WindshieldSurvey of Baltimore City
BaltimoreCity is one of the biggest cities in the state of Maryland. Itgracefully seats on the coastline and has a seaport with a longhistory (Bearss, Schwarz, Memon & Everett, 2008). The city sharesits border to the North, East, and West with the Baltimore County andto the south by Patapsco River and Anne Arundel County. According tothe 2010 USA Census, Baltimore City had a residential totality of616,802 residents, therefore, making it the biggest city in Maryland.
Theresidents were below the legal adult age comprised 21.6% of thepopulation, while those with up to 64 years were 66.5% while thosewhose age was above 65 years were 11.8%. The city has a majority ofblack people comprising 63.3% and a female population of 53.3%.However, the city is computed as the poorest county in Maryland. Ithas an average household income of 37,395 dollars compared to anaverage state income of about 72,419 dollars. An estimated 22.7% ofthe residents in Baltimore City live below poverty compared to anaverage of 9% countrywide. Education is a key to higher income andcan significantly impact on a person’s efforts to access healthcare services. In the year 2009, the bachelor’s degree holders’percentage was lower in Baltimore than in Maryland or the UnitedStates.
Baltimorecity has attractive features such as community gardens, pocket parks,forest patches and other open spaces that are managed by theBaltimore green space in conjunction with the community. Thispractice allows this community to ensure the endurance of their urbanoases. The Baltimore department of recreation & parks and EnochPratt free libraries provide to the residents a huge supply ofoutdoor leisure and enrichment facilities.
Baltimorecan be described in simple terms as well connected infrastructuralwise. It is very easy to get around and see all the charming aspectsof the city. Many inner harbor attractions are close together suchthat one can walk from one to the other. When one wants to get acrossthe harbor, one can take advantage of the excellent private andpublic boat transport. The city has a well-developed road networkwith local buses for public transport. There is also a super-cheapday pass for the train.
Thecity has now adopted the Zipcar. This transportation mode makes itpossible for the residents to afford to live without a car and yetquickly acquire one when needed. There are strategic locations forthe Zipcar lots easy access. Applications such as Uber help tocoordinate traveling activities (Sowbel, 2009). One just needs torequest for a lift from any place in the city and within fifteenminutes the driver arrives and takes one to their destination. Fairis also chargeable through the app. Another commonly used mode oftransport in the city is the bicycle. The city hosts a monthly eventcalled the Baltimore Bike Party where thousands of cyclists gatherand take over the streets for two to three hours.
Baltimorehas a range of activities going on, good eating joints, many peopleto interact with, good accommodation hotels and shopping stores. Theshopping stores vary from shopping districts to shopping rows,shopping malls, and shopping centers. Baltimore is a continuouslyevolving place. The increased urbanization has brought with it newliving quarters, restaurants, malls, stand-alone retail stores, andcenters.
Baltimorecity has a rich and diverse media landscape. There are a lot of localpublications found online that supplement the traditional printpublications, therefore, creating massive volumes of information.Other documents found online are blogs and magazines covering manyaspects of the city’s culture including dining, sports, politicsand various other fields. The major components of Baltimore’s mediainclude the newspaper, magazines, local news channel and news radio,blogs and online magazines
Baltimorecity has a strategically located East-Coast Port which acts as a goodentry and exit point for goods as well as personnel such as tourists.Baltimore is a medicine and biosciences center. The city hostsnational headquarters for Advanced Medical Treatment and Research.There are also two pioneer training Hospitals Johns Hopkins Hospitaland University Hospital at the University of Maryland. There are manyschools both public and private and numerous other educationalfacilities such as libraries within the city (Posner & Costanza,2011). The city majorly exports grain, steel, iron, coal, and copperproducts. It is also a building place of ships. There are three majorindustries in the city’s metropolitan area which are on the Fortune500 lists of the largest companies in the country.
Acomparison of Baltimore city’s health results obtained from myclinical placement preceptor displays profound segregation resultsamong the residents, similar to the trend of the town being worsethan the rest of the state. For instance, the life expectancy inBaltimore city stands at 71.8 as compared to the states, 78.8. Thereare also higher cases of infant mortality rates in the country at1.22 per 100 live births compared to the state’s infant mortalityrates of 0.67 per 100 live births. From my research, the five leadingcauses of death in the Baltimore city are heart diseases that take ashare of 25.8% of all deaths. Cancer is the second leading killersharing 23.1% of deaths followed by the stroke at 5.2%. HIV/AIDStakes up a share of 3.9% while acute lower respiratory sicknessestake up 3.9% of the deaths.
TheBaltimore city health department is the oldest known healthdepartment that has been continuously operating (Posner &Costanza, 2011). It was formed in 1793 when the government hired thefirst health officers from the city to counter a yellow feveroutbreak in the neighboring area of Fells Point. Since then they havebeen working towards enhancing the health status of the people ofBaltimore. According to my clinical placement preceptor the healthdepartment has made collaborations with other city agencies, healthproviders, community organizations and donors to provide theBaltimoreans with access to knowledge and a healthy environmentFeild, (Edstrom, Graham, & Udouj, 2007). Its responsibilityincludes controlling acute communicable diseases, preventing chronicdiseases, animal control, responding to emergency services, maternaland child health, inspecting the restaurants and schools for hygienicstandards, HIV/STD, senior services and youth violence issues.
TheBaltimore city health department(BCHD) has initiated an integrativeapproach for evaluating the health status of the society it servessince 2009. They have set objectives on methods to enhance health andformation of partnerships to help with the realization of thesegoals. BCHD utilizes a three-pronged approach influenced by communityfeedback and guidance. The approach recognizes that the healthcondition of the city dwellers has linkages to other socialvariables. The three phases are:
• Thecommunity health survey: the health department carried out the firstcommunity health survey in 2009 with an aim of obtaining the city’sconcrete data on the occurring and prevailing health conditions andtrends.
•Neighborhoodhealth profiles: there are big variations between thesocio-demographic, health and economic status among the residents ofthe Baltimore city. The community health profiles enable thecomparison of health-influencing factors and results, therefore,revealing health differences and highlighting the most affectedareas.
• HealthyBaltimore 2015: this is the city’s health policy published in 2011.The document points out on the critical areas that the healthinstitution and its associates can improve on such as cases ofmorbidity and mortality and make the level of quality of life better.
HealthyBaltimore 2015 has a set of ambitious but realistic goals aiming todrive the city to a level where residents realize their full healthcapacity. They aim at promoting access to quality health for alltheir inhabitants, support a tobacco-free society, come up withmeasures to reduce obesity and improve heart health. HealthyBaltimore 2015 objective is diminishing alcohol and drug abuse, stopthe spread of HIV and other STIs, encourage early detection of cancerand to recognize and treat mental health needs among many other goals(Feild, Edstrom, Graham & Udouj, 2007).
Intheir agenda for change, healthy Baltimore 2015 acknowledges thatlocal public health department cannot adequately enforce the planworking alone. They recognize that the success of their goals relieson the partnerships they make with their neighbors, businesses,academic institutions, medical institutions, community-basedorganizations, non-profit organizations among various other groups.The contribution of the partners to the realization of the goals maycome in different ways such as facilitation through activeparticipation in initiatives such as incorporation of wellness at thework programs. They can display and distribute health informationmaterials and actively participate in decision making.
Baltimoredepartment of social services assists low income earning householdswho encounter financial problems. However, this grant is limited toan amount of 600 dollars once after two years for those familieswhose children are below the age of 21 years. Pregnant women alsobenefit from these grants. There are emergency grants meant fordisasters, security deposits, foreclosures, eviction prevention,water bill turn-off notices, lack of heating firewood and burialassistance.
Baltimorehas a set of health indicators. Lower life expectancy levelscharacterize the city as compared to the rest of the state. Baltimorealso experiences high rates of infant mortality rates and high adultmortality. The top killer diseases in Baltimore include cancer,stroke, HIV/AIDS and lower respiratory diseases. In spite of theseproblems, the community’s strengths are that it has goodwell-recognized hospitals such as Johns Hopkins Hospital andUniversity Hospital at the University of Maryland. Also, there aresplendid health policies designed for the residents such as HealthyBaltimore 2015. A social service department is set up and is entitledto assist the poor Baltimoreans. The society’s weaknesses stem fromthe high levels of poverty among the city’s residents.
Itwould not be possible to talk about the health and welfare of theBaltimoreans without considering the factors of health equity andsystematic variations. While there has been a decreased overallmortality rate, it is still higher than the rest of the state(Carroll, Harris-Bondima, Norris & Williams, 2010). The problemis generated further by a series of complex systematic social,political, economic and environmental factors. More than one out ofthree Baltimore’s children live below federal poverty line. Income,poverty, and race have an enormous effect on health outcomes. Thisstate of health needs to be addressed swiftly especially becauseBaltimore hosts among the best heath care institutions in America.
Communityhealth nursing incorporates the healing process and individuals,families and groups within the community or the entire community. Thenurse may solve health problems through planning. It can occurthrough identifying the needs, priorities, and challenges of theindividuals, the family or the whole community. After identification,there is the formulation of a municipal health plan, which does notrequire a doctor then the subsequent interpretation andimplementation of the nursing plan along with program strategies,directives, and a pamphlet for the concerned personnel. The nurse canalso provide technical assistance to the rural health midwives onhealth issues.
Thecommunity health nurse can also provide direct health services to thecommunity. It is an essential process as the nurse would fill a gapin the health sector and thus offset the problem. The nurse may alsotrain the family members on how to take care of the ill, physicallychallenged and the dependent society members. Therefore, thesevulnerable groups will live a healthy life as they observe properhygienic and care measure. The nurse is also a community organizer.He stimulates and promotes community engagement by planning,managing, implementing and analyzing health services. These plans maybe in the form of immunization schedules for the young one or familyplanning education for the adults. He also actively contributes andtakes part in the social facilitation initiatives.
Communityhealth nurse works with the individuals, society, and groups formedical services given by various health practitioners(Edstrom,Graham & Udouj, 2007). Therefore, all the families would acquireproper care whenever they coordinate with the nurse. It is also thenurse`s role to coordinate the nursing schedule with other medicalprograms such as environmental hygiene, education on health, dentalhygiene and mental wellness. As a health trainer, the nurse conductsconsultation meetings for patients hence act as a resource advocateon medical services. The nurse may initiate the use of media forhealth education purposes.
Thenurse sets a good example to the society, and the residents canobserve the good health practices they portray. The nurse alsomonitors the health of the community individuals and groups throughcontact visits and hence they can quickly detect deviations from thegood health plan and thus proper measure would follow to facilitatesustained good health. The nurse also keeps records about theparticular society and submits the required reports and files forproper assessment by the relevant bodies (Bearss, Schwarz, Memon &Everett, 2008).
Insolving the numerous community health problems, the community healthnurse can utilize some partners such as neighboring regions,businesses, academic institutions, medical institutions,community-based organizations, non-profit organizations among variousother groups.
Bearss,N., Schwarz, L., Memon, P., & Everett, M. (2008). Survey ofPharmacies in Baltimore City and Baltimore County Regarding Access toEmergency Contraception. JournalOf The American Academy Of Physician Assistants, 21(6),1. http://dx.doi.org/10.1097/01720610-200806000-00066
Carroll,V., Harris-Bondima, M., Norris, K., & Williams, C. (2010).Changing Lives: The Baltimore City Community College Life SciencesPartnership with the University of Maryland, Baltimore.CommunityCollege Journal Of Research And Practice, 34(11),936-938. http://dx.doi.org/10.1080/10668926.2010.509663
Feild,C., Edstrom, P., Graham, J., & Udouj, J. (2007). WINDSHIELDSURVEY TO TEACH JUNIOR MEDICAL STUDENTS COMMUNITY HEALTHASSESSMENT. JournalOf Investigative Medicine, 55(1),S286-S287. http://dx.doi.org/10.1097/00042871-200701010-00754
Porter,C. (2004). Differences in demographics and risk factors among menattending public v non-public STD clinics in Baltimore,Maryland. SexuallyTransmitted Infections, 80(6),488-491. http://dx.doi.org/10.1136/sti.2004.011049
Posner,S. & Costanza, R. (2011). A summary of ISEW and GPI studies atmultiple scales and new estimates for Baltimore City, BaltimoreCounty, and the State of Maryland. EcologicalEconomics,70(11),1972-1980. http://dx.doi.org/10.1016/j.ecolecon.2011.05.004
Sowbel,L. (2009). Personalitytraits predictive of field performance for foundation year MSWstudents.