Lower curious and quite interested to acquire more

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.

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
to 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 over. The 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 is either “excellent,” “very good,” or “good.”

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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.

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 establishments such as 14 public safety facilities,
emergency services, and administration of justice locations. In addition, there
are other beneficial facilities that contribute to the environment of the Lower
East Side and Chinatown such as 132 health and human service centers. Also,
there are 33 hospitals and clinics (“Manhattan Community District 3,” 2016).

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 older 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 take delight in.

For example, there are 198 parks, gardens, and historical sites in community district
3. Of the 198, there are 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 overall impression is that most of the
inhabitants seem very happy and involved in community activities.

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. Also, 4.17% of the land consists of transportation and utilities and
1.17% include industrial and manufacturing (“Manhattan Community District 3,”

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 low-income 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

             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
Christian church on 76 2nd Avenue, 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

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 cancer, 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, taken lives, 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 resolved.

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).

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.

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.

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.

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.

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.

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
recommendations to a smoking cessation program.

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.

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 the stress and possibly resolve their problems.

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.

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.

assessing the Lower East Side and Chinatown, I had discovered that substance
abuse is not only problematic for the residents within the community but it is
also life threatening. It has been an eye opening experience for me and I hope
with this newly gathered information I can help make a difference in community
district 3.