1. Description of selected community based on the assessment. Cultural assessment:
Edgecombe County is a very rural community lying in the eastern section of North Carolina. The county has a population of 52,150 with the majority of the population being African American females with the median age group of this population being 38 years old and primary langue being English (Michelle B. Etheridge, MAEd, 2010). The culture of this population hinges greatly on their religious belief. The cultural group of this county is of Christian belief but more specifically Southern Baptist Convention (retrieved from http://www.city-data.com/county/Edgecombe_County-NC.html, January 14, 2013). In interviewing various members of the Southern Baptist religious group I have found that the culture of this group is a feeling of belonging and being joyful even during times of stress.
Major stressors for this group are usually personal stressors, such as individual’s health or job status for example. These issues are often then brought to the groups’ church and prayed upon by the whole congregation and support is shown as a group to help individuals through their times of hardship. This group also believes in western medicine but believes in the power of healing by way of prayer and miracles from God. The culture of marriage for this group is the belief that marriage is viewed as being something sacred and this union should be between man and women and any relationship between same sex individuals is not viewed as valid.
The group also believes that infidelity is a sin (retrieved from http://en.wikipedia.org/wiki/Southern_Baptist_Convention on January 16, 2013). The typical family structure of the southern Baptist is that of man and women in margarine possibly children with the man being the head of household. The view of conception is that children are a gift from God and they do not believe in abortion. Newborns are baptized by minister and it is considered a religious purification (retrieved from http://christianity.about.com/od/faqhelpdesk/f/whatisbaptism.htm on January 16, 2013). These cultural groups are law abiding and anything other than that committed by other members would be unacceptable.
In order for members of these various churches to stay informed most have newsletter and prayer list for the various members who may be in distress. These various items are their way of communicating current events within the community and the church itself. Upon completion of the interviews with various members of Southern Baptist churches and various research the conclusion seems to be that the cultural group of Edgecombe County being predominantly of the Southern Baptist religion that this is a very conservative county in their beliefs.
The population of Edgecombe County is estimated at 56,552. The median income of the population is around 32,172 and the unemployment rate is at 17.7%. There is about 25% of the population living at or below the poverty level (Retrieved from www.edgecombecountync.gov/ on January 16, 2013).
Neighborhood/Community Safety Inventory:
The air quality of Edgecombe County has been rated as good and has 81% of days out of the year with good air quality. There are recognized air carcinogens, air developmental toxicants, and reproductive toxicants. The top rated cancer risk being arsenic and noncancerous risk being mercury compounds. There are three companies that contribute to the air pollution in Edgecombe County and they are Cogentrix, Trinity Inds. Inc. and Superior Telecommunications Inc. The rate of water pollution for Edgecombe County is 12% for pathogens and 4% ammonia (retrieved from http://scorecard.goodguide.com/envreleases/county.tcl?fips_county_code=37065#major_chemical_releases on January 16, 2013). The county is at risk for dangerous weather conditions due to the fact that this county is susceptible to hurricanes, tornados, and sometimes snow.
There is a drowning risk as the Tar River runs through the county, and there have been reported drownings that have occurred there. Poisonous plants that grow in the area of the county are poison ivy and poison oak that often times cause rash and itching. Unable to find the county information about home fires and turning to the state level it was found that the state of North Carolina has on average less than 20 deaths a year from house fires (retrieved from http://www.usfa.fema.gov/downloads/pdf/statistics/profile_fitus_15th.pdf on January 16, 2013). There is only one swimming pool in the county and it is adequately fenced and has on duty life guards during operational hours. Edgecombe County crime rate is 4,007 per 100,000 persons with property crime being 4,068 and violent crime being 632.4 (retrieved from http://dailysoutherner.com/x1447689740/County-crime-rate-drops on January 16, 2013).
Officers interviewed report that their response time to calls can be just minuets due to the small size of the county. There are community watches to help law enforcement patrol rural communities. There has been some gang activity reported in the county and is a strong focus for the police department and sheriff’s office at this time. There are some reports of domestic violence in the area that is met with a domestic violence unit through the health department. There is a great threat of flooding in Edgecombe County due to the proximity of the Tar River and there has been a major flood in the last ten years. This county also has a sever weather threat for hurricane because the county lies on the east cost of the state.
This information was obtained by interviewing Ginger Gay, RN who is a member of the Disaster Planning Committee for Edgecombe County. The age composition of the population most likely to be affected by a disaster would be the geriatric population due to the fact that a lot of these people are on dialysis, home oxygen, and take multiple medications. The greatest threat for this community would be hurricanes with flooding. Injuries related to this could be near drowning, hypothermia, insect and snake bites, or broken bones, abrasions, cuts or injuries related to flying debris from high winds. The major communicable disease threats related to flooding as a result of a hurricane would be water born illnesses. Most of the community members are not prepared for major disaster according to the community because most people do not take the threat seriously.
The last major disaster was 1999 when there was a major flood after hurricane Floyd. The community response to this flood was good; most people went for shelter or made the necessary arrangements when the warnings were given. During this disaster there was moderate loss of life. There were drownings, motor vehicle deaths, and fire related deaths. The psychological effects of a disaster for this community are great because it is rare. As a result there is a Critical Incidence Stress Debriefing Tram that responds to all disasters in the county. Structures most likely to be damaged during a disaster in this community would be buildings related to the fact that the community is most at risk for hurricanes and flooding.
The emergency shelters that are available to the community are The National Guard Armory, Vidant Multi Disciplinary Clinic, schools, and the community college. All of these buildings are converted into shelters in the event of emergencies. It is very likely that the water supply would be in danger in the event of this type of disaster. Animals will be involved in these types of disaster and it has been seen in the past that people of this county do not like to leave their animal and that becomes a safety issue for the resident. There are several social support systems available for victims during a disaster such as The American Red Cross, The Department of Social Services, FEMA, and The United Way are just a few. Community agencies are involved in emergency planning.
The health department, the emergency department administrators from Vidant Edgecombe Hospital, the Edgecombe County Emergency Services directors, and Eastern Regional Emergency Services are all involved in the county disaster planning. The county manager is responsible for activating the community disaster plan. The equipment available for disasters such as this is alternate care facility trailers that can be set up to house 50 bed emergency room. There are plans for air support from area hospital outside of the county. The likely medications needed are medications such as tetanus shots, antibiotics, and epinephrine for example. There are several agencies and people involved and ready to respond to disaster situation in Edgecombe County.
2. Interpret the collected data using epidemiology
In Edgecombe County the leading causes of death included heart disease, cancer, and cerebrovascular disease. The mortality rate for Edgecombe County related to stroke and kidney diseases are higher than the surrounding counties. Prostate cancer was of the highest incidence of the types found cancers found in the community. HIV rates for Edgecombe County are the highest in the state of North Carolina. An estimated 20.7% of residence ages 0-64 had no health insurance. Obesity in this county for adults is around 66%. There was a reported 8% of total dollars spent in Medicaid funds related to obesity (Retrieved from www.edgecombecountync.gov on January 16, 2013).
In order to help with the obesity initiative the health department has developed a Health Promotion Program to increase community involvement with the local farmers market, the health promotion coordinator has started educational classes at the senior center, and The Edgecombe County health Department Health Educator worker with the public school system to revise the healthy options for students at meal times. The County has a Diabetes Education Program to help educate the population about new onset or chronic diabetes. There is also a stroke focus group that is help for support of the stroke victims in the community (Retrieved from www.edgecombecountync.gov on January 16, 2013). In the community survey the concerns of the community were overweight/obesity and chronic disease.
Disaster Assessment and Planning
* Several agencies in community involved in disaster plan
* Emergency transport assistance from surrounding counties
* Residents respond well to warnings
* Critical Incidence Team Available
* Several social support systems
EDGECOMBE COUNTY, NORTH CAROLINA
5. Community Diagnosis
Edgecombe County is a relatively safe and healthy community with strong religious beliefs. Areas that need improvement are decreasing the HIV rate and decreasing the obesity rate. The HIV rate is the highest in the state and needs to be address immediately. There are efforts from the community to decrease the obesity rate in the adult and child population. If the obesity rate was more controlled there would be more control in chronic disease processes. Upon community survey the community members concerns were obesity and chronic disease. The community should be more focused on disease prevention.
* More females than males
* Predominantly African American
* Median age being 38 years old
* Very rural area
* Largely religious community
* Southern Baptist is the predominant religion
* Highest HIV rate in the State
* Good air quality
* Large body of water with potential for drowning
* Good police response
* Community watch programs
* Potential for water quality problems
* At risk for dangerous weather conditions
Population Economic Status
* Located in the eastern part of the state
* Population 56,552
* Median household income $32,172
* Unemployment rate 17.7%
* 25.7% of persons living at or below poverty level
* 8% of total county dollars goes to Medicaid funding related to obesity *
4. Interpretation of the genogram
The genogram highlights that Edgecombe county population is primarily African American females age 38. Edgecombe County is a very rural is located in the eastern portion of the state of North Carolina with the Tar River running right through the county. The area has a very religious culture that is mostly made up of the Southern Baptist church with very conservative views.
The median household income is $32,172 with a 17.7% unemployment rate. The county has 25.7% of the population at or below the poverty level. This county is at great risk for flooding during hurricanes. In the event of a flood the community is at risk for water quality problems. The community has a community watch program with good police response time. Several agencies are involved in the disaster planning such as the county health department, the emergency department administrators
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