Case study: (at least 250 words )

Sandville is a small community in Texas situated 5 miles from the U.S.-Mexico border. The primary industry in the area is cattle ranching. Most of the Anglo residents are descendants of the western cattle barons and make up about 40% of the town's population of 3,000. Another 25% of the population is composed of long-time Latino residents descended from wranglers who worked on the ranches in the past. Now many work in service occupations. Mexican immigrants who cross the border (legally or illegally) to obtain work make up about 10% of the population. Members of this group return frequently to Mexico, where extended family members continue to reside. The remainder of the town's population includes a group of newly arrived Asian engineers and their families who have come to staff the recently opened electronics plant and a small group of African Americans who have lived in the area since the end of the Civil War.

Most young people do not stay long in the area and those who do have few children, so the population (with the exception of the Asian families) is aging. Cardiovascular disease and motor vehicle accidents on the two-lane highway passing through town create a booming business for the small local hospital. There are three primary care physicians in the community, one dentist, one pediatrician, and two family nurse practitioners. The county health department maintains a branch office in the town that is staffed by a public health nurse and a sanitation engineer 2 days a week.

Community health problems, in addition to cardiovascular disease and accidents, include arthritis and anemia. There is also a high rate of tuberculosis among the Mexican immigrants.

What problems might be present in the community other than those specified? What information in the case study led you to suspect the presence of these problems?

What nursing interventions would you employ as the community health nurse assigned to this community? Why?