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Community Assessment Project: Filipino Culture

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1 Community Assessment Project: Filipino Culture
Sandra Colon Dironada Gross Angela Caridi Shelley Young Laci Wells Laura Griffis

2 Data about the Community Gainesville, Florida By: Sandra Colon
Section I


4 Area: approximately 62 square miles
Population: 130,898 (255,692 countywide) estimated as of April 2010 by the BEBR (updated 9/14/10) Industry: Variable from agricultural to manufacturing, academic research, health care, corporate infrastructure, many small/minority business enterprises

5 History of Gainesville, Florida
Throughout the sixteenth century Spanish explorers like DeSoto plundered the region, then Franciscan priests founded missions and finally ranchers established a large cattle ranch on Payne's Prairie. During the early 1700s the English and their Indian allies destroyed these missions and later the Seminole Indians made settlements around Micanopy. During the Civil War, Gainesville served as a major Confederate Commissary and was the site of two battles. Reconstruction brought martial law, Republican rule, the immigration of freed slaves, and an economic prosperity. Two main schools were established, the Union Academy for African Americans, and the East Florida Seminary for whites. In1905 Gainesville was chosen as the site for the University of Florida. The postwar era brought Alachua County a tremendous population growth and economic expansion. The influx of thousands of veterans seeking an education transformed both the University and Gainesville. The County and City also changed dramatically in the postwar years. By 1970 Alachua County had 104,000 inhabitants with three-fourths of them residing in or around the Gainesville city limits.

6 Gainesville Governmental Representatives
U.S Senators: Bill Nelson and Marco Rubio U.S House of Representatives: (District 6) Clifford B. Stearns Governor of Florida: Rick Scott Florida Senate: (District 14) Steve Oelrich Florida House Representatives: (District 23) Charles S. "Chuck" Chestnut IV  (District 22) W. Keith Perry (District 11) Elizabeth W. Porter

7 Elected Officials MAYOR Craig Lowe SHERIFF Sadie Darnell

8 Gainesville City Commission
Gainesville's City Commission performs such duties as passing the city's budget, setting the mileage rate and approving the ordinances and resolutions. The commissioners are ultimately responsible to the citizens of Gainesville. The commission consists of seven members: four commissioners are elected from single member districts, two commissioners are elected at-large, and one member is elected as mayor.

9 City Commissioners Mayor Craig Lowe Thomas Hawkins (At-large) Todd Chase (District II) Jeanna Mastrodicasa (At-large) Susan Bottcher (District III) Scherwin Henry (District I) Randy Wells (District IV)

10 (As pictured above from left to right)
Lee Pinkoson, Democrat, Chair Paula M. DeLaney, Democrat, Vice Chair Mike Byerly, Democrat Susan Baird, Republican Rodney J. Long, Democrat (As pictured above from left to right)

11 Analysis Gainesville is the largest city and county seat of Alachua County. It serves as the cultural, educational and commercial center for the north central Florida region. The city provides a full range of municipal services, including police and fire protection; comprehensive land use planning and zoning services; code enforcement and neighborhood improvement; streets and drainage construction and maintenance; traffic engineering services; refuse and recycling services through a franchised operator; recreation and parks; cultural and nature services; and necessary administrative services to support these activities. Additionally, the city owns a regional transit system, a municipal airport , a 72-par championship golf course and a utility company. Gainesville is home to Florida's largest and oldest university, and is one of the state's centers of education, medicine, cultural events and athletics. The University of Florida and Shands Hospital at UF are the leading employers in Gainesville and provide jobs for many residents of surrounding counties.

12 Analysis Residents from surrounding cities and states may travel to Gainesville for their education and health needs at the University of Florida and Shands Teaching Hospital. As a community health nurse, in order to help someone in the community efficiently and effectively, it would be vital to know the district one resides in and which city council member to contact about their particular situation. It would be beneficial which councilman and/or house representative within the local government to contact for health care policies. It could also be helpful to know the policies and procedures within the neighboring hospitals and medical facilities to provide the best medical access for members of the community.

13 Analysis The community health nurse must also understand the common illnesses and medical conditions affecting the area (i.e. motor vehicle accidents, water related incidents, infectious diseases). It is the job of the community health nurse to work closely with governmental officials and local medical facilities providing the appropriate health care and education to the residents. Primary prevention is essential to the success of the population and everyone must work together to ensure that Gainesville becomes and remains a healthy community.

14 Risk for Childhood Obesity
Diagnosis Risk for Childhood Obesity Risk of Obesity among children 6 to 11 years of age related to inactivity and poor eating habits as evidenced by 17.4% of the youth were classified as obese in Healthy People 2020 National Health Objective # NWS-10 is to reduce the proportion of children and adolescents who are considered obese.

15 References Alachua County, Florida. (2011). Retrieved from City Of Gainesville, Florida. (2011). Retrieved from U.S. Department of Health and Human Services. (2011). Healthy People Retrieved from

16 Information about the People by: Dironada Gross
Alachua County, Florida Section II

17 Race Population Within Alachua County In Comparison to Florida

18 Within A Culture

19 Alachua County and Gainesville
Population Increase U.S. Census Bureau Alachua County and Gainesville

20 Age Comparison

21 Education

22 Education Attainment

23 Population 25 Years and Over
Education Attainment Population 25 Years and Over

24 Gainesville Elementary Schools
Chiles B C Finley A Duval D Foster Metcalf Glenn Springs Hidden Oak Rawlings Tabolt Littlewood Lake Forest Terwilliger Wiles Idlylwild Williams FCAT Scores

25 Gainesville Middle Schools
FCAT Scores Gainesville Middle Schools Bishop A Fort Clarke Kanapaha Lincoln B Westwood

26 Gainesville High Schools
FCAT Scores Gainesville High Schools Eastside High School D A P.K. Younge High School Buchholz High School B Gainesville High School Loften High School C

27 Marital Status, > 15 years old
U.S. Census Bureau, American Community Survey

28 Household Income U.S. Census Bureau 2005-2009

29 Below Poverty, 2009 U.S. Census Bureau, American Community Survey

30 Below Poverty Population Percentages
U.S. Census Bureau, American Community Survey

31 Unemployment U.S. Census Bureau American Community Survey

32 Homeless

33 Homeless

34 Religion

35 Analysis As shown by my research of Alachua County, as nurses we need to be aware of the different race and religious backgrounds when caring for our patients. Making sure not to be judgmental or pass bias because what may be acceptable in one culture is not always acceptable in other cultures. The City of Gainesville and Alachua county does offer some of the best schools, but due to the unemployment rate on the city and county level, individuals living below the poverty level, and the homeless community, as community health nurses, knowing our community resources is vital to providing excellent patient care, knowledge, and understanding to individuals faced with many obstacles at their most difficult time.

36 Community Diagnosis Risk for limited health services and access among the homeless, unemployed, and individuals living under the poverty level related to high cost and lack of insurance coverage, as evidenced by 23% of residents living below the poverty level and 7.3% unemployment rate in Alachua County. Healthy People 2020 AHS-1 goal is to increase the proportion of person with health insurance.

37 State and County Quick Fact http://quickfacts. census
State and County Quick Fact Employment Status ds_name=ACS_2009_5YR_G00 Poverty levels ds_name=ACS_2009_5YR_G00_&-redoLog=false Alachua County mt_name=ACS_2009_5YR_G2000_B02001: Race/Population Household Income, Alachua County ds_name=ACS_2009_5YR_G00_&-redoLog=false Gainesville, Fl quick facts Gainesville Religion Alachua County Homeless Alachua County FCAT Scores Reference

38 Health Statistics By: Angela Caridi
Section III

39 Population

40 Population As the data shows, among Alachua County residents in 2009, the Caucasian child-bearing age is of the highest population. The next most populated group in Alachua County are Caucasians 45 and older, followed by African Americans between years of age. The population in Alachua County and specifically Gainesville, FL is in large contributed by the presence of the University of Florida and Shands Teaching Hospital, thus the high population of young adults.

41 Birth Rates

42 Birth Rate & Population
As you can see by the data provided, the highest population in the Alachua County area is the Caucasian race among childbearing age, although birth rates are not consistent with the population in the area. African Americans show a significantly higher birth rate in the Gainesville and Alachua County area in the adolescent to 24 year old range, which is inconsistent in relation to the population of the county. While African Americans show higher birth rates among the adolescent to mid twenties range, Caucasians show a higher birth rate in the mid twenties and above age range, while other races stayed consistently lower and congruent to their population. Births in Alachua county accounted for 1.3% of births in the state of Florida in 2009, while Gainesville specifically accounted for 0.9%.

43 Mortality Rate

44 Mortality Rate

45 Mortality Rate Among Alachua County Residents, 2009
While the total population in Alachua County in 2009 was 254,690, a total of 1,685 deaths occurred that year in that county, accounting for 0.67% of the population. Cancer, heart disease, and unintentional injuries are among the leading causes of death in the Alachua County area, together causing 50.4% of all deaths. Suicide accounts for 1.6% of deaths, while homicide shows less prevalent at 0.6%. Alachua County infant mortality resulted in 1.8% of all deaths, and 2% of infant mortality statewide.

46 Morbidity Communicable & Infectious Diseases Years 2007-2009, rate per 100,000
County Rate State Rate Vaccine preventable diseases 5.0 3.8 HIV cases reported 25.5 33.2 AIDS cases reported 17.2 22.9 HIV/AIDS age-adjusted death rate 4.4 7.4 TB cases reported 2.9 4.9 Chlamydia cases reported 688.1 357.3 Gonorrhea cases reported 216.1 119.7 Infectious syphilis cases reported 5.7 5.3

47 Morbidity Chronic Diseases Years 2007-2009, rate per 100,000
Coronary Heart Disease County Rate State Rate Coronary heart disease age-adjusted death rate 93.1 108.5 Coronary heart disease age-adjusted hospitalization rate 406.4 440.4 Stroke County Rate State Rate Stroke age-adjusted death rate 39.3 31.6 Stroke age-adjusted hospitalization rate 246.0 268.6

48 Morbidity Chronic Diseases (continued) Years 2007-2009, rate per 100,000
Heart Failure County Rate State Rate Heart failure age-adjusted death rate 11.1 7.6 Congestive heart failure age-adjusted hospitalization rate 185.3 Adults with diagnosed hypertension (%) 22.2% 28.2% Adults who have diagnosed high blood cholesterol (%) 26.8% 37.1% Lung Cancer County Rate State Rate Lung cancer age-adjusted death rate 52.6 46.9 Lung cancer age-adjusted incidence rate 77.0 67.7

49 Morbidity Chronic Diseases (continued) Years 2007-2009, rate per 100,000
Colorectal Cancer County Rate State Rate Colorectal cancer age-adjusted death rate 22.2 14.7 Colorectal cancer age-adjusted incidence rate 49.2 43.0 Breast Cancer County Rate State Rate Breast cancer age-adjusted death rate 23.2 20.4 Breast cancer age-adjusted incidence rate 127.8 109.3 Prostate Cancer County Rate State Rate Prostate cancer age-adjusted death rate 21.4 18.3 Prostate cancer age-adjusted incidence rate 153.9 130.6

50 Morbidity Chronic Diseases (continued) Years 2007-2009, rate per 100,000
Cervical Cancer County Rate State Rate Cervical cancer age-adjusted death rate 1.6 2.5 Cervical cancer age-adjusted incidence rate 10.1 9.1 Melanoma County Rate State Rate Melanoma age-adjusted death rate 4.2 2.9 Melanoma age-adjusted incidence rate 16.4 17.4

51 Morbidity Chronic Diseases (continued) Years 2007-2009, rate per 100,000
Chronic Lower Respiratory Diseases (CLRD) County Rate State Rate CLRD age-adjusted death rate 41.5 37.1 CLRD age-adjusted hospitalization rate 357.8 339.9 Adults who currently have asthma (%) 6.9% 6.2% Asthma age-adjusted hospitalization rate 702.2 729.9 Diabetes County Rate State Rate Diabetes age-adjusted death rate 27.3 20.0 Diabetes age-adjusted hospitalization rate 2342.7 2130.8 Adults with diagnosed diabetes (%) 6.3% 8.7%

52 Morbidity Most infectious diseases listed are similar among the statistics between Alachua county and the state, however Gonorrhea and Chlamydia are highly prevalent in the Alachua County area. They are both nearly double the state rate. The actual count, according to the department of health, was 1,803 cases in Alachua county in 2009. While cardiovascular disease and lung cancer are two of the leading causes of death, the Alachua county area has better statistics than that of the state rate for cardiovascular disease, however lung cancer is slightly increased in Alachua county than that of the state. Diabetes in Alachua county is only slightly elevated compared to the state rate, however both rates are extremely high.

53 Nutrition, Exercise, and Health Awareness Alachua County, 2007
Physical Activity County Rate State Rate Adults who meet moderate physical activity recommendations (%) 39.2% 34.6% Adults who meet vigorous physical activity recommendations (%) 31.3% 26.0% Adults who engage in no leisure-time physical activity (%) 16.9% 26.4% Overweight & Obesity County Rate State Rate Adults who consume at least five servings of fruits and vegetables daily (%) 29.2% 26.2% Adults who are overweight (%) 37.8% 38% Adults who are obese (%) 25.4% 24.1%

54 Nutrition,Exercise,and Health Awareness Alachua County, 2007
Testing County Rate State Rate Adults who had their cholesterol checked in the past five years (%) 66.6% 73.3% Adults 50 years of age and older who received a sigmoidoscopy or colonoscopy in the past five years (%) 54.6% 53.7% Adults 50 years of age and older who received a blood stool test in the past year (%) 21.1% 21.2% Women 40 years of age and older who received a mammogram in the past year (%) 70.8% 64.9% Women 18 years of age and older who received a Pap test in the past year (%) 70.5% 64.8%

55 Nutrition, Exercise, and Health Awareness
According to the Behavioral Risk Factors Surveillance Survey (BRFSS), residents in Alachua County are more physically active and have a more well-balanced diet than that of the state rate. BRFSS also shows that women in Alachua County have a higher rate of getting routine testing for female related issues such as mammograms and Pap testing, while cholesterol testing for both genders is below average compared to the rest of the state.

56 Lifestyle Habits

57 Lifestyle Habits

58 Lifestyle Habits After reviewing the information on alcohol consumption among different races, gender, and age ranges, the rates show that whites, males, and adults between the ages of 18 and 44 in Alachua county are bigger drinkers than the same population for the state of Florida. In fact, every population is either similar to, or bigger alcohol consumers in Alachua county to the state of Florida. The opposite is true for adults who smoked in 2007 in Alachua County. With the exception of the age range between 45-64, Alachua county had a lower incidence of adult smokers than the state of Florida.

59 Windshield Survey People in the Gainesville, Fl community appear to be quite healthy when driving through the city. There are always people exercising on the side of the road at all times of the day and evening, as well as bike lanes on every major road. Gainesville is also highly populated with nature trails, gyms and home to four YMCA’s. There are many sports teams and leagues to join as well. The city of Gainesville appears to be more populated with bars and clubs, as well as liquor stores, in order to cater to college aged adults.

60 Analysis Due to the elevated birth rate among teens and young adults in the Alachua County and Gainesville area, abstinence and contraception should be a big focus on adolescents in this community, especially among young African American females. Health teaching and effective contraception should be implemented in this community for STD prevention due to the extremely elevated rates of Chlamydia and Gonorrhea, specifically targeting the college aged population.

61 Analysis Information regarding smoking cessation and necessary screening for cancers should be implemented. Important key information to include would be the tests and age that should be initiated to decrease the incidence of cancer in Alachua county. Special focus should be on men to get regular physical examinations with digital rectal exams, as well as sigmoidoscopies every five years and colonoscopies every ten years starting at age 50, in order to decrease colorectal and prostate cancers. Women should be taught the importance of self-breast examinations every month and necessity of regular gynecologic appointments to screen for cervical cancer and breast cancer, as well as the necessity for annual mammograms starting at age 50. Nutrition, exercise, and lifestyle habits should be evaluated for increased risk of cardiovascular disease. The need for healthy lifestyle choices, regular physical examinations, as well as blood pressure and cholesterol screenings should be taught to increase awareness and to decrease heart disease.

62 Analysis Necessary day to day safety precautions should be enforced to decrease unintentional injury and deaths that occur in the Alachua County area. These precautions includes driving the speed limit, no texting while driving, necessity of wearing a safety belt, appropriate child seat restraint use, and responsible alcohol consumption. Diabetes and nutrition counseling should also be enforced to assist in decreasing the incidence of diabetes and diabetic-related complications and hospitalizations. Counseling on substance abuse, specifically alcohol use, would be a necessary objective for a community health nurse in this area to decrease the rates of alcohol consumption and possible health related conditions and risky behavior associated with alcohol consumption.

63 Health Problems Needs/Risks
Risk for sexually transmitted infections among young adults related to unsafe sexual practices as evidenced by high incidence rate of Chlamydia and gonorrhea ( per 100,000 residents in Alachua county compared to the state of Florida rate of per 100,000) and by the Healthy People 2020 objectives: STD-1 Reduce the proportion of adolescents and young adults with Chlamydia trachomatis infections STD-6 Reduce gonorrhea rates

64 References Florida Department of Health (2010). Florida Population Estimates. Retrieved from Florida Department of Health (2010). Florida Birth Query System. Retrieved from Florida Department of Health (2010). Major Causes of Death for Retrieved from 9 Florida Department of Health (2010). Florida Death Query System. Retrieved from Florida Department of Health (2010). County Health Status Summary. Retrieved from 9 Florida Department of Health, Division of Disease Control. (2007). Florida Behavioral Risk Factor Surveillance System (BRFSS) Data Report (Data File). Retrieved from U.S. Department of Health and Human Services (2011). Healthy people 2020: Sexually Transmitted Diseases. Retrieved from Maurer, F. A. & Smith, C. M. (2009). Community/public health nursing practice: Health for families and populations. St. Louis, MO: Saunders Elsevier.

65 Filipino Cultural Assessment By: Shelley Young
Gainesville, FL Section IV

66 Demographic Filipinos are included in the Asian American/Pacific Islander category and are considered the second largest Asian American group in the United States. California, New York, Hawaii have the largest Asian American population. Florida is the eighth highest with 2.1% according to the Florida Department of Health. Gainesville is the largest city within Alachua county with a Asia American population of 4.2 % (Alachua County Department of Community Support Services, ). It is double the rate for the state This may be attributed to the University of Florida and the large amount of Filipino nursing families (2-4 hundred) that was brought to the area by Shands UF between (Employment Director, Shands at UF, Personal communication, June 25, 2011). HHS Personal Conversations

67 Filipinos in Gainesville
The Asian American/Pacific Islander community is so small, not much is know on when they came to Gainesville and what percentage is Filipino. According to Aragon, the earliest Filipino came to Gainesville as spouses of veterans. Mrs. Aragon’s mother came to Gainesville almost 30 years ago as the wife of a navy officer who was stationed in the Philippines. Personal Conversations

68 Community resources available
PAGASA and the UFFSA have a Barrio Fiesta once a year where students perform the traditional folk dances of the Philippines one of which is “Tinikung PAGASA UFFSA Filipino Student Association at the University of Florida PAGASA was established in and means “HOPE” The acronym is Pilipino American Association of Gainesville and Surrounding Areas. Monthly social/gatherings are held UFFSA, PAGASA, Personal Conversations

69 Language and Culture Purnell
In the Philippines more than 100 dialects are spoken but Filipino or Tagalog is the national language English is the second official language. It is used to conduct internal and global business and legal transactions. Among Filipino Americans, a combination of English/Tagalog or “Tag-Lish” a hybrid language, is spoken by many and used in health education. Filipinos are not confrontational they will walk away from an argument; they speak politely and in a gentle tone, and avoid any conflict Communication is considered highly contextual Non verbal communication is very important to Filipinos Comfortable with silence Do not always maintain eye contact Learn best if shown a task then asked to demonstrate. Purnell

70 Religion and Family Beliefs
The majority of the Filipino population is catholic. However, they’re very superstitious and still believe in some of the “old ways” Fathers are the head of the families and the providers, whereas mothers are considered soft and calm who take care of the domestic needs and promote the development of ones emotions and values Multigenerational households are accepted arrangements where respect and love for parents and older family members are taught and expected of the children An important belief to be aware of as a healthcare worker, is that they believe in family centered decision making, which contributes to the beliefs that a patient should not be informed of a terminal illness, preferring to protect them from despair and allowing them to maintain hope Dating at an early age is discouraged and sex education or sex is not openly discussed. It is desired that women remain chaste until marriage and pregnancy out of wedlock is frowned upon and shames the family. Purnell, Personal Conversation

71 Filipino Health Issues
Filipino women have the life expectancy 81.5 years in comparison to that of Asian American women with that of 85.8 years the highest of any other ethnic group in the U.S. Many issue influence the health of Filipinos such as the lack of medical care/doctor visits, language/cultural barriers as well as a lack of insurance. Conditions such as terminal illness, mental illness, unwanted pregnancies, HIV/AIDS as well as criminal offenses and divorce are not shared with outsiders unless trust has been developed. Asian American/Pacific Islander’s are most at risk for the following health conditions: cancer, heart disease, stroke, unintentional injuries (accidents), and diabetes. There is a high prevalence rate of the following conditions and risk factors: chronic obstructive pulmonary disease, hepatitis B, HIV/AIDS, smoking, tuberculosis, and liver disease. TB is 24 times more common in Asians than in Whites SIDS is the fourth leading cause of infant mortality CDC, Purnell

72 Health Care Practices Purnell
Filipinos do not seek medical attention usually until an illness is advance, often they accept minor illnesses stoically and as a natural imbalance that will run its course naturally and disappear. Often times the decision to seek medical care is that of a family decision. This includes the nuclear and extended family. Pain is often not complained about is is viewed as part of living an honorable life and a opportunity to reach a fuller spiritual life, so as a healthcare worker offer and encourage pain medication educating to the advantages. They place a high value on cleanliness, and often times take aromatic baths for both pleasure and to restore balance. It is believed that a bad body odor is bad for the heath and to be unkempt and disorderly is shameless. Western medicine is acceptable and familiar but folk medicine/healers are also consulted, but are not as common here in the united states. Utilizing a primary care physician or a linguistically and ethnically congruent practitioner will often improve the Filipinos acceptance and learning . Purnell

73 Birth and Death are Significant Moments for the Filipino family.
A loved one’s death is much more ritualistic and extended. Births Pregnancy is a family and community affair. Everyone gets involved especially grandparents. Fathers are involved in baby showers and birthing if they would like. There is no exclusion. Children are celebrated and everything is centered on the child. The christening is a very big celebration in the Filipino culture, this usually occurs before the first birthday Deaths After a loved one death, for most Filipinos there is three stages of grieving. The first nine days, then 40 day followed by a one year mourning period. First stage is the nine-day novena (prayer) is held every evening after the Holy Mass. Second celebration is the 40 day mourning period (soul goes to heaven after 40 days ) Last is the one year mourning. The Filipino culture holds that the “longer the grief, the better.” Most often, for a year and often beyond that, men will wear a black ribbon and women will dress in black to indicate they are in mourning . Then on the first anniversary a celebration mass is held. Rituals surrounding death as very “showy.” Women are expected to grieve very openly -- publicly sobbing, swooning, fainting, and/or hugging the casket of the dead person Men are typically more reserved, they are considered disrespectful to show emotions that are anything but “somber and depressed.” Purnell

74 Strengths of the Filipino Culture
Most Filipino families function within an extended family structure with strong emphasis on interpersonal dynamics, group harmony and loyalty, respect for elders and authority, and maintenance of a natural support system by a complex process of building interdependent/dependent relationships and family roles Caring for aging relatives is integrated over time into these relationships, and interdependence is deeply embedded in the culture. Caring for others is a complex skill that is learned throughout Pakikipagkapwa-Tao which is regard for others, it is a word Filipinos live by. They regard others with dignity and respect, and deal with them as fellow human beings. Pakikipagkapwa-tao is manifested in a basic sense of justice and fairness, and in concern for others. It is demonstrated in the Filipino's ability to empathize with others, in helpfulness and generosity in times of need. Pakikipagkapwa-tao results in camaraderie and a feeling of closeness one to another Personal Conversation

75 Struggles Filipinos Encounter
One of the Filipino's greatest strengths is also their weakness, they are family focused and centered but this can be their flaw in extremes. Excessive concern for the family creates an in-group to which the Filipino is fiercely loyal, to the detriment of concern for the larger community or the common good. Their lack of discipline incorporates several related qualities for example their casual and relaxed attitude towards time and space which displays itself in lack of precision and compulsiveness, in poor time management and procrastination. The Filipino's are also generally passive and lacking in initiative. They will wait to be told what has to be done. Personal Conversation

76 Windshield Survey The houses I saw were of mixed age and architecture there are developments with newer housing and materials but there is also older areas with smaller homes in various conditions. Most of the houses in the areas I drove around are close together maybe ¼- ½ acre lots. I did not see much damage or bad neighborhoods where I was. I did see lots of parks and open areas and tree lots. The lawns were well maintained and green Some of the neighborhoods or developments are well marked with signs others are not. There is a lot of natural parks and recreation parks, I drive on a highway on my way into Gainesville but during the windshield survey I rode around back roads and neighborhoods. I also saw many college apartments and dorms. There were lots of medical office buildings and small shopping centers with food stops and small stores, I did not notice alternative medicine shops Many of the people I saw on the streets were still students there were some people walking dogs in all the neighborhoods I drove through. And everyone was dressed as expected for a college town.

77 References Personal conversation with Gainesville community members: Pamela Aragon, Agnes E, and Ruth Tuazon. Purnell, L. D. (2009). Guide to culturally competent healthcare (second ed., pp ). Philadelphia, PA: F.A Davis. Multiple conversations with Filipino &lvlID=53

78 Knowledge about the Environment By: Laura Wells
Section V

79 Nutritional Options There are many grocery stores available such as Publix, Sweet Bay, Fresh Market, Winn Dixie. There are also ethnic food stores such as Indian Bazzar and La Fortuna Latin Market. All basic food items such as milk, bread, eggs, fruits, vegetables, and meats can be bought. There are notable differences in food prices with the Fresh Market store. Since the food is gourmet and fresh it tends to be a little more expensive. The other stores listed primarily have the same products and prices.

80 Education Residents have numerous choices for good schools. According to the there are a variety of schools that are highly recommended by residents for children to attend. According to the Gainesville Chamber of Commerce about 90% of students graduate with a high school diploma and 45% graduate with a bachelor’s degree or higher.

81 Safety Services Services providing safety for the community are Gainesville Police Department, Alachua County Sheriff’s Office, University of Florida Police, and Gainesville Fire Rescue. The manpower is adequate to provide quality protective services. The ratio of police officers to the population in Gainesville is adequate to provide safety to the community. The population statistics from the Alachua County Sheriff’s Office states there are approximately 970 inmates residing in the county jail. Gainesville Fire Rescue has 8 fire stations located in the city. The closest one being SW Archer Road. Archer road is the main road in Gainesville, FL.

82 Transportation Patterns and Resources
Typically you will see the residents of Gainesville driving in their cars. Gainesville does become congested with traffic with peak times being 7:00am-9:00 and 5:00pm-7:00pm during the weekdays. There are also the RTS buses that provide transportation services for the public and students at University of Florida and Santa Fe College. RTS offers one way only fares for $1.50 for adults and children are free. They also give discounted rates for seniors citizens, Medicaid recipients, veterans, and active military duty. A semester pass for students is $60 per month with valid student ID. Employees of Gainesville also have discounted rate with RTS. The option is also available for monthly passes that range $35. Also there are many people who like to walk or ride their bicycles to work or to the stores. There are many accessible sidewalks along the roads and there are bike lanes.

83 Physical Environment Maintenance
EWS provides trash pick up for the City of Gainesville which is called MWS known as Municipal Solid waste collection. City limits are kept clean with weekly garbage pickup. There is a sewage system that serves local businesses and homes within the city limits. Newer housing is being built everyday in addition to renovations of shopping plazas and restaurants. There are also new additions to the local hospitals Shands and the VA.

84 Special Hazards On the Alachua county website there are no special hazards listed for Gainesville, FL. The website provides the precautions taken to avoid special hazards and forms businesses have to complete.

85 Communication Patterns
Communication patterns include the local news channel, Cox communications which provide advertisement commercials, radio and billboard advertisements. Informal sources such as the grocery stores and hair salons provide flyers or businesses cards on upcoming events in the community.

86 Summary and Analysis Schools grades are equivalent with each other in their grade performance. There is adequate safety personnel available to the community. There is public transportation that provides transportation for every individual around the city. There are no environmental hazards or special hazards at this time. Primary communication is through the local news, commercials, and flyers posted around town. Information is helpful to nurses to be more knowledgeable about their communities with their health status, what improvements need to made, special hazards in the community, and what ways are best to announce upcoming health fairs or activities going on in the community.

87 References Alachua County Chamber of Commerce (2011). Retrieved July 1, 2011, from Higher_Education.aspx Alachua County Florida (2011). Environmental Protection Department. Retrieved July 1, 2011, from ions.aspx Alachua County Sheriff’s Office (2011). County jail. Retrieved on July 1, from Florida Department of Education (2011) Florida school grades. Retrieved from City of Gainesville (2011). Gainesville Fire Rescue. Retrieved on July1, from GainesvilleFireRescueDepartmentGFR/FireStations/tabid/128/Default. aspx

88 Community Health Services By: Laura Griffis
Section VI

89 Health Services ■ Hospitals in Gainesville, Florida
▪ Shands Rehabilitation Center ▪ Shands UF ▪ Shands Children Hospital ▪ Shands Homecare ▪ North Florida Regional Medical Center ▪ VA Medical Center - All hospitals are open to the public at all times.

90 Walk In/ Emergent care Centers
1. North Florida Regional Medical Center 2. Immediate Care Center of North Florida Regional Medical Center 3. Urgent Care Affordable Unscheduled medical care Instant access to quality physicians

91 Assisted Living Facilities
◦ There are numerous assisted living facilities located in Gainesville, Florida for Filipino’s. They are: - Clare Bridge of Gainesville - Emeritus of Gainesville - Harborchase of Gainesville - North Florida Retirement Village - Oak Hammock of UF - Southwest Retirement Home - Sterling House of Gainesville (Assisted Living Directory, 2011)

92 Assisted Living Facilities Cont..
◦ Many Filipino’s need help paying for assisted living facilities. ◦ There are many support systems in the U.S. that will help people pay for assisted living. They are: - Long term care insurance - Medicare - Medicaid - Supplemental Security Income (National Senior Citizen Law Center, 2011)

93 Local Dentist for Filipino’s
▫ There are many dentist offices in Gainesville, Fl that are very expensive to afford. ▫ Some families in Gainesville, Fl including Filipino’s struggle to pay for dental insurance. ▫ The University of Florida dental students provide dental care to low income families at a much lower price than regular dentist offices. ▫ The fees at UF patient dental care are usually 30-50% less than fees of a private practice. (College of Dentistry, 2011) ▫ Family & Cosmetic Dentistry is another dentist with a low payment charge located in Gainesville, Fl. (Family & Cosmetic Dentistry, 2011) ▫ Both dentist offices accept everyone to come and get their teeth cleaned. ▫ They would love to have more people come into their offices.

94 Social Services PAGASA:
- Philippine Association in Gainesville and Surrounding Areas - Started in April 1996 - Organization to organize activities that will have goodwill, friendship, and fellowship among Filipino-American residents in Gainesville - Engages in charitable projects that benefit local community - Goal: to help Filipinos assimilate to life in the U.S., share rich, beautiful and colorful heritage within the people of Gainesville - Support network for an exchange of knowledge and ideas to Filipinos and Americans - Encourage a friendship and fellowship ( PAGASA, 2011)

95 Social Services Cont.. UFFFA
- University of Florida Filipino Student Association - Purposes of UFFSA: ▪ Promote culture, heritage, and unity of Filipino peoples ▪ Promote values of family, excellence, passion, and experience ▪ Promote welfare of its members ▪Enhance social interaction between members and other students, faculty, and staff at UF ▪Provide a social atmosphere for all FSA members ▪ Sponsor activities within the community - Open to anyone who is interesting in learning the heritage and cultural of Filipinos - Members of UFFSA elect officers to be in charge of each committee - Involved in numerous community activities. ( UFFSA, )

96 Social Services Cont… Philippine Express
- A restaurant located on Newberry road in Gainesville, Fl. - A great place for people to go to get a little bit of the Filipino culture and food. - According to reviews by customers the Philippine Express had: ▪ Great food ▪ Family-friendly atmosphere ▪ Great social place to get together ▪ Felt like you were in the Philippines ▪ Great prices, very cheap - Warm and inviting social atmosphere for the Filipino-American Culture ( Yelp, 2011)

97 Religion for Filipinos
♦ Filipino Christian Fellowship is a local church in Gainesville, Florida ♦ They have a partnership with a local church nearby called Westside Baptist Church ♦ Mission: bring hope of Christ to all peoples beginning with our Jerusalem (people in Gainesville) through outreach, our Judea (people in Florida) through partnerships, our Samaria (people in North America) through North America Mission Board, and the ends of the earth through the International Mission Board. ♦ Great place for people to gather together to hang out, relax, and enjoys each others fellowship. (Westside Baptist Church, 2011)

98 Religion Cont… ♦ Holy Faith Catholic Church in Gainesville, Fl. ♦ 80% of Filipino’s are Roman Catholic ( Miller, 2008) ♦ Holy Faith Catholic Church welcomes all new members with open arms. ♦ This church is a place where Filipino’s can go and feel welcomed. ♦ Filipino’s can come to this church to fellowship with friends and family. (The Catholic Directory, 2011)

99 Community Health Problem Shelley Young
Reduce unintended pregnancies among adolescent females years old related to unprotected sex as evidenced by Alachua county teen birth costs of $5,959,000 for 290 teen births and Healthy people statistics of 40.2 pregnancies per 1,000 females aged 15 to 17 years occurred in 2005. Main Florida/Costs_of_Teen_Pregnancy_in_Florida.pdf

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