries natural (a river, a different terrain); physical (a highway, a
railroad); or economic (differences in real estate or presence of industrial or
commercial units along with residential)?
•Do the neighborhoods have an identity or a name? Do you see them displayed? Are
there unofficial names?
“Commons”:
•What are the neighborhood hangouts (e.g., schoolyard, convenience store, bar,
restaurant, park, 24-hour drugstore)?
•What groups of people tend to gather at these hangouts?
•At what time do they typically meet?
•Does the commons area have a sense of territoriality, or is it open to everyone?
Transportation:
•How do people get in and out of the neighborhoods (e.g., car, bus, bike, walking)?
•Are the streets and roads conducive to good transportation and bicycle use and also
to community life?
•Are there major highways running through the county? Who do these highways
serve?
•How frequently is public transportation available?
•Are gas stations available?
•Are there train stations or light rail stations?
Service centers:
•Do you see social agencies, clients, recreation centers, signs of activity at the
schools?
•Are there offices of doctors, dentists, and other such services?
•Are there parks? Are these parks in use?
Stores:
•Where do residents shop (e.g., shopping centers, neighborhood stores, outdoor
markets)?
•How do they travel?
People out and about:
•If you are traveling during the day, who do you see on the street (e.g., an occasional
passerby, a father with a baby)?
•Do you see anyone you would not expect?
•Can you spot the purpose of those that you see, such as a door-to-door salesperson
or a postal worker?
•Is the dress of those you see representative or unexpected?
•What animals do you see (e.g., stray cats, pedigreed pets, watchdogs, birds, wild
life)?
Signs of community vibrancy:
•Is this neighborhood on the way up or down?
•Is it alive?
•How would you decide?
•Do you see any of the following: street vendors, trash, abandoned cars, political
posters, neighborhood-meeting posters, real estate signs, abandoned houses, mixed
zoning usage, people tending their yards, sidewalks in good repair?
Race:
•Are the residents primarily Caucasian, African-American, Asian, of another group, or
is the area integrated?
Ethnicity:
•Are there indications of ethnicity (e.g., food stores, churches, private schools,
information or signs in a language other than English)?
Religion:
•Of what religion are the residents?
•Do you see evidence of heterogeneity or homogeneity?
•What denominations are the churches, temples, and mosques?
•Do you see evidence of these religious facilities being used other than on days of
worship?
Health:
•Do you see evidence of acute or of chronic diseases or conditions?
•Do you see evidence of accidents, communicable morbidity diseases, alcoholism,
drug addiction, mental illness, etc.?
•How far it is to the nearest hospital? To the nearest clinic?
Politics:
•Do you see any political campaign posters?
•Is there a headquarters present?
•Do you see evidence of a predominant party affiliation?
Media:
•Do you see indications of television use such as satellite dishes?
•What magazines and newspapers do residents read?
•What media do you see being sold in the stores?
•What form of media seems most important to the residents (e.g., radio, television,
print, online)?
•What languages are represented in the various forms of media?
Physical Environment:
•Are there indications of an excess of certain types of activities, such as stores that
sell alcohol or fast food restaurants?
•What sorts of billboards are displayed and what do they indicate?
•Are there many cell phone towers or is cell phone access limited?
Adapted from Anderson, E.T., & McFarlane J.M. (1988). Community as client: Application of
the nursing process. Philadelphia, PA: Lippincott.
Community and Population Health Scavenger Hunt
Explore your community and choose six of the following facilities (within your
city/county or just outside of your county):
Women, Infants, and Children office (WIC)
Health department
Food pantry
Department of human/social services
Fire department
Police department
Substance abuse .facility
Ymca
Senior center
Community center
Domestic violence center/shelter
Crisis child care center
Homeless shelter
Emergency management department(e.g., NAMI: National Alliance on Mental Illness)
American red cross
Mental health association
Boys and girls club
Planned parenthood
Chamber of commerce
Consider the following questions while interacting with these service providers in you
1. What is the organization’s target population?
2. How does the organization advertise its services to the community or target population?
3. Are there any barriers to service?
4. What written information do they have available (e.g., pamphlets, brochures)?
5. What is the appearance, both internal and external, of the facility?
6. How do staff members present themselves (e.g., appearance, attitude, knowledge of
services, diversity)?
7. What language capabilities do staff members have?
8. Does the organization have a referral process or does it operate on self-referrals?
9. Are there fees for the services provided? Are payment options available?
10. Does the organization have a presence on the Internet?
11. Is the organization’s facility accessible from various types of transportation (e.g., bus,
train)?
12. What specific services does the organization provide?
13. (Your Choice) Community and Population Health Scavenger Hunt

CULTURAL ASSESSMENT TOOL
Biophysical Considerations
What is the age composition of the cultural group?
Age Group Population Size
0–1 year
1–5 years
6–12 years
13–19 years
20–29 years
30–49 years
50–64 years
65–74 years
75–84 years
Over 85 years
What attitudes toward age and aging are prevalent in the culture? ________________________
_____________________________________________________________________________________
How do attitudes toward aging affect health? _________________________________________
At what age are members of the culture considered adults? ________________________________________________
Are there cultural rituals associated with coming of age? _______ What are the health effects of these rituals and practices, if any? __________________________________________________
What is the gender composition of the cultural group? ____________________________
Does gender play a role in the acceptability of health care providers? If so, how? _________
_____________________________________________________________________________________
Do members of the cultural group display genetically determined physical features or physiologic differences? If so, what are they and how do they influence health? _______________________
_____________________________________________________________________________________
Do group members display differences in normal physiologic values? If so, what are they? _________
_____________________________________________________________________________________
What genetically determined illnesses, if any, are prevalent in the cultural group? _______
_____________________________________________________________________________________
What are the cultural attitudes toward body parts and physiologic functions? ___________________________
_____________________________________________________________________________________
What physical health problems are common in the cultural group? ________________
_____________________________________________________________________________________
Psychological Considerations
Does the cultural group have an individualist or collectivist perspective? _______________
How do members of the cultural group prioritize individual, family, and group welfare and goals? ___________
_____________________________________________________________________________________
What is the extent of stress experienced by members of the cultural group? _______________________________
_____________________________________________________________________________________
What are the usual sources of stress? ________________________________________________________________
How do group members typically cope with stress? ___________________________________________________
_____________________________________________________________________________________
Is there intergenerational conflict within the cultural group that contributes to stress? ______________________
_____________________________________________________________________________________
How do members of the cultural group perceive change? _______________________________________________
_____________________________________________________________________________________
How do they adapt to change? ______________________________________________________________________
_____________________________________________________________________________________
Do members of the cultural group exhibit attitudes of resignation and fatalism? If so, what effect does this have on the use of health care services? ______________________________________________________________________
________________________________________________________________________________________
What attitudes toward mental health and illness are held by members of the cultural group? ___________________
________________________________________________________________________________________
Is there stigma attached to mental illness for the individual? _______ For the family? _________________________
How does stigma affect health and willingness to seek health care services? _________________________________
________________________________________________________________________________________
Physical Environmental Considerations
How do members of the cultural group perceive their relationship to the environment? ____________________
_____________________________________________________________________________________
How do members of the cultural group perceive personal space? ________________________________________
What is the orientation of the cultural group to time? __________________________________________________
What changes in their physical environment have members of the cultural group experienced? ______________
_____________________________________________________________________________________
What influence do these changes have on the health status of the group? _________________________________
_____________________________________________________________________________________
Sociocultural Considerations
Relationships
What are the perceptions of members of the cultural group with respect to supernatural forces? _________________
________________________________________________________________________________________
What roles, if any, do supernatural forces have in health and illness? ________________________________________
________________________________________________________________________________________
What are the religious affiliations of members of the cultural group? ________________________________________
________________________________________________________________________________________
What are the major tenets of the religion(s)? _____________________________________________________________
________________________________________________________________________________________
What influence does religious affiliation or spirituality have, if any, on health care beliefs and practices? _________
________________________________________________________________________________________
Do religious leaders have a role with respect to health and illness within the cultural group? _______ If so, what is that role? _________________________________________________________________________________________
Are religious beliefs and practices incorporated in health care? If so, how? ___________________________________
________________________________________________________________________________________
Do magical influences play a part in health and illness within the cultural group? _______ If so, how? ___________
________________________________________________________________________________________
How is marriage perceived within the cultural group? ____________________________________________________
________________________________________________________________________________________
At what age does marriage usually occur? _______________________________________________________________
Who is considered an appropriate spouse for a member of the cultural group? _______________________________
________________________________________________________________________________________
What is the typical family structure within the culture? ___________________________________________________
What gender roles are expected within the cultural group? ________________________________________________
________________________________________________________________________________________
What are the expected roles and responsibilities of couples? _______________________________________________
________________________________________________________________________________________
How are couples expected to interact with other family members? ____________________________________________
What roles are typically performed by family members? __________________________________________________
________________________________________________________________________________________
How interchangeable are these roles? ___________________________________________________________________
How congruent are family roles with those of the dominant culture? ________________________________________
________________________________________________________________________________________
Who is responsible for decisions within the family? _______________________________________________________
Within the larger cultural group? _______________________________________________________________________

DISASTER ASSESSMENT AND PLANNING GUIDE
Description: This tool is intended to assist community health nurses and other community members to assess the level of disaster preparedness in the community and to plan for effective disaster response. The assessment component of the tool is based on the six dimensions of health in the dimensions model and reflects biophysical, psychological, physical environmental, sociocultural, behavioral, and health system factors influencing disasters and community response to them. Community health nurses and others assessing community disaster preparedness may want to begin the assessment with the Community Disaster Preparedness Checklist (p. 121) to identify areas in which more in-depth assessment is required and then use this tool to direct that in-depth assessment.
Appropriate populations: May be used to assess and plan for disaster preparedness at the community level. May also be used to develop disaster plans for specific health care agencies and institutions or other groups within the community (e.g., schools). Some of the questions also address assessment after a disaster event has occurred.
Data sources and data collection strategies: Sources of data for community disaster assessment and planning may include community historical records, official government documents, existing disaster plans of community agencies and organizations, and interviews with key individuals within the community. Additional sources of data may include local businesses and industries, schools, health departments, civil defense/disaster agencies, and the local chapter of the American Red Cross. Information on community resources may also be available from social and civic organizations and clubs. Area maps and personal observation by the community health nurse and others may also provide important information. Because disaster planning should be a community-wide endeavor, community health nurses will be only one group involved in obtaining assessment data and developing a community disaster plan. Community health nurses, however, may create the impetus for disaster planning and/or coordinate data collection and interpretation and disaster response planning.
Use of information: Data obtained using the tool will be used to identify community disaster potential and to plan means of preventing disasters from occurring or mitigating their adverse effects on the community. Assessment data should be used to develop a general plan of community disaster response that would fit many types of disaster events. Assessment data may also serve as an impetus for educating the general public regarding disaster preparedness.
DISASTER ASSESSMENT AND PLANNING GUIDE
Assessment
Biophysical Considerations
What is the age composition of the population(s) most likely to be affected by a disaster? ___________________
________________________________________________________________________________________
Are there special health needs present in the age group(s) identified? ____________________________________
________________________________________________________________________________________
What is the ethnic/racial composition of the population(s) most likely to be affected by a disaster? What effects, if any, will ethnicity have on response to a disaster? _____________________________________________________
________________________________________________________________________________________
What is the extent of injury anticipated as a result of a disaster? What types of injuries are most likely to occur? ________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
What chronic health problems are prevalent among the population(s) most likely to be affected by a disaster? ____
________________________________________________________________________________________
________________________________________________________________________________________
What communicable disease problems are anticipated as a result of a disaster? ____________________________
________________________________________________________________________________________ POPULATION ECONOMIC STATUS ASSESSMENT
Population size _______
Average household income _______
Percentage of households at or below poverty level _______
Composition of the low-income group:
Racial/Ethnic Group Percentage of Poor Age Group Percentage of Poor
African American Birth–1 year
Asian 1–12 years
Hispanic 13–20 years
Native American 21–30 years
White 31–50 years
Other 51–65 years
66–84 years
Over 85 years
Proportion of families eligible for public assistance _______
Proportion receiving assistance _______
Population unemployment rate _______
Proportion of the population with employment-based health insurance benefits _______
Annual public health funding allocation _______
Per capita personal health care expenditures _______
Percentage of people with unmet health needs due to financial constraints _______
Percentage of the population that is homeless _______
Source of payment for health care services:
Payment Source Percent of Expenditures
Private insurance
Medicare
Medicaid
Military
Other government
Out of pocket
Uncompensated
NEIGHBORHOOD/COMMUNITY SAFETY INVENTORY
Description: This tool can be used to assess physical and psychosocial safety hazards in a given client’s neighborhood or in a community at large. The tool assesses elements of the physical environmental, psychological, and social dimensions of health in the dimensions model. The inventory promotes identification of safety problems in the neighborhood or community and planning of nursing interventions to resolve identified problems.
Appropriate populations: Any neighborhood or community. May also be used to assess the neighborhood in which a specific individual client or family lives.
Data sources and data collection strategies: Personal observation of the neighborhood and interviews with residents and key informants are excellent means of obtaining information about neighborhood or community safety. Examples of key informants include local police and fire personnel, business and industry leaders, community officials, local disaster planning groups, department of transportation officials, and insurance company representatives. Review of police, fire, and insurance records may also be a source of important environmental safety information.
Use of information: Information derived using the tool can be used to educate individual clients regarding elimination or avoidance of safety hazards. Information may also be helpful in planning community safety education programs, in initiating disaster planning efforts, or to support political activity to enhance neighborhood or community safety. Finally, neighborhood safety information may assist the nurse to take precautions to promote his or her own safety while working in the area. Using information derived from the inventory, the community health nurse develops nursing diagnoses related to safety problems and plans interventions for those problems. Frequently, the interventions needed will require collaboration with other agencies and individuals, but may be initiated by the nurse.
NEIGHBORHOOD/COMMUNITY SAFETY INVENTORY
Neighborhood or community assessed: ______________________________________________________________
Safety Hazards in the Natural Environment
What is the extent of air pollution? What pollutants are involved? _______________________________________
_____________________________________________________________________________________
What is the extent of water pollution? What pollutants are involved? _______________________________________ ________________________________________________________________________________________
What is the extent of natural radiation in the area? ________________________________________________________
________________________________________________________________________________________
Are there other environmental pollutants in the area? _____________________________________________________
________________________________________________________________________________________
Do local weather conditions pose health hazards? ________________________________________________________
Are there drowning hazards (e.g., lakes, rivers) in the area? ___________________________________________________
Do wild animals in the area serve as reservoirs for disease? ________________________________________________
Do stray animals pose a safety or health hazard in the neighborhood? _______________________________________
What poisonous plants or plant allergens grow in the area? ________________________________________________
________________________________________________________________________________________
Safety Hazards in the Built Environment
Do residential units pose safety hazards? ________________________________________________________________
________________________________________________________________________________________
What is the extent of disrepair in housing units? _________________________________________________________
Are there structural defects in area buildings, roads, and so on that pose safety hazards? ______________________
________________________________________________________________________________________
Do local building codes effectively address safety issues? __________________________________________________
Are building safety codes enforced? ____________________________________________________________________
Are there broken sidewalks (or lack of sidewalks) or other external safety hazards in the neighborhood that pose health risks? ________________________________________________________________________________________
Is there a lead exposure hazard in the area? ______________________________________________________________
How adequate is sanitation and waste disposal? _________________________________________________________
Is there a problem with trash or garbage that poses a health risk? ___________________________________________
What is the prevalence of residential fires? ______________________________________________________________
What proportion of homes in the area have functional smoke alarms or sprinkler systems? ____________________
What are the local fire insurance rates? _______________________________________________________________
To what extent do residents (home owners and renters) carry fire insurance? ______________________________
What is the response time for fire personnel? _________________________________________________________
Are area swimming pools adequately fenced? ________________________________________________________
What is the prevalence of traffic accidents? ______________________________________________________________
Do traffic accidents tend to occur in specific areas? _______ If so, where and why? ____________________________
________________________________________________________________________________________
What are the local car insurance rates? __________________________________________________________________
To what extent do residents carry automobile insurance? __________________________________________________
What is the response time for emergency personnel? ______________________________________________________
Are there significant noise hazards in the area? ___________________________________________________________
What safety hazards are posed by local industry? ________________________________________________________
________________________________________________________________________________________
To what extent do local industries adhere to safety standards? _____________________________________________
________________________________________________________________________________________
Safety Hazards in the Psychological Environment
How secure do area residents feel? __________________________________________________________________
To what extent do environmental conditions contribute to stress? ________________________________________ _____________________________________________________________________________________
Safety Hazards in the Sociocultural Environment
What is the extent of crime in the area? _______________________________________________________________
What types of crime are involved? __________________________________________________________________
_____________________________________________________________________________________
What is the response time for police personnel? _______________________________________________________
Do area residents take an active part in crime prevention? ______________________________________________
What is the extent of intergroup conflict in the area? ___________________________________________________
_____________________________________________________________________________________
Is there tension between racial or ethnic groups in the area? ____________________________________________
Is there gang violence in the area? ___________________________________________________________________
What is the extent of family violence in the area? ______________________________________________________
What is the response of protective services personnel to episodes of family violence? _______________________
_____________________________________________________________________________________
What is the extent of drug and alcohol use/abuse in the area? ___________________________________________
_____________________________________________________________________________________
Are drug dealers a problem in the area? ______________________________________________________________
What is the extent of drug-related crime in the area? ___________________________________________________
Disaster Potential
What is the potential for flooding? __________________________________________________________________
What is the potential for earthquakes? _______________________________________________________________

_________________________________________________________________________________________
________________________________________________________________________________________

Paper for correction

Community health
Introduction
Healthy people 2020 goals are a futuristic oriented strategy that is aimed at improving people’s health and livelihood by 2020. Healthy people, 2020 goals are community oriented, and its success greatly depends on positive health gains from the grass roots. Community health workers have on their shoulders a great responsibility to assess the community health environment to establish community needs that require attention (Healthypeople.gov, 2015).
Community needs are the gaps in health care that need to be taken of as priority to improve general community health. Health people 2020 is primarily based on four pillars, its mandate is to identify community needs, increase community awareness and understanding on health and the existing opportunities, provide for measurable strategies and objectives that are easily realizable from a national to a community level and identify community health needs that need research and evaluation (Healthypeople.gov, 2015).
Its key objectives are high-quality health services that will improve the life expectancy of individuals, achievement of equity in health care provision, the creation of conducive environment both socially and environmentally that promote good health and promotion of healthy practices and behaviors across the state.
Study area
This study is aimed at assessing the health needs of Queens County; it is one of the boroughs of New York, and it is highly populated and still posting population increase in the county. This assessment is aimed at assessing the health needs of the people in Queen County in alignment with the healthy people 2020 initiative. A need assessment is critical and imperative to create a health strategy and budget for the people of Queens County.
The county is home to a multi-cultured community, the indigenous people in this county amount only to the 60% of the total population whereas the rest are from other parts of the world. The Chinese people are the highest in some the Asian community in Queens County. The Chinese people are more cultural and traditional which calls for extensive cultural assessment to establish their needs and perspectives to health.
Queen county health needs are affected by three major forces; economic, environmental and cultural forces. The county is a melting pot of different communities living together; each community has different cultural practices and health needs. The county has some environmental hazards that pose danger to the community. On the economic front, the amount of resources will determine the ability of the county to get quality medical equipment and health products (Scorecard pollution information cite, 2015).
Need assessment
A need assessment is the establishment of the society health requirements and gaps that need attention from health providers and regulators. It is the initial stage to the attainment of healthy people 2020 goals. A need assessment tool varies from one region to another depending on the size of the community and resource endowment.
Need assessment approach
To conduct a need assessment study of a community, it is important to have a variety of information. This information is primarily sourced from the community using different apparatus, the choice of apparatus is imperative to quality, accuracy and credibility of the results.
The study used four major assessment tools;
1. Economic assessment tool
This tool was used to report on the financial ability of the population in Queens County; it assesses the economic power ability to get health products and medical equipment. This can be achieved by assessing the per-capita income, employment rate and the number of the population in the county. The total population of Queen County was found to be 2.2million people. Most of the adults in the county were insured i.e. 82% whereas 93% were employed. However, the population that was said to be below poverty level posted a 16% of the total population. The birth rate recorded a 13.5% in every 1000 people whereas mortality rate was 611 in every 100,000 born (Department of health, 2015).
2. Safety inventory assessment tool
This was used to determine the safety of the neighborhoods for the populations. This was carried out through direct observation and interviewing. Also, the local disaster planning groups and community officials provided important information. The study found out that the population health safety was faced by three major pollutants; chemical release, lead hazards and Superfund. These pose the great health danger to the health of the community through an outbreak of respiratory and other diseases. Another health safety scare in Queen Community is out of assault and accidents. The neighbor hoods are congested risking social crimes and accidents (Scorecard pollution information cite, 2015).

3. Disaster and planning guide assessment
This aims at providing information on how well the community is prepared for disasters. In Queens County most disaster management strategies are primarily focused on securing business, and it lacks measure to secure the people from health-oriented disasters like a disease outbreak. The county housing set up is too congested which is risky in case of a disease outbreak, the level of pollution deposits in the county also is a loaming disaster threat to the people’s health. Healthy people 2020 goals are aimed at preventing disease occurrence in which measure should be put in place to protect the people’s health (Healthypeople.gov, 2015).
4. Cultural assessment tool
A cultural assessment tool assesses the cultural makeup of a community. Different cultures have different practices and beliefs this greatly affects health care providers and planners approach and strategies on health. Queens County is made of people of different cultures that call for a great deal of studies on their beliefs and practices to provide good healthcare to the community (Department of health, 2015).
Problems identified
Three major diseases affecting the community of Queens County were established these diseases are; asthma, obesity and HIV aids. Asthma cases in the county were from the high number of toxic waste from industries and smoking that was a big vice in the County (Department of health, 2015).
Asthma is caused by allergies or increased hypersensitivity, high chemical pollutants and smoking in the county increases the chance and is reason for high number of asthma cases in the county.
There was high childhood obesity in the city; this was blamed on the poor life styles of the people in the county and poor diets. There were less than enough spaces for outdoor activities for children to work out which would help burn calories.
Human immune deficiency virus was prevalent because of great moral permissiveness in the community and congestion. Testing centers for early diagnosis were not immediately available to the people. Some diseases like HIV and AIDS can be difficult to cure but can be managed and reduced. People should be encouraged to go for testing regularly for early diagnosis and treatment. More health facilities should be established to increase counseling services and education to the people on wellbeing and healthy living.
Conclusion
The study found Queens County much populated with health hazards which greatly increases the rate of infection in the population. The contaminated superfunds and other pollutants not only cause danger to the people of Queen County but also the environment and ecosystem which supports the people. These hazardous wastes also increase the risk of cancerous diseases and respiratory diseases. For instance, industrial lead and mercury.
Healthy people 2020 greatly emphasizes on the importance of preventing prevalence of diseases. In this case there is need to sensitize the population on the dangers posed by these polluted environments. Asthma and cancer are difficult diseases to cure but can be prevented through healthy living styles and ensuring a clean environment.
Queen County has a lot to be done to achieve the healthy people 2020 initiative; more strategies need to be put in place to control respiratory disease prevalence in the county. The county should create more awareness to the population to control smoking and littering, more recreation outdoor facilities should be established to provide children an avenue to play and grow healthy. More awareness should also provide concerning lifestyle change and counseling for those who have contracted HIV and AIDS. Testing and counseling facilities should be set up in the county for the same purpose.

The diagnosis of Queen Community health calls for community involvement in creating and establishing healthy lifestyles in the society. Health care organizations can hardly achieve healthy people 2020 goals if the communities are not involved. Health care organizations working in the regions should however initiate home based asthma and HIV assessment; this will help to educate the community on the dangers of smoking, pollution and late diagnosis.

Reference list
Department of health (2015). Socio-economic status and general health indicators – Queens County. New York State. Retrieved 11/2/2015 from: https://www.health.ny.gov/statistics/chac/chai/docs/ses_61.htm
Healthypeople.gov (2015). 2020 Topics and objectives-objectives A-Z\Healthy people 2020.
Retrieved11/3/2015: https://www.healthypeople.gov/2020/topicsobjectives
Scorecard pollution information cite (2015). Pollution locator: USA. Retrieved: 11/3/2015 https://scorecard.goodguide.com/env-releases/us-map.tcl

What is the extent of drug and alcohol use/abuse in the area?

PLEASE READ ALL INFORMATION THROUGHLY
This is the third revision for this paper. This paper is good but still needs the below adjustments. Just add on to it. Please refer to the previous submissions. Do not change this paper just expand in the lacking areas
Below is a list of the tools used and the corrections needed .Thank you for all your time and effort

Corrections needed:as follows
12/2/15: Four of the tools are identified and discussed. The Windshield Survey and Population Health Scavenger Hunt are not found. Please identify and discuss how these tools were used/

.
12/2/15: Once all six assessment tools are utilized, please provide an overall interpretation of the data using the concepts of epidemiology.

..

12/2/15: Healthy People 2020 initiatives are mentioned in general; however, specific goals are not found. Please discuss each of the three problems in relation to specifically corresponding Healthy People 2020 goals.

.
.
TOOLS USED
Windshield Survey
Directions:
This assessment is a foundational exercise for you to learn about your environment and
explore where you live. Take some time to intentionally explore your county. Look at your
county as the home and the place of work for the county residents.
While driving through your community, stop for coffee or have lunch in a neighborhood.
Find a place to eat where you can sit down as part of the community. You may want to walk
around your community as well so that you can explore it from both a driving perspective
and a walking perspective.
Once you have observed the area, write about your impressions of the county in your notes.
Reflect on any surprises and whether the county looks different to you now after taking the
time to note the various elements. What would you like to learn more about related to your
topic and population of interest? You may want to sketch a map related to your topic area
for future reference when writing your community description.
Take notes on the county using the following questions as a guide. These questions are only
to provide guidance; you may discover other areas that you want to note. Include your
findings in the community description section of your paper. You will use this information to
complete task 1 for your “Community Health and Population-Focused Nursing” course.
Collecting this data will help you define your population of interest and prepare for your
practicum experience. You may also want to reference these results in the resources and
partners section of your paper.
ELEMENT DESCRIPTION:
Housing and Commercial Buildings:
•How old are the houses and buildings in the community?
•What materials are the homes and buildings constructed from?
•Are all the houses similar in age and architecture?
•How would you characterize their differences?
•Are the houses detached or connected to each other?
•Are there solar panels? Windmills?
•Do the houses have space in front or behind them?
•What is the general condition of the houses and buildings?
•Are there signs of disrepair (e.g., broken doors or windows, leaks, missing locks)?
•Are there signs of neighborhood pride, such as well-tended yards?
•Is there central heating, modern plumbing, air conditioning?
Open space:
•Is the county primarily rural, suburban, urban, or a mix? How much open space is
there?
•What is the quality of the space (i.e., lush green parks or rubble-filled lots)?
•What is the lot size of the houses, lawns, and flower boxes?
•Do you see trees on the streets or a green island in the center of the streets?
•Is the open space public or private? Who uses this space?
Boundaries:
•What signs are there of where neighborhoods begin and end?
•Are the boundaries natural (a river, a different terrain); physical (a highway, a
railroad); or economic (differences in real estate or presence of industrial or
commercial units along with residential)?
•Do the neighborhoods have an identity or a name? Do you see them displayed? Are
there unofficial names?
“Commons”:
•What are the neighborhood hangouts (e.g., schoolyard, convenience store, bar,
restaurant, park, 24-hour drugstore)?
•What groups of people tend to gather at these hangouts?
•At what time do they typically meet?
•Does the commons area have a sense of territoriality, or is it open to everyone?
Transportation:
•How do people get in and out of the neighborhoods (e.g., car, bus, bike, walking)?
•Are the streets and roads conducive to good transportation and bicycle use and also
to community life?
•Are there major highways running through the county? Who do these highways
serve?
•How frequently is public transportation available?
•Are gas stations available?
•Are there train stations or light rail stations?
Service centers:
•Do you see social agencies, clients, recreation centers, signs of activity at the
schools?
•Are there offices of doctors, dentists, and other such services?
•Are there parks? Are these parks in use?
Stores:
•Where do residents shop (e.g., shopping centers, neighborhood stores, outdoor
markets)?
•How do they travel?
People out and about:
•If you are traveling during the day, who do you see on the street (e.g., an occasional
passerby, a father with a baby)?
•Do you see anyone you would not expect?
•Can you spot the purpose of those that you see, such as a door-to-door salesperson
or a postal worker?
•Is the dress of those you see representative or unexpected?
•What animals do you see (e.g., stray cats, pedigreed pets, watchdogs, birds, wild
life)?
Signs of community vibrancy:
•Is this neighborhood on the way up or down?
•Is it alive?
•How would you decide?
•Do you see any of the following: street vendors, trash, abandoned cars, political
posters, neighborhood-meeting posters, real estate signs, abandoned houses, mixed
zoning usage, people tending their yards, sidewalks in good repair?
Race:
•Are the residents primarily Caucasian, African-American, Asian, of another group, or
is the area integrated?
Ethnicity:
•Are there indications of ethnicity (e.g., food stores, churches, private schools,
information or signs in a language other than English)?
Religion:
•Of what religion are the residents?
•Do you see evidence of heterogeneity or homogeneity?
•What denominations are the churches, temples, and mosques?
•Do you see evidence of these religious facilities being used other than on days of
worship?
Health:
•Do you see evidence of acute or of chronic diseases or conditions?
•Do you see evidence of accidents, communicable morbidity diseases, alcoholism,
drug addiction, mental illness, etc.?
•How far it is to the nearest hospital? To the nearest clinic?
Politics:
•Do you see any political campaign posters?
•Is there a headquarters present?
•Do you see evidence of a predominant party affiliation?
Media:
•Do you see indications of television use such as satellite dishes?
•What magazines and newspapers do residents read?
•What media do you see being sold in the stores?
•What form of media seems most important to the residents (e.g., radio, television,
print, online)?
•What languages are represented in the various forms of media?
Physical Environment:
•Are there indications of an excess of certain types of activities, such as stores that
sell alcohol or fast food restaurants?
•What sorts of billboards are displayed and what do they indicate?
•Are there many cell phone towers or is cell phone access limited?
Adapted from Anderson, E.T., & McFarlane J.M. (1988). Community as client: Application of
the nursing process. Philadelphia, PA: Lippincott.
Community and Population Health Scavenger Hunt
Explore your community and choose six of the following facilities (within your
city/county or just outside of your county):
Women, Infants, and Children office (WIC)
Health department
Food pantry
Department of human/social services
Fire department
Police department
Substance abuse .facility
Ymca
Senior center
Community center
Domestic violence center/shelter
Crisis child care center
Homeless shelter
Emergency management department(e.g., NAMI: National Alliance on Mental Illness)
American red cross
Mental health association
Boys and girls club
Planned parenthood
Chamber of commerce
Consider the following questions while interacting with these service providers in you
1. What is the organization’s target population?
2. How does the organization advertise its services to the community or target population?
3. Are there any barriers to service?
4. What written information do they have available (e.g., pamphlets, brochures)?
5. What is the appearance, both internal and external, of the facility?
6. How do staff members present themselves (e.g., appearance, attitude, knowledge of
services, diversity)?
7. What language capabilities do staff members have?
8. Does the organization have a referral process or does it operate on self-referrals?
9. Are there fees for the services provided? Are payment options available?
10. Does the organization have a presence on the Internet?
11. Is the organization’s facility accessible from various types of transportation (e.g., bus,
train)?
12. What specific services does the organization provide?
13. (Your Choice) Community and Population Health Scavenger Hunt

CULTURAL ASSESSMENT TOOL
Biophysical Considerations
What is the age composition of the cultural group?
Age Group Population Size
0–1 year
1–5 years
6–12 years
13–19 years
20–29 years
30–49 years
50–64 years
65–74 years
75–84 years
Over 85 years
What attitudes toward age and aging are prevalent in the culture? ________________________
_____________________________________________________________________________________
How do attitudes toward aging affect health? _________________________________________
At what age are members of the culture considered adults? ________________________________________________
Are there cultural rituals associated with coming of age? _______ What are the health effects of these rituals and practices, if any? __________________________________________________
What is the gender composition of the cultural group? ____________________________
Does gender play a role in the acceptability of health care providers? If so, how? _________
_____________________________________________________________________________________
Do members of the cultural group display genetically determined physical features or physiologic differences? If so, what are they and how do they influence health? _______________________
_____________________________________________________________________________________
Do group members display differences in normal physiologic values? If so, what are they? _________
_____________________________________________________________________________________
What genetically determined illnesses, if any, are prevalent in the cultural group? _______
_____________________________________________________________________________________
What are the cultural attitudes toward body parts and physiologic functions? ___________________________
_____________________________________________________________________________________
What physical health problems are common in the cultural group? ________________
_____________________________________________________________________________________
Psychological Considerations
Does the cultural group have an individualist or collectivist perspective? _______________
How do members of the cultural group prioritize individual, family, and group welfare and goals? ___________
_____________________________________________________________________________________
What is the extent of stress experienced by members of the cultural group? _______________________________
_____________________________________________________________________________________
What are the usual sources of stress? ________________________________________________________________
How do group members typically cope with stress? ___________________________________________________
_____________________________________________________________________________________
Is there intergenerational conflict within the cultural group that contributes to stress? ______________________
_____________________________________________________________________________________
How do members of the cultural group perceive change? _______________________________________________
_____________________________________________________________________________________
How do they adapt to change? ______________________________________________________________________
_____________________________________________________________________________________
Do members of the cultural group exhibit attitudes of resignation and fatalism? If so, what effect does this have on the use of health care services? ______________________________________________________________________
________________________________________________________________________________________
What attitudes toward mental health and illness are held by members of the cultural group? ___________________
________________________________________________________________________________________
Is there stigma attached to mental illness for the individual? _______ For the family? _________________________
How does stigma affect health and willingness to seek health care services? _________________________________
________________________________________________________________________________________
Physical Environmental Considerations
How do members of the cultural group perceive their relationship to the environment? ____________________
_____________________________________________________________________________________
How do members of the cultural group perceive personal space? ________________________________________
What is the orientation of the cultural group to time? __________________________________________________
What changes in their physical environment have members of the cultural group experienced? ______________
_____________________________________________________________________________________
What influence do these changes have on the health status of the group? _________________________________
_____________________________________________________________________________________
Sociocultural Considerations
Relationships
What are the perceptions of members of the cultural group with respect to supernatural forces? _________________
________________________________________________________________________________________
What roles, if any, do supernatural forces have in health and illness? ________________________________________
________________________________________________________________________________________
What are the religious affiliations of members of the cultural group? ________________________________________
________________________________________________________________________________________
What are the major tenets of the religion(s)? _____________________________________________________________
________________________________________________________________________________________
What influence does religious affiliation or spirituality have, if any, on health care beliefs and practices? _________
________________________________________________________________________________________
Do religious leaders have a role with respect to health and illness within the cultural group? _______ If so, what is that role? _________________________________________________________________________________________
Are religious beliefs and practices incorporated in health care? If so, how? ___________________________________
________________________________________________________________________________________
Do magical influences play a part in health and illness within the cultural group? _______ If so, how? ___________
________________________________________________________________________________________
How is marriage perceived within the cultural group? ____________________________________________________
________________________________________________________________________________________
At what age does marriage usually occur? _______________________________________________________________
Who is considered an appropriate spouse for a member of the cultural group? _______________________________
________________________________________________________________________________________
What is the typical family structure within the culture? ___________________________________________________
What gender roles are expected within the cultural group? ________________________________________________
________________________________________________________________________________________
What are the expected roles and responsibilities of couples? _______________________________________________
________________________________________________________________________________________
How are couples expected to interact with other family members? ____________________________________________
What roles are typically performed by family members? __________________________________________________
________________________________________________________________________________________
How interchangeable are these roles? ___________________________________________________________________
How congruent are family roles with those of the dominant culture? ________________________________________
________________________________________________________________________________________
Who is responsible for decisions within the family? _______________________________________________________
Within the larger cultural group? _______________________________________________________________________

DISASTER ASSESSMENT AND PLANNING GUIDE
Description: This tool is intended to assist community health nurses and other community members to assess the level of disaster preparedness in the community and to plan for effective disaster response. The assessment component of the tool is based on the six dimensions of health in the dimensions model and reflects biophysical, psychological, physical environmental, sociocultural, behavioral, and health system factors influencing disasters and community response to them. Community health nurses and others assessing community disaster preparedness may want to begin the assessment with the Community Disaster Preparedness Checklist (p. 121) to identify areas in which more in-depth assessment is required and then use this tool to direct that in-depth assessment.
Appropriate populations: May be used to assess and plan for disaster preparedness at the community level. May also be used to develop disaster plans for specific health care agencies and institutions or other groups within the community (e.g., schools). Some of the questions also address assessment after a disaster event has occurred.
Data sources and data collection strategies: Sources of data for community disaster assessment and planning may include community historical records, official government documents, existing disaster plans of community agencies and organizations, and interviews with key individuals within the community. Additional sources of data may include local businesses and industries, schools, health departments, civil defense/disaster agencies, and the local chapter of the American Red Cross. Information on community resources may also be available from social and civic organizations and clubs. Area maps and personal observation by the community health nurse and others may also provide important information. Because disaster planning should be a community-wide endeavor, community health nurses will be only one group involved in obtaining assessment data and developing a community disaster plan. Community health nurses, however, may create the impetus for disaster planning and/or coordinate data collection and interpretation and disaster response planning.
Use of information: Data obtained using the tool will be used to identify community disaster potential and to plan means of preventing disasters from occurring or mitigating their adverse effects on the community. Assessment data should be used to develop a general plan of community disaster response that would fit many types of disaster events. Assessment data may also serve as an impetus for educating the general public regarding disaster preparedness.
DISASTER ASSESSMENT AND PLANNING GUIDE
Assessment
Biophysical Considerations
What is the age composition of the population(s) most likely to be affected by a disaster? ___________________
________________________________________________________________________________________
Are there special health needs present in the age group(s) identified? ____________________________________
________________________________________________________________________________________
What is the ethnic/racial composition of the population(s) most likely to be affected by a disaster? What effects, if any, will ethnicity have on response to a disaster? _____________________________________________________
________________________________________________________________________________________
What is the extent of injury anticipated as a result of a disaster? What types of injuries are most likely to occur? ________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
What chronic health problems are prevalent among the population(s) most likely to be affected by a disaster? ____
________________________________________________________________________________________
________________________________________________________________________________________
What communicable disease problems are anticipated as a result of a disaster? ____________________________
________________________________________________________________________________________ POPULATION ECONOMIC STATUS ASSESSMENT
Population size _______
Average household income _______
Percentage of households at or below poverty level _______
Composition of the low-income group:
Racial/Ethnic Group Percentage of Poor Age Group Percentage of Poor
African American Birth–1 year
Asian 1–12 years
Hispanic 13–20 years
Native American 21–30 years
White 31–50 years
Other 51–65 years
66–84 years
Over 85 years
Proportion of families eligible for public assistance _______
Proportion receiving assistance _______
Population unemployment rate _______
Proportion of the population with employment-based health insurance benefits _______
Annual public health funding allocation _______
Per capita personal health care expenditures _______
Percentage of people with unmet health needs due to financial constraints _______
Percentage of the population that is homeless _______
Source of payment for health care services:
Payment Source Percent of Expenditures
Private insurance
Medicare
Medicaid
Military
Other government
Out of pocket
Uncompensated
NEIGHBORHOOD/COMMUNITY SAFETY INVENTORY
Description: This tool can be used to assess physical and psychosocial safety hazards in a given client’s neighborhood or in a community at large. The tool assesses elements of the physical environmental, psychological, and social dimensions of health in the dimensions model. The inventory promotes identification of safety problems in the neighborhood or community and planning of nursing interventions to resolve identified problems.
Appropriate populations: Any neighborhood or community. May also be used to assess the neighborhood in which a specific individual client or family lives.
Data sources and data collection strategies: Personal observation of the neighborhood and interviews with residents and key informants are excellent means of obtaining information about neighborhood or community safety. Examples of key informants include local police and fire personnel, business and industry leaders, community officials, local disaster planning groups, department of transportation officials, and insurance company representatives. Review of police, fire, and insurance records may also be a source of important environmental safety information.
Use of information: Information derived using the tool can be used to educate individual clients regarding elimination or avoidance of safety hazards. Information may also be helpful in planning community safety education programs, in initiating disaster planning efforts, or to support political activity to enhance neighborhood or community safety. Finally, neighborhood safety information may assist the nurse to take precautions to promote his or her own safety while working in the area. Using information derived from the inventory, the community health nurse develops nursing diagnoses related to safety problems and plans interventions for those problems. Frequently, the interventions needed will require collaboration with other agencies and individuals, but may be initiated by the nurse.
NEIGHBORHOOD/COMMUNITY SAFETY INVENTORY
Neighborhood or community assessed: ______________________________________________________________
Safety Hazards in the Natural Environment
What is the extent of air pollution? What pollutants are involved? _______________________________________
_____________________________________________________________________________________
What is the extent of water pollution? What pollutants are involved? _______________________________________ ________________________________________________________________________________________
What is the extent of natural radiation in the area? ________________________________________________________
________________________________________________________________________________________
Are there other environmental pollutants in the area? _____________________________________________________
________________________________________________________________________________________
Do local weather conditions pose health hazards? ________________________________________________________
Are there drowning hazards (e.g., lakes, rivers) in the area? ___________________________________________________
Do wild animals in the area serve as reservoirs for disease? ________________________________________________
Do stray animals pose a safety or health hazard in the neighborhood? _______________________________________
What poisonous plants or plant allergens grow in the area? ________________________________________________
________________________________________________________________________________________
Safety Hazards in the Built Environment
Do residential units pose safety hazards? ________________________________________________________________
________________________________________________________________________________________
What is the extent of disrepair in housing units? _________________________________________________________
Are there structural defects in area buildings, roads, and so on that pose safety hazards? ______________________
________________________________________________________________________________________
Do local building codes effectively address safety issues? __________________________________________________
Are building safety codes enforced? ____________________________________________________________________
Are there broken sidewalks (or lack of sidewalks) or other external safety hazards in the neighborhood that pose health risks? ________________________________________________________________________________________
Is there a lead exposure hazard in the area? ______________________________________________________________
How adequate is sanitation and waste disposal? _________________________________________________________
Is there a problem with trash or garbage that poses a health risk? ___________________________________________
What is the prevalence of residential fires? ______________________________________________________________
What proportion of homes in the area have functional smoke alarms or sprinkler systems? ____________________
What are the local fire insurance rates? _______________________________________________________________
To what extent do residents (home owners and renters) carry fire insurance? ______________________________
What is the response time for fire personnel? _________________________________________________________
Are area swimming pools adequately fenced? ________________________________________________________
What is the prevalence of traffic accidents? ______________________________________________________________
Do traffic accidents tend to occur in specific areas? _______ If so, where and why? ____________________________
________________________________________________________________________________________
What are the local car insurance rates? __________________________________________________________________
To what extent do residents carry automobile insurance? __________________________________________________
What is the response time for emergency personnel? ______________________________________________________
Are there significant noise hazards in the area? ___________________________________________________________
What safety hazards are posed by local industry? ________________________________________________________
________________________________________________________________________________________
To what extent do local industries adhere to safety standards? _____________________________________________
________________________________________________________________________________________
Safety Hazards in the Psychological Environment
How secure do area residents feel? __________________________________________________________________
To what extent do environmental conditions contribute to stress? ________________________________________ _____________________________________________________________________________________
Safety Hazards in the Sociocultural Environment
What is the extent of crime in the area? _______________________________________________________________
What types of crime are involved? __________________________________________________________________
_____________________________________________________________________________________
What is the response time for police personnel? _______________________________________________________
Do area residents take an active part in crime prevention? ______________________________________________
What is the extent of intergroup conflict in the area? ___________________________________________________
_____________________________________________________________________________________
Is there tension between racial or ethnic groups in the area? ____________________________________________
Is there gang violence in the area? ___________________________________________________________________
What is the extent of family violence in the area? ______________________________________________________
What is the response of protective services personnel to episodes of family violence? _______________________
_____________________________________________________________________________________
What is the extent of drug and alcohol use/abuse in the area? ___________________________________________
_____________________________________________________________________________________
Are drug dealers a problem in the area? ______________________________________________________________
What is the extent of drug-related crime in the area? ___________________________________________________
Disaster Potential
What is the potential for flooding? __________________________________________________________________
What is the potential for earthquakes? _______________________________________________________________

_________________________________________________________________________________________
________________________________________________________________________________________

Paper for correction

Community health
Introduction
Healthy people 2020 goals are a futuristic oriented strategy that is aimed at improving people’s health and livelihood by 2020. Healthy people, 2020 goals are community oriented, and its success greatly depends on positive health gains from the grass roots. Community health workers have on their shoulders a great responsibility to assess the community health environment to establish community needs that require attention (Healthypeople.gov, 2015).
Community needs are the gaps in health care that need to be taken of as priority to improve general community health. Health people 2020 is primarily based on four pillars, its mandate is to identify community needs, increase community awareness and understanding on health and the existing opportunities, provide for measurable strategies and objectives that are easily realizable from a national to a community level and identify community health needs that need research and evaluation (Healthypeople.gov, 2015).
Its key objectives are high-quality health services that will improve the life expectancy of individuals, achievement of equity in health care provision, the creation of conducive environment both socially and environmentally that promote good health and promotion of healthy practices and behaviors across the state.
Study area
This study is aimed at assessing the health needs of Queens County; it is one of the boroughs of New York, and it is highly populated and still posting population increase in the county. This assessment is aimed at assessing the health needs of the people in Queen County in alignment with the healthy people 2020 initiative. A need assessment is critical and imperative to create a health strategy and budget for the people of Queens County.
The county is home to a multi-cultured community, the indigenous people in this county amount only to the 60% of the total population whereas the rest are from other parts of the world. The Chinese people are the highest in some the Asian community in Queens County. The Chinese people are more cultural and traditional which calls for extensive cultural assessment to establish their needs and perspectives to health.
Queen county health needs are affected by three major forces; economic, environmental and cultural forces. The county is a melting pot of different communities living together; each community has different cultural practices and health needs. The county has some environmental hazards that pose danger to the community. On the economic front, the amount of resources will determine the ability of the county to get quality medical equipment and health products (Scorecard pollution information cite, 2015).
Need assessment
A need assessment is the establishment of the society health requirements and gaps that need attention from health providers and regulators. It is the initial stage to the attainment of healthy people 2020 goals. A need assessment tool varies from one region to another depending on the size of the community and resource endowment.
Need assessment approach
To conduct a need assessment study of a community, it is important to have a variety of information. This information is primarily sourced from the community using different apparatus, the choice of apparatus is imperative to quality, accuracy and credibility of the results.
The study used four major assessment tools;
1. Economic assessment tool
This tool was used to report on the financial ability of the population in Queens County; it assesses the economic power ability to get health products and medical equipment. This can be achieved by assessing the per-capita income, employment rate and the number of the population in the county. The total population of Queen County was found to be 2.2million people. Most of the adults in the county were insured i.e. 82% whereas 93% were employed. However, the population that was said to be below poverty level posted a 16% of the total population. The birth rate recorded a 13.5% in every 1000 people whereas mortality rate was 611 in every 100,000 born (Department of health, 2015).
2. Safety inventory assessment tool
This was used to determine the safety of the neighborhoods for the populations. This was carried out through direct observation and interviewing. Also, the local disaster planning groups and community officials provided important information. The study found out that the population health safety was faced by three major pollutants; chemical release, lead hazards and Superfund. These pose the great health danger to the health of the community through an outbreak of respiratory and other diseases. Another health safety scare in Queen Community is out of assault and accidents. The neighbor hoods are congested risking social crimes and accidents (Scorecard pollution information cite, 2015).

3. Disaster and planning guide assessment
This aims at providing information on how well the community is prepared for disasters. In Queens County most disaster management strategies are primarily focused on securing business, and it lacks measure to secure the people from health-oriented disasters like a disease outbreak. The county housing set up is too congested which is risky in case of a disease outbreak, the level of pollution deposits in the county also is a loaming disaster threat to the people’s health. Healthy people 2020 goals are aimed at preventing disease occurrence in which measure should be put in place to protect the people’s health (Healthypeople.gov, 2015).
4. Cultural assessment tool
A cultural assessment tool assesses the cultural makeup of a community. Different cultures have different practices and beliefs this greatly affects health care providers and planners approach and strategies on health. Queens County is made of people of different cultures that call for a great deal of studies on their beliefs and practices to provide good healthcare to the community (Department of health, 2015).
Problems identified
Three major diseases affecting the community of Queens County were established these diseases are; asthma, obesity and HIV aids. Asthma cases in the county were from the high number of toxic waste from industries and smoking that was a big vice in the County (Department of health, 2015).
Asthma is caused by allergies or increased hypersensitivity, high chemical pollutants and smoking in the county increases the chance and is reason for high number of asthma cases in the county.
There was high childhood obesity in the city; this was blamed on the poor life styles of the people in the county and poor diets. There were less than enough spaces for outdoor activities for children to work out which would help burn calories.
Human immune deficiency virus was prevalent because of great moral permissiveness in the community and congestion. Testing centers for early diagnosis were not immediately available to the people. Some diseases like HIV and AIDS can be difficult to cure but can be managed and reduced. People should be encouraged to go for testing regularly for early diagnosis and treatment. More health facilities should be established to increase counseling services and education to the people on wellbeing and healthy living.
Conclusion
The study found Queens County much populated with health hazards which greatly increases the rate of infection in the population. The contaminated superfunds and other pollutants not only cause danger to the people of Queen County but also the environment and ecosystem which supports the people. These hazardous wastes also increase the risk of cancerous diseases and respiratory diseases. For instance, industrial lead and mercury.
Healthy people 2020 greatly emphasizes on the importance of preventing prevalence of diseases. In this case there is need to sensitize the population on the dangers posed by these polluted environments. Asthma and cancer are difficult diseases to cure but can be prevented through healthy living styles and ensuring a clean environment.
Queen County has a lot to be done to achieve the healthy people 2020 initiative; more strategies need to be put in place to control respiratory disease prevalence in the county. The county should create more awareness to the population to control smoking and littering, more recreation outdoor facilities should be established to provide children an avenue to play and grow healthy. More awareness should also provide concerning lifestyle change and counseling for those who have contracted HIV and AIDS. Testing and counseling facilities should be set up in the county for the same purpose.

The diagnosis of Queen Community health calls for community involvement in creating and establishing healthy lifestyles in the society. Health care organizations can hardly achieve healthy people 2020 goals if the communities are not involved. Health care organizations working in the regions should however initiate home based asthma and HIV assessment; this will help to educate the community on the dangers of smoking, pollution and late diagnosis.

Reference list
Department of health (2015). Socio-economic status and general health indicators – Queens County. New York State. Retrieved 11/2/2015 from: https://www.health.ny.gov/statistics/chac/chai/docs/ses_61.htm
Healthypeople.gov (2015). 2020 Topics and objectives-objectives A-Z\Healthy people 2020.
Retrieved11/3/2015: https://www.healthypeople.gov/2020/topicsobjectives
Scorecard pollution information cite (2015). Pollution locator: USA. Retrieved: 11/3/2015 https://scorecard.goodguide.com/env-releases/us-map.tcl

Kudler Fine Foods is a client of the accounting firm where you work. Kudler’s management is interested in effectively integrating technology into its business operations. They have asked you to prepare a paper detailing how computer systems might be more effectively integrated to meet their business needs and improve their accounting operations. Resource: Kudler Fine Foods Virtual Organization found by using the Virtual Business Portal Write a paper between 1,300 and 1,400 words in which you address the following: 1.Identify Kudler’s key business and accounting information needs. 2.Analyze the strengths and weaknesses of Kudler’s current computer system and technology use, including hardware and software. 3.Explain what opportunities Kudler has in terms of technology and provide suggestions for improving Kudler’s ability to maximize these opportunities. 4.Evaluate the threats that Kudler may encounter given their current systems and offer your suggestions, in terms of using technology. Format your paper consistent with APA guidelines.

Kudler Fine Foods is a client of the accounting firm where you work. Kudler’s management is interested in effectively integrating technology into its business operations. They have asked you to prepare a paper detailing how computer systems might be more effectively integrated to meet their business needs and improve their accounting operations.

Resource: Kudler Fine Foods Virtual Organization found by using the Virtual Business Portal

Write a paper between 1,300 and 1,400 words in which you address the following:

1.Identify Kudler’s key business and accounting information needs.
2.Analyze the strengths and weaknesses of Kudler’s current computer system and technology use, including hardware and software.
3.Explain what opportunities Kudler has in terms of technology and provide suggestions for improving Kudler’s ability to maximize these opportunities.
4.Evaluate the threats that Kudler may encounter given their current systems and offer your suggestions, in terms of using technology.

Format your paper consistent with APA guidelines.

Identify Kudler’s key business and accounting information needs.

Kudler Fine Foods is a client of the accounting firm where you work. Kudler’s management is interested in effectively integrating technology into its business operations. They have asked you to prepare a paper detailing how computer systems might be more effectively integrated to meet their business needs and improve their accounting operations.

Resource: Kudler Fine Foods Virtual Organization found by using the Virtual Business Portal

Write a paper between 1,300 and 1,400 words in which you address the following:

1.Identify Kudler’s key business and accounting information needs.
2.Analyze the strengths and weaknesses of Kudler’s current computer system and technology use, including hardware and software.
3.Explain what opportunities Kudler has in terms of technology and provide suggestions for improving Kudler’s ability to maximize these opportunities.
4.Evaluate the threats that Kudler may encounter given their current systems and offer your suggestions, in terms of using technology.

Format your paper consistent with APA guidelines.

Apolitical (i.e. neutral) and encouraging?

Overview of Submission, Quality of Research and Analysis
view longer description
This is a nicely written and constructed essay. You’ve researched it well and show good understanding of the concepts you’re reflecting on. However, the essay is not sufficiently directed towards the question. It starts off well, but then doesn’t examine enough the characteristics of a buzzword and then use those to examine your chosen words. So, what is it about participation and empowerment as buzzwords that matters? Is it the fact that there are different interpretations? Vague definitions? Apolitical (i.e. neutral) and encouraging? etc. The essay would have received a mark in the early to mid pass range.
0 pts
Evidence of Key Skills
view longer description
The essay has a good structure and you have a good style of writing. Many places needed more references though and try to avoid making sweeping statements that you can’t support.
0 pts
Potential Areas for Improvement
view longer description
Given your good style of writing, I’m confident that you can get a better mark through orienting the essay more directly towards the question. That is, bring out the characteristics of buzzwords more clearly and in more detail and use those to reflect critically on your chosen words, with examples. Draw on a wider range of sources, particularly academic sources.(that was the feedback i got from the essay)

So, what is it about participation and empowerment as buzzwords that matters?

Overview of Submission, Quality of Research and Analysis
view longer description
This is a nicely written and constructed essay. You’ve researched it well and show good understanding of the concepts you’re reflecting on. However, the essay is not sufficiently directed towards the question. It starts off well, but then doesn’t examine enough the characteristics of a buzzword and then use those to examine your chosen words. So, what is it about participation and empowerment as buzzwords that matters? Is it the fact that there are different interpretations? Vague definitions? Apolitical (i.e. neutral) and encouraging? etc. The essay would have received a mark in the early to mid pass range.
0 pts
Evidence of Key Skills
view longer description
The essay has a good structure and you have a good style of writing. Many places needed more references though and try to avoid making sweeping statements that you can’t support.
0 pts
Potential Areas for Improvement
view longer description
Given your good style of writing, I’m confident that you can get a better mark through orienting the essay more directly towards the question. That is, bring out the characteristics of buzzwords more clearly and in more detail and use those to reflect critically on your chosen words, with examples. Draw on a wider range of sources, particularly academic sources.(that was the feedback i got from the essay)

What happens to the “significance” of each child’s data as the data are progressively more dispersed?

Hypothesis Testing and Inference

This assignment focuses on estimation and hypothesis testing with one-sample and two-sample inferences.

The essence of parametric testing is the use of standard normal distribution tables of probabilities. For each exercise, there will be a sample problem that shows how the calculations are done and at least one problem for you to work out.

For the first assignment, you will not need any statistical software. However, you will use a standardized normal distribution table (a z-score table) provided in the course textbook (Table 3—The normal distribution—in the Tables section in APPENDIX) to obtain your responses.

Click here to access the standardized normal distribution table from your course textbook.

Problem 1: Probability Using Standard Variable z and Normal Distribution Tables

Variables are the things we measure. A hypothesis is a prediction about the relationship between variables. Variables make up the words in a hypothesis.

In the attention-deficit/hyperactivity disorder’s (ADHD’s) hypothetical example provided in the tables below, the research question was, What is the most effective therapy for ADHD? One of the variables is type of therapy. Another variable is change in ADHD-related behavior, given exposure to therapy. You might measure change in the mean seconds of concentration time when children read. This experiment is designed to obtain children’s concentration times while they read a science textbook and to find out whether the therapy used worked on any of the children.

Use the stated µ and σ to calculate probabilities of the standard variable z to get the value of p (up to three decimal places). In addition, respond to the following questions for each pair of parameters:
•Which child or children, if any, appeared to come from a significantly different population than the one used in the null hypothesis?
•What happens to the “significance” of each child’s data as the data are progressively more dispersed?

In addition to the above, write a formal statement of conclusion for each child in APA style. A report template is provided for submission of your work.

Note: Tables 1 and 2 are practice tables with answers. Tables 3 and 4 are the assignment tables for you to work on.

Table 1 (µ = 100 seconds and σ = 10)

Child Mean seconds of concentration in an experiment of reading z-score
(z = [X – µ]/σ) p-value
1 75 –2.50 0.006
2 81 –1.90 0.029
3 89 –1.10 0.136
4 99 –0.10 0.460
5 115 1.50 0.067
6 127 2.70 0.004
7 138 3.80 <0.001
8 139 3.90 <0.001
9 142 4.20 <0.001
10 148 4.80 <0.001

Table 2 (µ = 100 seconds and σ = 20)

Child Mean seconds of concentration in an experiment of reading z-score
(z = [X – µ]/σ) p-value
1 75 –1.25 0.106
2 81 –0.95 0.171
3 89 –0.55 0.291
4 99 –0.05 0.480
5 115 0.75 0.227
6 127 1.35 0.089
7 138 1.90 0.029
8 139 1.95 0.026
9 142 2.10 0.018
10 148 2.40 0.008

Table 3 (µ = 100 seconds and σ = 30)

Child Mean seconds of concentration in an experiment of reading z-score p-value
1 75 –0.83
2 81 –0.63
3 89 –0.37
4 99 –0.03
5 115 0.50
6 127 0.09
7 138 1.27
8 139 1.30
9 142 1.40
10 148 1.60

Table 4 (µ = 100 seconds and σ = 40)

Child Mean seconds of concentration in an experiment of reading z-score p-value
1 75 –0.63
2 81 –0.48
3 89 –0.28
4 99 –0.03
5 115 0.38
6 127 0.68
7 138 0.95
8 139 0.98
9 142 1.05
10 148 1.20

Click here for a template to provide your answers and submit the assignment.

Refer to the Assignment Resources on this page for Two Independent Samples of t-Test to view an example of probability using standard variable and normal distribution tables. The same resource is also available under lecture Estimation and Hypothesis Testing.

Submission Details:
•Name your document SU_PHE5020_W1_A3a_LastName_FirstInitial.doc.
•Submit your document to the W1 Assignment 3 Dropbox by Saturday, December 5, 2015.

Problem 2: Two-Sample Inferences

A two-sample inference deals with dependent and independent inferences. In a two-sample hypothesis testing problem, underlying parameters of two different populations are compared.

In a longitudinal (or follow-up) study, the same group of people is followed over time. Two samples are said to be paired when each data point in the first sample is matched and related to a unique data point in the second sample.

This problem demonstrates inference from two dependent (follow-up) samples using the data from the hypothetical study of new cases of tuberculosis (TB) before and after the vaccination was done in several geographical areas in a country in sub-Saharan Africa. Conclusion about the null hypothesis is to note the difference between samples.

The problem that demonstrates inference from two dependent samples uses hypothetical data from the TB vaccinations and the number of new cases before and after vaccination.

Table 5: Cases of TB in Different Geographical Regions

Geographical regions Before vaccination After vaccination
1 85 11
2 77 5
3 110 14
4 65 12
5 81 10
6 70 7
7 74 8
8 84 11
9 90 9
10 95 8

Using the Minitab statistical analysis program to enter the data and perform the analysis, complete the following:
•Construct a one-sided 95% confidence interval for the true difference in population means.
•Test the null hypothesis that the population means are identical at the 0.05 level of significance.

Click here to install Minitab Software.

In addition, in a Microsoft Word document, provide a written interpretation of your results in APA format.

Submission Details:
•Name your Minitab output file SU_PHE5020_W1_A3b_LastName_FirstInitial.mtw.
•Name your document SU_PHE5020_W1_A3c_LastName_FirstInitial.doc.
•Submit your Minitab output file and document separately to the W1 Assignment 3 Dropbox by Saturday, December 5, 2015.

Problem 3: Cross-Sectional Study

In a cross-sectional study, the participants are seen at only one point of time. Two samples are said to be independent when the data points in one sample are unrelated to the data points in the second sample.

The problem that demonstrates inference from two independent samples will use hypothetical data from the American Association of Poison Control Centers.

There are two groups of independent data collected in different regions, which also calls for a t-test. The numbers represent the number of recorded cases of poisoning with chemicals in the homes of 100,000 people in two regions.

Table 6: Cases of Poisoning With Chemicals

Year Region 1 Region 2
1 150 11
2 160 10
3 132 14
4 110 12
5 85 10
6 45 11
7 123 9
8 180 11
9 143 10
10 150 14

Using the Minitab statistical analysis program to enter the data and perform the analysis, complete the following:
•Formulate a null and an alternative hypothesis for a two-sided test.
•Conduct the test at the 0.05 level of significance.

In addition, in a Microsoft Word document, provide a written interpretation of your results in APA format.

Submission Details:
•Name your Minitab output file SU_PHE5020_W1_A3d_LastName_FirstInitial.mtw.
•Name your document SU_PHE5020_W1_A3e_LastName_FirstInitial.doc.
•Submit your Minitab output file and document separately to the W1 Assignment 3 Dropbox by Saturday, December 5, 2015.

Assignment 3 Grading Criteria
Maximum Points

Initial setup of the assignment—introduction.
10

Accuracy of the z-scores.
20

Accuracy of the p-values.
20

Proper use of the Minitab statistical analysis tool and execution.
10

Provided a copy of the output.
10

Written interpretation of results using correct spelling, grammar, professional vocabulary, and APA format.
30

Total:
100

Which child or children, if any, appeared to come from a significantly different population than the one used in the null hypothesis?

Hypothesis Testing and Inference

This assignment focuses on estimation and hypothesis testing with one-sample and two-sample inferences.

The essence of parametric testing is the use of standard normal distribution tables of probabilities. For each exercise, there will be a sample problem that shows how the calculations are done and at least one problem for you to work out.

For the first assignment, you will not need any statistical software. However, you will use a standardized normal distribution table (a z-score table) provided in the course textbook (Table 3—The normal distribution—in the Tables section in APPENDIX) to obtain your responses.

Click here to access the standardized normal distribution table from your course textbook.

Problem 1: Probability Using Standard Variable z and Normal Distribution Tables

Variables are the things we measure. A hypothesis is a prediction about the relationship between variables. Variables make up the words in a hypothesis.

In the attention-deficit/hyperactivity disorder’s (ADHD’s) hypothetical example provided in the tables below, the research question was, What is the most effective therapy for ADHD? One of the variables is type of therapy. Another variable is change in ADHD-related behavior, given exposure to therapy. You might measure change in the mean seconds of concentration time when children read. This experiment is designed to obtain children’s concentration times while they read a science textbook and to find out whether the therapy used worked on any of the children.

Use the stated µ and σ to calculate probabilities of the standard variable z to get the value of p (up to three decimal places). In addition, respond to the following questions for each pair of parameters:
•Which child or children, if any, appeared to come from a significantly different population than the one used in the null hypothesis?
•What happens to the “significance” of each child’s data as the data are progressively more dispersed?

In addition to the above, write a formal statement of conclusion for each child in APA style. A report template is provided for submission of your work.

Note: Tables 1 and 2 are practice tables with answers. Tables 3 and 4 are the assignment tables for you to work on.

Table 1 (µ = 100 seconds and σ = 10)

Child Mean seconds of concentration in an experiment of reading z-score
(z = [X – µ]/σ) p-value
1 75 –2.50 0.006
2 81 –1.90 0.029
3 89 –1.10 0.136
4 99 –0.10 0.460
5 115 1.50 0.067
6 127 2.70 0.004
7 138 3.80 <0.001
8 139 3.90 <0.001
9 142 4.20 <0.001
10 148 4.80 <0.001

Table 2 (µ = 100 seconds and σ = 20)

Child Mean seconds of concentration in an experiment of reading z-score
(z = [X – µ]/σ) p-value
1 75 –1.25 0.106
2 81 –0.95 0.171
3 89 –0.55 0.291
4 99 –0.05 0.480
5 115 0.75 0.227
6 127 1.35 0.089
7 138 1.90 0.029
8 139 1.95 0.026
9 142 2.10 0.018
10 148 2.40 0.008

Table 3 (µ = 100 seconds and σ = 30)

Child Mean seconds of concentration in an experiment of reading z-score p-value
1 75 –0.83
2 81 –0.63
3 89 –0.37
4 99 –0.03
5 115 0.50
6 127 0.09
7 138 1.27
8 139 1.30
9 142 1.40
10 148 1.60

Table 4 (µ = 100 seconds and σ = 40)

Child Mean seconds of concentration in an experiment of reading z-score p-value
1 75 –0.63
2 81 –0.48
3 89 –0.28
4 99 –0.03
5 115 0.38
6 127 0.68
7 138 0.95
8 139 0.98
9 142 1.05
10 148 1.20

Click here for a template to provide your answers and submit the assignment.

Refer to the Assignment Resources on this page for Two Independent Samples of t-Test to view an example of probability using standard variable and normal distribution tables. The same resource is also available under lecture Estimation and Hypothesis Testing.

Submission Details:
•Name your document SU_PHE5020_W1_A3a_LastName_FirstInitial.doc.
•Submit your document to the W1 Assignment 3 Dropbox by Saturday, December 5, 2015.

Problem 2: Two-Sample Inferences

A two-sample inference deals with dependent and independent inferences. In a two-sample hypothesis testing problem, underlying parameters of two different populations are compared.

In a longitudinal (or follow-up) study, the same group of people is followed over time. Two samples are said to be paired when each data point in the first sample is matched and related to a unique data point in the second sample.

This problem demonstrates inference from two dependent (follow-up) samples using the data from the hypothetical study of new cases of tuberculosis (TB) before and after the vaccination was done in several geographical areas in a country in sub-Saharan Africa. Conclusion about the null hypothesis is to note the difference between samples.

The problem that demonstrates inference from two dependent samples uses hypothetical data from the TB vaccinations and the number of new cases before and after vaccination.

Table 5: Cases of TB in Different Geographical Regions

Geographical regions Before vaccination After vaccination
1 85 11
2 77 5
3 110 14
4 65 12
5 81 10
6 70 7
7 74 8
8 84 11
9 90 9
10 95 8

Using the Minitab statistical analysis program to enter the data and perform the analysis, complete the following:
•Construct a one-sided 95% confidence interval for the true difference in population means.
•Test the null hypothesis that the population means are identical at the 0.05 level of significance.

Click here to install Minitab Software.

In addition, in a Microsoft Word document, provide a written interpretation of your results in APA format.

Submission Details:
•Name your Minitab output file SU_PHE5020_W1_A3b_LastName_FirstInitial.mtw.
•Name your document SU_PHE5020_W1_A3c_LastName_FirstInitial.doc.
•Submit your Minitab output file and document separately to the W1 Assignment 3 Dropbox by Saturday, December 5, 2015.

Problem 3: Cross-Sectional Study

In a cross-sectional study, the participants are seen at only one point of time. Two samples are said to be independent when the data points in one sample are unrelated to the data points in the second sample.

The problem that demonstrates inference from two independent samples will use hypothetical data from the American Association of Poison Control Centers.

There are two groups of independent data collected in different regions, which also calls for a t-test. The numbers represent the number of recorded cases of poisoning with chemicals in the homes of 100,000 people in two regions.

Table 6: Cases of Poisoning With Chemicals

Year Region 1 Region 2
1 150 11
2 160 10
3 132 14
4 110 12
5 85 10
6 45 11
7 123 9
8 180 11
9 143 10
10 150 14

Using the Minitab statistical analysis program to enter the data and perform the analysis, complete the following:
•Formulate a null and an alternative hypothesis for a two-sided test.
•Conduct the test at the 0.05 level of significance.

In addition, in a Microsoft Word document, provide a written interpretation of your results in APA format.

Submission Details:
•Name your Minitab output file SU_PHE5020_W1_A3d_LastName_FirstInitial.mtw.
•Name your document SU_PHE5020_W1_A3e_LastName_FirstInitial.doc.
•Submit your Minitab output file and document separately to the W1 Assignment 3 Dropbox by Saturday, December 5, 2015.

Assignment 3 Grading Criteria
Maximum Points

Initial setup of the assignment—introduction.
10

Accuracy of the z-scores.
20

Accuracy of the p-values.
20

Proper use of the Minitab statistical analysis tool and execution.
10

Provided a copy of the output.
10

Written interpretation of results using correct spelling, grammar, professional vocabulary, and APA format.
30

Total:
100