Public Health Nursing

A community’s state of health depends on various factors including social, economical and behavior aspects. This paper evaluates the community of Goulds, Florida. This rural area has poor housing conditions, limited employment opportunities and a small proportion of elderly population, so a research on the ways that these factors have affected the health of inhabitants poses interest. The main purpose of the paper is to determine the primary health problem and the factors that have influence them.

Community Overview

The community under consideration is Goulds, Florida. It is a rural area with much land used for farming. Farmers grow primarily strawberries and ornamental plants. Most of population lives in small houses, which are less than two floors high. The housing conditions far from perfect, which is expected because the inhabitants have primarily low and average incomes. The most prevalent races are African American and white. The community does not provide many employment opportunities. However, there are quite a lot of small businesses, so it is possible to find a job here. Inhabitants do not have many opportunities for entertainment, so people normally spend their free time outside. In general, the community is quiet, small and one that has limited resources.

Demographic Data

According to U.S. Census Bureau (2010), the population of the community is 11,210 inhabitants and women make up 52.1% of the population. The survey also found that the average age the local population is 33.6 years and the proportion of individuals over 85 is insignificant. Another important finding of the Bureau is that Goulds has more African Americans (54.5%) than whites (37.1%). Goulds has 3,302 housing units, which are usually either owned (1,511) or rented (1,476) (U.S. Census Bureau, 2010). Therefore, the majority of the local people live in their own houses.

The community is located in Florida but its demographic characteristics differ from the state profile. Thus, U.S. Census Bureau (2010) found that the state has much more whites (approximately 14 million people) than Afro Americans (nearly 3 million people). The study also revealed that Florida has generally older population than Goulds. According U.S. Census Bureau (2010), more than half of population is over the 35-49 age group. On the other hand, the Bureau reported that most of Florida’s inhabitants are women and the majority of the state’s population lives in owned households. Therefore, the main differences between the profiles of the community and state are that there is a greater amount of Afro Americans in Goulds and that it has a population of younger age.

Epidemiological Data

The community has one of the highest mortality rates in the county. Gould’s average rate was 74.21 deaths per 100,000 people in 2010-2012 (Florida Department of Health, 2012).

The state department of health also found that the most common causes of death were heart diseases and cancer. The most prevalent diseases are sexually transmitted diseases (STDs), HIV and AIDS (Florida Department of Health, 2013). These diseases are particularly typical for people in the age group of 15-54.

Epidemiological data of the community is similar to that of the state. In particular, reports identify that individuals in Florida also suffer from STDs, HIV and AIDs and the primary causes of death are cancer and heart diseases as well (Florida Department of Health, 2013). However, the mortality rate in Florida is lower than in the community. Moreover, the average rate in the county in which Goulds is located is only 43.39 per 100,000 people (Florida Department of Health, 2012).

Windshield Survey

Goulds is a rural area, and the local culture may place cause discomfort for the inhabitants when discussing sex-related topics. The majority of the community is African Americans. During the survey, there have been some pregnant teenagers. Some of people smoked. Both women and men looked unkempt; particularly men were not wearing shirts. Houses were quite small and, generally, in a bad condition, which indicated that the level of poverty in the community might be quite high. The nearest hospital, Homestead Hospital is which 7.8 miles away is. Majority of the population does not have cars, so it must be difficult for the community members to get to the hospital. The survey identifying that there were also two free clinics and three WIC centers that help out pregnant women and their children until they are five yeas old. However, these clinics have only one Advanced Registered Nurse Practitioner (ARNP). The rest of the specialists are licensed practical nurses (LPNs). All these health centers are popular among the inhabitants, so they were quite crowded. Besides, there was a birthing center for women with low income. The community does not make much effort to enhance the health of the neighborhood. Particularly, there were no health-related advertisements, even on public places such as bus stops. There were also no YMCA or community centers. The streets were generally clean but there have been a lot of stray dogs and cats. Young adults were walking in groups, which could indicate that they felt unsafe.

Problem Diagnosis

The primary health problem of the community is STDs. According to HealthyPeople.gov (n.d.), there are ten major objectives related to this health issue, including a reduction in the proportion of youth with Chlamydia infections and an increase in the number of women (aged 16-24 years) screened for genital Chlamydia infections. Besides, HealthPeople.gov (n.d.) plans to reduce the gonorrhea rates of occurrence among people aged 15-44 years as well as decrease domestic transmission of syphilis, the proportion of women with human papillomavirus and the proportion of young adults with genital herpes.

Goulds has a high rate of STDs due to a range of diverse reasons. First, the community has quite a high level of poverty, so people cannot always afford to purchase condoms for having safe sex. Second, the local youth could lack the needed knowledge about STDs because there are not any advertisements about these issues on the streets. Finally, the community also has limited healthcare resources and scarce access to them, so individuals could have difficulties with having regular screenings for STDs and further treatment.

Overall, five major factors contribute to the problem in the community. First of all, the demographic factors make a significant contribution to the problem. People usually have higher rates of STDs due to poverty, limited access to health care and a smaller desire to receive to treatment (Harling et al., 2013). Second, high level of poverty resulted in high-risk behavior of people. Third, limited health resources in the community made it difficult to reduce the proportion of individuals with STD, especially in relation to teenagers, who neglect health issues more often (Harling et al., 2013).

Fourth, substance abuse could be one of the reasons as well. The survey did not find that people drink alcohol or take drugs but some of teenagers and young adults smoked. Therefore, they could have other unhealthy habits, which increase the risk of having unprotected sex (Yan et al., 2007). In addition, Goulds is a rural area, so people could feel uncomfortable discussing sex-related topics due to the local culture, so adolescents might not have enough knowledge about STDs (Yan et al., 2007).

Summary

Goulds is a rural area with high poverty level and restricted health resources, so some people cannot afford to have regular screenings and proper treatment of STDs. Besides, inhabitants of rural areas avoid talking on intimate themes, so youth probably does not realize the dangers of unprotected sex and STDs. During the survey, there have been some pregnant teenagers and young parents, which indicates that local people tend to engage in unprotected sexual activities. However, STDs is not only the problem of Goulds. This health issue is common for the whole state. HealthyPoeple.gov recommends to focus on reducing the proportion of people with Chlamydia infections, gonorrhea, genital herpes, syphilis and human papillomavirus.

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