Community Assessment Flashcards
(29 cards)
Nursing/Care Management Process in Community
Assessment – Data Collection
Diagnosis – Identifying Strengths and Problems
Planning – Program Development
Implementation
Evaluation – Program Outcomes
•The community is the client
Assessment (Data Collection) is the _______ step in the Nursing Process/Care Management Process.
FIRST!
Just as you assess your individual patients before you intervene, we assess a community before we plan community programming.
Community Assessment
• Process of data collection about a community
• Describes the health of the community
• Guides nursing diagnoses
• Becomes the basis for program planning and development
• Remember Assessment is one of the Core Functions of PH
We do assessment in the community for the exact same reasons we do assessment with individual clients.
Types of Community Health Assessments
Comprehensive Assessment
Population-focused
Setting-specific
Problem-based or Health-issue based
Health Impact Assessment
Rapid Needs Assessment
Comprehensive Assessment
Collection of data about populations living in a community
• Look at assets, unmet needs, and opportunities for improvement
• Use of community statistics: Health status, Health needs, Epidemiological studies
• Mandate for conducting comprehensive assessments
• IOM directed 1988
• Affordable Care Act: Nonprofit hospitals must conduct community health assessments
Population-focused
Considers a larger group or aggregate – remember, members may or may not interact with one another, but they shares at least one similar characteristic/issue
• Can focus on a specific age group, gender, or health issue (Community Assessment for Homeless in Charlotte)
Setting-specific
must have clear understanding of purpose
• Considers: strengths/weaknesses of: An organization, policies/procedures, programs.
• Identify indicators specific to setting
• Treats the setting as the community
• People within a specific setting
• Data specific to the setting
Problem-Based or Health-Issue Based
Focus on specific problem or health issue, analysis of data determines who is at risk
• Promote understanding of: Policies, practices, and the environment
• Determines who is at risk? (Obesity)
Health Impact Assessment
Provides advice to community on optimizing its health by identifying the:
• Potential effects on the health of a population and the distribution of those effects within the population.
• Combination of policies and methods used to judge programs/projects
• Associated with: the environment and social influences on populations
Rapid Needs Assessment
Measures present and potential public health impact of an emergency
• Effective use of limited resources
• Comprised of: Existing information, visual inspection, interviewing key people, rapid surveys (Haiti following earthquake)
Kinds of data
Quantitative
Qualitative
Quantitative data examples
• Census figures
• Local agencies
• Community surveys
• Observations
Qualitative data examples
• Community surveys
• Key informant interviews
• Resident interviews
• Observation
Refresher: what are the determinants of health?
Biology and genetics
Personal behavior/Lifestyle
Health services
Policymaking
Social factors
Refresher: what are the SOCIAL determinants of health?
Education access and quality
Healthcare access and quality
Economic stability
Neighborhood and build environment
Social and community context
Remember, that the data (to use for PH) that we want is _______ scope.
BROAD
We are going to consider all of the DETERMINANTS OF HEALTH.
So, we not only want to consider the ________ health status of a community – the rate of heart disease in the population. We must also consider the determinants of health in the community – considering heart disease again, we need to consider the number of fast food outlets or the rate of smoking. What other factors would we want to assess?
Physical
Availability to healthy food options in the area
Education on healthy eating/heart disease prevention
Access to preventable HC for those at risk
Data Collection Methods
Use existing data when possible
• Public information (US census, CDC, local health department)
• Other existing data (hospital statistics, other local agencies)
Gather new data as necessary
• Windshield survey
• Informant interviews
• Participant observation
• Surveys
• Focus groups
What data do we have? What data do we need? How can we get the data we need?
10 things to know about Health
- Health is more than HC
- Health is tied to the distribution of resources
- Racism imposes an added health burden
- The choices we make are shaped by the choices we have
- High demand + Low control = Chronic Stress
- Chronic Stress can be TOXIC
- Inequality - economic and political - is bad for our health
- Social policy IS Health policy
- Health inequalities are NOT nature
- We ALL pay the price for poor health
10 things to know about Health - Health is more than health care.
Doctors treat us when we’re ill, but what makes us healthy or sick in the first place? Research shows that social conditions – the jobs we do, the money we’re paid, the schools we attend, the neighborhoods we live in – are as important to our health as our genes, our behaviors and even our medical care.
10 things to know about Health - Health is tied to the distribution of resources.
The single strongest predictor of our health is our position on the class pyramid. Whether measured by income, schooling, or occupation, those at the top have the most power and resources and on average live longer and healthier lives. Those at the bottom are most disempowered and get sicker and die younger. The rest of us fall somewhere in between. On average, people in the middle are almost twice as likely to die an early death compared to those at the top; those on the bottom, four times as likely. Even among people who smoke, poor smokers have a greater risk of dying than rich smokers.
10 things to know about Health - Racism imposes an added health burden.
Past and present discrimination in housing, jobs and education means that today people of color are more likely to be lower on the class ladder. But even at the same rung, African Americans typically have worse health and die sooner than their white counterparts. In many cases, so do other populations of color. Segregation, social exclusion, encounters with prejudice, the degree of hope and optimism people have, differential access and treatment by the health care system – all of these can impact health.
10 things to know about Health - The choices we make are shaped by the choices we have.
Individual behaviors – smoking, diet, drinking, and exercise – matter for health. But making healthy choices isn’t just about self- discipline. Some neighborhoods have easy access to fresh, affordable produce; others have only fast food joints and liquor and convenience stores. Some have nice homes; clean parks; safe places to walk, jog, bike or play; and well-financed schools offering gym, art, music and after-school programs; and some don’t. What government and corporate practices can better ensure healthy spaces and places for everyone?
10 things to know about Health - High demand + low control = chronic stress.
It’s not CEOs who are dying of heart attacks, it’s their subordinates. People at the top certainly face pressure but they are more likely to have the power and resources to manage those pressures. The lower in the pecking order we are, the greater our exposure to forces that can upset our lives – insecure and low-paying jobs, uncontrolled debt, capricious supervisors, unreliable transportation, poor childcare, no healthcare, noisy and violent living conditions – and the less access we have to the money, power, knowledge and social connections that can help us cope and gain control over those forces.
