One of the main potential health issue identified in the City of Horizon

One of the main potential health issue identified in the City of Horizon

This report is an in-depth community assessment of the City of Horizon. The purpose of the report is to help healthcare professionals understand the health needs of the city’s population, create a roadmap of directing the available resources to areas that are in dire need to enhance health outcome and thirdly to enhance the health of the community and attain measurable result over a given period of time (Issel 2004). Additionally, the report is intended to promote collaboration among various stakeholders in the community to facilitate attainment of positive health outcomes in the community.

The report is important for nursing because it informs nurses on the key priority areas in need of various health promotion services, thereby enabling the healthcare professionals plan and provide services to the most needful group in the population (Cibula, Novick, Morrow, & Sutphen 2003; McKenzie, Neiger, & Thackeray, 2009).

The first section of the report examines the social determinants of City of Horizon community and second part of the report analyses potential health needs of the community. In the third and final part, the report explores the role of registered nurses in health promotion of the community. The scope of the report includes identification of the social determinants and possible healthcare needs of the community to enable nurses develop an appropriate plan of actions to address the community needs. However, the report does not include a plan of action for addressing the identified needs in the community.

City of Horizon Community Assessment

Demographic profile

The city of Horizon has a lower population density of 6.86 persons per hectare than Melbourne which has 32 people per hectare (City of Horizon 2016). The demographic data indicate that the city has the oldest population at 56 years compared to the regional and national average of 42 years and 37 years receptively (City of Horizon 2016). Advanced age could have a significant effect on a person’s health and income. Older population is at higher risk of poor health, which undermines their ability to engage in gainful employment (Mackenbach 2015). This is demonstrated by the fact that the city has the lowest average weekly earnings at $751 compared to the regional and national average of $881 and $1234 respectively (City of Horizon 2016). Studies associate low income with poverty, which makes people vulnerable to diseases and poor health.

The city of Horizon has the highest population of older couples without children at 23% compared to regional and national levels at 12% and 9% respectively (City of Horizon 2016). This implies that the population has dismal social support and connectedness, which affects a person’s mental health and resilience against poor health. The city has a growing population of Aboriginal and Torres Straits Islanders ethnic groups, which increased from 1.6% to 2.3% of the total population from 2011 to 2016 (City of Horizon 2016). Ethnic minority groups are associated with poor health outcomes because of social exclusion and discrimination, which increases the risks of disability and mental health disorders (AIHW 2016).

Psychosocial profile

At 9%, the City of Horizon has the lowest proportion of people with university and higher education qualifications compared to South Australia’s 16% and the national average of 19% (City of Horizon 2016). Higher education achievement is related to better health throughout the lifespan, because it empowers people with information to make better health decisions, increases access to better and secure jobs and increased income (Marmot 2005). Labor statistics indicate that the city of Horizon has the highest unemployment level compared to regional and national average. The younger population (15-24) years has the highest unemployment rate at 9.6% (City of Horizon 2016).

Unemployed population has higher mortality and disability rates compared those engaged in gainful employment (Song, Hall, Harrison, Sharpe, Lin & Dean, 2011). Joblessness has profound effects on physical and mental health of people, with unemployed persons reporting higher prevalence of disease and poor health (Olds 2016). Healthcare and social assistance is the most popular industry, followed by retail and agricultural related sectors (farming, fishing and forestry) in the City of Horizon (2016). Employment statistics indicate that the three sectors provide the highest number of job opportunities in the city. These industries require relatively low skilled labor force, with low income and low job security.

Income data indicates that the city of Horizon has lower proportion of persons earning over $1500 weekly and a higher proportion of low income earners(less than $400) compared to South Australian Region (City of Horizon 2016). Additionally, the city of Horizon reported the highest prevalence of households earning the minimum weekly income of $400-$ 599 at 18.4% compared to Southern Australia average of 13.4% (City of Horizon 2016). Higher income is associated with improved health outcomes, because it increases access to better nutrition, housing, and wider healthy options. Housing data from the city of Horizon indicates that 44.7% owned their residences, 23.2% were in the process of purchasing while 21.8% resided in rented apartments. The number of home owners in the city was higher than the regional rate of 36.2% (City of Horizon 2016).

The type of housing has a direct influence on people’s health because the type of residence determines the safety, availability of sanitary amenities and behavior of the occupants (Adler, Cutler & Fielding 2016). Research findings indicates that well organized communities that facilitate provision of basic housing services and utilities provide social support to the members and are more inclined to adopting healthy behaviors, such as improved sanitation, conservation of the environment , recreational and relaxation amenities (AIHW 2016). The most common mode of transport in the city of Horizon is road transport. However, the city has lower number of motor vehicles than South Australian region (City of Horizon 2016). Access to transport has considerable effects on health outcomes, because it determines access and mobility to healthcare services, movement to workplaces and access to fresh food markets (Shepherd & Zubrick 2012). However, the city residents reported high level of social connectedness and were confident of getting support during the time of crisis (City of Horizon 2016). Social support and increased connectedness is associated with improved health outcomes (AIHW 2016).

Community infrastructure, goods and services

Access to shopping facilities, such as farm and fresh products markets has direct impacts on health (Wilkinson & Marmot 2003. Increased shopping facilities imply that individuals have wide options of accessing healthy food, which reduces prevalence of lifestyle disorders such as obesity. However, only 33% of the population in the city of Horizon has limited access to shopping outlets, telecommunication, sports and recreation facilities in addition to entertainment amenities (City of Horizon 2016). Access to telecommunication services such as broadband access is associated with increased access to health information, through internet enabled devices (AIHW 2016). The city of Horizon has higher rates of physical inactivity in adults than the regional standards in South Australia (City of Horizon 2016). Physical inactivity among adults has considerable health effects, and is associated with increased mental and physical disability.

Medical research evidence indicates that physical inactivity is a risk factor to development of obesity, cardiac disorders, diabetes, depression and other mental health problems across the population demographics (Mackenbach 2015). The city of horizon has limited cycling paths and the street lighting is not adequate especially in public spaces. Availability of cycling paths has considerable health impacts and it is associated with motivating people to engage in physical activities by riding bicycles to their places of work. Poor lighting especially in public places has major health effects because it increases security risks to people using public amenities for entertainment and recreational purposes (Markwick, Ansari, Sullivan, Parsons & McNeill 2014). The poor lighting in public places across the city could be contributing to physical inactivity, by discouraging people to use the facilities due to security fears.

Health services and Resources

Only two thirds of the city’s residences have access to healthcare facilities, such as hospitals, clinics and specialist facilities (City of Horizon 2016). Access to healthcare services has tremendous effects on the health of the population, because it determines the availability of curative and preventive interventions to manage and treat various communicable and non-communicable infections in a population (AIHW 2016). The available community healthcare facilities in the city of Horizon demonstrate limited usage by the local residents. Health attendance records indicate that the rate at which the residents of the city use the community health services is lower by 11 % compared to the regional areas in South Australia. However child and adolescent mental health services have the greatest demand among the residents attending to 58% more patients in the city than in the South Australia region (City of Horizon 2016).

The demand for government funded mental health services among the adults in the community was reported at 47% higher than the other metropolitan areas (City of Horizon 2016). The high demand for mental health services for both children and adults demonstrates the city has considerable mental health disease burden in the region. Access to preventive services especially child immunization in the city is lower than the national average in Australia. Immunization health records indicate that the number of fully immunized children below 5 years is at 89.8%, less that the national average (City of Horizon 2016). The high demand for government funded mental health services indicates limited access to healthcare among the residents due to various socio-economic factors, which undermines the population’s ability to afford the health services provided.

Potential Health Issues In The City Of Horizon

One of the main potential health issue identified in the City of Horizon is poor nutrition and physical inactivity. Nutrition and physical activities are major determinants of the health. Poor nutrition and physical inactivity are major risk factors for various chronic conditions, including diabetes, hypertension colon cancer, osteoporosis and excess weight gain. Poor nutrition is associated with various dietary factors, including consumption of unhealthy diet, lack of sufficient food and eating unbalanced diet. Unhealthy eating habits include excessive consumption of food with high fat, salt and sugar content. Health specialist and nutritionists also recommended incorporation of adequate fruits and vegetables in the diet (Shepherd & Zubrick 2012).

The main social determinant of health linked to poor nutrition and inactivity is socio-economic position (Mathers & Schofield 1998). Socio economic position of individuals in a given population has considerable effects on health. Individuals from poor economic and social backgrounds are at increased risks of poor health, physical and mental disability, high mortality and low life expectancy. The major indicators associated with socio-economic position as a determinant of health includes education achievement, income and occupation. The health issue of poor nutrition and physical inactivity in the city of Horizon is attributed to low education achievement, low incomes and involvement in low skilled occupations. In the city of horizon, about 20% of 16 year old children do not attend secondary school education (City of Horizon 2016). Additionally, the proportion of the population with university education in the city is 9%, the lowest rate in the region and in the country (City of Horizon 2016).

Low education achievement is associated with inability to make informed health decisions and choices, regarding the importance of healthy nutrition and physical activity. Low income limits the ability of a population to access a wide choice of healthy foods, such fresh farm products, including fruits and vegetables. Additionally low income levels restrict the population from participating in sports and other recreational activities involving physical exercises (Heckman & Mosso 2014). The issue of poor nutrition is of priority to the community because of the adverse health outcomes associated with unhealthy diet.

Excess consumption of fatty and sugary foods is associated with increased risks to developing chronic conditions, such as diabetes, obesity, hypertension and cardiovascular disease (Wilkinson & Marmot 2003). The population in the city of Horizon mainly comprises of aging persons and poor nutrition increases the risks of developing chronic conditions in old age, including functional impairments especially those associated with excess weight gain. The problem of poor nutrition is also a priority to the population because the city of Horizon has very high obesity rates, with 79% of adult population being obese (City of Horizon 2014). Additionally, the city has high prevalence of childhood obesity and the other forms of the study and the issue of poor nutrition should thus be prioritized (City of Horizon 2014).

Role of Registered Nurse in Health Promotion

To address the health issue of poor nutrition in the city of Horizon population, registered nurse could apply three strategies, namely enablement, advocacy and mediation. The Ottawa Charter of health promotion identifies enablement as a critical strategy of health promotion (WHO 1986). Enablement involves empowerment of individuals and groups of people in the community, to enhance their capacity to take control of the various factors influencing their health outcomes. The population could empower by imparting life skills, providing them with information and establishment of an environment that supports adoption of sustainable healthy behaviors (WHO 1986).

Advocacy is another role of registered nurse in health promotion. As health advocates, registered nurses are required to undertake deliberate actions, through various processes and platforms including lobbying in political and community forums to promote health in the society. This could be achieved by lobbying and participation in formulation of policies aimed at improving health of people in the community. The third approach that registered nurses could apply in health promotion entails mediation. Mediation entails coordination of various stakeholders involved in the healthcare systems such as government, patients, public and private enterprises including media to deliver synchronized healthcare services to the population. The role of mediation is to ensure the involvement and participation of all stakeholders in care delivery by negotiating the diverse interest of the different groups, with the ultimate goal of promoting collaboration while delivering care (Keleher & Parker 2013; Virpi, Kerttu & Hannele 2013).

The registered nurse standards for practice (NMBA, 2016) outlines various standards required of the healthcare professionals to ensure delivery of patient centered, high quality and evidence based care in disease prevention and treatment across the population. To advocate for health in the city of Horizon concerning the issue of poor nutrition, registered nurse could lobby through the political system for formulation of appropriate policies to address the health issue. The policy could include providing affordable, accessible and healthy food rations to vulnerable members of the community including children and elderly to prevent obesity. To mediate healthcare activities for the community, the registered nurse could engage diverse stakeholders involved in the healthcare system, including community leaders, government, media, drug companies and non-governmental organizations to gain their support in initiating preventive approaches to poor nutrition in the Horizon community. The preventive measures could include initiating community education to empower the population with knowledge regarding healthy eating and benefits of consuming food with low fat and sugar content, in addition to the importance of eating fruits and vegetables daily.


The objective of the report was to identify the various health needs affecting the population in the city of Horizon, with an objective of developing a roadmap of addressing the issues and to promote the health of the community. The population reported diverse findings in regards to the influence of social and economic factors on their health. First the population mainly comprised of aged persons, with lower income levels compared to the national standards. The population had low education achievement levels, limited access to healthcare services, recreational facilities and public transport. Moreover, the city of Horizon reported high prevalence of obesity, and behaviors adverse to health, including smoking and physical inactivity. However, a majority of respondents reported presence of strong social support system. The main health issue identifies was poor nutrition and physical inactivity, which caused a high prevalence of obesity and other chronic disorders associated with unhealthy eating and sedentary lifestyle. To address the health issues, registered nurse could participate in health promotion through advocacy and lobbying in various political and professional platforms. Moreover, mediation with other stakeholders is critical facilitate in health promotion.

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