Data Collection Worksheet Template
Name: Parveen Qureshi
Statistical Information is from what City or County: Suffolk County, New York
Health Topic : Alzheimer’s Disease
SECTION ONE: Data Collection
Demographics-Related Data | ||||
Indicators | Data from Your
Chosen Location (City or County) |
Data for US * |
Data Source
(Cite appropriately) |
Sampling Notes |
Overall population of area of focus | 1,476,601 | 328,239,523 |
https://www.census.gov/quickfacts/fact/table/suffolkcountynewyork/HCN010212 |
Estimates from July 1,2019 |
Population under the age of 5 | 5.4% | 6.0 % | ||
Population over the age of 65 | 17.3% | 16.5 % | ||
Population of male and female | Female : 50.8%
Male : 49.2 % |
Female : 50.8%
Male : 49.2 % |
||
Ethnic backgrounds | ||||
Percentage of non-native speaking population/ households | ||||
Education levels | ||||
Income levels | ||||
Poverty level
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HEALTH RELATED DATA | ||||
Indicators | Data from Your
Chosen Location (City or County) |
Data for US * |
Data Source
(Cite appropriately) |
Sampling Notes |
Life expectancy | ||||
Infant mortality | ||||
10 diseases with the highest mortality (or prevalence) | 1. | |||
2. | ||||
3. | ||||
4. | ||||
5. | ||||
6. | ||||
7. | ||||
8. | ||||
9. | ||||
10. |
* International students – data from your country
References:
SECTION TWO: Proposal Outline – Final Project InitiativeProposal
Write 2-3 paragraphs comparing and analyzing your city or county data with US data (or your country).
State the health issue you are choosing for your population health initiative (one – twosentences):
Explain why you chose this health issue (one – twoparagraphs):
Describe your chosen population. Be specific by providing demographics to fully explain your population(provide two – three sentences to explain why these demographics areimportant):
List and describe three objectives you hope to accomplish with your initiative (one sentence for each objective). Use the SMART topics as a guide. (SMART – specific, measureable, actionable, reasonable, time bound)
1.
2.
3.
Describe two – three activities you will use to accomplish each of these objectives (one – two sentences for eachactivity).
Directions: Writethe activity on the line by the number and then use space underneath the number to provide specific discussion. Please bespecific in describing the activity. For example, if you want to have a 10 K race, state details about the event.
Three Activities for Objective 1
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2
3
Three Activities for Objective 2
1
2
3
Three Activities for Objective 3
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2
3