Functional Health Patterns Community Assessment

Sharp Healthcare offers groups for breastfeeding mothers, postpartum depression, grieving for loss of a child, obesity, eating disorders etc. Do the community members value health promotion measures? What is the evidence that they do or do not (e.g., involvement in education, fundraising events, etc.)? Fundraising events for local kids with Neuroblastoma (Pediatric) Cancer Fundraise for community sports like football and cheerleading What does the community value? How is this evident?

Religion- Church on Sundays with family
Family Values- many family functions like concerts in the local park, movie night at the Lake On what do the community members spend their money? Are funds adequate? Cars
Homes, rent- cost of living is high in CA
Eating out
Shopping
Middle Class majority, funds can get tight

Health Perception/Management
Predominant health problems: Compare at least one health problem to a credible statistic (CDC, county, or state).

Obesity
33% in San Diego are overweight, 26% are obese
30% of kids grades 5/7/9 are overweight/obese in San Diego County (“Community profile: county”, 2013) Immunization rates (age appropriate).

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4.5% of Kindergarteners are missing one or more vaccines
Out of 43,000 kindergarteners in the county, 1900 are not fully immunized Not all families in San Diego are immunizing their children due to things they hear about vaccines- EX: vaccines causing autism Parents do not do their research and often listen to hear-say or false news reports Appropriate death rates and causes, if applicable.

Top 10 causes of death in San Diego: Malignant neoplasms, diseases of the heart, Alzheimer’s, chronic lower respiratory diseases, cerebrovascular disease, accidents (unintentional injuries), diabetes, intended self-harm (Suicide), chronic liver disease (cirrhosis), hypertension/hypertensive renal disease and influenza/pneumonia (“San Diego County”, n.

d.) In 2012, in San Diego alone there were 20,018 deaths

3,684 in East County San Diego
1,806 were Male
1,876 were Female
377 Hispanic
3,015 White
130 Black
88 Asian
70 Other
Age groups 0-4 (28 deaths), 5-14 (6 deaths), 15-24 (42 deaths), 25-24 (68 deaths), 35-44 (90 deaths), 45-54 (278 deaths), 55-64 (474 deaths), 65-74 (587 deaths), 75-84 (863 deaths), 84+ (1,248 deaths) (“San Diego County”, n.d.) Prevention programs (dental, fire, fitness, safety, etc.): Does the community think these are sufficient? Drug Abuse prevention programs, Delinquent and school failure prevention programs CAL Fire teaches a fire prevention program locally in San Diego, CA Safe Kids San Diego which teaches prevention of unintentional accidents such as drowning, child passenger safety, sports and recreation safety and pedestrian safety (“Safe Kids San”, 2014) Western Dental provides services for people who no insurance for a cheaper rate Multiple gym facilities such as 24 hour Fitness, Crunch and Chuze are some of the biggest gyms out here Available health professionals, health resources within the community, and usage. Planned Parenthood- health care for pregnancy and STD prevention Local hospitals- Kaiser Permanente, Sharp Grossmont Hospital, Scripps Hospital, Sharp Memorial Hospital are a few big hospitals in San Diego, CA Urgent Care clinics like Doctors Express are available

San Diego Public Health
Language Specific healthcare such as Arabic, Spanish, Tagalog etc. Common referrals to outside agencies.
WIC- Women, Infants and Children
Black Women, Infants and Children
Food Stamps
Low Cost medical and dental care
Habitat for Humanity

Nutrition/Metabolic
Indicators of nutrient deficiencies.
Vitamin deficiencies such as Vitamin D and Iron
Unexplained fatigue, brittle, dry hair, ridged or spoon shaped nails, mouth problems, diarrhea, irritability or lack or appetite can all indicate nutrient deficiencies San Diego has one of the largest homeless populations in the country, especially homeless veterans. Malnutrition is prevalent in this group of people Obesity rates or percentages: Compare to CDC statistics.

This bullet was answered up above in a previous question.
Affordability of food/available discounts or food programs and usage (e.g., WIC, food boxes, soup kitchens, meals-on-wheels, food stamps, senior discounts, employee discounts, etc.). Food Stamps
WIC (Women, Infants and Children)
BWIC (Black Women, Infants and Children)
Meals on wheels
Senior discounts offered at some restaurants like Soup Plantation. 55 plus is considered senior citizen here in California Project Homeless Connect
Availability of water (e.g., number and quality of drinking fountains). Water fountains in all stores and schools
Drinking water (Tap water) meets most government standards but needs to be more thoroughly treated Water comes from 3 places: Northern California from snow and rain, the Colorado river and local rain water runoff Fast food and junk food accessibility (vending machines).

Vending machines at most all high schools
California trying to change contents to offer healthier choices Fast food on almost every corner- very accessible
Evidence of healthy food consumption or unhealthy food consumption (trash, long lines, observations, etc.). Always long line as fast food places
Gyms always crowed, protein/workout drinks always in hand
Beaches are full of people in bathing suits (fit and unfit)
Farmers markets on Wednesdays crowded
A lot of people do special programs like Weight Watchers, Opti-Fast, Medi-Fast, Nutri-System, Jenny Craig etc “Re-think your Drink” this program is trying to eliminate sugar sweetened drinks and are replacing them with water, low fat milk for 50% or greater natural fruit juices Provisions for special diets, if applicable.

Items containing specific allergies have them stated on the label like nuts, shellfish or specific fruits For schools (in addition to above):
Nutritional content of food in cafeteria and vending machines: Compare to ARS 15-242/The Arizona Nutrition Standards (or other state standards based on residence) Fruit/veggie based drinks with no less than 50% fruit juice

Milk 2% fat, non-fat, soy or rice milk
Not more than 35 percent of its total calories can come from fat (excluding: nuts, seeds, eggs, cheese, fruit, vegetables and legumes) Not more than 10 percent calories from sat fat (Excluding: eggs and cheese) Not more than 35% of its total weight may be composed of sugar, including naturally occurring and added sugar (excluding: fruits and vegetables that have not been deep fried) Not more than 250 calories per individual food item (Middle schools and Jr High Schools, High Schools) No more than 175 per individual food item for elementary schools Amount of free or reduced lunch

60% free or reduced lunch in schools in San Diego, CA

Elimination (Environmental Health Concerns)
Common air contaminants’ impact on the community.
Smog, Allergies- Pollen, Mold
Noise.
Major Airport, major Military bases, heavy traffic noises
Waste disposal.
Miramar Landfill
Pest control: Is the community notified of pesticides usage? Yes, individual residences take care of their own pest problems Hanta Virus- In mouse poop in our area
Hygiene practices (laundry services, hand washing, etc.).
Laundry mats are in abundance, dry cleaners and individual washer and dryers in some residences Singing the “Happy Birthday” song twice while washing hands was on the local news to help people wash their hands more efficiently Toilet seat covers in most public bathroom services

Signs stating “Must wash hands before returning to work” in all restaurant bathrooms Bathrooms: Number of bathrooms; inspect for cleanliness, supplies, if possible. Most public bathrooms have signs for employees to sign when they have checked and maintained the restroom Public bathrooms are generally clean and well stocked, if not usually an employee of the place is easily notified Universal precaution practices of health providers, teachers, members (if applicable). Protective gowns, gloves, shields when handling bodily fluids for health providers when in facilities Teachers usually do not have access to all of the equipment necessary but generally have gloves on hand Temperature controls (e.g., within buildings, outside shade structures). Temperatures generally in the 70-75 ranges in controlled areas such as schools and stores Shades provided at local parks

Community pools and beaches available for hot temperatures
Safety (committee, security guards, crossing guards, badges, locked campuses). Most day cares are locked facilities
Crossing guards at most elementary and middle schools
Security guards at stores and hospitals to prevent theft and crime Trolley Guards
Volunteer Police patrol (Elderly men and women)

Activity/Exercise
Community fitness programs (gym discounts, P.E., recess, sports, access to YMCA, etc.). YMCAs
Gyms: 24 hour fitness, crunch, chuze
AYSO (local soccer leagues for kids)
T-ball/ baseball/ softball fields at Cactus Park (name of play park) P.E in middle school/high school for 2 years
Recess at elementary schools
Zumba and Jazzercise programs locally

Recreational facilities and usage (gym, playgrounds, bike paths, hiking trails, courts, pools, etc.). Playgrounds at most local parks
Mission Trails- hiking, bike trails
Cowles Mountain, Iron Mountain- Hiking trails
Community pools- YMCAs
Safety programs (rules and regulations, safety training, incentives, athletic trainers, etc.). Lifeguards at local community pools and beaches
Safe drivers incentives with Allstate Insurance
Discounts on car insurance with good grades and no trouble
Crime Stoppers, Mc Gruff Crime Dog, Kidzwatch Academy, Safety Sam are police station programs that kids and other community members can participate in to ensure community safety Injury statistics or most common injuries.

In San Diego, unintentional injuries were the sixth leading cause of death in 2009 Nearly 1000 people died that year of unintentional injuries with 30% of those caused by poisoning including overdose Every hour in San Diego, an average of 19 people are hospitalized or treated in the ER because of injuries Car accidents, drowning, falls, assault, struck by an object, burns, overexertion and suffocation are some of the most common causes of injury in all age groups Evidence of sedentary leisure activities (amount of time watching TV, videos, and computer). Computers used as primary resource for schools

Internet used as primary resource for community
Driving short distances that could be walked
T.V takes up, on average, 2.8 hours of most people’s day
Ages 15-19 spend read for an average of 4 minutes per weekend day and 52 minutes playing a game on the computer Ages 75 and over spend an average of 1 hour of reading per weekend day and 20 minutes playing games or using a computer Employed adults with no children spend about 4.5 hours per day doing leisure activities and employed adults with a child/children spend about 3.5 hours doing leisure activities per day Means of transportation.

Trolley, Bus, Cars, Bikes, Walking and park and ride for carpool

Sleep/Rest
Sleep routines/hours of your community: Compare with sleep hour standards (from National Institutes of Health [NIH]). Eating heavy dinners, caffeine, smoking and exercise late in the day is effecting sleep of people in San
Diego Graveyard shifts are common due to places being open 24/7

Sleeping anywhere from 6-9 hours
Indicators of general “restedness” and energy levels.
Lack of “bags” or “dark circles” under eyes
Hair, makeup and outfit appropriate for environment
Less caffeine needed
Factors affecting sleep:
Shift work prevalence of community members
All shifts, mostly 12 hour shifts in the healthcare field,
Mainly anywhere from 7am-6pm for most full time employed people Environment (noise, lights, crowding, etc.)
Near main airport, military bases, lights and crowds near football and baseball stadiums, colleges, living near freeways Consumption of caffeine, nicotine, alcohol, and drugs
A least 3 major Universities in San Diego (Caffeine intake!) Average age in San Diego is 20s-30s and large nightlife crowd downtown San Diego (Alcohol and drugs) 2012 drug stats: Heroin increase, crack/cocaine decrease, methamphetamines increase, marijuana increase, prescription opioids decrease, ecstasy decrease (“Drug abuse patterns”, 2014) Homework/Extracurricular activities

High school student average 3 hours of homework per night
Anywhere from 6.8 to 17.5 hours of homework per week for high school students Elementary schools 2.9 hours per week
Middle school 3.2 hours per week
After school sports- up to 3 hours of practice for some like football Health issues
Stress, common colds/flu, pediatric cancers, diabetes types 1 and 2, obesity, hypertension

Cognitive/Perceptual
Primary language: Is this a communication barrier?
English/ Spanish, Arabic, Vietnamese (possible communication barriers) 37.1 % of San Diego’s population speaks a different language than English
Educational levels: For geopolitical communities, use http://www.census.gov and compare the city in which your community belongs with the national statistics. San Diego County : High school graduates 85.4 %

Bachelor’s degree or higher 34.4 % (“State and county”, 2014) Opportunities/Programs:
Educational offerings (in-services, continuing education, GED, etc.) Many programs offering GED programs and prep classes including community colleges All hospitals and healthcare centers provide in-services

Grossmont college, Grossmont adult night school
ROP (Regional Occupation Program)
Learn English (program in El Cajon, CA to help foreigners learn English) Educational mandates (yearly in-services, continuing education, English learners, etc.) CEUs for nurses- 30 hours every 2 years for RNs

Special education programs (e.g., learning disabled, emotionally disabled, physically disabled, and gifted) GATE- gifted and talented education program
Children’s outreach project
Library or computer/Internet resources and usage.
El Cajon library
Internet on all phones, ipads
Computers at most schools including elementary schools
Funding resources (tuition reimbursement, scholarships, etc.). Scholarships offered through the Chamber of Commerce for academics up to $3,000. Many colleges offer academic scholarships and sports scholarships (Full and partial rides) UCSD and Rady’s Children’s Hospital both have tuition reimbursement and student loan repayment programs UCSD will repay two thirds of the tuition or student loans

Board of Governor’s Fee waver
Military discounts

Self-Perception/Self-Concept
Age levels.
Many families in El Cajon
Mainly 20s and 30s in San Diego County such as downtown San Diego Kids under age 5= 6.5% of population
People under age 18= 22.6 % of population
People 65 and over= 12.3 percent of population
Programs and activities related to community building (strengthening the community). San Diego City College peer mentoring program
MAD (mothers against drunk driving)
Big Brothers/Big Sisters program (Mentoring adolescents)
Peer Leaders (high school program- students give other students “counseling” when they feel like they cannot talk to an adult) Community history.
The area now known as San Diego County has been inhabited for over 10,000 years by the Kumeyaay Indians San Diego became part of the United States by the Treaty of Guadalupe Hidalgo on 1848 ending the U.S. –Mexican War One of the original counties of California

San Diego used to be a very large county including all of Los Angeles and extended to the Colorado river Pride indicators: Self-esteem or caring behaviors.
San Diego is one of the most sought out cities to visit and/or live Very expensive because they demand is there
A lot of plastic surgery in San Diego
Spray tans, fake nails, fake hair, people are in shape (wears bikinis) San Diego residents support a lot of charities and cancer/disease foundations Donating money to a good cause is common among this community

Published description (pamphlets, Web sites, etc.).
San Diego Magazine
Sandiego. org for local media (Website)
Union Tribune San Diego (News Paper)

Role/Relationship
Interaction of community members (e.g., friendliness, openness, bullying, prejudices, etc.). East San Diego is more friendly than West or North San Diego (More money in those areas) Very accepting of Gays and Lesbians in San
Diego ( Hill Crest is a city known for an abundance population) Gay Pride Parade is a huge event in SD

Very large interracial community, not a lot of prejudices
Programs to prevent in-school bullying
Vulnerable populations:
Why are they vulnerable?
Homeless population downtown San Diego
Lack of medical insurance
How does this impact health?
Increase spread of disease
Increased severity of disease
No access to medication or medical treatments
Power groups (church council, student council, administration, PTA, and gangs): Mexican Mafia
Logan Heights Gang
Hells Angles
PTAs in elementary schools
Jehovah’s witness
Mormons
How do they hold power?
Influential
Have a lot of people under them or following them
PTA helps make decisions for schools
Positive or negative influence on community?
Gangs usually a negative influence
Hells Angels used to have more of a negative influence but now are more positive towards the community and support local charities like pediatric cancer ones Harassment policies/discrimination policies.

Under the California Department of Public Health all employees have a right to work in an environment free from all forms of discrimination, including sexual harassment, intimidation, retaliation or coercion. The CDPH is committed to providing a work environment free from sexual harassment. Sexual harassment is a form of sex discrimination that is illegal under both state and federal law The Fair Employment and Housing Act defines sexual harassment as harassment based on sex or of a sexual nature; gender harassment; and harassment based on pregnancy, childbirth, or related medical conditions. The definition includes harassment based on sexual orientation, and also protects an individual’s actual or perceived gender identity, whether or not different from the individual’s actual gender at birth The CDPH endorses a “zero tolerance” policy aimed at preventing all such inappropriate behavior. As a result, CDPH may take corrective actions, up to and including formal discipline, when policy violations occur, even if they are not so serious as to be unlawful (“Sexual Harassment Prevention”, 2008) Relationship with broader community:

Police
San Diego has had allegations of inappropriate behavior of police officers such as groping and sexual favors CHP, Sheriff’s department, Police in each city such an San Diego Police Department Fire/EMS (response time)

Generally called from the City in which the Emergency is
Response time is good- generally under 10 minutes
Fire departments all work together from all surrounding cities when needed Large fire in Escondido/ San Marcos just happened in San Diego County, fire departments from all around came to help Cedar fire in El Cajon more than 10 years back, fire departments from out of state came and helped Other (food drives, blood drives, missions, etc.)

San Diego Blood Bank- always has blood drives in parking lots of big stores like walmarts and businesses Local food drives at schools and healthcare clinics/facilities

Sexuality/Reproductive
Relationships and behavior among community members.
Have had many allegations of teacher/student relationships
Many older male/young female relationships and visa-versa
Many relationships with more than 10 year gaps
Young marriages/pregnancies common
Married Population 45.15%
Single Population 54.85%
Now Married 43.16%
Married but Separated 1.99%
Never Married 40.39%
Widowed 4.58%
Divorced 9.88%
Married, w/children 35.54%
Married, no children 37.34%
Single, w/children 16.27%
Single, no children 10.86% (“People in San”, 2014)
Educational offerings/programs (e.g., growth and development, STD/AIDS education, contraception, abstinence, etc.). Planned Parenthood- teachings and prevention methods of STDs and Pregnancy, prenatal care Access to birth control.