Introduction

As we began to assess the community we noticed that city of Linden, NJ focused on two

types of vulnerable population which is the elderly and juveniles. According to Judith Earlene,,

Vulnerable Population is describe as, “those individuals who lack control over at least some

portion of their lives; they are often characterized as being powerless.”(W. Pinch & A. Haddad,

2008, p.175) During our research we found out that Linden, NJ is small family oriented town.

Not only do they focus on the Nuclear family but they have a vested interest in the extended

family, which as community health nurses we feel that it is one of their strong points. According

to Merriam Webster.com the extended family is defined as, “a family that includes in one

household near relatives in addition to a nuclear family.”

In order to know strengths and weakness within the community for most of our strengths

and weakness we use the Seven A’s to guide our thought and focus. According Truglio-

Londrigan and Lewenson (2010), describing the Seven A’s:

“The health of individuals and communities also depends greatly on access to quality health care. Expanding access to quality health care is important to eliminate health disparities….Health care in the broadest sense not only includes services received through health care providers but also health information and services received through other venues in the community.”

First Strength

According to Health and Aging.org it states that, “Elderly people who live alone, often

having lost a spouse, usually prefer to remain independent and continue living alone as long as

their health (and finances) allow it. Many who live alone have families or friends nearby.”

Social Statistics of Linden, NJ grandparents living in household with one or more children

attributed to 1,222. As community health nurses we feel it is important that we focus on well-

being of it elderly because, they are usually the forgotten population. In study that was done by

The National Academies in Focus on how many of the elderly are abused or neglected states:

Their golden years are hardly peaceful for the estimated 1 million to 2 million elderly people who are victims of abuse and neglect. Even though the problem of "granny battering" hit the news in 1978 as a result of congressional hearings, there is an abysmal absence of research into the neglect and abuse of elderly Americans, says a new report from the National Research Council.

For a community to think of vulnerable population such as the elderly is a strong point.

According to research that was done by MayoClinic.Org it states that, “The rapid growth in the

elderly population in many countries has highlighted the importance of exercise training to

decrease the likelihood of disability and age-associated disease, promote independence, and

enhance quality of life.” We as public Health nurses want to operate under primary prevention

because; we want to treat the illness before it happens. We did find out that community offered

varies programs through the Department of Recreation and Community Services of Linden and

The Senior Citizen Newsletter. Varies activities that our offered are:

Nutrition Program, Craft classes, Health Screening, Woodshop Studio, Social Line Dancing, Exercise Room, Emergency Response System, Bus Transportation, Bowling League, Ceramic Club, Sunnyside Recreation Center, Retired & Senior Volunteer Program, Knitting/ Crocheting for a cause, Senior Citizen Picnic, Yoga/Tai Chi/QIGong, Summer Craft Classes, adult ,Non-emergency Medical Transportation, Efficiency First, Lifeline-P.A.A.D. Home Energy Programs , Pilates Exercise Class.

We went into the community to assess the resources that community offered the elderly

using the Seven A’s. Aware: The elderly are aware of these activities because, News Letters are

sent to their homes. Access: They can get into contact with the program directors through phone

and internet. Available: The different activities are offered during different parts of the day to

accommodate everyone in the community, and are offered at the Senior Center which is the John

T. Gregorio Recreation Center. Affordable: Yes, the necessary thing such as, Health Screening

are free and Lunch programs are $1.75 donations. Acceptable: Yes, because these programs

offer varies types activities ranging from physical, mental, and spiritual health. Appropriate:

We felt that the programs fit because, there not only one side they are here to help the elderly get

through, what we see as their golden years. Adequacy: There are adequate amounts of programs

because there is about a total of 20 services offered in Linden for the elderly.

First Weakness

According to Housing Authority City of Linden, they built a new low income housing to

accommodate providing Assistance to the elderly and disable. The prices for rent vary from

$32.00 a month to about 1,000.00 a month. These are all things that community has been doing

to provide adequate care for their aging population.

During our research we began to ask to question in regards to what about the low income

family living in Linden, NJ. During our research we found out that there is lack of resources in

affordable housing for the family member living in Linden. According to Head of Housing

Authority City of they did not offered Public Housing for families but, do have Section 8

housing for families living below poverty. According, to Linden, New Jersey Census Data &

Community Profile it states that only 5 % of family live below poverty line compared to 9.2 %

of the nation.

According to The US Department of Housing and Urban development Section 8 is

defined, as “United States Housing Act of 1937, as repeatedly amended, authorizes the payment

of rental housing assistance to private landlords on behalf of approximately 3.1 million low-

income households. It operates through several programs, the largest of which, the Housing

Choice Voucher program, pays a large portion of the rents and utilities of about 2.1 million

households.” Initially, we thought it was good alternative but, upon research we found that

approximately 1,400 people apply for section 8 and they can only service 342 families. This

numbers, only counts for a fourth of people who apply, as community health Nurses it broke our

hearts to find there are people who has been on the waiting list since 2001 which is

approximately 10 years. We established Affordable housing as on the city of Linden weakness.

Using The Seven A’s it was able to help us organized it as community weakness. Aware:

Not many families are aware of these deficits because, the average family is not living beyond

the poverty line. Access: No they cannot because, only 342 families can utilize the service and

1400 people need it. Available: It’s not available because, 1400 families are left without

services. Affordable: After speaking to a represent of the Housing Authority City of Linden she

said, due to state budget cuts they will not be able have more vouchers for family anytime soon.

Acceptable: It is an acceptable for family who do can’t afford to pay regular rent. A represent of

the Housing Authority City of Linden explained to us that a person who meets the initial criteria

that lives below the poverty line can on average pays $165.00 for efficiency that regularly cost

$916.00. Appropriate: Even though, majority is not living under poverty line but, as

Community Health Nurses we would love to bring extra money to the community so everyone in

the community can have affordable housing. Adequacy: There is not enough in quantity as

mentioned previously to provided care to all those who are in need.

Even though, it’s not realistic goal for us to try to get vouchers but, we would like to talk

with city officials so we can figure out way to increase more vouchers for the families. Even

though, the city can not provided everyone in the community with affordable housing they make

sure that there is adequate services for the children within the community.

Second Strength:

There are currently 39,394 people living in Linden of this number 22 percent of them are

people who are 18 years old. So for every 5 adult there is 1 child. As community Health Nurse it

is important for us to understand resources are available for the children in a community.

According to Research that was done by Facts about After School Programs & At

Risk Youth, it states that “In America today, millions of young people are alone and

unsupervised in the hours after school, before parents return home from work. This situation

places children and teens at grave risk for juvenile crime, substance abuse, teen pregnancy, and

other problems. It means students are wasting precious time when they could be learning.” So

we wanted to assess how well the Youth are being engage because, most of the parents in

Linden, NJ are working class. According, Ignativiticus, D. & Workman, L. (2010) Primary

Prevention is described as strategies used to avoid or delay the actual occurrence of a specific

diseases or illness.”(pp.1806) Primary Prevention is the route that we wanted to take with the

youth, it is so much easier to help a teen stay away from gangs but, once they become a member

it harder. “gang youth differ from other vulnerable population due to their increased

participation in violence…much more likely to kill one another in comparison with killing a non-

gang member.” (Bill Saunders et al, 2009)

Once again through the Department of Public Property and Community Services, City of

Linden, NJ, the children are able to get after school programs. According to the a Report done by

NJ.Today.Net states, “That Department of Public Property and Community Services are a group

of people that has appointed a committee, composed of the Mayor’s Senior Citizen Advisory

Committee, Recreation Committee and local civic organizations to make the final selection.”

The programs that our offered to the youth consist of Little Kickers Spring Soccer boys

and girls age four and five and cost $25.00, Magic Show free for kids ages preschool through 5th

grade during two times 10:00am and 11:30am, Tennis Classes for boys and girls ages 7 through

16 at different times to accommodate different age groups, and Summer Camps targeting

different age groups from first through sixth grades from June 27th through August 18th for cost

$350.00

Through utilizations of the Seven A’s we found out that this a youth activity is a strength

of the community of Linden. Aware: The community is aware of these programs because, they

are advertise throughout the schools to let them know of the variety of activities in the

community. Access: Yes, they can gain access because the offered different time frames to

accommodate the different families. Available: We felt that there was enough programs

available for everyone in the community because, it is only limited to the children who are in

Linden, NJ. Affordable: Some activities were free and the ones that require parents to come out

of pocket were in reasonable amounts. According to Best Newton Summer Camps the average

after school programs cost $598.00 in New York (http://camp.findthebest.com/directory/b/New-

Jersey/Newton) compared to Linden prices. They also offer parents payment plans so that they

are not burdened with the cost all at once. Acceptable: The programs that they offer are

acceptable because, they target seasonal activities, so the youth can stay engaged. Appropriate:

These programs are appropriate, For example, as mentioned previously Summer Camps from

8am-5pm Monday-Friday to accommodate the working family, because these parents are going

to work. They need adult supervision for the children because, Linden, NJ has a highworking

class members. Adequacy: There were adequate amounts of programs to target students of all

ages.

Second Weakness/Strength:

As community health Nurses we were concern about the fact of the lack of Hospital for the

citizen. Due to the use of Supra systems when services are not available within its boundaries,

the citizen of Linden have to utilize two hospitals which, are Trinitas Regional Medical Center

in Elizabeth, NJ and Robert Wood Johnson University Hospital which is located in Rahway,

NJ. According to Nies and McEween (2011), “The larger system of which the family is a part,

such as environment or community.”(Pp. 388) These hospital provide excellent service to the city

Linden, NJ per a long time resident who did not want to identify.

Even though, they do not have a medical center but as mentioned previously they offer

The Care Stations mission, “is to serve the healthcare needs of all our patients, assist client

companies with cost containment, and lost time prevention through pre-employment physicals

and testing, and to promote a healthy lifestyle for everyone.” After studying community Health

nurse we know that there is about 45 million people living without health insurance. A

community health nurses we are afraid for patients but, we were pleased to know that the city of

Linden has, The Care Station within the community to help service basic health needs it is

community strength! (http://www.carestationmedical.net/linden.asp)

Third Weakness: Community/Public Health Nursing Diagnosis

As a Community/Public Health Nurse it’s the nurses duty to work outside of acute-

care settings; by meeting i goals by identifying problems and supporting community

participation in the process of preserving and improving the health , safety and wellbeing of the

community. The focus is on the health of the larger group rather than the health of the individual.

As a community health nurse for the town of Linden, the safety of our residents is our ultimate

goal. This includes: Workplace safety and health, food and drug safety, and other health/safety

areas, as well as the regulations that provide for people of the town Linden.

According to Linden-nj.org, between 2003 and 2006, the City of Linden had 2,013 traffic

accidents on its main roads. The accidents occurred on the following streets because of non

compliance with traffic laws:

Rte # 1&9 - 595 accidents, Wood Ave. - 523 accidents,

St. Georges Ave. - 286 accidents, Stiles St. - 292 accidents,

Park Ave. - 119 accidents, Linden Ave. - 62 accidents.

The report indicated that 1/3 (five Intersections) of the crash locations were located in Linden. These are:

Park Ave. - 82 accidents, Stiles St. - 77 accidents,

Wood Ave. - 63 accidents, Woodlawn Ave. - 56 accidents

Ave. C- 52 accidents.

In 2005, Federal Highway Administration and State of NJ, Dept. of Transportation conducted

a Safety Impact study on Route US 1 & 9 between M.P. (Mile Point) 35.00 to M.P. 45.50. The

study was prompted by the extremely high number of accidents and fatalities in this section of

Route 1&9, which occurred in 2005. The safety impact study identified 15 crash locations on Rte

1&9 due to red light violations in the town of Linden. Recently it was reported that two men

were killed last month after running a red light at an intersection by the ConocoPhillips Bayway

refinery plant on Routes 1 & 9, at a light where Linden has requested state approval for a camera.

That intersection is not among the first round of camera installations going up now

Community/Public Health Nursing Diagnosis

The community of Linden, NJ is at Risk of Impaired Safety Among Driving and Pedestrian Population Related to non-compliance with traffic laws.

As demonstrated in Between 2003 and 2006, the City of Linden had 2,013 traffic accidents on

its main roads. The accidents occurred on the following streets because of non-compliance with

traffic laws:

Rte # 1&9 - 595 accidents, Wood Ave. - 523 accidents,

St. Georges Ave. - 286 accidents, Stiles St. - 292 accidents,

Park Ave. - 119 accidents, Linden Ave. - 62 accidents.

Agreed Upon Interventions/Plan:

We plan to go every Saturday morning at the Shoprite in Linden Plaza and the BJ’s at

Linden:

Programs targeting the general motoring public.

Public education campaigns should be created that will combat the problem of driver

awareness.

Driver should be educated on how to read and interpret the meanings of traffic lights to

limit the confusion and reckless driver behavior.

Public education campaigns should also address the driver's responsibility in terms of

adhering to the proper driving safety laws.

Drivers should be educated on the rules and penalties for failure to comply

For high school drivers host an assembly on safe driving with The Board of Education

focusing on the importance of obeying proper driving protocols.

Evaluation Strategy

To evaluate the effectiveness of our interventions, in 6 months we will do survey to see if

people have been more compliant with the interventions and plans that were augmented if efforts

to reduce resident violating vehicular safety. Surveys will be sent to the targeted population were

will work with the Department of Public Property and Community Services, of the City of

Linden to handout survey at each event that they have for the elderly and the children. By

utilizing the Department of Health we are going to target the parent of the children and also the

elderly who are still able to drive. We will also target teenage drivers in the high school, by

working with the Board of Education in Linden to host an assembly on compliance on safe

driving. Then, once the assembly is finish, afterwards we will survey the students to see if they

had a change in attitude.

Even though, the Police department was able to decrease Red Light Violation to 55

percent in six month are ultimate goal is 95% percent so, will work closely with the police

Department of Linden until goal is met!

Reference:.

Best Newton Summer Camps (2011) Retrieved From: http://camp.findthebest.com/directory/b/New-Jersey/Newton

Department of Public Property and Community Services, City of Linden, NJ (2011) Retrieved from: NJ.Today.Net

Elderly (2011) Retrieved From: Mayo Clinic.com

Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. (2002) Risk and Prevalence of Elder Abuse and Neglect, Committee on National Statistics and Committee on Law and Justice, Division of Behavioral and Social Sciences and Education 568 pp.; ISBN 0-

309-08434-2

Facts about After School Programs & At Risk Youth (2011) Retrieved From: http://www.afterschoolallstars.org/site/pp.asp?c=enJJKMNpFmG&b=854685

Healthy In Aging (2011) Retrieved From: www.healthinaging.org

Ignativiticus, D. & Workman, L. (2010). Medical-Surgical Nursing Patient Centered Collaborative Care, St. Louis: Saunders

Information Please Com. (2011) Social Statistics of Linden. Retrieved From: http://www.infoplease.com/pages/copyright.html

Linden, New Jersey Census Data & Community Profile (2011) Retrieved From: Linden, New Jersey Census Data & Community Profile

Nies, M. A. & McEwen, M. (2010). Community/Public Health Nursing: Promoting the health of populations, (5th ed.). Philadelphia, PA: W.B. Saunders Company.

Nursing and Health Care Ethics: A Legacy and A Vision. (2008) W. Pinch & A. Haddad Editors. Which came out of the Center for Health Policy and Ethics at Creighton University.

Official Website of Linden New Jersey (2011) Retrieved from: http://linden-nj.org/

Sanders, B., Schneiderman, J. U., Loken, A., Lankenau, S. E., & Bloom, J. (2009). Gang

Youth as a Vulnerable Population for Nursing Intervention. Public Health Nursing, 26(4), 346-352. doi:10.1111/j.1525-1446.2009.00789.

The US Department of Housing and Urban development (2010). Section 8. Retrieved From: http://www.va.gov/landing2_contact.htm

Truglio-Londrigan, M. & Lewenson,S.B. (2010). Public Health Nursing: Practicing Population-Based Care. Sudbury, MA: Jones & Bartlett Publishers