Arthritis Foundation Community Assessment of
(Community Name)
q Introduction
q Demographics
o Age Breakdown
o Income
o Education
o Racial Classification
o Economic Profile
q Arthritis Burden
o Arthritis Prevalence
o Health Behavior/ Impact data
q Leadership
o Key Leaders
q Community Profile
o Top 10 Employers
o Media
o Medical Facilities
o Education
o Major Industries
o Community Organizations Serving the Community
q Mission
o Current Arthritis Foundation Activities
o Physical Activity
o Availability of Medical Care
q Fundraising
o Arthritis Foundation Special Events
o Other Non-profit Organization Events
Introduction
Below is an assessment of the (Community Name) Community. This assessment tool will allow the identifying of key employers, healthcare facilities, leadership and opportunities in this community and assist in future planning for growth.
Here are some resources to use to help you get started in this assessment:
· Local chamber of commerce
· Visitor’s bureau
· Phonebook/Internet directories
· Local Library
· Book of Lists
· www.census.gov
· www.cdc.gov
As the community changes, the assessment should reflect those changes in order to be utilized for effective community planning. All calculations should be provided based on the most current statistics available at the time of this report.
Demographics
(Community Name)Market size / (small, medium or large)
Population / (# of people)
Population Growth between 1990 & 2000 / (% of Growth)
Female / (% Female)
Male / (% male)
Poverty rate / (mild, moderate or severe)
(%) of the people living below the national poverty line. / (%)
The following report is a description of the socio-demographic characteristics of the community and the leading Arthritis issues.
Age Breakdown:* Source: (List Source)
Age / Population Count / % of Population<20
21-44
45-64
65+
Income: *Source: (List Source)
The following is based on information from the (DATE) census. Income percentages are calculated by number of households.
Income / Household Count / % of Household<$15,000
$15,000-$49,999
$50,000-$99,000
>$100,000
Education: *Source: (list source)
Education Level / Number / % of PopulationLess than 12 years
High school or GED
13-15 years (college/technical school)
4-yr college degree and higher
Racial Classification: *Source: (List Source)
Race / Population Count / % of PopulationCaucasian
African-American
Latino/Hispanic
Other
Economic Profile: *Source: (List Source)
(%) percent are below poverty level compared to a state level of (%.)
The (Community Name) community consists of (list cities that are in this community or county.)
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1. ______
2. ______
3. ______
4. ______
5. ______
6. ______
7. ______
8. ______
9. ______
10. ______
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Arthritis Burden
The following is a picture of the overall Arthritis prevalence figures in (Community Name) community:
Check state health department Behavioral Risk Factor Surveillance System (BRFSS) data, CDC web page, surveys done by local academic/ arthritis center, large health plans, employers & chapter information and referral requests.
· Estimated total number of people with arthritis:
· Arthritis prevalence rate:
· Any populations identified with higher arthritis prevalence rate? (List here and identify prevalence rate):
(DATE) Arthritis Prevalence Source: (List Source)
Sex / Community[note that not all states will have county or community level data through the BRFSS database] / State
Male
Female
Health behavior/ impact data:
Behavior/Impact Data / Approximate # / % of PopulationHave not seen doctor for arthritis diagnosis
Overweight
Inadequate physical activity level
Report activity limitations due to arthritis
Report significant arthritis pain
Report work loss/ limitations due to arthritis
Local Health plan data on medical costs due to arthritis
Other health indicators- list
Leadership
Key Leaders who serve in local or national leadership positions:
Leaders with the Arthritis Foundation Local leaders (Local or National) (Mayor, Chamber President etc.)
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1. ______1. ______
2. ______2. ______
3. ______3. ______
4. ______4. ______
5. ______5. ______
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Community Profile
The following is a profile of major employers in (Community Name) community.
Top 10 Employers: / 1.______2.______
3.______
4.______
5.______/ 6.______
7.______
8.______
9.______
10.______
Media: / (#) Local radio stations
(#) Local newspapers
(#) Local television stations
Education: / (#) Public Elementary Schools
(#) Public Middle Schools
(#) Public High Schools / (#) Universities
(#) Medical Schools
(#) Research Institutions
Medical Care
Healthcare & Medical Industry / (#) Physicians
(#) Major hospitals / Healthcare systems:
1.______
2.______
3.______
4.______
5.______/ Major institutions involved with Arthritis Healthcare
1.______
2.______
3.______
4.______
5.______
Other Potential Partners* / 1.______
2.______
3.______
4.______
5.______
Arthritis-Related Doctors: / (#) of Rheumatologists
(#) of Pediatric Rheumatologists / (#) Orthopedic Surgeons
(#) of Physical/Occupational Therapist
Community Organizations Serving the Community
(Places of worship, civic groups, etc.) / Places of Worship (by system or organization size):
1.______
2.______
3.______
4.______
5.______/ Civic Clubs / Organizations:
1.______
2.______
3.______
4.______
5.______
Tour of the Town / (Attach copy)
*Organizations with access to large numbers of people with arthritis, multiple delivery points/meeting facilities and ability to sustain programs over time, e.g. hospital systems, health club chains, area agencies on aging, area health education centers, university extension services etc.
Mission Activities
Current ArthritisRelated Physical Activity Programs: (Add contact information for how people can find out about this program in your Chapter)
Program / Contact person & phone / Location / AddressArthritis Foundation Exercise Program
Tai Chi from the Arthritis Foundation
Arthritis Foundation Aquatic Program
Active Living Everyday
Arthritis Foundation Walk with Ease Program (group led)
Enhance Fitness
Fit and Strong!
Service:
# of Arthritis Patients in (Name Community) / # of Patients Servedin (Name Community) / # of Arthritis Patients in (Name State)
List below the major health, wellness and fitness organizations in the community (major health facilities, neighborhood community health centers, local health departments, fitness clubs etc.) and check off the programs they offer:
Facility / site location name / Contact person & phone number / AF Program / Other type of physical activity offeringsSelf-Help / Aquatic / Ex / Pool / Exercise / Weight machines / Walk club / Walk trail / Bike trail
Fundraising
Identify current Arthritis Foundation activities in the community.
Arthritis Foundation Special Events(Name of Event) / Type (Walk, Gala, Golf, JBR, etc.) / Date / Approx. Amount Raised
Other Community Events (non AF)
(Name of Event-include name of non-profit organization) / Type (Walk, Gala, Golf, JBR, etc.) / Date / Approx. Amount Raised
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