Solved by verified expert:OverviewConduct a windshield survey to identify a population and its primary health concern. Develop a 3–5-page report that explains demographic changes for a population and describes the health disparities and social determinants of health that can affect the population.Note: The assessments in this course build upon each other. You are strongly encouraged to complete them in sequence.Competency 1: Explain the principles and concepts of disease prevention and health promotion for diverse and vulnerable populations.By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:Describe a vulnerable or diverse population living within a neighborhood or community.Describe health risks and health care needs for a vulnerable or diverse population.Competency 3: Apply basic epidemiological concepts, data analysis methods, tools, and databases to determine the effectiveness of health promotion and disease prevention initiatives for diverse and vulnerable populations.Explain demographic changes for a vulnerable or diverse population.Competency 4: Examine the ethical, legal, and economic factors related to health disparities in diverse and vulnerable populations.Identify health disparities and social determinants of health that can affect a vulnerable or diverse population.Competency 5: Communicate in a manner that is scholarly, professional, and consistent with expectations for members of the health care professions.Describe the overall condition of a neighborhood or community.Write content clearly and logically, with correct use of grammar, punctuation, and mechanics.Correctly format paper, citations, and references using APA styleContextAs the population of the United States grows more diverse, the health care workforce must increase awareness of cultural differences and the overall shift in the demographics of the entire population. To provide high-quality health care to a community or population, health workers and educators must be competent in their understanding of the relevant characteristics of its ethnic or cultural groups. The ability of nurses to deliver high-quality care to a diverse population will influence health prevention and the treatment of illness.SHOW LESSWindshield SurveysA windshield survey helps you create a portrait of the people who live within a specific neighborhood or community. This is an inexpensive, time-efficient way to assess and better understand a community and the people who live within that community. Understanding the demographics of a community will help you determine the kinds of health-related issues that are likely to exist, so you can plan the most appropriate types of wellness programs, health education, and disease prevention.Assessment InstructionsPreparationOver the past few years, leadership for the health care organization for which you work has noticed a distinct change in the population served by the organization. Leadership wants to make sure they are addressing the needs of this population. You have been asked to participate on an interdisciplinary team that is charged with learning how the population has changed and what needs to be done within the organization to develop a wellness education program that will target the needs and concerns of the population. Your first step in this process is to conduct a windshield survey and report your findings back to your team.A windshield survey is an inexpensive, time-efficient way to assess and better understand a community and the people who live within that community. Understanding the demographics of a community will help you determine the health-related issues that are likely to exist so you can plan the most appropriate types of wellness programs, health education, and disease prevention programs. Windshield surveys are done by making visual observations of a neighborhood or community while driving; hence the name. This type of survey lets you observe the housing conditions, use of open spaces, shopping, schools, types of transportation, human services, protective services, and other aspects of the overall daily life of a community.Before you start, you need to identify the boundaries of the neighborhood or community you plan to observe. For the purposes of this course, you should keep the size of the area to no more than 2–3 square miles. The area should be large enough for you to gather relevant information, but small enough that your observation does not take you more than 1–2 hours. With this size, it is not necessary to use a car to complete the survey; you can also walk or bike. Whichever method you use, be mindful of your personal safety. It may be helpful to map out the route you will take ahead of time. It can also be helpful (and safer) to have another person do the driving while you observe and make notes.Once you are on the route, start making observations right away. Stop frequently to write down notes. A template is provided in the Required Resources to help you document your observations.The timing of your observation can be important in helping you focus on specific items. If possible, consider conducting your survey more than once at different times of the day. For example, if you make your observations too early in the morning, you may miss things that take place later in the day that provide a different perspective of the neighborhood. It is also important to be as objective as possible when making your observations.RequirementsConduct the windshield survey, using the template located in the Required Resources for this assessment.Use the template as a guide to write a report for your team. If possible, look at other written documents used within your organization. How are they formatted? Follow that format as closely as possible, making sure you still use APA guidelines for your in-text references, citations, and reference page.Based on your observations and notes from your survey experience, write a report that includes the following:Describe, briefly, the neighborhood or community you observed (overall condition, types of spaces and businesses, evidence of services, and so forth).Describe a vulnerable or diverse population you observed living within the neighborhood or community.Now you will need to do some research on the population you described:Explain how the demographics for the population have changed over the past 5–10 years. Note: This information should be readily available through the United States Census Bureau, similar state Web sites, the Bureau of Labor Statistics, or other professional sites. Be sure your information is current.Describe the most prevalent health risks for the population. For example, if your population is senior citizens, then the health risks might be diabetes and loss of mobility. Include statistics on the health risks, such as frequency of occurrence in the population and number of deaths per year in the population.Identify the health disparities and social determinants of health that can affect the population. In other words, what will you need to overcome to develop a successful health promotion and disease prevention program for the population?Your completed assessment should be 3–5 pages in length, not including the title page and reference page. Support your information with references to at least three professional, scholarly, or government resources, and follow current APA guidelines for your in-text citations and references.Additional RequirementsInclude a title page and reference page. The completed assessment should be 3–5 pages in length, not including the title page and reference page.Reference at least three current scholarly, professional, or government resources.Use current APA format for citations and references.Use Times New Roman font, 12 point.Double space.Required ResourcesThe following resources are required to complete the assessment.(attached below)
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Running head: WINDSHIELD SURVEY
Health Promotion and Disease Prevention in Vulnerable and Diverse Populations
Copyright © 2017 Capella University. Copy and distribution of this document is prohibited.
This paper addresses the question of diversity in health care by focusing on the health
risks and health care needs of those living in East Harlem, New York. The paper will first
provide an overview and statistical information about the population demographics of the East
Harlem community. It will then discuss the findings from a recent windshield survey of the
community. From this information, the demographic changes for the minority population in the
community will be explained. This will be followed by a description of health risks and health
care needs for the minority population and an examination of the prevalence and impact of
different illnesses on the same population. Finally, there will be an explanation of the health
disparities and the social determinants of health that can affect the vulnerable population in this
An Overview of East Harlem
Comment [A1]: Great intro! This
lets the reader know exactly what to
expect in the paper.
East Harlem, also called Spanish Harlem or El Barrio is home to many immigrant
communities including one of the largest Hispanic communities in New York City with a
population of nearly 120,000. It also has a small Italian-American population. The majority of
the population is Hispanic (50%), and the rest of the population consists of African-Americans
(31%), whites (12%), and Asians (6%). The median age in the East Harlem community ranges
from 25–44 years. Around 22% of the population is between 0 and 17 years of age, and 12% of
the population is more than 65 years old. The average life expectancy of people in this
community is 76 years.
Surveillance Survey of the East Harlem Community
A windshield survey will provide a detailed picture of the people living in the area (New
York City Department of Health and Mental Hygiene [NYCDOHMH], 2015).
Comment [A2]: You did a nice job
of describing the overall
Housing. Around 76% of the homes in East Harlem are renter-occupied homes with one
or more maintenance defects; that include water leaks, the presence of mice or rats, cracks and
holes in the wall, inadequate heating, peeling paint, and toilet breakdowns. The community
consists of residents from a low socioeconomic background and cannot afford better housing.
Open Space. According to a study by the group New Yorkers for Parks, East Harlem has
1.2 acres of open space for every 1,000 residents, which is less than the recommended minimum
of 2.5 acres. Adequate open space allows children to play and exercise and offers parks for
relaxation which can improve the physical health of children and aging seniors.
Pollution. Unfortunately, East Harlem has a high concentration of fine particulate
matter—one of the harmful air pollutants in New York City. Air pollution is a leading cause of
health issues for people in East Harlem, especially among children, senior residents, and those
with preexisting health issues such as asthma and other respiratory ailments (NYCDOHMH,
Education. The neighborhood has many private, public, and charter schools. However,
an acute lack of resources in school and poor family life cause a majority of children to drop out
of school at an early age. Therefore, East Harlem consists of a substantial section of adults (26%)
who have not graduated from high school.
Culture and religion. From the first wave of Italian immigrants in the 19th century to
the tidal wave of musicians in the “mambo era,” East Harlem has set the stage for arts and
culture for over a hundred years. Because of its Italian-American population, East Harlem is still
influenced by southern Italian food, tradition, and ceremony. East Harlem has residents who are
followers of different religions ranging from Christianity and Islam to Scientology, and they have
their own places of worship in the area.
Health services. East Harlem has several health centers in its community. Even with the
presence of these health centers, the residents of East Harlem do not have easy access to health
care primarily because they come from low-income families and lack health insurance.
Transportation and businesses. East Harlem has a wide range of business institutions,
one of the most famous being the East Harlem Chamber of Commerce. East Harlem is also
known for its well-run public transit system.
Hispanic Culture in East Harlem
East Harlem is a predominantly Hispanic neighborhood, due to immigration of Puerto
Ricans, Latin, South, and Central Americans. About a third of the Hispanic populations in East
Harlem are college graduates, while approximately 26% of the population has not finished high
school. These subgroups face barriers due to lack of language fluency. This language barrier can
lead to miscommunication and prevent Hispanic populations from accessing important health
education material and regular medical care, which in turn make them a vulnerable population
Demographic Changes in East Harlem
Hispanics and black residents comprise 81% of the population in this area, with about a
quarter of the residents being foreign-born. Around 31% of the residents in East Harlem live
under the Federal Poverty Level, making it the twelfth most underprivileged community in New
York. One out of eight East Harlem residents aged 16 and above is unemployed. More than half
the residents use nearly 30% of their overall income on rent.
Over the last decade, East Harlem has observed a large wave of gentrification, a process
of renovation and reconstruction of an area leading to an influx of affluent families in that area.
The impact of gentrification takes place through increased rent burdens instead of direct
Comment [A3]: You did a good job
of discussing East Harlem and the
transportation, health services, culture,
religion, education, housing and
displacements—rents have increased by more than 40% in East Harlem. This has resulted in a
deeper class divide between the rich and poor (Florida, 2016).
Health Risks and Health Care Needs in East Harlem
Comment [A4]: Very nice job in
this section. You described the
demographics very well and also
identified the reasons for the change.
Due to poor diets, a serious health risk faced by residents of East Harlem is obesity,
which is a leading cause of diabetes and heart disease. Cancer and heart disease are the leading
causes of death for people in East Harlem. Smoking is the main cause of preventable death in
NYC and also the cause behind many illnesses including stroke, heart disease, lung cancer, and
emphysema. More than 25% of East Harlem residents smoke, which puts its residents at a higher
risk of suffering from cancer and heart diseases than any other community in the state of New
Substance use is a major social and health issue in low-income neighborhoods due to
their inability to cope with their low quality of life. Limited educational, housing, and
employment opportunities combined with the availability of drugs contribute to drug and alcohol
addiction (NYCDOHMH, 2015).
Two other health risks in this neighborhood are asthma among children and HIV. East
Harlem has the sixth-highest rate of asthma hospitalization among children aged 5 to 14 in the
state of New York and death due to AIDS in East Harlem neighborhood is thrice as high
compared to the rest of New York City.
While there are several challenges, health care in East Harlem can be improved by
providing cultural competency training to health care professionals in language skills, crosscultural communication skills, and health literacy strategies which will help them earn the trust
of the population (NYCDOHMH, 2015).
Comment [A5]: There seem to be
many health disparities in East Harlem.
The prevalence of various diseases
Health Disparities and the Social Determinants of Health in a Diverse Population
According to the World Health Organization (WHO), the social determinants of health
(SDH) are defined as circumstances within which persons live and work (World Health
Organization, n.d.). The financially deprived residents struggle to meet their basic needs; have
scarce occasions to achieve constructive goals; experience more undesirable life events such as
marital trouble, joblessness, and monetary loss; and must deal with discrimination,
marginalization, segregation, and helplessness. Owing to these stressors, people with low
socioeconomic status are at a higher risk of obesity, diabetes, substance abuse issues, violence,
The existence of disparities in access to health care has been recognized for a while in the
United States. Recently, the U.S. government has started many initiatives to address the social
determinants of health. Medicaid, a government insurance scheme for the underprivileged, has
also developed several initiatives that relate health care to wider social needs. An important
project under this initiative is the Harlem Children’s Zone (HCZ), which aims to improve the
health of the Harlem community through a wide range of social, health, and family programs.
This project has reported a 92% acceptance rate for its programs (Heiman & Artiga, 2015).
East Harlem is known for its diverse population and rich cultural history. However, given
that most of the residents in the area are poor and come from marginalized backgrounds, they
face different health risks and have difficulties accessing health care. Reducing these health
inequities requires policymakers, health professionals, researchers and community groups to
work together for systemic change. Framing health policies with the help of the social
determinants of health will enable the poor residents of East Harlem access better health care.
Florida, R. (2016). Where New York is gentrifying and where it isn’t. The Atlantic
Heiman, H. J., & Artiga, S. (2015). Beyond health care: The role of social determinants in
promoting health and health equity. The Henry J. Kaiser Family Foundation. Retrieved
New York City Department of Health and Mental Hygiene. (2015). Manhattan community
district 11: East Harlem. Retrieved from
New Yorkers for Parks. (2012). East Harlem open space index. Retrieved from
World Health Organization. (n.d.). Social determinants of health. Retrieved from
Windshield Survey Template and Instructions
Note: Content adapted from the Work Group for Community Health and Development:
Community Tool Box’s “Windshield and Walking Surveys.”
Windshield and walking surveys are useful ways to assess specific aspects of a community or
neighborhood and help give you a sense of the community.
Conduct your survey at the time that works best for your schedule, but keep in mind that to truly
understand the people who live within the community (or neighborhood), you may wish to do the
survey more than once, and at different times of the day or different days of the week. For the
purposes of this course, you are not required to do the survey more than once.
Please be mindful of your personal safety. If there is a known issue with hostility between
specific groups, it may not be safe for some people to survey particular neighborhoods. Do not
knowingly put yourself in harm’s way.
Get familiar with the survey questions and know what you will be looking for.
Use a checklist to be sure you have covered all the questions and observed all the areas
you want to.
Be as inconspicuous as possible. Not only do people act differently when they know they
are being observed, they may also become suspicious or hostile.
Be sure you carry identification.
Take notes along the way. You can also take photos with a camera or cell phone to help
you remember what you have seen.
Always pay attention to your safety. Be aware of the neighborhood and the situation.
Use the spaces between the questions below for your notes. You can write more complete
observations once you return home.
Housing: What is the age and condition of housing in the community or neighborhood?
Are the houses and apartments kept up, or are they run-down and in need of repair? Are
the yards neat or overgrown?
Other Buildings: Are other buildings mostly or fully occupied? Are public and
commercial buildings accessible by people with disabilities?
Parks and Public Spaces: Are parks and other public spaces well maintained? Are
they used by a variety of people? Are there sports facilities such as baseball fields,
basketball courts, and soccer fields?
Culture and Entertainment: Are there museums, libraries, theaters, restaurants,
historic sites, and so forth? Do they reflect the culture of the community? Are they readily
Streets: Are there trees and plants along the streets? Are there sidewalks? Are the
streets and sidewalks clean? Are there trash cans sitting out in sight? Are there people
on the streets? Do they interact with each other? Are the streets well-lit at night?
Business and Industry: What kinds of businesses are there? Are there vacant
storefronts? In what languages are business signs? Do the businesses provide the
necessities for the community (such as groceries and medications)? Is there any kind of
Traffic and Transportation: Is there evidence of public transportation? Is it well used?
Is it easy to navigate and use? How much does it cost? Who uses it? How heavy is the
traffic? Is there a major road or highway close by? Is the traffic mostly commercial (such
as delivery vans and trucks) or private cars? Are there many bicycles? Are there bike
lanes and bike racks?
Public Services: Are there identifiable public service providers such as mental health
clinics, food banks, and homeless shelters? Are there police or fire stations nearby? Are
they easy to reach?
Religious Centers: Are there churches or other religious institutions? Are they of one
faith, or do they represent a variety of faiths? Is there one dominant religion
Health Services: How many hospitals and clinics are there? How big are they? Are they
easy to get to?
Education: Are there public or private K-12 schools nearby? Are they well-maintained?
Are there any two- or four-year colleges or universities? Are they public or private?
Population: Who lives in the community? Are there identifiable racial or ethnic groups?
Do particular groups seem to live in particular areas? Is one age group or gender more
obvious? Do the people who live in this community seem to interact with each other?
What is your overall impression of the community?
Summary and Analysis
To help you analyze what you have seen and decide how to use it, here are some questions
you should consider:
• What are the community’s outstanding strengths?
• What seem to be the community’s biggest challenges?
• What was the most unexpected thing you observed?
• What aspect of the community really stood out for you?
• How can you use this information to help develop a health promotion and wellness plan
for the population that lives here?
Work Group for Community Health and Development. (n.d.). Windshield and walking surveys.
Retrieved from Community tool box Web site: http://ctb.ku.edu/en/table-ofcontents/assessment/assessing-community-needs-and-resources/windshield-walkingsurveys/main
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