Assessment and diagnosis in clinical practice

¶ … Diagnosis

The relevance of maintaining healthy communities cannot be overstated. In basic terms, communities should be designed and maintained in a way that promotes the well-being of their inhabitants. In so doing, such communities could end up realizing not only the economic but also the social benefits of a happier, healthier, and more productive society. There is therefore a need to assess and diagnose the key health problems specific to various communities. This way, lasting and innovative solutions can be sought and implemented to rein in the identified health problems.

Community

For this particular assignment, I will concern myself with North Las Vegas which also happens to be one of the largest cities in Nevada. In terms of governance, the city falls under the administration of a mayor who is assisted in this role by four members of the council. When it comes to city life, it is important to note that in an attempt to promote recreational activities, the city of North Las Vegas maintains and operates numerous parks as well as open spaces.

Demographic and Epidemiological Data

According to 2012 population estimates, North Las Vegas had an overall population of 223,491 people (United States Census Bureau, 2013). More specifically, the percentages of various racial and ethnic groups were as follows: White Persons -- 47.4%, Black Persons -- 19.9%, American Indian and Alaska Native Persons -- 0.8%, Asian Persons -- 6.3%, Native Hawaiian and Other Pacific Islander -- 0.8%, persons reporting two or more races -- 5.8%, Persons of Hispanic or Latino Origin -- 38.8%, White Persons not Hispanic -- 31.2% (United States Census Bureau, 2013).

As of 2012, Nevada had a total population of 2,758,931 people. This effectively means that North Las Vegas accounted for 8.1% percent of the total population of the state. Further, while the state had a population percent change of 2.2% in the year 2010, the city of North Las Vegas registered a population change of 3.0% for the same year (United States Census Bureau, 2013). This means that the city of North Las Vegas has experienced slower growth in terms of population than the state of Nevada.

Today, numerous career opportunities exist in the community's numerous casinos and hotels. As of 2012, Nevada had a total of 256 casinos (Sieroty, 2013). According to the American Casino Guide (2013), "Las Vegas is truly the casino capital of the world." Indeed, 72 of the state's 256 casinos are located in the city of Las Vegas (American Casino Guide, 2013). Currently, North Las Vegas has a total of 11 fully operational casinos.

Windshield Survey

The community's landscapes are amongst some of the best maintained in the state. The needs of the city's shoppers are also well catered for by three Target retail stores and a super Wal-Mart. The medical and health needs of the community are also well served with residents having various healthcare options to choose from. To encourage healthy living, the community has been designed to encourage fitness with various side walks and bicycle lanes. It is not uncommon to see people jogging or strolling around. It is however important to note that although the physical needs of people who live in this particular community seem well catered for, a major physiological problem lurks in the shadows.

Being one of the cities with the highest number of casinos in the United States, it would be fair to state that residents of this particular community are proportionately exposed to the risk of pathological gambling. The city has casinos and slot machines in numerous locations and establishments including but not limited to gas stations, grocery stores, and in Wal-Mart. Pathological gambling according to Johnson (2010, p.615) "is defined as persistent and recurrent maladaptive gambling behavior that jeopardizes personal, occupational, or social functioning."

Problem

Given the widespread gambling in the community, I am strongly convinced that pathological gambling is one of the most significant problems that should be addressed with immediate effect. This is however not to say that the community is not currently faced with other problems. For instance, it is important to note that currently, the city seems to have difficulty implementing regulations with regard to food safety. This is particularly the case given that it is not uncommon to see people selling food in the gas stations and parking lots after the sun goes down. Such street vendors escape the scrutiny of health officials and for this reason, the foods they sell may not be fit for human consumption. However, as I have already pointed out, the widespread gambling in the community is of greater concern especially given its impact on the well-being of individual gamblers, their families and the entire community at large.

Those suffering from pathological gambling are often unable to fight the urge to gamble. For an individual, excessive gambling could lead to financial ruin. Excessive gambling could also be a cause of emotional distress as individuals hopeful of winning continue on a losing streak. To families, pathological gambling could lead to money problems, marital challenges, and even emotional isolation. In the words of Castellani (2000, p.178), "the girlfriends, the boyfriends, the parents, and the children all pay a price for their relationship with the pathological gambler." A community not at peace with itself because of numerous problems at both the individual and familial level cannot be regarded a progressive community. It is easy to see why gambling should be considered a serious problem for this particular community. Reining in this particular problem will be in line with the goal of one of the objectives of Healthy People 2020. Under Mental Health and Mental Disorders, the initiative has an aim of "improving mental health through prevention…." (Healthy People, 2013).

Historical Significance

For many reasons, Las Vegas is "the mother city of all gambling and casinos" (Casino-History, 2009). This is more so the case given that it was Nevada that was the pioneer state in the legalization of gambling in the U.S. Indeed, for years, Las Vegas has derived a significant chunk of its revenues to drive its economic agenda from gambling licenses and fees. It was the success of El Rancho, the first casino to be opened in the city, that motivated the establishment of numerous other casinos across the city (Casino-History, 2009).