Community Assessment Essay

This paper discusses a specific community, the county of Charleston South Carolina. It includes in-depth demographic information, describes the population. Geographic details are also addressed.

The population being assessed are the residents of Charleston County, South Carolina. They are known as Charlestonians. The racial makeup within this population varies to include 69% White, 27% Black, 1.8% Asian, 0.4% American Indian or Alaska Native, 1.7% two or more races, 0.1% Native Hawaiian or other Pacific Islander. Hispanics make up approximately 5% of the population and can be of any race (census.

gov.n.d.). Approximately 52% are female, 16% are over age 65, 20% are under 18 years of age and 6% are under age 5 (census.gov.n.d.). There are nearly 29,000 veterans and living in Charleston County. Close to 5% of the population is foreign-born (census.gov.n.d.). There are approximately 192,000 housing units in Charleston County, with 61% of those being owner-occupied. The median value of the owner-occupied housing units is $296,000, with a monthly owner cost of $1,700. The median gross rent is $1,150. There were nearly 4,00 building permits in 2018 (census.

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gov.n.d.). There are close to 160.000 households in Charleston County, with the average number of persons per household being 2.45. Approximately 84% of the population loved in the same house the year prior. Over 6% of households speak a language other than English at home.

The boundaries include the Atlantic Ocean on the east, Georgetown County to the North, Berkeley and Dorchester Counties to the West, and Colleton County to the South (sciway.net. n.d.).The municipalities included within Charleston County include the city of Charleston, city of Folly Beach, city of North Charleston, city of Isle of Palms, town of Awendaw, town of James Island, town of Kiawah Island, town of Lincolnville, town of McClellanville, town of Meggett, town of Mount Pleasant, town of Ravenel, town of Rockville, town of Seabrook Island, and the town of Sullivan’s Island (charlestoncounty.

org.n.d.). This group exists in Charleston County which is located within the state of South Carolina in the United States (charlestoncounty.org.n.d.). As of July 2018, the total estimated population is almost 415,000 (census.gov.n.d.). Charleston County contains three of South Carolina’s largest cities, with the city of Charleston being the largest (city-data.com.n.d.). Universal characteristics that set apart this group from others are that it is part of what is known as the Stroke Belt, even more specifically the Stroke Buckle. The Stroke Belt is a group of southeastern states with an extraordinarily high rate of stroke-related deaths. These states include South Carolina, North Carolina, Tennessee, Virginia, Kentucky, Alabama, Louisiana, Mississippi, Arkansas, Indiana, and Georgia. Charleston county is also within the Stroke Buckle. The Stroke Buckle includes eastern counties in South Carolina, Georgia, and North Carolina with the highest stroke death rates in the United States (scdhec.gov.n.d.). 92% of this population has a high school diploma or higher and 43% have a bachelor’s degree or higher. Approximately 11% of the population under age 65 is uninsured (census.gov.n.d.). South Carolina has a birth rate of 58.1 births per 1,000. Death rates for Charleston County females are 661 per 100,000 and 946 per 100,000 for males. For South Carolina, death rates for females are 668 per 100,000 and 930 per 100,000 for males. The life expectancy for females in Charleston County is 80.8 years and 75.9 years for males. In South Carolina, life expectancy is 79.4 years for females and 74.3 years for males (healthdata.org.n.d). Charleston County is considered urban, per the definition established by the Office of Management and Budget (OMB) (ers.usda.gov.n.d). Charleston County is situated along the center of South Carolina's east coast. It is the biggest county in the state and has a total area of land and water of 1,358 square miles (sciway.net. (n.d.).

A community assessment is being performed because there is a need. An outlier exists. People who live in Charleston County have a much higher chance of dying from a stroke than most people in the country. The purpose it will serve will be to increase education regarding stroke symptoms, risk factors, and the importance of calling 911. This is to reduce the likelihood of death or disability due to stroke. In the best-case scenario, it is to prevent a stroke from occurring at all. Objective HDS-3 Reduce Stroke Deaths has a target of 34.8 deaths per 100,000 population (healthypeople.gov.n.d). Objective HDS 17.1 is to increase the number of people over age 19 who can recognize the symptoms of stroke and know to call 911 (healthypeople.gov.n.d). Objective 17.2 is to expand the number of people who are aware of the symptoms of a stroke (healthypeople.gov.n.d). Objective 17.3 describes the need to expand the number of people over age 19 who are cognizant of the need for emergency care for a stroke by dialing 911 (healthypeople.gov.n.d). South Carolina has a stroke mortality of 49.8 per 100,000 (scdhec.gov.n.d.). The population in South Carolina ranks higher in certain risk factors for stroke. Inadequate diet is a risk factor for having a stroke. Approximately 82.6 percent of the adult population in South Carolina do not eat five servings of fruits and vegetables per day. This is more than the national average of 76.6% (scdhec.gov.n.d.). Cigarette smoking is another risk factor for stroke. The national average of adult smokers is 17.9%, while the average in South Carolina is higher at 20.4%. Approximately 38% have high cholesterol and 32% have high blood pressure (scdhec.gov.n.d.). One-fourth of South Carolinians are physically inactive, which is an additional risk factor. Being overweight or obese is also a risk factor for stroke. 66% of adults in South Carolina are overweight or obese versus the national average of 64%. To further break it down, 36% of South Carolinians are overweight (BMI 25 – 29.9) and 30% are obese (BMI 30+). The incidence of obesity is considerably greater for African Americans 30.1%, versus Whites 27.3% and the national average of 26.9% (scdhec.gov.n.d.). Diabetes is a known risk factor for stroke. The South Carolina population has one of the highest rates of diabetes in the nation, particularly among African Americans. Approximately 10.4% of all adults in South Carolina claim to have diabetes, but it is believed to be much higher (scdhec.gov.n.d.). The health disparities have continued for some time. African American South Carolinians die from a stroke at a rate of 53% more than their White counterparts. In South Carolina, stroke is the third leading cause of death in women. In men, it is the fifth leading cause of death (scdhec.gov.n.d.). South Carolina does have some health benefits. These include low amounts of air pollution, low rate of deaths due to drugs, and low incidence of heavy drinking (americashealthrankings.org.n.d).

Due to a current stay at home citywide ordinance and social distancing restrictions, data generation technique options were limited. A survey via a social media page for women was posted asking the respondents several questions. The survey was open to any woman over the age of 19 who currently lived in South Carolina. The survey included if they had their blood pressure checked within the last year and if they had, did they know what their most recent value was? Was it within the normal range or was it high? Another question was when should 911 be called for a stroke? Respondents were asked to directly massage the writer with responses. They were asked to specify which race and ethnicity they identified with and their age. The survey was posted for 24 hours on a site with 1,304 members. There was a total of 146 responses. 117 were White, 22 were African American, 2 were Asian, and 5 declined to answer. 4 stated they were Hispanic of any race. The median age was 39 years. 89% had their blood pressure taken within the last year. 74% did not know the exact value, only that it was within the normal range. Of those that did know the exact blood pressure value, the great majority were correct in whether it was within the normal range or high, 93%. There was a no answer rate of 2%. The question of when should 911 be called received a wide response from never to right away. 40% replied right away, 24% replied after calling their doctor, 31% replied call if symptoms do not improve, 2% replied never, and 3% did not answer. These questions corroborate the need for further education regarding stroke risk factors, signs and symptoms, and when to call 911, particularly with women in South Carolina.

Conclusion

The state of South Carolina and Charleston County South Carolina has a few health assets, such as low drug-related deaths, low rates of heavy drinking, and good air quality. They also have some negatives, including a higher rate of hypertension, cigarette smoking, physical inactivity, obesity, poor nutrition, diabetes, high cholesterol, and a much higher rate of stroke deaths, especially among African Americans. There is a need for increased stroke education to include risk factors, signs and symptoms, and when to call 911. Regarding risk factors, high blood pressure is a major one yet some in the area were unaware of what a normal blood pressure reading was. The survey conducted for this essay was limited and the median age of respondents was younger than many who suffer a stroke.