Running head: BIG RAPIDS WINDSHIELD SURVEY

Big Rapids Windshield Survey Sara Staffen Ferris State University

BIG RAPIDS WINDSHIELD SURVEY Big Rapids Windshield Survey Community reflects a small, social unit of varying size that includes the living environment and people that share common values. I tend to think of a community as a group of

people living within a certain proximity to each other that share similar lifestyles, interests, local government, religion, occupations, incomes, heritage, and common values or morals and beliefs. Community health is an important component of any population; therefore an entire sector of nursing is dedicated to community wellbeing and health care. Community health can be broken down into several categories including: relevance of health problems in the specified community, focus areas of community health practice, availability of health care services, and the utilization of those health care services based on the population being served. Community health nurses can work in a variety of settings that teach health promotion and disease prevention, including the patients home, walk-in clinics, schools, migrant health clinics, federally mandated clinics, and more. (Mandleco & Potts, 2012) According to a study done by Gilmore, B., & McAuliffe, E. (2013) 99 percent of maternal and child deaths occur in low income communities where there is a severe shortage of resources for health care. Community health care nurses are identified as a distinguishing feature by providing primary care for individuals in communities lacking resources. Community health nurses provide essential care at the household and community level, reducing inequalities in health care for low income populations, providing education and preventative health services, and allocating continuity of care by acting as a facilitator between the community and other health care workers and facility-based services. Community health nursing is population based and focuses on the health care disparities of an entire community or population, not just a specific patient.

BIG RAPIDS WINDSHIELD SURVEY One of the Healthy People 2020 health indicators is children aged 19 to 35 months who receive the recommended doses of DTaP, polio, MMR, Hib, hepatitis B, varicella, and PCV vaccines(IID-8). (Healthy People, 2013). Nurses play an integral role in not only administering recommended immunizations to children but also in educating the parents on the importance of these vaccinations. Generally populations with lower incomes, below the poverty level also are less educated. This lack of education also includes a health care knowledge deficit. Nurses can play a role in educating the community on the importance of immunizations, protecting themselves and the community as a whole, from the spread of preventable diseases. Big Rapids does have a proportionate amount of physicians and medical clinics for the number of people in

the community, but without proper information and education people might not access the health care or immunizations at the appropriate times. Community Health Risks Transportation in Big Rapids and the surrounding areas is a significant problem that could be a potential health risk for the community. Although there are several public buses and modes of transportation, there is nothing that runs on a regular schedule. In order to access public transportation in Big Rapids, you must pay a fee and be within specific city limits. This is a potential health risk because it could prevent a community member from accessing health care on a regular basis or even eating fresh healthy foods if it is difficult for them to get to a grocery store. The number of fast food establishments, sit-down restaurants, and bars in the Big Rapids area is probably typical for a developing city, but I think for per capita it is rather high. The entire population of Big Rapids in 2012 was 10,702 people according to the US Census Bureau and there are currently over 20 restaurants and 7 bars within the community survey boundaries.

BIG RAPIDS WINDSHIELD SURVEY This over abundance of restaurants can lead to potential health risks because of its convenience; people will tend to eat unhealthy foods more frequently. The high number of bars also has the potential to lead to higher rates of alcohol abuse. The vast array of fast food choices may be a contributing factor in the obesity and morbidity rates in Big Rapids. The higher rates of poverty and lower rates of education are also likely an equal component. According to the Michigan Care Improvement Registry (2012) 16% of Mecosta County does not have a high school education, 23% live below the poverty line, and the median house hold income is roughly $37,000. These statistics extend outside of the community survey boundaries, but I think they still give a good overall generalization of Big

Rapids. There is a direct correlation between low income, lack of education, and increased health risk behaviors. All of these factors contribute to the overarching 27% obesity rate that is evident by people that are seen in the community and walking on the streets. Although there is a hospital within roughly five miles of all of the citys boundaries and at least 5 medical clinics or Doctors office within the survey boundaries, that doesnt make health care in Big Rapids accessible to all. As mentioned before there is a lack of reliable transportation and a high rate of poverty which can implicate an underinsured population. According to the Michigan Care Improvement Registry (2012) 23% of Mecosta County is uninsured and another 16% of the community does not access health care due to cost. Not accessing regular health care including screenings and disease prevention measures will end up being more expensive in the end when a seemingly preventable problem turns chronic. The insight I gained in performing this community windshield survey is that all of the potential health risks that I observed relate back to each other. Poverty, no transportation, lack of

BIG RAPIDS WINDSHIELD SURVEY education, a multitude of fast food, and no health insurance all lead to increased health risk behaviors and less access to regular health care.

BIG RAPIDS WINDSHIELD SURVEY References Gilmore, B., & McAuliffe, E. (2013). Effectiveness of community health workers delivering preventive interventions for maternal and child health in low- and middle-income countries: a systematic review. BMC Public Health, 13, 847. Mandleco, B. L. RN, PhD, & Potts, N.L. RN, PhD. (2012). Pediatric Nursing: Caring for Children and Their Families. Clifton Park, NY.: Delmar. Retrieved from STAT!Ref Online Electronic Medical Library. Michigan Department of Community Health. Michigan Behavioral Risk Factor Surveillance System. (2006-2010). Retrieved from http://dhd10.org/images/Mecosta_Chartbook_2012_April_2_2013.pdf U.S. Census Bureau: State and County QuickFacts. (2013) Population Estimates, American Community Survey, Census of Population and Housing, County Business Patterns, Economic Census, Survey of Business Owners, Building Permits, Census of Governments. Retrieved from http://quickfacts.census.gov/qfd/states/26/2608300.html. U.S. Department of Health and Human Services. (2013, July 30). Healthy People 2020 Leading Health Indicator Topics. Retrieved from http://www.healthypeople.gov/2020/LHI/2020indicators.aspx

BIG RAPIDS WINDSHIELD SURVEY Appendix A Community Assessment

Housing and zoning 1950s era, 1-2 story one family houses in residential area. College housing 2-3 stories, older homes made into apartments. Most houses appear to need some updates and paint. Not much landscaping, small side and back yards. Street lights on most main and side roads Transportation Race and ethnicity

Dial-a-ride public bus Bulldog taxi Back Country taxi The Rapid (transportation to

93% Caucasian (In Mecosta County) FSU students add diversity to the city

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Personal Vehicles Walking Biking Rails-to-trails Plentiful sidewalks in most

residential and business areas

Service centers 8 Dentists 3 Optometrists 6 Doctors/4 Chiropractic Planned Parenthood 4 Pharmacies 6+ Hair Salons 4 Used auto sales 5 Auto stores 8 Churches 20+ Restaurants 7 Bars 2 Bakeries 4 Gyms Movie Theatre 5+ Insurance agencies 3+ Realty firms 4 Fire/Police stations Secretary of State City Hall Court House/Sheriff Religion and politics

Open space

Parks (maintained small parks, some with play equipment) Hemlock, Holland Rest Park, Mitchell Creek Park, Pocket Park Parking lots: abundant throughout the community, FSU mainly, several city & business owned

An abundance of churches per the population Mainly Christian religions, different denominations however 1 Seventh Day Adventist Church Political signs only evident near election time of year Small town issues: zoning, small business problems, etc. Few visible political signs for all different parties Church/Elderly peace protestors near family video

BIG RAPIDS WINDSHIELD SURVEY

Boundaries Stores and street people 2 Hardware stores 3 Party stores 4 Resale shops 2 Furniture stores Many small independent shops downtown 2 Jewelry stores College students walking FSU employees walking (business attire) Unaccompanied minors around parks and city sidewalks Several people walking in their work uniforms to fast food restaurants Young people (students) in good shape seen running on sidewalks Overweight people seen walking on the sidewalks Health and morbidity

North: West Ave (fairgrounds road) East: Ives Ave (East FSU Campus) South: Northland Drive (Health Dept./Pizza Hut) West: Sheridan Ave (residential); State St. (business)

Major hospital within approx. 5 miles of every city border Many Medical Clinics Morbidity: low-income, high rates of obesity, high rates of health disease and cancer (Mecosta County) Alcoholism: potential problem with college students

Commons Rite-Aid Parking Lot (high school/college male hangout) Bars (Shooters, Schubergs, Crankers, The Pub, The Gate, BWW) Biggby Coffee (college study place) FLITE library (FSU students & community) Parks (family centered)

Signs of decay Abandoned Buildings: of Simmonds International?, empty lot by Family Video, Old China Fair, Old El Burrito, and Hanchett. Some run down houses/buildings that have been abandoned, mainly privately owned or for sale, some in the process of being worked on A lot of houses in the community (rentals & residential) need updates and painting or new siding and roofs. Not much landscaping commonly

Media Some TV antennas in yards. Direct TV and Charter cablemost commonly News Papers: Pioneer, TriCounty, Torch, Grand Rapids Press Radio Stations: 100.9country & 102.3- pop music Magazines-in stores People, Readers Digest, Recipe Books, & pop culture magazines Wi-Fi access EVERYWHERE 1 Movie Theatre 1 Movie Rental 3 Redbox Movie Rental