Windshield Survey: Boonville, NY, Essay Example

Introduction

All communities, both large and small, possess unique approaches to addressing problems and concerns as related to the makeup of their populations and the resources that are available. These efforts demonstrate the important impact of community-based approaches and interventions to address specific problems that communities face in their daily lives. It is important to identify specific areas of strength and weakness in order to identify the factors that are most relevant in shaping outcomes for a specific population group. All populations face specific risks and require interventions to some degree to manage problems in an effective manner, particularly when health issues are of primary concern. The following discussion will address the community of Boonville, NY, a rural community with a small population, including the makeup of this community, such as geography, population, environment, and health concerns. These issues will be addressed in the context of developing new ideas and approaches that utilize health promotion and nursing interventions in order to achieve improved outcomes with this population over a period of time.

Body

Boonville, New York is located in a rural area near the Jackson Hill State Forest and the Sand Flats State Forest and is north of Utica (City-Data, 2012). The city is located in Oneida County with a zip code of 13309 and has a population of 2,072 residents as of 2011, with 987 males and 1,085 females (City-Data, 2012).The average age of the population is 45.3 years and the median household income is $29,822, as compared to $54,659 for the State of New York (City-Data, 2012). According to USA City Facts (2012), 13.4 percent of the population lives at or below the poverty line, and the unemployment rate is 1.6 percent. The largest majority of residents living in poverty are younger, with the largest gaps between the ages of 15-17 years (City-Data, 2013). Approximately 11.6 percent of the population has attended college and 73.2 percent have earned a GED or high school diploma (USA City Facts, 2012).

In Oneida County where Boonville is located, the infant mortality rate for 2005-2007 was 7 deaths per 1,000 live births, and the life expectancy rate is on the rise because elderly persons over the age of 65 are living longer (Oneida County, 2013). In this county, the leading cause of death is cardiovascular disease, with increased numbers of hospitalizations and an expanded mortality rate (Oneida County, 2013). This community also faces a high risk of hypertension, with a hospitalization rate of 3.95 per 1,000 patients, and 27.1 percent of the county’s population has been diagnosed with hypertension (Oneida County, 2013). In addition, Chronic Lower Respiratory Disease is a leading cause of death, including COPD and Asthma (Oneida County, 2013). Diabetes impacts 8 percent of the county population, and cancer impacts females more than males (Oneida County, 2013). In addition, cancer is the second leading cause of death in the county at 178.9 deaths per 100,000 residents (Oneida County, 2013). For this population, “According to the ACS 2008 Oneida County Cancer Burden profile, 28 individuals are diagnosed with cancer each week and 11 die from cancer each week. Incidence rates have increased 15.3% since 1991-1995. However, the annual mortality rate has decreased 13.4% since 1991-1995. Four cancer sites represent 53.2% of all new cancer cases and 50.8% of all new cancer deaths in Oneida County, these include: lung and bronchus, prostate, female breast, and colorectal. These findings show the need for improvements in the areas of screenings and early detection, and the prevention and cessation of tobacco use” (Oneida County, 2013, p. 117). With these examples, it is important to identify the specific areas whereby there are significant opportunities to improve health and wellbeing through various channels that will positively impact local residents and improve their overall health through promotion activities.

Windshield Assessment

Understanding a community, its people, and its surroundings requires an effective understanding of the different elements that confirm its identity and its core strengths. These efforts are important because they convey the values and beliefs of that community that have shaped the population and its overall status. In exploring the community of Boonville, NY, it is important to evaluate specific areas that are important indicators of the type of environment that exists and the ability of the community to be successful on many different levels. This is an important contributor to the development of new ideas and approaches that will satisfy the needs of the community and its people over time. The following paragraphs will address some of the most important areas of Boonville, New York that support its continued growth and development as a rural community.

Housing

Boonville, NY is represented by various types of homes, mostly modest in size, due to the size of the community and the people who live there. There are primarily single family homes in different neighborhoods, along with a few apartment homes and condominiums. However, the primary means of housing is the single family home. Since this is an older and rural community, the large majority of the homes are older structures. The neighborhoods appear to be mixed with respect to home upkeep, as some homes are generally in better shape than others. Some homes appear to be repainted and their yards are in good shape, while others have weeds and poorly kept yards. The number of homes for sale is relatively low; therefore, the community population is relatively stable because they likely prefer the small town rural environment. Based upon the type of houses that are evident in this community, the income level appears to be consistent with the home size and probable value.

Open Space

Since this is a rural community that is surrounded by several forest areas, there is considerable open green space and many trees that surround the community. The open space is generally untouched except for some areas where farmland exists for grazing. The primary areas where there is any form of significant activity is in various neighborhoods and the small downtown area where businesses exist. In the areas where there are large amounts of untouched land, there was little if any activity. These open spaces appear to be safe and provide a level of attractiveness because of their natural beauty. In the areas where roads exist and at intersections, there are stop signs or traffic lights that are in normal operation.

Transportation

For this small rural community, the primary form of transportation is automobiles because there is no real need for a comprehensive transportation system, including public transportation. In addition, the streets of the community are wide enough for cars to pass and there are sidewalks on some streets, particularly in the downtown area. Street signs are maintained and traffic lights are in full operation.

Protective Services

Since this community is small and is relatively safe, there is no visible heavy police presence, except for the occasional police car driving through town to monitor the area. A small police and fire station were also identified adjacent to the downtown area in case of emergency.

Health Services

Within this small community, a hospital is not present, but a few doctor’s offices were spotted in the downtown area, along with a few dentist offices. In case of the need for hospitalization, residents must travel to a nearby community for these services.

Schools/Houses of Worship

The schools that are present in Boonville are part of the Adirondack Central School district and include Boonville Elementary School, Forestport Elementary School, West Leyden Elementary School, a middle school, and a local high school (Adirondack Central School District, 2013). In addition, a number of child care centers are available within the community to meet the needs of working parents. In addition, the community is represented by several churches, including Catholic, Protestant, and Jehovah’s Witnesses organizations (Village of Boonville, 2013). These religious organizations appear to be well maintained and no vacancies are currently available.

Stores

There are a number of smaller retail stores in the community, in addition to grocery stores, a liquor store, gas stations, and other specialty stores. This community is a prime area for tourists during different parts of the year because it is between several large forest areas and is ideal for a weekend getaway. Therefore, smaller retailers are available to provide items for purchase that are ideal for visitors and residents alike.

Decay

Within the Boonville community, the downtown area and many of the neighborhoods are kept up nicely and there is little decay to be found. However, there are a few areas where some homes require repairs and their yards are not in the best condition.

People

The people who comprise the Boonville community are primarily Caucasian, and a variety of ages were observed, from younger children and teenagers to middle age and elderly adults. It is believed that this community is not likely to be very diverse due to its rural location and surrounding forest areas, which attract visitors from all over the state of New York and in surrounding states.

Services

The community of Boonville offers a variety of services, including retail, healthcare, safety, beauty, automobile repair, automobile sales, gasoline, grocery, restaurants, and other related services, most of which are common in many different communities of different sizes.

Media

Within the community, there is no significant media or news presence, although community news is shared on the city website so that residents may keep up to date with specific items of interest.

Primary Health Concerns

Within the community of Boonville, there are many health concerns that are prevalent that are similar to other communities. Three of the most important concerns are cardiovascular diseases, which include hypertension, cancer, and type 2 diabetes. Each of these concerns is represented by specific data and statistics that were mentioned in a previous section. For Oneida County, it is known that “According to the 2009 Expanded BRFSS for Oneida County, the estimated prevalence for High Blood Pressure among Adults in Oneida County was 27.1%; this is slightly higher than New York State at 25.8%; both percentages exceed the HP 2010 Target of 16.0%. The estimated prevalence for Blood Pressure Medication among Adults with High Blood

Pressure in Oneida County is 83.6%, slightly higher than New York State (80.4%)” (Oneida County, 2013, p. 99). Therefore, this community faces a number of risks in its efforts to achieve successful outcomes with respect to chronic illness; therefore, it is necessary to develop an effective approach that will accomplish the desired tasks to reduce the risks associated with these conditions.

For Boonville, the management of chronic illnesses such as hypertension or type 2 diabetes requires a number of strategies that are designed to facilitate improved outcomes for residents. For example, telehealth is a more recent practice that has been effective in demonstrating the important aspects of communication between nurses, physicians, and patients accordingly (Schwartz and Britton, 2011). To be specific, “By enabling more-frequent contact between the patient and the primary care provider, the use of remote monitoring can result in earlier detection of potential problems and allow real-time alerts when a patient’s data are abnormal, resulting in a proactive solution” (Schwartz and Britton, 2011, p. 216). Under these conditions, it is important to address the most important areas that require further consideration to enable local residents to obtain better access to healthcare services on a regular basis (Schwartz and Britton, 2011). These efforts are important because they convey a commitment to managing chronic illness more effectively for patients who have already been diagnosed, while others might benefit from specific prevention efforts in this regard (Schwartz and Britton, 2011).

An article by Guedes et.al (2012) considers the ability of nurses to provide effective interventions for such conditions as hypertension in order to achieve greater outcomes. Nurses play a significant role in the provision of care and treatment to their patients and in educating their patients regarding their specific needs (Guedes et.al, 2012). These efforts are important indicators of the potential for nurses to work effectively in community-based settings to promote greater health and wellbeing for patients, particularly in the areas of prevention of chronic illnesses and cancer, amongst others (Guedes et.al, 2012). In this context, nurses work effectively to encourage their patients to modify their behaviors so that they are better prepared to manage the outcomes that are necessary to improve the quality of life and general wellbeing (Guedes et.al, 2012). It is known that “To achieve a state of complete physical, mental and social well-being, groups and individuals should be able to identify their aspirations, satisfy their needs and favorably modify their environments (Guedes et.al, 2012, p. 152). These efforts are important because they reflect the capacity of nurses to achieve greater results with their patients in the area of health promotion and behavioral changes (Guedes et.al, 2012).

For patients with the risk of type 2 diabetes, it is necessary to consider the different aspects of this condition that are instrumental in reducing this risk for different population groups (Jackson, 2011). It is important to identify these areas and to take the steps that are necessary to promote successful outcomes for these patients (Jackson, 2011). In rural communities, the risk of type 2 diabetes is even greater due to the lack of knowledge regarding the risks of this condition as well as the lack of access to healthcare services on a routine basis for many patients (Dabney and Gosschalk, 2010). According to the authors, “The prevalence of diabetes varies by urbanicity and degree of rurality…diabetes may vary significantly across different rural regions of the country. As the differences between rural and urban lifestyles disappear, higher rural prevalences may reflect differences in socioeconomic, racial/ethnic, or age status, more so than rurality per se” (Dabney and Gosschalk, 2010, p. 110). Under these circumstances, it is evident that type 2 diabetes is likely to increase in prevalence in a community such as Boonville, NY because it is smaller and does not reflect as many urban ideals as some of the larger cities (Dabney and Gosschalk, 2010).

Similarly, nutritional concerns are prevalent in many communities such as Boonville due to the lack of knowledge and understanding regarding the nutritional needs of residents. Many rural communities have higher obesity rates, thereby demonstrating that behaviors are less than ideal and nutritional concerns are significant in this type of community (Tai-Seale and Chandler, 2010). In general, “Rural residents experience an increased prevalence of obesity and overweight compared to their urban counterparts” (Tai-Seale and Chandler, 2010). In this context, it is important to identify specific nutritional concerns that might be supported by a nursing intervention or strategy that could be used to accommodate specific needs in the community (Tai-Seale and Chandler, 2010). These efforts are important because they reflect upon the different challenges of nursing practice and provide greater insight into problems and areas where there are significant gaps in knowledge that limit the quality of life and wellbeing of these groups (Tai-Seale and Chandler, 2010).

Community Nursing Diagnosis

In order to effectively promote a successful nursing intervention program, the community of Boonville must rely upon knowledgeable and experienced nurses who work collectively to ensure that the needs of local residents are met in different areas, such as health promotion and improved nutrition. For this community, cancer, cardiovascular disease, and type 2 diabetes are some of the key primary health concerns; therefore, it is important to recognize these challenges and to take the steps that are required to conduct a thorough and detailed nursing intervention that will capture the importance of improved health and wellbeing for this community. In addition, there must be a concentrated effort in place to work collaboratively to meet the needs of individuals in the community who are at the highest risk of illness or disease, based upon their risk factors. These individuals must be supported by a widespread effort to facilitate improved health promotion for this group. At the same time, it is necessary to develop a greater understanding of the different elements that are captured by creating new outcomes and expectations for the community in relation to their health status and wellbeing. These efforts will demonstrate that it is necessary for the residents of Boonville to take charge of their own health and to take the steps that are necessary to achieve greater outcomes for their own lives. It is with these principles in mind that nurses must work collaboratively in order to invoke knowledge and to promote greater results within the community to individuals, children, and families. All age groups are likely to benefit from this type of endeavor and should be considered as a key opportunity to improve the outcomes of the community as a whole, in spite of their limitations and location in a rural area.

Conclusion

Boonville, New York is a small rural community with a rich history and a great sense is of community. This geographic region offers a number of important resources to its residents, but as with other communities, there is a greater risk of health conditions due to lack of access and knowledge regarding chronic illnesses, nutrition, cancer, and other concerns. The role of nurses in expanding health promotion activities in this community is critical to the ability to achieve long-term success and wellbeing for this group and its people in different ways. It is important for nurses to play a critical role in interventions that are conducted in order to identify specific areas of need and to improve compliance rates for patients. Boonville is a typical community in many respects because of its core values, resources, and health concerns; however, its rural location increases those risks in different ways and requires a greater understanding of the different elements that healthcare providers may offer the community to improve knowledge and health promotion for all residents who might be at a greater risk of one or more conditions, including chronic illnesses.

References

Adirondack Central School District (2013). District home. Retrieved from http://www.adirondackcsd.org/education/district/district.php?sectionid=1

City-Data.com (2012). Boonville NY. Retrieved from http://www.city-data.com/city/Boonville-New-York.html

City-Data.com (2012). Boonville, New York (NY) Poverty rate data – information about poor and low income residents. Retrieved from http://www.city-data.com/poverty/poverty-Boonville-New-York.html

Dabney, B., and Gosschalk, A. (2010). Diabetes in rural America. Rural Healthy People 2010, retrieved from http://www.srph.tamhsc.edu/centers/rhp2010/05Volume1diabetes.pdf

George, P.P., Molina, JAD, Cheah, J., Chan, S.C., and Lim, B.P. (2010). The evolving role of the community pharmacist in chronic disease management – a literature review. Annals of the Academy of Medicine in Singapore, 39, 861-867.

Gomes Guedes, N., Moreira, R.P., Cavalcante, T.F., de Araujo, T.L., de Oliveira Lopes, M.V., Ximenes, L.B., and Vieira, N.F.C. (2012). Nursing interventions related to health promotion in hypertensive patients. Acta Paul Enferm, 25(1), 151-156.

Jackson, S. (2011). Undiagnosed type 2 diabetes: recognize risk factors. Medication Review, 30, 778-782.

Oneida County (2013). Oneida County 2010-2013 Community Health Assessment. Retrieved from http://www.ocgov.net/health/CommunityHealthAssess2010-2013

Schwartz, K.A., and Britton, B. (2011). Use of telehealth to improve chronic disease management. NC Medical Journal, 72(3), 216-218.

Tai-Seale, T., and Chandler, C. (2010). Nutrition and overweight concerns in rural areas: a literature review. Rural Healthy People 2010, retrieved from http://srph.tamhsc.edu/centers/rhp2010/09Volume2nutrition.pdf

USA City Facts (2012). Boonville, NY. Retrieved from http://www.usacityfacts.com/ny/oneida/boonville/

Village of Boonville (2013). Home Page. Retrieved from http://village.boonville.ny.us/content/

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