Roberta, GA Community Assessment

Autumn Lucas, RN,Carolee Shackelford, RN, Aaron McDaniel, RN

Roberta - Crawford County

Community Introduction

✦ Roberta is a small town located west of Macon, Georgia in Crawford County

✦ Rural, as evidenced by < 99 persons/square mile and fewer than 20,000 residents (Stanhope & Lancaster, 2010)

✦ Incorporated on December 8th, 1822

Population Introduction

✦ Close-knit community

✦ Self-sufficient in nature, as evidenced by neighbors helping neighbors during storm, such as after tornado damage in 2007 per resident recollections and interview with Randall(Guido) Pate, Fire Chief

The People: Demographics

✦ 12,511 residents

✦ Median age 39 years old

✦ Total population < 18 years old: 18%

✦ Total population > 65 years old: 13%

✦ Population between age 18 and 65: 64%✦ http://factfinder.census.gov/servlet/ACSSAFFFacts?

geo_id=05000US13079&_state=04000US13&pctxt=cr

Demographics: Race

✦ White Non-Hispanic (72.3%)

✦ Black (23.8%)

✦ Hispanic (2.4%)

✦ Other race (1.8%)

✦ Two or more races (1.0%)

✦ American Indian (0.9%)✦ http://www.city-data.com/county/Crawford_County-GA.html

Vital Statistics

✦ Births: 10.6 per 1000

✦ Deaths: 8.4 per 1000

✦ Infant Deaths: 8.7 per 1000 live births

✦ Data range: 2000-2006✦ http://www.city-data.com/county/Crawford_County-GA.html

Morbidity & Mortality✦ Over period of one year, 1 murder reported

✦ Adult diabetes rate: 11.7% (GA: 10.4%)

✦ Adult obesity rate: 30.1% (GA: 27.8%)

✦ Children obesity rate: 13.1% (GA 14.6%)

✦ Top causes of death in rural Georgia, Roberta included: cardiovascular disease, obesity, diabetes, cancer

✦ http://www.city-data.com/county/Crawford_County-GA.html

Physical Environment✦ Rural, large amount of wooded areas/farmland

✦ Geographic Isolation

✦ Population: 12,511 in 2009

✦ Geographic Size of Crawford County: 325 square miles

✦ Roberta is the only city in the county✦ http://crawfordcountyga.org

Geographic Isolation

Health Services

✦ MD Offices in central Roberta: Dr. Balcos and Dr. Gaton

✦ Crawford County Health Department

✦ Dental: Dentures Center only, no acute/preventative care or dental offices within community

✦ Optometrist: None within Crawford County, all eye care done outside of community

✦ No Urgent/Emergency Care, only MGA post

✦ 1 pharmacy in Roberta, only open on week days during daytime business hours

✦ 1 nursing home with 100 beds (Roberta Nursing Home)

Hospital Distances

✦ Peach Regional Medical Center - Ft Valley 14.5 miles

✦ Upson Regional Medical Center- Thomaston 26.5 mile

✦ Coliseum Medical Center - Macon 28.4 miles

✦ Medical Center of Central Georgia - Macon 29.4 miles

✦ Coliseum Northside Hospital - Macon 29.6 miles

✦ Monroe County Hospital - Forsyth 32.1 miles

✦ Houston Medical Center - Warner Robins 39.9 miles

EMS Presence

✦ Only community source of urgent care

✦ 2 ambulance stations, only 1 manned by EMS

✦ Middle Georgia Ambulance post located centrally in Roberta, residents can come in for screening if ambulance is present out front

✦ If one ambulance on call, one will be routed

Social Services

✦ Crawford County Senior Center

✦ Department of Family and Children Services

✦ School Board

✦ Meals on Wheels (via Senior Center)

✦ WIC Nutrition/Food Stamps Services

✦ Georgia Department of Labor (workforce)

Senior Center = Social Cornerstone

Communications

✦ Public Service Telephone Company

✦ Flint Cable

✦ Adequate cell towers and public/private antennae presence (per FCC)

✦ Ample TV and Radio (AM/FM) reception✦ http://www.city-data.com/county/Crawford_County-GA.html

$ Economics $

✦ 2 banks within Roberta city limits

✦ 10 vendors that serve prepared hot meals

✦ 1 grocery store

✦ 4 outlying “country stores”

✦ 2 retail stores (Family Dollar/Dollar General)

Individual Economics

✦ Crawford County Median Income: $42,447

✦ Georgia Median Income: $ 47,589

✦ Estimated Housing Costs: Rent $370 in Roberta area vs. $637 for Georgia overall

✦ Median house price: $146,061(Roberta) vs. $224,856 (GA)

✦ http://www.city-data.com/county/Crawford_County-GA.html

Median Incomes

✦ Less than high school degree: $23,365

✦ High school/GED: $30,655

✦ Some College: $34,905

✦ Bachelor Degree: $41,444

✦ Graduate: $67,969

Education

✦ 1 public elementary school

✦ 1 public middle school

✦ 1 public high school

✦ Satellite campus of Central Georgia Technical College

✦ 2000 students total

✦ School superintendent and 5 board members

Educational Attainment

✦ Age 18-24: 40% less than high school degree, 26% high school graduates, 31% some college, 2% bachelors degree

✦ Age 25-34: 82% high school graduates, 18% bachelors degree

✦ Age 35-44: 85% high school graduates, 7% bachelors degree

✦ Age 45-64: 76% high school graduates, 11% bachelors degree

✦ Age 65 and over: 61% high school graduates, 11% bachelors degrees

SafetyVolunteer Fire Dept.

*40 members*CPR/First Responders

*6 stations*Paid Fire Chief

Crawford County Jail

Safety/Police

✦ 1 sheriff

✦ 1 captain

✦ 2 lieutenants

✦ 8 deputies

✦ 1 jail, next to courthouse in central Roberta✦ http://crawfordcountyga.org

Sanitation

✦ City water and sewage system in city

✦ Septic/wells outside Roberta city limits

✦ Curbside garbage pickup throughout Crawford County

✦ No curbside public recycling centers

✦ No radon/air pollution due to lack of industry

Transportation

✦ Personal: vehicle (84%), carpools, 8 registered personal aircraft, no city bus, little bicycling

✦ Taxi: Lizella Safety Cab (13.4 miles away)

✦ Public: Southeast Transportation, Medicaid Transport Van, school buses for children, carpool van for Senior Center

✦ Greyhound Bus Station: Macon (30.6 miles)

Roberta Politics

Politics and Government

✦ Roberta City Government: Annual budget $600,000 (includes waste management, water department, city office, street maintenance)

✦ Mayor and 5 member city council

✦ Crawford Co. Government: 5 member county commission, water departments, building permits, probation court

Elections/Voting Trends✦ 2004 Presidential Elections✦ 65% Republican

✦ 35% Democrat

✦ 2008 Presidential Elections✦ 65% Republican

✦ 35% Democrat✦ http://www.city-data.com/county/Crawford_County-GA.html

Religion

✦ Church facilities serve as disaster relief shelters (per fire chief)

✦ Churches are community centers with outreach programs, food banks, and social activities

✦ 49 churches listed in Crawford County

✦ 63% southern baptist, 32% methodist, 5% other

Recreation✦ Crawford Co. Parks and Recreation Dept.

✦ Public Parks (tennis courts, baseball fields)

✦ Public School sports programs

✦ Boys and Girls Club

✦ Lake Tobesofkee (14 miles away), Macon activities (26 mi. away), Warner Robins (30 mi. away), Fort Valley (15 mi. away)

Population Strengths

✦ Residents know one another, close-knit

✦ Community and government resources all centrally located within one area

✦ Neighbors are likely to help each other in times of need, little outside intervention needed

✦ Vibrant community spirit, small-town pride

✦ Independent citizenry

Population Weaknesses

✦ Only source of urgent care is EMS

✦ Lacking in satellite resources

✦ Geographic isolation from hospitals, specialists

✦ Grandparents raising grandchildren(292)

✦ Poverty (20.1% is double US rate of 9.9%)

Top Health Risks

✦ Diabetes (11.7% vs 10.4% in GA)

✦ Obesity (30.1% vs. 27.8% in GA)

✦ Cardiovascular Disease (leading cause)

✦ Lack of urgent care and increased distance to acute care = higher risk of poor outcomes with accident/injury/illness

✦ Lack of health insurance coverage (16%)✦ http://emergency.cdc.gov/snaps/data/13/13079.htm

Evidence of Intervention

✦ Education project targeting the functional elderly residents of Roberta, GA

✦ Topic: Basic Nutrition Improvements for a Better Life Now and a Longer Life Later

✦ Objectives: choosing fresh foods over processed foods, healthy seasoning of foods, lowering intake of daily sodium, making personal connection between food intake and physical health

✦ Materials: magnetic modified food pyramid, handouts, survey, posters

Crawford Co. Senior Center

Educational Approach/Implementation

✦ Cognitive/Affective foundation in objectives and goals

✦ Health Promotion Model

✦ Positive education with emphasis on making healthy modifications to diet on a daily basis rather than abandoning all current preferences

✦ Educational method appropriate for age group by offering key components of positivism and personal health education (Boulton-Lewis, 2010, p. 218-219)

Supporting Data

✦ Nutritional priority need identified during interview with Pat Jenkins, coordinator of senior center, on 2/23/2011.

✦ Current studies depict that rural elderly populations are vulnerable to nutrition-related health concerns, obesity, and poor eating habits, with health outcomes worsened by low-economic status (Beebout, 2006, p. 58)

Project Evaluation

✦ Direct feedback from the participants by verbal engagement during lecture

✦ Seniors prompted to choose healthy food when presented with multiple options

✦ Administration of health belief survey

✦ Networking and informal one-on-one conversation r/t individual needs/beliefs

Evaluation Continued✦ Data collection for project by direct interviews

with local residents and community officials, windshield survey, observation, grocery store tour, and professional literature search

✦ Positive feedback from participants and nurse educator course leader’s evaluation

✦ Goal met by verbal commitments to personal health from participants

Lessons Learned✦ Setting (senior center) was appropriate and

convenient for participants, but noise level was high due to staff in facility kitchen

✦ Some verbal dominance by one listener, but speaker able to incorporate comments into group learning opportunity

✦ More active engagement from audience needed (less lecture, more Q&A, diversity)

Community Recommendations

✦ More urgent care presence (no resources after hours except 1 EMS station)

✦ Need for affordable and reliable public transportation

✦ Increased awareness and access to GA public assistance for grandparents raising grandchildren

✦ Personnel to staff more than one EMS station

✦ Public safety to inspect personal care homes

✦ Community-wide public recycling initiative

References

✦ Beebout, H. S. (2006). Nutrition, Food Security, and Obesity. Gender Issues, 23(3), 54-64.

✦ http://www.city-data.com/county/Crawford_County-GA.html

✦ http://factfinder.census.gov/servlet/ACSSAFFFacts?geo_id=05000US13079&_state=04000US13&pctxt=cr

✦ http://crawfordcountyga.org

✦ http://emergency.cdc.gov/snaps/data/13/13079.htm

✦ Stanhope, M. & Lancaster, J. (2010). Foundations of nursing in the community (3rd ed.). St. Louis: Mosby.