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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.
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