Community Nursing Process Paper: Mott Haven and Melrose
Destiny Lopez, Jian Qiao, Karolyn Baldera, Michael Grullon, Tao Meng
School of Nursing, Monroe College
NS410-45: C.C.C. in Community Health & Role of the Pro
Professor Tanya Morris
April 7, 2024
Community Nursing Process Paper: Mott Haven and Melrose
Community Assessment
The Community Assessment for Mott Haven and Melrose is a crucial step in understanding the health needs of these neighborhoods. We are delve into the specifics:
Location: Mott Haven and Melrose are part of Bronx Community District in New York City .This district encompasses these neighborhoods and plays a significant role in shaping the health outcomes of its residents.
Health Needs Assessment: The community health nurse initiates the assessment by gathering existing data. This includes information from national, state, county, and local health needs assessments. Understanding the unique challenges faced by Mott Haven and Melrose residents is essential for designing effective health interventions.
Community Profile: Mott Haven and Melrose are characterized by diverse populations, socioeconomic disparities, and varying health conditions. The assessment considers factors such as access to healthcare, social determinants of health, and prevalent health issues.
Healthcare Services: NYC Health + Hospitals plays a vital role in providing essential inpatient, outpatient, and home-based services to over a million New Yorkers annually across the city’s five boroughs. Nurses, including those from Mott Community College, contribute significantly to community health by addressing the specific needs of residents .
In summary, the Community Assessment for Mott Haven and Melrose aims to identify health gaps, promote preventive measures, and enhance overall well-being. By understanding the unique context of these neighborhoods, healthcare providers can tailor interventions to improve health outcomes.
Demographics
They are dynamic communities with diverse populations, economic disparities, and ongoing efforts to address housing issues. Understanding these demographics informs targeted interventions for community well-being.
Population: In 2021, an estimated 159,556 people resided in Mott Haven and Melrose combined.
The racial and ethnic composition is as follows:
0.7% identified as Asian.
27.4% identified as Black.
65.5% identified as Hispanic.
3.5% identified as white.
Income and Poverty:
The median household income in 2022 was $32,010.
Notably, 38.5% of households had an income of $20,000 or less.
The poverty rate declined from 45.5% in 2000 to 36.6% in 2021.
Labor Market: The labor force participation rate increased from 47.8% in 2000 to 53.1%.
However, unemployment rates fluctuated, with the latest rate at 18.80%.
Housing: The homeownership rate improved slightly to 9.0%.
Severe housing code violations per 1,000 rental units increased to 127.8.
The neighborhood faced foreclosure challenges, but recent rates have decreased.
Mortality and Morbidity
Cancer (62.3%) and heart disease (52.1%) are the leading causes of premature death (death before the age of 65) in Mott Haven and Melrose, similar to the rest of NYC. However, Mott Haven and Melrose residents die prematurely at a higher rate. Lung cancer, liver cancer and colorectal cancer are the three leading causes of cancer-related premature death in Mott Haven and Melrose. Death rates due to drug use (24.9%), HIV (22.1%) and homicide (13.6%) are more than twice the citywide rates (New York City Department of Health and Mental Hygiene, 2018).
Mott Haven and Melrose’s adult obesity rate is 42%, which is higher than the rest of NYC. More than 700,000 adult New Yorkers have been told they have diabetes. An additional 164,000 are estimated to have diabetes but not be aware. 20% of Mott Haven and Melrose adults have been diagnosed with diabetes and 38% of adults have been told they have hypertension. Hypertension is the leading risk factor for stroke and the most important to control. Rates for both are higher than the rest of NYC. Additionally, Mott Haven and Melrose’s new HIV diagnoses are significantly higher than NYC (New York City Department of Health and Mental Hygiene, 2018)..
Avoidable hospitalizations are those that could be prevented with timely access to quality outpatient care. The rate of avoidable pediatric hospitalizations among children ages 4 and younger in Mott Haven and Melrose is higher than the citywide rate. Many childhood asthma emergency department visits could be prevented by reducing the presence of pests, mold, secondhand smoke and other asthma triggers, and by taking daily medication. The asthma emergency department visit rate among children ages 5 to 17 in Mott Haven and Melrose is nearly triple the citywide rate (New York City Department of Health and Mental Hygiene, 2018)..
Physical Environment
Although NYC air quality is improving, air pollution, such as fine particles (PM2.5), can cause health problems, particularly among the very young, seniors and those with preexisting health conditions. In Mott Haven and Melrose, levels of PM2.5, the most harmful air pollutant, are 8.6 micrograms per cubic meter, compared with 7.8 in the Bronx and 7.5 citywide (New York City Department of Health and Mental Hygiene, 2018).
Most heat stroke deaths in NYC occur in homes without air conditioning. Three-quarters of households in Mott Haven and Melrose have working air conditioners. Every resident has the right to live in housing that is safe and pest-free. In Mott Haven and Melrose, only 24% of renter-occupied homes are adequately maintained by landlords – free from heating breakdowns, cracks, holes, peeling paint and other defects (New York City Department of Health and Mental Hygiene, 2018).
Mott Haven and Melrose residents have a higher pedestrian injury hospitalization rate than NYC overall. Access to bike lanes can make it easier and safer to ride a bike more often. 18% of roads in Mott Haven and Melrose have bike lanes, which is higher than NYC overall. Bodegas are less likely to have healthy food options than supermarkets. The lowest ratio among NYC community districts is one supermarket for every three bodegas (healthier); the highest is one supermarket for every 57 bodegas (less healthy). Mott Haven and Melrose is home to three of NYC’s farmers markets, another source of healthy food. For every one supermarket in Mott Haven and Melrose, there are 25 bodegas (New York City Department of Health and Mental Hygiene, 2018).
Health and Social Services
Education
Recreation/Aesthetics
Economy
Transportation
Safety
Strengths and needs of the Community
Community Diagnoses
We identified the following nursing diagnosis after analyzing the results of our assessment to determine which three health issues or disparities present the greatest opportunities for community interventions.
First, risk of developing obesity (42%) related to the people having high level of food insecurity, high daily intake of sugar-sweetened beverages, and a lack of adequate physical activity. Second, risk of developing diabetes (20%) related to less than body requirements related to insulin deficiency, as evidenced by unexplained weight loss, increased urinary output, dilute urine, high blood glucose levels, fatigue, and weakness. third, risk of developing heart disease and stroke (38%) linked to high rates of hypertension, unhealthy diets, lack of exercise, lack of knowledge, and a larger black population.
Risk Population
Obesity, diabetes, heart disease and stroke are three prominent health disparities in this community. Children are at risk, as 24% of this community’s population is elementary and middle school students (New York City Department of Health and Mental Hygiene, 2018). Childhood obesity increases the risk of high blood pressure, diabetes and heart disease in adulthood. Obesity in childhood raises the risk of high blood pressure, diabetes, and heart disease. Latino and black people and persons aged 45 and older are the main risk categories for heart disease and stroke because these two groups are prone to high blood pressure. Individuals aged 45 and up account for 31% of the population, with black people accounting for 97% of the total (New York City Department of Health and Mental Hygiene, 2018). The obese or overweight, physically inactive, have unhealthy diets, are aging, and have other chronic diseases population are the risk groups for diabetes.
Current Available Services
Healthy People 2030 Objectives
According to the situation and community diagnoses of Mott Haven and Melrose, we identify two objectives from Healthy People 2030 for this community. The first objective is obesity. Our goal is reducing the prevalence of obesity and improve health outcomes among adults and children. Evidence shows that comprehensive strategies, including healthier eating and regular physical activity, are effective in reducing the rates of obesity among adults and children (Madigan et al., 2022). Programs that provide individuals with access to nutritious foods, opportunities for physical activity, and education on maintaining a healthy weight to decrease the rates of obesity.
The second objective is hypertension in adults. Our goal is reducing the prevalence of hypertension and improve cardiovascular health among adults. Evidence shows that lifestyle interventions, including dietary changes and increased physical activity, combined with stress management techniques, have been effective in reducing or maintaining blood pressure levels within a healthy range for adults (Goetsch et al., 2021). Programs that provide adults with resources for healthier eating, stress management, regular physical activity, and health education to reduce the rate of hypertension.
Plan for Project Implementation
To address the three health issues of obesity, diabetes, and hypertension, our group members read and debated various articles and data and created strategies and plans. All programs and measures contain four aspects: Inputs, activities, outputs, and outcomes.
In developing interventions to address obesity, we can use data from primary health centers, community centers, overweight and obese populations, and dietary inputs. With these inputs, we can conduct nutritional health education programs and physical activity programs, develop related wellness policies, and establish public exercise areas such as parks and gyms (Pearce et al., 2019).
Implementation of these activities will lead to increased educational achievement, physical activity participation, and health policy implementation. Ultimately, we expect these interventions to increase public health awareness, change public lifestyles, and reduce obesity rates.
In developing diabetes-specific interventions, we can use data from primary health centers, community centers, overweight and obese populations, diabetes data, and dietary intake data. These inputs will support the development of nutritional health education programs and physical activity programs, the development of relevant wellness policies, and the establishment of public exercise areas such as parks and gyms (Kelley, Nocon, & O’Brien, 2020).
The implementation of these activities will result in the following outputs: effectiveness of nutritional health education, participation in physical activity, enforcement of wellness policies, and utilization of public exercise areas. We expect these activities to ultimately lead to the following outcomes: a decrease in the prevalence of diabetes, lifestyle changes, improved community health, and increased public health awareness.
In developing interventions for heart disease and stroke caused by hypertension, we can use data from primary care centers, community health centers, people with hypertension, hypertension prevalence data, and dietary data. These inputs will support our hypertension awareness campaigns, blood pressure screening programs, lifestyle improvement programs, policy advocacy, and healthcare provider training.
Implementation of these activities will result in the following outputs: number of individuals screened for hypertension, participation in educational programs, establishment of public health policies, and availability of resources（Xia, Zhao, & Nianogo, 2022). We expect these activities to ultimately lead to the following outcomes: blood pressure control, lifestyle changes, reduction in hypertension-related complications, and community health impact.
Project Evaluation
Cultural Competence and Ethics
References
Goetsch, M. R., Wagle, A., Valilis, E. M., Razavi, A. C., McEvoy, J. W., Blumenthal, R. S., & Whelton, S. P. (2021). Dietary and lifestyle modification for the prevention and treatment of hypertension. Current Cardiovascular Risk Reports, 15(10). https://doi.org/10.1007/s12170-021-00683-7
Kelley, A. T., Nocon, R. S., & O’Brien, M. J. (2020). Diabetes Management in Community Health Centers: a Review of Policies and Programs. Current Diabetes Report (Print), 20(2). https://doi.org/10.1007/s11892-020-1289-0
Mott Haven/Melrose neighborhood profile. (n.d.). https://furmancenter.org/neighborhoods/view/mott-haven-melrose
Nursing A.A.S. – Programs | MotT Community College. (n.d.). https://www.mcc.edu/degree-pathway/NURS.shtml
NYC Food Policy Center (Hunter College). (2022, January 22). Foodscape: Mott Haven/Melrose. NYC Food Policy Center (Hunter College). https://www.nycfoodpolicy.org/foodscape-melrose-mott-haven/
Oxiris Barbot. (2018a). COMMUNITY HEALTH PROFILES 2018: MOTT HAVEN ANDMELROSE. https://www.nyc.gov/assets/doh/downloads/pdf/data/2018chp-bx1.pdf
Pearce, C., Rychetnik, L., Wutzke, S., & Wilson, A. (2019). Obesity prevention and the role of hospital and community-based health services: a scoping review. BMC Health Services Research (Online), 19(1). https://doi.org/10.1186/s12913-019-4262-3
Xia, T., Zhao, F., & Nianogo, R. A. (2022). Interventions in hypertension: systematic review and meta-analysis of natural and quasi-experiments. Clinical Hypertension, 28(1). https://doi.org/10.1186/s40885-022-00198-2
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