Sharp Healthcare offers groups for breastfeeding parents, postpartum depression, grieving for the loss of a child, obesity, eating disorders, etc. How can the community members be made to value wellness promotion steps? What is the reason that they do or do not (e.g. engagement in education, fundraising events, etc.)?
Fundraising events for local children with Neuroblastoma (Pediatric) Cancer and fundraising for community sports like football and cheerleading. What does the community value? How is this evident?
Religion – Church on Lord’s days with family. Family values – many family activities like concerts in the local park, movie night at the lake. On what do the community members spend their money? Are finances equal? Cars, homes, rent – cost of living is high in CA. Eating out, shopping. Middle-class majority, finances can get tight.
Health Perception/Management Predominant health problems: Compare at least one health problem to a reliable statistic (CDC, county, or state). Obesity – 33% in San Diego are overweight, 26% are obese. 30% of children in grades 5/7/9 are overweight/obese in San Diego County (“Community profile: county”, 2013).
Immunization rates (age-appropriate): 4.5% of preschoolers are missing one or more vaccines. Out of 43,000 preschoolers in the county, 1,900 are not fully immunized. Not all families in San Diego are immunizing their children due to things they hear about vaccines. For example, the misconception that vaccines cause autism. Parents do not do their research and often listen to hearsay or false news reports. Appropriate death rates and causes, if applicable.
Top 10 causes of death in San Diego: Malignant tumors, diseases of the heart, Alzheimer’s, chronic lower respiratory diseases, cerebrovascular disease, accidents (unintentional injuries), diabetes, intended self-harm (suicide), chronic liver disease (cirrhosis), hypertension/hypertensive nephritic disease and influenza/pneumonia (“San Diego County”, n.d.).
In 2012, in San Diego alone, there were 20,018 deaths: 3,684 in East County San Diego; 1,806 were male, 1,876 were female; 377 were Latino, 3,015 were White, 130 were Black, 88 were Asian, and 70 were of other races. Age groups 0-4 (28 deaths), 5-14 (6 deaths), 15-24 (42 deaths), 25-24 (68 deaths), 35-44 (90 deaths), 45-54 (278 deaths), 55-64 (474 deaths), 65-74 (587 deaths), 75-84 (863 deaths), 84+ (1,248 deaths) (“San Diego County”, n.d.).
Prevention plans (dental, fire, fitness, safety, etc.): Does the community think these are sufficient? Drug abuse prevention plans, delinquent and school failure prevention plans. CAL Fire teaches a fire prevention plan locally in San Diego.
CA Safe Kids San Diego teaches prevention of unwilled accidents such as submerging, child rider safety, athletics and diversion safety, and pedestrian safety (“Safe Kids San”, 2014). Western Dental provides services for people without insurance for a cheaper rate.
Multiple gym installations such as 24 hr Fitness, Crunch, and Chuze are some of the biggest gyms here. Available health professionals, health resources within the community, and usage. Planned Parenthood provides healthcare for pregnancy and STD prevention. Local hospitals like Kaiser Permanente, Sharp Grossmont Hospital, Scripps Hospital, and Sharp Memorial Hospital are a few large hospitals in San Diego, CA. Urgent care clinics like Doctors Express are available.
San Diego Public Health Language-specific healthcare such as Arabic, Spanish, Tagalog, etc. Common referrals to outside agencies. WIC (Women, Infants, and Children), Black Women, Infants, and Children. Food Stamps. Low-cost medical and dental attention. Habitat for Humanity.
Nutrition/Metabolic Indices of nutrient deficiencies. Vitamin deficiencies such as Vitamin D and Iron. Unexplained fatigue, brittle, dry hair, ridged or spoon-shaped nails, oral cavity problems, diarrhea, irritability, or loss of appetite can all indicate nutrient deficiencies. San Diego has one of the largest homeless populations in the state, particularly homeless veterans. Malnutrition is prevalent in this group of people. Obesity rates or percentages: compared to CDC statistics.
This slug was answered above in a previous inquiry. Affordability of food/available price reductions or nutrient plans and use (e.g., WIC, food boxes, soup kitchens, meals-on-wheels, food casts, senior discounts, employee discounts, etc.). Food Stamps, WIC (Women, Infants, and Children), BWIC (Black Women, Infants, and Children), Meals on Wheels.
Senior discounts are offered at some restaurants like Soup Plantation. 55 plus is considered a senior citizen here in California. Project Homeless Connect. Availability of water (e.g., number and quality of drinking fountains). Water fountains in all shops and schools. Drinking water (Tap water) meets most government standards but needs to be more thoroughly treated. Water comes from three sources: Northern California from snow and rain, the Colorado River, and local rainwater overflow. Fast food and junk food availability (vending machines).
Vending machines at most high schools. California is seeking to change contents to offer healthier options. Fast food on almost every corner – very accessible. Evidence of healthy food consumption or unhealthy food consumption (junk, long lines, observations, etc.).
Always a long line as fast food places. Gyms always crowded. Protein/workout drinks always in hand. Beaches are full of people in bathing suits (fit and unfit). Farmers markets on Wednesdays are crowded. Many people do special programs like Weight Watchers, Opti-Fast, Medi-Fast, Nutri-System, Jenny Craig, etc. “Re-think your Drink” program is trying to eliminate sugary drinks and replace them with water, low-fat milk, or 50% or greater natural fruit juices. Provisions for special diets, if applicable.
Items containing specific allergens have them stated on the label like nuts, shellfish, or specific fruits. For schools (in addition to above): Nutritional content of food in cafeteria and vending machines: compared to ARS 15-242/The Arizona Nutrition Standards (or other state standards based on residence).
Fruit/veggie based drinks with no less than 50% fruit juice.
Milk: 2% fat, non-fat, soy, or rice milk. Not more than 35% of its entire calories can come from fat (excluding nuts, seeds, eggs, cheese, fruit, veggies, and legumes). Not more than 10% of calories from saturated fat (excluding eggs and cheese).
Not more than 35% of its entire weight may be composed of sugar, including naturally occurring and added sugar (excluding fruits and veggies that have not been deep-fried). Not more than 250 calories per single nutrient point for middle schools and Jr High Schools, high schools. No more than 175 per single nutrient point for simple schools. Amount of free or decreased tiffin: 60% free or decreased tiffin in schools in San Diego. Calcium.
Elimination (Environmental Health Concerns): Common air contaminants’ impact on the community, smog, allergies (pollen), dust, noise (major airport, major military bases, heavy traffic noises), waste disposal (Miramar Landfill). Pest control: Is the community notified of pesticides usage? Yes. Single abodes take attention of their own plague jobs. Hanta Virus: In mouse droppings in our country. Hygiene patterns (laundry services, hand rinsing, etc.).
Laundry mats are in abundance, dry cleaners and single washer and dryers in some abodes. Singing the “Happy Birthday” song twice while rinsing hands was on the local news to help people rinse their hands more efficiently. Toilet place screens in most public bathroom services. Signs saying “Must wash hands before returning to work” in all restaurant bathrooms.
Bathrooms: Number of bathrooms, inspect for cleanliness, supplies, if possible. Most public bathrooms have signs for employees to sign when they have checked and maintained the public toilet. Public bathrooms are generally clean and well-stocked, if not, usually, an employee of the place is easily notified. Universal safeguard patterns of health providers, teachers, members (if applicable): protective gowns, gloves, shields when handling bodily fluids for health providers when in facilities.
Teachers usually do not have access to all the equipment necessary but generally have gloves on hand. Temperature controls (e.g., within buildings, outside shade structures): temperatures generally in the 70-75 ranges in controlled areas such as schools and shops. Shades provided at local parks.
Community pools and beaches available for hot temperatures. Safety (commission, security guards, crossing guards, badges, locked campuses): most day cares are locked installations. Crossing guards at most elementary and middle schools. Security guards at shops and hospitals to prevent theft and crime. Trolley Guards. Volunteer Police patrol (elderly men and women).
Activity/Exercise:
- Community fitness plans (gym discounts, P.E., deferment, sports, access to YMCA, etc.): YMCAs, Gymnasiums such as 24-hour fitness, Crunch, Chuze
- AYSO (local association football conferences for kids)
- T-ball/baseball/softball fields at Cactus Park
- P.E. in middle school/high school for 2 years
- Deferment at elementary schools
- Zumba and Jazzercise programs locally
Recreational Installations and Use:
- Gyms, playgrounds, bike trails, hiking trails, courts, pools, etc.
- Playgrounds at most local parks
- Mission Trails, hiking and bike trails at Cowles Mountain and Iron Mountain
- Community pools at YMCAs
Safety Plans:
- Rules and regulations, safety training, incentives, athletic trainers, etc.
- Lifeguards at local community pools and beaches
- Safe drivers’ incentives with Allstate Insurance
- Discounts on auto insurance with good grades and no problems
- Crime Stoppers, McGruff Crime Dog, Kidzwatch Academy, and Safety Sam are police station programs that children and other community members can participate in to ensure community safety.
Injury Statistics or Most Common Injuries:
- In San Diego, unintentional injuries were the sixth leading cause of death in 2009.
- About 1,000 people died that year from unintentional injuries, with 30% of those caused by poisoning, including overdose.
- Every hour in San Diego, an average of 19 people are hospitalized or treated in the ER because of injuries.
- Car accidents, drowning, falls, assault, struck by an object, burns, overexertion, and asphyxiation are some of the most common causes of injury in all age groups.
Evidence of Sedentary Leisure Activities:
- Computers are used as the primary resource for schools.
- The Internet is used as the primary resource for the community.
- Driving short distances that could be walked.
- On average, TV takes up 2.8 hours of most people’s day.
- Ages 15-19 spend four minutes reading and 52 minutes playing a game on the computer per weekend day.
- Ages 75 and over spend an average of one hour reading and 20 minutes playing games or using a computer per weekend day.
- Employed adults with no children spend about 4.5 hours per day doing leisure activities, and employed adults with a child/children spend about 3.5 hours per day doing leisure activities.
Means of transit.
Trolley, bus, cars, bikes, walking, and park and ride for carpooling.
Sleep/Rest
Sleep routines/hours in your community: Comparison with sleep hour standards (from National Institutes of Health [NIH]). Eating heavy dinners, caffeine, smoking, and exercising late in the day are disrupting the sleep of people in San Diego. Graveyard shifts are common due to places being open 24/7.
People sleep anywhere from 6-9 hours. Indicators of general “restedness” and energy levels: Lack of “bags” or “dark circles” under eyes, hair, makeup, and outfit appropriate for the environment. Less caffeine needed.
Factors affecting sleep: Shift work prevalence of community members. All shifts, mostly 12-hour shifts in the healthcare field. Mainly anywhere from 7am-6pm for most full-time employed people. Environment (noise, lights, crowds, etc.). Near the main airport, military bases, lights, and crowds near football and baseball stadiums, colleges, and living near freeways.
Consumption of caffeine, nicotine, alcohol, and drugs. At least three major universities in San Diego (caffeine intake!). The average age in San Diego is 20s-30s and a big nightlife crowd downtown San Diego (alcohol and drugs). 2012 drug statistics: Heroin addiction, crack/cocaine decreasing, methamphetamine increasing, marijuana increasing, prescription opioids decreasing, ecstasy decreasing (“Drug abuse patterns,” 2014).
Homework/Extracurricular activities
High school students average 3 hours of homework per night. Anywhere from 6.8 to 17.5 hours of homework per week for high school students. Elementary schools 2.9 hours per week. Middle school 3.2 hours per week. After-school sports: up to 3 hours of practice for some, like football.
Health issues
Stress, common colds/flu, pediatric cancers, type 1 and 2 diabetes, obesity, high blood pressure.
Cognitive/Perceptual
Primary language: Is this a communication barrier? English, Spanish, Arabic, and Vietnamese (possible communication barriers). 37.1% of San Diego’s population speaks a different language than English.
Educational levels: For geopolitical communities, use http://www.census.gov and compare the city in which your community belongs with the national statistics. San Diego County: High school graduates 85.4%. Bachelor’s degree or higher 34.4% (“State and county”, 2014).
Opportunities/Programs:
Educational offerings (in-services, continuing education, GED, etc.): Many programs offer GED programs and homework classes, including community colleges. All hospitals and healthcare centers provide in-services. Grossmont College, Grossmont Adult Night School, ROP (Regional Occupation Program), and a Learn English program in El Cajon, CA, help foreigners learn English.
Educational authorizations (annual in-services, continuing education, English learners, etc.): CEUs for nurses- 30 hours every 2 years for RNs.
Special education programs (e.g., learning disabled, emotionally disabled, physically disabled, and gifted): GATE- gifted and talented education program.
Children’s outreach project, library or computer/Internet resources and use:
El Cajon library, Internet on all phones, iPads, and computers at most schools, including elementary schools.
Funding resources (tuition reimbursement, scholarships, etc.): Scholarships offered through the Chamber of Commerce for faculty members up to $3,000. Many colleges offer academic and athletic scholarships (full and partial rides). UCSD and Rady’s Children’s Hospital both have tuition reimbursement and student loan refund plans. UCSD will refund two-thirds of the tuition or student loans.
Board of Governors fee waiver Military price reductions
Self-Perception/Self-Concept Age levels: Many families in El Cajon are mainly in their 20s and 30s. In San Diego County, children under age 5 make up 6.5% of the population, people under age 18 make up 22.6% of the population, and people 65 and over make up 12.3% of the population.
Plans and activities related to community building (strengthening the community): San Diego City College peer mentoring program MADD (Mothers Against Drunk Driving) Big Brothers/Big Sisters program (mentoring teenagers) Peer Leaders (high school program – students give other students “counseling” when they feel like they can’t speak to an adult)
Community history: The area now known as San Diego County has been inhabited for over 10,000 years by the Kumeyaay Indians. San Diego became part of the United States by the Treaty of Guadalupe Hidalgo in 1848, ending the U.S.-Mexican War. One of the original counties of California, San Diego used to be a very large county, including all of Los Angeles and extending to the Colorado River.
Pride indicators: Self-esteem or caring behaviors. San Diego is one of the most sought-out cities to visit and/or live in, and is very expensive because demand is high. There is a lot of plastic surgery in San Diego, as well as spray tans, fake nails, and fake hair. People are in good shape (wearing bikinis). San Diego residents support many charities and cancer/disease foundations. Donating money to a good cause is common among this community.
Published descriptions (booklets, websites, etc.): San Diego Magazine sandiego.org (local media website) Union-Tribune San Diego (newspaper)
Role/Relationship: Interaction of community members (e.g., friendliness, openness, intimidation, biases, etc.). East San Diego is more friendly than West or North San Diego (more money in those areas). San Diego is very accepting of gays and lesbians (Hillcrest is a city known for an abundance of this population). The Gay Pride Parade is a huge event in San Diego. San Diego has a very large interracial community, with not many biases. Plans to prevent in-school bullying.
Vulnerable populations: Why are they vulnerable? Homeless population in downtown San Diego. Lack of medical insurance. How does this impact health? Increase spread and severity of disease. No access to medicine or medical interventions.
Power groups (church council, student council, administration, PTA, and gangs): Mexican Mafia Logan Heights Gang Hells Angels PTAs in elementary schools Jehovah’s Witnesses Church of Jesus Christ of Latter-day Saints How do they maintain power?
Influential. Have a lot of people under them or following them. PTA helps make decisions for schools. Positive or negative influence on community? Gangs are usually a negative influence. Hells Angels used to have more of a negative influence, but now are more positive towards the community and support local charities like pediatric cancer ones. Harassment policies/discrimination policies.
Under the California Department of Public Health, all employees have the right to work in an environment free from all signifiers of favoritism, including sexual harassment, bullying, revenge, or coercion.
The CDPH is committed to providing a work environment free from sexual harassment, which is a form of sex favoritism that is illegal under both province and federal law. The Fair Employment and Housing Act defines sexual harassment as torment based on sex or of a sexual nature, gender torment, and torment based on pregnancy, childbearing, or related medical conditions.
The definition includes torment based on sexual orientation and also protects an individual’s actual or perceived gender identity, whether or not different from the individual’s actual gender at birth. The CDPH endorses a “zero tolerance” policy aimed at preventing all such inappropriate behavior. As a result, CDPH may take disciplinary actions, up to and including formal subject, when policy violations occur, even if they are not so serious as to be improper (“Sexual Harassment Prevention”, 2008).
Relationship with the broader community:
The San Diego Blood Bank frequently holds blood drives in parking lots of large shops, such as Walmart, and businesses. Local food drives occur at schools and healthcare clinics/facilities.
Sexuality/Reproductive Relationships and behavior among community members:
There have been many allegations of teacher/student relationships, as well as many older male/young female relationships and vice versa. There are also many relationships with more than 10-year age gaps, and young marriages/pregnancies are common.
The married population is 45.15%, and the single population is 54.85%. Of the married population, 43.16% are currently married, 1.99% are married but separated, 40.39% have never been married, 4.58% are widowed, and 9.88% are divorced. 35.54% of the married population has children, while 37.34% are married with no kids. 16.27% of the single population has children, and 10.86% are single with no kids (“People in San”, 2014).
Educational offerings/programs (e.g., growth and development, STD/AIDS instruction, contraception, abstinence, etc.):
Planned Parenthood provides instruction and prevention methods for STDs and pregnancy, as well as prenatal care and access to birth control.
