Appendix C

FUNCTIONAL COMMUNITY HEALTH ASSESSMENT PATTERN #1 Health perception – health management pattern * | Strength | PotentialNeed | Problem | Comments | 1. Environment 2. Residential space 3. Commercial space 4. Industrial space 5. Health Agencies and personnel 6. Methods of health care financing (Private pay, health insurance, HMO, Medicaid, Medicare, Worker’s compensation 7. Prevalent diseases and conditions 8. Welfare | | XXX | XXXXX | XX Valley is located in northwest XX. The environment consists of scrub desert. There is a potential for problems associated with dehydration while indoors and outdoors year round due to the climate, and many community members not having enough income to maintain essential utilities, such as air conditioning. The area has multiple open spaces and one public park. XX Valley has many rural roads with no street lights, or sidewalks. The school has one crosswalk. Two major roads connect the rural community of XX Valley to interstate 10. The interstate is approximately 10-20 miles away depending on route. The interstate is the main access to the city of Tucson, and the closest hospital of Northwest Hospital.XX Valley is an area that consists of a variety of manufactured homes and site built homes on acreage, varying in age and condition. The area has no apartments, condominiums, or public housing. No high rise buildings have been noted. Informants have identified condition of homes to be a risk for elderly within the community, due to lack of resources and help to improve living conditions.XX Valley has minimal retail establishments, consisting of three mini mart gas stations that also serve has supplemental grocery stores, and two local bars. For any major grocery store or retail establishment the community must travel into Tucson. The closest grocery store is approximately 15 miles away.There is one power plant located within the XX Valley census tract. All other industrial outlets are not within census tract 4419.XX Valley has no medical resources located within the census tract. The closest healthcare facility is XX Health Center, which is approximately 8 miles from the community. The XX Valley fire department acts as the primary care provider for many residents within the community. There are 13 primary care providers in the town of XX, 10 nurse practitioners, 179 registered nurses, and 1,786 resident primary care providers. The fire department life flights an average of 5 people per month out of this community to local Tucson hospitals. The closest hospital is Northwest hospital located approximately 20 miles from the community. For trauma and pediatric serves the community must travel to University Medical Center located approximately 30 miles or Tucson Medical Center located 36 miles from the community.Health care financing is a major concern for the XX Valley community 13.1% of the population uses AHCCCS. Another 9% use Medicare. The remaining 80 % of the population; there is no statistical data distinguishing percentages of those with private insurance or no medical insurance coverage for the XX Valley community.The XX Valley community has many identifiable diseases and health risks including cardiovascular disease, cancer, COPD, and substance abuse, which have been identified through informant interviews with the XX Valley fire department, in contrast from statistical data. The estimated average income of XX Valley residents is less and $50,000 a year, and is less that the state average for annual income. 5.2% of the residents have an income below 50% of poverty level. 11.7% of the residents have income below poverty level, compared to 14.2% for the state of Arizona. Children below poverty level make up14% of the poverty population and high school graduates make up 17.4% of residents living at the poverty level. 35.8% of non high school graduates live at the poverty level in the XX Valley community. |

#2 Nutrition/Metabolic Pattern* | Strength | PotentialNeed | Problem | Comments | 1. Water presence, prevalence and influence 2. Food supply 3. Natural resources | X | X | X | XX valley is a rural community West of the Town of XX. XX Valley residents use community wells for their water, which is sufficient for this area. Tucson Water produced groundwater from aquifers located in the Tucson Basin and in XX Valley. XX Valley is one of five major well fields from which water is produced. There are several washes that flow through the census tract, which could elevate the potential for flooding if heavy rains were to occur. Accessibility to food is a major problem within this census tract. The closest supermarket is approximately 15.81 miles away. The community has three convenience stores were some grocery items may be purchased. There is a local food bank, but it is not within the census tract. The elementary school provides breakfast for every student, and offers a reduced/free lunch program for those that qualify. -The census tract was once known for its agricultural background. There are many residents that raise and sell animals, and there are a few residents that have gardens in which they grow produce. The only drawback is that because of the areas desert environment adequate water is a necessity for this area |

#3 Elimination Pattern* | Strength | PotentialNeed | Problem | Comments | 1. Sanitation, effective controls, utilization, need 2. Pest, animals and vectors 3. Pollution 4. Fuel availability, uses and relationship to climate5. Community’s perception of waste problem, vector, pest, pollution or other problems. | X | XXXX | | XX Valley, Arizona has Waste Management as their sanitation company. The city dump is approximately 9 miles from the census area. There are street drainage systems however these are just ditches and washes for rainwater. This area has flooded in the past thus causing a potential needMany of the families within the area do not live in a clean environment which has caused potential problems with lice. Printed educational information is provided by the Elementary School to help reduce lice problems for students and their families. At this time the problem is under control. Within this area there are not many pollution problem, the freeway does not run through the area which reduces air pollution. The main natural fuel source is natural gas. Informants did identify problems related to lice within the area. |

#4 Activity/Exercise Pattern [activity, exercise, leisure, and recreation] * | Strength | PotentialNeed | Problem | Comments | 1. Community fitness, programs, focus, agencies involved2. Activities connecting the population3Transportation, travel and Roads connecting the population. 4. Utilities that support health and connecting the population: | | | XXXX | There is no public recreational facility within the area. The Elementary School does have an after school fitness program in place however the program in new and the program is only available twice a week. The only activities that connect the population within this area are provided by the school. These activities include Halloween night, Taco Family Dinners, Winter Wonderland, Father Daughter Dance, and Mother Son Dance. The roads within XX Valley area connect to a major Interstate-10 that connects to all parts of the city. Water from wells, natural gas, propane electric and telephone services are available. |

#5 Sleep/Rest Pattern* | Strength | PotentialNeed | Problem | Comments | 1. Timely availability of city offices, businesses, restaurant, medical facilities (hours) 2. Noise control and compliance 3. Identify quite and busy areas of the community 4. Community lighting that effects sleep5. Community’s perception of quality and quantity of sleep and rest: | XXX | | XX | The school follows normal businesses ours 0800 to 1700 Monday to Friday schedule. The gas stations and convenience stores are open 24 hours a day.Emergency services are available twenty four hours provided by the local Fire Department. The clinic and food bank hours vary throughout the week. The Pima County Sheriff’s Department enforces noise ordinances; however there is still a problem with noise control within the community. The busy areas of the community are located around the Elementary School and XX Valley Road. The community does not have any issues with lightning. The Community Informants did not identify any issues with sleep or rest patterns related to community causes. |

#6 Cognitive/Perceptual pattern* | Strength | PotentialNeed | Problem | Comments | 1. Education 2. Education level of the community 3. Effect of the outside system on the community (laws and rules) | X | XX | | XX Valley has an excellent educational program for students from preschool-12th grade. The school provides opportunities including speech therapy, special needs assistance and job training. For ages greater than 25, 74% of the population graduated high school. 26. 4% of the community are receiving a higher education program. The community has a public school system which is affected by local, state funding, and voting measures. |

#7 Self-perception/self-concept pattern* | Strength | PotentialNeed | Problem | Comments | 1. History of community (founding, growth) 2. Major economic and political trends and influences 3. Physical alterations or shifting centers (ie: commercial, downtown or city center location, suburban shopping), favorability of land use for population and economic growth 4. Published description of the community 5. Communities self-portrayal, pride indicators, nicknames (ie: ‘bricktown’, “that’s a high crime area”, psychological barriers that exist, areas frequently avoided or feared by residents or deemed safe 6. People: patterns of population growth since first settled, migration, 7. Vital and demographic statistics 8. Individual and family living practices: Family types 9. Socio-economic status:10. Category: urban, rural or frontier | X | XXXX | XXXXX | -XX Valley encompasses approximately 22 square miles with a population of 5000-6500 people. XX Valley consists mainly of flat arid desert, mesquite washes and plenty of creosote bushes. Wide open spaces with few housing developments attract most residents, and the Town of XX is slowing annexing parts of this area.- There are economic issues to be addressed for this community. With the economy in a slump many residents have lost their jobs or have to travel long distances to their work. This in turn has created a problem for many families both financially and emotionally. The Town of XX has the only shopping and commercial areas available to the residents of XX Valley. All the growth is centered in the area of Interstate 10, the Town of XX and Northwest Tucson. Although development in XX Valley has slowed due to the economic crisis, there is adequate space for population and commercial growth.XX Valley consists mainly of flat arid desert, mesquite washes and plenty of creosote bushes. Wide open spaces with few housing developments attract most residents, and the Town of XX is slowing annexing parts of this area. XX Valley has no public website of its own because it shares its zip code with the town of XX. It is extremely difficult to get any information about XX Valley.XX Valley is portrayed as a low income, high illegal immigrant, drug area. It consists of mostly manufactured homes, which carries the stigma of a low income population. There are a few streets that are referred to as “Meth Alley” within the community. Although the houses are primarily manufactured homes, many residents have well kept, and quite lavish residences.XX Valley has increased in its population over the years. As of 2009, XX Valley’s population is 5,755 people. Since 2000, it has had a population growth of 15.44 percent.Using the most current information from the Census Bureau, census tract XX has a population of 5,355 residents. 51.1% are male, and 48.9% are female. The racial makeup of this census tract is predominantly White (82.4%) and Hispanics (22.1%). All age groups are represented, but the majority for this census tract falls between the ages of 25 and 54. There are a total of 1,810 households for this census tract, with 1,388 being family households with children under 18, and 422 nonfamily households. There are 1,502 owner occupied housing units. Of those 1,502, 62.5% are occupied by a married-couple family, and 20.9% are occupied by nonfamily households. The median household income is $35,459 in this census tract, but the majority falls below this level. The majority of residents in this census tract are of low socioeconomic status.*See above (vital and demographic statistics).*See above (vital and demographic statistics).Census tract XX, which contains XX Valley is a rural community which is defined as having less than 20,000 residents or fewer than 99 persons per square mile. |

#8 Role/Relationship Pattern* | Strength | PotentialNeed | Problem | Comments | 1. Regional Position2. Government financing and budget3. Government and leadership/management system4. Highway and public works programs5. Contracts with other communities6. What and where is the social center for the community?7. Communication systems: Public and private (radio, television, newspapers, etc)8. Community friendliness, openness9. Infrastructure Support | XX | XXXXX | XX | XX Valley is a rural community in Pima County located about 25 miles Northwest of Tucson. XX is 3.5 miles away & Picture Rocks is 2.9 miles away. Two major roads connect the rural community of XX Valley to Interstate 10. I-10 is approximately 10-20 miles away depending on the route taken.XX Valley has no public website of its own because it shares its zip code with the town of XX. It is extremely difficult to get any information about XX Valley finances specifically, but financial statistics are available for XX (same zip code). Taxes provide the most funding at about 34$ million while local governmental support generates about 2$ million.Like stated above, XX Valley is part of XX due to the zip code, and lacks of resources specific to XX Valley itself are available. The community has a public school system which is affected by local, state funding, and voting measures. The school system is important with education, as well as a leader for providing information regarding resources such as the XX Food Bank and the XX Health Center.XX, zip code 85653, has an estimated 5$ million set aside for public highways, $86,000 for regular highways, 8$ million for police protection and $256,000 for community development. From observation and key informants, road conditions are poor and there is a complete lack of resources (parks, recreation, shopping) available in XX Valley.From interviews with key informants, as well as contact with local businesses such as the XX Health Center and the XX Food Bank, it seems that a lot of these support comes from other communities; chiefly XX. XX Valley itself does not have a lot of resources available, but it is included in the zip code 85653 for XX and is located within the XX School District, thus both communities work together.No after school programs are available to students, no parent participation with PTA. There is a community center attached to Fire Dept; only utilized by boy scouts and the food bank bi-weekly. It seems as if the social center for the community, and what gives them commonality, is the school.-Access to television, radio and local newspaper are all available.All of our key informants were very willing to talk to us, and were open and friendly. They were able to see potential problems in the community, and express them to us. A few members who live in the community were a little less open; they seemed hesitant to let us in. This may be due to feeling invaded, or possibly the fact they are content and happy with their community and do not see any areas of concern.There is no public transportation in this community. Infrastructure support in XX Valley consists primarily of public institutions; elementary school and fire department. |

# 9Sexuality/Reproduction Pattern* | Strength | PotentialNeed | Problem | Comments | 1. Population characteristics: size, density/per square mile and distribution 2. Influences on longevity3. Influence of growth or decline of population in the community | | XXX | | Population of XX Valley is an estimated 5,355 with an average household size of 3.33 persons. There are about 260 persons per square mile (low population density). Majority of population is between 35-44 years of age, with 5.8% 75-84 and 2.8% 85-94. Total births in 2008 were 74 with 13.5% born to mothers 19 or younger and 1.35% receiving no prenatal care.For zip code 85653, fertility rate per 1,000 females age 15-44 is 36.0. Since 2000, the population of XX Valley has grown by 15.44 percent. |

#10 Coping/Stress Pattern* | Strength | PotentialNeed | Problem | Comments | 1. Support Groups 2. Crime 3. Suicide rate 4. Child, spouse, elderly abuse 5. Occupational stress 6. Psychiatric illness incidence and prevalence 7. Disaster Preparedness 8. Delinquency 9. Percent of population with incomes below poverty level, receiving public assistance 10. Percent of females in the work force11. Community ability to manage and control ongoing situations | XXX | XXX | XXXX | The need for support groups in this community is vast. The only support group in the census tract is through the Community Church of XX Valley. The elementary school offers resources for parents with disabled children, and also various parenting resources available to them in the Tucson area.The crime rate in XX Valley is moderately high for the area. Within the last month there have been 128 documented crimes by the Pima County Sheriff’s Department. There are two different crime classes, Part I Crimes and Part II Crimes. Part I crimes consist of homicide, sexual or aggravated assault, burglary, and arson. Part II Crimes are fraud, stolen property, sex offenses, controlled substances, etc. In Pima County last year there were 13,123 Part I crimes and 21,662 Part II crimes.In 2008, there were no suicides documented.The vice principal of the elementary school in this census tract spoke of neglect, which was a major concern but not so much of abuse. A Pima County Sheriff also agreed with the findings of the vice principal, neglect more than abuse. The 300+ substantiated reports of child abuse or neglect reported in Pima County last year represent 27.5% of the total cases reported statewide in Arizona.- Information provided by a key informant suggests that there is occupational stress within this census tract. This is a bedroom community, where many residents must drive more than 25 minutes to get to their workplace.Unable to assess at this timePima County has an emergency disaster plan on file in all government/municipal facilities. The town of XX also has their own disaster preparedness plan. There are brochures that highlight the information for evacuation, preparation, and contain supply lists in the event of a disaster. These brochures are readily available to the public.There has been a problem with delinquency of minors in census tract XX. There have been multiple reports by the elementary school staff of graffiti and minor destruction to school property. There is a curfew for children age 16 years or younger is 10 p.m. and for children age 16-18 is midnight. The fine for a curfew violation is $25 for the first violation, up to $50 for the second, and up to $75 for the third violation.According to statistics, in census tract XX there are 121 families and 20.5 % are below the poverty level. There are 585 individuals living in the census tract and 22% of these individuals are below the poverty level. In Pima County there is 15.2% of the population living below 100% of the federal poverty guideline. In Pima County, 100,795 people are receiving Food Stamps, and 13,781 are receiving Cash Assistance/Welfare benefits.57% of the females in census tract XX are a part of the labor force.This community is so vast in area and socioeconomic class that it is impossible for members of the community to manage and control ongoing situations. The school district is making good progress in efforts to alleviate many situations that arise in school, but cannot seem to make much progress with parent involvement within the school. |

#11 Value /Belief Pattern* | Strength | PotentialNeed | Problem | Comments | 1. Religion/Spiritual orientation/observances evident 2. Values, attitudes, and norms 3. Cultural influences 4. Designated sacred or historical areas (ie: ancient burial grounds, memorial parks, etc.) 5. Community-identified health problems and expectations of health. 6. Philosophies, goals and social issues of the community | | XXXXX | X | The XX Valley community has one non denominational community church, with the census tract. During church events, the parking lot is full, symbolizing community involvement. The church has services on Wednesday evenings, Saturday and Sunday, and various other church activities.The community values family and family autonomy, and does not reach out to help other community residents in need, which is a weakness within the community.Ethnicity within the community is comprised of primarily Caucasians and Hispanic ethnic groups. Although the community is made up of multiple ethnic groups there is not a real sense of culture within the community. Properties show no identifiable signs of culture. There are no resources within the community to meet culture needs of the community.There are no designated sacred or historical areas within the XX Valley census tract.Identified health problems with the community include nutrition, COPD, asthma, diabetes, and substance abuse. Increased access to health care services is a need of the community, and relates to over use of the fire department as primary healthcare provider. Goals of the community include improving access to healthcare and food services, and improving living and health conditions of community members. |