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Category: Social Issues
Autor: anton 08 December 2010
Words: 5303 | Pages: 22
Fayette, the county seat of Jefferson County, in Southwest Mississippi, is a civic town with a population of approximately 2,242, according to the 2000 census. The latitude of Fayette is 31.711 North; the longitude is 91.06 West with elevation of 290 feet (www.epodunk.com, 2006). The land area is calculated at 3.1 kilometer2 (Census, 2000).
Since Fayette is a relatively small town, there is no public transportation available to the residents. Many of the citizens have their own transportation. However, for those who do not possess a vehicle, make use of other alternatives, such as asking family members or walking, which can prove to be very dangerous considering that Fayette is not well illuminated at night. Fayette has four stoplights in the entire community. Three major highways bisect the county and run through Fayette, they include:
Â· U.S.Highway 61
Â· State Highway 33
Â· State Highway 28
There is a wide range of business establishments in Fayette; however, many of the establishments are in deplorable conditions. The newest building, which is located along highway 61, is a private physicianâ€™s office. The office is located approximately 4 miles away from downtown, which is the primary residential location. The businesses located in the residential areas are underdeveloped; many are older buildings with poorly established parking lots. The library, which is the main source of information for educational purposes, lacks updated material. Furthermore, there is little information concerning the city of Fayette itself. There was no census data available in the library.
The residential areas of Fayette are struggling to thrive. The condition of many homes in the residential area pitiable, the landscaping is not well keep; grass stands at least 3 inches. At the door of one home was a horse. Many of the homes have old chipping paint or broken screen doors. Roads are also in poor conditions; there are a plethora of potholes.
Fayette, as referenced by the locals, has one hospital, which is also in downtrodden conditions. Jefferson County Hospital has limited parking and poor service to the community. Phone calls are not returned and EMT service is not prompt (D. Johnson, personal communication, November 29, 2006). Conclusive, Fayette is a city that has much to offer; however, the conditions as it is can prove to be very harmful to the citizens. Furthermore, safety and building conditions are in dire need of improvement.
According to the U.S. Census 2000, Fayette City, Mississippi has a total population of 2,242 of which 1,277 are female and the remaining 965 are male. The median age is 27.8 years with the greatest number between the ages of 35 to 44 years. There are approximately 856 school-age children, ages 0-19 years. The elderly population is composed of approximately 234 people with 102 being male and 132 being female (U.S. Census, 2000).
In Fayette, the majority of the population is composed of people of one race and a small percentage claims two or more races. African-Americans make up the dominant culture with 2,183 people, followed by Caucasian-Americans, Asian-Americans, American-Indian, and Native Hawaiian with 43, 5, 4, and 1, respectively (U.S. Census, 2000).
English is the primary language spoken and written, but a small percentage of the people speak languages other than English. Of this small percentage, only a handful speaks English less than â€œvery well.â€
Fayette has three public schools, all being under the direction of the Jefferson County School District. Jefferson County Elementary School serves grades pre-kindergarten through 4th grade, with 614 children currently enrolled. Jefferson County Middle School currently has an enrollment of 511 children with grades 5th through 8th. Jefferson County High School enrolls 9th through 12th grade and currently has 468 students (Great Schools, 2006).
There are approximately 775 total households with 543 being family households, 189 being married-couple families, 312 being female householder with no husband present, and 232 are non-family households. The average household size is 2.82 people and the average family size is 3.46 people. Households with individuals under age 18 years total 378 and households with individuals age 65 years and older total 156. These families occupy a total housing units of 775 with 441 being owner occupied and 334 are renter occupied dwellings (U.S. Census, 2000).
There are many informal groups in Fayette with varied interests. Sometimes a group may last a few weeks and other groups have been around for years. There is a summer softball league for children of all ages and a newly initiated fall flag football league. The Tigers and Parents support group (TAPS) act as an informal booster club for the athletic department. They are not officially affiliated with the school system, but the parents decided to work together with the students to help with school related events. The Garden Club provides beautification projects for homeowners and hold biweekly meetings. There is also a group called The Southwest Cruisers is a group of older gentlemen who love to work on cars. They fix up antique cars and attend car shows throughout the state and neighboring states (J.Lee, personal communication, October 23, 2006).
The formal groups are linked more to churches than anything else. There is a horse riding club call the Union Church Riders and a Womenâ€™s Youth Organization from the Locus Grove Baptist Church. The Heroh of Jericho is a church organization that does community service and provides activities for the children in the community. The Women on the Move are also a church based organization. They go from church to church providing bible study for the members. Some non-church related groups in Fayette and in the Jefferson County area include the Order of Eastern Star and Masonic Lodges. Some sorority and fraternity members reside in the area, but the chapters are located in nearby counties (J.Lee, personal communication, October 23, 2006).
The city of Fayette has no major industries, although Jefferson County is one of 25 areas in the state certified to operate as "enterprise zones." These are areas in which new industry is entitled to a variety of tax incentives and special consideration from state and local agencies (http://members.aol.com, 2006) The closest industry is Guedon Produce, which is about 20 miles away in Church Hill, Mississippi. Guedon Produce, produces fruits and vegetables to distribute to retailers. ITT and Jeffco also operate plants in the county, which produce wiring harnesses for automobiles. There is also a sawmill, which cuts dimension lumber for furniture. Several small pulpwood companies provide added employment and income (H.Davis, personal communication, October 17, 2006).
The areas that account for the largest number of employees in Jefferson County are utilities, health care and social assistance, transportation, retail trade, warehousing, finance and insurance. Other areas include: forestry, fishing, hunting, agriculture support, mining, construction, manufacturing, wholesale trade, information, real estate and rental leasing, professional, scientific and technical services, administration, support, waste management, remediation services, accommodation and food services and other services, except public administration (www.census.gov, 2006). There are also many retail and service facilities located in Fayette. They include: grocery stores, clothing stores, car dealerships, medical supply stores, drug stores, gas stations, and several other miscellaneous store retailers (H.Davis, personal communication, October 17, 2006).
Because Fayette is such a small community, the churches play a major role in the maintenance of the community. There are several dominations of churches in Fayette. They include: Baptist, Apostolic, Methodist, Catholic, United Methodist, African Methodist Episcopal, Seventh Day Adventist, Church of God and Christ and Muslim (http://local.yahoo.com, 2006). New members are usually welcome into the community by the churches, as well as the recently registered Jefferson County Chamber of Commerce. The Chamber of Commerce will take part in welcoming new members of the community by having brochures and other information about the town available.
Fayette has one fire department and one police department. The police department works together with the Jefferson County Sheriffâ€™s Department to fight crime in the area. The police department employs nine police officers. Examples of calls to the police department related to community health concerns are to assist and elderly person who has not eaten to an unknown person lying in the street (possible heart attack). The police department handles two types of responses: calls for service where no EMT is needed and pro-active incidents (e.g. speeding or other violations of the law).
The police department does not have a jail, but transfers all prisoners to the Countyâ€™s Sheriffs Department on Highway 33 for incarceration. They do have temporary holding cells to hold criminals awaiting transfer, minor troublemakers and drunks needing short term counseling services (H.Davis, personal communication, October 17, 2006).
Mutual aid is provided to the community through a couple of different organizations. Once again the churches play a huge role in helping the community. The congregations carry out a variety of ministries intended to help motivate persons to help themselves. Members of the churches work with families to help them understand and make use of social services available. The families are helped with budgets, planning menus, etc. Occasionally when persons need gas money to travel to a job, the churches try to help. One particularly important ministry concept of the congregations is team visits. Persons from the congregations go to the homes of elderly, handicapped, newcomers, and others. In the homes, the team sings, gives communion, reads the scriptures, teaches a church school lesson, or does whatever is needed at that home. Most importantly, they leave the clear expectation that someone will come again to that home in the Name of Christ (H.Davis, personal communication, October 17, 2006).
Another organization is the Department of Health and Human Services. The Health Department has several different programs, including (www.msdh.state.ms.us, 2006):
Â· Women & Childrenâ€™s Programs (Womenâ€™s Health Programs, Child and Adolescent Programs and WIC Nutritional Programs)
Â· Family Programs (Dental and Oral Programs, Family Planning, and Seniors)
Â· Preventive Health Programs (Chronic Disease Prevention, Know You Numbers and Injury Prevention)
Â· Other Health Programs (Emergency Preparedness, Emergency Medical Services and Health professional recruitment)
Â· Healthy Living Programs (Restaurant inspections, My Healthy Weight and Nutrition)
Â· Disease Control Programs (West Nile Virus, Immunizations and Epidemiology)
Medicaid is state administered program (www.cms.hhs.gov, 2006). To become eligible for Medicaid in Mississippi, a person must be in one of these general categories: pregnant, a child or teenager (under the age of 18) or be aged, blind or disabled. Medicare is a federal program. Its requirements include: 65 years of age or older, younger than 65 with disabilities or a patient with end-stage renal disease (ESRD). One other program is the Mississippi State Childrenâ€™s Health Insurance Program (MSCHIPS). This program is designed to meet the health care needs of low-income or underinsured children.
According to the Mississippi State Department of Health Annual vital statistics report, the percentage of live births by race in 2001 for Jefferson County, which includes Fayette, was 134. This number can further be divided into two categories: Non-White and white. For the non-white population, the number of live births was 126. For the white population, the number of live births was only eight. Jefferson County has a live birth rate of 13.8 per 1,000, which is slightly lower that the state rate of 14.9 per 1,000 (MSDH, 2001).
The infant mortality rate, which is the overall indicator of health in a community, in Jefferson County for the non-white population remained at a constant number of 11.8 while the rate for the white population has been on a sharp incline over the last ten years. Having babies when the mother is too young or too old, having them too closely together, poor maternal health or poor nutrition all increases the risk of infant death. Other factors that increase the risk for infant death includes chemical toxins such as alcohol, drugs, and tobacco. After the first month of life, poor infant nutrition, poor hygiene and infectious diseases also increase risk.
Neonatal mortality denotes infant deaths in the first twenty-eight days of life. Causes affecting the mother before and during pregnancy are the generally the cause of deaths during this time. According to the Jefferson County Health Profile, the neonatal mortality rate has decrease from 5.9 to 4.7 over the last ten years for the non-white population. Information was not available for the white population (MSDH, 2001). Information about maternal deaths for Fayette or Jefferson County was not available.
The leading cause of death in Jefferson County for all races is heart disease
(MSDH Vital Statistics, 2001). Accidents and Cancer followed heart disease in the leading cause of death. According to MSDH vital statistics report, the leading cause of death for the white population in Jefferson County is from cancer and heart disease. For the non-white population, the leading cause of death in Jefferson County was from Heart Disease (MSDH Vital Statistics, 2001). Smoking is the single most modifiable risk factor for cardiovascular disease and coronary heart disease.
Mississippi has the highest rate in the nation of births to teens. They are more likely to drop out of school, thus requiring long-term financial support. They are also more likely to be involved in child abuse. Over the past ten years, teenage motherhood in Jefferson County has decreased by a substantial number, but it still occurs at a higher proportion than the statewide percentage (MSDH Vital Statistic, 2001).
A health risk profile is a series of questions, which can help determine a personâ€™s risk for developing certain diseases or conditions. The profile can be disease specific or general. An overall health risk profile is often used during a regular physical exam. It can help physicians direct the course of treatment or give counseling about behaviors or activities that may put people at risk for developing certain kinds of conditions. For an example, smokers may be counseled about smoking cessation and individuals with high body mass indexes may be counseled about weight reduction. The more specific the health risk profile, the more likely it will identify risk factors for conditions. The health risk profile for Jefferson County targeted select aggregates in the each community. These select aggregates are individuals with hypertension, heart disease, obesity, poverty, teenage pregnancy, and individuals with limited access to health care. The profile asked questions relating to eating habits, genetic predisposition for certain diseases, exercise activities, education level, and whether or not individuals had sufficient transportation and an adequate living environment. Even though a heath risk profile is not a definitive diagnostic method, it can still help identify people early on that might be at risk for developing certain conditions. A person in a high-risk group may be able to change risk by changing behavior.
The functional ability level of any community is characterized by the functional level of the individuals of the community. School enrollment, educational level, marital status, housing, income, and sufficient transportation can all depict the functional level of a community. The highest educational attainment for residents living in Jefferson County is high school diploma, which was a total of 28.1 percent of the total population according to the 2000 U.S. Census. Twenty-one percent of the population had attended college or obtained an associateâ€™s degree. Only six percent had a bachelorâ€™s degree and four percent had a masterâ€™s degree, professional or doctoral degree. The remainder of the population did not finish high school. Lower education levels affect the functional ability of the community severely because there are no qualified personnel to hold job positions that are required to maintain the community at a healthy level. The median household income for Jefferson County is $18, 447 per year according to the 2000 U.S. Census Bureau. According to Maslowâ€™s Hierarchy of needs, physiologic needs must be met first to sustain life before reaching the other levels of the hierarchy. Without sufficient income, these needs could not be met therefore indicating that the functional ability level must remain at the lowest level of the hierarchy. Sufficient transportation is also needed to maintain a healthy functional ability level. Without good transportation, access to healthcare is limited.
Fayetteâ€™s residents have several healthcare facilities at their disposal. There is Jefferson County Hospital, Jefferson County Health Department, and a Family Clinic. The local residents in this community depend on these facilities to provide their basic healthcare needs such as: immunizations, birth control, yearly wellness exams, sick visits, and emergency stabilization.
Jefferson County Hospital is a 20 bed facility with two an acute care unit, behavior unit, and an emergency room. The acute care unit has nine beds with a staff of 13 nurses including both registered nurses and licensed practice nurse, and 15 certified nursesâ€™ assistant. The behavior unit has 19 beds, which only accommodate adult patients. The behavior unit is staffed with 5 registered nurses and 11 certified nursesâ€™ assistant, and one nurse practitioner. The emergency room consists of two beds and seven registered nurses. There are currently five physicians on staff at the Jefferson County Hospital, two social workers, and 2 activity directors. The hospital is not accredited by Joint Commission, however is accredited by the state of Mississippi (G. Smith & I. Wilson, personal communication, November 27, 2006)
The Jefferson County Comprehensive Health Center provides a wide variety of services to the residents of Fayette, MS; with a staff of four physicians, four licensed practical nurses, 2 certified nursesâ€™ assistants, and one nurse practitioner. This facility works in conjunction with Women, Infants, and Children (WIC), Adams, Jefferson, Franklin, Claiborne Community Action Agency (AJFC- Head Start), and Pharmaceutical services. Other services include:
Â· Dental assistance
Â· Family planning- Early, Periodical, Screening, Diagnosis, and Treatment
Â· Transportation services
The services of this facility are expanding into the neighboring city of Natchez, MS which is approximately 30 miles south of Fayette (D.Tenner, personal communication, November 27, 2006).
The Jefferson County Nursing Home is a 60 bed facility providing a variety of services to its residents. The workforce if the nursing home includes three (3) registered nurses, twelve (12) licensed practical nurses, two (2) social workers, one (1) occupational therapist, one (1) recreational therapist, and one (1) physical therapist (L. Bradford, personal communication, November 27, 2006).
Due to the limited resources of these healthcare facilities, residents seeking major procedures seek services at hospitals in neighboring towns. Fayette is located approximately 30 miles from Natchez, MS which consist of two major hospitals, and 45 miles from Vicksburg, MS with one major hospital. With an aging healthcare workforce, and a declining entry into the workforce is a major concern of this community. However, the benefit of having a small community and workforce is the family-like relationship among residence and healthcare professionals are readily available to assist when needed or asked.
The vernacular language among local residents includes slang and Ebonics. The communication patterns for Fayette include one newspaper company the Fayette Chronicle. There is no radio station in Fayette, but residents usually communicate through 97.7 WTYJ in Natchez, MS. The Fayette Chronicle publishes its newspaper each Thursday. The newspaper includes articles on area news, sports, weather, and police reports. The radio station, 97.7, is a FM station that reports news from Fayette as well as Natchez and surrounding areas. This station usually plays gospel music in the afternoon and evening. This station is also the primary source in Fayette for information during bad weather and tornado reports.
Residents of Fayette are active participants in all area activities. Annual events include Fayette Day, Annual Christmas Parade, and Jefferson County High School Homecoming parade. Fayette Day is an annual event that was originally started by Charles Evers in remembrance of his brother, the civil rights leader Medgar Evers. Itâ€™s a three day event that starts on Friday and ends on Saturday.
Residents of Fayette travel to surrounding communities in search of resources not available in a small town. Neighboring communities within a thirty mile radius provide means for health care, shopping, and entertainment.
The majority of the registered voters in Fayette, MS belong to the Democratic Party. Democrats believe in equality for all people regardless of race, gender, or economic status, all workers deserve fair pay and retirement, all students are entitled to high quality education, and the environment should be consumed and protected (Statement of Democratic Principles). Most decisions in the town are made by the mayor and the board of alderman which consist of five members.
The first nursing diagnosis is poverty among the residents of Fayette, MS related to low incomes, lack of major industries, and lack of education. The goal related to this diagnosis is to reduce the prevalence of poverty. The first objective for this goal is that an outreach program will be developed at the high school level to determine career interest and ways to obtain career goals. The interventions for this objective are to identify ways to implement career programs in high school; and to provide in-service to staff members that will be implementing the programs. To do this, we must have permission from the Jefferson County School Board to write a grant to the Mississippi Department of Education for funding for the program. The second objective is to work together with the State of MS to bring a WIN job center to the area to help adults find careers for which they are qualified and interested. The interventions for this objective are to identify ways to implement career programs in Jefferson County; and to provide information about grants such as WIA, to entice people to go to school or get training to learn a trade. The second goal is to increase the number of jobs in the Fayette area. The objective is that the City Council and Chamber of Commerce will inform companies of the benefits of owning/operating a business in Jefferson County. The interventions for this objective include investigating and recruiting research companies that are looking for new areas to open a business site; informing companies/business owners of the tax breaks available for opening a business in Jefferson County, informing companies of the rich soil in the area that would be conducive to a good turnaround in pine trees, and training workers to work in the forestry industry.
The second nursing diagnosis is risk for hypertension among residents of Fayette, MS related to noncompliance with medication; obesity; and sedentary lifestyles. One goal for this diagnosis is to reduce the number of residents suffering from hypertension. An objective for this goal is that 50% of all residents at risk for hypertension will have their blood pressure checked monthly. The interventions to fulfill this goal include having the community health clinic to provide a day specifically for blood pressure checks and screenings; and have area nursing students provide free weekly blood pressure checks as a part of their community health clinical rotation. A second objective for this goal is that residents with diagnosis of hypertension will lose 5% of their current body weight. The interventions to fulfill this goal include establishing a community wide fitness challenge; and initiate neighborhood â€œwalk-timesâ€ each evening. A second goal for this diagnosis is to reduce the long-term complications associated with uncontrolled hypertension. An objective for this goal is that residents with medication orders for hypertension will take their mediation as ordered. The interventions for this objective are to provide medication schedules to remind people to take their medication; and to provide a medication organizer to people taking scheduled medications more than once a day. In order to accomplish this, drug representatives will be contacted to provide these complementary drug dispensers. The second objective for this goal is that residents at risk for hypertension will have annual physical exams and health screenings. The interventions for this objective are to have complete lab values drawn and analyzed to locate the residents most at risk for cardiovascular disease; and the community health clinic will provide reduced rates for families below poverty level for health screens. Funding that is received through grants will be allocated towards compensating health care professional for their reduced services.
A third nursing diagnosis is obesity among residents of Fayette, MS related to increased food consumption and insufficient energy expenditure for intake. The first goal for this diagnosis is to reduce the prevalence of obesity among the residents. An objective for this goal is that 50% of the obese residents will engage in an exercise plan that will promote adequate weight loss. The interventions for this objective include establishing a community wide exercise program/fitness plan that will promote weight reduction; and devise a meal plan that will enhance weight loss and promote better eating habits. We will work with local health care providers to provide sample menus and meal plans for the citizens who will participate in the weight reduction program. A second objective states that residents will lose 5% of total body weight over a period of six weeks. The interventions used to make this objective a reality include motivating residents by organizing a competition program to see which team can lose the most weight in a specific time period; and establishing a specific day of the week for â€œweighing inâ€ to see exactly how much weight is being lost per week. The second goal for this diagnosis is to educate residents about long-term complications and risks associated with obesity. An objective associated with this goal will be that residents will organize a support group for those whom are overweight. The interventions include encouraging residents to discuss their perception of obesity and how they think it correlates with health problems; and educating residents about risks of obesity, such as diabetes mellitus and hypertension. A second objective for this goal is to educate individuals and/or families who are at risk for obesity and inform them of the risks that are associated with obesity. The interventions include having area nursing students to provide education classes about healthy eating habits and exercise regimens. Also to have the local health department to provide free screenings for aggregates at risk.
A fourth nursing diagnosis is sedentary lifestyle among residents of Fayette, MS related to lack of resources such as time, money, and facilities. The goal for this diagnosis is to build a fitness facility. The objective for this goal is to develop a grant to maintain the funds to build the facility. The interventions include working with the local chamber of commerce to gather funds and to work with The Partnership for a Healthy Mississippi to provide the facility at a low cost to residents.
A fifth nursing diagnosis is pregnancy among the teenage population of Fayette, MS related to knowledge deficit of oral contraceptives, sex education, and increase sexual activities. The first goal for this diagnosis is to reduce the number of pregnancies among adolescents. The first objective is that both male and female adolescents will be provided sex education. An intervention for this objective is that the school-based clinic will provide comprehensive health education related to contraceptive services and STD prevention. Also parents, schools, the church, and media will help make teenagers aware of the relationship between teenage pregnancy and risk factors such as poverty, sexual abuse, substance abuse, violence, poor school performance, and dropout rates. The second objective involves establishing a peer support group. The interventions for this objective includes the assessment of teenagersâ€™ knowledge about sex and sexuality; and the encouragement of adolescentsâ€™ participation in peer-support groups that allow them to discuss social and dating pressures and other issues related to teen pregnancy. The second goal is to encourage teenagers to stay in school and graduate. The first objective is that teenagers will be assigned a mentor to help them plan short and long-term goals. The interventions include checking school attendants record daily and contacting the parents of excessively absent students. The second objective is to develop day care services at the attending school of the teenage mother. The interventions include identifying state and federal programs that will provide funding; and providing parenting classes for the teenage participants.
The interventions will be carried out through grant funds acquired from the Mississippi Department of Health and Human Services. The proposed grant, written by the members of the Fayette Improvement Commission, will solicit sums totaling $200,000 to cover costs associated with establishment of these new programs.
The community members will express the need for recruitment of new businesses in order to improve the economic condition of Fayette. An increase in this will help facilitate a better life for the citizens. With this increase there is an expected increase in academia of the local students. As a result, the community will witness an increase economic and educational development.
The community members will express their concern with health disparities. They will understand that education concerning hypertension, obesity and their relating factors must take precedence before a change will occur. They will understand that screenings must be consistent and the regimen prescribed by the healthcare professional must be followed. Consequently, the community will experience an improved health status.
The community members will express concerns about the lack of neighborhood health facilities. They will participate fully in the building and establishment of a neighborhood gym. The citizens will encourage each other to participate and obtain information concerning the improvement of their health. Conclusively, the community will report an increase in fitness activities and a decrease in blood pressure and weight.
The community members will express an awareness of the serious teen pregnancy problem. They will express the need to develop and implement a plan to reduce incidence of teen pregnancy, including school based sex education classes and community outreach programs. As a result they should report a reduction in the rate of teen pregnancy.
The community of Fayette, MS was interesting to assess. Even though the townâ€™s weaknesses include poverty, hypertension, obesity, and teenage pregnancy; the town shows its strengths through programs created for improvement. We identified these problems because they ultimately lead to more serious problems. It is important to start at the source so that primary prevention can play a major role in the solution. The windshield survey was completed both during the day and at night. It was used to assess the houses, businesses, highways, and people of Fayette. As a result of these surveys, we were better able to assess the needs of the community. We decided that it is important for us to work with the community leaders and businesses to help with their needs. As a nurse, assisting, facilitating, educating and empowering the community to recognize and implement healthy changes is the overall goal.
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Center for Medicaid and Medicare Services (2006). Retrieved November 10, 2006, from http://www.cms.hhs.gov.
Fayette City Guide (2006). Retrieved November 10, 2006, from http://local.yahoo.com.
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Great Schools (2006). The parentâ€™s guide to K-12 success. Retrieved November 1, 2006, from http://www.greatschools.net/city/Fayette/MS.
Services and programs (2006). Retrieved November 10, 2006, from http://www.msdh.state.ms.us.
U.S. Census Bureau (2000). Profile of general demographic characteristics: 2000. Retrieved October 22, 2006, from http://quickfacts.census.gov/qfd/states/28000.html.
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ePodunk (2006). Retrieved November 12, 2006, from http://www.epodunk.com
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