Community Health Assessment Example Brownsville

Community Health Assessment: Introduction

Human health is very much related to the environment we live in. Our health is affected by every negative and positive factor around us, ranging from experiencing racism to not having enough opportunities at the hand of bad policies made by the government. To understand a community’s health standards, one must inspect how the neighborhood affects the group’s physical and mental health. As the title suggests, Brownsville is the poorest district in New York City, both in means of health and wealth (Culliton, 2019). In this paper, I will be examining the health conditions of Brownsville, along with the reasons behind it. This paper is also meant to show the reader how much health conditions vary by neighborhood to neighborhood. The numbers and figures I am going to use will be directly taken by New York City’s 2018 Community Health Profiles. It is vital to start this analysis by the racist factors in Brownsville.

Key Elements of a Health Assessment

Although community health assessments may vary, they tend to share seven core components, and they are often considered within three strategies data collection, information, and research, prioritization, and action stage. Accordingly, the statistical profile, quantitative survey of residents, qualitative research on the healthcare community, and qualitative research with stakeholders are among the primary elements of a community health assessment. Also, strategic planning priority, along with action plan and implementation, and an Improvement Plan are among the other critical components. Also, RHA Staff and Boards, government departments, health service providers, and the general public should be included in a health assessment.

On the other hand, an individual health assessment refers to a comprehensive analysis that is completed a patient’s initial encounter. A comprehensive history of the patient, age, mental status, diagnosis and plan of care, developmental examinations, and preventive services, along with the Individual Health Education Behavioral Assessment, are among the key components of an individual health assessment.

Comprehensive Health Assessment

Evaluation of cultural and social needs, strengths, limitations, and preferences such as support systems, patient/family concerns, family/household structure, and household/environmental risk factors are among the components of a comprehensive health assessment. Accordingly, considerations should be based on a variety of characteristics such as sexual orientation, homelessness, gender identity, unemployment, social support, and education level. More specifically, KM2-C (Cultural Characteristics), KM2-D (Communication Needs), KM2-A (Family History), KM2-I (Advanced Care Planning), KM2-E (Assessment of Behaviors Affecting Health), KM2-B (Patient History, Substance, and Mental Health), KM2-H (Developmental Screening), KM3 (Depression Screening), and KM8 (Assessment of Health Literacy) are among the critical components of a comprehensive health assessment (“New York City Health,” 2018).

Brownsville, New York

Before looking at any factors, we should note the enormous difference in health quality between Brownsville and other neighborhoods of New York City (Culliton, 2019). Unfortunately, the ability to live a healthy life is not available to all of the NYC residents. For instance, a kid born to a family living in the Upper East Side will live 11 years more compared to a kid born to a family in Brownsville (Culliton, 2019). Many factors are contributing to this issue, and most importantly, this is unacceptable. Maybe the most contributing factor is the policy developed in 1930, named redlining. Redlining is, in its roots, a racist policy. Neighborhoods were rated based on the majority of the residents' skin colors, ethnicity, and origin (Gross, 2017). Neighborhoods with a majority of people of color were colored red on the map, labeled hazardous (Gross, 2017). The inequality starts here because, in areas labeled as 'hazardous,' no home loans or other investments were approved.

Whereas, the wealthiest and whitest neighborhoods in NYC received everything above mentioned and even received more help & health opportunities. This denial of resources widened the gap that was already between neighborhoods in NYC. Thus, creating the massive life expectancy gap, we have already mentioned. Before I move on to the detailed statistics of the issue, an important fact is that apart from investments and help funds, according to the International Journal of Health services, experiencing racism in an environment causes many health issues such as chronic stress which, after building up, contributes to major causes of death like diabetes and heart disease. Policies that are based on a history of discrimination, such as the 'Redlining policy' is often referred to as structural racism. Unfortunately, structural racism created neighborhoods with high rates of poverty and limited access to health resources.

According to U.S. Census Bureau Population Estimates in 2016, Brownsville is 76% black, compared to NYC's general 22% black population. One of the alarming factors is the percentage of population by age. Because of violence and early deaths, almost one-third of Brownsville's population is made up of people between 0 to 17 years of age. The percentage of people of color population is the main reason why the redlining policy targeted this neighborhood. Harsh life conditions force the people of Brownsville to violence and indirectly lowers the quality of education. 27% of adults in Brownsville have not completed high school, and this is a rate higher than the citywide rate. Many of the factors that affect health happens outside of a doctor's office. This includes access to quality education, jobs, and safe environments to live. Unfortunately, residents living in high-poverty neighborhoods often lack these resources. We can connect these dots of unhealthy living by understanding that Brownsville's poverty rate, unemployment rate, and rent burden rate are all higher than the city average by a considerable margin. There is the term "Avertable death," which means the deaths that could have been avoided if the neighborhood had the same death rate as the five wealthiest neighborhoods. If we use the avertable death measure on Brownsville, 54% of death could have been avoided. But none of the factors we have mentioned has a bigger influence than the violence in this neighborhood.

Hospitalization rates related to assault injuries shows us the consequences of community violence, which is a crucial factor that negatively affects the incoming investment and improvements. Sadly, it can be easily said that Brownsville is the most violent part of NYC. According to the New York State Department of Health, non-fatal assault hospitalizations per 100,000 people is 175 in Brownsville, whereas the city average is just 59 (Leonhardt, 2019). Though this violence does not come from nothing. Racism in incarceration is difficult to not-notice. People of color in NYC experience longer incarceration times compared to White residents of NYC, and it is a known fact that incarcerated people are more likely to experience mental and physical health problems, and sadly, getting help in a poor neighborhood is near impossible. Also, after being incarcerated, it is hard to find a job, proper housing, and access to healthy food. Talking about proper housing, although every resident has the right to live in a safe dwelling, that is not the case in Brownsville.

Poor health conditions are also connected with dangerous housing. For instance, a house with heating breakdowns, cracks, holes, peeling wall paints, or even with cockroaches can trigger many health problems (Do & Zaho et al., 2016). For instance, a house with poor airflow can lead to worsened asthma or any other respiratory illness. Taking a look at the NYC Housing and Vacancy Survey from 2014 shows us that only less than one-third of rented dwellings are adequately maintained, and around 40% of households reported that they had seen cockroaches in their dwellings that can trigger asthma attacks (Do & Zaho et al., 2016; “New York City Health,” 2018). Health conditions of Brownsville residents are atrocious and even depressing, but can we say that it is the resident’s fault? Definitely not. Being born in a poor neighborhood leaves you no choice but to accept your faith and to go around just like everyone else in your environment, which is unhealthy. Teenagers not going to school, living in inadequate housings starts living in the streets, and at this moment, we know what it leads to. Either violence or very unhealthy choices. Let us talk about the chance that you are born in this environment.

As a kid, you have not a lot of choices. Either you have childhood obesity like the quarter of other kids in school, or you have asthma from the pests, mold, and secondhand smoke in your dwelling. Because you have no chance of timely access to quality outpatient care, you are more likely to face pediatric hospitalizations. As a matter of fact, double the chance of NYC's average and asthma? This time, the chance of you going to the asthma emergency department is more than double the citywide rate. Unless the government helps the neighborhood, which is, at this point, very unlikely, this situation is just going to be a lot worse.

Conclusion

In conclusion, according to the statistics and reports in this paper show that the situation in Brownsville is not very bright, and we definitely cannot blame the residents for this. The policies ignore the population based on their race, and make the situation worse instead of giving a helping hand. The main idea I wanted to give in this health assessment is that not all of the adverse conditions of a group is their fault. Community resources and funds to create more resources are the building blocks of healthy residents. It may look like all hope is lost, but with communities acting together and seeking justice can help to remove the unjust policies that create this poor health in neighborhoods. A helping hand and initiatives from the government can improve this situation without a doubt though it requires cooperation from the community too.

References

Culliton, K. (2019, July 11). This Is the Deadliest Neighborhood In New York City. Accessed on patch.com/new-york/brownsville/deadliest-neighborhood-new-york-city

Do, D. C., Zhao, Y., & Gao, P. (2016, April). Cockroach allergen exposure and risk of asthma.

Gross, T. (2017, May 3). A 'Forgotten History' Of How the U.S. Government Segregated America. Accessed on npr.org/2017/05/03/526655831/a-forgotten-history-of-how-the-u-s-government-segregated-america

Leonhardt, A. (2019, September 7). NYPD: Brownsville, East NY Saw 70 Percent of the Borough's... Accessed on bkreader.com/2019/09/04/nypd-brownsville-east-ny-saw-70-percent-of-the-boroughs-shootings-in-august/

New York City Health. (2018). Community Health Profiles 2018 [PDF File].