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Community Health Nursing Final

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Identification of Community
Originally called the Tri-City, Westminster is in Orange County, California. “Westminster is landlocked and bordered by Seal Beach on the west, by Garden Grove on the north and east, and by Huntington Beach and Fountain Valley on the south”, (Westminster Wikipedia entry, 2014). Westminster is also called Little Saigon. “The 2010 United States Census reported that Westminster had a population of 89,701 with a population density was 8,926.5 people per square mile”, (Westminster Wikipedia entry, 2014). 29.6% of the population is between the ages of 35-54. "Most people were hospitalized due to diseases and disorders of the circulatory system", (OC Health Info, 2011). Industry overview of Westminster is comprised of small businesses and services. Majority of adult population reported that their health was good, very good, or excellent.
Summary of Assessment

Population Economic Status Assessment
The total population of Westminster in 2010 was 89,701 people. “The 2010 census shows racial makeup of Westminster was 32,037 White, 849 African American, 397 Native American, 42,597 Asian, 361 Pacific Islander, 10,229 from other races, Hispanic or Latino of any race were 21,176 persons, and 3,231 from two or more races”, (Westminster Wikipedia entry, 2014). “40.2% of the population is comprised if Vietnamese Americans making Westminster the highest concentration of Vietnamese Americans in the country” (Westminster Wikipedia entry, 2014). Westminster’s median household income has improved since 2000 from $49.150 to $54,780 with 15.3% of the population living under the federal poverty line”, (Westminster Wikipedia entry, 2014).
Neighborhood/Community Safety Inventory
Westminster is located in southern California with the annual average temperature at 64.3 F. Westminster has major freeways that pass through it. Air pollution and heavy traffic is a big concern for this city. Exposure to bad pollution is associated with decreased lung function, respiratory symptoms, hospitalizations, for cardiopulmonary causes, emergency room visits for asthma and premature death, (Orange County Health, 2013). Westminster also has a higher carbon monoxide levels compared to the national average. “There are a total of 146 Westminster police officers”, (Westminster crime rates and statistics, 2014). “This results in 1.6 police officers per 1,000 residents which is 26.5% less than the California average and 41.6% less than the National average”, Westminster crime rates and statistics, 2014). “Even so, Westminster has a 4% lower crime rate than the California average”, (Westminster crime rates and statistics, 2014)
Cultural Assessment
Westminster has the largest Vietnamese population in the United States that resides outside of Vietnam. Among the Vietnamese, family is valued highly and plays a central role in the culture. Vietnamese family often lives close by each other. Most elderly parents live with married children and grandchildren until death. Children do not move out of the house until marriage. Husbands usually make decisions outside the home, and wives care for the home. Education is very important in Vietnamese culture. They believe that school is the ticket to successful life. Elders are respected while children are expected to obey them. Roles of the families slowly reversed as women working outside of home. Women are more independent and make their own decision.
Vietnamese community does not recognize substance use and perceives it as a minor issue. Where being addicted is not always viewed as bad, and a lot of families protect and enable their loved ones, especially if the person with an addiction is male. Lack of parental contact, as well as intergenerational conflict, are major causes of substance use disorders among Vietnamese youth. Parents work long hours, which limits the amount of attention they can give their children. The clash between Vietnamese parents’ strict parenting styles and their children’s need for nurturing as another factor in drug use among children. High academic expectations, accompanied by stress and parents’ expression of disappointment in their children’s progress, add to the pressure. Ignorance of substance use by their children is common among parents, (Santa Clara County, 2011). Parents are not open to seeing mental health or substance use issues in their children. The majority of Vietnamese individuals who receive treatment for substance use are males who were mandated to do so. They were caught using or selling and had the choice of incarceration or rehabilitation. If it were not mandated, it would be very hard to engage Vietnamese individuals in treatment. It is difficult for Vietnamese individuals to answer the very personal questions that are asked in substance abuse therapy. It is seen as a betrayal to talk about private family issues, (Santa Clara County, 2011).
Gambling is deeply ingrained in the Vietnamese culture. Gambling is considered a social activity and is integrated into family gatherings and festivals. Many do not view gambling as an addiction but a bad habit. They do not seek help because of shame. Along with a lack of a concept of problem gambling, barriers to addressing this issue are similar to those reported by leaders in interviews about mental health—shame, stigma, and difficulties with self-disclosure, (Santa Clara County, 2011).
Smoking is another health problem with Vietnamese men. Nearly 1 in 4 Vietnamese men (24%) are current smokers. Many were influenced to smoke mostly by their peers and in social situations. Many were advised to quit by doctor or nurse, but did not offer methods on quitting, (Santa Clara County, 2011). Disaster Assessment and Planning Guide
“The City of Westminster has a comprehensive Emergency Management Program which includes all elements necessary to respond quickly and effectively to major emergencies”, (Westminster Police, 2014). “These elements include an Emergency Operations Plan, Emergency Operations Center, Public Safety Officers, Public Education Programs and trained volunteers”, (Westminster Police,2014). The three major areas of focus include: fire, earthquakes, and disease outbreaks, such as Hepatitis and TB. These disasters would most likely effect the young and the elderly. “Relief plans include our Community Emergency Response Teams (CERT) and Radio Amateur Civil Emergency Services (RACES)”, (Westminster Police, 2014). Problems may arise due to language barriers.
Windshield Survey
The environment of Westminster is entirely urban with a few open lots. “Residents of the Westminster community can enjoy the benefits of twenty-four parks with a range of amenities”, (Westminster, 2014). “Picnic areas, ball fields, basketball courts, playground equipment and many other recreational venues are offered at the park sites”, (Westminster, 2014). The houses of Westminster are well maintained with nice lawns and flowers. Most of the houses are single or two levels, which were built in the 1960s. All the homes have access to the sidewalk with some sidewalks having green islands. There majority of businesses in the city are restaurants, grocery stores, health offices, financial offices, and salons that cater to the Vietnamese community. Most of the stores have Vietnamese signs. There are few fast food restaurants. The other restaurants serve traditional Vietnamese food. There are many coffee shops where you will find middle aged men drinking and socializing. There are also many business that also cater to the Vietnamese people such as travel agencies to Asia. Westminster only has one long term care hospital. The residents use hospitals in neighboring cities for emergency care, surgical, and short term hospitalization. Westminster does have many medical offices where the staffs generally speak English and Vietnamese. There are 17 schools in Westminster. The schools are in good condition and well maintained. The school district provides pamphlets in English, Vietnamese, and Spanish. The main modes of transportation are cars, buses, bicycles, and walking. You would generally see older people walking or biking with bags full of groceries. There are 3 fire stations, 1 police department, a senior center, and a DMV. There are many catholic churches with English, Vietnamese, and Spanish services. There are also many Buddhist temples. Westminster has many radio stations, television shows, newspapers, and magazines in Vietnamese. Overall, Westminster is a nice city with many Vietnamese influences.
Population Health Scavenger Hunt
The Orange County Health Department’s target population is the residents of Westminster County and to support the health of the County. The Westminster website promotes the health department and health information regards to upcoming events and programs. The director of Chamber is promoting to improve activities within the city. Police and fire department within the city educate and protect its’ residents. Project S.H.U.E is a program to assists children in 1st and 2nd grades to reach their grade level through mentoring and tutoring from senior volunteers. The police department has a program designed to educate citizens about police procedures. The police department also has a program called SHEILD that is designed to help children at high risk. Senior Center provide activities, transportation, and meals for the elderly. Monthly Surplus Government Food Distribution for low-income, 60+ and live in Westminster. Westminster city also provides many others services to their elderly like blood pressure testing once a week and income tax assistance during February. It also provides legal counseling once a month. Movies are shown weekly. Nutrition education lectures are offered four times a year. Westminster also has programs that involve families such as family advocacy and family reunification. Description of Selected Community
Westminster City is a community built with multiple cultural and ethnicity. It has the largest Vietnamese population in the United States. People within the population are thriving and making this place their permanent home. Strong sense of Vietnamese cultures are apparent with development of business, increase in population, and services. "The leading cause of death in the county is cancer, heart disease, accidents, and cerebrovascular disease", (OC Health Profile, 2013). Health disease provided through programs through nearby hospitals and outside activities.
Interpretation of Data
The Vietnamese population is steadily increasing while other ethnic groups are in decline. The leading causes of death among young people are injuries while older people die from cancer or heart disease. Type 2 diabetes mellitus is also on the rise due to high carbohydrate diet and lack of exercise. Vietnamese men smoke more so they are more prone to lung cancer. Hepatitis and TB are more prevalent in Asian communities because of frequent traveling to Asia. There is a language barrier among the older generation and recent immigrants.
Problems in the Selected Community
According to Healthy People 2020 goals, the leading cause of mortality topics are Heart Disease, Stroke, and Cancer appear to be top three problems. Like most cities in the United States, these three major causes of mortality also contribute to the leading death of the residents in Westminster. Solutions to these problems would be to increase outreach programs in alternative languages and more available assess to transportation. Prevention of the above diseases also start with controlling cholesterol, blood pressure, tobacco use, physical education, and nutrition.

Problems in Relation to Goals
The goal for Healthy People 2020 is to improve the health of all Americans. “Healthy People 2020 strives to identify nationwide health priorities, increase public awareness about diseases and disabilities, and provide measurable goals over a ten year period”, (Healthy People, 2014). By identifying the health needs of a community, the community can determine which areas are good and which areas need improvement. “By doing this, the community members live longer, healthier lives and prevent premature deaths”, (U.S. Department of Health and Human Services). With proper nutrition, exercise, and education awareness will help reduce complications of adult onset diabetes. Well control of diabetes will reduce heart diseases and strokes which are the leading cause of mortalities.
Availability of Community Resource
Westminster Senior Center provides monthly health and nutrition classes. The center also offers weekly excise classes for the elderly. There is a daily luncheon at a low price and provides transportation to local supermarkets. The city offers many parenting programs. Some programs include prenatal and maternal education for expecting parents. Fountain Valley Hospital offers monthly health education classes on hypertension, stroke, and diabetic. Garden Grove hospital offers flu shots to the community during flu season. The city also offers English as a Second Language (ESL) classes to the community to help bridge the language gap. And for the children, there are after school tutoring programs and community classes for low income family.
Primary Prevention Topic
My primary prevention topic is the prevention of adult onset type two diabetic by means of healthy nutrition, physical activities, and education. The goal is to decrease the economic burden and complication of diabetes (DM) and improve the quality of life for those who are at risk.
Use of Questions
The largest contributors to disease and premature death are heart disease, cancer, and stroke.
The most recent controversial news is water conservation due to drought in Southern California. New laws have been passed to help conserve water such as no hosing off landscapes and hose washing cars without a shut-off nozzle. Earth quake preparedness is also a big concern for Southern California. Drills are conducted yearly in schools and media.
Most people in the community are concerned about staying healthy. Hospitals and the media provide programs to help people stay healthy.
Stroke and heart disease are generating the most visited to the emergency room. By changing lifestyles and education, you can reduce the amount of hospitalization due to stroke and heart disease.
The lack of education due the language barrier is reducing the quality of life in the community. There is also a lack of transportation to access medical care and grocery shopping. Increase quality of life can improve with easy access to public transport and having more information available in different languages.

References
Climate in Westminster, California (2014). Retrieved from http://www.bestplaces.net/climate/city/california/westminster
Orange County Health Profile (2013). Retrieved from http://www.ochealthinfo.com/pubs

Santa Clara County, California (2011). Retrieved from http://www.sccgov.org/sites/sccphd/en-us/Partners/Data/Documents/VHA%20Full%20Report,%202011.pdf
Westminster, CA Crime Rates & Statistics (2011). Retrieved from http://www.areavibes.com/westminster-ca/crime/
Westminster, California (2014). Retrieved from http://www.city-data.com/city/Westminster-California.html
Westminster, California. Wikipedia (2014). Retrieved from http://en.wikipedia.org/wiki/Westminster,_California
Westminster Police (2014). Retrieved from http://www.westminster-ca.gov/depts/police/default.asp
Westminster Schools, California (1999). Retrieved from http://www.greatschools.org/california/westminster/
The City of Westminster, California (2014). Retrieved from http://www.westminster-ca.gov/
U.S. Department of Health and Human Services. (2013). About Healthy People. Healthy People.gov. Retrieved from http://www.healthypeople.gov/2020/about

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