Running head: COMMUNITY HEALTH ASSESSMENT 1

Community Health Assessment

Meghan O’Neal

Frostburg State University

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When it comes to Paw Paw, WV it is easy to overlook such a small town. Located in

Morgan County this town was incorporated in 1981 (Paw Paw, WV 2003). What this small town

lacks in size, it makes up for in historical value. Paw Paw, WV (2003) states “The town is named

for the Paw Paw fruit that grew abundantly in the area at the time. The near-by Paw Paw Tunnel,

was named for the town and is a major attraction for travelers along the C&O canal that runs

from Cumberland, MD to Washington, DC; which was built to by-pass the 6 mile stretch of the

Potomac known as the Paw Paw Bends. It opened for canal traffic in 1850, and continued

operating until 1923.” According to Paw Paw, WV Basic Facts (2018) the land area equals .53

sq. miles and 0 sq. miles of water area. This town also sits at a 574 feet elevation (Paw Paw, WV

Basic Facts, 2018).

Location

The housing sections of Paw Paw, WV do not seem to be in bad condition while viewing

from a windshield type of assessment. The average household value of this town is around $92,

032 as of 2016 as seen in table 10. For the 40.9% of the population that does not own a home the

average rent cost is around $588 which is also available in table 10. The poverty rate is 36.6%

with table 1 and 2 showing us the medium household income as $29, 821 as well as the

staggering rent to own ratios (Paw Paw, WV 2014). During the windshield assessment I was able

to see that the housing is mostly single family homes, not necessarily apartments or complexes

filled with multiple families. There are a few trailer like homes that sit closer to each other but it

does not appear to be a community within. Out of the ten of eleven houses I was able to view

during this windshield assessment it appears that possibly one is abandoned with no persons

living inside. It is obvious that the homeowners in this town do not value materialistic things
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such as lawn care or outside decorations. This could be due to a lack of extra money or possibly

just a personal preference.

After a closer look at imagine 12 it is obvious that this town is not very large and has one

main roadway that travels through the town which is route 9. Amongst the single roadway Paw

Paw it also neighbored by the Potomac River which is visible within the map displayed as

imagine 12. When it comes to waste disposal for this town, the state of West Virginia complies

with the requests of Republic Services which has been around since 1996 and collects a majority

of the resident’s trash weekly. Other residents reported disposing of their own waste at a nearby

dump in West Virginia. Paw Paw Waterworks is able to supply this town with its water

essentials and the main source comes from the surrounding Potomac River (State of West

Virginia Source Water Assessment and Protection Program Source Water Assessment Report,

2014). The average rain fall each year is approximately 37 inches (US Department of Health and

Human Services, 2018) which helps to contribute to the number of stream miles and movement

of water within the Potomac River. According to the US Department of Health and Human

Services (2018) “Water sampling conducted for the Paw Paw Water Works, which draws water

from the Potomac River, indicated no detection of semi-volatile organic compounds required to

be tested for.”

Finally the air quality index for Paw Paw could not be found but for the surrounding

towns the AQI is labeled as “good” with a ranking of 46. Any number below 50 is good for the

air quality index scale. The largest air pollutant found in this town according to the West

Virginia Department of Environmental Protection (2018) is ozone. Ozone can be defined as a

colorless unstable toxic gas with a pungent odor and powerful oxidizing properties, formed from

oxygen by electrical discharges or ultraviolet light (WV Department of Environmental

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Protection, 2018). Lastly, table 7 shows us that 43% of the residents in Paw Paw, WV rely on

electricity as their main source of heat, which is cause for concern when it comes to natural

disasters within such a small town. The potential for the entire electrical system to be down at

once is more likely in this situation.

People

After completing the windshield assessment of Paw Paw, WV it is evident that not only is

the population small here but there are also not many people outside at all throughout a days’

time. This population is a 92.1% Caucasian population, with a 2.6% Hispanic group, and a 2.4%

African American population (Paw Paw, WV 2018). With the large racial difference between

Caucasian residents and non-Caucasian residents it causes concern for a racial tendency,

especially being in such a small rural community such as this one. This is a cause for concern

when it comes to the health and safety of young children and young adults trying to make a

living within this community. According to table 9 the population is about 494 people, and of

those 494. 4.9% are unemployed as seen in table 9. This is a concerning number as table 9 also

shows that the entire state of WV has a 6.2% unemployment rate. I believe this unemployment

rate is directly affected by the fact that only 5.5% of the population have a Bachelor’s degree or

higher according to table 8. This information also directly correlates with the types of jobs listed

in table 3. The largest amount of people are employed under the construction and extraction

category, which does not always require a degree of some sort. However, if one does not have

the skills to be in this construction type of business then he or she is more than likely

unemployed according to the numbers. Unfortunately Paw Paw does not have a lot of job

opportunity within the town limits, and a majority of people over 30 minutes to get to a place of

work (Paw Paw, WV, 2018).

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Additionally the U.S Census Bureau (2015) tells us that 18.8% of the population in Paw

Paw are below the poverty line. This evidence is revealed in Table 13 which shows a pie graph

of both residents of the town below the age of 18 as well as senior citizens. Having both

populations with a percentage is a concern for the overall abilities of the community. The

questions begin to arise of will these people have the financial ability to purchase medications,

have transportation to appointments, or even pay a health insurance deductible. This poverty

level is also directly affected by the fact that residents of this town must travel for work.

Traveling for work requires a certain level of personal abilities, some of which include proper

self-health. If residents of Paw Paw cannot afford to maintain a healthy life style then they will in

turn not be able to travel such distances for work. Table 14 provided by the U.S Census Bureau

(2015) shows us that the majority of residents travel alone to work and up to 30.8 minutes in a

car. This type of commute tends to promote a more “quick fix” type of lifestyle, which includes

fast food for the sake of time saving, in addition to over the counter treatment sickness and

disease due to the lack of free time off from the commute and/or the workplace.

Social System

As for the overall health of such a small population the research has revealed that 31.2%

of people are overweight according to table 6. Additionally table 6 reveals that the average BMI

of Paw Paw residents is 28.4 According to Healthy People 2020 (2018) this BMI is also

considered to be in the overweight category. Table 11 and 6 give us a good insider look at why

this may be a problem with the decreased number of grocery stores, and increased number of

residents with poor nutritional health. This problem of a large portion of the population being

overweight ranks high on a plan of care for a healthier lifestyle within Paw Paw, WV. The

nursing diagnosis for this problem would be ineffective health maintenance related to poor eating
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and exercise habits as evidence by increased BMI across the residents of Paw Paw, WV.

According to Healthy People 2020 (2018) a goal for this population would be to allow this

population to learn more about healthy lifestyle choices regarding food and exercise. Two

objectives would be that first, the residents of Paw Paw are able to identify the proper foods

needed for adequate nutrition using the Healthy People 2020 website. Finally the residents would

also be able to identify age appropriate exercises that are suitable for any skill level using the

tools provided from the Healthy People 2020 website.

Unfortunately the closest health care centers and hospital for residents of Paw Paw, WV

is in Cumberland, MD at the Western Maryland Health System. Here patients can access the

Emergency Room, in patient care, as well as outpatient clinics and centers. Unfortunately the

residents of Paw Paw are outnumbered when it comes to visiting a physician for medical care.

The ratio of primary care providers to residents is 1 to 52, for dentistry the ratio is 1 to 29, and

finally mental health has a staggering ratio of 1 to 40 (Paw Paw, WV 2014). With these types of

numbers it is not shocking that the residents of this town are not able to prevent such diseases as

Pneumonia, or manage CHF and Diabetes. Healthy People 2020 (2018) is striving to improve

these rations and prevent these types of chronic patients from having to visit a hospital often. The

nursing diagnosis most appropriate for this ongoing issue would be ineffective healthcare

maintenance related to low provider to patient ratios as evidence by the mileage required to get

to a local healthcare facility. The goal for this problem would be to improve accessibility to

healthcare centers with objectives such as, providing public transportation to and from the closest

healthcare center such as WMHS. Second, provide proper information and benefits regarding

regular healthcare visits provided from the Healthy People 2020 website.
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In addition to weight loss, it is also evident by table 4 and 5 that heart disease and

pneumonia are statistically higher in this town compared to the entire state of WV. “In 2014 26

Medicare enrollees were treated for Pneumonia, and 19 were treated for Congestive Heart

Failure” (Paw Paw, WV (2014). These two diseases in particular are more often seen in the older

population which correlates with the information provided in table 10 which shows the medium

age to be 34.1 years old. In addition to these two diseases, table 5 also shows us how diabetes

care is also a high percentage of the Medicare enrollees. The nursing diagnosis most appropriate

for this problem would be ineffective chronic care management related to Pneumonia, COPD,

Congestive Heart Failure, and Diabetes as evidence by increased prevalence of disease within

population numbers. The goal would be to have a decreased exacerbations of these chronic

diseases most prevalent in Paw Paw, WV. With objectives such as, provide education on

symptom management described on the Healthy People 2020 website. As well as the promotion

of community care based home visits for these patients with chronic illness. In an attempt to

promote overall economy wellbeing an increase in healthcare resources would not only boost the

health of the residents but also help to create more funding opportunities for healthcare

initiatives. Priority based care would lead me to bring more access to healthcare for these

residents. Secondly, address the overweight population and provide more information regarding

a healthy lifestyle. With the goal of having patients within a normal weight range would then

lead me to the third initiative of providing all around better care for those suffering from chronic

diseases such as CHF, Pneumonia, and Diabetes.

In conclusion although small, Paw Paw has a lot of potential when it comes to the

expansion of jobs and healthcare. The numbers prove that this small town has not hit rock
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bottom and with an ever-growing need in the construction and dexterous type of jobs Paw Paw

could be a town full of growth and promise.

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References

Chapter 5- Public Services. (2018). In Public Services (pp. 1-14).

doi:morgancountywv.gov/resources/Chapter05_Public_Services.pdf

Office of Disease Prevention and Health Promotion (2018). Healthy people 2020. Retrieved from

https://www.healthypeople.gov/2020/topics-objectives/topic/Access-to-Health-Services

Paw Paw, WV. (2003). Retrieved April 13, 2018, from

http://www.townofpawpaw.com/

Paw Paw, WV. (2014). Retrieved April 13, 2018, from

https://datausa.io/profile/geo/paw-paw-wv/

Paw Paw, West Virginia. (2018). Retrieved April 13, 2018, from

http://www.city-data.com/city/Paw-Paw-West-Virginia.html
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Paw Paw, WV Basic Facts. (2018). Retrieved April 13, 2018, from

https://westvirginia.hometownlocator.com/wv/morgan/paw-paw.cfm

U.S. Census Bureau (2015). American community survey 5-year estimates. Retrieved from

Census Reporter Profile page for Paw Paw, WV.

https://censusreporter.org/profiles/16000US5462332-paw-paw-wv/

U.S. Department of Health and Human Services. (2018, April 13). State of West Virginia Source

Water Assessment and Protection Program Source Water Assessment Report (pp. 1-12,

Rep.). WV: WV Bureau for Public Health.

doi:http://www.wvdhhr.org/oehs/eed/swap/get.cfm?id=3303308

West Virginia Department of Environmental Protection. (2018). Air Quality Index. Retrieved

April 25, 2018, from https://dep.wv.gov/daq/air-monitoring/Pages/AirQualityIndex.aspx

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Table 1

Table 2
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Table 3

Table 4
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Table 5
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Table 6

Health and Nutrition:

Healthy diet rate:
This city:44.7%
State: 50.5%

Average overall health of teeth and gums:

This city: 36.7%
West Virginia:47.3%

Average BMI:
Here: 28.4
West Virginia:28.6

People feeling badly about themselves:

Here: 23.9%
West Virginia:21.2%

People not drinking alcohol at all:

This city:12.8%
State: 10.4%

Average hours sleeping at night:

Here: 6.8
West Virginia:6.9

Overweight people:
Paw Paw:31.2%
State: 34.2%

General health condition:

Here: 48.4%
West Virginia:56.8%

Average condition of hearing:

Paw Paw: 75.1%
West Virginia:77.9%
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Table 7
Most commonly used house heating fuel:

 Electricity (43%)
 Fuel oil, kerosene, etc. (31%)
 Wood (15%)
 No fuel used (8%)
 Bottled, tank, or LP gas (2%)

Table 8

For population 25 years and over in Paw Paw:

 High school or higher: 87.2%

 Bachelor's degree or higher: 5.5%
 Graduate or professional degree: 0.6%
 Unemployed: 8.8%

Table 9
Unemployment in September 2015:
Paw Paw: 4.9%
West Virginia:6.2%

Table 10

Population in 2014: 494

Males: 263 (53.3%)
Females: 231 (46.7%)
Median resident age:
34.1 years
West Virginia median
42.3 years
age:
Zip codes: 25434.

Estimated median house or condo value in 2016: $93,032 (it was $42,800 in 2000)
Paw Paw:$93,032
WV: $117,900
Median gross rent in 2016: $588.
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Table 11

Food Environment Statistics:

Number of grocery stores: 2
Morgan County:1.22 / 10,000 pop.
West Virginia: 2.41 / 10,000 pop.

Number of convenience stores (no gas): 2

Morgan County:1.22 / 10,000 pop.
West Virginia: 1.09 / 10,000 pop.

Number of convenience stores (with gas): 5

Morgan County:3.06 / 10,000 pop.
State: 5.38 / 10,000 pop.

Number of full-service restaurants: 10

Here: 6.12 / 10,000 pop.
State:6.22 / 10,000 pop.

Adult diabetes rate:

This county: 12.9%
West Virginia:12.2%

Adult obesity rate:

Morgan County:30.0%
West Virginia: 31.1%

Low-income preschool obesity rate:

This county:12.8%
State: 13.1%
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Image 12

Table 13
18.8% of Paw Paw, WV are below the poverty line.

Under age 18

36% Non Poverty

64% Poverty

Seniors (65 & Older)

9%
Non Poverty
Poverty
91%
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Table 14
30.8 Minutes in the mean travel time for Paw Paw residents to get to work.

Mean of Transportation to Work

3%6%
13% Drove Alone
Carpooled
Walked
Worked from Home
78%