PHNsplanandimplementinterventionsatallthreelevelsofcare.docx

PHNs plan and implement interventions at all three levels of care (individual/family, community and systems). The most effective plans include interventions at all three levels of care. 
1. After reading the New York Times article, please respond to the following discussion questions:
1. What are the social and environmental variables that might contribute to the health status of residents of the Low Opportunity Neighborhoods described in the New York Times article?
2. What should be the focus of additional research in these Low Opportunity Neighborhoods?
3. Review the intervention wheel and identify community or system level interventions that could be taken by a public health nurse or public health agency in these areas to improve the health status of the residents.  Feel free to assume you have access to some of the federal funds referenced in the article.

Detailed New National Maps Show How
Neighborhoods Shape Children for Life

https://www.nytimes.com/2018/10/01/upshot/maps-neighborhoods-shape-child-
poverty.html?rref=collection%2Fsectioncollection%2Feducation

By Emily Badger and Quoctrung Bui October 1, 2018

SEATTLE — The part of this city east of Northgate Mall looks like many of the neighborhoods that
surround it, with its modest midcentury homes beneath dogwood and Douglas fir trees.

Whatever distinguishes this place is invisible from the street. But it appears that poor children who
grow up here — to a greater degree than children living even a mile away — have good odds of
escaping poverty over the course of their lives.

Believing this, officials in the Seattle Housing Authority are offering some families with housing
vouchers extra rent money and help to find a home here: between 100th and 115th Streets, east of
Meridian, west of 35th Avenue. Officials drew these lines, and boundaries around several other
Seattle neighborhoods, using highly detailed research on the economic fortunes of children in nearly
every neighborhood in America.

The research has shown that where children live matters deeply in whether they prosper as adults.
On Monday the Census Bureau, in collaboration with researchers at Harvard and Brown, published
nationwide data that will make it possible to pinpoint — down to the census tract, a level relevant to
individual families — where children of all backgrounds have the best shot at getting ahead.

This work, years in the making, seeks to bring the abstract promise of big data to the real lives of
children. Across the country, city officials and philanthropists who have dreamed of such a map are
planning how to use it. They’re hoping it can help crack open a problem, the persistence of
neighborhood disadvantage, that has been resistant to government interventions and good
intentions for years.

Nationwide, the variation is striking. Children raised in poor families in some neighborhoods of
Memphis went on to make just $16,000 a year in their adult households; children from families of
similar means living in parts of the Minneapolis suburbs ended up making four times as much.

The local disparities, however, are the most curious, and the most compelling to policymakers. In
one of the tracts just north of Seattle’s 115th Street — a place that looks similarly leafy, with access to
the same middle school — poor children went on to households earning about $5,000 less per year
than children raised in Northgate. They were more likely to be incarcerated and less likely to be
employed.

The researchers believe much of this variation is driven by the neighborhoods themselves, not by
differences in what brings people to live in them. The more years children spend in a good
neighborhood, the greater the benefits they receive. And what matters, the researchers find, is a
hyper-local setting: the environment within about half a mile of a child’s home.

https://www.nytimes.com/by/emily-badger

https://www.nytimes.com/by/quoctrung-bui

https://www.census.gov/ces/pdf/opportunity_atlas_summary.pdf

https://www.census.gov/ces/dataproducts/opportunityatlas.html

https://www.census.gov/ces/dataproducts/opportunityatlas.html

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At that scale, these patterns — a refinement of previous research at the county level — have become
much less theoretical, and easier to act on.Image
A map used by the Seattle Housing Authority identifies neighborhoods, shaded in purple, where
housing officials and researchers believe that poor children have particularly good odds of rising out of
poverty.CreditSeattle Housing Authority

“That’s exciting and inspiring and daunting in some ways that we’re actually talking about real
families, about kids growing up in different neighborhoods based on this data,” said the Harvard
economist Raj Chetty, one of the project’s researchers, along with Nathaniel Hendren at Harvard,
John N. Friedman at Brown, and Maggie R. Jones and Sonya R. Porter at the Census Bureau.

The Seattle and King County housing authorities are testing whether they can leverage their voucher
programs to move families to where opportunity already exists. In Charlotte, where poverty is
deeper and more widespread, community leaders are hoping to nurse opportunity where it’s
missing.

In other communities, the researchers envision that this mapping could help identify sites for new
Head Start centers, or neighborhoods for “Opportunity Zones” created by the 2017 tax law. Children
from low-opportunity neighborhoods, they suggest, could merit priority for selective high schools.

https://www.nytimes.com/interactive/2015/05/03/upshot/the-best-and-worst-places-to-grow-up-how-your-area-compares.html

For any government program or community grant that targets a specific place, this data proposes a
better way to pick those places — one based not on neighborhood poverty levels, but on whether we
expect children will escape poverty as adults.

That metric is both more specific and more mysterious. Researchers still don’t understand exactly
what leads some neighborhoods to nurture children, although they point to characteristics like more
employed adults and two-parent families that are common among such places. Other features like
school boundary lines and poverty levels often cited as indicators of good neighborhoods explain
only half of the variation here.

“These things are now possible to think about in a different way than you thought about them
before,” said Greg Russ, the head of the Minneapolis Public Housing Authority, which is also
planning to use the data. “Is opportunity a block away? These are the kind of questions we can ask.”

The answers shown here are based on the adult earnings of 20.5 million children, captured in
anonymous, individual-level census and tax data that links each child with his or her parents. That
data covers nearly all children in America born between 1978 and 1983, although the map here
illustrates the subset of those children raised in poorer families. The research offers a time-lapse
view of what happened to them: who became a teenage mother, who went to prison, who wound up
in the middle class, and who remained trapped in poverty for another generation.

Few of the children from Northgate still live in the neighborhood, but the data traces their outcomes
as adults today back to the place that helped shape them.

The patterns broadly hold true for children growing up today, the researchers believe, even though
the data reflects the experience of people now in their 30s. In rapidly changing cities like Seattle,
some neighborhoods will look quite different now. So in drawing their opportunity maps, the
housing authorities here, working with Mr. Chetty’s team, also considered indicators like poverty
rates and test scores for poor students today.

The researchers argue, however, that this data that looks back over the last 30 years can reveal
something about a place that’s not captured in snapshots of its conditions today.

In Seattle, that picture confirmed what housing officials feared — that their voucher holders had
long been clustered in neighborhoods offering the least upward mobility.

“It really struck us as, well, we are contributing to this problem, not solving the problem,” said
Andrew Lofton, the executive director of the Seattle Housing Authority.

Here the response means offering some of those families more choices in where to live. But that
solution won’t help every child, or even many of them. The larger question is how to convert
struggling neighborhoods into places where poor children are likely to thrive.

In other regions, the differences between such places are more visible than in Seattle.

In the Charlotte area, Ophelia Garmon-Brown, a longtime family physician, sees in these maps clear
traces of where the fewest jobs are, where the high-poverty schools are, where African-American
families live.

“You could drive from your home in south Charlotte to your banking job downtown and never see
poverty, because we’re so segregated,” said Dr. Garmon-Brown, who grew up poor herself, in
Detroit. “In some of this, we have to admit that was intentional.”

The earlier research showed Charlotte as among the worst large metropolitan areas in the country in
creating opportunity for poor children, a realization that prompted the community to create a task
force co-chaired by Dr. Garmon-Brown. At this finer scale, parsing outcomes by race and
neighborhood, poor white children in Charlotte have had more opportunity than poor black
children, even when they’ve grown up in the same neighborhoods. In many parts of the region,
however, their worlds simply don’t overlap.

In other communities, what separates neighborhoods is probably tied to incarceration. Included in
the new census data are neighborhood-level rates of children who were later counted in the census
in prisons or jails on April 1, 2010.

bout 1.5 percent of the entire cohort, adults then in their late 20s to early 30s, were incarcerated on
that single day. For some neighborhoods in Milwaukee or New Haven, that number was far higher:
As many as one in four poor black boys growing up in those places were incarcerated. Their
neighborhoods — or something about how those neighborhoods were policed — sent more poor
children into prison than out of poverty.

Poor indicates families making about $27,000 a year (in 2015 dollars), at the 25th percentile of the national

income distribution

Underscoring how difficult it will be to transform these places, the federal government has spent
billions in struggling neighborhoods over the years, funneling as much as $500 million into some
individual census tracts since 1990, according to a tally by researchers of major placed-based
initiatives like block grants and housing redevelopment programs.

“And yet we’ve never been able as a country to fully know whether and to what degree those
investments were efficacious,” said Kathryn Edin, a Princeton sociologist.

Ms. Edin and other researchers working with Mr. Chetty plan to re-examine those past government
programs with the new data, which makes it possible to identify where children lived when they
were exposed to those investments, and what happened to them afterward.

If the answers are not clear yet, there is a hint of answers coming, now that we have fine-grained
data on millions of children, now that cities alarmed by the results are taking notice, now that
philanthropists are lining up to help.

In Seattle, where all these pieces have converged, housing officials were recently driving past
neighborhoods their map doesn’t identify, into “opportunity areas” where families have begun to
move.

“I believe the results of the data, but we all wish we knew what the distinguishing attributes are, so
that we could build them in other neighborhoods,” said Andria Lazaga, the director of policy and
strategic initiatives with the Seattle Housing Authority. “That’s the dream — to figure that out.”

The poor children shown here were raised in families making about $27,000 a year (in 2015 dollars), at the

25th percentile of the national income distribution. Not all neighborhoods were home to such families, so

researchers calculated tract-level estimates by extrapolating from the results of families at other percentiles

who were present there. Data is not shown in tracts with few children. Results not shown here covering other

income levels and full outcomes including incarceration are available here.

http://www.equality-of-opportunity.org/assets/documents/mobility_geo.pdf

https://www.fftc.org/sites/default/files/2018-05/LeadingOnOpportunity_Report.pdf

https://www.fftc.org/sites/default/files/2018-05/LeadingOnOpportunity_Report.pdf

http://www.opportunityatlas.org/

Detailed New National Maps Show How
Neighborhoods Shape Children for Life
https://www.nytimes.com/2018/10/01/upshot/maps-neighborhoods-shape-child-
poverty.html?rref=collection%2Fsectioncollection%2Feducation
By Emily Badger and Quoctrung Bui October 1, 2018
SEATTLE — The part of this city east of Northgate Mall looks like many of the neighborhoods that
surround it, with its modest midcentury homes beneath dogwood and Douglas fir trees.
Whatever distinguishes this place is invisible from the street. But it appears that poor children who
grow up here — to a greater degree than children living even a mile away — have good odds of
escaping poverty over the course of their lives.
Believing this, officials in the Seattle Housing Authority are offering some families with housing
vouchers extra rent money and help to find a home here: between 100th and 115th Streets, east of
Meridian, west of 35th Avenue. Officials drew these lines, and boundaries around several other
Seattle neighborhoods, using highly detailed research on the economic fortunes of children in nearly
every neighborhood in America.
The research has shown that where children live matters deeply in whether they prosper as adults.
On Monday the Census Bureau, in collaboration with researchers at Harvard and Brown, published
nationwide data that will make it possible to pinpoint — down to the census tract, a level relevant to
individual families — where children of all backgrounds have the best shot at getting ahead.
This work, years in the making, seeks to bring the abstract promise of big data to the real lives of
children. Across the country, city officials and philanthropists who have dreamed of such a map are
planning how to use it. They’re hoping it can help crack open a problem, the persistence of
neighborhood disadvantage, that has been resistant to government interventions and good
intentions for years.
Nationwide, the variation is striking. Children raised in poor families in some neighborhoods of
Memphis went on to make just $16,000 a year in their adult households; children from families of
similar means living in parts of the Minneapolis suburbs ended up making four times as much.
The local disparities, however, are the most curious, and the most compelling to policymakers. In
one of the tracts just north of Seattle’s 115th Street — a place that looks similarly leafy, with access to
the same middle school — poor children went on to households earning about $5,000 less per year
than children raised in Northgate. They were more likely to be incarcerated and less likely to be
employed.
The researchers believe much of this variation is driven by the neighborhoods themselves, not by
differences in what brings people to live in them. The more years children spend in a good
neighborhood, the greater the benefits they receive. And what matters, the researchers find, is a
hyper-local setting: the environment within about half a mile of a child’s home.

Online Discussion Rubric 2019

Updated 9/2019

Criteria Exemplary Satisfactory Needs Improvement Unacceptable

Quality of Initial
Posting

Initial Posting includes all
components and meets or exceeds
all requirements indicated in the
discussion prompt. Thoroughly
synthesizes, analyzes, and
integrates relevant ideas from
assigned readings and/or scholarly
literature and cites source. Initial
posting is 250-300 words.
(8 pts)

Initial posting/response includes all
components and meets all
requirements indicated in the
instructions. Each question or part
of the discussion prompt is
addressed. Displays basis synthesis,
analysis, or integration of ideas
from the readings and/or scholarly
literature and sites source. Initial
posting is 250-300 words.
(5 pts)

Initial posting is missing some
components and/or does not fully
meet the requirements indicated
in the discussion prompt. Displays
incomplete integration or
understanding of course readings
or does not integrate course
readings or other scholarly
literature into posting. Initial
posting is less than 250 words
(2 pts)

No initial posting. (0 pts)

Quality of Peer
Responses

Reply posting(s) builds on the
ideas of other students,
contributes to developing new
discussion and deepening the
discussion. Responses are
supported by course readings
and/or other scholarly literature
Required peer responses are 150-
200 words.
(5 pts)

Reply posting(s) show an
understanding of the ideas of other
students, but may be restrictive in
developing new discussion or
deepening the discussion. Required
response(s) are supported by
course readings and/or other
scholarly literature Required peer
responses are 150-200 each.
(3 pts)

Reply posting(s) show basic
agreement or restatement of the
students’ ideas, but do not
develop or contribute to new
discussion. There is a lack of
support from the course readings
or other scholarly literature.
Required peer responses are less
than 150 words.
(1 pt)

No peer response. (0 pt)

Structure

Writing is clear, concise, and well
organized with excellent
sentence/paragraph construction.
Thoughts are expressed in a
coherent and logical manner.
There are no more than three
spelling, grammar, syntax errors,
or APA errors with in-text citations
and references.
(2 pts)

Writing is mostly clear, concise, and
well organized with good
sentence/paragraph construction.
Thoughts are expressed in a
coherent and logical manner. There
are no more than five spelling,
grammar, syntax errors, or APA
errors with in-text citations and
references.
For audio/video discussion post:
Discussion post is somewhat clear,
organized, and articulate. Credits
author/source in discussion.
(1 pt)

Writing is unclear and/or
disorganized. Thoughts are not
expressed in a logical manner.
There are more than five spelling,
grammar, syntax errors or APA
errors with in-text citations and
references.
For audio/video discussion post:
Discussion post is unclear, and/or
unorganized. Does not credit
author/source in discussion.
(.25 pts)

No posting (0 pt)

Online Discussion Rubric 2019
Updated 9/2019
Criteria Exemplary Satisfactory Needs Improvement Unacceptable
Quality of Initial
Posting
Initial Posting includes all
components and meets or exceeds
all requirements indicated in the
discussion prompt. Thoroughly
synthesizes, analyzes, and
integrates relevant ideas from
assigned readings and/or scholarly
literature and cites source. Initial
posting is 250-300 words.
(8 pts)
Initial posting/response includes all
components and meets all
requirements indicated in the
instructions. Each question or part
of the discussion prompt is
addressed. Displays basis synthesis,
analysis, or integration of ideas
from the readings and/or scholarly
literature and sites source. Initial
posting is 250-300 words.
(5 pts)
Initial posting is missing some
components and/or does not fully
meet the requirements indicated
in the discussion prompt. Displays
incomplete integration or
understanding of course readings
or does not integrate course
readings or other scholarly
literature into posting. Initial
posting is less than 250 words
(2 pts)
No initial posting. (0 pts)
Quality of Peer
Responses
Reply posting(s) builds on the
ideas of other students,
contributes to developing new
discussion and deepening the
discussion. Responses are
supported by course readings
and/or other scholarly literature
Required peer responses are 150-
200 words.
(5 pts)
Reply posting(s) show an
understanding of the ideas of other
students, but may be restrictive in
developing new discussion or
deepening the discussion. Required
response(s) are supported by
course readings and/or other
scholarly literature Required peer
responses are 150-200 each.
(3 pts)
Reply posting(s) show basic
agreement or restatement of the
students’ ideas, but do not
develop or contribute to new
discussion. There is a lack of
support from the course readings
or other scholarly literature.
Required peer responses are less
than 150 words.
(1 pt)
No peer response. (0 pt)
Structure
Writing is clear, concise, and well
organized with excellent
sentence/paragraph construction.
Thoughts are expressed in a
coherent and logical manner.
There are no more than three
spelling, grammar, syntax errors,
or APA errors with in-text citations
and references.
(2 pts)
Writing is mostly clear, concise, and
well organized with good
sentence/paragraph construction.
Thoughts are expressed in a
coherent and logical manner. There
are no more than five spelling,
grammar, syntax errors, or APA
errors with in-text citations and
references.
For audio/video discussion post:
Discussion post is somewhat clear,
organized, and articulate. Credits
author/source in discussion.
(1 pt)
Writing is unclear and/or
disorganized. Thoughts are not
expressed in a logical manner.
There are more than five spelling,
grammar, syntax errors or APA
errors with in-text citations and
references.
For audio/video discussion post:
Discussion post is unclear, and/or
unorganized. Does not credit
author/source in discussion.
(.25 pts)
No posting (0 pt)