Question

I used easybib for my paper and got a response this is not in apa format. Can you tell me why?

Introduction

The purpose of this project is to conduct a community assessment and apply the nursing process to an identified priority community health problem in Lynn, Massachusetts.

Lynn is located in Essex County. It borders Lynnfield, Nahant, Peabody, Revere, Salem, Swampscott, and Saugus, MA. Lynn, MA has a population of 92,074 people with a median age of 33 (McGillicuddy, "Community Background Report," n.d.).8 and a median household income of $50,774 (McGillicuddy, "Community Background Report," n.d.). Males in Lynn, MA has an average income that is 1 ("Torrance, CA," n.d.).33 times higher than the average income of females, which is $61,849 (Data USA, n.d.). The income inequality of Lynn, MA (measured using the Gini index) is 0.483 which is lower than the national average. Between 2015 and 2016 the population of Lynn, MA grew from 91,626 to 92,074, a 0 (Data USA, n.d.).49% increase and its median household income grew from $47,429 to $50,774, a 7 (McGillicuddy, Golden Beach Community Background Report, n.d.).05% increase. The population is 39% White, 38% Hispanic, and 11.5% black. Currently, 50.5% of the city speak a non-English language and only 81.3% are U.S. Citizens. The median property value is $263,700, taxes are approximately $3,000, with an ownership rate of only 44.1% which is lower than the national average. A large majority commute, while others own vehicles. The average car ownership is two cars per household (McGillicuddy, Golden Beach Community Background Report, n.d.). The economy of Lynn, MA employs 44,381 people. The economy of Lynn, MA is specialized in Admin., Support, Waste Management Services; Healthcare & Social Assistance; and Accommodation & Food Service, which employ respectively 1.41; 1.39; and 1.36 times more people than what would be expected in a location of this size (Data USA, n.d.). The largest industries in Lynn, MA are Healthcare & Social Assistance (8,617), Retail trade (5,443), and Accommodation & Food Service (4,848), and the highest paying industries are Professional, Scientific, Tech Services ($58,193), Educational Services ($48,896), and Finance & Insurance ($46,616). In 2018, 20% of the population live below the poverty line which is higher than the national average (Data USA, n.d.). Women between the ages of 25-34 living in Lynn have the highest rate of living in poverty (Data USA, n.d.). The most common racial/ethnic groups living below the poverty line in Lynn is the Hispanic’s or Latino’s followed by the White population (Data USA, n.d.). Insurance and Medicare coverage combined with state and county level health and safety statistics for Lynn, MA (Data USA, n.d.). The age groups most likely to have health care coverage are 6-17 and 45-54, men and women, respectively. The location has a 1 to 79 primary care clinician to patient ratio and a Medicare reimbursement average per patient per year of $9,285.

Community Resources

Lynn is a large city with over 92,000 but only has one hospital, North Shore Medical Center and Union Hospital, and that will be closing next year. Lynn Community Health Center offers walk-in services and has numerous primary care offices. There is a homeless shelter in the downtown area. There are numerous Christian parishes that help the needy and offer food banks throughout the city. Bay Ridge Hospital is located off of Boston Street and offers inpatient mental health and detox services for patients with insurance as it is a free-standing psychiatric facility. They do offer day treatment for mental health and partial hospitalization services for individuals who need more mental health structure. Habit Opco is an outpatient provider of Suboxone and is also a methadone clinic. The city does not have enough treatment available for opiate addicts and there is not a public detox available for Medicaid and Uninsured patients. The nearest public detox is in Danvers, MA. For the first 6 months of 2018, there are 657 confirmed opioid‐related overdose deaths in Massachusetts. Statistics from the Massachusetts Department of Health indicate that overall, opiate overdose deaths are down in Massachusetts since 2015 but this is not the case in Lynn. Lynn had 25 such deaths in 2013 and 60 overdose deaths in 2017. There are few half-way houses available in the city as Sober Living has recently added some housing in the city over the past 2 years now.

Problem Identification from Data

There are not enough resources to meet the needs of Lynn’s growing population and things will get worse when North Shore Medical Center at Union Hospital closes in 2019. There has been talk of a walk-in center opening there in its place that will provide day-time ES services from North Shore Medical Center much like the newer center built in Danvers, MA. but those plans have not been finalized to date. While being partially met in the city of Lynn, I feel that the lack of free influenza shots available and the lack of adequate opioid treatment options are two glaring unmet needs in the Lynn community.

CVS, Walgreens, and Rite Aid Pharmacies all offer the influenza shot for those who have insurance or are willing and able to pay for the influenza shot but there are little plans to provide influenza clinics in the city. There are three such influenza clinics planned for this year by the city of Lynn but there are no dates set yet for when they will be and as I write, it is influenza season. The city of Lynn is down one full-time RN and does not have the budget to provide more free influenza clinics according to the City of Lynn Public Health Meeting that I attended. In a city that has a population that has a poverty rate of 20%, this is simply insufficient. We have learned much in treatment and prevention from the world-wide flu break-out of 1918. It has only been 100 short years in history, but we have learned that we must have constantly updated vaccines that combat this plague to our societies even 100 years later. We must insure that we vaccinate as many of the at risk population as well as the rest of our city population in Lynn. As Wendy Paramet and Mark Rothstein wrote in the American Journal of Public Health in October of 2018, we must learn to always continue to research the influenza virus and produce better vaccines in the fight against this continually evolving virus with multiple ("American Journal of Public Health," n.d.).

There is a methadone clinic and there are some Suboxone providers scattered throughout the city but not nearly enough to meet the growing needs of this current opioid epidemic. Heroin, fentanyl, and other opiates are cheap and widely available in this inter-city. The number of deaths by opiate overdoses has risen every year in Lynn since 2013 according to Massachusetts Department of Public Health statistics with the number of deaths more than doubling from the 2013 number of twenty-five to the 2017 number of deaths at 60. These numbers do not include the crime, punishments, money spent, countless hours of family heartaches, and human pain and sorrow that goes along with these deadly drugs being used by the citizens of this diverse inter-city. The country as a whole has been in an opiate crisis for quite some time now and a major reason for this is that there simply is not enough education and treatment available in most US cities, Lynn is not an exception here.

Data Analysis

According to the most recent data from the CDC, there were 51,537 deaths from influenza-related deaths in 2015 nation-wide. The most vulnerable populations are the elderly and young children. These are also two of the most unlikely populations to seek out the shot without assistance. Pregnant women and people with compromised immune systems are also at greater risk for the flu as well. The CDC advises all people over 6 months old to get the flu vaccine this year as they expect large numbers of cases for the 2018-2019 flu season. On a national level, only 59.3% of all Americans from the ages of six months old- seventeen year olds got the flu shot in 2015-2016 during flu season. The percentage of over eighteen year olds who received the flu shot in that same year was only 41.7 % according to the CDC statistics. The latest data available from the CDC on “flu activity” lists Massachusetts in the Moderate Category for the Flu Season of 2017-2018. Current flu data indicate that there have been 61 influenza cases this year in the Lynn area so far and we just now approaching flu season which typically runs from October from March.

According to the Massachusetts Department of Public Health (2018), the number of deaths from opiate overdoses has decreased in Massachusetts since 2013. This is not the case in Lynn, MA, as the number of deaths by opiate overdoses has increased every year over the past five years now. The United States is experiencing an epidemic of opioid usage, opioid addiction, and opioid overdoses (Centers for Disease Control and Prevention, 2016). Since 2000, the rate of deaths from drug overdoses in the United States has increased 137% according to CDC statistics (Centers for Disease Control and Prevention, 2016). Drug overdoses and deaths affect all of us in our families and as professionals. Opiate-related deaths are defined as mortalities that occur from prescription opiates and “street” opiate drugs such as heroin and fentanyl, which unfortunately are both cheap and abundant in America’s cities right now. The Rates of opioid overdose deaths also increased significantly 7.9 per 100,000 in 2013 to 9 .0 per 100,000 in 2014 ("Increases in Drug and Opioid Overdose Deaths - United States, 2000–2014," n.d.).

These findings and data indicate that the opioid epidemic in our cities has worsened significantly and steadily since 2000 in the United States (Centers for Disease Control and Prevention, 2016). Lynn has a significant need for continued actions, education, and treatment options to help prevent opioid dependence and usage and to reduce the street supply of available opiates in this community. While there are some resources available in the community, there are not enough resources, and the data showing the number of increased deaths from opiate overdoses bares this horrific data out.

Conclusion

My Service Learning Project or SLP will be setting-up an influenza clinic at Sacred Heart School in Lynn, MA. Because there is a public health nurse shortage for the city, there are not enough flu clinics being held for the public. The parish was nice enough to allow me to do this in conjunction with the city of Lynn Health Department. I have been granted permission to do this by Michele Desmarais, Public Health Director for the city of Lynn, MA. I will be meeting with her again in the next two weeks to set-up the date of the flu clinic and getting the flu shots to administer. There will be no cost to anyone who does not have insurance or cannot pay for the influenza vaccine. Those who have health insurance will be covered by their insurance plans. This will allow more people to get vaccinated as well as help the city meet their goals in immunizing the citizens of Lynn. I have also set-up hand watching stations (Purell Dispensers) at Sacred Heart School and provided them with Clorox Bleach wipes as Sacred Heart had to close their school for three days last year due to an influenza outbreak at the school. With 61 reported cases of the flu in the Lynn area this year already and the school that I will be holding the flu clinic in conjunction with proper hand washing education, I am confident that my SLP can help to make a difference in this community. Preventative medicine is always more effective and costs less in the long haul over treatment and cures research has consistently shown in the nursing field.

References

American Journal of Public Health. (2018, October 10). Retrieved from

https://www.apha.org/publications-and-periodicals/american-journal-of-public-health

(2016, January 01). Retrieved from https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6450a3.htm

“Current Opioid Statistics.” Mass.gov, www.mass.gov/lists/current-opioid-statistics#updated-data---q2-2018---as-of-august-2018-.

Increases in Drug and Opioid Overdose Deaths - United States, 2000–2014. (2016, January 01). Retrieved November 04, 2018, from https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6450a3.htm

McGillicuddy, D. (n.d.). Retrieved from http://dpantherdev02.ad.fiu.edu/itis/cbr/golden_beach_townof.html

(n.d.). Retrieved from https://datausa.io/profile/geo/torrance-ca/

(n.d.). Retrieved from https://www.mass.gov/files/documents/2018/08/24/Opioid-related%20Overdose%20Deaths%20among%20MA%20Residents%20-%20August%202018_0.pdf

Answer 1

Answer: Your APA format is not correct, just for your convenience here are some guidelines to correct your format:

1. Utilize a standard inches paper or page.
2. The paper, when submitted in APA format, should always be double-spaced.
3. 12-point Times New Roman is the most accepted font.
4. Include a header on the top-left corner and a page number on the top-right corner on each page.
5. The author's last name and the year of publication, for example: (Rose, 2009).