Victoria Howard Western Governors University
C228
December 4, 2017
Task 1: Sentinel City Assessment
- Sentinel City Screenshots (see attachments)
B. Needs Assessment
Demographics Assessment
Sentinel City is an online simulation city used to practice the skills needed to assess the needs of a real community. My observations in this paper were made by travelling through the city and foot and by the information provided in the simulation. The population of Sentinel City is 634,265 (Sentinel City Simulation, 2017). The age percentage of the population consists of 10.5% of 65 years and up, 21.7% of 18 years and under, and 7.4% of 5 years and under (Sentinel City Simulation, 2017). There is little diversity in Sentinel City, with the majority of the population being White (80.6%) or Hispanic/Latino (31.5%); the rest of the population consists of African Americans (10.4%), American Indian/Alaskan Natives (2.0%), Asians (3.7%), Hawaiian Native/Pacific Islanders (0.2%), and two or more races (3.1%) (Sentinel City Simulation, 2017).
Sentinel City is divided into four distinct neighborhoods: Nightingale Square, Acer Tech Center, Casper Park District, and Industrial Heights. Nightingale Square has a population of 103,974. Acer Tech Center has a population of 168,390. Casper Park District has the largest population of 352,643. Lastly, Industrial Heights has the smallest population of 38,855. As with the population of Sentinel City, as a whole, the populations of the four neighborhoods are either primarily white or Hispanic/Latino. Nightingale Square consists of 81.3% white and 3.7% Hispanic/Lation, Acer Tech Center consists of 70.2% white and 13.7% Hispanic/Latino, Casper Park District consists of 63% white and 24% Hispanic/Latino, and Industrial Heights consists of 46.8% Hispanic/Latino and 13.1% Black/African American (Sentinel City Simulation, 2017).
The overall median household income of Sentinel City is $49,091 and 18.9% of its residents live below the poverty level (Sentinel City Simulation, 2017). The median incomes of each neighborhood differ drastically; Nightingale Square has a median income of $269,550, Acer Tech Center has a median income of $166,300, Casper Park District has a median income of
$80,134, and Industrial Heights has a median income of $24,672 (Sentinel City Simulation, 2017). Similarly, the percentage of uninsured residents of each neighborhood also differ greatly, however there seems to be a pattern between median household income and the percentage of uninsured residents; as the income decreases, the percentage of uninsured increases. Of the individual neighborhoods, 0.7% of residents of Nightingale Square are uninsured, 1.5% of residents of Acer Tech Center are uninsured, 22.7% of Casper Park District residents are uninsured, and 37.5% of residents in Industrial Heights are uninsured (Sentinel City Simulation, 2017).
Neighborhood Safety Assessment
My safety assessment of Sentinel City showed a few areas for concern, with the majority being in Industrial Heights. When entering Industrial Heights, the differences between this neighborhood and Nightingale Square are immediately evident. When first entering Industrial Heights, we see a soup kitchen with a very long line, stray dogs, trash littering the sidewalks, broken down cars, thick factory smoke, and a car on fire behind the Interfaith church. The buildings of Industrial Heights are also older and somewhat rundown; there is also graffiti on multiple buildings and buses. Although the School District does have a crossing guard, there does not seem to be any sort of school zone signs or speed limits posted, nor is there a sign indicating children playing near the playground. Beside the Transportation Center and the playground, there are large metal drums with the yellow biohazard symbol just lying around,
which is definitely a safety hazard and may indicate pollution. Throughout the city in general, there are multiple intersection that lack adequate traffic lights and signs, stray animals can be seen throughout, industrial and construction materials without any visible warning signs, and there does not seem to be any handicap access points, despite a large number of handicap individuals seen.
Sentinel City’s City Hall provides information from their police department. Based off this information, the most common arrests over the last year include: public intoxication (6%), reckless conduct (6%), criminal trespassing (9%), controlled substances (16%), battery (17%), cannabis (23%), and warrant (23%) (Sentinel City Simulation, 2017). Last year, there were 181 violent crimes committed in Sentinel City; 62 against males and 57 against females. It is also evident from this data, that there is a significant amount of drug use in the city, with 16% of arrests were for controlled substances and 23% were for cannabis use or possession. According to the data from Sentinel City’s Healthcare Systems Pharmacy, 12% of their population report using marijuana, 5% report using cocaine, 7% report using heroin, 0.5% report using methamphetamines, 2% report using club drugs, and 5% report using CNS depressants (Sentinel City Simulation, 2017). The information provided from the Police Department indicates a significant amount of gang violence over the last year. The data shows there were 20 homicides, 100 cases of aggravated assault, 38 cases of simple assaults, and 40 cases of robbery (Sentinel City Simulation, 2017).
Sentinel City’s City Hall also provides information from their fire and emergency services departments. Sentinel City has a total of 30 Paramedics and 250 Firefighters. Their EMS response time is 7.46 minutes, their Advanced Life Support response time is 7.54 minutes, their Fire response time is 6.33 minutes, and their Time to Shock response time is 6.37 minutes
(Sentinel City Simulation, 2017). In comparison to other cities, Sentinel City has the smallest number of civilians trained in CPR and/or the use of an AED; this subsequently leaves them with a smaller number of sudden cardiac arrest survivals (Sentinel City Simulation, 2017).
Scavenger Hunt
Sentinel City has many community resources available to its residents. One resource in the community is the Department of Parks and Recreations, located in Nightingale Square. This center offers many programs to the community, including swimming lessons, nutrition courses, gardening courses, adult fitness courses, after school programs, kid’s summer programs, and city sports leagues. However, despite being in, what appears to be, a “nicer” part of Sentinel City, the Parks and Recreations Center still has a significant amount of complaints and crime. In the last year, there were multiple crime citations at the center; these included citations for prostitution (9%), violent crimes (24%), trespassing (31%), public intoxication (16%), littering (11%), and selling without a permit (6%) (Sentinel City Simulation, 2017). The Parks and Recreations Center also received a large number of complaints about homeless population, stray animals, drugs, cleanliness, and crime.
Other community resources offered by Sentinel City are the Healthcare Systems for the Elderly and the City Hall’s Social Services, these are both located in Acer Tech Center neighborhood. The healthcare systems include dental, vision, emergency, ambulatory care, integrated services, inpatient care, pharmacy, and elderly care. Elderly care provides care to the senior citizens of Sentinel City; this programs assists and provides citizens with government assistance, senior transportation, community centers, meals on wheels, service animals, and they elder abuse prevention advocates (Sentinel City Simulation, 2017). The Sentinel City healthcare system also assists elders in finding a place to live; these options include senior living center
units, swing beds, long term care beds, skilled nursing beds, assisted living units, nursing home units, and independent senior apartment units. Another community resource in the Acer Tech Center neighborhood is City Hall’s social services. Social Services offers a variety of services to the community, including protective services, healthcare assistance programs, WIC, and SNAP (Sentinel City Simulation, 2017).
A community resource offered in the Casper Park District neighborhood, is the Affordable housing project. This housing project offers apartment housing for low income residents. Unit types include studio, one bedroom, and two bedroom; 44% of the studio units are occupied, 26% of the one bedroom units are occupied, and 43% of the two bedroom units are occupied (Sentinel City Simulation, 2017). In comparison to the crime rates in the rest of the city, the housing projects have a very low rate of crime. Last year there were only 14 reported crimes on the property, this is in comparison to the 2414 crimes total that were reported in the city (Sentinel City Simulation, 2017).
Community resources offered in the Industrial Heights neighborhood include the Better Health Clinic and the Interfaith Church’s Soup Kitchen. The Better Health Clinic offers contraceptive services, pregnancy testing and counseling, achieving pregnancy counseling, infertility services, preconception health, STD services, breast cancer screening, cervical cancer screening, and other preventative health services (Sentinel City Simulation, 2017). The other community resource in Industrial Heights is the Interfaith Church’s Soup Kitchen. The soup kitchen offers meals to a variety of residents, including the elderly, veterans, disabled adults, homeless adults and children, and healthy adults and children. On average, the soup kitchen serves approximately 40,000 to 51,000 meals each month to the residents of Sentinel City. The soup kitchen uses a variety of sources to maintain their supplemental nutrition for the
community. These sources include the Commodity Supplemental Food Program, Emergency Food Program, Food Assistance Program, and the USDA Commodity Program (Sentinel City Simulation, 2017).
Windshield Survey
When first entering the city, beginning in the Industrial Heights neighborhood, there are adults walking along the street. There is a long line outside the community soup kitchen and graffiti can be seen on the outside of multiple buildings. There are signs of age and ware on the brick buildings. Stray animals, broken down vehicles, and a fire can be seen along the street.
There are also large piles of trash in multiple alleyways and graffiti covers the buses parked at the Department of Transportation. Traveling further down the street, there are biohazard drums and large amounts of metal industrial supplies lying around without any sort of warning or hazard signs; construction workers can also be seen lined along the street in front of an upcoming Housing Project site. So far, the city has a general lack of traffic signs and citizens do not seem to abide by standard transportation laws. Next we enter the Casper Park District, there are no distinct markers that we are entering a new neighborhood. The buildings continue to appear older, and show signs of age, but there is a significantly smaller amount of graffiti and visible trash on the buildings and streets. Across from the daycare, there is a sitting area with benches, trees, and a food vendor. Further into the Casper Park District, we are able to see more people walking along the sidewalk, bus stops, and a small lot with green grass, trees, wooden crates, a fire, and more biohazard metal drums; there are people sitting in the lot near the biohazard drums. There seems to be a large number of people with handicaps walking along the sidewalk. There are people riding bikes, walking, and a few people driving on the roads. There are multiple restaurants, however nothing is written in other languages to give indication of the primary
ethnicity of each neighborhood; statistics are previously mentioned in this paper. When entering the Acer Tech Center, there is a noticeable difference in the amount of trash and stray animals that are seen, however they are still visible. There is a fresh fruit and vegetable market and more food vendors in this neighborhood. This neighborhood has the city’s hospital and dental office. Many people can be seen standing outside the hospital in varying degrees of handicap. This neighborhood also contains the pharmacy, and well known restaurant. As with the other two neighborhoods, there do not seem to be any houses, only apartment buildings. These apartments have little to no green spaces available. We now enter the Nightingale Square neighborhood; outside Jo’s Grocery, many adults and children can be seen. Some are playing music, children are playing games, and others are just sitting around enjoying the snow that has started to fall. There is a gas station and a green lot area; everything here looks much newer and up to date. Beside the Parks and Recreations center, there are new condos. In general, the buildings in this neighborhood are noticeably cleaner and do not show very many signs of age. There isn’t trash littering the ground and a trash pickup truck is seen cleaning. The city does not seem to have any specific religious or political affiliations and the only noticeable form of media is the radio station.
1. Analyze the collected data using concepts of epidemiology and health determinants.
There are many causes and factors that influence the occurrence of disease in a community. Once factor is the rate of vaccination in school age children; in Sentinel City the vaccination rates for elementary age children are: 50% received the dTap vaccine, 50% received the Hepatitis B vaccine, 50% received the MMR vaccine, 50% received the Polio vaccine, and 50% received the Varicella vaccine (Sentinel City Simulation, 2017). In comparison, the national average for vaccinations in children, ages 19 – 35 months are: 84.6% received the dTap vaccine,
92.6% received the Hepatitis B vaccine, 91.9% received the MMR vaccine, 93.7% received the Polio vaccine, and 91.8% received the Varicella vaccine (CDC, 2016). Sentinel City’s rate of vaccination is below the national average, but by implementing pro-vaccine campaigns and providing information on vaccination in doctor’s offices, schools, and pharmacies, Sentinel City can improve their rates and help prevent the diseases that these vaccines offer protection against. Another factor that influences the occurrence of disease and other health related events in a community is illicit drug abuse. Last year, Sentinel City reported 12% of the population used marijuana, 5% used cocaine, 7% used Heroin, 0.5% use Methamphetamines, 2% used club drugs, and 5% used CNS depressants (Sentinel City Simulation, 2017). In comparison, the national averages for illicit drug abuse in 2016 are: 13.9% use marijuana, 1.9% use cocaine, 0.4% use Heroin, 0.5% use Methamphetamines, 4% use club drugs like MDMA, PCP, LSD, inhalants, and hallucinogens, and 2.4% use CNS depressants like tranquilizers and sedatives (NIH, 2016). Sentinel City’s rate of illicit drug abuse is significantly higher than the national average, however the city can help reduce these rates by promoting anti-drug use and providing drug abuse counseling to those who report use. Sentinel City also reported that 24% of its population use tobacco products. The use of tobacco is one of the leading causes of preventable illnesses and death in the US. In 2016, the National Institute of Health reported that 27.1% of the US population use tobacco products (NIH, 2016). Sentinel City is below the national average, however they can continue to decrease their rate of tobacco use by promoting anti-tobacco campaigns anywhere tobacco products are sold, placing “no smoking” signs in public areas, and encouraging smoking cessation at doctor’s appointments and during inpatient education.
C. Formulate a community diagnosis for Sentinel City™
- Discuss the three problems for Sentinel City™ based on the Healthy People 2020
Similar to other large cities, Sentinel City has many problems that are addressed by Healthy People 2020. When reviewing the data, I felt that the rates of vaccination, illicit drug abuse, and tobacco use needed to be addressed in hope of improving the quality of life of the citizens of Sentinel City. Based on the data previously mentioned in Section B1, Sentinel City has a lower rate of vaccination than the national rate. The goal of Healthy People 2020 is to increase the rate of immunizations and decrease the rate of preventable infectious diseases (Healthy People 2020, 2014). The lack of vaccinations contributes to the rise of vaccine- preventable diseases; Viral Hepatitis, Influenza, and Tuberculosis are still some of the leading causes of illness and death in the US (Healthy People 2020, 2014). They propose we do this by implementing a multitude of immunization programs, including: vaccination home visits, vaccination requirements, standing vaccination orders, vaccination incentive rewards program, vaccination call and recall reminders, vaccination provider reminders, vaccinations programs for WIC recipients, and many others (Healthy People 2020, 2014). In section B1, I also discussed the rate of illicit drug abuse in Sentinel City, which is significantly higher than the national rate. The goal of Healthy People 2020 is to reduce substance abuse to protect the health, safety, and quality of life for all, especially children (Healthy People 2020, 2014). The effects of substance abuse are costly and significantly contribute to the cost of social, physical, mental, and public health issues. Healthy People 2020 propose the introduction of drug screenings, counseling, and school based intervention programs for children, adolescents, and young adults; they also propose sobriety checkpoints (Healthy People 2020, 2014). In section B1, I also mentioned the rate of Tobacco use in Sentinel City; their rate is somewhat lower than the national rate, however there is always room for improvement. The goal of Healthy People 2020 is to reduce illness, disability, and death related to tobacco use and secondhand smoke exposure (Healthy People
2020, 2014). Tobacco use is one of the leading causes of death in the US, Health People 2020 proposes the use of educational and behavioral prevention programs and educational packaging for all tobacco products (Healthy People 2020, 2014). These three problems have a significant impact on the overall health of Sentinel City, however early intervention programs can be initiated by the city to begin improvements.
2. Discuss community resources (e.g., Sentinel City™ Affordable Housing Project, Better Health Clinic) that are available to address one of the problems identified in part C1.
Sentinel City has multiple resources to address problems in the city. One problem in particular is the low immunization rate of the city. Sentinel City’s Pharmacy provides multiple resources to address this problem. They offer immunizations and information, Influenza awareness, and walk in clinics (Sentinel City Simulation, 2017).
3. Identify a primary prevention topic based on the problem you selected in part C2.
My primary prevention topic is Child Health: promotion of vaccination. According to the data collected from Sentinel City, the rate of vaccination in children is significantly lower than the national average. The improvement of vaccination rates is part of the goals for Healthy People 2020 (Healthy People 2020, 2014).
D. Discuss how you will apply the assessment strategies you have learned from the simulation environment to your community assessment
strategies in your community.
The Sentinel City Simulation and the assessment strategies required for this task have taught me how important it is to critically analyze the data provided. It has also shown me that even though not all data will be neatly written out and displayed for me, so it is just as important to analyze the community’s surroundings and the people within it. These strategies will help me
to assess my own community in order to address its needs. I plan to apply strategies, such as the demographics assessment, the safety assessment, and the scavenger hunt to better understand the needs of my community.
References
CDC – Center for Disease Control. (2016, May 03). Immunizations. Retrieved December 04, 2017, from https://www.cdc.gov/nchs/fastats/immunize.html
Healthy People 2020. (2014). 2020 Topics and Objectives. Retrieved December 04, 2017, from https://www.healthypeople.gov/2020/topics-objectives
NIH – National Institute of Health. (2016). National Survey of Drug Use and Health.
Retrieved December 04, 2017, from https://www.drugabuse.gov/national-survey-drug- use-health
Sentinel City. (2017). Retrieved December 4, 2017, from
http://citl.americansentinel.edu/twine/SC2.3_Healthcare System – Storyline output/story.html