Community Assessment Paper

CommunityHealthAssessmentTemplate_Summer2019.docx

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Fort Myers, Florida

Community Assessment 2019

Section 1: Community Identification & Features

Instructions	Use complete sentences; cite each box
1a. Geography	Location in State: complete Area in square miles: complete
1b. Topography	Elevation: complete Type of Terrain: complete Major bodies of water: complete
1c. Economic	Primary industries: complete Largest employers: complete
1d. Infrastructure	Public transportation: complete Major roads/highways: complete Airports: complete
1e. Education	Public school districts and public schools: complete Higher education institutions: complete

Section 2: Population Demographics

Instructions	Use data only, not complete sentences; all info from US Census Bureau; cite each box.
	Local	State	US
2a. Total Pop.	Pop. Estimate 2017: number	Pop. Estimate 2017: number	Pop. Estimate 2017: number
2b. Age	<5yrs: % <18yrs: % >/=65yrs: %	<5yrs: % <18yrs: % >/=65yrs: %	<5yrs: % <18yrs: % >/=65yrs: %
2c. Gender	Female: %	Female: %	Female: %
2d. Race	White: % Black: % American Indian/Alaska native: % Asian: % Native Hawaiian: % Hispanic or Latino: %	White: % Black: % American Indian/Alaska native: % Asian: % Native Hawaiian: % Hispanic or Latino: %	White: % Black: % American Indian/Alaska native: % Asian: % Native Hawaiian: % Hispanic or Latino: %
2e. Foreign born	Persons (2013-2017): %	Persons (2013-2017): %	Persons (2013-2017): %
2f. Population growth/decline	Population change 2010-2018: + or - %	Population change 2010-2018: + or - %	Population % change 2010-2018: + or -%

Section 3: Community Resources and Workforce

Healthcare Services

Instructions	Write your answers in complete sentences. You may use internet search engines to begin your search per assignment instructions.
3a. Hospitals (general not specialty)	Number in local area, general description with some details in a few short sentences.
3b. Urgent care centers (can include after hours walk in clinics or freestanding ERs)	Number in local area, general description with some details in a few short sentences.
3c. Community Health Centers (FQHCs)	Number in local area, general description with some details in a few short sentences.
3d. Mental Health Services (outpatient)	Number in local area, general description with some details in a few short sentences.
3e. Homecare Agencies	Number in local area, general description with some details in a few short sentences.
3f. Hospice Agencies	Number in local area, general description with some details in a few short sentences.

Services for Vulnerable populations

Instructions	Write your answers in complete sentences. You may use internet search engines to begin your search per assignment instructions.
3g. Agency that provides Services to elderly	Name one agency here followed by a few sentences discussing the services they provide
3h. Agency that provides Services to homeless	Name one agency here followed by a few sentences discussing the services they provide.
3i. Agency that provides Services to children	Name one agency here followed by a few sentences discussing the services they provide.
3j. Agency that provides drug treatment services	Name one agency here followed by a few sentences discussing the services they provide.
3k. Agency that provides healthcare services to uninsured/indigent	Name one agency here followed by a few sentences discussing the services they provide.

HRSA Designations

Instructions

Yes or No with complete sentences for any explanation; use HRSA website as directed in instructions.

3l. Health Provider Shortage Area (HPSA)

Yes/No and type of provider that are of shortage if

3m. Medically Underserved Area (MUA)

Yes/No

Healthcare Providers

Instructions	Data only needed as prompted.
3n. Area Name: Write Your Metropolitan/nonmetropolitan area name here Data Period: Write month/date here
3o. Physicians	Number employed: number
3p. Physician’s Assistants	Number employed: number
3q. Nurse Practitioners	Number employed: number
3r. Population to primary care physician	Ratio
3s. Population to other primary care providers	Ratio
3t. Your interpretation of HRSA and Healthcare Provider data above	Write a few sentences.

Section 4: Indicators of Health Status and Quality of Life

Mortality, Morbidity & Health Risk Factors

Instructions

Data only, not complete sentences.

Local

State

4a. Mortality: Leading Causes of Death (top 3)

List causes

Data year

List causes

Data year

List causes

Data year

4b. Mortality: Infant mortality Rate

List rate

Data year

List rate

Data year

List rate

Data year

4c. Mortality: Drug Induced Rate

List rate

Data year

List rate

Data year

List rate

Data year

4d. Morbidity: List Indicator here (choice)

List statistic

Data year

List statistic

Data year

List statistic

Data year

4e. Health Risk Factor: Adult Tobacco Use

List statistic

Data year

List statistic

Data year

List statistic

Data year

4f. Health Risk Factor: Adult Obesity

List statistic

Data year

List statistic

Data year

List statistic

Data year

Social Determinates of Health

Instructions

Data only with clear data identification; not complete sentences.

Local

State

4g. Economic: % Living in Poverty

List %

Data year

List %

Data year

List %

Data year

4h. Economic: % Unemployment Rate

List %

Data date

List %

Data date

List %

Data date

4i. Education: % with High School graduate

List %

Data year

List %

Data year

List %

Data year

4j. Education: % with bachelor’s degree

List %

Data year

List %

Data year

List %

Date year

4k. Health: % without health insurance <65yrs

List %

Data year

List %

Data year

List %

Data year

4l. Crime: Violent Crime rate

List rate

Data year

List rate

Data year

List rate

Data year

4m. Food Insecurity: % who lack adequate access to food

List %

Data year

List %

Data year

List %

Data year

Physical Determinates of Health

Instructions	Data only/complete sentences if needed for clarity.
4n. Mean MAX Annual Temperature	Degree Fahrenheit List years of data
4o. Mean MIN Annual Temperature	Degree Fahrenheit List years of data
4p. Mean ANNUAL Precipitation	Inches List years of data
4q. Air Quality	List Results (follow instruction) List dates of data
4r. Water Quality	List Results (follow instruction) List dates of data

Health People 2020 Goals and Progress complete sentences first column /data only for rest

Instructions

Complete sentences in the first column, data only for the rest. First column from HP2020 website.

Local

State

4s. Target goal 1: Write it here-goal plus target measure