Lower East Side of Manhattan because I have lived

Lower Manhattan is filled with such
a rich and diverse culture of people, art, and fashion. A once neglected
neighborhood, Downtown Manhattan has become a home for the new generation. I
have decided to conduct my community assessment on the Lower East Side of
Manhattan because I have lived there and it has molded me into the person I
have become. Naturally, I am curious and quite interested to acquire more
knowledge about the community that has been a part of me for many years. The
Lower East Side has so much life and soul but in other ways it has so many losses.
Although the community of the Lower East Side has changed tremendously over the
years, some things still remain the same.

            “Community
Board 3 in Manhattan covers the Lower East Side and part of Chinatown. The
boundaries of the district are 14th Street on the north, the East River on the
east and the south, and Fourth Avenue and the Bowery on the west, extending to
Baxter and Pearl Streets and the Brooklyn Bridge south of Canal Street” (District
Profile, 2014). Manhattan community district 3 consists of Chinatown, the East
Village, and the Lower East Side. Other neighborhoods include NoHo, Alphabet
City, and Two Bridges. According to the New York City Department of Health and
Mental hygiene (2015), “the total population in this community is 168,298. The
population according to race and ethnicity includes approximately 34% of Asians
(Non-Hispanic), 31% of Whites (Non-Hispanic), 25% of Hispanics, 7% of Blacks
(Non-Hispanic), and 2% of other races (Non-Hispanic). The population according
by age includes 13% for ages 0-17, 12% for ages 18-24, 35% for ages 25-44, 24%
for ages 45-64, and lastly 15% for those 65 years and older. Life expectancy is
approximately 80.9 years of age. Thirty-six percent of residents are foreign
born and thirty percent have limited English proficiency.” The most common languages
spoken in this community include English, Spanish, and Chinese. The population
according to gender contains approximately 48% of males and 52% of females (“Manhattan
Community District 3,” 2016). “The rate of premature death before the age of 65
in the Lower East Side and Chinatown is more than twice the rate in the
Financial District. The rate of infant mortality in the Lower East Side and
Chinatown is lower than the citywide rate” (New York City Department of Health
and Mental Hygiene, 2015). Fortunately, 71% of those in the community stated their
health status to be “excellent,” “very good,” or “good.”

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            Throughout
the community there are wide variations of income levels, 7.8% of the labor
force is unemployed and 19.1% of the residents have income levels below the
poverty threshold in comparison to the federal poverty rate. Also, 39% of
household families spend over 35% of their income on rent (“Manhattan Community
District 3,” 2016). In comparison to the overall Manhattan and New York City
percentages as a whole, the Lower East Side is either above the rates or close
enough. For example, the poverty measures for the Lower East Side as stated
earlier was 19.1%, Manhattan is 14.4% and New York City is 20.5% (“Manhattan
Community District 3,” 2016). These percentages indicate that families in this
particular community suffer with financial burdens.

            In
terms of crime, there was 2,452 major felonies that were reported in the year
of 2016 within the Lower East Side community. The Manhattan Community District
3 does have resourceful facilities such as 14 public safeties, emergency
services, and administration of justice locations. In addition, there are other
beneficial facilities that contribute to the environment of this specific
community such as 132 health and human services sites. Also, there are 33
hospitals and clinics (“Manhattan Community District 3,” 2016).

            There
is an abundance of sources for education throughout the community. There are
382 facilities in education, child welfare, and youth services in the Lower
East Side. Also, there are 124 libraries and cultural programs. Of those total
educational facilities, there are 63 public schools and 5 public libraries. In
the community, 42.9% of residents 25 years old and over have earned a bachelor’s
degree or higher. Though, 27% have not finished high school. (“Manhattan
Community District 3,” 2016). Moreover, there are plenty of parks and outdoor
activities for the children and families in the community to experience. For
example, there are 198 parks, gardens, and historical sites in community
district 3. Of the 198, there is a total of 61 parks. There are numerous open
spaces, outdoor playgrounds and recreations for the residents to enjoy. In
reference to access and availability to parks, 100% of the residents live
within walking distance of a park or outdoor space (“Manhattan Community
District 3,” 2016). I believe the parks and playgrounds are relatively a safe
and fun environment for the children in the Lower East Side. Most are very
large and you see a diverse group of children playing basketball, soccer,
baseball, softball and handball by the FDR drive especially. During the
weekends in the summer, most families have BBQ’s and outdoor picnics. You see
people of all ages run, exercise, and ride their bicycles by the FDR. There is
also a recreational pool on 128 Pitt Street that most locals attend. My
impression is that most of the inhabitants seem very happy and involved in
community activities.

            When
you think of any community, you must also consider the conditions of the
environment. In terms of cleanliness, 91% of the streets were rated as “acceptable”
on the Street Cleanliness Scorecard in fiscal year 2016 (“Manhattan Community
District 3,” 2016). The streets consist of many local and commercial businesses,
24.75% is mixed with residential and commercial land use. 16.09% is open space
and outdoor recreations, 10.53% is public facilities and institutions, and
5.47% is unoccupied land. 24.13% is multifamily elevators, 8.33% of multifamily
walk-ups, and 1.29% of parking facilities. There are also many transportation
services such as subways and buses, some including the M14A bus, M14D bus, the
6, F, and J trains. 4.17% of the land consists of transportation and utilities and
1.17% include industrial and manufacturing (“Manhattan Community District 3,”
2016).

The Lower
East Side is known for its public housing buildings some of which include
Baruch projects, Smith projects, and Rutgers projects. You may see a lot of
paintings and drawings posted on walls/buildings or on the streets throughout
the community. You see a lot of beautiful artwork and murals throughout the
neighborhood. It is filled with so much color, liveliness and culture. Some
neighborhoods are considered more quiet and peaceful than others. The buildings
in high-poverty areas such as affordable housing are considered a little rowdier,
dangerous and violent. Sometimes you will find graffiti inside the public housing
buildings like the staircases or elevators. Sadly, these housing buildings tend
to be less sanitary for example you may find broken bottles or garbage laying
around. The staircases may smell foul from urine or spoiled wastes.

             Like most communities, there is a wide range
of religions and religious facilities in the Lower East Side. To a name a few, there
is a Baptist church on East 7th street between avenue C and D, a
Pentecostal church on 44 East 2nd street, and NY Chinese Alliance
Church on 162 Eldridge Street. The Lower East Side also has great youth
organizations such as the Lower East Side Girls Club located at 101 Avenue D. This
program is so helpful to young girls still in middle school or high school. It
offers leadership skills and focuses on student’s academics and improving school
performance.

            When
conducting a community assessment, it is essential that you incorporate all
aspects of the community in its entirety. In order for a community and its
residents to successfully strategize on ways of eliminating or reducing the
risk of health problems they must analyze all factors in the community. Based
on the health topic areas from Healthy People 2020 and the research I have
discovered about community district 3, substance abuse is a major health
problem in the Lower East Side. Substance abuse is an overuse or dependence on
any addictive substance including alcohol, tobacco, and illicit drugs. Substance
abuse and addiction can cause many health problems and are potential risk
factors that lead to cancers, heart disease, and lung diseases. I decided to
focus on substance abuse in community district 3 because alcohol, tobacco, and
illicit drugs have negatively impacted the lives of so many. It has broken up
families, it has taken lives, it has caused people to lose their jobs or homes
and has led to illnesses and disabilities. It has even caused violence in many
communities. This is such an important matter and I believe with the appropriate
resources it can be avoided.

            According
to the New York City Department of Health and Mental Hygiene (2015), “Drug
and/or alcohol related hospitalizations reflect acute and chronic consequences
of substance misuse. In the Lower East Side and Chinatown, such hospitalization
rates are higher than the rates in New York City overall.” Alcohol related
hospitalizations (per 100,000 adults) in the Lower East Side and Chinatown was
1,144 in comparison to 1,084 in Manhattan and 1,019 in New York City. Drug
related hospitalizations (per 100,000 adults) in the Lower East Side and
Chinatown was 980 compared to Manhattan that was 1,025 and 907 in New York
City. These values indicate that the rates in community district 3 are much
higher than the numbers in New York City entirely. Furthermore, “the
incarceration rate in the Lower East Side and Chinatown is higher than the
citywide rate.” People who are incarcerated are more likely to have mental
illnesses, drug and alcohol addiction and other adverse health effects (New
York City Department of Health and Mental Hygiene, 2015).

            Additionally,
the leading causes of death in the Lower East Side and Chinatown are heart
disease and cancer. According to the New York City Department of Health and
Mental Hygiene (2015), “death rates due to stroke, lower respiratory diseases,
diabetes, HIV and drug use are higher than the citywide rates.” The number of
deaths reported for heart disease were 1,629 and 1,431 for cancer in the Lower
East Side and Chinatown. Strokes are the fourth most common health problem
leading to death in the Lower East Side and Chinatown, but it is only the sixth
most common health problem overall in New York City. “More
than 55.3% of HIV/AIDS mortality in the Lower East Side was among injected drug
users” (Amesty, Rivera, Fuller, 2011). Looking at these values, cigarette
smoking, alcoholism, and narcotic abuse can all be potential risk factors
associated with all of these diseases.

            We
now understand the effects that substance abuse has on the individuals in the
community but that’s look at the community as a whole- the environment. As stated in the New York
City Department of Health and Mental Hygiene (2015), “the prevalence of tobacco
retailers in the Lower East Side and Chinatown is similar to the citywide
prevalence.” This means that residents in the Lower East Side and Chinatown
have more access to tobacco and cigarettes. The greater the availability to
tobacco increases the likelihood of someone purchasing it. By people purchasing
tobacco this then eventually leads to addiction, exposure and sadly potential
risk factors leading to disease.

            Fortunately,
there are many resources that are currently accessible in the Lower East Side
and Chinatown to support people with substance abuse. For example, the Lower
East Side Service Center (LESC) is a treatment program intended to help
individuals overcome their addiction and dependency. Their goal is to support
and help those recover from substance abuse with the use of health care professionals
such as clinicians and medical providers. They have a variety of treatment and
care options using a holistic approach. They help anyone and everyone including
pregnant women and infants (Helping Recovery, 2017). There are many hospitals,
clinics and rehabilitation centers for those who are seeking recovery. For
example, Village Care Rehabilitation and Nursing Center on 214 West Houston
Street and Gouverneur Methadone clinic on 109 Delancey Street. In the
community, you will see many cigarette smokers and cigarette buds on the ground.
Other times you will hear disruptive drinkers leaving the bars and walking down
the streets.

            As
a community health nurse I would plan primary, secondary and tertiary
interventions to reduce the incidence of substance abuse hospitalizations in the
community.  The nurse has many roles and
a few of which include teaching, promoting, and encouraging their patients to
choose healthy lifestyles. Primarily, the nurse can educate the community about
health risks related to substance abuse. The nurse can educate the community about
what substance abuse is, signs and symptoms of substance abuse and ways of
prevention by bringing awareness to the community. Some people may have
addiction and dependency problems due to other health conditions or life
circumstances. For example, the nurse can teach alternative methods for coping
with stressors to prevent substance abuse. The nurse can do this by publicly speaking
in a community group center or at a school/college.

            For
secondary prevention, early detection of an illness or health condition may
provide the community health nurse the opportunity to determine effective
measures to prevent or minimize long lasting effects of substance abuse. For
example, the nurse would thoroughly assess the patient and gather both
objective and subjective information. The nurse can also detect the presence of
drugs or alcohol in the body by providing a drug test. Some drug tests include
urine tests, blood tests, saliva tests, and breath tests. Also, screenings for
certain cancers like lung cancer from exposure to cigarette smoking can help
for early detection. Furthermore, the nurse can then help plan and implement the
appropriate interventions.

            Lastly,
tertiary prevention provides interventions that are used to reduce the long
term effects of substance abuse. The community health nurse can introduce
information about helpful groups and programs. For example, support groups such
as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) helps members
maintain their sobriety and fight off their addiction. It gives the members an
opportunity to discuss their personal experiences and their strengths and
weaknesses. The members all have a common goal to achieve and it allows them
all to contribute in helping each other recover from their addiction. Also, the
nurse can determine those who may need detoxification, rehabilitation, and/or recommendation
to a smoking cessation program.

            Each
group or member of a society has a responsibility in contributing to the achievement
of a solution to a problem. This would include the government, families,
individuals, health systems and educational facilities. In this case, substance
abuse is a major problem in the Lower East Side and Chinatown.

            The
government can provide grants and funding to support programs for substance use
disorders. Substance Abuse and Mental Health Services Administration (SAMHSA) allows
grant funds to be used for substance abuse prevention centers, substance abuse
treatments, and mental health services (Elliott, 2017). “SAMHSA also has a free
24/7 national helpline that offers referrals to local facilities for treatment,
support groups, and community based organizations” (Elliott, 2017). The
government can also continue to provide health insurance and health care such
as Medicaid and Medicare for those in need.

            Families
responsibility is to make sure their family member or members are receiving the
help and support they need. Also, the family’s role and responsibility can be
keeping their family member on track so that they do not relapse. Family
therapy can also be beneficial because it meets the needs of all members within
the family. For example, alcohol addiction can cause stress to everyone in the
family and can affect relationships within the family. Someone suggesting
family therapy can decrease stress, speak openly, and resolve their problems.

            Individuals
are expected to attend meetings or private therapy sessions. The individual’s
responsibility is to seek help and treatment. The individual can set small
goals for themselves that are achievable and realistic. This may prevent the
individual from feeling frustrated or overwhelmed if they do not accomplish
something. The individual should also avoid temptations and/or old habits to
prevent them from relapsing. For example, if you have a friend who got you
involved you may want to stay away from bad influences.

            The
health systems role and responsibility in the resolution of substance abuse is
primarily providing medical care services. Health care professionals are
expected to educate people in the community about potential risk factors. Moreover,
health care professionals should identify the problem, evaluate the factors associated
with the problem, and treating the individuals with tobacco, drug or alcohol dependency.
For example, the nurse can offer advice on the appropriate and effective
treatment methods when considering the patient’s environment, medical history
and support systems.

            Educational
facilities such as schools can introduce preventive programs to the curriculum.
These programs promote healthy lifestyles and teach students how to resist
involvement in alcohol, tobacco, and other drugs. Community health nurses can
be spokesman or educators in these programs to prevent substance abuse.