Running head: WINDSHIELD SURVEY 1
Windshield Survey
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Community Health Assessment / Windshield Survey
Community Assessment
A community health assessment (sometimes called a CHA), also known as community
health needs assessment (sometimes called a CHNA), refers to a state, tribal, local, or
territorial health assessment that identifies key health needs and issues through
systematic, comprehensive data collection and analysis. Community health
assessments use such principles as
Multisector collaborations that support shared ownership of all phases of community
health improvement, including assessment, planning, investment, implementation, and
evaluation
Proactive, broad, and diverse community engagement to improve results
A definition of community that encompasses both a significant enough area to allow for
population-wide interventions and measurable results, and includes a targeted focus to
address disparities among subpopulations
Maximum transparency to improve community engagement and accountability
Use of evidence-based interventions and encouragement of innovative practices with a
thorough evaluation
Evaluation to inform a continuous improvement process
Use of the highest quality data pooled from and shared among, diverse public and
private sources
'''''''''''(Retrieved from'https://www.cdc.gov/publichealthgateway/cha/plan.html)
Windshield Survey:
"A' windshield survey is an informal method used by community health nurses to'obtain
basic knowledge about a given community. It provides a subjective view of the
various physical characteristics of a communal area as observed while driving or
walking through a neighborhood.
."(Retrieved from;'
mynursingprofessionalportfolio.weebly.com/uploads/8/9/3/3/8933086/
windshieldsurvey.docx)."
As stated in the syllabus please present your assignment in an APA format word
document,'Arial'12 font attached to the forum in the discussion board title' "Week 1
discussion questions".' A minimum of 2 evidence-based references is required (not
counting the class textbook) no older than 5 years. A minimum of 1000 words are
required.' Make sure the assessment is based in the community where you live.' I don't
want community health assessment from other communities, once again it must be from
the community you live.' Please mention the zip code of your community on the first
page of the assignment.
Please follow the instructions given in the syllabus''Discussion Question (DQ)
Participation Guidelines" and "Discussion Question (DQ) Submission
Guidelines.&&
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Respectfully;
Prof. Cruz
Windshield Survey
Community assessment is crucial to planning, implementation, and evaluation of programs to
improve the health of a population. A windshield survey is an informal method used by
community health nurses to obtain basic knowledge about a given community. It provides a
subjective view of the various physical characteristics of a communal area as observed while
driving or walking through a neighborhood.
A windshield survey is a valuable tool used by community health nurses to gather information
about a community. It involves observing and documenting the physical and environmental
features of a particular area while driving or walking through it. The purpose of a windshield
survey is to gain a general understanding of the community's health status, strengths, and areas
for improvement.
During a windshield survey, community health nurses typically pay attention to various aspects
of the community, such as:
Housing: They observe the types of housing available, their conditions, and the presence of any
environmental hazards.
Transportation: They note the availability and condition of public transportation, sidewalks, and
bike lanes.
Safety: They observe the overall safety of the community, including the presence of crime,
lighting, and the condition of parks and recreational areas.
Services: They look for the presence of healthcare facilities, schools, community centers, and
other social services.
Socioeconomic factors: They observe the economic status of the community, including the
presence of businesses, employment opportunities, and signs of poverty or affluence.
Demographics: They note the population's age distribution, cultural diversity, and any specific
demographic factors that may influence health.
By conducting a windshield survey, community health nurses can gather valuable information
that helps them identify community health needs and develop appropriate interventions. It
provides a starting point for planning, implementing, and evaluating health programs or
interventions to improve the overall health and well-being of the community.
Here are a few additional points to consider regarding a windshield survey:
Physical environment: Community health nurses observe the overall cleanliness, aesthetics, and
maintenance of the community. They may note the presence of litter, graffiti, abandoned
buildings, or any other factors that may impact the physical environment.
Social environment: Nurses also pay attention to the social dynamics of the community. They
may observe the presence of social groups, community organizations, or any signs of social
cohesion or disconnection.
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Accessibility: They assess the accessibility of essential services within the community, such as
grocery stores, pharmacies, and healthcare facilities. They note the distance residents may have
to travel to access these services.
Resources: Nurses look for the availability of resources that contribute to community health,
such as parks, playgrounds, recreational areas, and green spaces. They assess the quality and
maintenance of these resources.
Community assets: They identify community strengths and assets, such as active neighborhood
associations, volunteer organizations, or cultural centers. These assets can serve as a foundation
for community health initiatives.
Health indicators: While not directly observable during a windshield survey, nurses may gather
information about health indicators by observing factors such as the prevalence of tobacco or
alcohol advertisements, fast-food restaurants, or the general physical appearance of community
members.
It's important to note that a windshield survey provides a preliminary and subjective view of a
community. It helps community health nurses gather initial data and develop an understanding of
the community's unique characteristics. To obtain more comprehensive and accurate information,
additional assessments, such as community interviews, surveys, or focus groups, may be
conducted. These methods can provide more in-depth insights into the community's health needs
and priorities.
Here are a few more points to consider:
Cultural considerations: During a windshield survey, community health nurses may also note the
cultural diversity of the community. They observe the presence of cultural establishments, places
of worship, and signs of cultural celebrations or events. Understanding the community's cultural
background and beliefs is essential for providing culturally sensitive healthcare.
Social determinants of health: Community health nurses consider the social determinants of
health during a windshield survey. These determinants include factors like income, education,
employment, and social support networks. They observe signs of socioeconomic disparities or
social inequalities that may impact the health of community members.
Environmental health hazards: Nurses pay attention to any environmental health hazards present
in the community. This may include observing the proximity of industrial facilities, waste
disposal sites, or any other sources of potential pollution or contamination.
Community engagement: During a windshield survey, nurses may also observe the level of
community engagement and participation in local initiatives. They note the presence of
community events, meetings, or active involvement in addressing community issues.
Observations of public health practices: Nurses may observe the presence of public health
initiatives or practices within the community. This could include the availability of vaccination
clinics, health promotion campaigns, or signage promoting healthy behaviors.
Emergency preparedness: They may also take note of the community's emergency preparedness
measures, such as the presence of emergency shelters, evacuation routes, or disaster response
plans.
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By gathering all of this information, community health nurses can develop a comprehensive
picture of the community's health status, needs, and resources. This understanding helps in
developing targeted interventions and programs that address the specific health challenges faced
by the community. It also assists in fostering partnerships with community members,
organizations, and stakeholders to promote health and well-being collectively.
Community
Community refers to a group of individuals living in close proximity and sharing common
interests, characteristics, or goals. It can be defined in various ways, including geographical
boundaries (such as a neighborhood or town), cultural or ethnic identities, or communities of
interest (such as an online community or a group with a specific hobby or profession).
Communities play a crucial role in shaping individuals' lives and well-being. They provide social
support, a sense of belonging, and opportunities for collaboration and collective action.
Community interactions and relationships can influence various aspects of people's lives,
including their physical and mental health, access to resources, and overall quality of life.
Community health is a branch of public health that focuses on improving the health and well-
being of a specific community. It involves understanding the unique needs, strengths, and
challenges of the community and implementing interventions to promote health and prevent
disease. Community health efforts often involve collaboration among healthcare professionals,
community organizations, local government, and community members themselves.
In the context of community assessment, as discussed earlier, community health nurses and other
healthcare professionals use various methods, including windshield surveys, to gather
information about a community's characteristics, resources, and health needs. This information is
then used to develop and implement targeted programs and interventions that address the specific
health concerns of the community.
Overall, communities are vital in promoting health, fostering social connections, and creating
environments that support well-being. By understanding and actively engaging with
communities, healthcare professionals can make a significant impact on population health and
contribute to creating healthier and more resilient communities.
Here are some additional points about communities:
Community empowerment: Empowering communities is an important aspect of community
health. It involves engaging community members in decision-making processes, fostering their
leadership skills, and supporting them in taking ownership of their health and well-being.
Empowered communities are better equipped to address their health concerns and advocate for
necessary changes.
Social support networks: Communities often provide social support networks that can have a
positive impact on individual and community health. These networks can include friends, family,
neighbors, community organizations, and other formal or informal support systems. Strong social
connections contribute to emotional well-being and resilience in the face of challenges.
Community resilience: Resilience refers to a community's ability to adapt, bounce back, and
recover from adversity or disasters. Resilient communities have strong social networks, effective
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communication channels, and access to resources. Community health efforts often focus on
building resilience to ensure communities can withstand and recover from health crises or other
emergencies.
Health disparities: Communities may experience health disparities, which are differences in
health outcomes between different population groups. Factors such as socioeconomic status,
race/ethnicity, education, and access to healthcare can contribute to these disparities. Community
health initiatives strive to address these disparities and promote health equity by ensuring equal
access to healthcare and addressing the underlying social determinants of health.
Community-based interventions: Community health efforts often involve community-based
interventions that are tailored to the specific needs of the community. These interventions may
include health education programs, preventive screenings, access to healthcare services,
community gardens, physical activity initiatives, or policy advocacy.
Collaboration and partnerships: Successful community health initiatives rely on collaboration
and partnerships between healthcare professionals, community organizations, government
agencies, and other stakeholders. By working together, these entities can leverage their unique
strengths, resources, and expertise to maximize the impact of interventions and create sustainable
change.
Evaluation and continuous improvement: Community health initiatives should undergo
evaluation to assess their effectiveness and identify areas for improvement. This feedback loop
allows for adjustments to be made and ensures that interventions are evidence-based and
responsive to the evolving needs of the community.
By understanding the complexities and dynamics of communities, healthcare professionals can
implement meaningful and sustainable interventions that improve the overall health and well-
being of community members.
Certainly! Here are a few more points to consider:
Community engagement: Community engagement is a vital component of community health. It
involves actively involving community members in the planning, implementation, and evaluation
of health initiatives. By engaging the community, healthcare professionals can gain valuable
insights, build trust, and foster a sense of ownership and responsibility among community
members.
Cultural competence: Cultural competence is essential when working with diverse communities.
Healthcare professionals need to understand and respect the cultural beliefs, values, and practices
of the community they serve. This ensures that interventions are culturally sensitive and effective
in addressing the unique needs and preferences of community members.
Health promotion and disease prevention: Community health efforts focus not only on
addressing existing health issues but also on promoting overall health and preventing diseases.
Health promotion activities may include education campaigns, healthy lifestyle initiatives,
screenings, and immunization programs.
Advocacy: Community health nurses and other healthcare professionals often serve as advocates
for the health needs of the community. They may collaborate with policymakers, community
leaders, and organizations to raise awareness, influence policies, and secure resources to address
community health issues.
Sustainability: Sustainable community health initiatives aim to create long-lasting improvements
in health outcomes. This involves considering the long-term viability of interventions, building
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local capacity, and addressing the social, economic, and environmental factors that impact
health.
Data-driven decision-making: Community health assessments rely on collecting and analyzing
data to inform decision-making. Healthcare professionals use various sources of data, including
health records, surveys, and community input, to identify priorities, monitor progress, and
evaluate the impact of interventions.
Ethical considerations: Community health interventions must adhere to ethical principles, such as
respect for autonomy, confidentiality, and beneficence. It is important to ensure that
interventions are conducted with the informed consent of participants and that their privacy and
rights are protected.
Health literacy: Community health initiatives often aim to improve health literacy, which refers
to the ability of individuals to access, understand, and utilize health information to make
informed decisions. Health literacy programs and resources help empower community members
to take control of their health and make informed choices.
Health education and empowerment: Community health initiatives emphasize health education
and empowerment to enable individuals to make positive changes in their health behaviors. By
providing knowledge, skills, and resources, healthcare professionals support individuals in taking
an active role in managing their health.
These points highlight the multifaceted nature of community health and the range of
considerations that healthcare professionals take into account when working with communities.
By addressing the unique needs, strengths, and challenges of each community, community health
initiatives can have a meaningful and lasting impact on population health.
Community assessment is an essential function of community nursing. Understanding the
various types of community will help clarify the process. The first type of community described
is a “geopolitical community” (Harkness & DeMarco, 2012, p. 177). It is an aggregate of people
living or working in a defined geographic area. The second is “phenomenological community”
(Harkness & DeMarco, 2012, p. 177), which is a collection of people sharing common interests,
or philosophies and inter/intra personal connections. Borders for this type of community are not
as clear as a geopolitical community. A phenomenological community can exist within a
geopolitical community. An example of this is the homeless. The third is a broader view,
encompassing a society, a nation, or the international community of the world as we know it.
Community Health
Community health is usually focused on a specific geographic region. In this way, specific
epidemiological data can be obtained, and a precise community “report card” (Harkness &
DeMarco, 2012, p. 181) can be created. From there specific interventions, including measurable
goals can be planned to address specific risks identified in the community.
Community as client
"Community as client" is a concept often used in the field of nursing and community health to
shift the focus of care from individual patients to the entire community as a whole. It recognizes
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that communities, just like individual patients, have their own unique needs, strengths, and
challenges that can impact their health and well-being.
When viewing the community as the client, healthcare professionals, particularly community
health nurses, assess and address the collective health of the community by considering various
factors. This approach involves working collaboratively with community members to identify
health priorities, develop interventions, and evaluate outcomes. The goal is to improve the
overall health and quality of life for everyone in the community.
Key considerations when adopting a community-as-client approach include:
Assessing community health: Healthcare professionals conduct comprehensive assessments of
the community's health status by gathering data on demographics, health indicators, social
determinants of health, and community assets. This assessment helps identify health needs and
priorities.
Collaboration and partnerships: Building partnerships with community members, organizations,
and stakeholders is essential. By working together, healthcare professionals can leverage the
collective resources, expertise, and perspectives of the community to develop effective
interventions.
Community engagement: Involving community members in decision-making, planning, and
implementation fosters a sense of ownership and empowerment. Community engagement
ensures that interventions are culturally sensitive, relevant, and acceptable to the community.
Advocacy and policy change: Healthcare professionals act as advocates for the community,
addressing health disparities and advocating for policies that promote health and well-being. This
may involve raising awareness, influencing policymakers, and securing resources to support
community health initiatives.
Capacity building: Strengthening the community's capacity to address its health needs is crucial.
Healthcare professionals work with community members to enhance skills, knowledge, and
resources, empowering them to take an active role in improving their own health.
Holistic approach: Considering the social, economic, cultural, and environmental factors that
influence health is important when working with communities. It requires addressing the social
determinants of health, promoting health equity, and recognizing the interconnectedness of
various aspects of community well-being.
By adopting a community-as-client approach, healthcare professionals can design interventions
and programs that are tailored to the unique needs and characteristics of the community. This
approach recognizes that community health is influenced by a complex interplay of individual,
social, and environmental factors. By promoting community engagement, collaboration, and
empowerment, healthcare professionals can help communities achieve better health outcomes
and create sustainable change.
Here are a few more points to consider when viewing the community as a client:
Health promotion and prevention: Taking a community-as-client approach emphasizes the
importance of health promotion and prevention efforts. Healthcare professionals work with the
community to identify strategies that promote healthy behaviors, prevent diseases, and improve
overall well-being. This can include initiatives such as health education campaigns, screenings,
immunizations, and lifestyle interventions.
Tailored interventions: Just as healthcare professionals tailor treatment plans to meet the
individual needs of patients, interventions for the community as a client should be tailored to
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address the specific needs and characteristics of the community. This requires understanding the
community's cultural beliefs, values, and socioeconomic factors that influence health.
Cultural sensitivity: Communities are diverse, comprising individuals with varying cultural
backgrounds and beliefs. Recognizing and respecting cultural diversity is essential when viewing
the community as a client. Healthcare professionals should approach community health with
cultural sensitivity, taking into account the community's cultural practices, traditions, and
preferences in order to provide appropriate care and interventions.
Capacity for self-care: An important aspect of the community-as-client approach is to support the
community in developing its capacity for self-care. This involves providing education, resources,
and skills that empower community members to take charge of their own health and make
informed decisions. Building community members' self-efficacy and self-management skills
contributes to long-term sustainable health improvements.
Evaluating outcomes: Similar to individual patient care, evaluating the outcomes of interventions
is essential when the community is the client. Healthcare professionals assess the impact of
interventions on the community's health outcomes, quality of life, and overall well-being. This
evaluation helps inform future interventions and ensures continuous improvement in addressing
community health needs.
Long-term relationship: Adopting a community-as-client approach involves establishing a long-
term relationship with the community. Healthcare professionals work collaboratively with
community members over time, building trust and understanding the community's evolving
needs. This ongoing relationship fosters a sense of partnership and facilitates the implementation
of effective interventions.
Environmental considerations: Recognizing the impact of the physical environment on
community health is important. Healthcare professionals assess the community's environmental
factors, such as access to clean water, air quality, availability of green spaces, and exposure to
environmental hazards. Addressing these factors can contribute to improved community health
outcomes.
By viewing the community as a client, healthcare professionals can shift the focus from
individual care to a broader perspective that addresses the collective health needs of the
community. This approach recognizes the social determinants of health, the importance of
community engagement, and the power of collaboration in creating sustainable improvements in
community health and well-being.
Here are a few more points to consider when viewing the community as a client:
Health equity: A community-as-client approach emphasizes the importance of promoting health
equity. Healthcare professionals work to address health disparities within the community,
ensuring that all individuals have equal opportunities to achieve optimal health outcomes. This
involves recognizing and addressing systemic barriers that contribute to inequities in healthcare
access, quality, and outcomes.
Community resilience: Community resilience is a key aspect of the community-as-client
approach. Healthcare professionals support the community in developing resilience by helping
them to identify and leverage their strengths, resources, and social connections. This resilience
enables communities to effectively cope with and recover from adversity or health crises.
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Lifespan perspective: Communities consist of individuals across various life stages and ages.
Healthcare professionals adopt a lifespan perspective when viewing the community as a client,
recognizing the unique health needs and challenges faced by different age groups within the
community. This approach allows for targeted interventions and services that address the specific
needs of children, adolescents, adults, and older adults.
Social determinants of health: The social determinants of health play a significant role in shaping
community health. Healthcare professionals consider factors such as income, education,
employment, housing, and social support when assessing the health needs of the community. By
addressing these determinants, interventions can have a broader impact on improving health
outcomes.
Community mobilization: Community-as-client approaches often involve mobilizing the
community to take collective action. Healthcare professionals help facilitate community
mobilization efforts, empowering community members to identify and address their own health
needs, advocate for change, and participate in decision-making processes that impact their
health.
Cultural humility: Cultural humility is an essential component when working with the
community as a client. Healthcare professionals approach the community with an open mind,
acknowledging their own cultural biases and continuously learning from and valuing the cultural
perspectives and experiences of the community members. This helps build trust and fosters
culturally appropriate care and interventions.
Intersectoral collaboration: Addressing community health requires collaboration across multiple
sectors, such as healthcare, education, housing, transportation, and social services. Healthcare
professionals work collaboratively with stakeholders from various sectors to implement
comprehensive interventions that address the multifaceted determinants of health within the
community.
Sustainability and capacity building: Sustainable community health interventions focus on
building the community's capacity to address their own health needs over the long term.
Healthcare professionals work with the community to strengthen their knowledge, skills, and
resources, empowering them to sustain positive health outcomes beyond the intervention period.
By adopting a community-as-client approach, healthcare professionals can ensure that
interventions and services are responsive to the unique needs, strengths, and challenges of the
community. This person-centered approach to community health allows for more effective and
holistic interventions that promote health, equity, and community well-being.
Here are a few more points to consider when viewing the community as a client:
Health system navigation: Healthcare professionals play a role in helping community members
navigate the complex healthcare system. They provide information, guidance, and support to
ensure that individuals can access appropriate healthcare services and resources.
Health education and literacy: Promoting health education and improving health literacy within
the community is a key aspect of the community-as-client approach. Healthcare professionals
provide information and resources that empower community members to make informed
decisions about their health and engage in self-care practices.
Social and community networks: Recognizing the importance of social and community
networks, healthcare professionals work to strengthen and leverage these networks to support
community health. They foster collaboration, create opportunities for social connections, and
facilitate the exchange of resources and knowledge within the community.
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Disaster preparedness: Communities face various risks, including natural disasters, pandemics,
and other emergencies. Healthcare professionals assist communities in developing disaster
preparedness plans, educating community members about emergency protocols, and promoting
resilience in the face of adverse events.
Continuous monitoring and feedback: Community health is an ongoing process, and healthcare
professionals engage in continuous monitoring and feedback mechanisms to assess the
effectiveness of interventions and adapt strategies as needed. This ensures that interventions
remain responsive to the changing needs of the community.
Health policy advocacy: As advocates for the community, healthcare professionals play a crucial
role in influencing health policies and advocating for resources that address community health
needs. They collaborate with policymakers and community leaders to create policies that
promote health equity and improve community well-being.
Evaluation and research: Rigorous evaluation and research are essential to inform evidence-
based practices in community health. Healthcare professionals contribute to research efforts,
evaluating the impact of interventions, identifying best practices, and sharing knowledge to
advance community health initiatives.
Ethical considerations: When viewing the community as a client, healthcare professionals uphold
ethical principles such as autonomy, beneficence, and justice. They respect the rights, privacy,
and confidentiality of community members and ensure that interventions are conducted ethically
and with informed consent.
Health monitoring and surveillance: Healthcare professionals engage in health monitoring and
surveillance activities to identify emerging health trends, outbreaks, or other community health
concerns. They collaborate with public health agencies and community organizations to track
and respond to health issues proactively.
Health resource allocation: Healthcare professionals work with communities to allocate health
resources effectively. This involves identifying resource gaps, advocating for equitable resource
distribution, and leveraging community assets to optimize resource allocation for maximum
impact.
By considering the community as a client, healthcare professionals can engage in comprehensive
and holistic approaches to community health. This person-centered perspective recognizes the
unique needs, strengths, and aspirations of the community, leading to more effective and
sustainable health interventions and improvements in overall community well-being.
Community as a client requires collaborative practice among nurses, epidemiologists, genetic
counselors, and social workers (Harkness & DeMarco, 2012, p. 180), among others, to achieve
health promotion. There are many resources available within our various communities to
encourage health. A major nursing role is to assess deficits, and identify community assets for
implementation of change to improve community health.
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Healthy People 2020 Leading Health Indicator
Healthy People 2020 is a set of objectives and targets developed by the U.S. Department of
Health and Human Services to guide national health promotion and disease prevention efforts.
Leading Health Indicators (LHIs) are a subset of these objectives that highlight key areas of
public health concern. Here are some examples of LHIs from Healthy People 2020:
1. Access to Health Services: This LHI focuses on increasing access to comprehensive,
quality health services for individuals across the lifespan. It aims to improve access to
primary care, preventive services, and behavioral health services.
2. Clinical Preventive Services: This LHI aims to increase the use of clinical preventive
services among individuals, with a focus on vaccinations, cancer screenings, and
preventive counseling services.
3. Environmental Quality: This LHI focuses on promoting healthy environments, including
reducing exposure to environmental hazards, improving air and water quality, and
ensuring safe and healthy communities.
4. Maternal, Infant, and Child Health: This LHI aims to improve the health and well-being
of mothers, infants, and children. It focuses on reducing infant mortality, improving
prenatal care, increasing breastfeeding rates, and promoting healthy child development.
5. Nutrition, Physical Activity, and Obesity: This LHI addresses the prevalence of obesity
and promotes healthy eating and physical activity. It aims to reduce the prevalence of
obesity among children and adults, increase access to healthy food options, and promote
regular physical activity.
6. Oral Health: This LHI focuses on improving oral health and access to oral healthcare
services. It aims to reduce dental caries (cavities), increase the proportion of individuals
with dental insurance, and improve oral health-related quality of life.
7. Social Determinants of Health: This LHI addresses the social and economic factors that
influence health outcomes. It aims to reduce poverty, eliminate health disparities,
promote social connectedness, and improve educational and employment opportunities.
8. These are just a few examples of the LHIs outlined in Healthy People 2020. They
represent priority areas for public health action and provide a framework for
organizations and communities to work towards improving population health. Healthy
People 2020 has been succeeded by Healthy People 2030, which includes updated
objectives and LHIs to guide health promotion efforts in the United States.
9. Here are a few more examples of Leading Health Indicators (LHIs) from Healthy People
2020:
10. Substance Abuse: This LHI focuses on preventing and reducing substance abuse,
including the misuse of opioids, alcohol, and illicit drugs. It aims to decrease substance
abuse-related deaths, improve access to substance abuse treatment, and promote effective
prevention strategies.
11. Mental Health: This LHI aims to promote mental health and well-being, prevent mental
disorders, and ensure access to mental health services. It addresses the prevalence of
mental illness, suicide rates, and the availability of mental health treatment and support.
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12. Injury and Violence Prevention: This LHI focuses on reducing injuries and violence in
communities. It aims to decrease injury-related deaths, prevent motor vehicle crashes,
address domestic violence and child maltreatment, and promote safe environments.
13. Sexual and Reproductive Health: This LHI addresses sexual and reproductive health
issues, including reducing unintended pregnancies, promoting contraceptive use,
preventing sexually transmitted infections (STIs), and increasing access to reproductive
healthcare services.
14. Tobacco Use: This LHI aims to reduce tobacco use and its associated health risks. It
focuses on decreasing smoking rates, preventing tobacco-related diseases such as lung
cancer and heart disease, and implementing effective tobacco control policies.
15. Heart Disease and Stroke: This LHI targets the prevention, detection, and treatment of
heart disease and stroke. It aims to reduce deaths related to cardiovascular diseases,
promote healthy lifestyles to prevent heart disease, and improve access to cardiac care
and rehabilitation services.
16. Cancer: This LHI focuses on reducing the incidence and mortality rates of various types
of cancer. It addresses cancer prevention, early detection through screenings, access to
cancer treatment and support services, and the promotion of healthy behaviors.
17. Immunization and Infectious Diseases: This LHI aims to increase immunization rates and
prevent the spread of infectious diseases. It focuses on promoting immunization among
children and adults, reducing vaccine-preventable diseases, and responding to outbreaks
and public health emergencies.
These LHIs highlight important public health priorities and serve as targets for monitoring and
improving the health of the population. By addressing these areas, healthcare organizations,
communities, and individuals can work together to achieve better health outcomes and reduce
health disparities. It's important to note that with the release of Healthy People 2030, the LHIs
have been updated and revised to align with new public health goals and objectives.
Here are a few more examples of Leading Health Indicators (LHIs) from Healthy People 2020:
Diabetes: This LHI focuses on preventing and managing diabetes, a chronic condition that
affects millions of individuals. It aims to reduce the incidence of diabetes, improve diabetes
management and control, and increase access to diabetes prevention programs and resources.
HIV: This LHI addresses the prevention, treatment, and care of HIV (Human Immunodeficiency
Virus) and AIDS (Acquired Immunodeficiency Syndrome). It focuses on reducing new HIV
infections, increasing access to HIV testing and treatment, and promoting strategies to prevent
HIV transmission.
Respiratory Diseases: This LHI targets the prevention, diagnosis, and management of respiratory
diseases such as asthma and chronic obstructive pulmonary disease (COPD). It aims to reduce
hospitalizations and deaths related to respiratory diseases, improve disease management, and
promote healthy lung function.
Vision: This LHI focuses on promoting eye health and preventing vision loss and blindness. It
aims to increase access to vision screenings and eye care services, promote early detection and
treatment of eye conditions, and raise awareness about the importance of regular eye exams.
Sleep Health: This LHI addresses the importance of good sleep health for overall well-being. It
aims to promote healthy sleep behaviors, improve the diagnosis and treatment of sleep disorders,
and raise awareness about the impact of insufficient sleep on health.
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Social Determinants: This LHI highlights the social determinants of health and their impact on
health outcomes. It addresses factors such as education, employment, income, housing, and
community support. The goal is to reduce disparities related to these social determinants and
promote health equity.
Global Health: This LHI recognizes the interconnectedness of global health and aims to promote
health and well-being beyond national borders. It focuses on addressing global health threats,
supporting global health initiatives, and promoting collaboration and partnerships to improve
health worldwide.
These LHIs reflect the diverse range of health issues and challenges that impact individuals and
communities. They provide a framework for action and guide efforts to improve population
health and well-being. It's important to note that Healthy People 2020 has been succeeded by
Healthy People 2030, which includes updated objectives and LHIs to guide health promotion
efforts in the United States.
Here are a few more examples of Leading Health Indicators (LHIs) from Healthy People 2020:
Blood Pressure: This LHI focuses on preventing and controlling high blood pressure, also known
as hypertension. It aims to increase the proportion of individuals with controlled blood pressure,
promote awareness and management of hypertension, and improve access to blood pressure
screenings and treatment.
Oral and Craniofacial Health: This LHI addresses the promotion of oral health and the
prevention of oral diseases. It aims to increase the proportion of individuals who receive
preventive dental services, improve oral health literacy, and reduce the prevalence of dental
caries and periodontal diseases.
Older Adults: This LHI focuses on the health and well-being of older adults. It aims to promote
healthy aging, prevent or delay chronic diseases, improve access to geriatric healthcare services,
and enhance social support and community engagement for older adults.
Educational and Community-Based Programs: This LHI highlights the importance of educational
and community-based programs in promoting health and preventing diseases. It aims to increase
the proportion of individuals who participate in evidence-based interventions, programs, and
initiatives that support healthy behaviors and lifestyles.
Occupational Safety and Health: This LHI addresses the prevention of work-related injuries and
illnesses. It focuses on reducing the number of work-related injuries, promoting safe work
environments, and improving access to occupational health services and resources.
Substance Abuse: This LHI aims to prevent and reduce substance abuse and its related
consequences. It focuses on decreasing the initiation of substance use, increasing access to
substance abuse treatment and recovery services, and promoting community-wide prevention
efforts.
Social Determinants: This LHI emphasizes the impact of social determinants on health
outcomes. It addresses factors such as income, education, employment, and housing, and aims to
reduce health disparities associated with these determinants by promoting equitable opportunities
and resources.
Preparedness: This LHI focuses on enhancing community preparedness for public health
emergencies and disasters. It aims to improve community response plans, increase public
awareness and readiness, and strengthen coordination and communication during emergencies.
These LHIs highlight key areas of focus for improving population health and addressing
important public health issues. They provide guidance and direction for organizations,
WINDSHIELD SURVEY 15
communities, and individuals to work towards achieving better health outcomes and reducing
health disparities. While Healthy People 2020 has been succeeded by Healthy People 2030, these
examples can still serve as a reference for understanding the range of health indicators and areas
of public health concern.
Here are a few more examples of Leading Health Indicators (LHIs) from Healthy People 2020:
Social Determinants: This LHI emphasizes the impact of social determinants on health
outcomes. It addresses factors such as income, education, employment, and housing, and aims to
reduce health disparities associated with these determinants by promoting equitable opportunities
and resources.
Preparedness: This LHI focuses on enhancing community preparedness for public health
emergencies and disasters. It aims to improve community response plans, increase public
awareness and readiness, and strengthen coordination and communication during emergencies.
Global Health: This LHI recognizes the importance of global health and aims to promote health
and well-being beyond national borders. It focuses on addressing global health threats,
supporting global health initiatives, and promoting collaboration and partnerships to improve
health worldwide.
Physical Activity: This LHI highlights the importance of regular physical activity for overall
health and well-being. It aims to increase the proportion of individuals who engage in regular
physical activity, promote active transportation, and create environments that support physical
activity.
Substance Abuse: This LHI focuses on preventing and reducing substance abuse, including the
misuse of opioids, alcohol, and illicit drugs. It aims to decrease substance abuse-related deaths,
improve access to substance abuse treatment, and promote effective prevention strategies.
Mental Health: This LHI aims to promote mental health and well-being, prevent mental
disorders, and ensure access to mental health services. It addresses the prevalence of mental
illness, suicide rates, and the availability of mental health treatment and support.
Injury and Violence Prevention: This LHI focuses on reducing injuries and violence in
communities. It aims to decrease injury-related deaths, prevent motor vehicle crashes, address
domestic violence and child maltreatment, and promote safe environments.
Nutrition and Weight Status: This LHI addresses the importance of healthy eating and
maintaining a healthy weight. It aims to promote healthy dietary choices, reduce the prevalence
of obesity, and improve access to nutritious foods.
Maternal and Child Health: This LHI focuses on improving the health and well-being of
mothers, infants, and children. It aims to reduce infant mortality, improve prenatal care, promote
breastfeeding, and support healthy child development.
Access to Health Services: This LHI aims to improve access to comprehensive, quality health
services for individuals across the lifespan. It focuses on increasing access to primary care,
preventive services, and behavioral health services.
These LHIs represent a diverse range of health indicators that are crucial for improving
population health and addressing significant public health challenges. They serve as a roadmap
for individuals, communities, and organizations to focus their efforts and make measurable
progress towards better health outcomes.
A leading health indicator that must continue to be addressed is tobacco abuse in the adult
population (U.S. Department of Health and Human Services, 2010, p. 3). Nursing has a great
WINDSHIELD SURVEY 16
role in creating evidence based change for this indicator. In the authors work setting, nurses can
provide education toward secondary or tertiary prevention (Harkness & DeMarco, 2012, p. 72) at
the point of care for acute cardiac care. Nurses can also become involved in primary prevention
by forming collaborative relationships with various community agencies to educate the public
about risks and prevention. Nursing’s voice can also be heard through political expression.
Membership in professional organizations and exercising our right to vote can also pave the way
to primary prevention, and better health for all.
Conclusion
Nursing’s role in community health is crucial. Important skills are; knowledge of various
community types, strong assessment skills, and understanding of health risks and vulnerable
populations. Utilization of available resources and working collaboratively with other
professionals are steps to improving overall health of the population.
Appendix
Housing and zoning
Homes are mainly detached
single family dwellings. They
are well maintained. Primary
construction materials are brick
and board. All are modernized
with plumbing and central
heat. In town homes have
smaller yards than township
homes. All are well cared for.
Transportation
Transportation is mainly by
private car. There are many
walkers and cyclists observed.
There is also a public bus
system available that offers a
fixed schedule.
Roads are in good condition,
with main highways readily
available to serve businesses
and residents. A health
concern is that some of the
busier roads are dangerous
for walkers and cyclists due
to lack of/inadequate
sidewalks/crossings. There is
a paved recreational trail for
public use.
Race and ethnicity
Mainly Caucasian. There are a
few African Americans, and
Asians noted. There are no
overt indicators of ethnicity
observed. A local resident
would recognize that many of
the nail salons are owned and
operated by people of Asian
descent.
Open space
There are many parks and open
spaces available. Along the
bay front there is a large, well
maintained park and public
boat launch. The streets are
tree lined. There is a lush 60+
acre park with many varieties
of trees, and streams including
Service centers
The social security and post
offices are within walking
distance. There is a large,
easily accessible hospital, and
many physician and dental
offices, also within walking
distance. There are several
parks that are well used and
Religion and politics
There is religious
heterogeneity noted. On one
corner there is a large Lutheran
church; on another is a Jewish
temple. A couple of blocks
away a large Catholic church is
noted. There are two smaller
churches located in the
WINDSHIELD SURVEY 17
public trails. Many homeless
people and teens use this area
as a place to drink, which
poses a potential health
concern for all. The physical
grounds for this area were a
former state psychiatric
hospital, which has been
reclaimed from decay. The
buildings are gradually being
renovated and provide space
for businesses, condominiums,
low income housing, senior
housing, and office space.
maintained. There is even a
dog park where people can
take their pets for exercise. It
is fenced in and well used.
neighborhood. Evidence is
observed that they are not used
only for Sunday service.
There are posters for various
community meetings, and
shared sponsorship for events
such as Safe Harbor, which
helps shelter our homeless in
the winter.
Boundaries
The boundaries of this
neighborhood are mainly
natural. On the east is the
Boardman Lake, on the north
is Grand Traverse Bay, the
west is bordered by highway M
72, and the east is bordered by
Airport Road. The unofficial
description for this
neighborhood is the west side,
which includes bits of Old
Town Traverse City, and
Garfield township.
Stores and street people
There are several local grocery
stores/meat markets that are
accessible by car, bicycle, or
foot. The flourishing
downtown area offers many
fine restaurants and bars, as
well as specialty stores.
Most people observed on the
streets are walkers/joggers, and
pedestrians making their way
to a destination. Children are
seen walking to/from school.
There are occasional homeless
people noted. All are dressed
accordingly, except the teens
that seem to think shorts are
O.K. year round. The only
stray animals are the
occasional cat. Most dogs are
either leashed or escorted by
owners. A few people do not
feel leashes are necessary.
Dog’s that are not leashed in
a public setting pose a health
hazard.
Health and morbidity
The most obvious chronic
disease conditions are obesity
and tobacco abuse. Both of
these conditions are serious
health hazards. It is not
uncommon to observe severely
obese individuals/families in
this community. A few
compound the issue by
smoking. Since Michigan
banned smoking in restaurants
and bars, this phenomena is
much less obvious. It is still
noticeable when following the
car of a smoker, as one can
easily smell the tobacco.
Many of the homeless
observed have mental health
issues, as they are often in
conflict with local law
enforcement. Both our
excellent regional referral
hospital and the local Veterans
Affairs clinic are within
walking distance.
Commons
The major common area for
this neighborhood is downtown
Traverse City. There are many
Signs of decay
This neighborhood is very
alive and on the way up.
Traverse City is a popular
Media
The most common media has
become the smart phone.
People are able to review local
WINDSHIELD SURVEY 18
attractions for all to enjoy.
Many interesting specialty
stores, coffee shops, theaters,
event centers,
Micro-breweries, bars and
restaurants make the entire
downtown area a strong draw
for all. Hours are mainly six
A.M. to three A.M. Both locals
as well as visitors enjoy the
downtown and waterfront year
round.
place to live and work. The
described neighborhood is very
desirable for all the reasons
described above. Store fronts
are occupied and busy, homes
and yards are well maintained,
and schools/churches are busy
and are a vital part of the
community.
news, weather, and sports at a
moment’s notice, all while on
the go. The local newspaper is
still a popular way to stay
connected, as there is evidence
of many regularly used home
delivery tubes. Cable
television is also popular for
sporting events, as well as
news and weather. The only
outdoor antennas are satellite
dishes.
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References
Harkness, G. A., & DeMarco, R. F. (2012). Community and public health nursing evidence for
practice. Philadelphia, PA: Wolters Kluwer Health/Lippincott, Williams, and Wilkins.
U.S. Department of Health and Human Services. (2010). Healthy people 2020. Retrieved from
http://healthypeople.gov/2020/TopicsObjectives2020/pdfs/HP2020_brochure_with_LHI_
508.pdf
