Windshield Survey Summary and Reflection
There are many definition that define the community. The World Health Organization (WHO) refers to the community as “ a group of people, often living in a defined geographical area, who may share a common culture, values and norms, and are arranged in a social structure according to relationships which the community has developed over a period of time” (Stanhope & Lancaster, 2012, p.397). The healthy level of the community is called public health, and the responsibilities of public health include assessment, policy development, and assurance (Stanhope & Lancaster, 2012). Goals for public health are to promoting healthy status of the community as well as maintaining the community in a balanced healthy environment. The nurses who are employed by either private agencies or government departments to promote community health are the public health nurse. The public health nurse is to serve the community as the client by using the population-centered practice to seek beneficial health changes for the whole community (Stanhope & Lancaster, 2012). While working in a community-oriented nursing practice, it is important to work with the community partnerships like professional groups or non-medical groups to help promoting community health. The community that the student conducted the windshield survey is in the city of San Gabriel, Southern California. The City of San Gabriel is home to a population of more than 42,000 with a diverse population of Asian, Hispanic, Caucasian, and other ethnic groups (San Gabriel City, 2014). The selected family in the survey has been living in San Gabriel city for about ten years, and their two young children are attending school in San Gabriel Unified. The house of the Wang family is located in a quiet street with easy access to the freeway and stores. The neighbors are majority Cantonese Asian. Asian culture influence in the community is significant, and often the family describes the feeling of “belonging” here. The sense of “belonging” can determine whether the groups will survive (Stroope, 2011). There are many Asian supermarkets and restaurants in the San Gabriel area. Despite the majority of Chinese Asian in the community, there are also many different nationalities in this neighborhood such as Indian, Filipino, and Hispanic. The culture diversity creates unique phenomena in this community in which people might speak a different language but they can understand each other. People live in this multiple culture environment tends to have a higher tolerance for the difference between each other, and this impression is not often be seen in other places. The family that the student observed during the windshield survey belongs to the Chinese culture that the grandparents live with the daughter and son-in-law. During the day, grandparents take care of the grand daughters and pick them to and from school while the parents are at work. The family has a good relationship with the neighbors who are also Chinese and speak the same language. Similar culture in the neighborhood with Chinese family that grandparents are staying home watching grandchildren and the parents are both working. In this situation the main vulnerable population in the community is the elder and children, especially when the elders need to watch over the young while the stronger adults are away working. Three generations live in the same household is a shared tradition in Asian cultural because the idea of responsibility to take care of the elderly has been with Asian for over thousands of years. “Culture refers to the integrated lifestyle, the learned and shared knowledge, values, worldviews, artifacts, symbols, rules, and beliefs that guide behavior of a particular population" (Racher & Annis, 2007). The world is increasingly becoming multicultural; thus, it is important that the public health nurse develop the multiculturalism characteristic (Chambers, Thompson, & Narayanasamy, 2013). In the community that the student conducted the survey, there are few areas that have been identified and could affect resident’s health. First is the access to healthcare services. Based on the student’s observation, there are many medical office and hospitals in the area, but lack of urgent care facility and public resources to provide a different level of care. In addition, most of the residents are not aware of the help that public health can provide, and are not aware that it is not necessary to use the emergency room resources for non-urgent issues. Second is the screening for Hepatitis B as the Asian population is a high ratio of Hepatitis B virus infection. Moreover, according to the World Health Organization, there are over 2,000 million people infected with Hepatitis and 1 million people die from chronic active hepatitis, cirrhosis or primary liver cancer each year (World Health Organization, 2014). Most of the residents do not aware the importance of screening if positive for Hepatitis B, and residents who are chronic carriers do not aware the necessity of routinely follow up with the liver functions. Furthermore, the education on chronic disease management is another identified issue in the community. Most of the elder residents have a chronic disorder such as diabetes, hypertension, and heart disease and on medications. However, most of the elder residents do not understand the action and side effects of the drug but just take per their doctor’s prescription. Unfamiliar with medication management had led to few residents were hospitalized from the inappropriate medication dosage. One of the topics in Healthy People 2020 is the "increased proportion of persons with a usual primary care provider" (Healthy People, 2014). The vulnerable population in the community are elderly and children and fortunately, most of them have their own primary health care providers. In addition to the Medicare services, elderly receive Medicare insurance will assign or advise to have a primary care provider. Primary doctor is a medical physician who is trained and skilled in comprehensive first contact and provide continuing care for people with any unknown sign and symptoms, or health concern (American Academic Family Practice, 2014). The primary care physician is also the person to recommend clients for other medical specialty needs. It is important for especially elderly to select a primary physician who can speak the same language in order to provide a barrier free care.