Base on the expert committee report on community health nursing of the World Health Organization “A community is a social group determined by the geographic boundaries and/ or common values and interests. Its members know and interact with one another. It functions within a particular social structure and exhibits and creates norms, values and social institutions” World Health Organization (WHO), 1974, p.7). However, the direct, hands-on clinical nursing care delivered to individuals or families in a community setting as a whole is the target and the intended of the nursing practice in community health. Community health on the other hand according to the reference book is the meeting of collective needs by identifying problems and managing behaviors within the community itself and between the community and the larger society. It emphasizes the process dimension and also includes the dimensions of status and structure (Stanhope & Lancaster, 2008). The approach of looking at the care of the client in all dimension guides the nurse to think upstream and identify risks that could be prevented. The author’s subjective perspective is that it is easier said than done, one being that there is a popular misconception that by providing health care makes a healthy population in my opinion. Another point to consider is that we are caring for a culturally diverse population.
Caring for the culturally diverse groups has been a focus of nursing from its beginning. As early as 1893, under the leadership of Lillian Wald, nurses in New York City started public health nursing and provided home care to inner city people, particulary immigrants, who could neither read nor write the English language (Denker 1994). Because nurses were not form the same cultural background as the immigrants, they had to deal with the cultural differences between themselves and the persons they care (Stanhope & Lancaster, 2008, p. 142). But are we really equipped to take care of our community? Are we culturally sensitive-which was once thought that that is all we need to effectively care for our patients? Are we culturally competent? Nurses who strive to become culturally competent respect individuals from different cultures and value diversity. This author’s point of view, is that it is a much higher level of knowledge to be had. A nurse who strives to be culturally competent not only values the client but values the profession and values oneself. Cultural competence is a combination of culturally congruent behaviors, practice attitudes, and policies that allow nurses to use interpersonal communication, relationship skills, and behavioral flexibility to work effectively in cross-cultural situations. Cultural competence allows nurses to develop and form a sense of themselves and others within the context of their own culture (Carter,2003). It is in the outmost importance that we make a thorough introspection or assessment of ourselves if we have personal biases that could impede in delivering quality of care whether it is cultural blindness or ethnocentrism. Whatever term we use all can and will affect the delivery of care to our patients.
On another note, nurses can equip themselves with foremost knowledge but it requires commitment to make a difference or a change in the life of a client. It means the venture require considerable effort and a joint focus. A commitment to the health of the community client requires a process of change at each of these levels. One nursing role emphasizes individual and direct personal care skills. Another nursing role focuses on the family as the unit of service. A third focuses on the community as a unit of service. Collaborative practice models involving the community and nurses in joint decision making and specific nursing roles required (Constance et al,2002). Bernal, Sheliman, and Reid (2004) note that nurses must remember that collaboration means a shared roles and a cooperative effort in which those participating want to do so…. This means sharing not only the power but also the responsibility for the outcomes of the intervention.

Two of the most challenging health indicators in the population that applies to the field of specialty are obesity and tobacco use. Their effects on mortality and quality of life is widely known. “Smoking is a major risk factor for cardiovascular disease, chronic lung disease, and several cancers. Obesity leads to cardiovascular disease, diabetes, and joint problems. Estimates suggest that obesity accounts for 5 to 15% of deaths each year in the United States and smoking for 18%. Eliminating smoking can increase population life expectancy by as much as 1-2 years. In contrast, if obesity rates continue to grow as they have historically, a leveling off, or even a reversal, of past life expectancy trends has been predicted “(Stewart, Cutler, & Rosen, 2009, para. 1). Effective public health and behavioral interventions are crucial for fostering continued efforts to curtail smoking and addressing the roots of obesity, which include sedentary lifestyles, the widespread availability of high-calorie food in large portions, and reduced time for the preparation of food at home. According to Fielding “Health leaders must focus on the trajectory of a person’s life course and what can be done at each stage of life to point that trajectory toward good health, said Fielding, who called for taking an “ecological approach to health promotion.”

Windshield Survey Components for City of Downey, California
Ethnicity
• A major shift has occurred in the ethnic/racial composition of the City population from a non-Hispanic white majority to a Hispanic majority. In addition to the Hispanic Origin/White, Non-Hispanic demographic trends, between 1990 and 2000, the Black (African-American) population grew by 29 percent, and the Asian/Pacific Islander population increased by 8.6 percent. The 2000 Census identified 3,717 Black, and 8,310 Asian/Pacific Islander residents in the City. The Asian/Pacific Islander population already has a significant presence in the City while the African-American population is trending towards a significant presence. The small American Indian population of 446 persons in 1990, decreased by 27 percent to 328 people in 2000.
• Since 1990, the age composition of residents has remained relatively stable as revealed by the 2000 census, except for a decrease in the number of 55 to 74 year olds and slight increases in the under 9 year old group, as well as the 35 to 54 years of age group.

Housing
• There were a total of 34,759 dwelling units in the City in 2000. The City’s housing stock of 34,759 dwelling units is predominately characterized by single-family detached dwelling units which comprise 58.7% of the housing stock. Another 3.9 percent are single-family attached dwelling units and 4.8 percent are two to four units per lot. Upwards of 32.5 percent of the housing stock is multiple family dwelling units in buildings or complexes having 5 or more units. Almost all of the multiple family residential dwelling units in the City are located west of Lakewood Boulevard in the southern half of the City, and north of Firestone Boulevard in the central portion of the City
• Single-family detached homes remain the predominant housing type, and the majority of growth occurring in the City has been comprised of condominium and apartment complexes with five or more units. Due to the scarcity of vacant residential land in the City, most of the housing unit growth has been accommodated through recycling of existing lower density residential uses on underutilized parcels. As indicated previously, in 2000, the proportion of owner-occupied households in Downey was 51.8% which is slightly higher than that of renter-occupied households at 47.9%.
• In general, housing over 30 years old is usually in need of some major rehabilitation, such as a new roof, plumbing, etc. The majority (77%) of Downey’s housing units were constructed prior to 1970.
Transportation
Amtrak Stations in Downey
• 11 miles: LOS ANGELES (800 N. ALAMEDA ST.). Services: ticket office, fully wheelchair accessible, enclosed waiting area, public restrooms, public payphones, snack bar, free short-term parking, paid long-term parking, car rental agency, taxi stand, public transit connection.
• 12 miles: LONG BEACH (601 N. LONG BEACH BLVD.) - Bus Station. Services: fully wheelchair accessible, public restrooms, public payphones, full-service food facilities, paid short-term parking, paid long-term parking, call for taxi service, public transit connection.
• 13 miles: FULLERTON (120 E. SANTA FE AVE.). Services: ticket office, fully wheelchair accessible, enclosed waiting area, public restrooms, public payphones, full-service food facilities, free short-term parking, paid long-term parking, taxi stand, public transit connection.
Hospitals
• DOWNEY REGIONAL MEDICAL CENTER (11500 BROOKSHIRE AVENUE)
• LAC/RANCHO LOS AMIGOS NATIONAL MED CTR (7601 EAST IMPERIAL HIGHWAY)
• SURBURBAN MEDICAL CENTER (about 4 miles; PARAMOUNT, CA)
• BELLFLOWER MEDICAL CENTER (about 4 miles; BELLFLOWER, CA)
• KAISER FOUNDATION HOSPITAL (about 4 miles; BELLFLOWER, CA)

Religion
Name Charismatic Churches Independent Assemblies of God United Methodist Church International Church of the Foursquare Gospel Other
Adherents 1.3% 1.2% 1.0% 0.9% 20.0%
Congregations 0.3% 6.4% 4.4% 5.6% 56.5%
Source: Jones, Dale E., et al. 2002. Congregations and Membership in the United States 2000. Nashville, TN: Glenmary Research Center
Shopping Center
• Stonewood Center- 251 Stonewood St. Downey, CA 90241
• Downey Landing Center- Downey's newest commercial retail center is Downey Landing. It is home to a wide variety of businesses including shops, restaurants and offices. The center has 3 major restaurants and a casual dining food court serving a range of cuisine.
• Downtown-Downey is home to a wide variety of businesses including shops, restaurants and offices. The area is currently experiencing a renaissance after the opening of a stunning 10-screen Krikorian Theatre Complex and adjacent parking structure. Banners calling to "Celebrate Downtown Downey" have been installed to brighten up and add instant excitement to the area. Downtown is also home to over 20 restaurants serving a range of cuisine from Japanese and Italian to Mediterranean and Mexican. Other highlights of the area include the Civic Center, Downey Theatre, Embassy Suites Hotel and several major office buildings.

References
http://www.downeyca.org/_blobcache/0000/0003/2960.pdf