Walden STAT103 week 5 aplication

Question # 00027058 Posted By: msmonopoly Updated on: 09/29/2014 01:53 AM Due on: 09/30/2014
Subject Statistics Topic General Statistics Tutorials:
Question
Dot Image
Application: Case Exercise: Community Health Assessment forPitt County, North Carolina

Application: Case Exercise: Community Health Assessment forPitt County, North Carolina



This Application Assignment asks you to consider the kinds of data you would use, and how you would obtain the data, for a community health assessment.

Read through the case exercise on Community Health Assessment, linked below, and complete all the questions. All the information you will need to complete this assessment exercise is provided in the Appendix at the end of the document. Save this Word document to your computer before you begin to fill out the form.

Community Health Assessment Exercise

Note:Assessment is a very involved process, and you could easily spend many hours exploring this case exercise alone. However, for the purposes of this assignment, you should limit yourself to spendingno more than two hoursto complete this Application.

This Application Assignment is due byDay 7of this week.

You have completed Week 4. The course now shifts in focus to performance management. Please proceed to Week 5.



Your name:

Date:

Week 4 Application: Community Health Assessment for Pitt County, North Carolina[*]

Community health assessment is key to understanding the health problems and priorities of a population. This Application Assignment outlines a process by which you can complete a health assessment of a community using indicator-based methods. You will construct a set of health indicators from a variety of domains, evaluate problems, and report on the health priorities for a community.

Sections A–C ask questions about assessment in general. Section D involves assessment of a particular county in North Carolina, information on which is provided in that section and in the Appendix.

Instructions: Save this document to your computer and complete all questions in Sections A–D below. Submit by the end of Week 4 following the submission instructions in the Week 4 Application section.

Section A: Community Health Assessment

The goal of public health is to improve the health of a population. Public health interventions such as safe water sources, immunization programs, and improved motor vehicle safety regulations account for the majority of years of life expectancy gained in the United States over the last 100 years.

A community health assessment involves obtaining and interpreting information to determine the health status of a specific community. Once community health needs are identified, public health interventions can be developed and their effectiveness evaluated using a similar approach. Information necessary for performing a community health assessment, for example data on mortality rates or behavioral risk factors such as smoking, is available from various sources.

Questions:

1. How do you define community?



2. What stakeholders (groups/organizations) would you want to consult with for a community assessment?



3. What types and sources of data would you use for a community assessment?

Section B: Healthy People 2010

The Healthy People 2020 initiative is a national approach that identifies high priority health issues and establishes objectives to reduce the impact of these public health threats. To understand the significance of data on your own community, you have to be able to compare it to another standard. The questions in this section ask you about other standards that can be used.

Questions:

1. How are Healthy People 2020 standards used? What are advantages and disadvantages to applying them at a local community level? (Note: you may use the Healthy People 2010 standards if the 2020 standards are not reported.)




2. What other standards (national, state, or local) can be used?

Section C: Health Indicators

For this exercise, you will use an indicator approach to develop a community health assessment. A community health assessment involves three-step feedback loop.

The first step in such an assessment involves identifying important health indicators. The second step involves matching those indicators with available data. In the third step, standards such as those explored in Section B are applied to the data gathered in the first two steps to transform it into useful information about health needs of the population.

Health indicators are measurable health outcomes, such as death rate, insurance coverage measures, immunization rates, or other data items that are relevant to the health of a community.Indicators are thoughtfully selected data points that provide useful information about the health of a community.

Note that each indicator should be:

  1. An important health problem.
  2. Prevalent or common in the community of interest.
  3. Measurable on a community or population basis. There should be population data on a local level that is easily available—this cannot be collected from health facilities or providers because these data sources do not apply to the entire community.
  4. Ideally, because we want to use a limited number of indicators, the indicator should not be redundant—not measure the same thing—as another chosen indicator.

To organize indicators, it is helpful to identify major areas of focus. For this case, we will refer to these broad categories of public health concerns asdomains. Please refer to Table 1 below for examples of domains. For each domain, an example of an indicator is provided.

Table 1: List of Domains to Assist Developing a Community Health Assessment

Domain:

Example of an Indicator:

Communicable Diseases

(including Sexually Transmitted Diseases)

Incidence of Gonorrhea

Chronic Diseases (including Cancer)

Incidence of Diabetes

Injury and Violence

Homicide rate

Maternal and Child Health

Childhood immunization rate

Environmental Health

Rates of Lead Poisoning

Access to Health Care

Rates of Uninsured

Question:

1. How you would obtain data for these indicators. What sources might you use? Select 2 of the indicators above and provide specific sources of information on them (including URLs) for your own community or state.

Section D: Performing a Community Health Assessment

As a consultant to Pitt County Health Department, you are asked to perform a community health assessment for the county. Below is information about the county:

Pitt County is located in eastern North Carolina and has a population of 138,690 residents (2005 Census). Pitt County has been classified as urban for the first time in 2006. It and the surrounding counties are largely rural with a history of dependence on tobacco farming. Caucasians make up about 62.8% of the population, African Americans 33.6%, Hispanics 3.2%, Asians 1.1% and American Indians 0.3%. There are an estimated 6,606 migrant and seasonal workers or 5.4% of the population. About 18% or 26,000 adults in Pitt County adults have household incomes below the federal poverty level with a median per capita income of $18,243 (2000). The child poverty rate is estimated to be 21.8%. Approximately 20% of adult lack health insurance.

Pitt County contains Greenville, the largest city in eastern North Carolina with a population of 67,525 (2005). Greenville is considered the hub of eastern North Carolina. The major employers are Pitt County Memorial Hospital (PCMH), Brody School of Medicine and East Carolina University. If a state was created of all the land in North Carolina east of Interstate 95, it would be the poorest of all 50 states. In addition, it would rate 48th in terms of premature mortality. Consider these factors when evaluating populations at risk and targeting resources for public health activities.

You now embark on the steps needed to perform your assessment.

· STEP ONE: IDENTIFYING HEALTH INDICATORS

As noted earlier, the first step in a community health assessment is identifying health indicators. Develop a list of 18-20 indicators you would want to use in your assessment, identifying 3-4 indicators per domain.

Complete the column on the right in this table:

Domain:

Indicator: (provide 3-4 per domain

Communicable Diseases

(including Sexually Transmitted Diseases)

Chronic Diseases (including Cancer)

Injury and Violence

Maternal and Child Health

Environmental Health

Access to Health Care

· STEP TWO: MATCHING THE INDICATORS

Now that you have chosen indicators to use for a community health assessment, use the information provided in the tables below (Appendix) to match available data to your chosen indicators. In this example, residents of Pitt County constitute the community. If the Appendix does not give you the data for your indicator, you should choose another indicator (alternatively, you may seek out the data elsewhere that you need for your proposed indicator).

Question:

1. Have you matched each of your indicators to the data available in the Appendix?If not, explain how and where you got the data needed for your proposed indicator.

· STEP THREE: SETTING HEALTH PRIORITIES

Using the information gathered in the first two steps, please answer the following questions.

Note: Keep in mind that in order to plan an effective intervention program in real life, you must communicate with other constituents and stakeholders and see what they perceive to be priority health issues. Collaboration with community stakeholders in program design is critical to the success of an intervention plan. For this purposes of this assignment, however, you are reviewing the data on your own, without the input from other stakeholders.

Questions:

1. Looking at this data only, what would you conclude are three priority health issues for this population? (Can be picked by how the indicator compares)

2. Choose three of your indicators. Compare them to the Healthy People 2020 Standards (or 2010 if appropriate) and provide URL(s) for the relevant Web page from Healthy People to the specific indicator.





3. How do you explain the health disparities of these indicators? (i.e., as shown by this comparison with HP?]

You have completed this Application on assessment. Submit this completed form in the Dropbox following the submission instructions in the Week 5 Application area.

APPENDIX 1: DATA TABLES

Community Health Assessment Indicators Pitt County (NC),

North Carolina, and the United States

Domain: Maternal and Child Health (2004)

Indicator

Pitt County

North Carolina

United States

Infant mortality rate per 1,000 live births

(2004)

7.1

8.8

6.9

Black infant mortality per 1,000 live births

8.1

15.6

14.1

White infant mortality per 1,000 live births

7.0

6.2

5.8

Neonatal infant mortality rate per 1,000 live births(<28 days of age) (2000-2004)

5.7

6.0

4.6

Black neonatal infant mortality rate

8.9

11.2

7.3

White neonatal infant mortality rate

3.3

4.1

3.8

Low birth weight (<2,500 g) per 100 births

(2004)

11.6

9.1

7.9

Minority births <2500 g

15.9

13.4

13.0

White births <2500 g

8.3

7.4

6.5

Very low birth weight (<1500 g) per 100 births

(2000-2004)

2.8

1.9

1.4

Minority births <1500 g

3.3

3.6

3.0

White births <1500 g

2.4

1.0

Teen pregnancy rate per 1,000 teens

(ages 15-19)(2000-2004)

39.8

64.1

(11.9%)

83.6

Minority pregnancies

54.5

87.3

153.3

White pregnancies

27.0

53.6

71.4

Smoked during pregnancy

8.9

12.5

11.4

Postneonatal infant mortality per 1,000 live births (>28 days <1 year) (2000-2004)

1.4

2.8

2.3

Black postneonatal rate

1.1

4.5

4.8

White postneonatal rate

1.7

2.1

1.9

Immunization status at 2 years of age

NA

82%

Immunization status at school entry

NA

99%


BRFSS for 2004

Age adjusted rates

Pitt County

North Carolina

Adult disability

28.3

25.0

Current asthma

7.1

6.4

Smoking: women of childbearing age

30.4

24.4

Smoking everyday: men

32.9

37.6

Obesity

26.1

22.7

Binge drinking (childbearing age)

9.5

6.8

Binge Drinking (all)

12.0

8.4

Men

19.8

Women

3.1

No leisure time physical activity

26.4

26.3

Are any firearms kept in your home

39.6

40.9

Domain: Access to Care

Indicator

Pitt County

North Carolina

United States

% No medical insurance

20.8

17.5

16.5

% Children with no health insurance

14.3

12.5

9.8

% Children enrolled in Medicaid

36.7

32.6

26.0

% Children enrolled in NC Health Choice

5.2

5.9

NA

Primary Care Physicians/100,000 population

149

83.5

Dentists/100,000 population

37.8

40.5

58.4

Kindergarten Tooth Decay Rates

27.7%

22%

26% whites

36% A-A

43% Hispanic

BRFSS 2001

Eastern NC

North Carolina

Cost as barrier to health insurance

16.5

11.5

No usual place of care

24.0

22.1

No dental insurance

52.7

45.3


Domain: Communicable Diseases

Indicator

Pitt County

North Carolina

United States

TB rate per 100,000 population (2004)

5.0

4.5

4.9

Hepatitis A rate per 100,000 population

2004: 17 cases

12.1

(2004)

3.65

(2003)

2.6

(2003)

Hepatitis B rate per 100,000 population

2004: 11 cases

7.0

(2004)

1.9

2.6

Hepatitis C rate per 100,000 population

2004: 4 cases

2.9

0.2

0.4

Domain:Sexually Transmitted Diseases

Indicator

Pitt County

North Carolina

United States

Gonorrhea rate per 100,000 population

347.8

181.3

113.5

Black rate

848.3

673.8

629.6

White rate

52.6

38.4

33.3

Chlamydia rate per 100,000 population

645.9

313.3

319.6

Black rate

1206.4

929.7

1209.4

White rate

216.2

116.3

143.6

Syphilis rate per 100,000 population

3.2

8.9

2.7

Black rate

8.0

15.3

9.0

White rate

1.3

1.1

1.6

HIV rate per 100,000 population

18.0

25.2

20.7

Black rate

38.8

76.6

76.3

White rate

7.2

9.6

9.0

Domain: Cancer (2000)

Indicator

Pitt County

North Carolina

United States

Lung Cancer

Mortality rate per 100,000 population

68.7

61.6

54.2

Incidence rate per 100,000

78.8

69.7

67.5

Breast Cancer (Female)

Mortality rate per 100,000 females

27.7

26.5

14.4

Female incidence per 100,000 females

167.5

149.5

132.2

Colon/Rectum Cancer

Mortality rate per 100,000 population

22.7

20.0

19.1

Incidence rate per 100,000 males

64.7

48.4

52.0

Prostate Cancer

Mortality rate per 100,000 males

36.7

36.9

31.5

Incidence rate per 100,000 males

154.5

152.5

166.7

Incidence All Cancer

494.3

445.3

Domain: Chronic Diseases

Indicator

Pitt County

N.C.

(1999-2002)

United States

(2003)

Heart disease

Mortality rate per 100,000 population

248.5

246.6

235.4

Stroke

Mortality rate per 100,000 population

82.1

72.0

54.3

Diabetes

Mortality rate per 100,000 population

34.3

27.4

25.4

COPD

Mortality rate per 100,000 population

38.4

46.5

43.4

Youth death rates (Ages 0-17)/100,000

100.6

79.9

Domain: Environmental Health

Indicator

Pitt County

North Carolina

United States

Lead (2004)

2.8

1.3 >1100 infants

56% tested

Have you had an illness in the past 12 months that you think was caused by outdoor air pollutants?

9.1

12.0

Have you had an illness in the past 12 months that you think was caused by poor indoor air quality?

15.0

16.4

Domain: Injury and Violence

Indicator

Pitt County

North Carolina

1999–2002

United States

2003

Motor vehicle accidents

Mortality rate per 100,000 population

19.6

19.2

15.2

Mortality

Homicide rate per 100,000 population

11.2

7.6

5.9

Suicide rate per 100,000 population(10-24 yr)

10.82

11.36

10.5

Violent Crime rate per 100,000 population (2004)

617.2

446.9

Accidents Unintentional injuries

Mortality rate per 100,000 population

40.0

42.7

36.3

Child Maltreatment substantiated

18.1

14.5

12.3

Admissions to Juvenile Justice

38.6

34.1

Domain: Economic and Education

Indicator

Pitt County

North Carolina

United States

Premature mortality rate per 100,000 population

under 75

956 years

903 years

799 years

Percent below poverty level

17.5

15.2

12.4

Percent of children below poverty level

21.8

21.9

16.9

Unemployment rate

5.2

5.0

4.7

Percent children receiving food stamps

24.9

18.2

10.6 million

(14%)

Percent children receiving free or reduced lunch

48.4

44.3

41.9

Public school dropout rate (9-12th grade)2004-5

6.95

4.86

10.3%

High School completion (%)

56

86.1

85%

Percent >25 years of age with <9th grade education

7.6

7.8

7.5

Median Household income $

33,734

46,335

50,046

Median per capita income $

18,243

26,882

32,937

Migrant and seasonal workers number

6,606 (5.4%)

155,888

(2.1%)

13 million

(4.4%)

APPENDIX 2: Healthy People 2020

What Is Healthy People?

Healthy People 2020 provides science-based, 10-year national objectives for improving the health of all Americans..For 3 decades, Healthy People has established benchmarks and monitored progress over time in order to:

· Encourage collaborations across communities and sectors.

· Empower individuals toward making informed health decisions.

· Measure the impact of prevention activities

It can be used by many different people, states, communities, professional organizations, and others to help them develop programs to improve health.

Healthy People 2020 continues in this tradition with the launch on December 2, 2010 of its ambitious, yet achievable, 10-year agenda for improving the Nation’s health. Healthy People 2020 is the result of a multiyear process that reflects input from a diverse group of individuals and organizations.

What Are the Leading Health Indicators?

Healthy People 2020 provides a comprehensive set of 10-year, national goals and objectives for improving the health of all Americans. Healthy People 2020 contains 42 topic areas with nearly 600 objectives (with others still evolving), which encompass 1,200 measures. A smaller set of Healthy People 2020 objectives, called Leading Health Indicators, has been selected to communicate high-priority health issues and actions that can be taken to address them

. The Leading Health Indicators are composed of 26 indicators organized under 12 topics. The Healthy People 2020 Leading Health Indicators are:

  1. Access to Health Services 7. Nutrition, Physical Activity, and Obesity

  1. Clinical Preventive Services 8. Oral Health

  1. Environmental Quality 9. Reproductive and Sexual Health

  1. Injury and Violence 10. Social Determinants

  1. Maternal, Infant, and Child Health 11. Substance Abuse

  1. Mental Health . 12. Tobacco

http://www.healthypeople.gov/2020/about/default.aspx

Pitt County Municipalities Data:

Municipality

Child

<5 yrs

Pop.

Persons/

square mile

White

Non-Hispanic%

African-

America%

Amer.

Indian%

Hispanic (#) %

Asian%

Ayden

282

4,622

1992

47.6

49.5

0.2

(102) 2.2

0.2

Bethel

116

1,681

1618

40.2

58.1

0.0

(13) 0.8

0.1

Falkland

11

112

<112

68.8

30.4

0.0

(11) 9.8

0.0

Farmville

252

4,302

1431

47.4

50.1

0.1

(91) 2.1

0.2

Fountain

38

533

515

49.0

50.5

0.2

(3) 0.6

0.0

Greenville

3,361

60,476

2298

61.4

34.1

(181) 0.3

(1,244) 2.1

(1,098)1.8

Grifton

122

2,073

1188

63.2

33.2

0.0

(98) 4.7

0.2

Grimesland

19

440

850

62

29.1

0.0

(39) 8.9

0.2

Simpson

32

464

1125

56

42.5

0.0

(13) 2.8

0.0

Winterville

399

4,791

1877

58.7

38.4

0.5

(49) 1.0

0.1

Total

4,603

75,624

(1573)

Pitt County

8,653

133,798

216

62.1

33.6

(357)0.3

(4,216) 3.2

(1,443)1.1

North Carolina

72.1

21.6

1.2

4.7

1.4

U.S.

75.1

12.3

0.9

12.5

3.6

Municipalities

County/State

Median

Family

Income

% < HS

Education

Families below poverty

In labor force

>16 years of age

Median travel to work

(min)

% now

married

(>15 yrs of age)

Ayden

34,808

30%

21%

53.1%

X

45%

Bethel

35,278

40%

18.5%

49.2%

25

42.5%

Falkland

43,750

40%

5.0

57.4%

18

36%

Farmville

38,918

27.4%

14.6

57.5%

18.7

44.6%

Fountain

26,042

41%

35.6

51.6%

20.4

48%

Greenville

44,491

14%

9.0

66.3%

17.9

35.9%

Grifton

40,875

27%

12.2

55.9%

23.4

58.3%

Grimesland

36,250

40%

12.3

58.3%

22.9

53.5%

Simpson

47,500

23.6%

14.2

63.6%

17

56.6%

Winterville

47,167

16.6%

10.3

71.2%

25.5

56.7%

Pitt County

43,971

20%

13.5

65.8%

X

47%

North Carolina

46,335

22%

9.0

65.7%

X

56.3

U.S.

50,046

19.6%

9.2

63.9%

25.5

54.4

http://factfinder.census.gov http://www.city-data.com/city


Disclaimer regarding interpretation of data in this Community Assessment:

Various sources of data have been used in the development of this teaching case including but not limited to vital statistics, the 2004 BRFSS survey, N.C. Communicable Disease Control Branch reports, N.C. County Health Data Book, U.S. Census American Fact Finder, N.C. Child Advocacy Institute, N.C. Child Fatality Task Force.

The data in this report is not to be relied on for actual assessment activities because of various limitations including: different time periods for data collections and a small number of events during the reported time period. These factors subject the results to chance variation. Longer time periods of data collection are required before inferences can be made. For a full discussion of the issues and up-to-date data, refer to the report of the North Carolina State Center of Health Statistics, http://www.schs.state.nc.us/SCHS/.

Resources for Community Assessment

Advocates for Youth

http://www.advocatesforyouth.org

Cecil G. Sheps Center for Health Services Research – University of North Carolina, Chapel Hill

http://www.shepscenter.unc.edu/Data.html

http://www.shepscenter.unc.edu/hp/prof04.htm

Center for Disease Control and Prevention – STD Surveillance 2004

http://www.cdc.gov/std/stats/toc2004.htm

Center for Health Services Research and Development, East Carolina University

http://www.chsrd.med.ecu.edu

CLIKS: community-Level Information for Kids

http://www.aecf.org/cgi-bin/cliks.cgi

Employment Security commission of North Carolina – Labor & Wage Unit, Labor Market Information Division

http://eslmi23.esc.state.nc.us/ew/

Environmental Defense Fund

http://www.scorecard.org/

Geographic.org

http://www.geographic.org

Guttmacher Institute

http://www.guttmacher.org/pubs/fb_teens.html

Institute of Research in Social Science at University of North Carolina, Chapel Hill

http://unc.edu/depts/irss/

Log into North Carolina (LINK)

http://data.osbm.state.nc.us/pis/linc/dyn_linc_main.show

North Carolina Child Advocacy Institute

http://www.ncchild.org

North Carolina Child Fatality Task Force

www.preventchildabusenc.org/publications/press_releases/cftf

North Carolina Communicable Disease Control

http://www.epi.state.nc.us/epi/gcdc.html

North Carolina Crime Statistics

http://sbi2.jus.state.nc.us/crp/public/default.htm

North Carolina Department of Agriculture

http://www.agr.state.nc.us/stats/

North Carolina Department of Commerce

http://www.commerce.state.nc.us

North Carolina Department of Health and Human Services – Division of Medical Assistance

http://www.dhhs.state.nc.us.dma/

North Carolina Department of Health and Human Services – HIV/STD Prevention & Care Branch

http://www.epi.state.nc.us.epi/hiv/surveillance.html

North Carolina Department of Public Instruction

http://www.dpi.state.nc.us

North Carolina Department of Transportation Public Transportation Division

http://www.dot.state.nc.us/transit/transitnet/

North Carolina Division of Public Health – Oral Health Section

http://www.communityhealth.dhhs.state.nc.us/dental/

North Carolina Division of Public Health – Women’s and Children’s Health Section

http://wch.dhhs.state.nc.us/

North Carolina Employment Security Commission

http://esc.state.nc.us

North Carolina Office of State Planning

http://www/ospi.state.nc.us

North Carolina State Bureau of Investigation

http://sbi.jus.state.nc.us

North Carolina State Center for Health Statistics (NC-SCHS)

http://www.schs.state.nc.us/SCHS/index.html

North Carolina Rural Data Bank (by county)

http://www.ncruralcenter.org/databank/profile

Public Schools of North Carolina

http://www.ncpublicschools.org/accountability/reporting/sat/2005

State of North Carolina

http://www.state.nc.us

University of North Carolina Highway Safety Research Center

http://www.hsrc.unc.edu



[*]This case study exercise adapted by Lloyd F. Novick, MD, MPH and Jorg Westermann, PhD, from Cibula, D. A, Novick, L. F., Morrow, C. B., & Sutphen, S. M. (2003). Community health assessment. American Journal of Preventive Medicine, 24(4S), 118–123.

Dot Image
Tutorials for this Question
  1. Tutorial # 00026492 Posted By: msmonopoly Posted on: 09/29/2014 01:54 AM
    Puchased By: 2
    Tutorial Preview
    The solution of Walden STAT103 week 5 application...
    Attachments
    Week5_Application_community_assessment_exercise_week_5_REVISED.doc (242 KB)

Great! We have found the solution of this question!

Whatsapp Lisa