Community Health Epidemiology - Teenage Pregnancy in Columbus, Georgia - Research Paper Example

Community Health Epidemiology Assessment Jill Yates Western Governors Community Health Nursing Introduction. Community health is one of the central pillars of public health that entails taking care of all biotic elements in the society. Owing to the fact that health of a community is influenced and determined by a number of factors, it’s imperative then to look into the role of community nursing. The health status of a community dictates the life expectancy levels of individuals living in the community. Medical interventions are usually formulated so as to enhance the health status of a community. Community health as a discipline, may be categorized into three distinct categories; basic, secondary and tertiary health care. Of particular focus in this paper will be the current state of the problem, and interaction with the community entities that influence and respond to the issue of teenage pregnancies in Columbus, Georgia Alabama. It’s situated on the central western edge of the United States of America state of Georgia. It also forms part of the It is part of the Columbus, Georgia-Alabama. The total population of the county was estimated to be around 189,885 during the year 2010 population enumeration census. Owing to the high prevalence of teen pregnancies in Columbus, the centers for Disease control formulated efforts that were science based to prevent teen pregnancy through three ambitious programs; sex education focusing on abstinence and contraceptive use, programs that ensure the youth are actively involved in constructive activities in the community and school and also a multifaceted program that focused on studies, healthcare, sports and future careers they might take up. Based on these three tenets, it was assumed that the rates and prevalence of teen pregnancies and HIV infections would be reduced. However this has not succeeded hundred percent as teen pregnancies have been reported to date. Teenage pregnancies are often occasioned by pre-marital sexual interactions among youth of nineteen years and below. Most of the youths in this age bracket are usually experimenting oblivious of the dangers that accrue to their unhealthy practice. It is against this backdrop information that this paper intends to explore the current state and levels of teenage pregnancies in Columbus, Georgia Alabama. Community Description and Data Interpretation. Columbus, Georgia, the only city within Muscogee County, is located on the central western border of Georgia and is separated from Alabama by the Chattahoochee River. It covers a land area of around 216.3 square miles with a population of around 186,984 people as at 2010. Out of these area around 572.4 square kilometers which represents 97.9% percent of the total land the rest is water. The area has hosted a people of diverse backgrounds with the Creek people being the dominant inhabitants during the European encounter. The 1825 Treaty of Indian Springs saw Muscogee’s land being part of four counties whose land was ceded. This cessation was however nullified on the grounds that it did not reflect the will of majority of the population. The government of the United States bowed to pressure from the officials of Georgia state and created boundaries through the Georgia General Assembly and named it on the 14th day of December 1826.The name was adopted from the indigenous inhabitants of the region, the Creek people. The territory was expanded by incorporating neighboring regions to form part of the Georgia County. At the opening of the 2000 Millennium, the county had a total of 69,819 households and 47,686 families which translated to around 186,291 people who had established their residence in the county by then. This was a population density of around 860 persons per square kilometer. The racial composition in the county was multiple has there as the native Americans only represented a mere 0.38%,while the rest of the population comprised of; 50.42% White, 43.74% Black American, 0.14% Pacific Islander, 1.54% Asian and 1.90% from other races from different parts of the world. Columbus map Cultural Assessment. The age composition of Muscogee County follows the standard bell curve with 28% of the population under the age of 19 years old, 36% between the ages of 20-44 years old, 30% between the ages of 45-74 years old and 6% over the age of 75. There are slightly more females than males and the teenage pregnancy rate is significantly higher in Muscogee County with a rate of 44 per 1000 compared to 28 per 1000 at a state level. Only 6% of these pregnancies are of mothers who are in legal unions according to a 2013 report by the Maternal Health Analytical Statistical Information system. This high prevalence of teen pregnancies translates into high a relative higher number of premature births. Reports from the Georgia Department of Public Health indicated that Muscogee County had high prevalence rate of premature births at 16.8 per 1000 as opposed to other states that had 13.2 per 1000. Maternal health maternal report 2013 also acknowledges an upsurge of fetal mortality rates. Complications related to pregnancy among members of this age group were more frequent to health institutions than any other even from the whole state. Genitourinary system diseases also formed the second most important cause for their frequency to the health institutions. With Ft. Benning occupying 25% of the land, this section of the population significantly impacts several areas in the community. It houses a ranger basic training program and receives a large volume of young males into the program. These men go through a rigorous training and only have a small amount of time that they are allowed off of the base for recreational activities. Their home is usually not from the nearby area and unfortunately, they are here for months with nobody to lean on for emotional support. It is not uncommon for them to be attracted to young women in the community when they have the opportunity to leave the military base. The combination of high stress from the training, loneliness and participation in night life activities often results in increased sexual activity with the local females. Southern Baptist is the predominant religion and is reported as 51.6% of the population. 18.8% of the population is United Methodist and 7.3% are Catholic (City-data website, 2012, table Religion Statistics). The Southern Baptist religion is a very conservative religion that does not believe in premarital sex and does not approve of abortions. The Catholic Church does not approve of abortions and also states that it is a sin to use any form of birth control that interferes with the act of conception ("Family planning," n.d.). These beliefs could influence young girls that are sexually active and lead to unwanted pregnancies. Disaster Assessment and Planning. Precipitation in the area is predominantly rain with an average annual rainfall of 49 inches. Thunderstorms are observed 37% of the time when precipitation is present (Weather Spark website, n.d., table Precipitation). There have been some mild low lying flooding but this is not common and has not presented significant problems. Winds are mild to moderate with an average wind speed of 11 – 14 mph. The most likely natural disaster that will occur in Muscogee County is a tornado. The largest tornado that has been documented in the area was a F4 that injured 30 people and caused 7 deaths in 2011. Community emergencies can results from manmade hazards or natural disasters like the tornado mentioned above. If a disaster hits an area, seldom is there enough trained staff to meet the needs of the entire community. When this happens, individuals come to the aid of their families and friends and serve as informal emergency responders. To prevent unnecessary deaths of untrained volunteers from disasters, like the Mexico City earthquake, programs have been developed to prepare the community to take care of themselves and others until emergency responders arrive. The Muscogee County Sheriff’s office sponsors such a disaster preparedness program called the Community Emergency Response Team (CERT). CERT educates the participants in the potential threats and how to prepare to lessen the impact should one occur. The Emergency Management Division of the Columbus Fire and Emergency Medical Services is the group that operates and maintains the Emergency Operations Center for Muscogee County. In addition to implementing these emergency plans, this group is responsible for notifying the community. 47 outdoor emergency sirens were placed throughout the entire community to warn citizens with voice announcements and tone warnings. These sirens are activated at noon each Saturday with a test announcement and tone. The Columbus Fire & EMS Emergency Management Division and the Muscogee County Health Department have developed a disaster preparedness plan and are actively promoting this information to the community. It informs them of the supplies and quantities that need to be maintained and how to develop an emergency plan for their family. In addition to public awareness segments on radio and television, this plan is posted on their website and available on an app for iPhone and Android entitled Georgia Ready. This app provides a checklist with instructions on what is needed for specific segments of the population such as seniors, children and pets. It lists various possible threats and instructions specific to each threat. It also provides the phone number with a hyper link to dial the Department of Emergency Management. Once a user develops their plan, it can be shared with others of their choosing. The public officials are very proactive in preparing and educating emergency preparedness in Muscogee County and this should significantly reduce preventable losses. Neighborhood, Community and Safety. Muscogee County covers 216.39 square miles and has a population density of 877.5 people per square mile. This number is much higher that the state population of 168.4 per square mile (United States Census Bureau website, 2013). The community is diverse with 48.3% of the population Caucasian, 46.1% are Afro-American, 6.2% Hispanic, 2.3% Asian and 2.6% of two or more races (United States Census Bureau website, 2013, People Quickfacts). The principal language is English and it is the only language spoken in 90.8% of the population. The largest age group in the county is between the ages of 20-34 and the median age of the population is 33.6. 52% of the inhabitants are female and 46.8% of the births in the county are to unmarried women. As mentioned in the cultural assessment, the conservative nature of the community may have an influence on these numbers. 84.3% of the population in Muscogee County are high school graduates from one of the 9 area high schools and 21.70% have a bachelor’s degree or higher (Homefacts website, n.d.). Students have several options for secondary education in Muscogee County and can choose from any of the 6 technical or university campuses. Ft. Benning is a large military base that attracts a certain portion of the population that is not interested in initially pursuing secondary education. This accounts for 6.6% of the population that are in the armed forces. The clear sky UV index is high with an annual rate of 6.17. This is higher than the U.S. average of 4.9. The warmer months between May and August usually have an UV index of over 8.7. Approximately 2% of the total area in Muscogee County is water so this high UV index has a big impact. The warm temperature between May and September encourages outdoor activities and many people participate in water sports such as waterskiing, white water rafting and fishing. These activities put more people at risk for drowning and increases incidences of skin cancer. Air and water quality in Muscogee County are at or above governmental defined acceptable levels. Air quality is good based on an air quality index (ACI) of 0-50 for 94% of 2012 (Homefacts website, n.d., table 20120 AQI Values Pollution Summary). Although there are 3 superfunds in the area, the Columbus Water Works (CWW) met or exceeded the State of Georgia and U.S. Environmental Protection Agency (USEPA) drinking water standards. 100% of the public water supply for the area is obtained from surface water and which ranks Muscogee County as #31 on the lowest ground withdrawal counties for public drinking water (City-data website, 2012, table Top Lists). There are 4 hospitals in Muscogee County providing over 1000 beds and one is privately owned. According to City-Data, 17% of the population did not have health insurance benefits in 2000. Children under 18 that did not have coverage totaled 14%. This number is higher that the state average. One of the state funded hospitals has an indigent care program which delivers care for approximately 150,000 encounters annually. There are 14 fire stations in Muscogee County and they function at a very high level. “The department maintains an ISO Class 2 rating (1 of 374 in the nation) and is accredited by the Commission on Fire Accreditation International (1 of 106 in the world)” (Columbus, Georgia Fire & Emergency Medical Services website, 2002, para. 1). Muscogee County has 3 police departments and a sheriff department. The total crime level in the community is higher (163.47) than the national average with the property crime index being the highest (232.26) according to home facts on Crime. Crime rates were continually climbing and in 2008, the citizens recognized the significance of the problem. The community approved a tax increase to fund 100 additional officers. Additionally, a volunteer program called “Crime Stoppers” was formed to assist law enforcement in solving crimes. Citizens report any tips anonymously and if it leads to an arrest, they may receive a reward. Since that point, crime rates have decreased each year and were 25% lower in 2012 than in 2009. Population and Economic Status Assessment. As mentioned earlier, the age composition of Muscogee County follows the standard bell curve. Of the 198,413 people in Muscogee County, the median age is 33.6 and 51.4% of the population is female (City-data website, 2012). The total population of Muscogee County in 2012 was 198,413, which was a 4.5% increase since 2010. This is indicative of a community in a growth mode Unemployment rates have steadily increased since 2008 but finally had a slight decrease in 2012. It is the first time in four years that the number has declined. The Area Development Site and Facility Planning has recently ranked Columbus, Georgia in the top 50 leading locations with the strongest year over year economic growth. Although the unemployment rate in April 2013 was 8.4% (PolicyMap website, 2013), new industries are moving into the area and the prediction is that this will continue to improve. The cost of living index in Muscogee County is 3.3% less than the cost of living nationally and housing is the area with the largest savings. Housing expenses are close to 25% less than the national costs. Unfortunately, 18.8% of the people in the county are still below poverty level. The working population is mainly employed in four main areas. Health, education and social services account for 21.4% of the workforce. Manufacturing businesses employ 14.9% of the population. Retail is responsible for 11.6% of the employed population and finance, real estate and insurance account for 10.8% of the workforce. 11% of the males work in a construction field and 15% of the females work in healthcare (Justia website, 2013). The two main hospitals in the community are in the top 10 companies in the community for providing employment opportunities so healthcare is a major contributor to the labor work force. Overall earnings for males in the area are 44.8% greater than a female’s earnings. Most workers utilize private transportation or public buses to commute to work and the average travel time to work is 19 minutes (City-data website, 2012). 54.9% of the population own their own home and an average of 2.45 persons are in each home. 57% of the homes are owner occupied and the majority of these homes are 3 bedrooms. $131,900 is the median value of the homes (United States Census Bureau website, 2013). The median household income for 2011 in Muscogee County is $39,574 which is $6,433 less than the state median and $10,928 lower than the national median income. This is a 13% drop since the peak median household income of $45,487 in 2007. Interpretation. Based on the combined assessments discussed above, Muscogee County is a healthy and favorable area to live. The cultural assessment revealed several areas for improvement and, in the author’s opinion, is a section that needs attention. Teenage pregnancies of unwed females are higher than average and premature births and infant mortality needs to be studied. The conservative beliefs of the community may contribute to these young females feeling the need to hide these pregnancies and neglect obtaining adequate prenatal care. In addition to this, the transient male military population is seeking companionship in females in this age group and can result in more sexual activity. Educational programs on birth control and prenatal care should be developed and promoted to this segment of the population. Muscogee County appears to be performing very well in the disaster preparedness area. Based on the location of the county, the only significant potential for natural disasters is tornadoes. The emergency warning system is very effective and consequently, there have been minimal fatalities from tornadoes. There are some lakes and rivers but these have never presented any significant flooding problems. Several branches of public services have collaborated to develop disaster preparedness plans as well as work with individuals and community groups. The neighborhood, community and safety assessment uncovered some concerning areas requiring attention. Property crime is the highest type of crime in the community and may be partially the result of the high unemployment rate and lower mean household income. Several new measures have been implemented in the law enforcement division and there has been a substantial decrease in the crime rate. Although this is an improvement, there is still significant work to be done. Other public service departments such as the fire department and water works have excelled and achieved national certifications. Air and water quality are above national standards (Chin et al, 2012). Educational opportunities from elementary school through post-secondary schools are easily accessible in the community and utilized. Water sports are one of the most common recreational activities which lead to the potential for increased health risks in more than one area. Water safety education and sun protection should be stressed repeatedly and enforcement of water safety must be thorough. The population and economic assessment is promising for Muscogee County and will be one of the most positive factors in the sustainability of the county. Although the salary inequity based on gender is significant here, this is a national problem as well. Muscogee County is below the national level for cost of living which allows citizens the opportunity to do and have more. This is clearly evident in the housing market. Steady population increases substantiate that Muscogee County is in a growth mode. The influx of new businesses is contributing not only to the increase in population, but also the decrease in unemployment. It is a diverse community predominantly comprised of Caucasian and Afro-American but new businesses are bringing in more Asian populations. Community Diagnosis. Based on the assessment findings listed above, Muscogee County is a reasonably good county to live in but has opportunities for improvement in several areas. One of the first areas that need immediate attention is the high crime rate. Implementation of community involvement programs such as Crime Stoppers and additional police officers has reduced the crime rate but it is still significantly higher than the national average. High numbers of teenage pregnancies are the second area that needs attention. There are multiple factors that could be contributing to this and addressing any of these could have a positive impact. These teenage pregnancies increase the likelihood of increased premature births and can lead to a higher infant mortality rate. Ongoing education will be required in this area. Water safety is a third area that needs additional attention. The increase risk of drowning and skin cancer is a clear cut health risk. Conclusion. The research principally focused on the prevalence of teenage pregnancies amongst teenagers. The study revealed that the highest proportion of these teenage pregnancies is from youths engaging in premarital sex. A number of factors have been put forth has possible causes of this phenomenon. The study has identified Chief among the causes being poverty, low transition from lower levels of education to higher levels amongst other things. Lack of comprehensive sex education incorporation into the curriculum has also been forth as one of the key causes. The lack of productive activities for the youth to engage in further aggravates the situation. Interventions programs focusing on all these causes will in a great way reduce the prevalence of these cases. References. "American FactFinder". United States Census Bureau. Retrieved 2008-01-31. Catholicism and family planning. (n.d.). Retrieved from http://www.epigee.org/guide/catholicism.html Census 2000 U.S. Gazetteer Files: Counties. United States Census. Retrieved 2011-02-13. "U.S. Decennial Census". Census.gov. Retrieved July 22, 2013. "Annual Estimates of the Resident Population: April 1, 2010 to July 1, 2012". Census.gov. Retrieved July 22, 2013. Chin, H. B., Sipe, T. A., Elder, R., Mercer, S. L., Chattopadhyay, S. K., Jacob, V., ... & Santelli, J. (2012). The effectiveness of group-based comprehensive risk-reduction and abstinence education interventions to prevent or reduce the risk of adolescent pregnancy, human immunodeficiency virus, and sexually transmitted infections: two systematic reviews for the Guide to Community Preventive Services. American journal of preventive medicine, 42(3), 272-294. City-data website. (2012). http://www.city-data.com/county/Muscogee_County-GA.html Clark, M. J. (2008). Care of populations. In M. Connor (Ed.), Community health nursing: Advocacy for population health (5th ed., pp. 349-381). [Adobe Digital Edition]. Retrieved from http://media.pearsoncmg.com/pcp/2008935461/ebook/ebook_content/FM.swf Columbus, Georgia Fire & Emergency Medical Services website. (2002). http://www.columbusga.org/fire/fire.htm Department of Numbers website. (n.d.).http://www.deptofnumbers.com/income/georgia/columbus/ Homefacts website. (n.d.). www.homefacts.com Homefacts website. (n.d.). www.homefacts.com/airquality/Georgia/Muscogee-County/Columbus.html Justia website. (2013). http://stats.justia.com/georgia/columbus/ National Association of Counties. Retrieved 2011-06-07. Muscogee County History, University of Georgia Online Analytical Statistical Information System. (n.d.). http://oasis.state.ga.us/oasis/ PolicyMap website. (2013). United States Census Bureau. "2010 Census Data". United States Census Bureau. Retrieved 17 February 2012. United States Census Bureau website. (2013). Weather Spark website. (n.d.). http://weatherspark.com Read More