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Running head: LENNOX COMMUNITY ASSESSMENT

LENNOX COMMUNITY ASSESSMENT

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Introduction

As Public Health nurses new to Lennox, we want to have an initial comprehensive assessment of the community to know the community we will be working with. As a community partner working with individuals in Lennox, we must obtain a baseline information to identify priority interventions for the community. We want to look at measures of health indicators such as demographics, access to health services, environmental quality, injury and violence, nutrition, social determinants, and etc. to have a good understanding of the health of the community. In this assessment, we will be analyzing quantitative and qualitative data to better understand the status and needs of Lennox. Primary sources of data collection will be performed by windshield surveys, interview with key informant, taking photos, and eyewitness accounts. Secondary sources of data collection will be conducted with several reliable sources that provide existing published data such as the census. After our data collection, we will reflect on the community that we will be serving, the population characteristics, its baseline health status, its health and safety challenges, and strengths and resources. Thereafter, we will generate health issues, distribution of the issues, and determinants of the issue. The Community-as-Partner Model (C-A-P) will be the guiding principles of our community assessment. With C-A-P, the community assessment wheel will guide us in our assessment. Then, we will develop a nursing process with ADPIE followed by interventions using the Minnesota Intervention Wheel at the end.

Community Core

History

In 1855, Antonio Ignacio Avila received a formal land grant through the Treaty of Guadalupe Hidalgo. The land was known as Rancho Sausal Redondo, which would later become Inglewood, Hawthorne, Lennox, Redondo Beach, and Hermosa Beach. In the early 1900s, Lennox was a small farming community of about 800 residents. Lennox became a sought out residential area during World War II because of its proximity to Los Angeles Municipal Airport, which had a demand for workers to build and assemble aircraft for the war. The community had a few privately owned businesses, located on main streets like Hawthorne Blvd and Lennox Ave. Lennox was frequently threatened by annexation from Inglewood, but it has survived as a strong community. Lennox was originally an ethnically diverse community until the 1970s, when the Latino community increased (Hand & Gould).

Race & Ethnicity

To get a clearer look of the race and ethnicity aspect of the community, three different surveys were conducted and the final summary of the windshield survey was conducted on a Tuesday afternoon; Schools had closed for the day and many school children were walking in small groups and others with their parents. The majority of the people observed were Hispanic, with very few black and other races. This observation confirms the National Census Bureau’s report of 2010. According to the 2010 U.S. Census Bureau, out of the 22,753 population, 20.583 (92.6%) were Hispanic/Latino, 779 (3.5%) were Black alone, 391 (1.8%) were Asian alone, 379 (1.7%) were White alone, and 6 (0.03%) were American Indian alone. The remaining 72 (0.35%) were of Other race alone (U.S Census Bureau, 2010).

Religion

Religion plays an integral role in the Lennox community. Churches are easily recognizable and are of mostly Hispanic denominations. Numerous churches were recognized during the Windshield Survey. Few of those are: Lennox United Christian Church, The Redeemed Christian Church of God, Southside Christian Church, Church of Christ, Lennox Iglesias Quadrangular, Asamblea Apostolica Amor Viviente, and many other churches within Lennox vicinity. Most churches have current programs posted outside the building which describes the events and meetings for the week. The presence of numerous churches within the small community could therefore be attributed to the lack of other resources such as community centers and theatres.

Health/Vital Statistics

Lennox as a community doesn’t have a hospital on its own. The closest hospital, Centinela Medical Center, is about a mile away. The Centinela hospital provides services such as acute and transitional care. There are few family clinics and dentists offices within the community but many are accessible across their neighbors. The community also has access to other medical services such as dialysis centers and nursing homes. According the U.S Census Bureau, 28 percent of the population are without health insurance. The age group with largest coverage are those between the ages of 6 to 17 years. According to Data USA vital statistics website (2016), the Lennox Community as part of LA county has high incidence of heart disease and pneumonia, STDs such Chlamydia, and Diabetes. Coronary Artery Disease, Stroke and Lung Cancer were the reported leading causes of death.Also, according to LA County Public Health reports, between 2004 and 2008, 32.6 percent of Lennox population were considered obese or overweight. Obesity increases the population risks for heart diseases, diabetes, hypertension, and other chronic illness. Birth rates have decreased in all of LA County. The total fertility rate has dropped from 2.7 birth average per lifetime in 1990, to 1.8 in 2010. Latina women had the steepest drop, from 3.6 to 2.2 within the same timeframe (Rollin-Alamillo, 2015).

Politics

During our survey, we encountered a representative from the Lennox Community Council. He explained the political aspect of the community. According to him, Lennox is not a city, therefore has no mayor or political figure on its own, but rather Unincorporated area of Los Angeles County that relies on County services such as Police, Fire, and Social works. Lennox has a default representative from the County Board of Supervisors 2nd District who is represented by Mark Ridley-Thomas. Concerns in the community are directed through the Supervisor’s deputy and to the Supervisor at the County level for resolution.

Physical

Housing and Commercial buildings

Over 40% of the residential buildings in Lennox were built in the 40s and 50s, and roughly 35% built in the 30s or 60s. 47% of all residential buildings are single family houses (US Census, 2012-2016). The majority are wooden structures of similar appearance. Most houses have limited space in front and to the sides. Also, most appear in working conditions, with no obvious damage. Most of the yards are poorly maintained. The majority of houses, about 98%, have adequate plumbing and kitchen facilities (US Census, 2016).

Open space

Lennox is a one square mile urban community with little open space. There is very few green areas on sidewalks, with several palm trees lining the residential streets. The majority of greenery is seen in the few front yards that are well maintained, Lennox Park, and school fields. The front yards tend to be small, with mostly grass and very few brushes and trees. Some apartment buildings don’t have any green areas at all. There is only one park for a population of about 23,000 and one square mile of land, so it is not easily accessible to all community members. Lennox Park is 5.6 acres with several trees and grassy areas (Lennox Park). It was recently renovated through a grant provided by the LA Dodgers (“Dodgers Dream Foundation,” 2012). The streets are in poor condition, with cracks, potholes and graffiti on the pavement. Pollution from plane exhaust is highly likely, as ultrafine particles have been detected in the environment around aircraft flight paths (Barboza & Weikel, 2014, Hudda et al., 2014). This makes green space more important.

Boundaries

Lennox is bordered by the city of Inglewood to the north and east, Hawthorne to the south, and LA City to the west, mainly LAX. The boundaries are mostly Century Blvd to the north, Prairie Ave to the east, the 105 fwy to the south, and the 405 fwy to the west. The three main streets that run through Lennox are Hawthorne Blvd and Inglewood Ave, which run north and south, and Lennox Blvd that runs east and west. About 5,500 homes and 1,500 businesses make up Lennox (US Census, 2012-2016). The majority of businesses are located on the main streets listed above. Residential streets are narrow with lots of cars parked on the streets, a reflection of the crowded living conditions (Mapping L.A., 2018).

Commons

Lennox Middle School students can be seen gathering at Jim’s Burgers after school. Seniors gather at the senior center in Lennox Park for activities such as bingo. There’s a community garden that’s open during daytime hours (“Lennox Community Parks…,” 2016). Lennox Park and Lennox Library are also frequented by families with children. During night hours there is one bar that is frequented by regulars and does not look open to everyone in the community and does feel territorial.

Transportation

Lennox has accessible public transportation. Buses run on the main streets of Lennox every 5 minutes during the day on Hawthorne Blvd, Inglewood Ave, and Lennox Blvd. The Metro Green Line is also accessible from Hawthorne Blvd and the 105 fwy (“Lennox Community Parks and Rec.,” 2016). This is helpful since 7.9% of residents take public transportation to work (US Census, 2016). There is only two bike lanes, on Hawthorne Blvd and part of Lennox Blvd . Freeways are accessible since the 405 fwy and 105 fwy serve as city boundaries.

Physical environment

There are many privately owned fast food restaurants in Lennox. Most are ethnic foods from Mexico, many of which are taquerias. There is also several used car sales lots on Hawthorne Blvd, and a strip club next to Lennox Library. Billboards advertise affordable cell phone service, military recruiting, expensive private universities, beer and fast food restaurants.

Social and Health Services

Service Centers

Lennox has few organizations that provide aid to low-income families. St. Margaret’s center helps low-income individuals through employment, housing, and health services. Another organization is Youth Build, which is a program aimed towards helping dropouts to finish high school and learn job skills. The community garden allows low-income families to grow their own produce. Unfortunately, Lennox does not have a WIC center.

Lennox Park offers access to a baseball lot, basketball court, swimming pool, picnic tables and grills. It also includes a community center with afterschool programs, aerobics class, and a senior center (Lennox Park). The park is the only place that offers a well-kept outdoor playground for children. Since Lennox has no gyms, the park is utilized by adults for their outdoor fitness equipment. Lennox also has one public library that offers tutoring services to students.

The community of Lennox has 5 elementary schools, 1 middle school and 2 charter high schools. These schools all offer after-school clubs for students. In addition, the middle school has a running track, tennis and basketball courts that are open to the community after-school.

As for community based health centers, Lennox has one called, To Help Everyone Health and Wellness Center (T.H.E.). T.H.E. provides a variety of health services to low-income individuals. Overall, there are three dental offices, five medical clinics and no hospital. The closest hospital is Centinela Hospital which is in Inglewood.

In terms of religion, Lennox has close to 10 Christian denomination areas of worship. However, the closest Catholic church, St. Joseph’s, is in the city of Hawthorne.

Stores

Lennox only has two grocery stores with an abundance of liquor stores. Also, Lennox is mostly residential with no shopping centers or malls. For these reasons, most residents drive to do their shopping. The closest shopping centers are in Inglewood and Hawthorne.

Economics

Signs of Community Vibrancy

The community of Lennox is only composed of local mom and pop shops, beauty salons, barber shops, liquor stores, fast-food restaurants, car dealerships and street vendors. To buy home needs, residents travel outside of the community since the two groceries stores in Lennox are expensive and lack variety. It also appears that the neighborhood is not alive considering there are no shopping centers or malls. For this reason, the neighborhood is on the way down since most people travel outside of Lennox to shop. However, most stores do accept food stamps or EBT.

Most homes in Lennox are equipped with new windows, doors, and A/C systems. There are no abandoned houses or cars. Currently, around the community there are political posters from candidates running for the school board and the congressional district and a few real estate signs. The Lennox Library and social media share information about neighborhood meetings. In Lennox, most homeless are seen by the freeway and metro station. The organization, St. Margaret’s Center, offers food to the homeless. Lennox is a clean community however few individuals have concerns about the homeless leaving trash behind.

People Out and About

During a typical day, students and parents are seen walking to and from school. In terms of clothing, most people are dressed casually. As for unexpected ways of dressing, gang affiliated attire has been observed by residents. Most homes do have guard dogs. This is potentially a result of the 38 violent crimes that have happened in the last 6 months (LA Times, 2018). Additionally, people state that stray cats, raccoons and opossums are seen at night.

Labor Force and Financial Characteristics

From the data, Lennox is considered a low-income community. In 2016, the median household income was $39,177 with 30.7% of people living in poverty (U.S. Census Bureau, 2016). Also, in Lennox, 22.3% of females are the householders while 40.5% of female householders with children are considered living in poverty (U.S. Census-ACS 5 year, 2016). In the past 12 months, 20.4% of individuals were receiving food stamps/SNAP benefits (U.S. Census-ACS 5 year, 2016).

In terms of employment status, census data states that in Lennox, 67.5% of people were employed and had an unemployment rate of 11% (U.S Census Data-ACS 5year, 2016). According to the latest data, the occupational categories are as follows: 36% are in service, 24.5% sales/office, 18% production/transportation, 11% construction/maintenance, and 10.4 % management/business/science/arts (U.S. Census Bureau- 5year ACS, 2016).

As for housing, the U.S. Census (2016) states that the average renter pays $1,027 for rent and utilities in Lennox. In addition, the cost to own a home is an average of $342,700 with the average monthly mortgage of $1829 (U.S. Census, 2016). From the people that opt to rent, close to 50% of people pay between $1000 to $1499 (U.S. Census Bureau- 5year ACS, 2016). From interviews, most homes for a family of four were between the range of $1,500 to $2,500. Furthermore, data states that 52.7% of people in Lennox use 35% or more of their household income to pay rent (U.S. Census Bureau- 5year ACS, 2016).

Social

Media and Communication

Many houses within the Lennox Community are mounted with TV antennas and satellite dishes. During our Survey, we could easily access some FM and AM stations through our car radio system. The community doesn’t have a local television station but residents can easily access mainstream media such as ABC, NBC and CBS from LA County. There are local stands for newspapers, and some local stores are also filled with popular and current magazines. Lennox Library is accessible to residents and serves as a communication tool by distributing fliers and activities within the community.

Inferences and Community Nursing Diagnoses

From our assessment findings, we can see how Lennox is composed of a low- income Latino community. There is a critical issue concerning the health of this population. First of all, 28% of the population is uninsured. Secondly, 32.6% of the population are obese or overweight, leading to chronic diseases such as heart diseases, diabetes, hypertension, etc. Another issue we want to address is environment quality. Lennox is situated next to LAX, which raises concerns of particulates and noise pollution that would affect the health of the community in the long run. Furthermore, there’s a lack of greens, parks, and recreational areas that would better the health of Lennox. Contributing to internal stressors would be a lack of health services in the community. External stressors would be fast- food billboard advertisements and nearby LAX airport. From the collected data, our NANDA would be:

1) High prevalence of obesity related to a lack of accessible healthy food choices and areas to exercise as evidenced by the small 5.7 acres community park, abundance of fast- food restaurants and liquor stores, and a lack of groceries stores

2) Deficient community health r/t a lack of environment quality in the city as evidenced by air pollution of ultrafine particles from aircraft flight paths, noise pollution of loud aircraft sounds from nearby airport, and no greens on sidewalks.

Some public health interventions could be-

1) Individual Level: Surveillance of individuals at risk for obesity to prevent and control prevalence of the disease.

2) Community Level: Health teaching for community to share facts, ideas, and interventions to change behavior of unhealthy food choices.

3) System Level: Advocate for policy development to implement plans of making the neighborhood more green and building more exercise facilities.

Lennox does have a flexible 1st line of defense. There are several assistance program such as YouthBuild, St. Margaret’s, and T.H.E. that help those in times of crisis. However, Lennox has a unstable normal 2nd line of defense. Lennox has a high incidence of STDs, high morbidity of heart diseases, sizable unemployment rate of 11%, and a high crime of 38 violent crimes in the past 6 months. This tells us that the community’s health status at usual level is not doing so well. For Lennox’s line of resistance, the community does not have any resources to protect the core. Lennox does not have homeless shelters, AA, or free standing clinics. Thus, Lennox would greatly benefit from more clinics, healthy food options, groceries stores, green areas, and exercise facilities.

Conclusion

This community assessment project was a great start to our career as nurses. From public health perspective, we get to assess, analyze, and understand the people of the community that we will be serving. We will be the community partner working with individuals in the cities or neighborhoods that we will be working at. To better serve our community and make appropriate interventions, we must have a better understanding of all the determinants of health in the community. This windshield survey should be required for a public health nurse new to a community because it will allow the PHN to have a better understanding of the community and to be better partners.

References

Barboza, T., Weikel, D. (May 29, 2014). “Planes’ exhaust could be harming communities up to 10 miles from LAX.” Los Angeles Times. Retrieved from: http://www.latimes.com/local/la-me-0529-lax-pollution-20140529-story.html

“Dodgers Dream Foundation Dedicate Dodgers Dreamfield at Lennox Park.”(April 26, 2012). Retrieved from: https://www.mlb.com/dodgers/news/dodgers-dream-foundation-dedicate-dodgers-dreamfield-at-lennox-park/c-29743518

Hand, R., Gould, E. “A Documentary of the Lennox Community in Lennox, CA.” Retrieved from: https://www.lennoxlancershome.com/Lennox_Documentary/toc.html

Hudda, N., Gould, T., Hartin, K., Larson, T.V., Fruin, S.A. (2014). “Emissions from an International Airport Increase Particle Number Concentrations 4-fold at 10 km Downwind.” ACS Publications. Retrieved from: https://pubs.acs.org/doi/full/10.1021/es5001566

“Lennox Community Parks and Recreation Plan.” (February 2016). Los Angeles County Department of Parks and Recreation. Retrieved from: http://file.lacounty.gov/SDSInter/dpr/240515_LennoxCommunityPlanReduced.pdf

Lennox Park. Los Angeles County Parks and Recreation. Retrieved from: http://parks.lacounty.gov/lennox-park/#

Mapping L.A. (2018). Los Angeles Times. Retrieved from: http://maps.latimes.com/neighborhoods/neighborhood/lennox/

Rollin-Alamillo, L. (April 2015). Recent Birth Trends in Los Angeles County. Los Angeles: Los Angeles County Department of Public Health. Retrieved from: www.publichealth.lacounty.gov/epi

U.S. Census Bureau (2012-2016). Lennox CDP Quick Facts. Retrieved from: https://www.census.gov/quickfacts/lennoxcdpcalifornia

U.S. Census Bureau (2016). American Community Survey 5-year Estimates: Selected Economic Characteristics, Financial Characteristics, Occupancy Characteristics. Retrieved from: https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=CF

Functional Health Patterns Community Assessment Guide

Functional Health Pattern (FHP) Template Directions:

This FHP template is to be used for organizing community assessment data in preparation for completion of the topic assignment. Address every bulleted statement in each section with data or rationale for deferral. You may also add additional bullet points if applicable to your community.

Value/Belief Pattern

· Predominant ethnic and cultural groups along with beliefs related to health.

· Predominant spiritual beliefs in the community that may influence health.

· Availability of spiritual resources within or near the community (churches/chapels, synagogues, chaplains, Bible studies, sacraments, self-help groups, support groups, etc.).

· Do the community members value health promotion measures? What is the evidence that they do or do not (e.g., involvement in education, fundraising events, etc.)?

· What does the community value? How is this evident?

· On what do the community members spend their money? Are funds adequate?

Health Perception/Management

· Predominant health problems: Compare at least one health problem to a credible statistic (CDC, county, or state).

· Immunization rates (age appropriate).

· Appropriate death rates and causes, if applicable.

· Prevention programs (dental, fire, fitness, safety, etc.): Does the community think these are sufficient?

· Available health professionals, health resources within the community, and usage.

· Common referrals to outside agencies.

Nutrition/Metabolic

· Indicators of nutrient deficiencies.

· Obesity rates or percentages: Compare to CDC statistics.

· Affordability of food/available discounts or food programs and usage (e.g., WIC, food boxes, soup kitchens, meals-on-wheels, food stamps, senior discounts, employee discounts, etc.).

· Availability of water (e.g., number and quality of drinking fountains).

· Fast food and junk food accessibility (vending machines).

· Evidence of healthy food consumption or unhealthy food consumption (trash, long lines, observations, etc.).

· Provisions for special diets, if applicable.

· For schools (in addition to above):

· Nutritional content of food in cafeteria and vending machines: Compare to ARS 15-242/The Arizona Nutrition Standards (or other state standards based on residence)

· Amount of free or reduced lunch

Elimination (Environmental Health Concerns)

· Common air contaminants’ impact on the community.

· Noise.

· Waste disposal.

· Pest control: Is the community notified of pesticides usage?

· Hygiene practices (laundry services, hand washing, etc.).

· Bathrooms: Number of bathrooms; inspect for cleanliness, supplies, if possible.

· Universal precaution practices of health providers, teachers, members (if applicable).

· Temperature controls (e.g., within buildings, outside shade structures).

· Safety (committee, security guards, crossing guards, badges, locked campuses).

Activity/Exercise

· Community fitness programs (gym discounts, P.E., recess, sports, access to YMCA, etc.).

· Recreational facilities and usage (gym, playgrounds, bike paths, hiking trails, courts, pools, etc.).

· Safety programs (rules and regulations, safety training, incentives, athletic trainers, etc.).

· Injury statistics or most common injuries.

· Evidence of sedentary leisure activities (amount of time watching TV, videos, and computer).

· Means of transportation.

Sleep/Rest

· Sleep routines/hours of your community: Compare with sleep hour standards (from National Institutes of Health [NIH]).

· Indicators of general “restedness” and energy levels.

· Factors affecting sleep:

· Shift work prevalence of community members

· Environment (noise, lights, crowding, etc.)

· Consumption of caffeine, nicotine, alcohol, and drugs

· Homework/Extracurricular activities

· Health issues

Cognitive/Perceptual

· Primary language: Is this a communication barrier?

· Educational levels: For geopolitical communities, use http://www.census.gov and compare the city in which your community belongs with the national statistics.

· Opportunities/Programs:

· Educational offerings (in-services, continuing education, GED, etc.)

· Educational mandates (yearly in-services, continuing education, English learners, etc.)

· Special education programs (e.g., learning disabled, emotionally disabled, physically disabled, and gifted)

· Library or computer/Internet resources and usage.

· Funding resources (tuition reimbursement, scholarships, etc.).

Self-Perception/Self-Concept

· Age levels.

· Programs and activities related to community building (strengthening the community).

· Community history.

· Pride indicators: Self-esteem or caring behaviors.

· Published description (pamphlets, Web sites, etc.).

Role/Relationship

· Interaction of community members (e.g., friendliness, openness, bullying, prejudices, etc.).

· Vulnerable populations:

· Why are they vulnerable?

· How does this impact health?

· Power groups (church council, student council, administration, PTA, and gangs):

· How do they hold power?

· Positive or negative influence on community?

· Harassment policies/discrimination policies.

· Relationship with broader community:

· Police

· Fire/EMS (response time)

· Other (food drives, blood drives, missions, etc.)

Sexuality/Reproductive

· Relationships and behavior among community members.

· Educational offerings/programs (e.g., growth and development, STD/AIDS education, contraception, abstinence, etc.).

· Access to birth control.

· Birth rates, abortions, and miscarriages (if applicable).

· Access to maternal child health programs and services (crisis pregnancy center, support groups, prenatal care, maternity leave, etc.).

Coping/Stress

· Delinquency/violence issues.

· Crime issues/indicators.

· Poverty issues/indicators.

· CPS or APS abuse referrals: Compare with previous years.

· Drug abuse rates, alcohol use, and abuse: Compare with previous years.

· Stressors.

· Stress management resources (e.g., hotlines, support groups, etc.).

· Prevalent mental health issues/concerns:

· How does the community deal with mental health issues

· Mental health professionals within community and usage

· Disaster planning:

· Past disasters

· Drills (what, how often)

· Planning committee (members, roles)

· Policies

· Crisis intervention plan

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