Community Health

The following are directions to write the narrative description of your field project. It
should be written in APA (6th edition) format, appropriately noting in-text citations,
references, etc. You may attach as appendices any charts, tables, or other materials
(labeled with the source identified per APA format). The document should be a minimum
of 7 pages and no more than 10 pages, not including the cover sheet, reference page(s), and
appendices. Use the headings in the outline below as the headings for your written paper.
A. Cover Sheet

  1. Include a cover sheet with the following information:
    � Name of the community/population & health issue (Title)
    � Your name and WGU student ID #
    � Date of submission
    � �HGT Community Health Practicum
    � �Western Governors University
    B. Assessment
  2. Describe the community where you performed your fieldwork. t
  3. Create a community genogram/profile reflecting the health status of the community.
    Note: This should be included as an appendix.
  4. Discuss the health concern you studied in your fieldwork.


  1. Describe the population of interest affected by the health concern you studied in your

G. Conclusion

  1. Reflect on how your perspective of the community’s health and the national, state, and
    local efforts toward a healthier population has changed as a result of your fieldwork.

Community Health

Contra Costa County

Contra Costa County is basically a suburban county located in San Fransico in the state
of California U.S. During the 2010 census, the population of this county amounted to 1,049,025.
The seat of the country is located at Martinez. The 2010 census also point out that the county
has 2,077.6 km 2 or 802.15 square miles. Of this, 719.95 square miles constitutes land while 82.20
square miles consists of water. The county is surrounded in the West and South by Alameda
County ; San Pablo Bay on North, San Fransisco and Marin on Northwest and finally San
Joakim County on the east. USA Today (2012)

The physical geography of this county is dominated by the alluvial plain on the bayside,
Berkely Hills, Oakland Hills, mount Diablo, several inland valleys and another isolated peak at
the end of Diablo hills. The peak of mount Diablo happens to be the basis of Mount Diablo
baseline and Meridian where the survey of western Nevada and California are based. The
Hayward Fault Zone passes through the western part of the county, from Richmond to
Kensington. The Calaveras Fault on the other hand runs in the southern central part of the same
county from San Ramon to Alamo. Apparently, the Concord Fault passes through Pacheco and
Concord and also the Clayton-Marsh Fault passes through Clayton in its north end to Livermore.
The earthquake faults that appear slip strike as well as the Diablo thrust fault near Danville are
considered capable of being destructive at any moment. There are also many other smaller
faults in places with important infrastructure such as water areas, oil and gas pipelines,
highways, roads, railroads and the BART Rail ways.

The County is labors among the main corporate headquarters, such as The PMI Group
Inc., Chevron, Nevada, Bio-Rad and AAA’s Northern California, and Utah headquarters. Other
corporate entities in this region includes: ConocoPhillips, AT&T, Wells Fargo, Tesoro,
Safeway, Bank of America, PG&E and Dow Chemical. The County boasts of divergent a diverse
base with no single sector that is predominant in the job market. With regard to demographics,
the costa Contra has a population of 1,049,025 in accordance to a 2010 census report. In terms of
racial make up, 0.7% are Japanese, 97,161 (9.3%) are whites, 4,845 (0.5%) are Pacific Islander s,
4.6% Filipino, 3.8% Chinese, 0.2% Pakistani, 0.4% Laotian, 0.8% Korean, 2.1% Indian, 0.7%
Vietnamese, and people from either Hispanic or Latin origin were 255,560 (US, Census, 2010).

With regard to housing, it appears that the housing in this region is quite expensively
developed. As a result, most of the houses are quite expensive. This means that for those people
with low paying jobs, they may find it difficult to find a house in this place. This apparently
seems to be an endemic problem through out the region. There are a number of big corporations
which have there headquarters located in this place. With regard to media, there are two major
weekly newspapers, the Contra Costa times and Contra Costa post. Contra Costa Post is owned
by Contra Costa Post LLC while a Contra Costa time is owned by Bay Area News Group-East
Bay. These news papers offer both local, national, international, traffic and weather news. The
Concord Transcript on the other hand, provides news in Concord and Clayton region.
Contra Costa is a stronghold of Democratic Party. In US House of representatives the
county is divided into five congressional districts namely California’s 3rd congressional district ,
5th, 9 th , 11 th and 15h congressional district which are all represented by democrats. As of
December (2012) there were 556,351 registered voters. Out of these, 275,757 (49.6%) are noted
to be democrats while 137,025 (24.6%) are republicans. Only 120,278 (21.6%) have not pointed
out their stand on their political party. In this region, Democratic Party has the have the benefit
of a wider benefit all the entre political subdivisions except in Clayton and Danville which is led
by Republicans. Richmond city records the largest number of registered democrats in the region
(California secretary of state, 2012).


ALL CAUSES 6,975.0 662.9 629.8 614.8   644.8  
ALL CANCERS 1,704.7 162.0 154.9 147.4   162.4  
COLORECTAL CANCER 174.7 16.6 15.7 13.3   18.0  
LUNG CANCER 387.7 36.8 36.2 32.6   39.9  
FEMALE BREAST CANCER 133.0 24.6 21.4 17.7   25.1  
PROSTATE CANCER 93.0 18.2 21.4 17.2   26.2  
DIABETES 186.3 17.7 16.9 14.5   19.4  
ALZHEIMER’S DISEASE 353.3 33.6 31.3 28.0   34.6  
CORONARY HEART DISEASE 990.3 94.1 88.2 82.7   93.8  


440.3 41.8 39.7 36.0   43.5  

INFLUENZA/PNEUMONIA 137.0 13.0 12.4 10.3   14.5  



31.8   39.0  


109.0 10.4 9.4 7.6   11.1  


281.7 26.8 25.8 22.8   28.9  


64.3 6.1 6.1     4.7   7.8  
SUICIDE 118.7 11.3 10.8     8.8   12.8  
HOMICIDE 83.3 7.9 8.4     6.7   10.4  
FIREARM-RELATED DEATHS 116.0 11.0 11.4     9.3   13.5  
DRUG-INDUCED DEATHS 112.7 10.7 9.9     8.0   11.7  

A genogram of the Health Situation in Costa County


Accidental Deaths

Alzheimer’s Disease
Colo Rectal, Lung, Female Breast, Prostate

Coronary Heart Disease
Celebrovascular Diseases
influenza Pneumonia
Chronic Lower Respiratory Disease
Chronic Liver Disease and Cirrhosis

Motor Vehicle Crashes, Drug Induced, Suicides, Fire-arm related and Suicides
Contra Costa County

The genogram above represents the health situation in Contra Costa County by showing the
leading causes of death in their various Categories. The two categories that have sub-groups are
the Cancers and also the Accidental Deaths
This subsection will take a view of the health status of residents in Contra Costa in comparison
to other states.

The county’s promotion of those who enrolls in public and private hospitals with fair or poor
health status seem to be consistent with other counties and also higher than the state of
California. The findings of an interview survey by California health in 2010 points out that
12.9% of residents in contra costa have either poor or fair health.

Table I.2 Health Status of County Population, Percentage of Population, 2010



Alameda San


24.9% 24.4% 29.4% 26.3% 27.2%

31.8% 35.8% 33.8% 41.2% 33.2%

Good 28.0% 26.9% 23.4% 19.0% 24.1%
Fair 12.2% 9.7% 11.2% 11.0% 12.0%
Poor 3.0% 3.2%* 2.3% 2.5% 3.4%*
100% 100% 100% 100% 100%

Source: California health interview survey

The incidences of health related issues such as physical inactivity; smoking, drinking and illegal
drug could also be a gauge of the community’s health. Contra Costa’s health data estimates the
age adjusted rate of children and adult obesity for the whole county to be higher that it is
neighboring counties. With regard to disease incidences, the country does not have either higher
or lower level of HIV/AIDS, diabetes, STDs as well as T.B when compared with other counties.
Generally, majority of residents in Contra Costa are low class and poorly educated population. In
particular, African American residents experience the worst health status and consequently a
reduced life expectancy. Moreover, the high rate of poverty is associated with the poor health
status and shorter life span among the residents in this region.
In this county, African American residents pose a shorter life expectancy in comparison
to other county residents. In addition, these people are at high risk of numerous poor health
concerns in the entre life course. In addition, the African Americans also had high rate of death
when compared to other residents. The specific causes of death among these people includes
but not limited to homicide, cancers, heart ailments, female breasts, injuries and accidents,
fetal and infant deaths, stroke, HIV and AIDS. In more recent times, African Americans in this
county have also experienced high rates of colorectal, prostate and lung cancer, increased rates
of HIV/ AIDS, assault, self inflicted injuries, low birth weights, and obesity.
Most of the deaths on Contra Costa emanate from chronic diseases. Some of these
diseases include but not limited to heart diseases, accounting for (47.7% of all deaths) cancer,
stroke, (7.1%) and lung and breast cancer which are among the leading causes of cancer deaths
in this region. Apparently, obesity among the small children as well as smoking in older adults is
considered as the main risk factors for heart diseases, cancer, stroke and they have continued to
afflict the local citizens. The rate of smoking according to Contra Costa Health services, (2011)

was 10.7% among the adults in this county. In addition, 56.2% of the adult population and more
than one quarter of children in this region experiences obesity. A high number of fifth graders
especially in West Contra Costa, Antioch, and Pittsburg are recognized to be overweight in
comparison to other places.
Among the top ten leading causes of death in Costa Rica, homicide has been more
significant in comparison to the state. Residents at younger age, i.e 15-25 years of age, the
leading causes of death happens to be homicide, unintentional injury, suicide, homicide and
obesity. People who are aged 15- 24 are mostly hospitalized for injuries, accidents, and
assaults, in comparison to other age groups. This is because, deaths from this group affects these
younger population excessively. Moreover, they impact greatly on the years of potential life
that were lost. The high rate of homicide has been noted as threatening the health of other
communities in comparison to others. These include communities in San Pablo, Pittsburg,
Antioch and Richmond.
HIV cases are on the rise in this county. Most of these (73.5%) occurs among gay
people. Almost half of the cases are identified as being among whites. Citizens in places such as
Concord, Richmond, Walnut Creek and Antioch accounts for more than half (54.5%) of HIV
cases in this county. The rates of gonorrhea and Chlamydia are also noted to be higher among
young residents mostly in the age 15–29(Contra Costa Health services, 2011).


Nutritional Concern among School Going Children in Contra Costa County
Generally, the present food system in this county has posed as a problem to the citizens.
Most citizens in this county rely on food products that emanate from highly industrialized food
systems. As a community, the population does not harbor even a small capacity of sustaining
themselves other than from the industrialized system. In contra Costs County, 42% of fight
graders who were tested in 2012 were noted to be obese. A research conducted by the
Bloomberg School of Public Health established that if the rate of overweight and obesity
continued to rise more than the present phase, by 75% of people in this county are projected to
be overweight by 2015. Another study done by California department of health services found
out that obesity and overweight cost California an approximation of $9 billion dollars per year
with regard to medical costs, compensation claims for workers, and lost productivity . The
present food situation in this region is arguably one of the key factors contributing to the obesity
One of the basic components of the industrialized food system in this county happens to
be the strong marketing campaign by food organizations. The US agriculture department points
that between 2000 and 2010, food organization spent an approximation of $40 billion dollars in
advertising alone. The institute of medicine reports that during 2005, the food organizations
spent between $10 and $12 billion dollars on advertising that were especially focused on
children. This has in turn led to children in the age of 8-13 years on average viewing various
food advertisements for more than 50 hours a year, or more precisely 7,700 advertisements in a
year. Half of such advertisements include snacks, fast foods, and sweets and very few involve
health produce. Stated differently, children of age at present spend averagely more than 0.30%
of their lives being lured in consuming unhealthy products and foods. The present food system

in Contra Costa County has transformed agricultural goods into consumable products. Food
organizations have endeavored to lure children to becoming voracious consumers of unhealthy
products which in turn has lead to the obesity and overweight pandemic.
Community Resources and Partners
My first assignment was to attend to the children’s that were in needing at help us grow
successfully (Hugs) Home Program. This program offers services to pregnant women and also
children up to the age of five years plus their care givers. Visitors in these homes basically
establish a unique and voluntary association with a family in this home. The purpose of my
visit to this home was to identify potential problems, type of foods taken by the children and also
provide education with regard to the kind of foods the officials offer children. In this visit, I
noted that the Hugs program seeks to curb or minimize the risks that are typically associated with
the nutritional problems and the promotion of wellness and the children’s health in general.
I also took more than 1.50 hours at Food Bank Drive of Solano County trying to acquire
an insight regarding the best healthier foods for children. In this day, 13 th Jan 2013, I also
participated in the food programs by the food bank at places as the Baptist church, Mariposa
and Vacaville. The Sololano and contra costa food bank is focused at reduced hunger problems
and ensuring that the kids from low income families have access to health and nutritious foods.
The organization has established a comprehensive category of products that are aimed at
combating hunger, nutritional problems and their causes. The food bank is a member of two
other entities: California Association of Food banks and feeding America.
The organization has served the contra costa community for over 35 years. Each month,
more than 150,000 people are fed at community sites and through other network of more than

180 charitable organizations. The main aim of this entity according to the officials is to reduce
the wastage of food products, educating the public with regard to health foods and other food
issues, and feeding those experiencing hunger. The work is done by the help of many volunteers
who coordinate the food drives, distributing foods to hungry people, sorting and parking the
foods and so on. The interview with the management revealed that the institution advocates for
health foods among the recipient of these programs. Through the program they have named as
farm to children, the food bank offers fresh produce such as vegetables, and fruits to kids whose
families may not afford to keep food on the table. The founders had noted that since fresh
produce is expensive and perishable, a lot of families in contra cost have problems feeding
their children foods that have nutrients they so desperately require in order to grow and
develop. Each week, farm to children project offers between 3-5 pounds of fresh products to
more than 10000 children in 90 after school projects in Sololano and Contra Costa Counties.
More than half of the students in these schools are provided with either free or reduced cost
Interview Schedule
A lot more people wonder if there is hunger in USA and more especially in Contra Costa
County which is perceived to be an affluent country. Findings from the interview session from
parents and children concerning nutritional status indicates that in Contra Costa county there is a
fluctuation of food insecurity and hunger in accordance to the prevailing economic
circumstances. Families that experience less than 130% of the poverty level specifically reported
higher level of food insecurity in their families.

Across the ethnic groups of this region, food insecurity is related with deceases supply of
households as well as the consumption of vegetables and fruits. The survey also noted that the
intake of foliate, vitamin A, zinc and magnesium is more especially low among women in
moderate to extreme food insecure families. Further, the interview also revealed that the
intermitted episodes of food regulations that is mostly experienced during the financial
downturn is the main cause of overeating in much later time when such families have enough
money to spend. Our study also established a link between food insecurity and obesity in both
children and women. Apparently, food insecurity has also been related to psychological,
emotional and academic problems among school going children in contra Costa County.
The focus group discussion in contra Costa established that households that had low
households experience seasonal cycles of food insecurity that is associated with lack of
agricultural and employment opportunities. Interviewees also revealed that among the Mexican
Americans, food insecurity was apparently related with higher intakes of tortillas and beans
among the preschoolers. This is because these were the main foods that were readily available in
such moments. Consequently, foods such as pizzas, low fat milk, cooked vegetables, cookies,
crackers as well as other desserts were lowly consumed. Generally, the interview with parents
and caretakers plus the observation of small children in households with extreme food
insecurity failed to meet the food standards set forth by USDA food guide pyramid when
compared to those families that have food security. These findings indicate that cyclical food
security patterns are related with diets that are less varied. There are also indications that
permissive perceptions regarding food selection and snacking, which follows a period of anxiety
and food regulation which owes to the seasonal food insecurity subsequently leads to the
greater consumption of high fat /sugar foods among residents of Contra Costa County.


Majority of the interviewees acknowledged that food insecurity was related with a
decrease in house hold supplies of foods that are both nutritionally rich as well as those are less
nutritional. See Table 1.3 below.


Some of the foods that are dense in nutrients but less often reported when food insecurity
increases include: apples, lemons, tomatoes, carrots, beef, fish, whole wheat bread, bananas and
oranges. Foods that are low in nutrients including cookies, sodas, powdered chocolate flavoring,
and gelatin are also not frequently consumed as food insecurity increases. Basic foods appear to
remain stable among these citizens and include such foods as onions, white rice, corn tortillas,
beans and cooking oil. A crucial point that was noted was that the high number of high fat or
high sugar foods consumed by children remains the same whether there is food insecurity of
not. Such foods includes: turkey/beef franks, sweetened cereals, ice cream, candy and fruit
flavored punches.
In essence, food insecurity in Contra Costa household is related with a decline in the
supply of nutritious and less nutritious food products. Consequently, the food supply in the
families is associated with food intakes in such families. There is a strong need for strategies
designed to create awareness for these residents and also provide nutritious foods to families that
have no enough foods.
Impact of Poor Nutrition among School Children
In Contra Costa, poor nutrition has according to the observation and interview schedule
with the parents compromised the health status of the children in the school going age as well as
their academic achievement. A study done by Gorman (1994) on the impact of deficiencies of
minerals such as iron, Zinc, iodine and foliate on the cognitive development of school aged
children indicated that there is a correlation between nutrition and the children’s thinking
capability. For instance, lack of enough zinc and iron are related with the impairment of

neuropsychological role, retarded development and growth, increased vulnerability of ailments,
and reduced immunity. The crucial nutrients for optimal health and well being include energy,
proteins, fatty acids, calcium, and iron.
Children of school going age develop significantly, though at a slow rate. At this time, they are
generally active physically. Consequently, there nutritional needs are critical and at the same
time high. Furthermore, there are other factors such as gender, genetic background, body size
and shape that are crucial determinants of nutrient requirements among these children. Residents
of this county should be taught on how to maintain their balanced diet as well as regular
exercises more especially to children who are of school age of 6-12 years. Children of such an
age require taking a balanced diet as well as a variety of foods from every food category so as to
ensure that there bodies have enough minerals and vitamins. Apparently, these children may
encounter new challenges with regard to their food habits and food choices. Choices with
regard to what to eat are partly determined by what is offered in their school, home, peer
influences, media influences and more especially the television.
Provision of sufficient nutrition for school aged children ensures that they develop to
their full potential and also provides the stepping stone for a healthier life. Achieving optimal
nutrition translates that the kids take at least three meals a day plus two snacks that are
nutritional. The children’s caretakers and the children themselves should be made to limit the
intake of foods that are very high in sugar and fats. Apparently, the children should be made to
partake sufficient amount of fresh produce such as vegetables, fruits, low fat dairy products, lean
meats, including three intakes of milk on a daily basis, yoghurt or cheese so as to meet the

calcium requirements as well as preventing numerous health issues such as diabetes, obesity
and weak bones.

Role of Caregivers
Caregivers and parents act as role models to their
children. This means that there is a likelihood of any
dietary habits established by the parent to be either directly or indirectly reflected to the child.
If the caregivers employ their roles effectively in modeling health eating habits will ultimately
lead to a positive impact on the children’s eating habits when offering snacks and meals at home
environment. Therefore, the caregivers ought to offer different types of foods and establish
consistent snack and meal times.
In particular the nutrients requirements will be sufficiently met is the food pyramid is employed
in planning family meals. The essence of the food program is to enhance the nutritional health

for people of all ages. It guides daily food choices. According to the food pyramid, those foods
with a lot of sweets, oil and a lot of fat should be sparingly consumed.

Nutritional advice for Children of School age

The following measures if taken appropriately will make children stay health, they include:

 Making sure that the children take breakfast on a daily basis so as to be able to
concentrate in class. This break fast should be designed in such away that the
constituents contain a third of the total energy requirements for the particular day. The
breakfast may constitute a cereal for instance, bread, rice and oats. Foods that is rich in
protein such as milk, eggs and fruits such as papaya, orange, pineapples and so on.
Research has found out that the morning and overnight fast among children of school
age positively impacts on the attention and cognitive ability. Empirical evidence from
studies relating to the breakfast effects on cognition indicates that specifically for school
going children, not taking breakfast has negative effects on the general level and
cognition of these children.
 People should take diversified foods so as to have enough nutrient in take
 The food taken should be balanced with physical exercises
 The diet with sufficient grain produce, fruits and vegetables should be selected.
 The diet selected should be low in cholesterol, fat and saturated fat.
 The diet selected should also have sufficient iron, and calcium in meeting the
requirement of the body.
 These children should be taught early enough concerning foods, nutrition, drinks, health
life and also what goes on with the food they consume in their bodies.

 The diet so selected should be moderate in both salt and sugar. People ought to avoid
excessive sweet deserts, fruit flavored drinks, soft drinks, chips or candy, and sugar
coated cereals. Such foods have very low nutritional content.


Just like many other regions in this place, The ability of many health departments in
Contra Costs in demonstrating and documenting a direct link between the participation of the
community and health improvement on the population is found to be very much limited. In most
cases, health facilities do not have sufficient staff and the required data so as to effectively
evaluate the long term effects of such efforts which could take many years to realize. Therefore,
this article emphasizes on more results of community participation by calling for changes in the
health departments of these place, public or organizational policies impacting on the community
environment as well as the service delivery systems.

The timeline below covers the four months within which the project was conducted from the
start to the finish. As one moves to the left, the months progress while downward motion
signifies time progressing in the month in terms of days.


Year: 2013

January February March April
8th Attend
Children in need
of Hugs Home
8 th : Attend Food
bank drive Solano

13th: Attend, Interview and Participate in
the Food Bank Drive of Solano County at
True Baptist Church: 1956 Pennsylvania
Ave, Fairfield CA
15th: Toured the Food Bank Warehouse
of Solano County and talked to the Staff
and Volunteers
19th:Attend, Participate and Interview
Adults and Children about nutrition
At Buchanan Park
20th: Attend, Participate and Interview
Adults and Children about nutrition At :
Church of the Nazarene:
23rd: Attend, Participate and Interview
Adults and Children about nutrition At
Antioch High School
26th: Attend, Participate and Interview
Adults and Children about nutrition At
Immaculate Heart of Mary
27th: Attend, Participate and Interview
Adults and Children about nutrition
At Salvation Army
28th: Attend, Participate and Interview
Adults and Children about nutrition At


The Pentecostals
29th: Attend my daughter pre-school as a
concerning mother about the
meals/snacks they are proving the
29th: Attend the school with my neighbor
(mom and son) as a concerned mother
about the meals/snacks they are proving
to the children
29th:Go to local MacDonalds and
observed what children are eating and talk
to some of the parents regarding their
children’s health

2nd: Attend, Participate
and Interview Adults and
Children about nutrition
At Buchanan Park
6th: Attend, Participate
and Interview Adults and
Children about nutrition
At La Clinica de la Raza

If the community at Contra Costa County puts more emphasis and value chemically free,
fresh, health and less costly products for their children, they will have to do one simple thing,
feeding these children their own grown farm produce. The residents should opt of growing such
produce as berries, tantalizing fruits and nuts. Beautiful plants that could also produce health
and delicious foods such as raspberries, blueberries, citrus, plum and passion fruits could be
planted at very little or no cost at all. Just one fruit tree could be able to yield much fruits on a
yearly basis to schools, offices, hospitals, markets and so on. Once they are established, Olive
trees fro instance need very minimal watering and could be easily destroyed easily. Therefore,
they will provide food for many years to come.
Plants such as Blackberry, Raspberry should be planted especially in places where
children frequent. If they happen to pick clean fruits, they will provide the children with
phytonutrients that are extremely valuable for their health. Landscapping should be designed in
such a way that health fruits and food products are brought more close to people and connects
the culture and committees throughout the cycle of seasons. The residents themselves could
assist in embedding the value of fresh products in this region as well as the physical environment
by planting trees that are food bearing, vines, and bushes at workplaces, schools or homes. In
essence, designing an edible landscape would be one of the key factors in solving the food
situation that is affecting the children in Contra Costa County.




Contra Costa Health services, (2011). “Community
health indicators”
Gorman KS. (1994) “Nutritional deficiencies as developmental risk factors. In: Nelson CA, ed.
Threats to optimal development: integrating biological, psychological and social risk
factors” New Jersey: Lawrence Erlbaum Associates.
USA Today (2013) “Contra Costa County”
US, Census, (2010). “US Census Bureau”.