Community Health Survey

Community Health Survey

Jessica Listman-Ward
Frostburg State University

Community Health Survey

Introduction

Community health nurses must always be aware of the community in which they serve,
as well as the surrounding ones. Having a good understanding of the location, population and
social system of a community is essential to being able to serve and provide resources. Without
a good understanding of the community a nurse is unable to evaluate problems in the
community, and ways to fix them. Nurses utilize the Healthy People 2020 initiative to educate
and prevent issues that are prevalent within a community. The evaluation of a local community
and its resources can help give a better understanding of the needs that must be met.
Community as a Place
Easton, Maryland is a community located in Talbot County on Marylands Eastern Shore.
The town was founded in 1710 (Easton, 2014), and it is the county seat. According to the United
States Census Bureau the town is 10.56 square miles with 0.11 square miles of water (Unites
States Census Bureau, 2014). Below are two maps that illustrate how the town is located near
waterways. Map 1 highlights the county that the town in located in and the surrounding counties
in the state of Maryland. Map 2 is a close up of Talbot County. It shows where the town of
Easton is located. This map shows that the county seat is the largest town in the area. The town
is located near several waterways.

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Map 1 provided by Easton.org

Map 2 provided by Easton.org

Table 1 illustrates the housing condition of the town versus the state of Maryland.
Easton

Maryland

Housing units, 2010

7,405

2,378,814

Home ownership rate 20082012

63.8%

68.1%

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Housing units in multi-unit

structures
Median value of owneroccupied housing units 20082012

25.8%

25.5%

$291,300

$304,900

The table shows that the town is competitive with the state. The housing market is at par with
the state. Over half of the community owns a home. This shows that the town is able to keep up
with the housing market as compared to the state. This shows that the town is prospering within
the state.
People of the Community
The United States Bureau of Statistics follows up on the population of communities.
This is something that community health nurse needs to be aware of as well. Table 2 shows
some of the statistics that a community health nurse needs to look at when evaluating a
community. This data is for the town of Easton.
Table 2
Easton

Maryland

Population, 2013

16,687

5,928,814

Population, 2012

16,604

5,884,868

Persons under 5 years, 2010

6.3%

6.3%

Persons under 18 years, 2010

22.3%

23.4%

Persons 65 years and over,

2010

21.2%

12.3%

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Females, 2010

53.6%

51.6%

White, 2010

53.6%

51.6%

Black or African American,

2010

17.2%

29.4%

Hispanic, 2010

9.8%

8.2%

Graph 1
This table shows that there is a large Hispanic population. This is also depicted in the visual pie
graph. Race and ethnicity need to be considered when one looks at the health needs of the
community. Race is important when considering health issues. For example, research has
shown that there is a link between African Americans and cardiovascular disease. There is a
large population of African Americans in the town. Health conditions that are higher in that race
should be considered.
In addition, the Hispanic population is higher in the town than when we look statewide.
We need to consider the fact that some of them might speak Spanish and/or little English.

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Therefore when we educate the public we need to take the non-English speaking counterparts
into consideration. We many need to consider the use of interpreters when talking to the
community and possible patients.
Looking at the population data, there has been an increase in the population by 83 people.
Therefore one can see that the community is growing. There is a large percent of people over the
age of 65. In fact the town of Easton has a greater percentage than the overall state. This
suggests that the senior population in the town is growing as well. Community nurses need to
look at the age of the community when thinking of how to best serve the community. Nurses
need to consider ways to assist the older population. According to Judith Allender (2014),
growth in the aging population will present opportunities for nurses to work with communities
to strengthen and build programs and services that focus on supporting the aging populations
highest functional level (p. 783). With 21.2% of the population considered seniors this type of
growth needs to be taken seriously when planning community outreach and educational events.
Table 3
Easton

Maryland

High school graduate or

higher age 25+ (2008-2012)

89.0%

88.5%

Bachelor degree of higher age

25+ (2008-2012)

31.0%

36.3%

Persons below poverty level

(208-2012)

7.0%

9.4%

Table 3 indicates that there are a large percentage of people within the community that have
attended college. This means that they are well educated. This means that when it comes to

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teaching and educating it will be easier since many of them are educated. It also appears that the
town is less than that state percentage for people living below poverty level. This means that the
majority of the town is employed and able to provide for themselves. This means that they are
able to make better decisions when it comes to their health. Community health nurses that work
in areas that have people that do not graduate high school or live in poverty tend to have to
educate the population on health issues. Low income families tend to not have access to health
foods. Most of the community education ends up being on nutrition and ways to stay healthy. A
community health nurse who works in the town of Easton can still educate the community on
healthy food choices and exercise. This is not just limited to low income areas.
Graph 2 below illustrates the workforce breakdown in the town. The majority of
employment occurs in the health care field. This makes educating the community easier since
the majority of the town seems to work in the health care industry already. This means that they
may be up to date and aware of current health issues and concerns.

Most Common Industries

Health Care 14.5%
Accomodation/Food Services
9.3%
Education 7.9%
Construction 7.4%
Professional 5.6%
Public Administration 4.9%
Finance/Insurance 3.5%

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Community as a Social System

In order to understand a community nurses need to look at the resources that are
available. A community should have adequate facilities, modes of transportation and the ability
to provide services and goods. Graph 3 below shows the ways that the community gets to work.
The majority of the community drives a car either alone or through a carpool arrangement.

According to Talbot County Public Schools there are three public schools in the
community, Easton Elementary School, Easton Middle School, and Easton High School (Talbot
County Public Schools, 2014). There are also four private schools within the community. There
is also a free public library located in town.
The county Department of Parks and Recreation shows that there is a community center
located just outside the town limits (Parks, 2014). The community center had meeting rooms that
are available for the community. It also has a skating rink that community can use for lessons

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and recreation. There is a county senior center located in town. The Talbot County Senior
Center at Brookletts Place is a resource that is available for the senior community (Parks, 2014).
They offer exercise classes, computer classes and crafting classes for the senior population.
There are 16 community parks that are free for the community to use (Parks, 2014). Many of
these parks have a playground and baseball fields for the community to use. There is a small
charge to rent out the pavilions for events.
Safety is important when looking at a community. The town of Easton has its own police
force. They patrol the community with cars and on foot (Easton Police, 2014). There is also a
state police barracks located within the town (Maryland State Police, 2014). Maryland State
Police Barrack I serves Talbot County. In addition to police there is also a fire department in the
town. The Easton Volunteer Fire Department has been in service since 1808 (Easton Volunteer
Fire Department, 2014). It serves the community 24/7. There are two branches of the department
which serve the community. The members of the department respond to over 1000 fire and
rescue emergencies yearly (Easton Volunteer Fire Department, 2014).
The town has adequate health care facilities. There is a hospital located in the town. The
University of Maryland Shore Medical Center at Easton is a 132 bed facility (University of
Maryland, 2014). This facility provides care in the following capacities, medical and surgical;
neurosurgical, obstetrical/gynecological; pediatrics; oncology; renal; neuroscience; and critical
care (University of Maryland Shore Medical Center, 2014). With a medical center located in
the town there are an abundance of health care providers. There are 2 assisted living and nursing
facilities in the town. It appears that the town has the medical resources that are needed to serve
the population.

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Community Needs
After assessing the community and the available resources it appears that changes need to
be made. The town has some great resources but they can be improved. After reviewing the
available resources it appears as if there is limited transportation within the town. There does not
seem to be public transportation for those who do not own a car. While it does appear that the
majority of the town commutes in a car, there are still some that walk or have no access to the
things that they need. There needs to be a way for people within the community to get to doctor
appointments, grocery stores, and other necessary places. Not everything in the town is within
walking distance of the home. Therefore, a public transportation system needs to be addressed.
There also appears to be a large Hispanic population within the community, but limited
resources for those who are non-English speaking. Resources should be made available to the
community for those who are new to the area and those who do not speak English. People need
to feel that they are a part of a community and included in a community. If there are no
resources like classes to teach English, or interpreters at medical facilities then these people are
unable to get the benefits of a community. They tend not to seek medical assistance, and can put
the remaining community at risk. The community needs to address the concerns of the Hispanic
population and educate them on the health care facilities and resources that are available.
The increasing number of seniors in the community is also a concern. This population is
at risk for falling through the cracks in the medical world. Having a senior center for this
population to go to and stay active is a great start. It seems that there needs to be better access to
the facility and there are limited classes available. More medical classes need to be taught at the
senior center. Topics like cardiovascular disease, hypertension, diabetes and arthritis need to be

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taught at the senior center. Having outside resources partner with the senior center might help
the population make use of the facility.
These community needs can be addressed in terms of a nursing diagnosis. When a nurse
considers the Hispanic population we can address the language barrier. A nursing diagnosis for
this population would be ineffective health maintenance related to insufficient resources as
evidence by lack of knowledge and lack of adaptive behaviors to the environmental changes.
This population is new to the community and will undergo an adjustment period. This cultural
shock can cause the population to have difficulty adjusting.

The issue of transportation can be

looked at in terms of a nursing diagnosis as well. This population faces risk for powerlessness
related to a lifestyle of helplessness as evidence by dependency on others and inability to get
access to medical care. The senior population could fall under this nursing diagnosis since those
who no longer drive must rely on others for transportation. There are also other nursing
diagnoses that can be applied. This population has a readiness for enhanced self-health
management as evidence by desire to manage illnesses, prescriptions, and reduction of risk
factors.
Community health nurses use the Healthy People 2020 publication as a standard for
creating programs and reaching the public. Healthy People 2020 has an initiative that promotes
access to health care. The goal is to improve access to comprehensive, quality health care
services (Healthy People 220, 2014). When we consider the senior and Hispanic populations
they are at risk for not having proper access to the health care that they need. Therefore, by
following the healthy people goal we can improve the ability to provide care to them. By 2020
these populations will have the access to the health care that they need. Community nurses need
to reduce the number of people within the community who do not have access to health care.

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This can be done through community outreach and education. Nurses can go directly to the
vulnerable population and make sure that their needs are met. They can provide resources to the
population so that they can continue to get access to health care. Nurses can also work on
improving that quality and level of continued care for these populations. Many people do not see
their doctor when they should. They typically go when they are sick. If nurses can educate the
population on the importance of yearly checkups, bloodwork and testing, then some of the
chronic disease that are seen, like cardiovascular disease might be reduced. These goals and
objectives take time. They will not be achieved overnight. Following the Healthy People 2020
initiatives nurses can aim to have them completed by 2020.
Conclusion
Nurses need to evaluate the community in which they serve. They must look at the
location and housing situation of the community. They examine the population in terms of
gender, race, age and socioeconomic status. They want to see how quickly a community is
growing. They also look at the availability of facilities like schools, hospitals and police. Once
they evaluate the community they can search for weaknesses within the community. They create
ways in which nurses can help the community overcome the weakness. They create goals and
objectives that they would like to accomplish to help the community. The town of Easton is just
an example of how a community health nurse would evaluate and address issues within a
community.

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References
Access to Health Services. (2014, January 1). Retrieved December 3, 2014, from
https://www.healthypeople.gov/2020/topics-objectives/topic/Access-to-HealthServices/objectives
Allender, J., Rector, C., & Warner, K. (2014). Community & Public Health Nursing Promoting
the Public's Heath (8th ed.). Philadelphia: Lippincott Williams & Wilkins.
Easton Police Department. (2014, February 1). Retrieved November 28, 2014, from
http://www.town-eastonmd.com/Police/EPDmain.html
Easton Volunteer Fire Department. (2014, January 1). Retrieved December 1, 2014, from
http://www.eastonvfd.org/news/index/layoutfile/
Easton, Maryland. (2014, February 1). Retrieved December 3, 2014, from
http://www.city-data.com/city/Easton-Maryland.html
Maryland State Police. (2013, December 1). Maryland State Police. Retrieved December 3,
2014, from
https://www.mdsp.org/Organization/FieldOperationsBureau/Barracks/BarrackIEaston.asp
x
Parks - Talbot County, MD. (2014, January 1). Retrieved November 27, 2014, from
http://www.talbotcountymd.gov/index.php?page=Parks

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Talbot County - Public Schools. (2014, June 9). Retrieved December 2, 2014, from
http://www.tcps.k12.md.us/
Town of Easton. (2014, January 1). Retrieved November 19, 2014, from
http://www.town-eastonmd.com/Charter and Code/THE CHARTER HISTORY OF
EASTON.pdf
United States Census Bureau. (2014, January 1). Retrieved November 20, 2014, from
http://quickfacts.census.gov/qfd/states/24/2424475
University of Maryland Shore Medical Center at Easton. (n.d.). Retrieved November 27, 2014,
from http://umshoreregional.org/about/facilities/easton