Use data only, not complete sentences; all info from US Census Bureau; cite each box.
Use data only, not complete sentences; all info from US Census Bureau; cite each box.. Fort Myers, Florida
Community Assessment 2019
Section 1: Community Identification & Features
| Instructions | Use complete sentences; cite each box |
| 1a. Geography | Location in State: complete
Area in square miles: complete |
| 1b. Topography | Elevation: complete
Type of Terrain: complete Major bodies of water: complete |
| 1c. Economic | Primary industries: complete
Largest employers: complete |
| 1d. Infrastructure | Public transportation: complete
Major roads/highways: complete Airports: complete |
| 1e. Education | Public school districts and public schools: complete
Higher education institutions: complete |
Section 2: Population Demographics
| Instructions | Use data only, not complete sentences; all info from US Census Bureau; cite each box. | ||
| Local | State | US | |
| 2a. Total Pop. | Pop. Estimate 2017: number | Pop. Estimate 2017: number | Pop. Estimate 2017: number |
| 2b. Age | <5yrs: %
<18yrs: % >/=65yrs: % |
<5yrs: %
<18yrs: % >/=65yrs: % |
<5yrs: %
<18yrs: % >/=65yrs: % |
| 2c. Gender | Female: % | Female: % | Female: % |
| 2d. Race | White: %
Black: % American Indian/Alaska native: % Asian: % Native Hawaiian: % Hispanic or Latino: % |
White: %
Black: % American Indian/Alaska native: % Asian: % Native Hawaiian: % Hispanic or Latino: % |
White: %
Black: % American Indian/Alaska native: % Asian: % Native Hawaiian: % Hispanic or Latino: % |
| 2e. Foreign born | Persons (2013-2017): % | Persons (2013-2017): % | Persons (2013-2017): % |
| 2f. Population growth/decline | Population change 2010-2018: + or – % | Population change 2010-2018: + or – % | Population % change 2010-2018: + or -% |
Section 3: Community Resources and Workforce
Healthcare Services
| Instructions | Write your answers in complete sentences. You may use internet search engines to begin your search per assignment instructions. |
| 3a. Hospitals (general not specialty) | Number in local area, general description with some details in a few short sentences. |
| 3b. Urgent care centers (can include after hours walk in clinics or freestanding ERs) | Number in local area, general description with some details in a few short sentences. |
| 3c. Community Health Centers (FQHCs) | Number in local area, general description with some details in a few short sentences. |
| 3d. Mental Health Services (outpatient) | Number in local area, general description with some details in a few short sentences. |
| 3e. Homecare Agencies | Number in local area, general description with some details in a few short sentences. |
| 3f. Hospice Agencies | Number in local area, general description with some details in a few short sentences. |
Services for Vulnerable populations
| Instructions | Write your answers in complete sentences. You may use internet search engines to begin your search per assignment instructions. |
| 3g. Agency that provides Services to elderly | Name one agency here followed by a few sentences discussing the services they provide |
| 3h. Agency that provides Services to homeless | Name one agency here followed by a few sentences discussing the services they provide. |
| 3i. Agency that provides Services to children | Name one agency here followed by a few sentences discussing the services they provide. |
| 3j. Agency that provides drug treatment services | Name one agency here followed by a few sentences discussing the services they provide. |
| 3k. Agency that provides healthcare services to uninsured/indigent | Name one agency here followed by a few sentences discussing the services they provide. |
HRSA Designations
| Instructions | Yes or No with complete sentences for any explanation; use HRSA website as directed in instructions. |
| 3l. Health Provider Shortage Area (HPSA) | Yes/No and type of provider that are of shortage if |
| 3m. Medically Underserved Area (MUA) | Yes/No |
Healthcare Providers
| Instructions | Data only needed as prompted. |
| 3n. Area Name: Write Your Metropolitan/nonmetropolitan area name here
Data Period: Write month/date here |
|
| 3o. Physicians | Number employed: number |
| 3p. Physician’s Assistants | Number employed: number |
| 3q. Nurse Practitioners | Number employed: number |
| 3r. Population to primary care physician | Ratio |
| 3s. Population to other primary care providers | Ratio |
| 3t. Your interpretation of HRSA and Healthcare Provider data above | Write a few sentences. |
Section 4: Indicators of Health Status and Quality of Life
Mortality, Morbidity & Health Risk Factors
| Instructions | Data only, not complete sentences. | ||
| Local | State | US | |
| 4a. Mortality: Leading Causes of Death (top 3) | List causes
Data year |
List causes
Data year |
List causes
Data year |
| 4b. Mortality: Infant mortality Rate | List rate
Data year |
List rate
Data year |
List rate
Data year |
| 4c. Mortality: Drug Induced Rate | List rate
Data year |
List rate
Data year |
List rate
Data year |
| 4d. Morbidity: List Indicator here (choice) | List statistic
Data year |
List statistic
Data year |
List statistic
Data year |
| 4e. Health Risk Factor: Adult Tobacco Use | List statistic
Data year |
List statistic
Data year |
List statistic
Data year |
| 4f. Health Risk Factor: Adult Obesity | List statistic
Data year |
List statistic
Data year |
List statistic
Data year |
Social Determinates of Health
| Instructions | Data only with clear data identification; not complete sentences. | ||
| Local | State | US | |
| 4g. Economic: % Living in Poverty | List %
Data year |
List %
Data year |
List %
Data year |
| 4h. Economic: % Unemployment Rate | List %
Data date |
List %
Data date |
List %
Data date |
| 4i. Education: % with High School graduate | List %
Data year |
List %
Data year |
List %
Data year |
| 4j. Education: % with bachelor’s degree | List %
Data year |
List %
Data year |
List %
Date year |
| 4k. Health: % without health insurance <65yrs | List %
Data year |
List %
Data year |
List %
Data year |
| 4l. Crime: Violent Crime rate | List rate
Data year |
List rate
Data year |
List rate
Data year |
| 4m. Food Insecurity: % who lack adequate access to food | List %
Data year |
List %
Data year |
List %
Data year |
Physical Determinates of Health
| Instructions | Data only/complete sentences if needed for clarity. |
| 4n. Mean MAX Annual Temperature | Degree Fahrenheit
List years of data |
| 4o. Mean MIN Annual Temperature | Degree Fahrenheit
List years of data |
| 4p. Mean ANNUAL Precipitation | Inches
List years of data |
| 4q. Air Quality | List Results (follow instruction)
List dates of data |
| 4r. Water Quality | List Results (follow instruction)
List dates of data |
Health People 2020 Goals and Progress complete sentences first column /data only for rest
| Instructions | Complete sentences in the first column, data only for the rest. First column from HP2020 website. | ||
| Local | State | US | |
| 4s. Target goal 1: Write it here-goal plus target measure | List statistic with identifier
List year of data |
List statistic with identifier
List year of data |
List statistic with identifier
List year of data |
| 4t. Target goal 2: write it here-goal plus target measure | List statistic with identifier
List year of data |
List statistic with identifier
List year of data |
List statistic with identifier
List year of data |
| 4u. Target goal 3: write it here-goal plus target measure | List statistic with identifier
List year of data |
List statistic with identifier
List year of data |
List statistic with identifier
List year of data |
Section 5: Health Priorities and Interventions
| Instructions | Use complete sentences. | ||
| Intervention 1 | Intervention 2 | Intervention 3 | |
| 5a. Priority #1: State your priority here in 1 complete sentence | State intervention for priority in 1-2 sentences | State intervention for priority in 1-2 sentences | State intervention for priority in 1-2 sentences |
| 5b. Priority #2: State your priority here in 1 complete sentence | State intervention for priority in 1-2 sentences | State intervention for priority in 1-2 sentences | State intervention for priority in 1-2 sentences |
| 5c. Priority #3: State your priority here in 1 complete sentence | State intervention for priority in 1-2 sentences | State intervention for priority in 1-2 sentences | State intervention for priority in 1-2 sentences |
Section 7: References
APA Reference list here (starts on separate page)
Use data only, not complete sentences; all info from US Census Bureau; cite each box.
