A community’s health can be established through a myriad of differing factors. Three specific factors that will help to determine the health of the county in which I live are community safety, disaster preparedness, as well as an analysis of the population. The community under review, Merced, is located in central California and made up of seventeen cities and communities whose individual populations do not exceed more than 75,000 and covers an area of approximately 1,972 square miles (United States Census Bureau, 2010) with a total population of approximately 255,793 people in 2010 (Merced County California, 2012).
The first area of importance is community safety. It is important to beginning discussion with the one of the most basic of health indicators; the air we breathe. The air quality index in Merced County is 48, a median value that takes into account only the most hazardous air pollutants (Air Now, 2012). This value is only slightly lower than the air quality index of California, but is approximatly 30% higher than the national average (Air Now, 2012). Another important area that must be addressed is the water we drink.
In Merced County most of our drinking water comes from groundwater sources which are collected by two public water systems. Most all areas in Merced County are affected by three different pollutants: Nitrates, Ethylene Dibromide (EDB), and Dibromochloropropane (DBCP) (Air Now, 2012). Although all three of the pollutants fall below the water standard or eliminated through the public water systems, these pollutants will continue to be an issue because EDB and DBCP were used by farmers for many years to fumigate crops.
Another area of concern in community safety is the safety hazards within the sociocultural environment. The ability to work, shop, or simply ride your bike and feel protected within the area in which you live are important features in determining the health of a community. With 1. 2 police officers and 4. 4 sheriff officers per 100,000 people and an average response time of 3 minutes (Merced County Office of Economic Development, 2012); most people can be fairly confident that they and their property are protected. However, crime rates have risen in the past few years.
In 2009, Merced County experienced 1,658 violent crimes; the majority of which involved aggrivated assult but also included 26 murders, 78 forcible rapes, and 276 robberies (United States Department of Justice, 2012). There were also 4,390 property crimes and 90 cases of arson (United States Department of Justice, 2012). Rate of offenses per 100,000 are as follows: violent 568. 3, property 567. 3, drug 512. 9, sex 37. 9, other 489. 1, and totaling 2,175. 5 per 100,000 (United States Department of Justice, 2012).
Considering there are only 5. law enforcement officers per 100,000 people, it would appear as though crime will continue to rise for the foreseeable future. These numbers are especially troublesome considering budget cuts that will surely affect all public safety departments (Layoff Watch, 2011). There are a couple of ethnic groups within Merced County that feel especially vulnerable, the Hispanic community and the Asian community. The Hispanic community nearly makes-up 50 percent of the population and is congrigated in the poorest of neighborhoods. Yet another concern involving public safety is the ability to obtain medical services.
Within Merced County there are only two hospitals that offer emergency medical service, Memorial hospital of Los Banos and Dignity Health of Merced. Memorial hospital of Los Banos is a relatively small hospital with the ability to admit a total of 46 patients (Memorial Hospital Los Banos, 2008). The emergency room has the ability to care for a total of 6 patient’s requiring immediate emergency care, but has the capability to fly patients out to other facilities if required. Dignity Health of Merced is the larger of the two facilities and cares for the majority of the population of Merced County.
Dignity Health has a total of 194 beds available. Dignity Health has approximately 10,900 admissions per year and total emergency room visits equaling around 66,000 per year. On a typical weekend the emergency room will see about 250 patients between the hours of 7 a. m. and7 p. m. (M. Parker RN, personal communication, June 8, 2012). Also serving the community are 8 primary clinics. The majority of these clinics are located within the city limits of Merced and Los Banos. Those located outside of these locations will have to drive upto 30 minutes to obtain medical services.
Merced County also has five psychiatric facilities, only 2 of which are capable of admitting patients. Country Villa Merced Behavioral Health Center has 96 beds available for the community and has the ability to care for long-term patients between the ages of 18 to 65 years of age (Country Villa Merced Behavioral Health Center, 2012). Marie Green Psychiatric Center is a smaller facility that has the ability to admit upto 20 patients between the ages of 18 to 65 years of age, but this is a short term facility that can only care for patients for up to 90 days.
Currently, in the Merced County area there are no psychiatric facilities that have the capability to care for psychiatric patients under the age of 18 or over the age of 65. Emergency preparedness within Merced County is primarily controlled by the Department of Public Health. Merced County’s emergency preparedness was last updated in 2003 and in general addresses “preparedness, response, recovery, and mitigation activities” (City of Merced California, 2012). In the preparedness phase, activities are concentrated in advance of a disaster.
Actions are focused on “implementing hazard mitigation projects, developing hazard analyses, developing and maintaining emergency plans and procedures, conducting general and specialized training, conducting exercises, developing mutual aid agreements, and improving emergency public education and warning systems” (Merced County California, 2003). In the response phase an emergency situation is imminent or likely to occur. During this stage the county initiates actions to increase its readiness.
In the recovery phase the focus is to return public services to Merced county residents and return any area affected by the emergency to its previous condition. The mitigation phase occurs before and after emergencies. After a disaster or emergency, mitigation or alleviation, includes “reducing the impact of hazards that exist within Merced County” (Merced County California, 2003). Although Merced County Public Health Department concerns itself with the county as a whole, it must also make provisions for areas more susceptable to emergencies or areas where there is an increased difficulty to disseminate information.
Within these areas there are disproportionate ethnic minorities. The two primary ethnic groups, hispanic and asian americans, are particularily at risk because of transportational and housing issues as well as dysfunctional attitudes toward disaster planning or preparedness. Within Merced County the Hispanic community makes up nearly 50% of the population and constitutes the majority of those living below poverty level. This translates into the majority of the population within the economically depressed areas having inadequate housing or malfunctioning transportation.
When a disaster does occur, this group will be the hardest hit as they will not have the financial means to recover what they have lost. This group also has the highest potential for harm due to the inability to relocate to an area that is safe due to transportational issue. What places this group at highest risk are their attitudes toward disaster planning or preparedness. After speaking with six different families from a depressed area, all but one family put any thought into a potential emergency, and none of these families had money set aside for such a disaster (personal communication, June 1, 2012).