Provide a  report based on the outline below. At least 8 pages excluding title and references page.

The following categories are grouped according to community systems, and will be the focus of this community assessment. Much of the data will be found through computer databases, windshield survey and talking with key informants in the community if possible . Cite or reference each source of data collected.

SECTION ONE: Impacts of Health and Social Services

1. Location and History of Community or population chosen ( i.e., when did the parish program or clinic or homeless shelter start and who started it?)
2. Determine what geographical area your Community Assessment should consider. It should be census track (very small) or zip code level OR (large) at the county, and city levels. Just be sure to be able to collect enough data to complete the template for your chosen community.
3. Vital and Demographic Statistics of the Community in General
   1. Population density
   2. Population; composition ( gender, age, and race distribution and ethnic origin )
   3. Population characteristics ( marital status and family types )
   4. Mortality characteristics ( infant & maternal mortality rates, leading cause of death )
   5. Morbidity characteristics ( incidence and prevalence rates of specific diseases )
4. Values, Beliefs, and Religious Practices - demonstrate a good understanding of the underlying beliefs and values of the population chosen.
5. Health & Social Services - if possible collect data on services, resources, characteristics of users, statistics or persons served, and adequacy, accessibility and acceptability of facility according to users and providers, eligibility for use.
   1. Hospitals
   2. Private Care Providers, Population Practices, and Specialty Clinics
   3. Public Health Agencies
   4. Home Health Agencies
   5. Long-term, Extended-Care, and Continuing-Care Facilities
   6. Special Services for Specific Populations
   7. Pharmacies
   8. Social Service Facilities
   9. Mental Health Services
   10. Health Education

SECTION TWO: Impacts of Economics and Physical Environment

You may want to start by describing the community and whether it is predominately residential, commercial, or combination. Include a windshield survey of the area. What kind of feel do you have for this community? Describe the community and include the following physical elements.

1. Physical Elements (Windshield Survey of the Community)
   1. Natural resources including geography, climate, terrain
   2. Housing and zoning
   3. Open spaces and parks
   4. Boundaries- may also want to use a map, including major roads
   5. Commons or hangouts
   6. Shopping areas for meeting basic needs
   7. Churches or places of worship
2. Environmental inspection report - describe the physical layout of the chosen agency or organization. What is the water report for the community? What hazardous materials are within the community?
3. Economics
   1. Financial Characteristics of Households
   2. Business/Industries
   3. Labor Force (employment status, occupations)
   4. Major banks, Savings & Loans, Credit Unions

SECTION THREE: Impacts of Safety and Transportation on Community Health

1. Safety & Transportation
   1. Fire and Police Protection
   2. Sanitation which includes water sources and treatment, solid waste
   3. Air Quality
   4. Private and Public Transportation
   5. Roads
   6. Air &/or Rail Service

SECTION FOUR: Impacts of Politics and Government on Community Health

1. Politics & Government
   1. Type of government
   2. Elected Officials, terms, office location, house, availability
   3. Community Leaders
   4. Politically Active Community Organizations

OPTIONAL CONTENT AREAS: To include throughout Sections 1 through 4 above.

1. Communication
   1. Formal-newspapers, radio, television, postal service, telephone
   2. Informal - sources, dissemination
2. Education
   1. Education Status
3. Educational sources - public and private schools and day care facilities, libraries, home schooled
   1. Educational Services for Specific Populations
   2. Programs for Special Populations
4. Recreation
   1. Public & Private Facilities
   2. Entertainment and Cultural Events - museums, symphony, ballet, theater
   3. Recreations/ Leisure Activities
   4. Programs for Special Populations