¶ … Nurse-Care Analysis of Sheepshead Bay The area is 4,074 square miles. Its population is 123,178. The people density of people who live in Sheepshead Bay compared to general inhabitants of Brooklyn of people per square mile is 30,233 to 34,917 (City-data.com; web).

On my visits there, I was astounded by the mass of people rubbing shoulders one with the other. The streets seemed dense and crowded with a great number of apartment buildings, more than those in the more laid back areas such as Flatbush and Queens, and also more than those in the vicinity of Coney Island. There were also a lot of immigrant offices and lawyers specializing in immigration services that was telling of the area.

In fact, involvement with immigrants who had been seeking service with bureaucracy involved with obtaining a Green card revealed that many of them, although living in other parts of Brooklyn (sometimes far from Sheepshead Bay) had been recommended to travel to Sheepshead Bay for service.

Whether correctly or not, Sheepshead Bay has a reputation for attracting Russian emigres particularly those who are 'fresh off the boat from Russia'. Either way, there are certainly a lot of Russian-culture-oriented stores in the area, and Slavic faces and Russian language was a phenomenon that I encountered frequently and consistently as well as the selling of vodka, and it seemed to me, from the newspapers on display and advertisements and bulletins that I saw in passing that Marxism, in some form or other, is still a dominant political perspective. That is paradoxical since capitalism is huge here with many small and shabby stores (mainly corner markets) frenetically competing with one another.

My assumption that the majority of the population are elderly and retired, was supported by data on City-data.com (http://www.city-data.com/neighborhood/Sheepshead-Bay-Brooklyn-NY.html) that showed most of the population to be in the 45 age range +. Whilst there is a drop in the ages between 30 and 35, there seem to be more individuals in the ages between 20 and 30, otherwise the number of adolescents that live here are still lower, and still lower still are the amount of children between 0 and 10 years of age (City-data.com; web). Statistical data corroborates my impressions: that a mainly elderly population inhabits the area and that those of a more fertile age and capacity move to other localities.

There are also seemed to me to be relatively few schools in the region due perhaps to the depletion of younger parents there, possibly, although not necessarily, to the shabbiness of the place, and possibly due to the notoriety of the place attributable to crime (the so-called 'Russian mafia') and concerns of safety.

The overwhelming segment of races (85%) is Caucasian. Approximately 10% is Asian, 5% Hispanic, 3% Black, and 2% other races (City-data.com; web).

The median household income in 2009 was $44,279 compared to the general median household income in Brooklyn of the same year, which was $40, 478.

The median rent in 2009 was $856 compared to the median rent paid in Brooklyn of that same year which was $812 (ibid.). It seems to me that it is the proximity of Sheepshead Bay to Coney Island that raises the rent here that makes it an otherwise desirable neighborhood to live in despite its squalor and incidence of crime in certain parts of the region. Proximity to Coney Island also affords opportunities to up-and-coming businessmen and hustlers.

Interestingly enough, there are more females than males living in Sheepshead Bay (64,304 to 58,875). The median age of the males is 37.2 compared to the median age of the males in the city in general, which is 33.1. The median age of the females, on the other hand who live in Sheepshead Bay are 42.0 compared to the median age of the whole city, which is 34.8 (City-data.com; web). It seems as though a largely middle-aged female population is attracted to Sheepshead Bay, and this is intriguing.

There are, too, I noticed a lot of prostitute services and strip-tease industries in the area. My assumption is that it may be these that attract a lot of the women ('women of the night') to this specific region.

The average household size is small: 2.6 individuals compared to the average household size of Brooklyn as a whole, 2.8 individuals. The average family size of Sheepshead Bay is 3.2 members compared to that of Brooklyn in general that has 3.4 members (ibid.). This, again, cohered with my general impression of mainly middle-aged older population with few children.

On the other hand - and this was a piece of data that flummoxed me - City-data.com told me that approximately 51.0% of the population constituted married...

I was also surprised to discover that 22.4% of these couples had children compared to the 19.1% in Brooklyn as a whole (ibid.). It may be that other areas external to this specific region have more children and possibly more schools than I noted in my migrations. Or, simply perhaps that children traveled to schools outside the locality and that my observations were incorrect.
There are also a small percentage of single mother households (5.9%), but a significant number of never married males, 15 years and older (14.1%) and a slightly lesser, but still significant number, of never married families (11.9%); the proportion, in each case, to Brooklyn as a whole is 18.2% and 19.1% (City-data.com; web).

Congruent to my perception that Sheepshead Bay is an emigre locality is the statistical observation that a striking 16.0% of people in this neighborhood either speak little English or are totally unfamiliar with the language compared to the 12.3% of immigrants in Brooklyn as a whole. Indeed the percentage of foreign-born residents is a high 48.6% compared to the 37.8% of foreign residents in Brooklyn itself.

This factor of immigration coupled with the fact that such a high number have had a minimal high school education if at all (21.2% compared to the 28.5% of Brooklyn in general) can pose critical problems to the general health of the locality in that immigrants have peculiar health challenges. This is compounded by the fact, that there seem to be more non-college graduates here (i.e. people who have ceased education with high school) than in any other part of Brooklyn (28% compared to 27.8%) (ibid.).

This area also seems to have an inordinate amount of vehicles (1.1% of houses compared to the 1.0% in Brooklyn itself; and 0.6% of apartments compared to the 0.4% of general Brooklyn). This could be more an indicator of Russian values (the perceived value of possession of a car) than of general wealth. A large percentage of units, too, have a mortgage (61.3% compared to the general Brooklyn 67.1%). Housing prices range higher than the median price range of Brooklyn ($616,988 to $589,809); again it could be the proximity to Coney Island and the industrial advantage that hikes the prices. The average housing value (and this supported my impressions of the housing being largely shabby and uncared for) is lower than of Brooklyn in general ($275,942 compared to $284,435 for 2-unit structures). Indeed, most constructions in the zone were built in 1939 or earlier (City-data.com; web).

A huge percentage of the population is below poverty level (17.2% compared to the 25.1% of Brooklyn in general), many of the families have both members working strenuously to make ends meet (ibid.).

What I also noticed was the fact that a conspicuous number of the population are involved in industry or service jobs and this coheres with much of the research done on illiterate immigrants, generally, accepting lower-level, more dangerous jobs in the economic sector.

In this regards, 11.8% of males in Sheepshead Bay are absorbed in the service sector compared to the 17.3% of the borough as a whole. A large 12.4% are involved in construction, extraction, and maintenance occupations as compared to the 13.6% of the surrounding borough, and 9.2% are involved in transportation and material moving occupations (City-data.com; web).

Reports of American immigrants show that they invariably turn to the lowest paying and most dangerous jobs usually because of language difficulties, sometimes, it is thought due to prejudice (Ramakrishnan, 2006).

Part II. Nursing diagnoses

Based on the above information, the top five nursing diagnoses for the community nurse caring for the neighborhood would be the following: 1. Depression, 2. Suicide, 3. Alcoholism and substance abuse, 4. Reluctance to use services, 5. Work-related dangers.

1. Depression:

Numerous studies have documented disparities in depression between younger immigrants and older immigrants particularly those with language problems. Depression seems to be more rampant in the latter group. Some studies have noted that non-literate immigrants are more likely to receive sub-standard care and to experience poorer outcomes from anti-depressant treatment, with fewer follow-up visits and earlier discontinuation (Miranda et al., 2003). Some immigrants also seem to prefer psychology to pharmacotherapy. Higher rates of depression among the more illiterate group may also be referred to language differences, particularly incomprehension of language nuances relating to health factors, and a consequent fear of dealing with any…