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RenePowerpoint1.pptxSan Joaquin County California
Presented by: Virginia Borrell
Rosetta Norman
Taryn Pickerel
Manuel Sarte
Rene Turruviate
NURS-427VN
Professor Eva Hall
July 8, 2018
Introduction
In this presentation we will discuss substance abuse in San Joaquin County California.
Drug addiction is a problem for people in every community in the United States. From growing urban areas to beautiful suburbs to the friendly rural areas, people of all ages, genders and cultures struggle with addiction. Strong family backgrounds and socioeconomic status do not protect people from drug abuse. With more news reports about drug addiction and overdoses, it becomes clearer that drugs are a problem everywhere, even in places as idyllic as California. “San Joaquin County’s rate of drug-induced deaths is 56% higher than average rate across California (17.3 per 100,000 compared to 11.1 per 100,000)” ( San Joaquin County 2016 CHNA, 2016).
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Description of the community
San Joaquin County contains both rural and urban areas.
Multi-cultural community
Residents rate their health poorer than the state overall
Notable health disparities in health status between county and state
“San Joaquin County faces many of the same challenges seen throughout the state, but often to a greater degree” ( San Joaquin County 2016 CHNA, 2016). San Joaquin has one of the highest rates in California for diabetes mortality. Youth development tends to be undermined trauma and violence, unhealthy family functioning, and insufficient access to youth facilities. Poverty and unemployment are high compared to the state. Major concerns are often associated with family and community violence. “41.1% of community survey respondents report that drug abuse is among the most concerning health behaviors in their community” (San Joaquin County 2016 CHNA, 2016). There is a lack of safe and affordable housing. San Joaquin county ranks 9th highest in the nation for most polluted air.
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Description of the boundaries
The county is located in Northern California's Central Valley just east of the very highly populated nine-county San Francisco Bay Area region and is separated from the Bay Area by the Diablo Range of low mountains with its Altamont Pass.
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The Stockton Metro area is divided by the U.S. Census Bureau into four neighborhood clusters.
Stockton City North
Stockton City South
Tracy, Manteca, and Lathrop Cities
Lodi, Ripon, and Escalon Cities
The people
Total population is 701,050
57.8% people are white
39.7% people are Latino/Hispanic
14.6 people are Asian
7.2% people are Black
44.9% are Households with Housing Costs >30% of Total Income
41.4% abuse drugs from survey of 2,927 residents
39.5% are homeless from survey of 2,927 residents
Unemployment, poverty, and lack of education are key health drivers that can directly impact health outcomes. Specific groups noted that relationships with law enforcement officials are a barrier to feeling safe and supported in their community. Specific group participants noted that they felt that a strong sense of community vibrancy and engagement with their neighbors, and they identified diversity within their neighborhoods as a key community strength.
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The geographic
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The geopolitical boundaries
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Financial status of community
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The level of education for the community
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Ethnicity of the people in the community
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Phenomenological features
This is how people relate with each other.
They are governed by sheriffs
Initially they practiced racial antagonism which led to limitation to account publication.
Majority are less fortunate living in dilapidated housing.
Types of social interactions
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Common goals and interests
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Barriers and Challenges among the community
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Social Determinants of health
Access to Medical Care:
Without access to medical care individuals will reroute their needs of relief through alternative substances.
Education:
With lack of education individuals will partake in substance abuse or any kind of abuse that they have only been exposed to.
Violence:
Substance abuse leads to violence in most of the cases .
Youth Growth and Development:
Without proper youth growth and development adolescents tend to steer in the negative direction of substance abuse .
Access to Medical Care: Data related to health insurance , care access and preventative care. Learning how to use services , retention of coverage , and the shortage of primary care provides that will accept new patients remain challenges. The fact that the County’s many undocumented adult residents are without insurance also remains a barrier to care.
Education: Data related to educational attainment and academic success .
Violence: Data related to intended and unintended injury such as violence crime , domestic violence , gang activity among youth and child abuse. St Joaquin’s injury rates remain substantially higher that the California averages. The homicide rate is much higher than California as a whole.
Youth Growth and Development : Date related to support and outcomes affecting youth ability to develop to their full potential as adults. Unhealthy family functioning , exposure to negative institutional environments and practices. This includes disparities by race, ethnicity, gender, and sexual orientation.
Reference : San Joaquin County 2016 Community Health Needs Assessment.
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Summary of community assessment. Funding sources and Partnerships
San Joaquin County has a rich network of community –based organizations, government departments and agencies engaged in addressing many of the substance abuse problems in the county. Include the social and environmental conditions of everyday life as well as individual factors that influence our ability to make healthy choices. Offers affordable health care that focuses on both treatment and prevention . Has a healthy and safe environment, has high quality education. To promote equal opportunities for all people to be healthy and seek the highest level of health possible.
Reference :
Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.
4http://www.healthypeople.gov/2010/publications/healthycommunities2001/healthycom01hk.pdf
5 Rudolph, L., Ben-Moshe, K. & Dillon L. (2013). Health in All Policies: Guide for State and Local Governments. Washington DC and Oakland, CA: American Public Health Association and Public Health Institute.
6 http://healthequity.sfsu.edu/content/defining-health-equity
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Summary of interview
Bernadette Pua, BSN- Registered Nurse for St. Joseph’s medical Center, Stockton California of San Joaquin County.
St. Joseph’s Medical and Behavioral Health Center- Non profit facility providing medical and behavioral care for all those in need in the community
Roles: Provide inpatient and outpatient medical and behavioral treatment together with doctors, nurses, and terapists through the following:
Chemical Recovery Program,
Substance abuse Medical Detox Program,
Substance abuse Outpatient Programs
Suboxone clinic
Why do we have substance abuse in San Joaquin County?
Easy access to alcohol and drugs
Lack of family involvement
Socioeconomic status of the county
Social media and advertisements
Yellow Group Interview Questions and Answers: Bernadette Pua, BSN (San Joaquin County Nurse)
1) What different cultures do you mostly serve here in Stockton?
“We serve a community that is diverse with multiple cultures here in Stockton. I have cared for patients that are Caucasian, Hispanic, Asian, and sometimes Arabian, but most are Caucasian and Hispanic. I would say about 50% of the patients we get are Hispanic”.
2) What are your main responsibilities and roles in this community?
“I am a registered nurse at St. Joseph’s Medical Center, which also has a Behavioral Health Center department that specializes in adult and youth psychiatric and substance abuse treatment. I work in an inpatient hospital setting environment where I provide the medical needs of patients. I work with doctors, nurses, therapists and others to ensure health care is delivered to patients.”
3) What made you want to become a public health/community provider?
“I like to help those in need. Ever since I was young, I wanted to help those in need. My parents would tell me that. I love seeing families healthy and together. It makes me feel fulfilled when I get to offer help because not all can do that, especially here in Stockton. Not all are able to give a helping hand because they are already struggling on their own. So, I feel blessed that I can use the education that I have to help those in need.”
4) What are some health issues that you think are prevalent or needs health here in Stockton or San Joaquin County?
“Here in the center we get all kinds of patients with different diagnoses. Aside from the normal heart and lung diseases, I think the main health issues are drug and alcohol use and homelessness.”
(B. Pua, personal communication, July 03, 2018)
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Substance abuse issue in San Joaquin County
Substance abuse, including abuse of tobacco, alcohol, prescription drugs, and illegal drugs, can have profound health consequences, including increased risk of liver disease, cancer, and death from overdose.
Primary data collection from surveys, focus group discussions and interviews highlighted the importance of this issue for the county
41.1% of community survey respondents report that drug abuse is among the most concerning health behaviors in their community.
39.6 % report that alcohol abuse is among the most concerning health behaviors in their community
Drug induced deaths is 56% higher than average rate across California.
17.3 per 100,000 compared to 11.1 per 100,000
5) What is the PRIMARY health concern in this county?
“I would say substance abuse and homeless population but more substance abusers. Substance abuse can lead to being homeless, so I would say substance abuse.”
6) What is the primary health concern in San Joaquin County regarding substance abuse?
“Aside from the mental and physiological aspect of using drugs and alcohol, like liver disease, depression and addiction, I would say the primary health concern are injuries, mortality rates, and accidents caused by substance abuse. I get patients who are involved in motor vehicle accidents from DUIs. I also get patients who get into serious fights and gunshot wounds from dealing with addicts. Some just get drunk, pass out on the road, and police send them here in the center.
So, I think the primary health concern is injuries from being drunk or high and what it can do to other people. I am not sure about statistics, but it seems like I get at least one patient who is under the influence every time I work.”
(B. Pua, personal communication, July 03, 2018)
(San Joaquin County 2016 Community Health Needs Assessment, p.50)
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Community Teaching Work Plan Proposal
Nursing Diagnosis for San Joaquin
Risk for injury related to substance abuse as evidenced by drug induced deaths of 56% higher than average rate across California
Intervention
Increase youth awareness through starting support groups in school for those influenced by drug/alcohol abuse
Increase in-patient drug rehabilitation facilities
Create quality rehab programs
Organize resources to improve awareness of options and access.
Implement culturally relative injury prevention programs.
Nursing Diagnosis for San Joaquin
Ineffective Health Maintenance related to substance abuse as evidenced as evidence by 15.5% of population drinking alcohol excessively
Interventions:
Reduce liquor stores
Increase tax on alcohol and cigarettes
Limit alcohol sales
Conduct community centers
Provide education about health implications
7) What is being done to address the concern of substance abuse?
“St. Joseph’s Medical Center which also has a Behavioral Health Center department specializes in adult and youth psychiatric and substance abuse treatment. We provide programs like the Chemical Recovery Program, Substance Abuse Medical Detox Program, Substance Abuse Outpatient Program, and a Suboxone Clinic. They also provide behavioral evaluations in terms of mental health. Some patients I care for in the medical hospital have come from the Behavioral Health Center. We care for them through behavioral therapy, 12 step programs, and support groups.”
8) Can you explain what the 12 steps program are?
“Well, the 12- steps are spiritual principles that can help abusers not obsess about drinking, and by following these steps, they will become happier with themselves and with their life. The traditions are more of a fellowship, in which the person’s common welfare comes before everything else.”
9) What barriers exist for your role in the community?
“I would say budget and language are barriers in the community. Since we are a non-profit facility, we depend on community partnership and volunteers for help. In the medical department, I think the language barrier is one. We predominantly admit Hispanics and Asians who do not speak English at all. We try our best in using translators, but there is still slight confusion at times. In terms of Behavioral Health, I have heard from some of my patients that teenagers get alcohol from older adults outside liquor stores. So, I think the cooperation of the public is another barrier.”
10) What are some common goals and interests of the community?
“I think the common goal is to promote good health to all residents of San Joaquin County and to promote soberness to all who are affected by drugs or alcohol here. Another goal is to reduce the homeless population of course.”
11a) What are some challenges that you have found the people of the community may face…. in attempts to meet the goal?
“I say financial assistance from the government when talking about homelessness. I mean Stockton is one of the poorest communities in California. Some residents depend on pensions alone. I mean if you drive around here you will not see buildings with lights on, you will see buildings that are empty.”
11b) …. In terms of substance abuse?
“I think we need more treatment facilities like what we have here in the center. We need youth programs that can positively influence the youth.”
12) What projects and/or resources are available to assist with this goal?
“Here in the center we have chemical recovery programs, free mental health screenings, outpatient and inpatient programs, detox programs and a suboxone clinic. We also have the San Joaquin County Behavioral Health Services here in San Joaquin. They also offer Chemical Dependency Counseling Centers, Recovery Houses and Family Ties (a treatment program for pregnant ones).”
She handed me flyers of the available programs here in San Joaquin County
Behavioral Health Services Substance Abuse Services Administration 620 Aurora Street Suite #1 Stockton, CA 95202 (209) 468-3800 Fax: (209) 468-3723
Substance Abuse Services Central Intake 620 N. Aurora Street, Suite #6 Stockton , CA 95202 (209)468-9600
ADAP (Alernative Drug and Alcohol program)
620 N. Aurora St, Suite 3 Stockton, CA 95202 (209) 468-6840
Drug Diversion (Deferred Entry of Judgement) Program
620 N. Aurora St, Suite 3 Stockton, CA 95202 (209) 468-3720
Drug Court Case Management and Treatment Services
620 N. Aurora St, Suite 3 Stockton, CA 95204 (209) 468-3720
https://www.dignityhealth.org/central-california/locations/stjosephsbehavioral
St. Joseph's Behavioral Health Center | Central California Hospitals. (n.d.). Retrieved July 4, 2018, from https://www.dignityhealth.org/central-california/locations/stjosephsbehavioral
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Conclusion with key findings
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Conclusion with discussion of your impressions of the general health of the community
Stockton is a city in San Joaquin County California. This community requires a safe and violent free atmosphere. Substance abuse which include alcohol, drug and tobacco abuse as well as homelessness seem to be the main issues surrounding the city and county. According to San Joaquin County 2016 Health Needs Assessment, 41.1% of community survey respondents report that drug abuse and 23.3% report that drunk driving are among the most concerning health in the community. The county assessment also indicated excessive liquor stores and drugs readily available especially for youth. This leads to the county having 56% higher than other places in California in regards to drug induced deaths. Most importantly, this issues threatens not only the health of the abusers but also other members of the community. With this problem, the community has set forth behavioral services such as Chemical dependency Counseling Center, Family Ties, Recovery House, Manteca Healthy Connections, Medmark Treatment Center, Healthy Connections Lodi Clinic, Alternative Drug and Alcohol Program and etc. Both San Joaquin Behavioral Health and St. Joseph’s Medical and Behavioral Health Center also offer programs to assist reduce substance abuse.
Chemical Dependency Counseling Center (CDCC)
620 N. Aurora Street, Suite #1 Stockton, CA 95202 (209)468-3720 Fax: (209)468-8640
Family Ties
500 W. Hospital Road French Camp, CA 95231 (209)468-6208 Fax: (209)468-7032
Recovery House
500 W. Hospital Road French Camp, CA 95231 (209)468-6857 Fax: (209)468-6739
MedMark Treatment Center
1111 N. El Dorado St. Stockton, CA 95202 (209)938-0228
Healthy Connections Lodi Clinic
441 South Ham Lane, Suite A Lodi, CA 95242 (209)224-8490
Manteca Healthy Connections
955 W. Center St., Suites 12A & 14 Manteca, CA 95337 (209)239-9600
5th Street Medical Clinic Stockton
1839 S. El Dorado St. Stockton, CA 95206 (209)463-0872
http://www.sjcphs.org/sitesearch.aspx?SearchText=substance+abuse&Search=Search
BHS Staff on 8/28/15, & Former Behavioral Health Services Director, Vic Singh on 8/28/15. (n.d.). Retrieved July 4, 2018, from https://www.sjcbhs.org/
Program Locations. (n.d.). Retrieved July 4, 2018, from https://www.sjcbhs.org/Program_Locations.aspx
St. Joseph's Behavioral Health Center | Central California Hospitals. (n.d.). Retrieved July 4, 2018, from https://www.dignityhealth.org/central-california/locations/stjosephsbehavioral
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References
San Joaquin County 2016 CHNA. (2016). San Joaquin County 2016 Community Health Needs Assessment. Retrieved from https://healthiersanjoaquin.org/pdfs/2016/2016%20CHNA%20full%20document%20-%20narrative%20and%20health%20profiles.pdf
