Caring for the populations Assessment and Diagnosis Staten Island

Caring for the populations Assessment and Diagnosis Staten Island

The purpose of this paper is to provide an opportunity to utilize community assessment
strategies, uncover a community health problem, and identify the components of the
problem related to the community dynamics


Caring for populations’ assessment is an essential step in ensuring complete patient
satisfaction in a population. Assessment of patient progress in health may occur after or
during treatment. Diagnosis is part of the population care process which aims at identifying
the disease or infection of a community. There are many and different assessment strategies
and diagnostic procedures which are employed by a community to uncover its problem so as
to provide the best intervention for each of the components of the identified problem. The
interventions provided consider any related community dynamics. In this paper, I discuss the
how different assessment strategies to identify the health problem of Staten Island, the
possible components of the problem associated with family dynamics and diagnosis for the


North Shore of Richmond County is one two major communities in Staten Island. It is
served by Richmond University Medical Center. It is divided into smaller areas which
include George, Port Richmond, Mariner’s Harbour, Stapleton and West Brighton. . North

Shore is historically known to be poorer, less literate and subject to cultural and linguistic
barriers as a result of a considerable proportion of foreign born residents. These factors have
been limiting factors to the community’s access of better health care. According to released
by Richmond County Medical Society (RCMS) in 2008 commission, infant mortality in this
community was recently approximated to be 60 % higher than the over rate of the entire New
York City and almost three times above what was reported in South Shore.
The report commissioned by RCMS identified poverty as a major hindrance to access
to health care and has a great impact North Shore’s health status. The sub-regions in North
Shore are the leading in poverty levels in Staten Island. For instance, Stapleton (21%), Port
Richmond (17.5%), Mariner’s Harbor (17.4%) and West Brighton (15.4%) carry the highest
levels of poverty rates. Other regions have lower lover levels poverty levels such South
Shore of Staten Island with a rate of 4.6% in 2007. The community also faces the most
serious challenges in terms of healthcare resources, besides poor health status and high
poverty levels. Majority of the 2,000 individuals known with HIV/AIDS in RUM come from
North Shore.

Demographic and epidemiological data

According to the census carried out in 2,000, persons below 18-years old were
represented by 23.7 % while that of the state 23.6%. Those at the age of 65 and over
comprised of 15.5% against the state’s 13.8%. In a research carried out by Massachusetts
Department of Public Health for 1995-2013, the demographic data obtained collected
indicated great levels of inadequacy in all aspect of the community’s well being. The
population below 100 % and 200% of poverty level is 8.9% and 20.7% of 24,412 and 56, 868
respectively and that of the state is 9.3% and 21.7%. Children under the age of 18 years of
age leading a life below 100% of poverty line is for the community and the state are 20.7 %

and 21.7% while the unemployed people who are 16–years-old and above is 8.3% of 12, 536.
The population of the state Births to women aging 15 to 44 is 58% of 3,256. Infant mortality
is 3.1% out of a count of 10. Birth to adolescent mothers is 6.4 % of 210 and those benefitting
from publicly funded prenatal care 44.7 in a count of 1,450. On infectious diseases, the
community recorded an HIV/AIDS prevalence of in terms of a crude rate of 208.1 in a count
of 598, tuberculosis crude rate 5.2 out 15, pertussis 5.6 out of 16, hepatitis-B 80 out of 23. In
terms of injury indicators, the crude rates in suicide, homicide, and injury deaths related to
motor vehicle is 4.9(of 14 counts), 10.9 (31 counts) and 2.5 (2.5 of 7). Last, chronic disease
indicators, total deaths recorded is 687.3 out of 2,651 counts. The area adjusted rate of
cancer, 175.5(of 651 counts), breast cancer deaths 57.6 out of 208 and cardiovascular disease
deaths 196.1 out of 794 area counts (Richmond University Medical Center, 2013).

Windshield survey

Community assessment plays an essential role in community nursing. It is important
to understand various categories of the residents in the community is fundamental to
clarifying the process of assessment. The first category of residents described were the
HIV/AIDS young people between the age of 18 and 30 years old. The most of the women
were already married while fewer men had spouses. A few of HIV/AIDS positive patients
were low income earners while a majority were unemployed and depending on farm produce
and small business for survival. Those who suffered from HIV/AIDS related complications
received medical attention from a nearby health center. The second category identified was
old people aged 75 years and above. Most of them lived in abject poverty and received
inadequate attention from their caregivers. Most of them nursed chronic problems such as
diabetes and blood pressure. Besides the little support from family members, there no other
support system ( Wilkinson & Leuven, 2010).



The main problem this community is facing is a hindrance to accessing the right
health care as well as availability of healthcare facilities. Statistics show that only 8.7%
community members have the AFDC Medicaid Recipients and are 8.7% and 1.1%. As a
result of poor health care, infant mortality in the community and the state are 3.1% and 4.4 %
respectively. Multiple Assistance Unit Medicaid Recipients Poverty arises from inadequate
education of the residents of this community. It was discovered that most members of this
community and health care centers had no access to electronic health records. Different age
groups showed varying levels of poverty and rationale. Most young people are poor because
of unemployment, poor education and substance abuse. Closely associated with this problem
is poor medical care to the people. Ability to access proper medical attention depends on
one‘s level of education, access to a medical facility and other social-economic facts
(Cornelius & Price, 2013).


North shore is and its sub-regions are the poorest when it comes to Per Capita Income,
prevalence of disease and access to diagnostic center. The rates of poverty and disease
prevalence are high with poverty as the main underlying problem. Most youths are
unemployed. This community has poor access to health care despite a wide range of health
related issues it faces. From the windshield survey carried out it was seen that most people
were in abject poverty and help was not soon coming. In conclusion, serious interventions are
needed in order to help the community initiate and implement its health programs.



Cornelius, F., & Price, R. (2013). Community health nursing test success an unfolding case
study review. New York, NY: Springer Pub.
Richmond University Medical Center Community Health Needs Assessment &
Implementation Plan 2013. (2013, January 1). Retrieved November 22, 2014, from
Wilkinson, J., & Leuven, K. (2010). Fundamentals of Nursing Theory, Concepts, and
Applications. (2nd ed.). Philadelphia: F.A. Davis.