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Community Health and Population Task 1

In: Business and Management

Submitted By kinieva
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Community Health Survey Task 1
Kinita L. Evans
Western Governors University

Author Note This paper is being submitted on March 14, 2016, for C228 Community Health and Population Focused Nursing course.

Community Health Survey Task 1
Hillsborough County is a county located in the state of Florida. As of the 2010 census, the population was 1,229,226, making it the fourth most populous county in Florida. Its county seat and largest city is Tampa. Hillsborough County is included in the Tampa – St. Petersburg – Clearwater, Florida Metropolitan statistical area. Hillsborough County was created on January 25, 1834, from Alachua and Monroe counties, during the US territorial (1822 – 1845). It was named for Willis Hill, the Earl of Hillsborough, who served as British Secretary of State for the colonies from 1768 to 1772. The counties 1834 boundaries were much wider and included eight of the present day counties: Charlotte County, Desoto, Hardee, Manatee, Pasco, Pinellas, Polk, and Sarasota County. The last significant change in Hillsborough County’s borders was the separation of its western section to create Pinellas County in 1911 (Wikipedia, 2015) On New Year’s Day in 1914, the St. Petersburg – Tampa Airboat line initiated the first scheduled commercial airline service in history, from St. Petersburg to Tampa. According to the U.S. Census Bureau, the county has a total area of 1266 mi.² of which 1020 mi.² is land, and 246 mi.² is water. There is approximately 158.27 miles of shoreline on Tampa Bay. The county’s unincorporated area approximately 888 mi.², or more than 84% of the total land area. Municipalities account for 163 mi.². The modern boundaries of the county place it midway along the west coast of Florida. A narrow strip of Hillsborough County extends to the west to the Gulf of Mexico roughly along the Tampa Port Shipping Channel. This has the effect of keeping Hillsborough County from being landlocked. The central portion of the Sunshine Skyway Bridge is in Hillsborough County as is Egmont Key at the entrance to Tampa Bay. This narrow strip of land effectively separates Pinellas County from Manatee County. Hillsborough is home to Alafia River State Park and Hillsborough River State parks, as well as the C.W. Bill Young Regional Reservoir and Lithia Springs, the largest natural spring in Florida (Wikipedia, 2015).
The Population and Economic Status in Hillsborough County assessment is as follows: Hillsborough County is located midway along the west coast of Florida in the Tampa-St. Petersburg metropolitan area. One of 67 counties in Florida, with its 1,050.9 square miles in land area and a population density of 1,047.9 per square mile, Hillsborough County is the fourth largest county in the state. The estimated population reported by the United States Census Bureau in 2009 was 1,195,317, an increase of 19.7% from the 2000 census and 43.3% from the 1990 census. The population in Hillsborough County is projected to reach 1,537,290 by the year 2025. The city of Tampa, the county seat, has a population of 343,890 and is one of three municipalities in the county, the other two being Plant City and Temple Terrace. Hillsborough County has a predominately white population (Florida Department of Health in Hillsborough County, 2010-2011 pg.8).
According to current data from the Florida Community Health Assessment Resource Tool Set (CHARTS), of residents who reported being of one race, about 78% were White and about 17% were Black or African American. Collectively, Asian, Native American Indian, Native Alaskan, Native Hawaiian, and Pacific Islander accounted for 3.7% of the population. About 23.4% of the population also reported being of Hispanic or Latino origin. Hillsborough County has a slightly younger age distribution than the rest of the state. About 28% of the population falls within the 25-44 age group. The median age is 36.6 years. Notably, 75% of the county’s population is 18 years and older, with 12% being age 65 years and older. The ratio of females (51%) to males (49%) is nearly equal. In 2005-2009, there were 456,000 households reported in Hillsborough County with an average household size of 2.5 persons. Families made up 64% of the households in Hillsborough County. This percentage includes both married-couple families (45%) and other families (18%). Non-family households made up 36% of all households in the county. Most of the non-family households were people living alone, with 7.8% of those being age 65 years or older. Female-headed family households accounted for 13.5% of the total households (Florida Department of Health in Hillsborough County, 2010-2011 pg.10). The median household income in 2005-2009 was reported at $49,594, which is higher than the state’s ($47,450). Data compiled from the census indicated 82% of the households received earnings, while 15% received retirement income other than Social Security. Twenty-four percent of the households received Social Security benefits which averaged approximately $14,665. About 2% of the population received cash public assistance, and another 7% received food stamp benefits in the past 12 months (Florida Department of Health in Hillsborough County, 2010-2011 pg.12). Household income data from the U.S. Census Bureau 2008 indicates that 13.9% of individuals fall below the Federal Poverty Level. This is slightly higher than the percentage for Florida state overall which is 13.3% (Florida Department of Health in Hillsborough County, 2010-2011 pg.13). In 2009, an estimated 15.2% of the population in the county reported income in the past 12 months below the poverty level (Office of Economic and Demographic Research). From 2005-2009, a larger percentage of Hillsborough County families were living below the poverty level when compared to the state. According to the U.S. Census Bureau, in 2005-2009 67.7% of the population 16 years and older were estimated to be in the labor force, which is more than the state average (Florida Department of Health in Hillsborough County, 2010-2011 pg.16). In May 2010, the Hillsborough County unemployment rate was estimated to be 11.5%, which is slightly lower than the September 2010 estimate for Florida of 11.9% (Florida Department of Health in Hillsborough County, 2010-2011 pg.16). In 2005-2009, an estimated 86% of the Hillsborough County population 25 years and older had at least a high school diploma, and 29% had a bachelor’s degree or higher, which are slightly higher than the state (85% and 26%, respectively). Fifteen percent were dropouts; they were not enrolled in school and had not graduated from high school. The total school enrollment in Hillsborough County was 306,000 in 2005-2009. Nursery school and kindergarten enrollment was 35,000. Elementary or high school enrollment was 191,000 children. College or graduate school enrollment was 81,000(Florida Department of Health in Hillsborough County, 2010-2011 pg.14). The amount of health resources available is a proxy measure for access to health care. Hillsborough County residents can access a variety of health care resources and services provided by hospitals, nursing homes, licensed physicians, federally qualified health centers, and the county health department. Despite the number of health care resources in the county, 28% of adults surveyed in 2007 had no personal health care provider, which is higher than the state (23%). Those who were between the ages of 18 and 44, had less than a high school education, income less than $25,000, Hispanic, and never married were more likely to report not having a personal health care provider. In addition, nearly 16% of the adults surveyed were unable to get medical care in the last 12 months. Hispanic women (22%) were the most likely to report the inability to access medical care when compared to White and Black women (15% and 19%). Notable trend, Hispanic women are more likely to report an inability to access medical care when compared to White and Black women in the county. Notable trend, Hillsborough County has a lower number of licensed dentists, physicians, internists, and family practice physicians per 100,000 residents. The county also has a lower rate of nursing home beds and county public health department full-time employees as compared to the state rate ((Florida Department of Health in Hillsborough County, 2010-2011 pg.48). The Disaster Planning assessment for Hillsborough County is as follows: Warning for an emergency requires action on two levels: warning officials and organizations and warning the general public. The extent and method of warnings issued will be determined by the EM Director and County Administrator. The scope of a warning can range from countywide for an event like a hurricane to a limited area of the county for a hazardous materials incident. Warning will be made by County Warning Point personnel utilizing all available means of communications to inform and warn county officials, local governments, emergency responders, disaster organizations, other concerned agencies and the public. Notification lists and phone numbers of key emergency personnel are maintained by both EDC and EOC staffs. The EM Director normally decides which personnel are notified depending on the emergency scenario. The systems available for warning are: Two-way radio, emergency alert system, the media, NOAA weather radio network, computer-controlled telephone out dial systems, mobile public address systems, personal contact, and port silent alert system (Hillsborough County Cemp, 2014 pg.39-40).
Hillsborough County has an official disaster planning guide that has been established for the Tampa Bay and surrounding areas. This guide was developed to help families and businesses develop plans and gives them the proper resources in the event of an emergency or disaster. It takes the whole community to effectively prepare for, respond to, and recover from a disaster. Hillsborough County encourages each individual family to develop a disaster care plan which can be addressed in a total of 10 steps. Step 1 is to create a disaster plan. Performing this can prevent panic and confusion by making sure everyone knows where to go and what to do in an emergency, whether they are at home or at work. Individual families should know their risks, pick two meeting places, choose a primary contact person and make sure that contact information is up-to-date, and think ahead about evacuation. Step 2 covers disaster supplies. You want to make sure that there is enough drinking water, food, batteries for camera and flashlights etc. There are also items that should be stowed away until needed: first aid kits, flashlights, portable radios, non-electric can opener, fire extinguishers, and instant tire sealer. Step 3 covers bracing for a hurricane. This encourages listening to home weather updates on local stations, checking disaster supplies, clean and fill up tubs and sinks with water before the storm so you can have an extra supply of clean water. Turn refrigerator and freezer knobs to the coldest settings and avoid opening the doors to help keep foods perishable in the case of a power outage. Refill prescriptions, clear your yard of lawn furniture, protect windows and glass doors. Step 4 is when you determine whether you need to evacuate your home or if you are safe to stay. If your home is in a sound structure outside the evacuation area, then stay home and take the suggested precautions listed in the emergency guide. If you must evacuate, make sure your destination is not within a zone that has been ordered to evacuate as well. Hillsborough has storm shelters, homeless shelters, American Red Cross, and public schools that helps out as shelters in the event of an emergency disaster. Step 5 encourages that you help your neighbor. People who are disabled or in poor health may need special assistance from family members, friends, neighbors or social service agencies. Hillsborough County encourages its elderly and disabled citizens to register with the county’s emergency management agency and it will provide medical assistance in the event of disaster. Step 6 focuses on pets and the proper mechanics that should be performed to keep them safe. Step 7 promotes protecting your home and business via anchoring your roof, bracing your entry and garage doors, covering your windows, and establishing a safe room. Step 8 encourages citizens to obtain the proper insurance to cover their home in the event of a disaster. Knowing what is and what is not covered is very important this includes: floods, terrorism/violent crime, fire, tornado, hazard materials incident and disease outbreak. Step 9 encourages citizens to keep a paper trail. This may include proof of residence, birth and marriage certificates, passports, social security cards, etc. Step 10 explains everything to do after the disaster. This plan is easily accessible on Hillsborough County Department EOC page (Hillsborough County Board of County Commissioners, n.d.). The Neighborhood/Community Safety Inventory assessment for Hillsborough county showed that a major source of cost in the criminal justice system at all levels is the effect on behavior caused by mental disorder. According to the Florida Department of Law Enforcement, approximately 660,000 individuals are arrested in Florida in any given year. A recent study of jails found that nearly 15% of incarcerated men and more than 30% of women had symptoms of acute, serious mental illness (Florida Department of Health in Hillsborough County, 2010-2011 pg.18). In 2008-2009, 49,522 individuals were arrested in the county for a total of 115,932 arrests. From 2000-2010, the majority of major crimes decreased (Florida Department of Health in Hillsborough County, 2010-2011 pg.18). In 2010, the leading type of crime in the county was larceny with an average count of 24,758, or a rate of 2,061.9 per 100,000, lower than the state’s rate of 2,438.6 per 100,000. Burglary and domestic violence ranked second and third in number of acts committed, respectively (Florida Department of Health in Hillsborough County, 2010-2011 pg.18). Florida Department of Health (FDOH) - Hillsborough County Environmental Health Services staff are responsible for all regulatory activities pertaining to the permitting, inspection, monitoring and enforcement of all public drinking water facilities serving Hillsborough County. This includes public water systems regulated under the Safe Drinking Water Act (SDWA) and Federal Facilities, Florida Department of Environmental Protection Water Rules, Limited Use public water systems not covered under the Safe Drinking Water Act and private residential well systems (Florida Department of Health in Hillsborough County, n.d.).
Adult Day Care Facilities providing food service are required to have a health department food sanitation permit. This permit is an annual requirement. An Assisted Living Facility requires a health department group care permit. Private and Charter Schools require a health department Group Care and Food Sanitation Permit. Public Schools require a Food Sanitation Permit only (Florida Department of Health in Hillsborough County, n.d.). Approximately one-third of the households in the State of Florida are served by an Onsite Sewage Treatment and Disposal System (OSTDS). Hillsborough County has more than 120,000 septic systems. The OSTDS Section ensures that septic systems are permitted and inspected to the standards of Florida Administrative Code 64E-6. These standards help to protect the citizens and visitors of Hillsborough County from potential health hazards and protect the surface and drinking waters of Florida (Florida Department of Health in Hillsborough County, n.d.). All animal bites are required to be reported to Environmental Health Services. Unless the animal (except wild animals) is known to the bite victim and has documented rabies vaccinations, it will be quarantined for 10 days from the date of the bite or exposure and then released if in good health. The victim of the bite or exposure is notified that the animal is in good health after the 10 days and that rabies is not a concern (Florida Department of Health in Hillsborough County, n.d.). The culture I chose to assess was African Americans. They tend to be very protective of their children until they reach their teenage years enforcing all the values they were taught when they were children like being respectful and having manners. Early adulthood (age 18), is when the strings are usually cut and the child goes on to make their own life decisions. Attitudes toward aging tend to affect their health in a negative way, but usually not until long term abuse. Young adults tend to indulge in unhealthy life choices like eating foods high in calories and sugar, drinking excessively, abusing drugs, and not obtaining the appropriate amount of rest for their bodies. The gender composition of African American males to females are 3 to 1. That being said, there are more males than females. Females tend to accept medical attention right away, and follow up with medical care more than males. Males usually wait until the last minute to seek medical attention and usually doesn’t return for follow up appointments which can be very detrimental. High blood pressure, diabetes, obesity, and Lupus are common diseases in African Americans. They tend to not be organ donors for wanting to be put to rest whole. Home remedies are sought out prior to obtaining medical help. When death occurs, it is considered as being that person’s time to go up to heaven with god. Families mourn, and have funeral services which finalizes their family member as being laid to rest. They usually choose a burial site over cremation so everyone in the family would have a unified location to visit.
The important things in life are prioritized as god first, family second, and then work. The source of stress is usually derived from financial strain or health issues. Methods to relieve stress depends on the religious choice of the individual. Some use prayer, while others use a mood alternating substance. Change is something that is very prominent in this culture, so adapting to change becomes very natural. They have endured prejudice and embrace change as something good. Personal space is desired. Eye contact while speaking is appreciated. Education is desired, but not always pursued due to family financial strain. Low education levels serve as the burden for low paying jobs which does not allow the opportunity to seek adequate healthcare. This in return leads to the comorbidities obtained of high blood pressure, obesity, diabetes, coronary artery disease, etc. Religion, is respected highly. Belief that God will heal all things are respected. Marriage is valued but not deemed necessary by the young. Marriage usually takes place in the mid 30’s when they feel that they have enjoyed their youth years. Family usually consists of one parent and the child or children. The percentage of two-parent homes are low. Men are not considered the head of all households, because there are a lot of single mothers. In homes where there are two parents, the parental roles are typically shared. The mother could be the care taker and the father the provider, or the roles could be reversed. Wealth is valued as having a roof over their head, food in the house, and clothes on their back. This alone makes them feel rich. If there is money left over after that to do anything fun, that is considered a blessing.
The Community Windshield survey was quite an experience. The age of the houses varied from neighborhood to neighborhood. The architecture of the front of the houses changed from neighborhood to neighborhood as well. The older houses were all built similar with a basic layout. Driving around to different neighborhoods proved to be the same. The housing layouts are unique, and there are no two neighborhood developments that look the same. There seem to be a lot of one story homes built 15 – 30 years ago. The appearance of the houses built then are a little worn. Each home had plenty of front and back yard space and the colors of the houses are all different. There is also plenty of space in between homes. In the past 15 years, there has been an increase in the number of 2 story homes built. The appearance of the homes is newer. The front yard spaces are limited. The back yard gives you a little more to work with, and the homes are close in proximity. The old houses were primarily made of wood and brick, while the newer houses are made with Stucco. In the lower income neighborhoods, apartment buildings are primarily seen. There are few homes. The upkeep of the neighborhood is not the best. The selection of stores offered is limited and the landscaping is not a priority. To access certain stores, you are required to take a 15-minute car drive. While driving around to higher income neighborhoods, the apartments were very luxurious in appearance. The landscaping is beautiful, and the selection of stores is plentiful.
In the lower income areas, there tend to be a lot of people hanging out at stores and car washes. The age of the people hanging out varies from small children to elderly adults. The people seen are disheveled and appear to have visible health problems. There are primarily fast food restaurants. The parks are worn, but full of children playing. There are a lot of buses running to provide transportation. Side-walks are a hit or miss, some neighborhoods have them and some does not. The atmosphere is live and very busy. Seemed to be a lot going on all the time. The culture of the low income communities depends on the side of town that you are on. On the West side of Tampa, the race of the low income communities is primarily Hispanics. On the East side of the Tampa they are primarily black, and on the North side, they are mixed with multiple races. South Tampa is considered high income families, and it the culture there is primarily white. On the south side of the Tampa, most people are hanging out at malls or in restaurants. The age group hanging out ranges from children to adults. The parks are new and up to date with all of the latest gadgets, and they are being occupied by many play dates. There are buses, but primarily on the business routes and not many going through neighborhoods. There are clearly labeled bike lanes and the buildings and landscaping are manicured. The atmosphere is live, energetic and full of happy people.
During my Scavenger Hunt, I visited several places that offers assistance to people in the community. My first stop was the WIC office located inside a Department of health. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides Federal grants to States for supplemental foods, health care referrals, and nutrition education for low-income pregnant, breastfeeding, and non-breastfeeding postpartum women, and to infants and children up to age five who are found to be at nutritional risk (United States Department of Agriculture Food and Nutrition Service, 2016). The outside of the building has landscaping and big tress. The building is fenced in and is visibly seen from a street view. The staff is multi-cultural, so language barriers are not an issue. They were very friendly and full of smiles. They have pamphlets that educate you on the program and qualifications that must be met in order to be approved. You can arrive at this facility by bus, car, or ambulation. My second stop was Meals on Wheels. Meals on Wheels of Tampa is committed to the mission of “Nourishing and enriching the independent lives of the homebound and seniors.” Meals on Wheels serves approximately 700 individuals with a hot, nutritious meal delivered to their door by a caring volunteer. The quality of the food provides nourishment for the body. The encouraging words from volunteers, provides enrichment for the soul. For many of the homebound, a visit from a volunteer is the only human contact they will receive that day. Together they strengthen the community by caring for a segment of its population who are often forgotten and cannot get out of the house. Meals on Wheels of Tampa is a 4-star charity and a proud member of Meals on Wheels America (Meals on Wheels, n.d). The outside of the building is painted with bright colors. It easily accessible from the street. There are a lot of over grown trees that surrounds the side of the building. When you walk in the staff that greets you is very friendly and compassionate. They operate primarily off of volunteers. Volunteer staff is middle aged citizens. The cooking is performed on site. They have a pantry full of donated items to cook, and a fully loaded kitchen to cook it in. The services for M.O.W. is initiated by a social worker, or homecare facility. They have pamphlets there, but they also give them to hospitals and homecare offices. You can arrive at this facility by bus, car, or ambulation.
My third stop was the YMCA. Each year the YMCA helps more than 160,000 youth, adults, and seniors improve their health, learn new skills, and have fun. As a not-for-profit charity, the YMCA relies on charitable donations to ensure that everyone can be a part of the YMCA (Tampa Metropolitan Area YMCA, 2016). The YMCA is located in the downtown area. The streets surrounding it is very busy. When you walk in the building, there are a lot of posters of happy people displayed on the walls. The staff is a mix of young and older adults. The vibe is upbeat and they encourage participation unconditionally. There are several pamphlets that shares all of the programs that are offered. It is culturally diverse. They have grants as well as self-referrals for participation. You can arrive at this facility by bus, car, or ambulation.
My fourth stop was the Boys and Girls Club. This is a safe place for youth to spend time during non-school hours and the summer as an alternative to the streets or being home alone. It gives them a chance to play, have fun, laugh and learn. It offers opportunities to build new skills that raise each child’s belief that he or she can succeed and receive recognition for personal accomplishments. They offer generation-changing programs that support a commitment to learning, positive values, healthy habits and high expectations for success as an adult (Boys and Girls Club of Tampa Bay, 2012). The location is neighborhood friendly. It is easily accessible from the street. The parking lot is well manicured with trees. The outside appearance of the building is well kept. The staff is full of energetic young adults. The all have smiles on their faces and willing to help. Pamphlets are available to educate you on the services provided. Tours are offered to give you a close and personal look at the services provided. Children look happy while engaging in activities. The program has grants as well as self-paying participants. You can arrive at this facility by bus, car, or ambulation.
My fifth stop was Planned Parenthood. Planned Parenthood delivers vital reproductive health care, sex education, and information to millions of women, men, and young people worldwide. For nearly 100 years, Planned Parenthood has promoted a commonsense approach to women’s health and well-being, based on respect for each individual’s right to make informed, independent decisions about health, sex, and family planning (Planned Parenthood of Federation, 2014). The parking lot is small, but matches the small building. The plants in front of the building is manicured. When you walk in the building, the staff greets you with a smile and discreetly asks you your purpose for the visit. They have several racks of pamphlets educating you on everything from birth control to STD’s. Posters of families and pharmaceutical promotions are on the walls. Planned Parenthood accepts health insurance and private pay patients. You can arrive at this facility by bus, car, or ambulation.
My sixth stop was the American Red Cross. The American Red Cross prevents and alleviates human suffering in the face of emergencies by mobilizing the power of volunteers and the generosity of donors (The American National Red Cross, 2016). The parking lot is half paved and half dirt. It is a two story brick building. The trees located on the sides are over grown. It is easily accessible from the street. When you walk in the staff greets you kindly. There are pictures of hero’s and volunteers posted on the walls. Statistical data of donations and care provided to others is posted as well. It is culturally diverse. The staff is a combination of young and old. They have pamphlets advertising all services provided. You can arrive at this facility by bus, car, or ambulation.
In 2009, there were 9,197 deaths among Hillsborough County residents, which translated to an overall age-adjusted mortality rate of 727.7 deaths per 100,000. This was a 2.5% increase in the number of cases reported in 2005. Statewide, the estimated age-adjusted mortality rate for 2009 was 656.2 per 100,000. Of the 9,197 deaths in 2009, males accounted for 51% (4,715) of the deaths and females accounted for 49% (4,482). Whites accounted for 85% (7,784) of all deaths, while Blacks (1,236) and other (169) accounted for 13% and 1.8%, respectively. Age group 55 years and older accounted for the greatest number of deaths in the county, 7,507 (82%) during 2009. In Hillsborough County, the top 3 disease-related leading causes of death in 2009 were cancer, heart disease, and chronic lower respiratory disease unintentional injury was within the top three of all causes of death (Florida Department of Health in Hillsborough County, 2010-2011 pg.20).
After my assessment of the community, I have noted that there are a lot of middle aged unhealthy people. The origin of the diseases goes back to hereditary and lifestyle choices as a young adult. The lower income community has an increased need for healthcare assistance, but resources that are currently available leaves some without receiving the care that they need. I also noted that the lower income parts of town are culturally diverse while higher income neighborhoods are not. The community safety issues are different depending on the side of town that you are on. Some areas of the county safety issues are related to floods and natural disasters, while other area safety issues are related to crimes. Unemployment rates and poverty for Hillsborough County are consistent with the states average percentage. The leading causes of death in Hillsborough County for older adults are cancer, heart disease, and chronic lower respiratory infections. The leading causes of death for young people are homicides and car accidents.
The top three health concerns for my community is cardiovascular disease, diabetes, and cancer. Diabetes (mellitus) is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. Diabetes can be associated with serious complications that may include kidney damage, nervous system disease, amputation, blindness, stroke, heart disease, complications in pregnancy, and even premature death. However, people with diabetes can take steps to control the disease and lower the risk for complications. In 2007, the overall Florida population percentage with diabetes was 8.7% and 7.0% for the population in Hillsborough County. The number of diabetes-related hospitalizations in the county (2,455 per 100,000) is higher than the statewide level (2,130 per 100,000) (Florida Department of Health in Hillsborough County, 2010-2011 pg.39). The goal of healthy people is to reduce the disease and economic burden of diabetes mellitus (DM) and improve the quality of life for all persons who have, or are at risk for, DM. Informational classes for diabetes education are offered at the Health Department.
Approximately 1 out of every 2 American men and 1 out of every 3 American women will have some type of cancer at some point during their lifetime. Cancer involves a combination of environmental, genetic, and behavioral factors. Adopting a healthy lifestyle, in addition to regular cancer screenings, is strongly recommended to reduce risk and impact of disease. The overall age-adjusted cancer incidence in Hillsborough County in 2006-2008 was lower than the state (482.5 vs. 567.5 per 100,000, respectively). According to the CHARTS Minority Health Profile 2007-2009 data, Blacks have an age -adjusted death rate of 7.9 per 100,000 for cancer, and Whites have a rate of 6.8. Statewide, Blacks have an age-adjusted death rate of 9.4, and Whites have a rate of 7.4(Florida Department of Health in Hillsborough County, 2010-2011 pg.40). The goal of healthy people 2020 is to reduce the number of new cancer cases, as well as the illness, disability, and death caused by cancer. Informational classes for Cancer are offered at the health department as well as the Moffitt Cancer Center.
Cardiovascular disease refers to a wide variety of heart and blood vessel diseases including: Coronary heart disease, Hypertension, and Stroke. The two major forms of cardiovascular disease that make the greatest contribution to mortality are stroke and coronary heart disease. Although cardiovascular disease usually manifests itself clinically in middle age, the disease process begins in childhood and is associated with several modifiable risk factors including physical inactivity, tobacco use, diabetes, overweight, obesity, high blood pressure, and high cholesterol. In 2009, 2,756 average annual deaths from cardiovascular disease occurred in Hillsborough County, with 1,517 people who died of coronary heart disease, and 421 who died from stroke. There was an annual average of 5,574 hospitalizations for coronary heart disease between 2007 and 2009. Primary and secondary prevention efforts have focused on reducing the risk factors for heart disease and stroke, especially for women because they are disproportionately affected (Florida Department of Health in Hillsborough County, 2010-2011 pg.40). The goal for healthy people 2020 is to improve cardiovascular health and quality of life through prevention, detection, and treatment of risk factors for heart attack and stroke; early identification and treatment of heart attacks and strokes; and prevention of repeat cardiovascular events. Informational classes for cardiovascular disease are offered at the health department as well as there are some hospital based programs that offer education to patients prior to discharge and host follow up educational classes as well.
Cardiovascular disease is a disease that can be conquered with primary prevention. Heart disease is the leading cause of death in the United States. Stroke is the third leading cause of death in the United States. Together, heart disease and stroke are among the most widespread and costly health problems facing the Nation today, accounting for more than $500 billion in health care expenditures and related expenses in 2010 alone. Fortunately, they are also among the most preventable. The leading modifiable (controllable) risk factors for heart disease and stroke are: high blood pressures, high cholesterol, cigarette smoking, poor diet and physical activity, as well as overweight and obesity. Controlling risk factors for heart disease and stroke remains a challenge. High blood pressure and cholesterol are still major contributors to the national epidemic of cardiovascular disease. High blood pressure affects approximately 1 in 3 adults in the United States, and more than half of Americans with high blood pressure do not have it under control. High sodium intake is a known risk factor for high blood pressure and heart disease, yet about 90 percent of American adults exceed their recommendation for sodium intake. The risk of Americans developing and dying from cardiovascular disease would be substantially reduced if major improvements were made across the U.S. population in diet and physical activity, control of high blood pressure and cholesterol, smoking cessation, and appropriate aspirin use (Healthy People 2020, 2014). Hillsborough County’s health department offers free classes educating people on cardiovascular diseases, healthy lifestyle choices, dieting and smoking cessation. Other resources available are hospital based educational programs that are given to patients prior to discharge. Follow up classes are offered to the patients as well.

References
Boys and Girls Club of Tampa Bay. (2012). Boys and Girls Club. Retrieved from http://www.bgctampa.org/
Florida Department of Health in Hillsborough County. (2010-2011).Hillsborough County Health Department 2010/2011 Community Health Profile. Retrieved from http://hillsborough.floridahealth.gov/programs-and-services/community-health-planning-statistics/status-reports/_documents/hchd2010-2011-community-health-profile-report-optimized.pdf
Florida Department of Health in Hillsborough County. (n.d.). Environmental Health. Retrieved from http://hillsborough.floridahealth.gov/programs-and-services/environmental-health/index.html
Healthy People 2020. (2014). Heart Disease and Stroke. Retrieved from http://www.healthypeople.gov/2020/topics-objectives/topic/heart-disease-and-stroke
Hillsborough County Board of County Commissioners. (n.d.). Office of Emergency Management. Retrieved from http://www.hillsboroughcounty.org/emergency/
Hillsborough County Cemp. (2014, December). Comprehensive Emergency Management Plan (CEMP). Retrieved from http://hillsboroughcounty.org/DocumentCenter/View/16617
Meals on Wheels. (nd). About Meals on Wheels. Retrieved from http://www.mowtampa.org/about-mow/
Planned Parenthood Federation of America. (2014). Who We Are. Retrieved from http://www.plannedparenthood.org/about-us/who-we-are
Tampa Metropolitan Area YMCA. (2016). About Tampa Metropolitan Area YMCA. Retrieved from http://www.tampaymca.org/
The American National Red Cross. (2016). Mission & Values. Retrieved from http://www.redcross.org/about-us/who-we-are/mission-and-values
United States Department of Agriculture Food and Nutrition Service. (2016, March 3). Women, Infants, and Children (WIC). Retrieved from http://www.fns.usda.gov/wic/women-infants-and-children-wic
Wikipedia. (2015, February 5). Hillsborough County, Florida. Retrieved from http://en.wikipedia.org/wiki/Hillsborough_County,_Florida…...

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