Running head: COMMUNITY ASSESSMENT

Community Assessment of Mason County

Jennifer R. Williams
Ferris State University

Abstract
Community Assessment is an important part of community health. Recognizing issues
within a population assists in the improvement of health within communities. This paper
will discuss the overall review of Mason County, Michigan and the related health issues
identified in this small area. Community data will be discussed along with priority issues
for health promotion. Vulnerable populations will be identified along with a
nursing plan for improvement in these areas of health concern.
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Community Assessment of Mason County

Geographical Area
Mason County, Michigan is approximately 2000 square miles and is made up of a
large part of rural property (U.S. Census Bureau). The borders of this community are
defined by beautiful Lake Michigan. Lake Michigan defines the borders of Mason
County with 747 square miles of water. Business US 31 is a 3.1 mile highway business
spur running into the Ludington downtown area along a former routing of US 31. This
highway is a defining landmark of this county. US 31 ends at US 10 near the eastern city
limits of Ludington then continues at the base of Scottville city limit and runs through
Mason County up to Manistee County(masoncounty.net).
There are two main cities and three villages that make up Mason County,
Michigan. Ludington and Scottville are cities on the west side of the county, while
Custer, Fountain, and Free Soil villages make up the east portion. The cities maintain the
largest part of the economic enrichment in the area. Shopping, entertainment, healthcare,
and other amenities are found within these city limits.
Methodology
In assessing this community, the Epidemiologic framework will be utilized. This

framework “focuses on the health of the population” (Maurer-Smith, 2008). With this

framework, there will be a focus on the identification of at-risk and vulnerable

populations. Because Mason County is a small rural community, there are often

difficulties with creating and maintaining appropriate resources for vulnerable or needy

populations. Related to the impact of the recently faulty economy and decreased work

availability, there is increased stress on these populations. Programs created by this

framework are aimed at reducing risks to vulnerable and economically stressed

populations.
Cultural Factors and Ethnic Mix
Mason County, Michigan is a small community with a population of approximately

28,782. The county is primarily a Caucasian community with many small minority

groups. “The racial makeup of the county was 95.84% White, 0.73% Black or African

American, 0.78% Native American, 0.28% Asian, 0.02% Pacific Islander, 0.82% from

other races, and 1.53% from two or more races. 3.01% of the populations were Hispanic
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or Latino of any race. 24.5% were of German, 10.4% Polish, 8.8% English, 8.5% Irish,

7.7% American and 5.0% Swedish ancestry according to Census 2000. 96.0% spoke

English and 2.2% Spanish as their first language” (U.S. Census Bureau).
Government and Community Growth
The mission of Mason County government is to assist in supporting the quality of

life by providing a range of services relating to the safety, health, social and economic

well being of county residents. (masoncounty.net) Mason County has grown enormously

over the last ten years, however with recent economic issues and increasing

unemployment rate, the growth has temporarily halted. Many new businesses have

recently closed and some continue to struggle.

Healthcare
Healthcare dominates this area with the local hospital being the largest employer as

well as the largest healthcare provider. There are multiple health care organizations in the

community, though it is a small rural area. The local hospital is approximately a 100 bed

facility. There are two nursing home and rehab centers in the area. One 75 bed

government funded medical care and one 126 bed privately owned long-term car and

rehab center. We also have a local health department that provides community centered

care as well as our community mental health center. We do have an urgent care center

that is small, although serves its purpose. There are multiple home care services within

our area that provide care to those who attempt to remain independent at home as long as

possible. Finally, we have multiple family, obstetric, internist, psychiatric, dental, and

chiropractic practices.
Education
There are multiple school districts in Mason County divided by three separate city

limits; Ludington, Scottville, and Custer, Michigan. The schools get progressively larger

as you travel west into the county, Custer being the smallest of the three. Related to the
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lack of economical opportunity within this area, the school populations continue to

decline through the years. It is expected that the smallest of the schools will eventually be

forced to combine with one of the two larger schools due to lack of funding and

attendees. School districts in Mason County include Free Soil Community Schools,

Ludington Area Schools District, Mason County Central Schools, and Mason County

Eastern Schools (epodunk.com).

Transportation and Housing
There is only one public transportation system available within this community. It

primarily runs service within the Ludington area, although there are exceptions to this

rule on specific days of the week at specified times, where this transportation does travel

to the Scottville and Custer areas. There are also a few cab companies that run transport

within Ludington city limits.

There are multiple apartment complexes in the Ludington area, two in Scottville,

and none in Custer. Custer and Scottville are primarily defined by privately owned

homes. However, Ludington has multiple housing complexes in addition to the apartment

complexes, as well as multiple condominiums.

A geopolitical description was utilized to define this community. A geopolitical

community “is a spatial designation—a geographic or geopolitical area or place; these

areas a formed by either natural or human-made boundaries” (Maurer-Smith, 2008).

Health Trends/Social Issues

Mason County, Michigan has a strong backbone of health care services. However,

there are certain difficulties within this community that stand out. With over 400 of

approximately 1500 hospitalizations a year, Heart Disease is the number one cause of

hospitalization in this area. (dhd10.org). This illness is also the number one cause of
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death in Mason County. Nearly 80 deaths a year of almost 400 are caused by some form

of Heart Disease. (mdch.state.mi.us).

“The term "heart disease" refers to several types of heart conditions. In the

United States, the most common type of coronary artery disease (CAD), which can lead

to heart attack”(cdc.gov). This risk can be greatly reduced through lifestyle changes and,

in some cases, medication. It is essential that as health care workers, that we screen

individuals accurately for this type of disease. It is especially important in counties where

it is the cause of .a high rate of incidence and death. With these types of statistics, it is

important to focus on this area as a vulnerable population that is at risk for community

health issues. Many individuals are affected by this disease because of other resulting

issues including; heredity, in appropriate diet, lack of exercise, and inability to receive

appropriate healthcare.
Another issue affecting health trends in Mason County is the unemployment

rate. In January 2009, the unemployment rate in this county was 14.2%, almost one and a

half times the national average. The difficulties that individuals in this population face,

may lead to other health concerns and issues. “Socio-environmental and stress-based

theories of alcoholism propose that alcohol abuse and addiction develop as coping

reactions to stressful socio-environmental conditions such as unemployment. However, it

is also known that risky behaviors, such as problem drinking, result in increased

unemployment. Thus, it is likely that both causation and selection effects are involved in

the relationship between alcohol consumption and unemployment” (medscape.com).

Alcoholism, tobacco abuse, and lack of activity, are all typical health

behaviors identified within the unemployed population. These issues can all lead to the

original problem identified, heart disease. “There is evidence from longitudinal studies

that unemployment may impact body weight; data from the British Regional Heart Study
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showed that men who had experienced some unemployment during the study period were

more likely than continuously employed men to either lose or gain more than 10% of

their body weight. In the study of a factory closure in Michigan, job loss was shown to

have an impact on body weight. Subjects who lost their job showed greater instability in

their weight over the two years of observation, even after re-employment”

(medscape.com). Many of these issues are caused by underlying depression the

unemployed face when they are unable to provide appropriated lifestyles for their

families.
Homelessness is the final health issue identified in this community. For a small

area, there are many homeless individuals without appropriate housing for both

themselves and their families. There are not any specific statistics listed, however many

individuals are treated within the community, especially at the local emergency room,

that are identified as “homeless” or without appropriate shelter. Homelessness inevitably

causes serious health problems. Illnesses that are closely associated with poverty –

tuberculosis, AIDS, malnutrition, severe dental problems - devastate the homeless

population (nhchc.org). These health problems can be very difficult to treat without the

appropriate medical care and insurance coverage needed to prevent them.

Many individuals who are homeless do not attempt to pursue treatment or health

care needs until absolutely necessary. “Health problems that exist quietly at other income

levels - alcoholism, mental illnesses, diabetes, hypertension, physical disabilities - are

prominent and deadly in the homeless” (nhchc.org). Lack of treatment for many of these

diseased will eventually cause increased fatalities within the homeless populations. In

addition to common illnesses, these human beings without shelter may fall prey to

parasites, frostbite, infections and violence (nhchc.org).

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Finding health care can also be tough or near impossible for these individuals.

People who are homeless are more concerned with meeting immediate needs for shelter,

food, clothing, and safety than with seeking health care (nhchc.org). The fight to survive

is understandable and therefore putting healthcare at the bottom of the list for “necessity”.

For some, the symptoms of their illnesses or bad experience with the health care system

in their past cause them to actually avoid health care (nhchc.org). On the other hand, it is

the responsibility of healthcare workers to encourage the treatment of diseased that may

threaten not only the health of the homeless, but all who they may come into contact

with. Undetected communicable diseases can quickly escalate into a deadly public health

problem. This statement should empower healthcare workers to strive to make the

homeless individuals experience within their organization a good one. With the

appropriate approach and care, homeless individuals may find certain healthcare agencies

“a savior” in their long difficult experience.

Nursing Plan for the Homeless
The highest priority for change in Mason County would be the high rate of

homelessness in ratio to the population. In addition, this population has limited resources

within this area related to the rural location of the community. Finally, the risk to the

community is greater because of the possibility of the spread of communicable diseases

and the increased ratio of deaths for common illnesses.

In identifying realistic objectives, it would be important to create appropriate

resources for this vulnerable population. In order to do this, the community would need to

create appropriate homeless shelters within the area. There are currently no rescue

missions for the homeless in Mason County. The next intervention would be to educate

the emergency room on resources available to homeless individuals, in addition to being

able to identify this population. This would increase the ability to provide appropriate
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treatment and resources when needed. In addition to these interventions, there should be

education provided to the homeless regarding medical treatment, free clinics, prevention

of illness, and available resources. Finally, the implementation of a “homeless bank” at

the local hospital would also be appropriate. This type of “bank” could provide donated
food, clothing, and supplies to homeless individuals who choose not to comply with
available resources.
With the use of the interventions listed, it would be expected that the homeless of
Mason County would have a better outlook on life and healthcare choices. Individuals
who seek treatment in the local emergency room would have appropriate resources
provided along with needed education about their health and lifestyle. In addition, these
individuals would be provided with clean clothing, meals, and other needed essentials to
assist them after discharge. The expectation would be that available shelter resources will
improve within a year’s time. Organization of the “homeless bank” would begin
immediately and education would continue and improve over a three month period. With
all changes implemented, these individuals would be off the streets and in a shelter with
food and clothing.
Conclusion
Mason County Michigan is a small rural community that has many of the same
issues of a larger community. Even though Mason County is vast with medical resources,
it continues to struggle with community health issues. Vulnerable populations were
identified as individuals with cardiac disease, the unemployed, and the homeless. Each of
these issues continues to be identified as difficult situation within the health care
community of this small town. However homelessness remains prominent related to the
small area ratio. With the appropriate interventions and implementation of new programs,
there should be improvement in the overall health of the community. Making sure that
the vulnerable populations within a community are appropriately dealt with will create an
over all healthier community. Community assessment will continue to be an important
tool in the process of improving the health of community populations.
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Resources
Cause of Death by Age, Mason County 2007. (n.d.). Michigan Department of Community
Health. Retrieved from http://www.mdch.state.mi.us/pha
District Health Department #10: Statistics. (n.d.). District Health Department #10: Home.
Retrieved from http://www.dhd10.org/about/statistics
DELEG - January Unemployment Rates Increase in All of Michigan's Regional Labor
Markets. (n.d.). SOM - State of Michigan. Retrieved from
http://www.michigan.gov/dleg/0,1607,7-154--211061--,00.html
How to End Homelessness. (n.d.). National Alliance to End Homelessness. Retrieved
from www.endhomelessness.org
Linn, M., Sandifer, R., & Stein, S. (n.d.). Effects of unemployment on mental and
physical health.. National Center for Biotechnology Information. Retrieved from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1646287/
Mason County QuickFacts from the US Census Bureau. (n.d.). State and County
QuickFacts. Retrieved from http://quickfacts.census.gov/gfd/states/26/26105.html
Maurer, F. A., & Smith, C. M. (2008). Community/Public Health Nursing Practice:
Health for Families and Populations (null ed.). St. Louis: Saunders.
The basics of homelessness. (n.d.). National Health Care for the Homeless Council.
Retrieved from http://www.nhchc.org/Publications/basics_of_homelessness.html