Community Needs Assessment

For all to enjoy, here's a copy of my community needs assessment, done on the recent health fair in North Miami Elementary School:

COMMUNITY NEEDS ASSESSMENT

Community Health Nursing Fall 2006

1. Location: North Miami Elementary School

Date: November 4, 2006
Instructor: Marie Etienne/Marie Anglin
Activity: North Miami Elementary School Health Fair – Disease Screening
Health Issue(s): Diabetes/Hypertension/Women’s Health

2. What are the demographics of the population in the community that you will be addressing with this activity? (gender, race, ethnicity, age, group, etc.)

City of North Miami[1]:

31.8% of North Miami residents are between 25-44 years of age.
19.6% are between 45-64 years old.
Average age is 32.
The median income for a household in the city was $29,778, and the median income for a family was $31,760.
About 20.7% of families and 23.9% of the population were below the poverty line, including 29.5% of those under age 18 and 17.2% are 65 years old or over.
Ethnic Mix: 34.81% White, 54.89% African American, 0.32% Native American, 1.92% Asian, 0.05% Pacific Islander, 3.16% from other races, and 4.85% from two or more races. Hispanic or Latino were 23.16% of the population.
North Miami is known for its large Haitian-American population. In 2001, voters made Josaphat Celestin the first Haitian American mayor of a large Miami-Dade County community.

3. Prevalence. What are the risk factors facing this population(s)? What is the prevalence of this particular health problem among this population?
South Florida has a large and growing number of Haitians, particularly in North Miami. Unfortunately, Haitians are greatly affected by chronic illnesses that affect many groups of African descent: diabetes, hypertension, breast and cervical cancer. Data on the prevalence of diabetes and hypertension among North American Haitians are difficult to assess because they are categorized under “African American”. From what we do know, cancer, tuberculosis, and HIV are some the most prevalent diseases of Haitians who’ve recently emigrated from Haiti. From 1979-1984, among Haitian women, cervical cancer accounted for 39% of all cancers. Approximately 50% of Haitian women get pap smears compared to 25% of English-speaking Caribbean Americans and 10% of US-born blacks[2].

4. Identify some of the major health problems that this particular community faces.
Haitian Americans are at risk for contracting high-morbidity diseases such as hypertension, diabetes, breast and cervical cancer. This in part due to hereditary influences, as most groups of African descent are at higher risk of having cardiovascular disease from ages 30 and over (and in some cases, children are now having cardiovascular problems). Contracting STDs and HIV/AIDS is also a major problem in this community, as Haitians do not have the resources and the awareness of information that can prevent the spread the STDs. Tuberculosis is a major health problem in most Latin American countries, primarily due to the highly contagious rate of this disease and it’s similarities to other respiratory problems.

5. Why do you think that this community needed this educational program/health screening/other?
There is a lack of health resources available to Haitians, in particular for those who fear losing their residency status. The median income level of North Miami residents is about $29k with about 24% of the population below the poverty line. This population doesn’t have the financial resources to seek out preventative health care from health care professionals. Language barrier is also an issue, as the majority of Haitians speak Haitian Creole – it’s important to have health care professionals who can speak to them in their own language and building trust in the health care system.

6. Could you assess the community’s knowledge of your health issue during the activity? After the activity?
Unfortunately I was unable to obtain objective information through use of a survey. However, I was able to obtain subjective information from the blood pressure screening. The majority of the adults I screened (about 70%) had high blood pressure and didn’t know it. About 90% of the adults were more interested in knowing their blood sugar and cholesterol levels, stating that they could have their blood pressure checked at local supermarkets. Half of the women waiting for blood sugar and cholesterol results were interested in having a mammogram and pap test. Unfortunately, very few women were interested in learning how to do a breast-self examination.

7. How will your activity influence the long-term health of this community?
Our intention is to increase the Haitian community’s awareness of risk factors for common, chronic diseases and to detect certain cancers early for effective treatment. I believe the knowledge that H.A.N.A. and Miami Dade College provided to the community encourage them to reduce their risks by changing poor nutritional habits (high salt and sugar intake) and keeping appointments with local doctors and the Miami Dade County Health Department for routine screenings.

8. In your opinion, what are the specific needs of the populations as a community?
The Haitian community’s main obstacles to healthcare would be communication. It is essential that the Haitian community has health care professionals who not only speak Creole, but are knowledgeable about the culture and beliefs of Haitians, especially when it comes to potential conflicts between Haitian folk medicine and western allopathic medicine. This population also needs resources that are affordable, making access to screenings and treatments easier – thereby improving healthcare compliance.

9. In terms of your health issue, what type of resources do you believe that this community could utilize to help alleviate the health problem at hand?
This community needs more local health fairs in the community, local health centers for affordable treatment, and health promotion information pamphlets in Creole.

10. Identify one agency/organization/facility in this community that the population could refer to if they had to deal with this health problem.

Fanm Ayisyen Nan Miyami, Inc. (FANM)
[Haitian Women of Miami]
7900 NE 2nd Ave
Miami, FL 33138
(305) 756-8050

Miami Dade County Health Department
Project Screen
Jennifer M. Prince-RN, NPS
8600 NW 17 ST Suite# 200
Miami, FL 33126 (305) 470-5634
(305) 470-5635

---

[1] Taken from URL: http://en.wikipedia.org/wiki/North_Miami,_Florida#Demographics

[2] Holcomb, L.O. (1996). Haitian Americans: Implications for Nursing Care

Journal of Community Health Nursing, Vol. 13, No. 4. (1996), pp. 249-260.

Miami Children's Museum -- Last Visit

Today was my last visit to Miami Children 's Museum, completing my community service hours and observation hours at the same time. There were only 2 nursing students there, including myself. "Business" was slow until about noon when 3 different party groups came in to see the gallery. We were kept busy until 4 pm, teaching the kids about anatomy, exercise, and dental care. By 4 pm, I was alone, helping kids earn stickers and smiles for being good "doctors", fixing our doll "Tooter" with his ailments. Some children really enjoyed playing with the crutches -- so much so that one kids suffered a nosebleed from playing too rough with one of the other kiddies. At around 5 pm, I stayed in the Parent/Teacher Resource center and read a few books with kids until my time was over at the museum.

I learned a lot from the museum -- I'm a lot more comfortable around children than I was before doing hours there, and I feel good about teaching kids the importance of maintaining good healthy habits. I would recommend this community service activity to any nursing student who's interested in completing their hours. Maybe, by teaching this kids about the importance of healthy habits now, it can help them become more aware of ways to reduce the risk of receiving chronic illnesses such as diabetes and hypertension. Health promotion and primary prevention are some of the initiatives listed in Healthy People 2010.

Today's vocabulary word: Environment. The environment (pg. 38) is all that is external to the human host; physical, biological, social, cultural, etc. Environment plays a big role in what we learn, how we behave and think, and how healthy we are. The children at the museum, many of them from minority families, may be at risk to diseases such as hypertension. You can see the environmental influences of poor food choices when the kids choose pizza, burgers, and ice cream at the fake "Publix" as their food choices for the day. One child stocked his shopping basket with CHEESE, lots and lots of CHEESE!

North Miami Elementary School Health Fair

Today I (along with another student) assisted with a local health fair at North Miami Elementary School. It was my first health fair and a good change of pace from volunteering at the Miami Children's Museum. Surprisingly there were only two students who went to the fair, and a Barry University student who was part of the Haitian American Nurses Association (H.A.N.A.). We had project boards showing information on child safety, poison/burn prevention, breast self-examination, and preventing infections (handwashing). We had a children's corner where nursing student ("G") taught kids about germs, handwashing, safety, and entertained them with arts and crafts while the adult were screened for diabetes, high cholesterol, and hypertension.

The H.A.N.A. nurses screened the adults for blood sugar and cholesterol levels while I screened them for high blood pressures. Quite a few, in fact the majority, of the adults at the health fair had high blood pressure. Many of them were also in shock that their blood pressure was so high -- one man, on blood pressure medication (took one that morning), had a blood pressure of 170/110. Clearly his medication was ineffective, and Prof. "A" explained to him in Creole what to do to alleviate the problem (my Creole is a little rusty). About 80% of the adults who attended the health fair were Haitian, most living near the elementary school. What was great about the health fair was that there were other resources they can use after medical screening (making appointments with Miami Dade County Health and F.A.N.M. association, even a make-shift hospital with beds in the auditorium for routine mammograms and pap exams).

Most of the adults responded well to the fair and were interested in what we had to teach them. For example, many of the women at the fair responded favorably to the breast self-examination table, eager to learn methods to identify early signs of breast cancer.

What was surprising was the shear amount of resources available to the adults at the health fair. Doctors, nurses, and social workers were available to prescribe medication, consult, and screen for diseases. I wish more people in the community knew about the fair so they can benefit from it. This health fair, definitely helps meet some of the goals of Healthy People 2010, reducing health disparities in targeted minority populations, such as the Haitian community. It felt good to be a part of a proactive movement to assist local residents in getting the health care they need but otherwise cannot afford.

Today's vocabulary word: epidemiology. Epidemiology (pg. 33) is the study of the distribution and determinants of health-related states or events in a specified population and the application of this study to control the health problem. Epidemiology studies the similarities of people or populations that develop an illness. Knowing the prevalence of certain diseases in a population gives incite on how pervasive an illness is and what methods we can implement to reduce it. For example, at this health fair, many Haitians had high blood pressure, also true for most groups of African descent. We can use this information to find biological and environmental reasons for hypertension (such as greasy foods) and reduce this disease among Haitians.