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7019.1.1 : Epidemiology

The graduate applies principles of epidemiology to the assessment of the healthcare needs of communities.

7019.1.5 : Environmental Health

The graduate assesses the impact of the environment on the health of the community.

7019.1.8 : Cultural Competency

The graduate analyzes social and cultural factors that affect the care of diverse populations.


More emphasis is being placed on healthier communities as changes are occurring in the fields of healthcare financing, policy, and focus. One of the primary roles of a community health nurse is to assess the community or population in order to determine its health status in relation to its assets and needs.In this task, you will engage in a Community Health simulation for a total of 20 hours to gather information about a virtual communitySentinel City™ Community Health Simulation is a virtual city developed by Healthcare Learning Innovations to represent what you may find in any real United States city. You will be able to take a virtual bus trip and/or walk around the city while observing the environment and people of Sentinel City™. Through your observations, you will gather information to assess potential health issues and risks within this online virtual learning environment.You will assess different factors that may contribute to or detract from the health and wellness of the community and its citizens. During your trips through the city, you may be asked to describe the people you see and any expected or unexpected findings related to the citizens of Sentinel City™. Your keen observations will be the foundation to successfully completing assignments within your course. The simulation website will automatically log your hours and produce a special report at the end of each session. Be sure to have a notepad to record your observations of Sentinel City™ in preparation for this task.The link to Sentinel City™ is located in the Community Care and Collaboration section of the Course of Study. Please review the Sentinel City Quick Start Guide, Student Guide, and Troubleshooting and FAQs Guide prior to engaging in the Sentinel City™.

You may also want to download the Demographic Assessment, Neighborhood/Community Safety Inventory, Windshield Survey and Population Health Scavenger Hunt tools located in the attachment section to complete section B of this task.


Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. An originality report is provided when you submit your task that can be used as a guide.

You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.

A.  Within Sentinel City™ you will notice a camera icon. Use the camera to take pictures within the simulation. Use the \”enter text\” feature to add your observations to the pictures. Submit a PDF of your action report from Sentinel City™ that includes the following completed activities from Industrial Heights, Casper Park District, Acer Tech Center, and Nightingale Square:

•  Interfaith Church

•  Sentinel City School District

•  Sentinel City Department of Transportation

•  Better Health Clinic

•  ABC Daycare

•  Sentinel City Affordable Housing Project

•  City Hall

•  Radio Buzz 96.5FM

•  Sentinel City Healthcare System

•  Lilly’s

•  Joe’s Grocery

•  Sentinel City Department of Parks and Recreation

B.  Complete a needsassessment summary to determine the health needs and risks of the virtual community in Sentinel City™ by using each of the following tools:

Note: These tools can be found either in the web links section or as an attachment to this task.

•  Demographics Assessment

•  Neighborhood/Community Safety Inventory

•  Windshield Survey

•  Population Health Scavenger Hunt

Note: The name of each of the four tools should be identified in the needsassessment summary, along with a brief summary of how each of the four tools were used in the needs assessment.

1. Analyze the collected data using concepts of epidemiology and health determinants.

Note: Refer to these three sections of your COS for additional information: Epidemiology and Environmental Health, Epidemiological Data, and Application of Epidemiology.

C.  Formulate a community diagnosis for Sentinel City™ by doing the following:

1. Discuss the three problems for Sentinel City™ based on the Healthy People goals.

2. Discuss community resources (e.g., Sentinel City™ Affordable Housing Project, Better Health Clinic) that are available to address one of the problems identified in part C1.

3. Identify a primary prevention topic based on the problem you selected in part C2.

Note: See the attached “Primary Prevention Topics List” for guidance in formulating your topic.

D.  Discuss how you will apply the assessment strategies you have learned from the simulation environment to your community assessment strategies in your community.

E.  Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.

F.  Demonstrate Professional communication in the content and presentation of your submission.

File Restrictions

File name may contain only letters, numbers, spaces, and these symbols: ! – _ . * \’ ( )File size limit: 200 MBFile types allowed: doc, docx, rtf, xls, xlsx, ppt, pptx, odt, pdf, txt, qt, mov, mpg, avi, mp3, wav, mp4, wma, flv, asf, mpeg, wmv, m4v, svg, tif, tiff, jpeg, jpg, gif, png, zip, rar, tar, 7z

Expert Answer and Explanation

Community Health Assessment

A community health assessment is an important aspect of public health. Through community health assessment, community health nurses can describe the state of health of people from a specific community, identify major causes and risk factors of ill health and determine the interventions to solve the problems (WHO, n.d). Needs assessment can also help nurses to apply the principle of social justice and equality in care provision, provide quality and effective care to the population in greatest need, and ensure that limited resources are used where they are needed. Nurses can also identify stakeholders in a given community to work to plan interventions and solutions to address health issues of concern in the given community (CDC, 2018). This assignment aims to conduct a needs assessment of Sentinel City to identify health problems in the city and design a nursing intervention to solve the health issues.

B. Needs Assessment


The four neighborhoods making Sentinel City include Industrial Heights, Acer Tech Center, Nightingale Square, and Casper Park. The total population of the city is 663,862. The highest population is white with 80.6 %, and the least populated race is Native Hawaiian and other Pacific Islander alone with 0.2%. 51.1% of the city population are men and the rest female. Children are 9.6% and older people aged 65 years and above are 10. %. 21.7% of the population are individuals under 18 years, and 16.1% of people in the city are foreigners. African Americans alone are 10.4%, and Latinos are 31.5% of the population. Casper Park District has 352 643 people, making it the most populated neighborhood in the city. White people take the largest population in the city. The least populated neighborhood is Industrial Heights, with a total population of 38 855. The largest population in this neighborhood is Latino consisting of 46.8% of the total population.

Nightingale Square has 103 974 people, with its highest population being white, taking 81.3% of the total population. Acer Tech Center has 168,390 people, and individuals of white origin are the majority, with 70.20% of the total population. 50.4% of the total population have a home, and 45.8% of the housing units are multi-unit structures. The city has 261, 836 and each household has an average of 2.6 persons. The city’s per capita income during the last financial year was $32 597. The average household income is $49 091. The average cost value of the housing units is $246 300. 18.9% of the individuals in the city are below the city’s poverty level. 21, 961 organizations in the city are non-firm institutions. The institutions have employed 1.5% of the city’s population. The city has 55,830 non-employer companies. Black people own 4.3% of the companies in the city. The statistics show that most of the economic activities in the city are owned by the white population.

The neighborhoods where the white population is high have stringer economy people most of the people from this race own many companies. Therefore, the strongest neighborhood in terms of economy is Nightingale City. The neighborhood has the highest median income in the city, which is 269 500. Industrial Heights is the only neighborhood where whites are not the leading population. Statistics show that the neighborhood is the weakest in the city, with a median income of $24 672. The median income of Acer Tech Center is $166 300. The mortality rate is high among people with cardiovascular conditions, followed by heart problems in terms of health. Four hundred and two women in the city also smoke while pregnant. The rate of birth is high among women aged 30 years and above. The rate of disability is high in Industrial Heights. The neighborhood also records the lowest number of people with health insurance.

Neighborhood/Community Safety Assessment

One of the factors determining the safety of people in Sentinel City is education. According to Saeed et al. (2018), health literary skills can help patients control their well-being by making proper choices regarding their health, improving their communication with their caregivers, and accessing information that can help them maintain their health. Nightingale Square has the highest population of educated people, while Industrial Heights has the lowest number of educated individuals in the city. Most people in Industrial Heights lack knowledge about significant health data. The second safety issue in the city is the environmental population. Pollution is one of the causes of many health problems (Yang, 2020). The city is an urban center and thus is most likely to be polluted with industrial waste products and carbon emitted by vehicles. During the assessment, bags of garbage were observed near the Grocery Store building. The city also has many industries that can pollute its water sources, land, and air.

The high crime rate also impacts the safety of the city. Radio Buzz, the city’s largest communication medium, reports various incidents of criminal activities. The radio has reported sexual assault, harassment, and home breaking as some of the criminal activities in the city. Another safety issue is the number of women smoking while pregnant. Exposure to smoke during pregnancy can lead to preterm births (Hoyt et al., 2018). Huang et al. (2017) also note that smoking during pregnancy leads to small chest circumference and low birth weight. Another factor is the high number of births among people aged 17 and below. This factor explains the number of neonatal deaths and premature births in the city. The last factor is drug and substance abuse. Drug abuse is a risk factor for violence and criminal activities.

Scavenger Hunt

The city has numerous resources that can be used in improving the health of its population. One of the resources is Sentinel City Park and Recreational facility. The park is vital because it provides a good environment for physical activities, such as running, hiking, and walking. The park also harbors birds and improves the city’s air quality. Homeless people also come to the park to spend their night. The second resource is Sentinel City Healthcare System. This system provides health services to all residents of the city. Most people treated in the hospital have back pain. The system also offers care services to vulnerable groups, such as the elderly. Better Health Clinic is also vital because it offers basic health services to Industrial Heights and beyond residents. The facility also keeps vital healthcare data. For instance, it reports that most people are treated for Gonorrhea. The Sentinel City Department of Transport is significant in transporting residents to various destinations, including healthcare facilities. The City Hall can be used for various functions, including community educations and health promotions. It also hosts the city’s leadership. Other important resources include Sentinel City School District, Interfaith Church, ABC Daycare, Radio Buzz 96.5FM, Lily’s Restaurant, and Joe’s Grocery.

Windshield Survey

A windshield survey is a fundamental aspect of a community needs assessment. I identified various issues affecting Sentinel City in terms of health during the windshield survey. One of the things I observed is the status of the buildings around the city. Nightingale Square has good and furnished buildings. Most of the buildings also have all the necessities of a standard house. The roofs of the houses are also well-coated in good condition. However, most of the buildings in Industrial Heights are fairly old. The buildings are largely painted with grafting. Its roofs are rusty and are most likely to contaminate rainwater. The transport system of the city is well-managed and structured. The roads connect various city points, including the Affordable Housing Project, City Hall, Joe’s Grocery, Better Health Clinic, and many more facilities. I also observed that the city practices democracy. Most people in Industrial Heights travel by public transport. I saw people meeting in front of the city hall holding a peaceful demonstration about their rights. The city residents also enjoy security from the police forces. The city resources are also well distributed within the city.

B1. Data Analysis: Interpretation of Data 

Data shows that the health status of the neighborhoods is related to their economic status. For instance, more residents in Nightingale Square have health insurance than Industrial Heights citizens. Data also says that disability rates are high in Industrial Heights. The rate of homelessness is also high in Industrial Heights. Most homeless individuals often get shelter at Interfaith Church. The data confirms the argument that poverty is a social determinant of health. Oliveras et al. (2021) report that a high level of poverty leads to poor health. Data also reports considerable death of neonatal and newborns. This statistic can be equated to the high number of pregnant women smoking while pregnant and a large number of people below the age of 18 giving birth. Data also shows that cardiovascular disease kills more people than any other disease. Date reports a high birth rate among unmarried people, which can explain why there are many homeless individuals in Industrial Heights. The city’s leadership is also not competent.

C. Sentinel City Health Concerns

C1. Three Problem Areas  

The needs assessment has identified three health problems that should be focused on by community health nurses. The first health issue is cardiovascular conditions. Cardiovascular conditions cause the highest mortality. Health records show that heart problems killed 916 people, and cardiovascular diseases killed 1 236 individuals. The Healthy People 2030 objective for this health issue is to “improve the cardiovascular health of adults (Office of Disease Prevention and Health Promotion., 2020).” The problem should be solved first because it claims the lives of many city residents. The second issue is adolescents’ health. Many girls between the age of 10-18 give birth.

Fuchs et al. (2018) note that women who give birth below the age of 18b risk experiencing preterm birth, conceiving low-weight babies, or dying during birth. Better Health Clinic also reports that most patients are diagnosed with Gonorrhea. Adolescences may be at risk of STD because most of them do not have sexual health literacy. The Healthy People 2030 goal for the problem is to “Increase the proportion of adolescents who get support for their transition to adult health care” (ODPHP, 2020). The last problem is smoking among pregnant women. Statistics show that 417 women smoke while pregnant. Brannigan et al. (2021) report that smoking during pregnancy is a risk factor for offspring’s mental health problems, premature births, and preterm births. The Healthy People 2030 goal for this problem is to “increase abstinence from cigarette smoking among pregnant women” (ODPHP, 2020).

C2. Discussion of Community Resources

The problem that should be addressed in the city is cardiovascular diseases. One of the resources that can be used to address the problem is Better Health Clinic. The clinic can be used to screen the community to identify people with the issue and provide treatment for them. The Sentinel City Health System provides resources to be used in addressing the problem. Radio Buzz is also a significant resource. The radio can be used to communicate educative messages on improving cardiovascular health and preventing these diseases where possible. The radio can also be used to advertise any health promotion activity regarding cardiovascular health. Joe’s Grocery can also be a vital resource in dealing with the problem. The city residents can be urged to improve their heart health by practicing a proper diet. They can get fruits and other nutritious foodstuffs from the Grocery. The City Hall can be used to hold health promotion programs.

C3. Primary Prevention Topic

The primary prevention topic is “educating Sentinel City residents on the strategies they can apply to improve their cardiovascular health.” The city residents can be educated on the various strategies they can apply to improve their cardiovascular health. One of the strategies is regular exercise. Physical exercises, such as intensive jump training programs, prevent one from suffering cardiovascular problems (Kramer et al., 2017). Regular physical exercise can improve the health of the cardiovascular system (Fiuza-Luces et al., 2018). Another strategy is going for regular screening for cardiovascular conditions. The last strategy is maintaining a healthy diet. Rippe (2018) reports that eating foods with low cholesterol and fats can improve cardiovascular health.

D. Application of Assessment Strategies/Tools between Simulation and My Community

The tools I have learned in the needs assessment will help in my future role as a community nurse. For instance, I was able to assess the community quickly and collect data about the city. Similarly, I will use the tool to conduct a needs assessment of practical community to collect data faster. I will also identify the resources I need to solve health problems I have identified using a windshield survey and scavenger hunt. I will understand the social determinants of my community through demographics assessment. Safety assessment would help me identify factors impacting community health.


In this assignment, a community needs assessment has been done. The assessment founds that the community has three primary health problems. One of the problems is cardiovascular conditions. Cardiovascular problems have killed more than 2000 people. The second problem is adolescent health, and the last issue is smoking during pregnancy. The resources that can be used to solve the problem include the Sentinel City Health System, Radio Buzz, Better Health Clinic, Joe’s Grocery, and the City Hall. The proposed intervention to solve the problem is educating the residents about strategies to prevent cardiovascular problems.


Brannigan, R., Tanskanen, A., Huttunen, M. O., Cannon, M., Leacy, F. P., & Clarke, M. C. (2021). Maternal smoking during pregnancy and offspring psychiatric disorder: A longitudinal birth cohort study. Social Psychiatry and Psychiatric Epidemiology, 1-6.

Centers for Disease Control and Prevention. (2018). Community health assessments & health improvement plans.

Fiuza-Luces, C., Santos-Lozano, A., Joyner, M., Carrera-Bastos, P., Picazo, O., Zugaza, J. L., … & Lucia, A. (2018). Exercise benefits in cardiovascular disease: beyond attenuation of traditional risk factors. Nature Reviews Cardiology, 15(12), 731-743.

Fuchs, F., Monet, B., Ducruet, T., Chaillet, N., & Audibert, F. (2018). Effect of maternal age on the risk of preterm birth: A large cohort study. PloS One, 13(1), e0191002.

Hoyt, A. T., Canfield, M. A., Romitti, P. A., Botto, L. D., Anderka, M. T., Krikov, S. V., & Feldkamp, M. L. (2018). Does maternal exposure to secondhand tobacco smoke during pregnancy increase the risk for preterm or small-for-gestational age birth? Maternal and Child Health Journal, 22(10), 1418-1429.

Huang, S. H., Weng, K. P., Huang, S. M., Liou, H. H., Wang, C. C., Ou, S. F., … & Wu, M. T. (2017). The effects of maternal smoking exposure during pregnancy on postnatal outcomes: A cross sectional study. Journal of the Chinese Medical Association, 80(12), 796-802.

Kramer, A., Gollhofer, A., Armbrecht, G., Felsenberg, D., & Gruber, M. (2017). How to prevent the detrimental effects of two months of bed-rest on muscle, bone and cardiovascular system: an RCT. Scientific Reports, 7(1), 1-10.

Office of Disease Prevention and Health Promotion ( (2020). Healthy People 2030 sets data-driven national objectives to improve health and well-being over the next decade.

Oliveras, L., Peralta, A., Palència, L., Gotsens, M., López, M. J., Artazcoz, L., … & Marí-Dell’Olmo, M. (2021). Energy poverty and health: Trends in the European Union before and during the economic crisis, 2007–2016. Health & Place, 67, 102294.

Rippe J. M. (2018). Lifestyle Strategies for Risk Factor Reduction, Prevention, and Treatment of Cardiovascular Disease. American Journal of Lifestyle Medicine, 13(2), 204–212.

Saeed, H., Saleem, Z., Naeem, R., Shahzadi, I., & Islam, M. (2018). Impact of health literacy on diabetes outcomes: A cross-sectional study from Lahore, Pakistan. Public Health, 156, 8-14.

World Health Organization. (n.d). Community health needs assessment: An introductory guide for the family health nurse in Europe.

Yang, T. (2020). Association between perceived environmental pollution and health among urban and rural residents-a Chinese national study. BMC Public Health, 20(1), 1-10.

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