WINDSHIELD SURVEY 8
Windshield Survey
Molina Allen
Ferris State University
Author Note
This paper was prepared for Nursing 340, Section VL1, taught by Professor Doerr.
Windshield Survey
In conducting a windshield survey of the health aspects of a community led first to the definitions of community, community health, and identifying who exactly the client would be. Once established, the community of the area coined Slabtown, which includes the downtown and hospital areas of Traverse City, Michigan, was explored. With an idea of who lived in this area, their characteristics and demographics, a major Leading Health Indicator (LHI) was identified: Nutrition, Physical Activity, and Obesity. Following is a nursing role aimed at the major LHI for the area. Four notable health risks identified during the windshield survey are listed and the results of the windshield survey are attached.
Community
Conducting interviews aimed to define what constitutes a community, MacQueen et al. (2001) discovered what they refer to as five core elements repeatedly used to describe the concept of community: locus, sharing, joint action, social ties, and diversity. Of the most referenced, locus was cited by 77% of the respondents. In second place was sharing, mentioned by 58%. Further, community may be defined as, “where people work, live, or attend school,” (Harkness & Demarco, 2012, p. 3).
Community Health
Community has been established primarily as a border within which a group of people have a common element. Community health is the overall picture of wellness exhibited by the people within this space. According to Harkness and Demarco (2012), the goal of community health nursing is to, “deliver care to individual people, families, and community groups with a focus on promoting, preserving, protecting, and maintaining health. In doing so, the care directed to the individual person, family, or community group contributes to the health of the population as a whole,” (p. 9). The aim of community health is to improve the health of the collective, with the community as the client.
Community as Client
Community health brings a holistic, systems based approach to the health care genre. In treating the community as a client, problems must be identified through an assessment of the strengths and weakness (Harkness & Demarco, 2012). Further, MacQueen et al. (2001), found community members felt an interconnectedness with sharing, “Activities, goals, objectives,” (p. 1931). Reiterated by Harkness & Demarco, “. . . interconnectedness means health problems identified at the local community level often have causes or contributing factors that originate in the broader social, economic, environmental, or political system,” (p. 137). Addressing health at a community level requires a community effort in collaborating to deal with issues that arise from both within the community and without. Healthy People 2020 aims to improve the health of the nation by focusing on the community.
Healthy People 2020 Leading Health Indicator
A LHI that is an issue for the regional area selected for this particular community is Nutrition, Physical Activity, and Obesity. While the community offers ease of access and incentives for a healthier lifestyle, according to the Grand Traverse County Health Department (2008), 26% of residents were obese and 39.5% were overweight. The state average for obesity is 26.4% while being 36.4% for overweight. To combat this issue, a nursing role would involve developing a plan that would assist in increasing the activity levels of a vulnerable population in the area, the elderly. As this is a large retirement community, ease of access may still be an issue and bringing the intervention to this population may see improved outcomes. Through promotion of exercise classes and diet education physically taking place at the retirement community, the nurse may be able to reach the target audience in a more meaningful and effective manner.
Community Health Risks
During the windshield survey, four major health risks that have the potential to affect the community were identified. Lack of affordable housing is well-known in the area. With ever increasing real estate prices well above the $500,000.00 mark to own and rentals in high demand, it is difficult, if not impossible to live within the city walls on an average income. The choices for low-income families are to reside in small, cramped apartments in the downtown area with little left over to live on or to live outside of city limits where there is a 15 minute plus commute. The race and ethnicity of the area is predominantly Caucasian, which may increase the tendency towards discrimination of other races. Finally, the last two health risks involve the close proximity to water. With so many families living in the area, the potential for drowning is high and water safety a large concern. Related are the e-coli levels of the lake, with warnings of safe levels and swimming bans broadcast by the local news stations via radio and television on a daily basis in the summer. With the neighborhood being a pinnacle destination for living and tourism, an ongoing closer look and increased diligence to identify and address the issues of the community is important.
Conclusion
The community within Traverse City is revered as one of the most beautiful in Michigan. It is important that the issues of the community are not glossed over by comparison to other areas that are not thriving as well. The windshield survey and subsequent research identified several areas where this community may improve a major LHI identified by Healthy People 2020. With a high rate of obesity and overweight population as well as a high population of elderly at risk for this issue, a nursing role identified targeting this demographic with increased teaching and availability to participate in health activity. Further issues identified included availability of affordable housing, race disparities, and water safety. Through continual assessment to changes overtime, community nursing may identify the community risks and plan targeted interventions that will make a difference in the lives of the community members.
Survey Boundaries: Downtown, Slabtown, and Hospital area in Traverse City, MI
Housing and zoningWide range of housing options from new developments to estates from the 19th century. Many large apartment complexes and condominium developments. Rental units/duplexes either in historical districts or 20-30 year old housing that has been adapted. High taxes and very high property values limit affordability. Section 8 housing available, but is mostly located outside of a 15 minute drive to town. / Transportation
Bylaws support pedestrians and bikers with right-of-way. Downtown areas have many parks and walking trails that are free. Good bus system that is affordable and offers distant routes. Routes run set times which decreases use past 10pm and before 6am.The state highway runs through the middle of town but has not been expanded to accommodate traffic, especially during tourist season. / Race and ethnicity
Appears to be mostly Caucasian. Have seen few representations of other races.
Open space
Many large spaces, parks, and beach access open to the public. Selected areas are bordered off during festivals, but remain open the rest of the year. Access to areas is easy with ample parking and is often located on walking/biking trails. Water access is available in many areas and adjacent to parks. / Service centers
Many physician’s offices and clinics in area, especially around the hospital. The health department is unfortunately located in a remote area that is not easily accessible by walking as it is located up a large, steep hill (there is bus access). There are 3 elementary schools, 2 middle schools, and 1 high school located within 5-10 minute drive. Bussing is available to schools within the district. / Religion and politics
Witnessed 5 catholical churches, 1 presbyterian, 1 baptist, and 2 non-denominational within neighborhood. Many local events sponsored by various church groups.
As voting is coming up soon, I have seen a number of signs for candidates of both republican and democratic parties.
Boundaries
Slabtown encompasses the blocks surrounding the main highway, Division St. that runs through downtown Traverse City. This area also extends up to the hospital and Commons. / Stores and street people
Many shops available, large population of tourists during seasonal months. Did not observe any people that appeared to be homeless. Many children with families. / Health and morbidity
Aging population with a large retirement facility situated across from the hospital. As many of the residents in this area are hospital employees, there is a large representation of 30-50 year olds with families.
Commons
Actually called the Commons, there is a large grouping of condominiums across from the hospital. Includes a park, event site, famer’s market twice a week, and various shops and restaurants in the main level. / Signs of decay
Very well-kept, roads paved, sidewalks well maintained; lawns and gardens add beauty to neighborhood. / Media
Free issue of the Grand Traverse Insider offered at most grocery stores. Other papers available in print and online. Local news station is 9 and 10 News, with daily TV broadcasts as well as an online website. Charter and DishNetwork are available.
References
Grand Traverse County Health Department. (2008). Annual report for 2008. Retrieved from
http://www.co.grand-traverse.mi.us/AssetFactory.aspx?did=4562
Harkness, G. & Demarco, R. (2012). Community and public health nursing: Evidence for
practice. Philadelphia, PA: Lippincott.
MacQueen, K., McLellan, E.. Metzeger, D., et al. (2001). What is community? An evidence-
based definition for participatory public health. American Journal of Public Health,
91(12), 1929-1938. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/11726368.