CommunityDiagnosis:Afro-Caribbean Aged18-29 Years
Thepurposeof thepresentcommunitydiagnosiswasto assess and identifyareasof needforhealthpromotionamong theAfro-Caribbean youthsaged18-29 years.Thedata forcommunitydiagnosiswasobtainedfrom thedatabase of thePublic Health Agency of Canada andCanadian Women’s Health Network. Afro-Caribbean makesup 2.5 % of theCanadian population,where57 % of them residein Ontario. Loweducationalattainment,thelackof socialnetworksthataddresstheneedsof Afro-Caribbean,andincomeinequalitiesare thekeydeterminants of healththat haveincreasedtheriskof HIV infectionamong theselectedaggregate.This paper focuses on the issue of HIV/AIDS affecting this aggregate.
Keywords:Community diagnosis,aggregate,determinants of health.
Identificationof the Aggregate
CommunityDiagnosis:Afro-Caribbean Aged18-29 Years
Thehealthchallengeof HIV infectionamong theAfro-Caribbean youthsmanifests in thethrough substanceabuse,increasesin casesof mentalillnesses,anda highdeathrateof membersof theaggregatecomparedto otherracialgroups.
Communitydiagnosisis a criticalprocessthat determinessomeof thepatternsof healthchallengesthata givencommunityisfacedwith, includingspecificfactorsthat influencethispattern.Shrestha (2014) definedcommunitydiagnosisas a comprehensiveevaluation of healthstatusof a givencommunityin relationto its physical,social,andbiologicalenvironment.Thispaperdescribesthecommunitydiagnosisactivitieswith a focuson Afro-Caribbean aged18-29 yearslivingin Ontario. Thepaperwill document thethree keyhealthdeterminants andthehealthassessmentof theselectedaggregate(Afro-Caribbean aged18-29 years)based on thethree determinants of health.Thecommunitydiagnosiswill be based on thePopulation Health Promotion Model, which indicatesthefullrangeof healthdeterminants, differentlevels of action,andcomprehensiveactionstrategies(Public Health Agency of Canada, 2015).AlthoughAfro-Caribbean aged18-29 yearslivein one of theworld’sdevelopedcountries(Canada), lowincome,loweducationalattainment,andlimitedsocialsupportnetworksare thekeychallengesandfactorsthat determinetheir health.
About 4,348 were diagnosed with HIV in Ontario between 1985 and 2011.
About 51 % of the 4,348 cases were female
About 20 % of all cases of HIV / AIDs diagnosis are Afro-Caribbean
Afro-Caribbean makes up to 2.5 % of the Canadian population where 57 % of them live in Ontario.
Afro-Caribbean aged 15-25 years are 25 % and those that are within the age group 25-34 are 31.2 % of the total population of Afro-Caribbean.
About 24 % of Afro-Caribbean aged between 15 years and above have less than high school certificate.
Afro-Caribbean background aged 25 years and above and earn an average employment income of about $ 29,700 while the white Canadians who earn $ 37,200 annually.
HIV-related deaths of the Afro-Caribbean women account for about 32 % of all deaths that result from HIV / AIDs in Ontario.
Dueto the limitation of time, this community diagnosis could utilize anassessment method that would require a field study. The presentcommunity diagnosis relied on thedatabases of thegovernmentagencies,andcrediblenon-governmental agencieswerealso usedas themajorsourcesof data. Examplesof theseagenciesincludethePublic Health Agency of Canada andCanadian Women’s Health Network. However, the diagnosis suggeststhe use of a survey assessment method, which will facilitate thecollection of data from the aggregate instead of relying on thedatabases. A community survey should be followed by a review ofdifferent data sets as well as the evaluation of resources in thetarget community.
Acommunity diagnosis should be considered as a scientific random.Therefore, a purposeful sampling is suggested as the most suitablemethod of including respondents from the aggregate community. Asurvey may be conducted on a hundred-100 Afro-Caribbean Aged18-29 Years,where a questionnaire should be used as an effective survey tool tocollect the most relevant data.
Theimpactsof thehighprevalenceof HIV / AIDs among theAfro-Caribbean youthsmanifestsin three majorways.First,theHIV-related deathsare moreamong theAfro-Caribbean is thehighestcomparedto otherraceslivingin Ontario. However,femaleresidents areaffectedmorecomparedto malecounterpartsubjects.Accordingto CIHR (2015) theHIV-related deathsof theAfro-Caribbean womenaccountforabout32 % of alldeathsthat resultfrom HIV / AIDs in Ontario. Thesameresearchindicatedthat,on average,theHIV-related deathsof Afro-Caribbean accountforapproximately20 % of alldeathsthat are causedby HIV / Aids in Ontario annually.Thehighdeathratecan be attributedto thetendencyof Afro-Caribbean to concealinformationabouttheir HIV infection,which deniesthem theopportunityto seekforhealthbefore theinfectionprogressesto AIDs, all courtesy of stigmatization.
Secondly,thehighprevalenceof HIV infectionamong Afro-Caribbean communitymanifestthrough theincreasesin casesof substanceabuse.Thenewsabout theHIV infectionis, in mostcases,associatedwith stress,which in turnincreasestheriskof engagingin substanceabuse.In addition,HIV infectionis associatedwith personalturmoil,socialisolation,depression,andfatalismthat increasethesusceptibilityof theHIV patientsto theriskof substanceabuse(Bi, 2006). Afro-Caribbean whonoticethattheyare sufferingfrom HIV, will abusedrugsas an excuseto relievestress.
Third,theeffectofhighprevalenceof HIV infectionamong Afro-Caribbean manifests through theincreasesin casesof mentalillnessamong thispopulation.Afro-Caribbean youthssufferingfrom HIV / AIDs are at a higherriskof contractingmentalillnessescomparedto thegeneralpopulation.Thisiscommonamong theyouthswhorefuseto accepttheir healthconditionanddecideto livein denial.Theseyouthsendup sufferingfrom excess stressanddepressionthat culminatesin seriousmentalillnesses.Thisgivesa betterexplanationof thehighproportion(57 %) of Afro-Caribbean sufferingfrom traumatic stressdisorder(Haines, DeVellis, Keyserling, Siscovick, 2000).
Demographic& Epidemiological Data
HIVinfectionaffectsindividualsirrespective of their races.However,studieshaveindicatedthatAfro-Caribbean are themostaffectedby the HIV / Aids endemic in Ontario andCanada at large.Accordingto CACVO (2013) about4,348 werediagnosed with HIV in Ontario between 1985 and2011. About51 % of the4,348 caseswerefemale,which indicatesthatthefemaleresidentsof Ontario are at a higherriskof gettinginfectedwith HIV than their malecounterparts.The4,348 newcasesof infectionconstitute about 13 % of thetotalcasesof HIV patientsin Canada. TheLaboratory Enhancement Program reportindicatedthatabout 9.5 % of thegays in Ontario are Afro-Caribbean, whereHIV infectionfollowssimilarpatterns(CACVO, 2013).
SimilarstudieshaveshownthattheAfro-Caribbean havebecomethemajorcomponentof theHIV endemic in Ontario. Forexample,about 70 % of thetotalmaternalinfectiontransmissionsreportedin Ontario between 1994 and1996 occurredamong theAfro-Caribbean women(The Canadian Institute ofHealth Research, 2015). Thisaccountedforabout32 % of thetotalnumberof HIV / AIDs deathsamong womenin Ontario. Recentstatistics indicatethatthesetrendshavenot changed.Currently, about 20 % of allcasesof HIV / AIDs diagnosisare Afro-Caribbean (Solomon & Mishra, 2014). In addition,casesof newinfectionsamong theAfro-Caribbean communityhas beenincreasingat a highrateof about13.1 % everyyearandithas risenby about85 % within thelastfive years.Surprisingly, thelargestproportion(about 59 %) of infectionoccurredafter theaffectedpersonsstartedlivingin Ontario. Althoughthesestatistics donot specifytheHIV prevalencein theagegroupof 18-29 years,mostof theseinfectionsare reportedfortheyoungpeopleagedbetween 18-35 yearsandlivingin Ontario. Itis evidentthatHIV / AIDs is themajorhealthissueaffectingthelivesof Afro-Caribbean aged18-29,especiallythosewholivein Ontario.
Afro-Caribbean aged 18-29 years
Themainfocusof thiscommunitydiagnosisprojectis theassessmentof the populationof Afro-Caribbean whoareagedbetween 18 and29 yearsandwholivein Ontario, Canada. In total,itis estimatedthattheAfro-Caribbean makesup to 2.5 % of theCanadian populationwhere57 % of them livein Ontario (PHAC, 2015). Afro-Caribbean makesup about16 % of theminoritypopulation,which makesAfro-Caribbean thethirdlargestvisibleminoritygroup.Althoughthiscommunitydiagnosisfocuseson thepopulationaged18-29 years,theavailablecensusdata dospecifythesizeof thisagegroup,with one of thecurrentdatagaps.However,thedata reportedinthePublic Health Agency of Canada (2014) indicatedthatAfro-Caribbean aged15-25 yearsare 25 % those of agegroup25-34 are 31.2 % of thetotalpopulationof Afro-Caribbean. Thedata showthatthemajorityof Afro-Caribbean are youngpeoplelivingin theurbanareas.About54 % of theAfro-Caribbean are descendants of thefirstgenerationwhiletherestareconsideredas immigrants.
HealthDeterminants of the Aggregate
Thehighratesof prevalenceof HIV / AIDs among theAfro-Caribbean youthslivingin Ontario arecausedby three determinants of health,namelyloweducationattainment,lowincome,andthelackof socialsupportnetworks.
Low educational attainment
Afro-Caribbeanyouthslivingin Ontario seemto bedisadvantagedin nearlyallaspectsof life,includingtheaccessto education.Nearlyallpublicationsthat focuson theattainmentof educationin Canada, andOntario to be specific,agreethattheAfro-Caribbean are themostaffectedgroup,whereveryfewof them accesshighereducation.Accordingto PHAC (2014) about 24 % of Afro-Caribbean agedbetween 15 yearsandabove (thisincludesthosewhoareagedbetween 18-29 years)havelessthan highschoolcertificate.In addition,a smallerproportion(12.7 %) of Afro-Caribbean aged15 yearsandabovehave a universitydegreeas comparedto 15.4 % of theentireCanadian population(PHAC, 2014). Studiesalsoshowthatabout 20 % Afro-Caribbean immigrantshaveuniversityeducationcomparedto thenationalaverageof immigrantswith universitydegrees(PHAC, 2014). Therefore,Afro-Caribbean, both thefirstgenerationandrecentimmigrants,haveloweducationattainmentcomparedto othergroupsformingtheOntario population.
Althoughthegovernmentof Canada managedto formulateanti-racist policiesthat encouragedtheimmigrationof Afro-Caribbean in the1960s, itfailedto adoptpoliciesthat could helpimmigrant’saccesseducation.Accordingto Solomon & Mishra (2014) ideological swings(includingtheneedto supporttheglobal economyandstandardizationof curriculum) that characterizeprovincialgovernmentshavesupportedthedominantsocietywhileputtingtheminoritygroups(includingAfro-Caribbean) at a disadvantage.However,recentstudiesattributeunderachievement of Afro-Caribbean youthsto dysfunctional families,deprivedculture,andbehaviorpatterns(Solomon & Mishra, 2014).
Afro-Caribbeanyouthswith loweducationalachievementcannot getwell-payingjobsandthiscompromisestheir life standards to a point of desperation that subjectthem to theriskof engagingin crime, and irresponsible sexualbehaviorsthatin turnincreasetheriskof HIV infection,in the long run.
ThelowincomethattheAfro-Caribbean youthsearn with equivalenteducationallevel andexpertiseinexperienceincreasestheir riskof engagingin irresponsiblesexualbehaviors.Studieshaveshownthattheuniversitygraduatesof Afro-Caribbean background,bornin Canada, andaged25 yearsandabove, earnan averageemploymentincomeof about$ 29,700 comparedto thewhite Canadians whoearn$ 37,200 annually(PHAC, 2014).In addition,theforeign-bornAfro-Caribbean are theworstaffectedbecausetheyget an averageof $ 28,700 comparedto the non-Afro-Caribbean immigrantswhoarebornin foreigncountries(PHAC, 2014). Thewagegapat thegraduatelevel whereequityis expectedto beobservedshowsthattheAfro-Caribbean youthsare paidfarlesswhentheyacquirejobswithout highereducationcertificates.Mostimportantly, wagestandardizationhas beendecreasingat therateof 5 %, which meansthattheAfro-Caribbean will continueearninglessthan whattheir white Canadians earnannually.
Theexistenceof therelationshipbetween lowincomeandtheprevalenceof HIV / AIDs is a controversialissue.However,studieshaveshownthatearningan incomethat is lowerthan thesubsistencelevel increasethechancesfortheaffectedpeopleengagingin high-riskbehaviors(Parkhurst, 2009). Lowincomeiscloselyassociatedwith theweakendowmentof financial,humanresources,lowlevels of literacy,lowlaborproductivity,poorhealthstatus,andmarketableskills.Circumstancesof socialexclusionincreasethechallengesof reachingtheaffectedgroupsthrough that areaimedat reformingtheir sexualbehavior.
Therefore,lowincomeis one of thekeydeterminants of HIV prevalenceamong theAfro-Caribbean youths.
Social support networks
Socialsupportnetworksare criticaltoolsthat are usedto increasethecapacityof thestressed orsickpeopleto dealwith their healthconditions.Thesenetworksare madeup of peers,familymembers,andfriends(CIHR, 2015). However,socialsupportnetworkscan be establishedby healthypeoplesince theygivemembersthecomfortof understandingthatpeoplearound them careforthem. Socialsupportnetworkenhancesthewellbeingof thesocietyby improvingthesenseof belonging,a feelingof security,andsenseof self-worth. In thecaseof Afro-Caribbean youths,thelackof sufficientknowledgeabout andthenumberof socialsupportnetworkshas contributedtowards theincreasesinprevalenceof HIV. Astudyconductedto assesstheavailability of thesocialsupportnetworksandhealthcareservicesto womensufferingfrom HIV in Ontario revealedthattheavailablenetworksandhealthcareservicesweredesignedto addresson theneedsofthemainstream groups(CIHR, 2015).Thepolicymakersandthestakeholders in thehealthcaresectorfailedto recognizethattheAfro-Caribbean youthsagedbetween 18 and29 yearsare alsoat a highriskof contractingHIV.
Currently,there are veryfewnon-governmental andgovernmentagenciesthat providesupportto Afro-Caribbean. To thisend,thefewpeoplewhohaverelevant informationabout HIV andthesignificanceof networking learnediton their own(CIHR, 2015). Therefore,thelackof socialsupportnetworkandcommitmentof healthagenciesin Ontario will continuesubjectingtheAfro-Caribbean youthsto theriskof contractingHIV / AIDs.
Majorityof the Afro-Caribbean living in Ontario are poor, with the leastsalaries and poor life standards. This community is classified as avisible minority group. The data in this assignment presents theassessment and diagnosis of the youths aged 18-29 who are at a higherrisk of HIV infection compared to the youths from other racial groupsliving in Ontario, and Canada at large.
Afro-Caribbeangays are at a higher risk than non-gay youths. The risky behaviors(such as unprotected behaviors, prostitution, and same-sex practices)have increased the risk of infection among the youths in thisaggregate (CACVO, 2013). Currently, Afro-Caribbean are classified asthe third largest minority group, but ranked as the first among thatgroup that is at the risk of HIV infection, in addition to otherdiseases (PHAC, 2015). Therefore, this community diagnosis focuses onthe risk of HIV infection among the Afro-Caribbean aged 18-29 youthsliving in Ontario. The Afro-Caribbean youths form the aggregate forthis community diagnosis, including the first generationAfro-Caribbean and recent immigrants.
Afro-Caribbeanare classified as the third largest minority group, but ranked as thefirst among that group that is at the risk of HIV infection, inaddition to other diseases (PHAC, 2015). Therefore, this communitydiagnosis focuses on the risk of HIV infection among theAfro-Caribbean aged 18-29 youths living in Ontario. From thecommunity assessment in this paper, we can conclude that poverty isthe major factor that causes the emergence of many compromisedsituations and diseases and poverty is caused by low income and lowlevels of illiteracy.
Thedata in this paper is validated by the information obtained from theCity census, literature review that affects the aggregate and a closeassessment of this data.
Inequalityin the education sector in Ontario has disfavored the Afro-Caribbeanyouths, which has increased the risk of their engagement in riskybehaviors. In addition, the fact that Afro-Caribbean earns less thanthe white Canadians makes the aboriginals feel discriminated against.Moreover, most of them are paid salaries that cannot sustain them,which increases the risk of unhealthy behaviors. In addition, thelack of social support networks that can address the health needs ofAfro-Caribbean have contributed towards the high rate of HIVinfection among the aggregate. Consequently, the Afro-Caribbeanyouths have limited knowledge about the epidemiology of diseases(including its mode of transmission), which increases the risk ofinfection.
Thepoor health among the Afro-Caribbean youths is manifested by theincrease in the rate of risky behavior. This is confirmed by the highnumber of HIV-related deaths and mental illnesses among theAfro-Caribbean youths (Haines, DeVellis, Keyserling, Siscovick,2000). Moreover, the psychological distress that the infectedAfro-Caribbean youths undergo increases their risk of drugs abuse.
ANursing Diagnosis is a crucial part of the nursing process that is aclinical judgment of a community (in this case) experiences andresponses to actual or potential health problems. The data collectedserves to provide the most efficient and comprehensive clinicaldecision-making. Four (4) categories are provided in this nursingdiagnosis process (The Canadian Institute ofHealth Research, 2015):
Aclinical judgment is given here. The actual diagnosis is HIV/AIDS.HIV- infected patients suffer a range of other diseases once theyprogress to the AIDS stage. Such common diseases are Influenza, skinrashes, severe headaches and skin ulcers. Pain is also a challenge inthis stage. The intravenous drug users are more likely to suffer avariety illnesses derived from the substance indulgence (The CanadianInstitute ofHealth Research, 2015).
Therisk factor is at-riskto infection. Asdiscussed in this research paper, uneducated and low-incomeindividuals are the most likely to be infected. The risk is higher ascompared to the already settled individuals. Therefore, the healthypopulation of the Afro-Caribbean is twice likely to be infected bythis disease from their fellow community counterparts who are sick.This is by the basis of residing in the same setup. Also, othernon-HIV drug users are at a high chance of infection from infecteddrug users (The Canadian Institute ofHealth Research, 2015).
Health Promotion Diagnosis
Inthis aggregate, the complete package for health promotion diagnosiswould be readinessfor learning and empowerment.It covers the communities’ desire to embrace a social change,enhanced state of health and the motivation to search for better lifestandards. The community should be given better educationalfacilities, modern health treatments, better housing and betteremployment opportunities. All these are achieved in a vis-à-visaffair with the concerned stakeholders. Healthcare outreach programsare so important in this instance especially when the community lacksthe full information based on HIV/AIDS. Above all, education is theprime remedy for ensuring a healthy community (The Canadian InstituteofHealth Research, 2015).
Thisis a cluster of multiple nursing diagnoses. In HIV/AIDS relatedcases, the defining syndromes/characteristics are:
-Looseor liquid stool
Thenursing care tries to establish the viable method for administeringtreatment to sick patients who identify with the syndromes thatconform to HIV/AIDS. The treatment plan should be independent as wellas collaborative.
Afro-Caribbeanaged18-29 yearslivein Canada, a developedcountry,butthelackof theopportunityto acquireand attainedhighereducation,equalearningcapacity,socialsupportnetworksare criticaldeterminants of healththat havesubjectedthem to theriskof diseases.ThepresentcommunitydiagnosisindicatesthatAfro-Caribbean youthsare at thehighestriskof sufferingfrom HIV infectionthan anyothergroupin Ontario. AlthoughOntario communityblamestheAfro-Caribbean youthsforengagingin substanceabuseandriskysexualbehaviors,itis evidentthattheyouthsgetinto theseirresponsiblebehaviorsafter learningthattheyare sufferingfrom theHIV infectionandtheyhavenooneto supportthem.Tothisend,properinformationabout HIV, establishmentof socialsupportgroups,reductionin theincoming inequalities,andprovisionof an equalopportunityto attainhighereducationis the most significantin community development.
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