Atlantic City: Community-Based Interventions

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Atlantic City Community

The Atlantic City community is an urban area located in Atlantic County, New Jersey. The regions population decreased from 39,552 in 2010 to 37,743 in 2019. The racial/ethnic composition of the community comprises Black or African American (35.5%), Whites (31.3%), Hispanics (31%), Asians (16.9%), American Indians and Alaskan Natives (0.4%), and individuals of two or more races (4%) (QuickFacts, 2019). About 37.7% of the individuals in this area live in poverty, with an estimated median household income of $27,786 (QuickFacts, 2019). The community is family-oriented; the living arrangements or organization exist as family units with an average of 2.46 members in each home.

The regions largest economic industries include accommodation and food services, retail, healthcare, and social assistance industry, wholesaler sales, public administration, educational services, arts and entertainment, and merchant wholesaler sales (QuickFacts, 2019). The areas unemployment is 7.8% compared to 4.1% of the states unemployment rate. Approximately 73.5% of the community aged 25 and above have attained a high school diploma or higher. Only 16.4% of the community have achieved a Bachelors degree or higher (QuickFacts, 2019). Despite the socioeconomic differences, the city is diverse and has a broad range of languages and religions.

Community Resources

The availability of community resources is critical in providing adequate community-based care to poor and vulnerable health populations. Atlantic County offers a wide range of resources to the residents of Atlantic City. The services provided by the county office include supplemental nutrition assistance, general assistance, temporary assistance for needy families, housing assistance, and family care and Medicaid help (Department of Family, 2020). The family care and Medicaid program provide free or low-cost healthcare services to low-income individuals and families. The program is funded by the federal government and covers bills from medical care, doctor appointments and prescriptions, dental care, substance use, mental health services, and vision services. The adscititious nutrition assistance project offers food aid to families and individuals by covering food and grocery costs in any approved stores in the community (Department of Family, 2020). The General Assistance program provides monthly cash assistance to individuals without child dependents.

The homeless in the community can receive social services and rent and housing assistance support from the County office. Apart from the family care and Medicaid help program, the above programs are funded by the Atlantic Human Resource Inc agency. It is a non-profit organization aiming to eliminate poverty and help the needy, the elderly, and the vulnerable population in the Atlantic community to become self-reliant. The agency heavily relies on government grants and donations from the public; hence, the resources provided are limited (Department of Family, 2020). Through the state of New Jersey, the federal government funds essential health services such as blood pressure, cholesterol, and influenza screenings. These services are free for low-income individuals and families and are available in all public hospitals. The health facilities accessible in the community include ambulatory surgical centers, healthcare settings, acute care spaces, nursing homes, facilities for assisted living, psychiatric hospitals, and charity care.

Community Needs Assessment

A community needs assessment can help healthcare providers to identify available resources for their health interventions. The Atlantic Care Organization (ACO) conducted a health needs assessment in all cities of Atlantic County and identified six major health problems: obesity, drug and substance use, risky behaviors, cancer, heart diseases, and stress (AtlantiCare, 2016). The ACO reports findings were echoed by the GEOSTAT organization that reported obesity, high blood pressure, and sexually transmitted diseases as the health concerns specific to residents of the Atlantic City community (Health Concerns, n.d.). Among individuals aged 20 and above, 28% had obesity, and 28.7% had been diagnosed with high blood pressure (Health Concerns, n.d.). Inadequate physical activity, coupled with poor nutritional choices, significantly contributed to obesity levels.

The residents cited inadequate areas and facilities for physical activity as the primary physical activity barrier. About 74% of the community members participate in physical activity in 30 days, while 26% do not engage in any physical activity (AtlantiCare, 2016). In comparison to the national and state food index, the community had the lowest food index. The national one is 8.2, and the state is 8.3, while that of the Atlantic community is 6.7. Only 20% and 34% of the communitys population meet the daily fruit and vegetable requirements, respectively (AtlantiCare, 2016). It is a fact that poor nutrition significantly contributes to obesity and some cardiovascular conditions.

Atlantic City has among the highest uninsured population in the county. The U.S Census Bureau estimates that 17.6% of the population lack insurance covers. There is a 16.6% insurance gap between the city with the highest population of the insured and Atlantic City. About 97% of Margate city are insured compared to 80% in Atlantic City (QuickFacts, 2019). Of the insured, 48% are covered by public insurance systems and 39% by private ones. Other insurance options available in the community include self-paid insurance, employer insurance, and commercial insurances.

The high rates of sexually transmitted diseases in the community can be attributed to risky behaviors. The arts and entertainment industry, specifically the Casinos, is among the citys largest economic sectors. Arguably, the industry is associated with alcohol and substance use, which stimulates risky behaviors. Evidence indicates that STI increases the risk of cervical cancer, infertility, and pregnancy complications. The GEOSTAT organization reported that, in every 100,000 residents, 662 and 491 are living with HIV/AIDs and Chlamydia, respectively (Health Concerns, n.d.). The conditions are also linked with stigmatization and high healthcare costs.

Womens and infants health are another health concern of the community. About 9% of females that give birth are teenage girls aged between 10 and 19 years. About 9% of live births in the County are low birth weight children (AtlantiCare, 2016). Additionally, only 74% of women seek prenatal care from healthcare facilities (AtlantiCare, 2016). According to the Healthy People initiatives goals, the country aims to increase the number of women seeking prenatal care to 77.9% in the first trimester. The Atlantic City community registers approximately 879 infants (d 12 months) deaths per 100,000 live births (Health Concerns, n.d.). Maternal mortality rates indicate the existing health disparities in a specific populace.

Social Determinants of Health

Social determinants of health are the conditions in the physical, social, and economic environment that a person exists, which affects their health and life outcomes. The social determinants include employment, poverty, physical and built environment, access to nutritious foods, race/ethnicity, education, and socioeconomic status. The Center for Disease control developed a set of chronic disease indicators integrating social determinants of health to help health professionals survey, prioritize, and determine public health interventions (Sources for Data on SDOH, 2019). The tool contains 124 indicators grouped into 18 components vital for monitoring chronic diseases (Sources for Data on SDOH, 2019). The following indicators were selected based on the community needs assessments: alcohol, cardiovascular disease, physical activity, weight status, reproductive health, and overarching conditions. The following data has been retrieved from the database of the Center for Disease Control (Sources for Data on SDOH, 2019)

Alcohol Consumption

Binge drinking females aged 18-44 years (y/o) 13.4%
Binge drinking of amid men e 18 y/0 14.3%
Heavy drinking amid men and females e 5.2%
Alcohol intake amid females before conception 51.4%

Nutrition, Physical Activity, and Weight status

Obesity amid adults 25.5%
Overweight or obesity among adults 61.6%
Healthy weight among adults 36.2%

There was no data for physical activity/nutritional status.

Cardiovascular Disease (CVD)

Death from total CVD 206,6 cases per 100, 000 individuals
Death due to diseases of the heart 162.3 cases per 100,000 individuals
Demise due to coronary heart illness 91.3 occurrences per 100,000 individuals
Mortality resulting from heart failure 72.3 occurrences per 100,000 people
Mortality resulting from cerebrovascular disease (stroke) 30,2 cases per 100,000 people
Heart failure-related admissions amid Medicare-eligible persons aged > 65 y/o 15.4 cases per 100,000 people
Stroke-related admissions 18.96 cases per 100,000 people
Acute MI admissions 16.81 incidences per 100,000 people

Reproductive Health

Timeliness of regular healthcare checkups amid females aged 18-44 years 77.9%
Postpartum checkup 88.5%
Folic acid supplementation 37.4%

Overarching Conditions

Current lack of health insurance amid adults 18-64 y/o 14.5%
Current healthcare coverage amid females 18-44 y/o 81.7%
Health insurance coverage before conception 82.1%
High school completion amid adults 18-24 y/o 89.2%
Poverty among adults 10%

Health Priorities

The areas of opportunity in the community include reducing the number of insured, the rate of obesity, and the rate of heart diseases in the population. However, the highest health priority in the community is promoting healthy behaviors. Risky behaviors include insufficient physical activity, unhealthy diets, unsafe sexual practices, tobacco use, and alcohol consumption. The CDCs data indicates that 51.4% of women in the community use alcohol before pregnancy, 13.4% of men engage in binge drinking, and 5.2% of adults drink heavily (Sources for Data on SDOH, 2019). These behaviors can be positively correlated with health concerns such as obesity, heart diseases, and sexually transmitted diseases identified in the community. For example, alcohol consumption is associated with risky sexual behaviors, whilst physical activity and poor nutritional choices may cause obesity and some heart diseases. Approximately 61.6% of adults in the community are either overweight or obese (Sources for Data on SDOH, 2019). A recent systematic review conducted by Lacombe et al. (2019) indicated that alcohol use, unsafe sex practices, poor nutritional choices, and physical inactivity were leading death risk factors in high-income countries.

Interventions

An educational program could make a significant difference in the community. Achieving behavioral changes involves changing the attitude, beliefs, and perceptions of a healthy population on a particular subject. Various studies emphasize health education as an overarching intervention to change risky behaviors. A survey by Ramsubeik et al. (2018) showed that educational and behavioral interventions could help to improve chronic disease outcomes. Therefore, educating the community on the importance of healthy behaviors can better the citys health outcomes. The community needs to be educated on the risks of alcohol consumption, physical inactivity, and unhealthy diets. The health education program will equip the city with the necessary skills to adopt healthy habits. This will possibly result in a decrease in sexually transmitted diseases, alcohol consumption, heart diseases, and obesity.

References

AtlantiCare. (2016). Community health needs assessment Atlantic County, New Jersey [PDF document]. Web.

Sources for data on SDOH. (2019). Center for Disease Prevention. Web.

Department of family and community development. (2020). Atlantic County. Web.

Health concerns Atlantic City, New Jersey. (n.d.). GEOSTAT. 2020, Web.

Lacombe, J., Armstrong, M. E. G., Wright, F. L., & Foster, C. (2019). The impact of physical activity and an additional behavioural risk factor on cardiovascular disease, cancer and all-cause mortality: A systematic review. BMC Public Health, 19, 900. Web.

Ramsubeik, K., Ramrattan, L. A., Kaeley, G. S., & Singh, J. A. (2018). Effectiveness of healthcare educational and behavioral interventions to improve gout outcomes: A systematic review and meta-analysis. Therapeutic Advances in Musculoskeletal Disease, 10(12), 235252. Web.

QuickFacts: Atlantic City, New Jersey. (2019). United States Census Bureau. Web.

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