Miami Dade: The Community Health Fieldwork

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Introduction

Miami Dade is located in the Florida’s southeastern part. The population of this county as per year 2010 was 2,496,435. It is thus the most populous county in Florida. The county covers an area of 1,946 square miles in Miami. The county has both homestead areas and Redlands where agriculture is commonly practiced. In contrast to the agricultural Redlands, the urbanized area is densely populated (Moore, 1991).

Physically, the area is close to sea level, and located at the eastern edge of Florida. About 20% of the area is composed of water while 80% is land. Within the county, Miami is the biggest city constituting 424, 662 people. The population of the county has been increasing over the years.

Of the many households, about 34% had less than 18 years children, 48% constituting the married, 17% constitute the unmarried women and about 29% households consisted of the people with no families. The average size of family was estimated to be 3.35 as of 2000 census. Of the total population, about 25% are children below the age of 18, 61% are people aged between 18 – 64 years of age while 13.3% are the old above the age of 64. There are more females compared to males. Little Havana has many Cuban immigrant residents where social, cultural, and political activities take place (Helen, 1993).

The Community Genogram/Profile Reflecting the Health Status of the Community

This genogram shows how community lifestyle affects the community health in general. The community has got no access to good food. There are small stores selling mostly canned food as opposed to fresh food. Even if there are food stores selling fresh vegetables, the vegetables sold is not enough.

Food is an important factor in the health of an individual. If there is no food, people become malnourished and prone to various diseases. Fresh vegetables are essential to the body and prevent one from chemical exposure in packed food. When this happens, the victims end up in hospitals, use medications, and in some instances, it results in increased hospitalization, which can lead to infant motility.

Exercise is an integral part of living healthy; it is a good habit to pick up as a daily lifestyle. Without sufficient exercise, people become obese, and may result to heart disease and diabetes. Exercise is very important for people to live healthy lives and to increase the human life span. When this happens, the victims end up in hospitals, use medications, and in some instances, it results in increased hospitalization, which can lead to infant motility.

This community has no sufficient supply of groceries. It also lacks parks where kids should play. The only places such parks are present in the community are in the local schools. The parents prefer the children playing on the streets near home as opposed to the set parks for children. The present stores do not supply fresh fruits or vegetables but offer canned vegetables and fruits. In most dinners, this community buys meat on a stick.

The children of the residents played in streets by their homes since this was considered safer than sending them to the local parks available. Though there is baseball and soccer, parents find it quite expensive for their kids to join the leagues. An outdoor farmers market is said to be set up where fresh seafood, vegetables, and fruits will be available. However, these fresh vegetable vendors only come in the evenings to sell. The parks will be cleaned to make them safe for the kids to play.

The Florida Marlins will let part of the stadium’s parking lot be of use to the farmers where they will set the market for their products. They will also fund for development of sports.

The Health Concerns Studied in the Fieldwork

From the fieldwork, it was studied that the community had a problem accessing healthy foods. Most stores lacked fresh fruit and vegetables, preferring to stock canned food. The store owners also proved reluctant to endeavor supplying fresh foods to its customers. Additionally, there are issues in the environment people live in such that physical activity is hindered. To be healthy people need to make good choices concerning the foods that they eat. This is also important in preventing diseases. Food availability to the young influences their lives once they grow up.

The community around seem to have adopted poor eating habits and purchased the canned foods more. According the 2007 survey, around 28% of students were obese. This was aggravated in the half of the obese people who were not able to involve themselves in physical exercises. This problem was known to different bodies such as the University of Miami and the Children’s trust that developed free programs for students to become healthy. Everybody in Miami Dade benefited from these programs since they get lessons on healthy eating and the importance of having physical exercise (Ilcheva et al, 2008).

Obesity among children is a major concern and this issue needs be addressed strongly to prevent further damage. The children are prone to obesity today due to the modern lifestyle taken up by their parents. The parents buy more canned food in the stores than fresh foods and feed the children with it. This way the children barely acquire natural nutrients and this lowers their immunity (News in Health, 2005).

Population of Interest Affected by the Health Concern Identified in the Fieldwork

People of all ages and sexes are affected by the health problems identified in the fieldwork. Unavailability of fresh foods affects everybody since they all need to eat. Exercise is also important for all people to remain physically fit and prevent some of the heart diseases and obesity. The social class that each person belongs determines how capable they are at accessing some of the sport facilities like the soccer game.

The level of education affects population of interest in that those who are more educated know the kind of food good for them and their families. These people also utilize the available resources for exercises so that they are physically fit, and prevent other health problems such as obesity and heart diseases.

The people belonging to the poor social class cannot afford also to apply for membership in health clubs. This means that they may have to look for cheaper means to exercise and retain a healthy lifestyle. The rich who can afford to pay for health clubs encourage their children to also take part in the exercise. Chances are the children carry on this good practice and they prevent a lot of diseases related to lack of exercise.

Community Resources and Partners Currently Involved with the Health Concerns

The federal state and local agencies have joined hands to help improve the health concerns in the area. They make sure the formulated regulations are well enforced, and methods to develop physical activities are well determined. Through the agencies, effective communication is maintained with the partners to make sure that they meet the public needs in terms of nutrition and physical activities provided (Healthy People 2020, n.d.).

Obesity will be fought through the use of the federal government grant of $14.7 million which will be given Miami-Dade County (Miami-Dade County Health Department: Miami Herald Staff, 2010).

This grant will be used to provide bike paths to encourage the public to use bicycles to work or school. The bicycles will be a good form of exercise for the public as they head to their destination. Sitting on a bus or train or driving to work requires less energy as opposed to riding a bicycle. The bicycle paths will intend to also discourage people from using cars hence it will reduce air pollution as a result of fume emission by the car. Increase the availability of vegetables and fruits in the food stores and increase the number of outdoor markets for farmers.

The reason why most stores have canned food is due to the durability of such foods. Fresh foods easily go bad after a few days and most storeowners would not like to acquire perishable goods. The storeowners however are been educated on the importance of stocking fresh foods and how they can stock enough. The farmers are also been encouraged to consistently supply the stores of fresh foods.

There has been some education on the importance of physical activities and improved food. Also, the education informed about the risks of obesity. This education is being provided by the health school initiative through the department of health ( News in health. 2005). The local school district has a policy that the Miami-Dade county public schools hold fast.

“Let’s move” campaign by Michelle Obama promotes the youth’s health and wellness nationwide and the partners have joined the campaign. Miami date parks have joined the campaign and initiated its local fit-to-play program where interactive learning is integrated with physical activity to assist children develop healthy cultures.

To achieve the objective of improving the health problems such as overweight and obesity, workers, parents, caregivers, the community, the federal government, and the department of health. Different departments such as the department of agriculture, education and health in conjunction with the federal government and the house of the senate are responsible for securing funds and other materials that will help improve the identified health problems.

A move by the government to ensure that physical exercise is emphasized in all learning institutions is carried out. Corporations are also part of the community partner encouraging healthy living. In several occasions corporations cover medical check-up bills for their employees to have them medically tested. Corporations are also coming up with various activities that encourage the employees to have various exercises. The company provides access to the employees to engage in the various sports such as football, swimming, tennis, and rugby. This is to ensure that all employees are physically fit and can perform as expected by the company.

The Florida Marlins baseball team will also be donating the parking for the lot for the fresh market and the community has requested funding for sports clubs where the community will benefit through physical activities (Bush & Francois, 2006).

Aspects of the Health Concern Not Being Addressed Despite the Efforts of the Partners Involved

The Florida department of health has developed programs on healthy community and healthy people with an aim of preventing overweight and obesity through promotion of regular exercise and healthy nutrition for its community members. They have done this through encouragement of long breasting duration, and reduction in recreational screen time to an increase in other physical activities. Through the programs, every body has a defined role to play with a common goal of preventing overweight and obesity.

Through the reduction of overweight and obesity through improved nutrition and physical exercises, the community is guaranteed to do away with the negative outcomes of poor nutrition and lack of exercises.

The present economy has greatly affected healthy living with the great depression and hard economic times. Food is generally expensive, with the fresh food attracting a higher charge than canned foods. Due to the high rate of unemployment leading to lack of money, most people will go for the canned food. There has to be a way that fresh food can be available at a lower price, especially in major towns. People today prefer to eat in fast food restaurants that charge less as opposed to restaurants that price nutritious food expensive. It is always about the budget nowadays where people will buy what they can afford regardless of the quality.

The people’s culture is also an issue that needs to be formally addressed in regards to nutrition habits. Most people living in urban areas use cars or trains to move from place to place, in order to get there on time. There is hardly any time to walk to either the work place or to school which encourages people to not exercise. The culture in very developed countries is to have a takeout as opposed to cooking meals at home.

The Ultimate Outcome or Goals for Improvement Related to the Health Problems

Efforts should be directed towards having fresh market every Saturday morning in the little Havana. Both the young and the old will have access to fresh fruits and vegetables to improve their diets. There will be a change from the usual canned fruits and vegetables sold in the groceries.

The health clinic developed to have a booth at market offering free B/P, glucose, and WT. screening. With these initiatives, it will be easy to keep track on each of the community member’s blood pressure, glucose, and weight levels to control them as required. For example, when the parameters are above normal, the victim can do more exercises via the available resources to improve their health.

With safe sports facilities and parks, the community will achieve better health and prevent obesity which could have been caused by lack of physical exercise (The Nemours Foundation, 2011). These combined by the assistance for families to have child play sports and the starting of clubs in the area will see obesity gone for good in the community since there will be easy access to these resources and facilities. Generally, there will be improvement of health for the community members thereby realizing the main goal of finding solutions to the currently identified health problems in the community (Finkelstein, Trogdon, Cohen & Dietz, 2009).

Planning

The Nursing Actions to Improve the Health Concern

To improve the health concerns, the nurses develop policies and are sure to implement them. The nurses also will observe at a distance to see that the policies put in place are well adhered to. The policies have to be carefully reviewed from one community to the next because they all have varying health issues. The policies should directly address issues such as how to prevent malnutrition and other diseases such as diabetes.

If there is any sign of a presenting health problem, it will be the nurses’ duty to investigate for disease and any other health event. The investigation should go down to finding out the root cause of the problem. Health concerns in a community are determined by many factors and hence the nurse should use these factors to come up with long lasting solutions. For example if there is an increase of obesity in a particular school, the nurses should find out the student’s age, nutritional balance and level of activity. This can assist the nurses to find the root problem and find various solutions.

The nurses can also provide education to the community about the importance of physical activities and nutrition, and the risk of being obese due to poor diet and lack of exercises. Lack of awareness is one of the root causes for poor eating habits and lack of general exercise. The nurses can educate the low class on how to stay health within their budgets and also how to exercise more often. The education provided will consider also the rich class who have the funds but deem it unnecessary to exercise and eat a balanced diet. Additionally, the nurses can screen the community to find those with health problems identified in the fieldwork to find ways in which they could be helped to regain their health (Preventing Childhood Obesity, 2005).

Services that would be useful in this community include, promotion of education, and provide environment with activities aimed at preventing diseases to improve the health of the people living in the population. To achieve this, it would be better if safe drinking water would be made available to the people, food hygiene and improvement in the sanitation of the community (National Center for Chronic Disease Prevention and Health Promotion, 2010).

Working Together with the Community and the Population of Interest to Improve the Health Concern

Nurses should work together hand in hand with the general community and especially the population of interest to make sure they solve the health problems. They need to educate the community on the importance of physical exercises and good nutrition to help do away with the problem of obesity, which brings about cardiac diseases and diabetes. The fruits and vegetables have high fiber contents that help in the control of blood glucose levels. Additionally, they have antioxidants and phytochemicals known to reduce coronary heart disease.

Education to the community members is a primary intervention. (Alvarez. et al, 2001). Those still obese can also be screened for further involvement directly into the physical activities and nutrition. The society should combine efforts with the public to educate each other about the importance of healthy living. The society can play its role by setting a good example to the young generation through exercise and eating a balanced diet.

Public and Private Partnerships That Could Be Formed to Implement Recommendations

There could be the formation of bodies such as clubs that can help implement the recommendations in the communities. Health clubs in the community should offer free seminars on the importance of healthy living. The nutrition experts should advise the community on what is healthy and what the people should avoid. Schools both public and private can also be used in the implementation of the recommendations. Curriculum should adopt health and nutrition programmes as a compulsory course to all students.

Governmental bodies, private organizations and individual involvement can also help implement the recommendations. The legislation bills passed by parliament should look towards improving the health standards of the people.

The General Objectives for Implementing the Activities

The general objective for implementing these activities is to solve the health problem found in little Havana to have a community with improved health able to attend to their daily activities without health related constrains.

Raising a community that is poor health wise affects the level of productivity in the particular community. The aim is to prevent preventable diseases and outcomes such as obesity that could cost a country more than purchasing of nutritious foods.

A Timeline for Expected Outcomes

Having access to fresh market every Saturday is expected to take place after a month. People will start enjoying the safe sport facilities after their immediate development. The screening will start a week after both the fresh markets and parks for sports have been put in place.

Evaluation

To evaluate whether the efforts to improve the health concerns were effective, there will be close monitoring and follow up of the cases that after screening will be found with the health problem. Additionally, it will be determined whether the policies put in place were well enforced through screening done.

The policies put in place during evaluation will have an analysis drawing the difference depending on the outcome. If the nurses find that health issues are still on the increase then control techniques will be utilized to enforce the policies. Students say who are obese and after being placed on good diet still continue being obsessed then a stricter control diet will recommend by the nurse in charge.

Conclusion

My earlier perspective about community health effort towards a healthier population has really changed from the fieldwork, it was easy to identify a health problem present in a community through observation and close involvement with the residents. Before the fieldwork, I thought it was a very difficult task, which now seems quite easy and achievable.

A community as learned from the field is prone to adopt a culture set by its environment. In most close communities small stores offered canned food only and this is what the people bought. Some people in the same community found themselves buying the canned food even when they had access to fresh food. The belief in the community is that one should buy from a store and people hardly bought from the open vendor.

References

Alvarez, O., et al. (2001). Central Miami-Dade Community Health Initiative. Web.

Bush, J., & Francois M. R. (2006). Annual report on Healthy Communities, Healthy People Initiative. Healthy Communities, Healthy People. Web.

Finkelstein, E., Trogdon, G. J., Cohen, J. W., & Dietz, W. (2009). Annual Medical Spending Attributable to Obesity: Payor and Service-Specific Estimates. Health Affairs, 28(5), 822–831.

Healthy People 2020. (n.d.). Access to Health Services. 2011. Web.

Helen, M. (1993). Miami, U.S.A. Coconut Grove, Florida: Hurricane House Publishers.

Ilcheva, M., Gorski, A., Lerma, V., Martinez, A., & Smith, S. (2008). Comprehensive community needs assessment, Miami-Dade County. Web.

Miami-Dade County Health Department. Miami-Dade County Health Department Annual Report 2010. Web.

Miami Herald Staff. (2010). County gets $14.7M grant for prevention efforts. The Miami Herald. Web.

Moore, P. (1991). Miami: The Magic City. Miami, FL: Centennial Press.

National Center for Chronic Disease Prevention and Health Promotion. (2010). Healthy Youth! Health Topics: Childhood Obesity. Web.

News in health. (2005). Preventing Childhood Obesity. Web.

The Nemours Foundation. (2011). When being overweight becomes a health problem. Web.

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