Community Health Assessment Essay: Implications Of Diabetes.

Community assessment: Demographic Profile

Discuss about the Community Health Assessment Report.

The City of horizon is a virtual, fictional community created by the University of South Australia for supporting and enhancing the Bachelor of Nursing and Midwifery Programs. A dynamic community is created within the city with the resident (unisa.edu.au 2017). The present report is a community assessment of the City of Horizon. It aims to identify and discuss the implications of a health issue for the community that is diabetes. It also describes the role of the Registered Nurse in addressing the health care issue for the community. The first section of the report is the complete assessment of the City of Horizon and includes demographic profile including geography, gender, age, climate, family composition,; psychosocial profile including level of employment, education, income, occupations,; community infrastructure profile including recreation facilities, businesses, tourism; and health services and resources profile including medical clinics, hospitals, care facilities, social services and welfare services. The second section of the report identifies the potential health issue within the community and explains how it is linked with social determinants of health. It also analyses why the health issue is a priority for the community. The third section of the report discusses the role of registered nurse in addressing the health issue. The report ends with a logical conclusion to the entire discussion.

The City of Horizon is situated in the Limestone Coast Region of South Australia. Its location is around 530 kilometres north-west of Melbourne and 320 kilometres south of Adelaide with the boundary of the Southern Ocean to the east. The Yonder District Council is in the surrounding of the City of Horizon. The city has taken its name from Lord Admiral Asim Yonder. Due to the suitable location between the important cities of Melbourne and Adelaide, The Horizon is a popular tourist destination for the people coming to the limestone coast. The city has been known to be a well-established regional centre as it offers the transient tourist population and residents some exceptional facilities that individuals would need. The city includes the localities and suburbs of Beachside, Cape Arch, Woodside, Yonder Hill, Beachside and Limestone Point.

European settlements in the city of Horizon dates back to the year 1843 at the time when first land sales were made, and the land was used for sheep grazing and cattle. It was only in the 1850s that growth took place and the town developed as a significant coastal port. The expansion was remarkable between the 1870s and 1890s which were more prominent in the south. The railway line between Melbourne and Adelaide spurred this expansion. In the interwar period, there was some growth as the population reached around 7,700 in the 1920s. After the war period there was rapid development, and by the year 1961, the population was 14,000. Expansion continued its course, and after steep rises in population, it reached 28,500 in the year 2016.

Psychosocial Profile

The City of Horizon has estimated that resident population for the year 2017 has reached 29,308 with the population density of 6.86 persons per hectare.

The three largest ancestries in the City of Horizon in the year 2016 were Australian, English and Scottish. There is a smaller section of the population in the city who are born overseas (10.3%). In addition, a smaller section of the population is from a non-English speaking background (5.5%). In relation to proficiency in English, 335 people were able to speak in languages other than English in the year 2016.

Population in non-private dwellings encompasses all long-term and temporary dwellings providing a communal form of accommodation. This is to include hotels, hostels, nursing homes, prisons, army barracks ad hospitals.

Horizon is found to be having a strong commitment towards multicultural diversity of the city’s population. The indigenous population of the city has drawn attention as original inhabitants of the area were Boandik, Ngarrindjeri and Bindjali Aboriginal people.

The city has a co-located junior and primary school campus with the Early Learning and Child Care centres. University of South Australia and TAFE SA (Horizon Campus) is the main source of education within the city that caters to the need of higher education among the public.

In relation to employment status, 24,605 individuals were employed. Out of this section, 48% had full-time work, whereas 50% had part-time work. 4% of the population in the city has the income of $1,500 or more in a week. 16% of the households have couples with children. 30% of the households in the city have only one person. 3,296 individuals in the city had a tertiary qualification as of the year 2016. Educational qualification related to education attained from sources other than primary and secondary school. Education level became the most important indicator of socio-economic conditions. 31% of individuals with age over 15 years had done 12 years schooling as of the year 2016. 22% of the population in the city had attended any form of an educational institution as of the year 2016.  The employment statistics is a key measure of the socio-economic status. Employment rate is directly linked to factors such as age structure that has a key relation with social determinants of health. 

The religious compositions of the population vary greatly, and the mostly followed religions include Western Catholic, Anglican, Uniting Church and Presbyterian and Reformed.

The major features of the Horizon pertain to the community infrastructure, entertainment, shopping facilities and food outlets. These include Horizon Cultural Centre, Visitor Information Centre, Horizon Backpackers Hostel, Romero Vineyard and Wine Complex, Horizon Aquatic Centre, Yonder Museum and Library, Horizon Recreation Centre, Horizon Mall, Limestone Lake Adventure Park and Playground, Limestone Coast Maritime Village, Cape Arch Penguin Viewing Platform, the Horizon Hotel Limestone Coast Caves. The green parks are a pleasant recreation site for the community members and individuals can have a splendid time through enjoyable activities such as trail bike riding, sailing, hiking, fishing and winery tours.

Community Infrastructure, Goods and Services

The major centre of Horizon includes the industrial, commercial and residential area and the surrounding hinterland is rural in nature. Horizon Council area includes the total land area of 43 square kilometres, and much of the rural land is taken up for agriculture purpose. This mainly includes sheep farming, cattle farming, horticulture, cropping and viticulture. It is to be noted that fishing is also a major industry in the city. In relation to transportation, it is to be noted that the city population relies on bikes or prefers walking to work. The main modes of transportation are train, bus, taxis, tram, car and truck. The city is served by the Princess Highway.

Horizon Hospital and Health Service is the primary health service of the city. The city has a tertiary level hospital, and there is a wide range of healthcare facilities like Physiotherapy, Pharmacy, Radiology, Podiatry, Nutrition and Dietetics Pathology, Medical science services, and a GP Plus clinic.

From the community assessment of the City of Horizon, the potential health-related issue that has been identified for the Horizon community is Diabetes Mellitus. Diabetes includes two categories, type 1 and type 2 amongst which type 2 diabetes is most prevalent. The number of patients with Type 2 diabetes is increasing across South Australia (Verburg et al. 2014). Social determinants of health need to be considered when emphasising on bringing improvements in diabetes outcomes since these social-ecological factors are known to affect health largely. The individual, the wider social network, along with cultural and environmental conditions is responsible for forming the overall framework. Components of the physical environment are healthy food, neighbourhood safety and transportation. When barriers to these crucial factors are present to patients with diabetes, there is inadequate access to resources among such disadvantaged populations for overcoming the barriers. The effects are therefore magnified in such cases. Lower levels of education, poor levels of employment and less family income has a direct impact on socioeconomic status and consequently on health (Perm 2013). Social support refers to the informal and formal relationships that act a strong base of emotional support in a particular situation for bringing in better health outcomes for diabetes. Self-management, which is significant for diabetes, is usually poor among patients in the absence of social support (Clark and Utz 2014).

Diabetes Mellitus is a priority for the community since the disorder is a contributing factor towards a wide range of health complications that eventually leads to a high mortality rate. Diabetes is known to place the individual suffering from it at high risk for serious and long-term health complication including cardiovascular disease, blindness, hypertension, end-stage renal disease, stroke, lower limb amputations, neuropathy and even premature death. Annual healthcare costs in most of the communities across the world due to diabetes are considerably high, and this implies that the same would be the case for the Horizon community. Horizon community, therefore, needs to draw special attention on the allocation of health care resources, funding systems and cultural and social attributes of health for eliminating the wide spread impact of diabetes (Kaveeshwar and Cornwall 2014).

Health Services and Resources

Registered Nurse (RN) plays a pivotal role within a community in addressing the vital community health issue of diabetes. According to Levich (2011), type 2 diabetes can be controlled through proper screening and early diagnosis along with aggressive and prompt treatment interventions. Nurses are usually the first healthcare professional within a team of care members who interacts with the patients and are to apply their skills, knowledge and training for educating and motivating patients towards better health outcomes. Registered nurses have the specific training and required skills for providing this level of care. Registered nurses are well-positioned for filling up the gap in knowledge about diabetes management among patients. They also have the responsibility of improving efficiency in diabetes-related healthcare through assisting patients with self-management. As opined by Wilkinson, Carryer and Adams (2014) registered nurses are capable of understanding the behavioural aspects of living with diabetes and therefore the key role they play is in relation to impartment of patient education regarding diabetes management. Motivational interviewing is the passive and patient-centric counselling style used for encouraging patients to come up with resolutions to their health issues. Nurses, in this case, pose a number of questions that are directed towards eliciting the perceptions of patients about diabetes management. This is an important step towards addressing the community health problem as the interventions provided to the patients following a screening of diabetes can be made patient-centred, thereby optimising their impact.

As stated by Ortiz (2016) the role of nurses in relation to addressing community health issue of diabetes might be as a specialist or might be as part of the general care, primary or secondary. RNs provide the patients with reliable, up-to-date information regarding diabetes and notify them on management practices based on evidence-based care from continual research. Teaching can be on a one-to-one basis, however, group discussions have been found to be more useful, and patients can share their opinions with others in the presence of the nurse and get more benefits. Nurses also play an important role in target setting for patients so that priorities can be determined and patients can work towards the set goal appropriately. 

Conclusion

Horizon community is at the risk of facing health burden of diabetes, and the wide range of social determinists of health is associated with it. Housing, employment and level of education take the front row when it comes to acting as a driving factor for poor outcomes of diabetes among the individuals in the community. Diabetes is the catalyst for a number of associated health complications such as cardiovascular diseases and neuropathy, and thus it is crucial that the disease is kept under control. The role of nurses in addressing the potential health complication of diabetes within the community of Horizon is inevitable. The valuable role of the nurse within the community as a diabetes case manager is to make sure that patient satisfaction and treatment effectiveness is achieved. This is mostly done through patient education and assistance and support provided for self-management.

References

Clark, M.L. and Utz, S.W., 2014. Social determinants of type 2 diabetes and health in the United States. World J Diabetes, 5(3), pp.296-304.

Hill, J., Nielsen, M. and Fox, M.H., 2013. Understanding the social factors that contribute to diabetes: a means to informing health care and social policies for the chronically ill. The Permanente Journal, 17(2), p.67.

Kaveeshwar, S.A. and Cornwall, J., 2014. The current state of diabetes mellitus in India. The Australasian medical journal, 7(1), p.45.

Levich, B.R., 2011. Diabetes management: optimizing roles for nurses in insulin initiation. J Multidiscip Healthc, 4, pp.15-24.

Lo.unisa.edu.au. (2017). MC1036. [online] Available at: https://lo.unisa.edu.au/course/view.php?id=1036 [Accessed 20 May 2017].

Ortiz, E., 2016. Developing Registered Nurse Competency in Diabetes Care.

Verburg, P., Tucker, G., Scheil, W., Roberts, C. and Dekker, G., 2014. 315: Seasonality of gestational diabetes mellitus based on date of conception in South Australia–a retrospective population study 2006-2011. American Journal of Obstetrics & Gynecology, 210(1), p.S165.

Wilkinson, J., Carryer, J. and Adams, J., 2014. Evaluation of a diabetes nurse specialist prescribing project. Journal of clinical nursing, 23(15-16), pp.2355-2366.