Community Health Assessment in Lakeland Florida in Polk County

Community Health Assessment in Lakeland Florida in Polk County

Community health assessment (CHA) identifies health needs, service gaps, priorities, resources, and assets to effect a desired change. A CHA gives rise to a public report describing the community’s health indicators, health status, health needs, and recent changes to diagnose existing health problems and advocate for necessary change. The nurse uses their skills and knowledge to assess community needs and concerns and uses the findings to develop a plan and solve the identified concerns. Working in partnership with community members and other stakeholders, nurses develop solutions to better the community’s health outcomes. The common instruments or tools used in community assessment include walking and windshield surveys. Community assessment provides many benefits, such as strengthening community participation in decision-making, improving the community with public health organizations, improving data quality, and ensuring better utilization of resources. This essay describes community assessment in Lakeland, Florida, in Polk County. It will describe its demographic, environment, and social systems. It will also identify community needs and existing resources to address those needs.

Demographic Profile in Lakeland Florida

Lakeland is the most populous city in Polk County. It is situated midway between Orlando and Tampa along Interstate 4. Lakeland has a population of 121,380 residents, with an annual growth rate of 2.55% (World Population Review, 2023). The racial composition of the Lakeland population is as follows: Whites 67.79%, African-American 19.91%, two or more races 4.96%, Other race 4.75%, Asian 2.16%, Pacific islander/Native Hawaiian 0.07%, and Native American 0.36% (World Population Review, 2023). Most residents are natives, with foreign-born accounting for only 10.4%. The population is relatively young, with 78.2% of residents under 65. English is the most spoken language in the world. The female-to-male ratio is equal (51.28% female and 48.72% male). The median age is 40.9 (World Population Review, 2023).

Socioeconomic Factors

Income and Poverty

Income offers economic resources that influence education, housing, medical care, and food choices. As income increases or declines, so does health. Income is unevenly distributed in Lakeland. The gap between the rich and the working groups is widening. Lakeland has an average household income of $74,477 and a median household income of $52,972. In Tampa, the median income is $60,000 (). In addition, the report reveals that most of the working class earn less than %50,000. These current wages fall below the amount required to support households with more than two members. The lower wages are affecting the residents’ quality of life.

Further, working from home is impacting on the job market. Remote working allows people from other states to compete with the locals for jobs. The poverty rate is 15.1% (female poverty 16.85% and male poverty 13.24%), representing a 272% 1-year reduction. Some households live below the poverty level, especially senior adults on fixed incomes (World Population Review, 2023). 

Housing

Housing is one of the social determinants of health. Housing costs determine the overall cost of living in the city of Lakeland. Affordable housing options affect the quality of life of Lakeland residents, particularly lower-income families. In Lakeland, there are rent-occupied units, owner-occupied units, and occupied housing units. Most Lakeland residents are worried about the rapid housing costs related to homeownership and renting. Lakeland’s homeownership rate is 54.7% compared with a national average rate of 64.6%. The median property value of owner-occupied housing units stood at $171,700 in 2021, compared to the national average of $244,900 (World Population Review, 2023). Over 30% of residents are housing-cost-burdened. Cost burdening means that some residents spend over 30% of their income on housing costs, causing them to cut spending on food and other necessities. The percentage of renters who qualify as cost-burdened is higher than that of homeowners. A lack of affordable housing coupled with the arrival of new residents is driving high rental and housing costs.    

Education

Education is a major determinant of health and quality of life. 89.8% of the population aged 25 years+ has a high school diploma or higher. 26% have a Bachelor’s degree or higher. 82% of residents speak only English language. 17.55% speak other languages at home (World Population Review, 2023). 93.1% of residents were born in the U.S., while 5.26% are not American citizens by birth. 

Quality of Life:

Good quality of life is a state of living a healthy life. Residents hold varying perceptions about the quality of life. However, the majority consider themselves thriving and feel happier about their neighborhood. They believe their neighborhood is well-maintained, and residents can access parks, leisure, outdoor activities, and art. Residents tolerate and respect other races, religions, backgrounds, and ethnicities.   

Commuter Transportation

The transportation system people live in and how they get to work. Access to affordable and reliable transportation influences healthcare, food, employment, and education. There are limited public transportation options in Polk County. Because there are few bus routes, residents prefer to cycle, walk to work, or use personal car. The city is designated as a Walk and Bike friendly. However, Lakeland is a pivotal transportation hub because it is a city on Interstate 4. There are few highways, freeways, an airport, and cycling routes. Public transportation is well-developed, and most residents use the public transport system. 78.5% drive alone to work, 9.7% use carpooling, and 7.74% work from home (World Population Review, 2023). The average car ownership is two per household. Cycling is common because of the numerous multi-use bicycle routes such as Fort Fraser Trail, Lake-To-Lakes Trail, and University Trail. The rapidly growing population puts pressure on wider roads, more bike paths, and more transit stops. Polk County experiences several fatalities from road accidents. Both pedestrian and roadway safety are serious concerns. Road maintenance and traffic congestion are other concerns raised by residents.  

Employment

Employment offers income that can support healthcare-seeking behavior and healthy lifestyle choices. On the other hand, unemployment limits these choices, affecting overall health outcomes. The community’s economic condition plays an essential role in influencing employment opportunities. In Lakeland, 55.9% of Lakeland residents participate in the labor workforce, with an employment rate of 52.4% (World Population Review, 2023). The unemployment rate stands at 6%. Lakeland’s economy depends on agriculture and industries such as health and social services, government, education, retail, whole trade, accommodation and food services, manufacturing, business and professional services, financial and insurance services, administrative and support services, construction, transport, and warehousing. These industries employ about 48,000 residents (World Population Review, 2023). The common jobs include sales occupations, administrative and support, manufacturing, whole trade, construction, educational services, transport and warehousing, and management occupations. Finance and insurance, real estate, and leasing are the highest-paying industries.  

Assets and Resources

Assets are capacities that contribute to success. Assets include individual talents and skills, personal income, land, houses, businesses, business associations, parks, hospitals, public schools and universities, social services agencies, government agencies, internet and mass media, religious organizations, communication organizations, and cultural organizations. Assets and resources can be mobilized or tapped to address the needs and concerns of a community. 

Methodology

The Department of Health of Polk and community partners use the Mobilizing for Action through Planning and Partnership (MAPP) model to perform community assessment. The process involves performing four individual assessments to identify priority health areas of concern and formulate strategies and goals to address them. Survey questionnaires are used to gather information from residents. Lakeland residents were asked questions about their priority health concerns in 2023. Responses of respondents were analyzed to generate common themes. Most respondents reported mental health substance abuse, access to care, nutrition, and diet as priority health concerns. 

Priority Health Areas

The following areas were identified as priority health areas: substance use and misuse, nutrition and physical activity, mental health, and access to care. 

Behavioral Health

Behavioral health combines substance abuse and mental illness. Drug abuse and alcohol consumption are harmful to individuals’ wellbeing and health. Residents identified mental health problems as the top priority area of concern to address to improve the community’s health and wellbeing. Substance abuse and mental illness are the primary health concerns in Lakeland. Mental illnesses are the most common health conditions in the city. Mental illnesses are caused by an interaction of several factors, including adverse childhood life experiences, genetic influences, and isolation/loneliness. 

Based on the CHA survey 2020 for Polk County, 44.3% of respondents complained of depression once in the past two weeks. The level of depression is high among lower-income earners. Furthermore, residents with a high school diploma and below are more likely to experience sadness and depression. Residents prioritized substance abuse as one of the top health priority concerns for Lakeland. They rated alcohol and drug abuse as one of the most harmful behaviors in Lakeland. Repeated use of alcohol and drugs causes considerable impairment, such as failure to fulfill major responsibilities, health problems, and disability. Drug overdoses and drunk driving fatalities are associated with substance abuse fatalities. 

Substance abuse and misuse is a serious problem among school-going children. The percentage of high school and middle school students who report using illicit drugs has increased in recent times. 5.2% of middle scholars and 19.4% of high school students admitted to marijuana use in Polk County, compared with the statewide percentages of 3.7% and 16.3%, respectively. In addition, there is a rate of juvenile drug arrests in Polk County compared to the state (5.3% versus 4%). The city struggles with alcohol and drug problems among residents of all ages. Drug-related deaths rose by 7% in 2021 (Moore, 2023). According to the CHA Survey Report 2020, 48.57% of surveyed respondents identified substance-use-related health concerns, followed by the use of illicit drugs by 44.85% (Florida Health, 2020). Survey respondents also reported vaping and E-cigarette use in youth as a top substance-use problem. Most survey respondents cited youth and adult prescription abuse, youth alcohol consumption, and adult E-cigar as health priority concerns. Alcohol and drug use is on the rise in the city of Lakeland. Young people are struggling with alcohol and drug addiction. Repeated drug and alcohol use contributes to numerous adverse health outcomes, such as risky sexual behavior, hypertension, accidents, violence, and liver disease. Excessive alcohol consumption is a preventable cause of death.  

Hopelessness among Lakeland youth is alarming. The youth are considered the most vulnerable after the homeless group. They are vulnerable to suicidal thoughts, depression, and anxiety. The 2021 YRBS report showed that Polk County high school students self-reported a suicidal rate of 17% and a depression rate of 32% (Moore, 2023). Youth suicidal thoughts and suicidal attempts are increasing in the community. As a result, Lakeland schools have significantly increased the number of threat and risk assessments to determine students at risk for self-harm. 

Access to mental health professionals is a serious concern in Lakeland. Getting residents to seek mental health help and making sure they have access to mental health care is important. Stigma remains a challenge in treating mental conditions. Funding shortage is another compounded problem since treatment of mental problems is not covered under Medicaid. 

           Over 50% of Lakeland adult residents have experienced adverse childhood events before age 18 (Moore, 2023). Adverse childhood events subject individuals at risk for poorer health outcomes. Neglect, violence, abuse, and abandonment during childhood affect people into their adult life. These events contribute to severe mental health problems such as depression. Furthermore, the hospitalization rate for mental healthcare has soared for the youth. The rate is higher for African-American and Hispanic residents (Moore, 2023). Threat and risk assessments have intensified at schools in Lakeland. 

Mental health remains a challenge in the city. Lakeland struggles with problems of mental health, ranging from inadequate psychiatrists to youth who display signs of losing hope in life. There has been an increase in the rate of hospitalization for mental health for the youth group between 19 and 21 years. Youths of Black and Hispanic ethnicities are the most affected. 

Access to mental healthcare remains a major concern despite having mental health services and centers in the area (Moore, 2023). The city has been marked as a Health Care Professional Shortage Area. One in seven people in Polk County has one form of a mental health problem or another. In Polk County, the ratio of primary care physicians to residents is 1 to 2157; mental health providers to residents is 1 to 956; and dentists to residents is 1 to 2842 per annum. These ratios are wanting compared to Florida’s 1:670 and a national average of 1:310 

Physical Activity and Nutrition

Regular physical activity and a healthy diet are essential to a healthy life. They also influence the risk of being obese. Neighborhoods where people reside, learn, and work impact access to opportunities for exercise and food. High physical activity levels reduce the risk of premature death. Similarly, a healthy diet promotes better mental and physical health and wellbeing. They also affect one’s health status. Poor nutrition contributes to various conditions, such as obesity, cancer, and cardiovascular disease.

Although 82.2% of Lakeland residents have access to exercise venues, there is a high prevalence of obesity in the city (Florida Health, 2022). Overweight and obesity are high in Lakeland. The obesity rate is as high as 35% compared with 25 for the state. 27.2% of adults are physically inactive. In addition, 14.1% of adult residents live with diabetes (ABC et al., 2019). In 2019, 71.4% of adults in Polk were either overweight or obese. 30.6% of children were overweight or obese in 2021 (Florida Health, 2022). 

Access to Care

Equitable access to care is essential in achieving the highest level of health and increasing quality of life. Accessing care services is important to prevent diseases and thus reduce the potential for premature death. Access to care in Lakeland remains challenging due to barriers like cost, transportation, health coverage, inadequate health providers, and unavailability of specialized providers. Some residents are ineligible for the health coverage plans offered on the marketplace, even with the passing of Obamacare. These barriers contribute to financial burdens, delayed care, and health complications. 88.9% of Lakeland residents have health coverage, with 2% on veteran/military plans, 14.1% on non-group plans, 16.1% on Medicare, 17.8% on Medicaid, and 38.9% on employee plans. By gender, 48.4% of men are insured compared to 51.6% of women with healthcare (States Census Bureau, n.d). By age, 21.5% under 18 years are insured, 21.9% of persons aged between 18 and 34 are insured, 35.4% of persons aged between 35 and 64 have coverage, and 21.2% of persons over 65 are covered (States Census Bureau, n.d). 

Based on the survey findings, the four most health priority areas of concern for Lakeland residents are mental health, substance abuse, nutrition and exercise, and access to care. Improving these four areas will improve health outcomes and quality of life for the community. 

References

abc Action News. (2019). Lakeland, Winter Haven named most obese metro area in Florida. Retrieved on December 6, 2023 from https://www.abcactionnews.com/news/region-polk/lakeland-winter-haven-named-most-obese-metro-area-in-florida#:~:text=According%20to%2024%2F7%20Wall,in%20fair%20or%20poor%20health.

Florida Health (2022). Polk County Community Health Assessment. Retrieved on December 6, 2023 from https://polk.floridahealth.gov/programs-and-services/community-health-planning-and-statistics/_documents/2022-cha-data-updates.pdf

Moore, K.C. (2023, Jun 7). Study Finds ‘Economic Barriers’ Underlie Our Community’s Most Pressing Needs. Retrieved on December 6, 2023 from https://www.lkldnow.com/study-finds-economic-barriers-underlie-our-communitys-most-pressing-needs/

United States Census Bureau. QuickFacts: Lakeland city, Florida. Retrieved on December 6, 2023 from https://www.census.gov/quickfacts/fact/table/lakelandcityflorida/PST045222

World Population Review. (2023). Lakeland, Florida Population 2023. https://worldpopulationreview.com/us-cities/lakeland-fl-population