DUE 5/24/2021...ASSIGNMENT 2 OF 4....PLEASE READ AND FOLLOW DIRECTIONS CAREFULLY. NO PLAIGARISM!!!

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Direct Care Project Part 1 Substance Use Assessment and Diagnosis Template

Directions: Collect the data outlined in this template. Fill in the blanks in the tables provided. There are two parts - online data collection and a modified windshield survey data collection. You will then identify a nursing problem in a vulnerable population and write a nursing diagnosis. See the assignment directions for suggestions and best practices. For full credit, all information in a category must be completed. This will be the topic of your Assessment and Nursing Diagnosis Template and also Parts 2 through 4 of your course project.

Name: Laquana Brown Date: May 15, 2021

Online Data Collection

1. Community Information

Your Community Data

Name of city or town and state Brooklyn, New York

Population 2,559,903

Nature of this community (rural, suburban, urban)

Urban

Describe your community in 2-3 sentences

Brooklyn, also called Kings County, is one of the best places to live in New York City as it provides the urban feel with many restaurants, bars, parks and coffee shops. It is the home of about 200 languages, and about 40% of its 2,559,903 population are foreign, making the community one of the most culturally diverse and as a shining example of multi-culturalism in the US.

2. Community Demographics a. Go to https://www.census.gov/quickfacts/fact/table/US/PST045218

i. The US data should automatically populate ii. Input your zip code or county/township name iii. Then input your state for comparison data iv. Enter the data into the table below v. Compare the county, state, and US data

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County Data State Data U.S. Data Population total 2,559,903 8,336,817 328,239,523 Male (subtract female % from 100)

47.4% 47.7% 49.2%

Female 52.6% 52.3% 50.8% Persons under 5 7.1% 6.5% 6.0% Persons over 65 14.4% 14.5% 16.5%

Race and origin data County Data State Data U.S. Data

White alone 49.8% 42.7% 76.3% Black or African American alone 33.8% 24.3% 13.4%

American Indian and Alaska Native alone 0.9% 0.4% 1.3%

Asian alone 12.7% 14.1% 5.9% Native Hawaiian and other Pacific Islander alone

0.1% 0.1% 0.2%

Two or more races 2.7% 3.6% 2.8% Hispanic or Latino 18.9% 29.1% 18.5% White alone, not Hispanic or Latino 36.8% 32.1% 60.1%

Significant population characteristics County Data State Data U.S. Data

Veterans 37,191 150,924 18,230,322 Foreign born persons 36.1% 36.8% 13.6%

Housing overview County Data State Data U.S. Data

Housing units 1,065,399 x 139,684,244 Owner-occupied housing unit rate 30.1% 32.7% 64.0%

Median selected monthly owner costs with a mortgage

$2,903 $2,730 $1,595

Median selected monthly owner costs without a mortgage

$909 $903 $500

Median value of owner-occupied housing units

$706,000 $606,000 $217,500

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Median gross rent $1,426 $1,443 $1,062 Family and living arrangements

County Data State Data U.S. Data Households 958,567 3,167,034 120,756,048 Persons per household 2.66 2.60 2.62

Living in same house 1 year ago 90.5% 90.0% 85.8%

Language other than English spoken at home

45.0% 48.5% 21.6%

Computer and Internet Use County Data State Data U.S. Data

Households with a computer 87.5% 89.1% 90.3%

Households with broadband internet subscription

80.0% 81.5% 82.7%

Education County Data State Data U.S. Data

High school graduate or higher 82.4% 82.2% 88.0%

Bachelor’s degree or higher 37.5% 38.1% 32.1%

Health County Data State Data U.S. Data

With a disability under age 65 years 5.8% 6.8% 8.6%

Persons without health insurance under age 65 years

7.8% 8.6% 9.5%

Economy County Data State Data U.S. Data

Civilian labor workforce ages 16+ 63.6% 63.6% 63.0%

Transportation-mean travel time to work (minutes)

43.0 41.5 26.9

Income and poverty County Data State Data U.S. Data

Median household income $60,231 $63,998 $62,843

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Persons in poverty 17.7% 17.9% 10.5%

3. Community Epidemiological Data a. Go to: https://www.countyhealthrankings.org/ b. Click on your state

i. Start with Overall Rankings in Health Outcomes ii. Then choose your county

**you will need to use the “+” to see all of the data**

County Data State Data Health Outcome Rank N/A N/A Length of life rank N/A N/A Premature death 5,100 5,400 Low birth weight 8% 8% Adult smoking 15% 13% Adult obesity 24% 26% Physical inactivity 24% 23% Excessive drinking 18% 19% Alcohol impaired deaths 11% 21% STIs 817.6 602.4 Teen births 16 14 Drug overdose deaths N/A N/A Uninsured 8% 6% Unemployment 4.1% 4.0% Children in poverty 25% 18% Violent crime 586 379 Air pollution 7.9 6.6 Drinker water violations No N/A Long commutes 61% 39%

4. Substance Use a. Go to: https://www.samhsa.gov/data/report/behavioral-health-barometer-

state-barometers-volume-6?page=0 i. Find your state and download the report. ii. Review the report and document the following:

1. Go to Substance Use, Misuse, and Use disorders section. This will be the area that discusses those 12 and older (near end of report).

iii. Find the following percentages:

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State Average Regional Average National Average

Tobacco use 23.5% 23.2% 26.8% Marijuana 16.2% 15.0% 16.2% Marijuana use disorder

1.8% 1.6% 1.6%

Heroin use 0.20% 0.31% 0.30% Misuse of prescription pain reliever

2.8% 2.9% 3.7%

Opioid use disorder

0.5% 0.6% 0.7%

Illicit drug use disorder

2.8% 2.7% 2.9%

Alcohol use disorder

5.2% 4.9% 5.3%

Substance use disorder

7.1% 6.8% 7.4%

Windshield Survey It is recommended that you have someone drive you around your community at least 2 times, ideally at different times of day and weekend vs. weekday.

Look at the people in your community.

Did you observe:

No Yes If Yes, provide

number or state “many”

“some” or “few”

 *pregnant women Yes Few  *pregnant adolescents Yes Few  *infants (under the age of 1 year old) No  *young children (1-5 years old) Yes Few  *school-age children (6-18 years old) Yes Many  adults (18 – 60 years old) Yes Many  *older adults (over the age of 60 years old) Yes Few  people exercising Yes Few  people driving Yes Many  people walking Yes Many  people biking Yes Few  people congregating in groups on the street Yes Many

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 *people that had hygiene issues or were unkempt Yes Few  people that were appropriately dressed Yes Many  people that were physically fit Yes Many  people that were obese Yes Few  *people that were undernourished, thin No  people that appear healthy Yes Many  *people that have obvious physical disabilities,

such as those using walkers or wheelchairs Yes Few

 *people with apparent mental/emotional disabilities

Yes Few

 *people who appeared homeless or unemployed Yes Few *Represents vulnerable populations

Social and Economic Conditions

Did you observe:

No Yes If Yes, provide number or

state “many” “some” or

“few”  housing that was run down or dilapidated No  areas undergoing renewal Yes Few  public housing Yes Many  public transit (subway, train, buses, taxis, etc) Yes Many  transportation to health care resources Yes Few  landfills No  restaurants Yes Many  any political signs Yes Few  any evidence of health education on billboards,

advertisements, or signs Yes Many

 any efforts to improve the neighborhood’s health such as advertisements for health-related events, health fares, clinics, or lectures

Yes Many

 any group efforts in the neighborhood to improve the living conditions or the neighborhood

Yes Few

 churches, synagogues, and other places of worship

Yes Many

Health Resources

Did you observe:

No Yes If Yes, provide number or

state “many” “some” or

“few”  hospitals Yes Many  community clinics Yes Many

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 family planning clinics Yes Few  generalist doctors Yes Few  dentist offices Yes Few  pharmacies Yes Many  urgent care clinics No  skilled nursing facilities Yes Many  mental health or counselling clinics Yes Few  homeless or abuse shelters No  public health department office Yes Few  substance abuse treatment center Yes Few  alternative medicine practices, botanicals, or

herbal medicine shops No

Answer the following question:

If some of the above health resources were not observed, approximately how far away would a person need to travel to find these resources? One would have to visit the neighboring towns to find abuse or homeless shelters about 10 Kilometers away. Herbal medicine shops could be available a few Kilometers away, like three or so. Urgent care clinics are available in neighboring town, which is 2 Kilometers away.

Environmental Conditions

Did you observe:

No Yes If Yes, provide number or

state “many” “some” or

“few”  evidence of anything that might make you

suspicious of ground, water, or air pollutants Yes Few

 poor road conditions with potholes, or poor drainage

No

 adequate traffic lights, signs, sidewalks, and curbs Yes Many  railroad crossings fitted with warnings and barriers Yes Few  streets and parking lots well lit Yes Many  handicapped access to buildings, sidewalks, and

streets Yes Many

 recreational facilities, playgrounds, and/or facilities like the YMCA

Yes Many

 children playing in the streets, alleys, yards, or parks

Yes Many

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 evidence of nuisances such as ants, flies, mosquitoes, or rodents, or stray animals observed

No

Problem Identification: Marijuana use

Vulnerable Population Identification: Adolescents, especially those aged 12 years and above

Nursing Diagnosis: Increased risk of Marijuana use among adolescents is related to low number of graduates and larger portion of persons in poverty compared to national data as demonstrated in the community data from above.

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References

Substance Abuse and Mental Health Services Administration (SAMHSA). (2020). Behavioral health barometer, volume 6. https://www.samhsa.gov/data/report/behavioral-health-barometer-state- barometers-volume-6?page=0

County Health Rankings and Roadmaps. (2018). Explore rankings. http://www.countyhealthrankings.org/

U.S. Census Bureau. (2018). State and county QuickFacts. https://www.census.gov/quickfacts/