NURS 424: Health in the Community
Windshield Survey- Westminster, Maryland
Sandra R. Berman School of Nursing and Health Professions, Stevenson University On-line
NURS 424: Health in the Community
Professor
Windshield Survey- Westminster, Maryland
Located in an outlying community of the Baltimore metropolitan area under the zip code 21157 and 21158, the Westminster neighborhood has a total population of 175,305. Individuals below the age of 17 comprise the largest percent of the population at 21.7%, next being 65 and older at 18.1% (Data USA, 2024). According to County Health Rankings females accounted for 50.1% of the population and the male population was not reported. Racially, 86.5% of the population identify as non-Hispanic White, 4.6% identify as Hispanic, and 4.1% identify as non-Hispanic Black. All other races/ethnicities for which data are available each represented 2.5% or less of the population (Data USA, 2024). The area is rural and predominately farmland with areas of single-family homes, and apartment buildings. Carroll Hospital Center, a Life Bridge Health facility, is the major healthcare provider for this area.
Characteristics of Clinical Community of Westminster, Maryland
During the windshield survey, one of the most important aspects in the clinical community of Westminster, Maryland is the access to healthcare facilities. The clinical community in the city has been is well equipped with excellent healthcare facility at both the local and regional level. These facilities are also very accessible for the residents of the region. One of the most accredited hospital is Carroll hospital center which serves as the cornerstone. There are also various offices and facilities within Westminster area that ensures professional clinical practice and that the population is kept in good health.
In terms of clinical services, the Carroll hospital center is located at 200 Memorial Avenue, with a 193 bed capacity. This is a hospital campus that provides medical and preventative care for people of all conditions and ages. This include physicians, specialists, surgery, emergency treatment, specialized care, and wellness education. There are also more than 400 physicians on the medical staff who represent 38 specialties. The hospital encounters is estimated at 575,000 each year and this includes an inpatient and outpatient medical care and community programs.
The hospital also provides care for cancer patients, cardiovascular care which also includes an emergency angioplasty, the family birth place, and the center for breast health. Cardiac rehabilitation, diabetes and wound care, medical laboratories among other services. There are also satellite locations around the country that includes south Carroll health and wellness pavilion which is situated in Eldersburg. The hospital center also promotes healthy living through hospital sponsored community events, classes, and support groups. Other affiliates of the hospital include Carroll health group which is the only group affiliated with the hospital and specialty care providers who work from a common electronic medical record.
In Maryland the proximity of Westminster to Baltimore region also provides the city with a close access to other state of art medical facilities. For example the John Hopkins hospital, the University of Maryland center which is renowned for service as a model for emergency care. Other medical facilities include the Kennedy Krieger institute, st Joseph medical center, Sheppard Pratt health system, and Union memorial hospital among others. When it comes to assisted living facilities, Westminster has his Carroll Lutheran Village and the Westminster Ridge that continues to care for senior citizens.
Community Health Indicators
A community health indicator for any city is made of Sociodemographic characteristics, health status, and quality of life of that city, the health risk factors, and health resources that are relevant for that community. In terms of demographics, a 2022 report by Data USA, (2024), indicates that Westminster had a population of 20.1 thousand people with a median range of 37.3 with a median household income of $71,286. Also between 2021 and 2022 the population of Westminster Maryland grew at a rate of 1.6% with a median household include at $71,286. The 5 largest groups in the city are Non-Hispanic whites at 79.6%, blacks and non-Hispanic African americans at 6.72%, Asians at 2.99 an Hispanics at 2.67. All of these population speak English fluently as their primary shared language at home (Data USA, 2024). The largest university in the city is McDaniel College which as at 2022 awarded 863 degrees. Also the median property value of the city was $292,900 with home ownership at 53.8%, also most people in the city drive by themselves to work (Data USA, 2024). There is also an average commute time at 29.7 minutes, with an average car ownership being 2 cars per household.
Strengths and weaknesses
One of the main strength of the city is economy, where out of its population 10,000 people are employed with the largest industry being the education sector that employs 1500 people, second is the healthcare and social assistance with 1400 people, the retail and trade sector with 930 people (Data USA, 2024). The highest paying industry in Westminster is information at $95,500, science, and technology at $79,200 then finance and insurance at $75,900. The average income for men is 1.24 times higher than that of females at $77,200 with the income inequality in Maryland standing at 0.454, which is lower than the national average (Data USA, 2024).
Poverty levels - the population of poor people in Westminster is relatively low at 12% which is about 2,000 people out of 20,000 that live below poverty line. This number is also lower than the national average of 12.5%. Males have the largest number of poor people that females with whites leading followed by Hispanic then other races. Other factors that affect poverty levels include family size and total income.
Health- this is a great strength in Westminster were 94.8% of people have health coverage, with 52.6% already in employee plans, and 14.8% on Medicaid, 13.7% on Medicare and 12.5% on the non-group plans while 1.2% are on military or the VA plans. The survey also found that primary care physicians see 2255 patients per year which is a 1.76% increase from the previous year of 2021. Also dentist see 1774 patients each year while mental health providers will see 404 patients per year. According to the survey also the patient to clinic ration stands at 2255 patients to 1 clinic. In terms of healthcare diversity, when it comes to insurance coverage and age range, 20.7% of insured persons are under 18 years, while 26.5% are under 34, and 18% are over 64 years. In terms of gender 47.8% of male are insured while 52.2% are women.
Healthcare issue and solutions
The healthcare issues in Westminster evolve around the rising cases of chronic healthcare conditions such as : diabetes, obesity, behavioral health, heart disease, and cancer. Studies show that the current prevalence for people living with diabetes in Westminster stands at 8.3% with the national median standing at 10.4%, also those living with obesity stand at a prevalence of 31.1% in comparison to the national median of 36.2% (John Hopkins Medicine, 2024). There are also high rates or cancer and respiratory diseases which stand at 54% due to social and medical factors. Also approximately 24% of cancer deaths in the city are of lung and bronchus, second most cancer related deaths are of the colon at 9% and breast cancer at 8% while liver cancer stands at 5%. Other cancer related deaths include prostate at 5% and pancreatic cancer at 7% (John Hopkins Medicine, 2024).
To address this concern, it will be important for healthcare providers to focus on providing the community with nutrition education, and ensuring and environment that is compatible with doing physical activity or increasing social support for weight loss. Also diabetes has been identified as one of the prioritized health conditions USA News, 2024). This is because patients that already have diabetes can be minimized through ensuring proper nutrition, diligent monitoring of blood glucose level and exercise. Also rural Marylanders can benefit from management of diabetes, healthcare prevention programs, and community support.
Another healthcare concern for Westminster, Maryland is heart disease. The risk can be decreased through education on proper nutrition. It is also important for the clinical community to educate the people of Westminster about the risk factors related to smoking as a strategy to decreasing the prevalence of heart disease in Westminster, Maryland. Nutritional education, physical activity programs, and cessation of smoking will have a bigger potential of going a long way in the prevention of heart disease. Another important approach to healthcare issues is to look at behavioral health of the community which includes factors such as substance abuse, mental health and other behavioral factors like sexual practices which will also include preventable screening. It is important to have interventions at a young age as this is one of the best strategies to deal with behavioral health problems (John Hopkins Medicine, 2024). By understanding the root of behavioral health conditions and coming up with a supportive environment for individuals that suffer from the said behavioral health conditions, this can greatly improve the life of people in Westminster Maryland.
During the windshield survey it was also discovered that there is a desire of more screening including the prevention of services within the city. Annual screening for disease such as cancer and diabetes, expanding outreach on health education and an emphasize on the three can also help in minimization of health risk behaviors. Another main health concern is the prevalence of cancer in the community as there are different types of cancer and those diagnose also have varied outcomes (McLendon et al., 2019). Factors such as lifestyle changes, cancer screenings, and HPV vaccination are also among the evidence based approaches to use when it comes to cancer prevention. It is important that the healthcare community at Westminster sets up and environment that this can be easily obtained thus improve the outcomes of those diagnosed.
Community Health Nursing Interventions
Based on the healthcare issues identified in Westminster, Maryland, the community health nurses can implement various interventions as they understand the specific needs that the community members required. There are several innovative ways that they can use in improving the healthcare of the community.
The first intervention is development of more community healthcare centers that can include a non-wrong door policy as a way of ensuring better coordination of care. Community healthcare centers are also vital in serving as a one stop shop for services that include comprehensive care for residents which is ensure the streamlining, effective and seamless. Another community health intervention is the use of telehealth especially when making a following and monitoring for patients with chronic condition such as diabetes and cancer or heart diseases. This will help address the patient’s barriers to transportation. The telehealth mobile health unites can be a new supplemental services to the current services. With telehealth the community nursing team will be able to eliminate barriers of attracting and retaining nurses and healthcare professionals especially in the rural parts of Westminster, Maryland. Telehealth health units are also very important resources that ca offer medical services to all residents. This will also allow most residents to be served without having to worry about cost of transportation.
Role of the Community Health Nurse
The community health nurse plays very important role in delivery of healthcare services to meet the current healthcare issues. The community healthcare nurse will be instrumental in developing a community health demonstration program which allow nurses and clinicians to test new delivery models before they are scaled to other rural communities in Westminster, Maryland and were they can be applicable. For example, the community health nurse will help in developing patient centered health neighborhoods that can serve as a coordinated center for diverse health needs of Westminster, Maryland. Community health nurses will also play a very important role in stigma reduction especially in chronic health conditions such as heart disease, diabetes, cancer, sexually transmitted infections and obesity. This is because stigma is one of the largest barriers for community health nursing and care (Data USA, 2024). In particular stigma around those diagnosed and treated for behavioral health conditions such as HIV/Aids or sexually transmitted infections. Community health nurses will thus engage demystification campaigns regarding various diseases so as to increases understanding about services offered and approaches to management of various healthcare conditions.
Prevention Solutions
With the increased levels of prevalence of individual with chronic conditions such as obesity, cancer, and heart disease within the community of Westminster, Maryland, one of the most important approaches to prevention is educate this community regarding the diseases and how they can prevent or manage them. it is will also be important to increase access to information centers through establishing a hotline for emergencies, social media accounts that deal with sensitization of the community regarding the statistics of chronic disease and how they can manage or ways that they can get help (Kamalam, 2017). Community health clinics can also offer more resources to aid those that are in need of medical insurance and promote screening of various chronic conditions.
Conclusion
In summary the windshield survey was able to explore social, economic and health needs of residents of Westminster Maryland. Some of the common healthcare issues that were identify include dealing with chronic health conditions such as diabetes, cancer, and heart disease, dealing with behavioral health conditions such as HIV/Aids and sexually transmitted infections among other factors. In this windshield survey solutions were also discussed which include community health nursing interventions, the role of the community health nurse and proposed solutions. In conclusion thus, Westminster, Maryland can be rated as one of the cities that have been able to ensure implementation of various social determinants of health such as education, employment, and provision of Medicare and Medicaid healthcare insurance. It is also important that the community members are sensitized enough to use these healthcare facilities so that the rates of admission to hospital can be reduced and access to healthcare can be realized. The ratio of healthcare facilities to patients is still very low; among the interventions suggested from the windshield survey was the implementation of telehealth services which can go a long way in ensuring access to health even in remote areas of Westminster, Maryland (McLendon et al., 2019).
References
Data USA. (2024). Westminster, MD. Retrieved June 29, 2024, from https://datausa.io/profile/geo/westminster-md?redirect=true
John Hopkins Medicine. (2024). Cancer in Maryland. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/kimmel-cancer-center/community-outreach-engagement/cancer-maryland
Kamalam, S. (2017). Community health nursing process. Essentials in Community Health Nursing Practice, 39-39. https://doi.org/10.5005/jp/books/12932_5
McLendon, S. F., Wood, F. G., & Stanley, N. (2019). Enhancing diabetes care through care coordination, telemedicine, and education: Evaluation of a rural pilot program. Public Health Nursing, 36(3), 310-320. https://doi.org/10.1111/phn.12601
USA News. (2024). Healthiest communities. www.usnews.com. https://www.usnews.com/news/healthiest-communities/maryland/carroll-county
