NR 443 Week 2 Discussion – Demographic and Epidemiological Assessment

NR 443 Week 2 Discussion – Demographic and Epidemiological Assessment

The county I chose to write my demographic and epidemiological discussion about this week is the one in which I currently live – Marshall, NC, in Madison County. Located in the beautiful Appalachian Mountains and right next to the French Broad River, our rural town and larger sister cities attract many tourists who like to hike, bike ride, fish, leaf look, or just enjoy our culture-rich Mountain arts, music, and scenery. According to the U.S. Census, Madison County has a population estimate of only 21,340 compared to our larger sister city of Asheville, N.C., with a population of 89,121, which has increased by 2.7% since 2010 (U.S. Census Bureau, 2016). Madison County residents are proud of their land, with most having lived on or inherited land from their ancestors. Having only one local Ingles grocery store with no Starbucks and limited produce selections, residents tend to rely on local farmers who set up their produce stands on Saturdays at the local Farmer’s Market stand. Steeped in Southern Baptist heritage, many residents in this community are Caucasian, around 96.1%. The Latino community comprises 2.6% of the population, while African Americans make up only 1.7%. Other races make up more than 1% (U.S. Census Bureau, 2016). High school graduates and higher make up around 80.7%, as some locals were raised within farming families. There are 8,450 households in Madison Country, with about. 2.36 persons per household, according to the U.S. Census Bureau (2016). The ratio of males to females is about 49.6%:50.4%, with the highest age prevalence of residents being of retirement age over 65 years at 20.6% (U.S. Census Bureau, 2016), adolescents making up 18.6% and children under the age of 5 only 4.9%. Our little town is not far above the poverty line, with an average household income of only around $37,904 compared to the $53,889 national average. And since there are few places to work around town, most residents are forced to make the 16-mile trek to the next big city, which is about a 27-minute commute. This can be straining on the community, sacrificing both time and gas expenses.

According to Madison County’s health rankings, the leading cause of death before the age of 75 were Cancer (highest prevalence), Heart disease, and unintentional injuries. 17% of the population is considered to be in fair or poor health. Smoking remains high at 18%, 25% adult obesity, 7.6 food environment index, 24% physical inactivity, 40% access to exercise opportunities, 16% excessive drinking, 27% alcohol-impaired driving deaths, 157 reported cases of sexually transmitted diseases, and 28 teen births (County Health Rankings, 2017). There is a high rate of children in poverty at 29%, 5.7% are unemployed, and only 63% get regular mammography screenings (County Health Rankings, 2017).

NR 443 Week 2 Discussion – Demographic and Epidemiological Assessment

It is important to collect data within communities to help prevent the spread of diseases by identifying associated factors in disease development (Nies & McEwan, 2015). There are several areas of concern regarding public community health in Madison County. According to the area’s largest Healthcare System’s assessment of Madison County’s community health, priority areas include chronic disease, child health, and mental health/substance abuse as of 2012. Some definite opportunities for improvement would be in the areas of better access to preventative healthcare, treatment for chronic illnesses, improved child health outcomes, and Improved access to mental health services, with poverty continuing to pose a large threat to this area (Madison County Community Health Assessment, 2012). Healthcare providers offering services to this community must be sensitive to the general attitude toward healthcare from the residents. These residents tend to view healthcare in terms of how their grandparents viewed it. In other words, some common sayings would be, “If it ain’t broke, don’t fix it,” “It’s not bad enough to see a doctor yet,” and “Why should I see a doctor every year if there’s nothing wrong with me?” So, there is a definite need for education regarding regular screenings to prevent Cancer and regarding better management of chronic illnesses, perhaps at community health fairs, art festivals, churches, or the local farmer’s market stand. Another barrier preventing residents from obtaining much-needed mammograms, for instance, is the lack of diagnostic centers. Residents are forced to make the long drive to the city for such services, which can sometimes be a deciding factor for people in terms of whether they should even bother at all. Tobacco use most likely contributes to the high mortality rates of lung cancer, heart disease, and lower respiratory illness as compared to N.C. overall. With baby boomers making up much of the population, tobacco use is also culturally related, as this used to be “tobacco land,” after all. Residents of this community are proud of their deep roots in the industry. Poverty and lack of health insurance play a big role in terms of preventative healthcare, screenings, and dental care. Access to mental health providers is a big problem due to a lack of funding at the state and federal levels. An example of this is the emergency overflowing with mental health patients having to stay for days at a time due to the shortage of rooms available for this patient population. The sad truth is that 27% of those surveyed in 2011 were told they only have depression or anxiety (Madison County Community Health Assessment, 2012).

References:

County Health Rankings (2017). Retrieved from http://www.countyhealthrankings.org/app/north- Carolina/2017/rankings/madison/county/outcomes/overall/snapshot

Madison County Community Health Assessment (2012). Retrieved from http://www.mission- health.org/mydocuments/download.php? f=2012_madison_county_community_health_assessment.pdf

Nies, M. A., & McEwen, M. (2015). Community/Public health nursing: Promoting the health of populations (6th ed.). St. Louis, MO: Saunders/Elsevier.

U.S Census Bureau (2016). Retrieved from https://www.census.gov/quickfacts/fact/table/madisoncountynorthcarolina,ashevillecit north Carolina,US/PST045216

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NR 443 Week 2 Discussion – Demographic and Epidemiological Assessment

For this discussion, you will collect assessment data about your city or county. This post will include information about demographics (general characteristics). You will then find epidemiological data (disease or health behavior rates) about one priority health problem in your community.