Community Health Assessment Report

This report focuses on the community health assessment of Horizon City, discussing the psychosocial factors and social determinants that impact the health of the population. It specifically addresses the issue of chronic diseases, such as obesity, diabetes, and mental health conditions, and explores the role of registered nurses in health promotion. The report provides insights into the education, employment, income, housing, and communication networks in Horizon City, highlighting the challenges and opportunities for improving community health.

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ASSESSMENT 2: COMMUNITY HEALTH ASSESSMENT REPORT
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Table of Contents
Introduction.......................................................................................................................3
Part – A. Psychosocial assessment of the Horizon City........................................................3
Education.....................................................................................................................................4
Employment.................................................................................................................................4
Occupation...................................................................................................................................5
Income.........................................................................................................................................5
Housing........................................................................................................................................5
Transport.....................................................................................................................................6
Communication networks............................................................................................................6
Volunteer and community groups................................................................................................6
Social support and emergency services........................................................................................6
Law enforcement, Government and leadership arrangements.....................................................7
Part B - Health Issue (chronic disease) in the Horizon city...................................................7
Part C - Role of the Registered Nurse in Health Promotion to manage obesity....................9
Enablement..................................................................................................................................9
Advocacy......................................................................................................................................9
Medication.................................................................................................................................10
Conclusion........................................................................................................................10
Reference List...................................................................................................................11
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Introduction
The report focuses to perform community health assessment of the Horizon city that
is situated in the east coast region of South Australia. The city of Horizon is a well-
established city a healthy population settlement with a good quality lifestyle. Apart from
having a quality living structure, just like various other regions of Australia, the city of
Horizon also faces some critical health issues that require serious attention and amendments
(City of Horizon 2018a). One of the critical health issues is “chronic disease” that has been
specifically discussed in this study. The health issue of chronic disease or condition like
obesity, asthma, diabetes, cardiovascular diseases etc. affects almost all the age group of the
population moving from young children to senior adults (Vannini 2016). Any type of chronic
health condition like obesity, back pain, arthritis can dwell into chronic disease like
cardiovascular arrest, asthma, mental health disorder etc. The chronic diseases are long-term
health imbalances that have persistent effects affecting the quality of life. As per survey
analysis in Horizon city, 79% of the population in Horizon city are obese or overweight
where 1 out of 5 deal with obesity. The rate of diabetes effect is higher in Horizon city
compared to other South Australian regions. Further, the city is also identified with sufferers
of mental health chronic conditions (City of Horizon 2015b).
According to Khan and Sievenpiper (2016) studies the management of chronic
disease in Australia requires a community-wide approach with multidimensional strategies to
control the further impact of this health issue. A similar situation is applicable for the
Horizon city where a community-wide multi-dimensional approach is needed to manage
diversified chronic conditions affecting the quality of life. The present report details about the
psychosocial assessment of the Horizon city explaining the overall structure of the city.
Further, the report involves a detailed assessment about the issue of chronic disease and the
social determinants related to this health issue as per the psychosocial assessment details.
Lastly, the role of Registered Nurse in health promotion dealing with the issue of chronic
disease is detailed in this report. In this manner, the report is helpful to understand the health
assessment process and the importance of a nurse’s role in managing health-related issues.
Part – A. Psychosocial assessment of the Horizon City
With the current population of 29,308 this city is a prosperous one being a home of
60+ age people as a dominating group of the city. Horizon is a mixed cultural city just like
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other areas of Australia with 43.5% Australians, 40.2% English, 9.9% Scottish, 8.9% Irish
and 7.8% German (City of Horizon 2018a). The psychological assessment of Horizon city is
performed to understand the impact of social determinants on the health of people dealing
with chronic disease. The below provided are the cultural, social and psychological factors
that structure the community health in the city of Horizon.
Education
The education level of Horizon city can be considered an average one where almost
20% of its teenagers are not involved in full-time secondary education making only up to
primary education level (City of Horizon 2018a). Only 12.2% of teenagers passing 12th in
2015 got enrolled in University education in 2016. This means the approach of Horizon
population to higher-level education is very low (City of Horizon 2015b). As per provided
data analysing the qualification level of the year 2016, 8.5% population hold a higher
qualification, 4.9% make up to diploma level, 22.7% vocational qualification, 54.6% no
qualification and 9.2% not stated their educational qualification. Out of 24,605 aged 15+
students, only 7,602 make up to the 12th level of schooling in Horizon city. This means more
than half of the population of Horizon city holds no proper qualification level (City of
Horizon 2018a). Doull et al (2017) stated that education literacy is the key to the economic
and social welfare of people. Health status is benefited by proper education literacy because it
strengthens the socio-ecological model of health. This indicates that education literacy of
Horizon city is not powerful enough to provide a better socio-ecological model of health as
more than half population lacks proper education qualification.
Employment
The 6.7% population between the age group 16 to 64 years are registered to
unemployment benefit scheme with more number of younger populations registered to Youth
allowance benefit schemes (City of Horizon 2015b). According to Sweeney et al (2015)
studies, employment is the most important factor that directly impacts the health status of
people by affecting socio-economic status. The powerful is the economic status the better is
the lifestyle, eating habits and health status. The city of Horizon persist 93.3% population
being employed, 6.7% being unemployed with 4.1% search full-time work and 2.6%
searching part-time work. However, the rate of unemployment in Horizon city is a bit higher
compared to other South Australian regions which are 6.7% in Horizon and 5.4% in other
regions of SA (City of Horizon 2018a).
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Occupation
The Index of Relative Disadvantage IRSD score of Horizon city is 927, which is
lower than that of the other regional South Australian areas indicating a low socio-economic
status of the city (City of Horizon 2015b). The classification of industrial sector employment
indicates that most popular employment sector is healthcare and social assistance (15.3%
employment), agricultural, forestry and fishing (10.6% employment) and retail trade (14%
employment). The occupation employment rate of Horizon city is higher compared to
Regional SA areas in healthcare, social assistance, agricultural, forestry, fishing and retail
sector (City of Horizon 2018a).
Income
The city of Horizon people has a Median weekly household income of $751 that is
very low compared to other Australian regions. In regional SA it is $881/week, South
Australia $1,044/week and Australia $1,234/week. This low value of weekly wages indicates
a low socio-economic status of the city (City of Horizon 2018a). According to Cosgrave
Hussain and Maple (2015), social status and income of any individual directly impact or are
directly proportional to the access to healthcare facilities, medicines, nutritional intake, stress
level and low self-confidence. Low income leads to low social status, access to healthcare
and quality life in the city of Horizon. The statistics indicate that out of the overall Horizon
population, 44.9% have a low income below $400/week and 4.5% earn high income above
$1,500/week.
Housing
Housing is the least important yet effective psychosocial factors that indirectly impact
the health and wellbeing at the individual level. The better housing facilities promote better
health, social circle, employment, education and security at the individual level. The dwelling
type determines the housing structure of any region. The better higher density, separate
dwelling and social housing facilities attract a healthy population to establish in any area
(City of Horizon 2015b). The medium density (12.9%) and higher density dwelling (1.1%)
in the city of Horizon is more compared to other Regional SA having medium density
dwelling (9.7%) and higher density dwelling (0.3%). The unoccupied dwelling was 27.2% in
Horizon which is large compared to 21.5% unoccupied dwelling in Regional SA (City of
Horizon 2018a).
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Transport
In the city of Horizon, the private vehicles are considered a better mode of
transportation where 71.6% population use private mode of transportation while only 0.2%
population uses public transport system. This indicates that public transportation services are
either not good or not trustworthy from people’s perception in this city (City of Horizon
2018a).
Communication networks
The Internet connection, dial-up connections and telephonic services are the most
important modes of communication networks (Fitzpatrick and Tinning 2014). As per
statistical findings, 65.5% of households have a proper Internet connection or dial-up
communication facilities whereas 31.5% have no proper communication networks in the city.
The communication network facilities in Horizon city is much better compared to other
Regional SA having 64.8% Internet connections and 28.8% of households with no proper
communication network (City of Horizon 2018a).
Volunteer and community groups
The resident of Horizon city ensures a proper volunteer and community support in times of
crisis. The 90.2% population feels that volunteer and community connectedness with people
is satisfactory in times of crisis. Even 22.2%population of Horizon is involved in volunteer
services (City of Horizon 2018a).
Social support and emergency services
The one-third population of Horizon city indicates difficulty in access to social and
emergency services like telecommunications, healthcare services, doctors, Commonwealth
income support and others. The only limited number of population is booked with community
health services, which is 11% lower than in other metropolitan areas. However, the
population engaged in Child and Adolescent Mental Health Services is higher in Horizon city
(58% of people booked to CAMHS) compared to other regions. Horizon has a 47% higher
population booked to government-funded community mental health services than other non-
metropolitan regions. This indicates that support services provided in Horizon city are good
but the social connectivity services are low (City of Horizon 2015b).
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Law enforcement, Government and leadership arrangements
The South Australia Public Health Act 2011 plays a major role in structuring the law, policies
and management related to public healthcare facilities in the city of Horizon. This healthcare
act puts more concentration in preventing the cause of health disaster to reduce the burden of
health diseases. The South Australian Public Health Plan (SAPHP) is the most effective
policy implemented under this act (City of Horizon 2018a). This policy follows “A better
place to live” policy for better planning and development of the city. Further, the Local
Government Act 1999 is managed by the Council of Horizon city to implement strategic
healthcare management plans. These plans manage social, economic, physical and
environmental development in the city (Delany et al 2015).
Part B - Health Issue (chronic disease) in the Horizon city
The chronic diseases are health-related conditions or diseases lasting from 3 months
to more time, further persisting a long-lasting impact on the body leading to various other
harmful diseases. The chronic disease does not have any vaccination or medication that can
completely cure them rather these diseases can only be controlled and managed by taking
necessary precautions (Hpcsa.com.au 2019). The leading chronic diseases affecting
developed countries like Australia are obesity, arthritis, diabetes, stroke, seizures etc. (Lewis
et al 2015). According to Hamar et al (2015) studies, unhealthy living circumstances and bad
lifestyle lead to health-damaging behaviours like tobacco use, substance abuse, low physical
activity, obesity and poor eating habits that result to the development of chronic diseases.
While performing community health assessment for the Horizon city it is identified that
chronic diseases also relay a devastating impact on the health of people living in this city.
The highest percentage of diabetes type -2 is present in the Horizon city in the Limestone
coast area of South Australia. About 22.7% of young adults above 18years of age perform
tobacco smoking and 19.9% pregnant women were found involved in smoking during their
pregnancy. Further, obesity is a health issue of major concern in the city of Horizon where
79% of adults are obese. One out of five adult males is identified with higher BMI index
getting into the range of obesity with 20.1% men being overweight. The issue of poor
physical activeness and poor nutrition is also present in Horizon population’s especially
young adults, which makes them vulnerable to a higher risk of chronic disease in their
adulthood (City of Horizon 2015b).
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The analysis of psychosocial factors of Horizon city indicates that there are various
social determinants that either directly or indirectly escalates the chronic health conditions
and disease for people living in this area. According to Heijmans et al (2015) studies, chronic
diseases are physical health conditions that develop due to bad eating habits, lack of fitness
knowledge, stress, higher energy intake etc. these habits are largely influenced by social
determinants because social behaviour is developed as per the social determinants of any
location. However, genes of an individual along with social habits also influence chronic
diseases as per this study.
The city of Horizon is an average city with good health and well-being yet there are
certain social factors that raise the risk to a chronic condition. Some the social determinants
escalating chronic health diseases are lack of education, low income, poor daily living
activities and low socio-economic status (City of Horizon 2018a). According to Heijmans et
al (2015) study, health literacy is a very important factor that influences better health and
well-being of people. People living in areas having proper education literacy tend to develop
less dramatic health hazard. Lack of health literacy in the city of Horizon leads to a chronic
condition because people lack knowledge of eating habit, balanced diet, proper exercise,
avoiding alcohol and healthy lifestyle. Further, the city of Horizon already has a low socio-
economic status, more than half of the population has income value below $751/week. This
indicates that people are not able to afford better living habits, proper medications, healthy
foods etc. that can benefit their health; in response, the increase in chronic conditions like
obesity, diabetes, asthma, stroke etc. is very obvious in the City of Horizon (City of Horizon
2018a).
Lastly, daily living activities also directly influence the health of the body. According
to Woodruffe et al (2015) studies, a lack of average daily physical activity can enhance
harmful conditions in the body. People of Horizon use private mode of transportation with
only 4% population walking and 0.2% using public transport to commute. Further, only
40.1% of adults are physically active in Horizon city and 48.2% of people meet the
recommended healthy diet condition. In this manner lacking effective daily living activities
also escalates the chronic conditions and diseases for people living in Horizon (City of
Horizon 2018a).
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Part C - Role of the Registered Nurse in Health Promotion to manage obesity
Registered Nurse plays an important role in managing the health issue like chronic diseases to
control its further hazards to the patient’s health. The following three strategies are used by
Registered Nurse of Horizon to manage obesity.
Enablement
The disease conditions like chronic conditions or diseases are better managed with
prevention strategies rather than cure. A control over increasing chronic conditions with
enablement activities by Registered Nurse helps the patient to avoid further harmful
consequences of a chronic condition leading to serious diseases or death (Moore et al 2016).
One of the enablement activity that can be performed by RN is to provide regular
consultation to their patient regarding better eating habits, maintaining a healthy lifestyle,
avoiding alcohol/smoking, physical activity etc. (Vannini 2016). Further, RN can also
implement strategies to provide health literacy to their patients lacking proper education and
knowledge about healthy living habits. According to Woodruffe et al (2015) studies, health
literacy cannot cure the existing disease but can surely control its consequences. With proper
health literacy, chronic conditions like diabetes, obesity, tobacco intake etc. can be well
managed and cured at any stage of life. In this manner, these two enablement activities by a
professional nurse can help their patient to manage chronic diseases.
Advocacy
Advocacy is an approach that professional RN can adopt to protect their patient’s
rights and provide them with better laws and policies. In advocacy, nurses have the right to
speak ‘for’ ‘or against’ any health-related action, law or policy for the betterment of their
patient (Berkman, Kawachi and Glymour 2014). In a process to manage the chronic disease
conditions, the professional RN of Horizon can perform advocacy to implement the Ottawa
Charter for Health Promotion (1986) for their patient’s welfare. According to Hamar et al
(2015) studies, the five action plan of Ottawa Charter Health Promotion involves supportive
environment creation, developing personal skills, reorientation of health services, powerful
community actions and developing healthy public policy. This five-action plan has proven
itself beneficial to manage chronic conditions like obesity, diabetes etc. in various other
Victorian Regions. The city of Horizon still lacks any such workable plan to manage chronic
diseases. The government of this city is focussed to implement public health activity related
to chronic diseases especially cardiovascular diseases and obesity. Therefore, nurse advocacy
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for Ottawa Charter Health Promotion shall work in a positive manner to help people in
overcoming this health issue (Betterhealth.vic.gov.au 2019).
Medication
The Registered Nurse does not hold any authority to provide medication while dealing
with a chronic condition but still they can implement disease management using their
workable nursing interventions (Moore et al 2016). Some of the nursing interventions that
can be beneficial to control the harm of chronic diseases are commercial diets, lifestyle
modifications, promoting physical activities and providing health education. This is the only
role that an RN can play in providing medication for chronic conditions as per Registered
Nurse Standards for Practice (Nursingmidwiferyboard.gov.au 2019).
Conclusion
The report involves a detailed assessment of the community health of Horizon city,
South Australia. The psychosocial assessment of this region is conducted to develop an idea
about psychosocial factors structuring the city of Horizon. As per this assessment, Horizon
city has a low socio-economic status yet people here have an acceptable life structure. There
are various health issues faced by the people of Horizon out of which the health issue of
chronic disease is detailed in this report. Chronic diseases and conditions are an issue of
concern for the children as well as adults of Horizon city. The social determinants escalating
this health issue are lacking health literacy, low socio-economic status, low income and lack
of physical fitness.
This study on one specific health issue and social determinants escalating this issue
helped to develop health promotion strategies that a professional nurse can use to manage or
control chronic diseases in Horizon city. The health promotion strategies are advocacy,
enablement and medication that can help people of the Horizon city to control further
consequences of chronic diseases. As a nurse, this detailed analysis of a specific region and a
specific health issue faced by this region can help to better understand the connection
between the social factors and their impact on health welfare. Further, the study helped to
understand the importance of a professional role in managing these social factors to
implement healthy welfare for any specific region.
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Reference List
Books
Berkman, LF, Kawachi, I and Glymour, MM, 2014, Social epidemiology, Oxford University
Press, Oxford, United Kingdom.
Fitzpatrick, K and Tinning, R, 2014, Health education: Critical perspectives, Routledge,
Abingdon, United Kingdom.
Lewis, SL, Dirksen, SR, Heitkemper, MM, Bucher, L and Camera, I, 2015. Medical-Surgical
Nursing-E-Book: Assessment and Management of Clinical Problems, Single Volume, Elsevier
Health Sciences, Australia.
Moore, G, Durstine, JL, Painter, P and American College of Sports Medicine, 2016, ACSM's
Exercise Management for Persons With Chronic Diseases and Disabilities, 4E, Human
Kinetics, Australia.
Vannini, P, 2016, Body/embodiment: Symbolic interaction and the sociology of the body,
Routledge, Abingdon, United Kingdom.
Journals
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City of Horizon 2015b, Public health and wellbeing, in City of Horizon, ver. 3, computer
program, City of Horizon, Novus Res, Adelaide.
Cosgrave, C, Hussain, R and Maple, M, 2015, ‘Factors impacting on retention amongst
community mental health clinicians working in rural Australia: A literature review’,
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Delany, T, Lawless, A, Baum, F, Popay, J, Jones, L, McDermott, D, Harris, E, Broderick, D
and Marmot, M, 2015, ‘Health in All Policies in South Australia: what has supported early
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Doull, M, O'Connor, AM, Tugwell, P, Wells, GA and Welch, V, 2017, ‘Peer support
strategies for improving the health and well‐being of individuals with chronic diseases’, The
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Hamar, GB, Rula, EY, Coberley, C, Pope, JE and Larkin, S, 2015, ‘Long-term impact of a
chronic disease management program on hospital utilization and cost in an Australian
population with heart disease or diabetes’, BMC health services research, vol. 15, no. 1,
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Heijmans, M, Waverijn, G, Rademakers, J, van der Vaart, R and Rijken, M, 2015,
‘Functional, communicative and critical health literacy of chronic disease patients and their
importance for self-management’, Patient Education and Counseling, vol. 98, no.1, pp.41-48.
Khan, TA and Sievenpiper, JL, 2016, ‘Controversies about sugars: results from systematic
reviews and meta-analyses on obesity, cardiometabolic disease and diabetes’, European
journal of nutrition, vol. 55, no. 2, pp.25-43.
Sweeney, S, Air, T, Zannettino, L and Galletly, C, 2015, ‘Psychosis, socioeconomic
disadvantage, and health service use in South Australia: Findings from the second Australian
National Survey of Psychosis’, Frontiers in public health, vol. 3, no. 2, pp.259.
Woodruffe, S, Neubeck, L, Clark, RA, Gray, K, Ferry, C, Finan, J, Sanderson, S and Briffa,
TG, 2015, ‘Australian Cardiovascular Health and Rehabilitation Association (ACRA) core
components of cardiovascular disease secondary prevention and cardiac rehabilitation
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Websites
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<https://www.betterhealth.vic.gov.au/health/ServicesAndSupport/ottawa-charter-for-health-
promotion>.
Hpcsa.com.au. 2019, 3-9 | Health Performance Council :: Health Performance Council,
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viewed 18 May 2019, <https://www.hpcsa.com.au/state_of_our_health/chapter_3/3_9>.
Nursingmidwiferyboard.gov.au. 2019, Nursing and Midwifery Board of Australia - NMBA
has released new standards for practice for enrolled nurses, viewed 18 May 2019,
<https://www.nursingmidwiferyboard.gov.au/News/2015-10-21-media-statement.aspx >.
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