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Community Health Project Paper Part 1

Old Dominion University
Lareka Young

Health promotion and education is a very important role in nursing. I have always been

a firm believer that education is a vital component in healthcare. The aggregate group I chose to

work with for this community project is the adult population in Hampton City, Virginia. I chose

this aggregate because of my experience with the group working as a public health nurse. The

biggest problem I come across working in the community is the lack of knowledge on how to

adequately manage their health conditions. The community partner I chose to work with is the

Hampton Public Library because it is located in the community I am targeting. I am able to gain

access into this community through my job working as a public health nurse and scheduled

meetings at the library. This paper will discuss my experience working with this population to

identify and prioritize a community diagnosis and develop a plan to address it.

Aggregate Characteristics

The target aggregate consists of adults 18 years and older who reside in the Victoria

Boulevard Historic District and surrounding areas in Hampton, Virginia. Prior to researching, I

had perceived that the statistical data would have been much worse than what I actually

discovered. The total population in Hampton in 2016 was 135,410 according to the Virginia

Department of Health (VDH). Females made up 51.94% of that population and males made up

the other 48.06%. Whites accounted for 71.5% of the population, Black/African Americans

represented 20.7%, American Indian/Alaskan Native made up 0.6% and Asian/Pacific Islander

accounted for 7.2%. In 2015, 61.5% of Hampton residents had regular healthcare visits. In

2017, 19% of Hampton is considered to be in poor or fair health in and 9% of the population

were uninsured.

Social determinants of health can also have an effect on the health of a community. In

Hampton, the two identified social determinants of health according to VDH are poverty and

unemployment. In 2016, there were 21,458 people identified to be in poverty with a rate of

16.4%. In the same year, 3,614 people were unemployed with a rate of 5.62% of the population.

The unemployment and poverty rates can inadvertently negatively affect the health of aggregate.

Both internal and external factors can influence the health of the aggregate. Internal

factors include motivation, enthusiasm, knowledge, self-esteem, financial status and religious

beliefs. External influences include family dynamics, access to transportation and healthcare.

These factors can either negatively or positively affect the health of the aggregate depending on

the specific circumstances.


It was very interesting to capture the socio-demographics similarities and differences of

Hampton and Virginia. The median household income of Hampton was much less than that of

Virginia. Obesity in Hampton accounted for 9% more than Virginia. The percentage of

residents’ uninsured, in poor or fair health, lacking physical activity and adult smokers did not

vary significantly between Hampton and Virginia. Overall, the statistical data between Hampton

and Virginia did not have significant differences. Refer to Table 1 below for more details.

Table 1

Year - 2016 Hampton Virginia

Poor or fair health 19% 16%
Limited excess to healthy 10% 4%

Uninsured 9% 10%
Median Household Income 52,900 71,500
Obesity 38% 29%

Physical Inactivity 22% 22%

Adult smokers 17% 15%
Preventable hospital stays 4,230 per 100,000 of 4.454 per 100,000 of
Medicare enrollees Medicare enrollees
Information obtained from County Health Rankings
Population Needs

After assessing and interacting with the community, I was able to identify the needs of the

population. The nursing diagnoses appropriate to this aggregate are Knowledge Deficit and

Ineffective Self-Health Management. Many people of the population admitted to not fully

understanding the different diseases and conditions they have been diagnosed with. This aggregate

lacks the necessary knowledge to adequately manage their health. The rate of preventable hospital

stays in Table 1 can support this need. Between the two diagnoses, I think knowledge deficit holds

prioritization because the lack of knowledge contributes to ineffective self-health management.

Literature Review

Low Socioeconomic status can be associated with many different health outcomes and

medical conditions such as diabetes, hypertension, depression, angina, and respiratory illnesses

(Cene et al., 2016). “Socioeconomic status is a measure of social status, which profoundly

impacts health by structuring an individual’s access to both material and social resources

required to achieve and maintain good health” (Cene et al. 2016, p. 2624). Hampton

socioeconomic economic status could potentially be affecting their health status.

Hypertension has been diagnosed in 31.1% of the residents in Hampton. It is also the

most commonly diagnosed chronic disease in Hampton. “It is estimated that by 2025, more than

1.5 billion individuals worldwide will have hypertension, accounting for 50% of heart disease

risk and 75% of stroke risk” (Himmelfarb, Commodore-Mensan and Hill, 2016, p. 243).

According to VDH, the leading cause of death in Virginia in 2017 was major Cardiovascular

Diseases. In the United States, among those with hypertension, about 30% of them are not

engaged with hypertension care and 25% are unaware of the diagnosis (Himmelfarb et al., 2016).

The Centers for Disease Control (2016) suggests getting regular blood pressure checks, eating a

healthy diet, maintaining a healthy weight, being physically active, limiting alcohol use,

preventing or managing diabetes and not smoking tobacco to maintain normal blood pressure


Health Planning/Needs

Knowledge deficit related to Hypertension is the final nursing diagnoses selected for this

population. Hypertension is defined as a systolic blood pressure of 140mmHg and or a diastolic

blood pressure of 90mmHg or greater (Forette & Riguad, 2001). I chose to focus on

Hypertension because that is the most commonly diagnosed chronic disease in Hampton. Both

systolic and diastolic blood pressure increase with age and hypertension stands out as the major

risk for cardiovascular morbidity and mortality in the elderly population (Forette & Rigaud).

Because of this, it is important to educate the community on the management of hypertension as

early as possible. Sentara CarePlex Hospital’s Community Health Needs Assessment (2016)

revealed that the rate of preventable hospitalizations related to Hypertension was 30.2 in 2013.

The study region of this assessment includes Hampton, Newport News, Poquoson and York.

Lifestyle changes and or medication can significantly reduce a person’s risk for

cardiovascular disease and stroke (Himmelfarb, Commodore-Mensan and Hill, 2016) . To


address these needs, my objectives are to educate clients on hypertension and its correlation to

stroke and to educate clients on lifestyle modifications to manage and or prevent hypertension.

By the end of the teaching sessions, the community members will demonstrate the ability to

operate an automatic blood pressure cuff, know the correlation between hypertension and stroke

and identify three lifestyle behaviors that will aid in adequate management of hypertension.

Alternative Interventions

In order to accomplish these objectives, it will take more than a few education sessions.

It requires constant education and monitoring by healthcare providers. I will share resources

regarding affordable healthcare opportunities in the community such as H.E.L.P clinic,

Peninsula Agency on Aging and Southeastern Virginia Health System to encourage regular

healthcare visits. Regular appointments with a healthcare provider are essential in managing



In conclusion, education regarding the management of Hypertension is the highest

priority in this community. The statistical data prove that the health of the residents in Hampton

needs improvement. My ultimate goal is for the community to have the necessary skills and

resources to manage their health, beginning with their blood pressure.


Cené, C., Halladay, J., Gizlice, Z., Roedersheimer, K., Hinderliter, A., Cummings, D., . . .

Dewalt, D. (2016). Associations between subjective social status and physical and mental

health functioning among patients with hypertension. Journal of Health Psychology,

21(11), 2624-2635.

Communicating Needs for Community Action. (2016). Needs Assessment in Public Health,61-

74. doi:10.1007/0-306-47610-x_4

High Blood Pressure Fact Sheet|Data & Statistics|DHDSP|CDC. (2016, June 16). Retrieved from


Himmelfarb, C. R., Commodore-Mensah, Y., & Hill, M. N. (2016). Expanding the Role of

Nurses to Improve Hypertension Care and Control Globally. Annals of Global

Health,82(2), 243. doi:10.1016/j.aogh.2016.02.003

Rankings. (n.d.). Retrieved from



Rigaud, A., & Forette, B. (2001). Hypertension in older adults. The Journals of Gerontology.

Series A, Biological Sciences and Medical Sciences, 56(4), M217-M225.

Virginia Department of Health. (n.d.). Retrieved from