Assessment of Haywood Park Community Hospital

The availability and affordability of healthcare are fundamental requirements for any community. Closure of a local medical facility impedes the community’s access to healthcare, resulting in huge negative medical implications and welfare. Demographic and anthropometric information is important in conducting community assessments to ascertain the extent of the prevailing problem within the community. Haywood Park Community Hospital (HPCH) in Brownsville, Tennessee was shut down following the state’s decision not to be part of the Medicaid program. The facility served a large section of Brownsville’s population; including the Native Americans, Whites, Hispanics, and the African-Americans. Consequently, the community suffered health problems necessitating the assessment to be conducted to determine the extent of the problem. The assessment was conducted among the Black and White communities within Haywood County. Information such as employment status, safety, support systems, nutrition, hygiene, health promotion activities, stressors, and risky behavior were gathered using methods such as surveys and focus groups. 

Defining the Community 

Blacks and Whites comprise the majority of Haywood County population, constituting 64.2% and 30.2% respectively. Of these demographic groups, the majority of the residents are the elderly aged between 55-74 years. The focus of this assessment is on the elderly people of the Blacks and White community in Haywood County. For the group, boundaries such as income, education level, and lifestyle are non-existent. The elderly people within Haywood County, Tennessee have no particular traits that differentiate them from other groups. 

Most of the residents of Haywood County are educated beyond high school level; thus are competitive for some white collar jobs available. The elderly are mostly insured as they need medical attention now and then. Moreover, these elderly folk are geographically situated in rural areas. Therefore, a community assessment will help in identifying all the resources available within the County so that these can be used effectively to bring to an end the misery of the elderly folk. With the resources identified, it becomes easier to plan strategically for the accomplishment of both individual and communal goals. The information, on the other hand, will be collected through Participant observation, Surveys, informant interview, focus group, and windshield surveys. 

Assessment of Resources 

Windshield Survey 

In this survey, a walk through the county revealed that Oakwood cemetery that was well maintained, with evidence of a previous yellow fever outbreak in the region. This points out to one of the possible health needs of the community – prevention and treatment of future yellow fever and other hemorrhagic viral infections. The people were religious as indicated by the presence of the Three-way Baptist Church and the Catholic Church (Hiel et al., 2015). The people also practice cotton farming as exemplified by the vast cotton fields and in some places cotton that has been baled is seen ready for transportation. More so, cotton farming is not the only economic activity as the county is also involved in forestry, hunting, and fishing. Other activities that are of economic significance include manufacturing, educational, retail trade, transportation and warehousing 

Participant Observation 

Observation provided substantial information for the community assessment. Through observation, it was ascertained that due to the hospital being closed down, the services of an ambulance were extremely problematic especially when there was an emergency (Hiel et al., 2015). A recent scenario of such an incident took place where one of the two ambulances was in Memphis while the other was in Jackson and the minimum time for the earliest arrival was expected after two hours. Faced with a patient suffering from a heart attack, the family had to take the option of driving the patient on their private car, luckily the patient survived. 

Informant Interviews 

The people of Brownsville are very social people; hence, it was not difficult to generate a number of informants who were more than willing to provide necessary data. For instance, informant interviews conducted within the county indicated that residents who were educated to the level of high school and beyond were the majority regardless of age or race (Kaufman et al., 2016). Those with a bachelor’s degree and beyond were second while those graduated or had professional degree were countable. A more significant part of the populace was employed and took approximately 20 minutes to get to their work stations. Furthermore, some occupations have been identified to be attracting several people such as production occupation, sales and marketing, material moving, transportation, management occupation, office and administrative support, and building and ground clearing and general maintenance occupations. 

Focus Groups 

These groups proved to extremely valuable in generating data about certain areas of the community such as marriage status of the majority of the population is unmarried. Several reasons were raised as to why so many residents of Brownsville chose to remain single, and one such an excuse was the hard economic times. From the focus groups, it was discovered that the loss of the Haywood Park Community Hospital made the county which is synonymous for a large number of restaurants compared to fast food joints had made the place to be more rural (Lum, Sudore, & Bekelman, 2015). Local leaders are said to have been concerned with the situation and had initiated a wellness campaign aimed at influencing the residents to adopt a healthy lifestyle. From the same campaign, the leaders expected to raise funds for the services of an ambulance, establish a clinic, and possibly a room operator who will be attending to emergencies within the area. 

Natural Calamities 

The area has previously been hit by the F4 tornado that killed six people and left 106 others injured and millions of property damaged. Similarly, another F4 max hit the place in 2003 and injured 86 people and killed 11 while destroying property worth approximately USD$ 40 million. This calls for more revision of the current status of the area staying without a disaster management team, no hospital nearby suggesting that if another act of God strikes, there would be catastrophic consequences. Moreover, the county has been exposed to seven earthquakes; thus making one of the most vulnerable places within the United States. The causes of the natural disasters vary from floods, winds, storms, tornadoes, flash flood, winter storms, hurricane to name but a few of them. 

Surveys 

1. Statistics between Brownsville and Tennessee 

Surveys were conducted, and data obtained from different within the county suggested that in 2014, there were more females than males with their numbers being 5,511 and 4,463 respectively. Moreover, the median age of residents within Brownsville in comparison to Tennessee was found to be 38.2 and 38.6 years respectively (Mossialos, Wenzl, Osborn, & Sarnak, 2016). A further survey revealed that median household income (EMHI) and the per capita income (PCI) were estimated to have increased significantly compared to the year 2000. Thus, the statistics showed that in 2014, the EMHI was USD$ 29,285 an increase from USD$ 27,276 back in 2000. Likewise, the PCI increased from USD$ 15,217 in 2000 to USD$ 20,254 in 2014 (Mossialos et al., 2016). Further statistics from the averaged value of houses showed an increase in the value of the property from the year 2000 where the average value was USD$ 67,800 to USD$ 101,749 in 2014. The averaged value of property was slightly less than that of property in the urban Tennessee that had an average value of USD$ 157,000. 

2. Health-related Issues 

In 2014, around 74 patients were found to be suffering from congestive heart failure, while those suffering from pneumonia were 77, and those patients with acute myocardial infarction were approximated to be 52 in number (Rose, 2018). On diabetic conditions, it was discovered that elderly people were profoundly affected with enrollees of the Medicare that were between the ages of 65 and 75 taking the lead. The 1,156 enrollees that were non-black were found to be suffering from diabetes while those that were black were estimated to be 19 in total. To show the seriousness of the matter, 814 individuals of the same bracket were diagnosed but suffering from eye related problem (Rose, 2018). To facilitate the care for those with diabetes, 1,044 enrollees diagnosed underwent hemoglobin tests while lipid tests were conducted on 923 of the same candidates. 

Within the same year, preventive health services for women were done, and the same age brackets were classified under the blacks and non-blacks groups within Haywood County. Out of the 866 female medical enrollees, mammographic tests were conducted on 591 (Schwartz et al., 2017). Other conditions that were noted include risky and harmful behavior such as adult smoking and the use of Opioid misuse and the death rate associated. 

From statistics obtained from state offices, Tennessee has healthy nutrition of 48.2% while Brownsville had 47.8% which means a good part of the residents are eating healthy meals, and another indicator is the lack of fast food chains that are notorious for selling junk food. On average, the teeth and gum are both not very healthy, within both Tennessee and Brownsville County; thus the needs for a sensitization exercise to teach people how best to maintain their teeth help. The figure further shows how Brownsville has more overweight persons that Tennessee; thus the need to target these people with the healthy foods campaign. 

3. Crime within Haywood County 

From statistics obtained in 2014, the police officer ratio to residents was 3.47 slightly higher than in Tennessee where the ratio was at 2.46. The crime rate was not that high, and the county can safely be classified to be safe. There was 3 murder case within that year, 6 rape cases, 13 robberies, 112 burglaries, 311 theft cases, 39 auto theft cases, 6 arson cases and 122 assault cases within the county. In general, the rate of homicide and crime was extremely low within Haywood County; hence, the place can be concluded to be very safe for visitors. 

The county boasts of several courthouses such as on the 11th South Lafayette Avenue is the General Sessions Court Clerk, Chancery Court Clerk, Circuit Court Clerk, and County Clerk Juvenile Court Clerk (Schwartz et al., 2017). Therefore, the County has not experienced a backlog of cases hence, making the residents more comfortable and confident of the judicial setting. Also within the County is Haywood County Jail that assists in correcting some of the petty offenders as it is seen the number of petty offenders being higher than those with capital offences. 

4. Educational and Religious Infrastructure 

There are approximately seven universities or colleges that are within the proximity of the county and serve nearly 2000 students, one public high school namely Haywood School in Brownsville, and three middle-class public schools serving a total of 3,091 students (Lum, Sudore, & Bekelman, 2015). The County has one massive library that is located on the main street and with a total 30,239 books of which 77 hardcovers, there are also 32, licenses in the state to remember, 3,235 were video and audio materials. 

Churches present within Haywood include Zion Church, Catholic Church, Church of God in Christ, Farmers Chapel Christian Episcopal Church, First Presbyterian Church of Brownsville, St. Johns Roman, First Methodist Church, and fire Methodist Church. There are seven cemeteries within Brownsville Oakwood Cemetery, Israel Cemetery, Rosenwald Cemetery, Magnolia Cemetery, Knights of Pythias Cemetery, and Richards Cemetery. 

Conclusion 

After the closure of Haywood Park Community Hospital, the elderly residents have faced numerous challenges as they are the most in need of the healthcare services. All the data collected and analyzed provided evidence that the residents are suffering due to the worsening conditions (Lum, Sudore, & Bekelman, 2015). Leaders from the region have tried to come up with alternative ways to raise funds for an ambulance and an emergency operating room, but the presenting problem is too huge for them to alleviate by themselves. The biggest hurdle is the lack of funds necessary to initiate the projects. Therefore, the government should expand its Medicaid to allow for the establishment of health centres and consequent extension of medical services to the residents of Haywood County, Brownsville. 

References 

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Lum, H. D., Sudore, R. L., & Bekelman, D. B. (2015). Advance care planning in the elderly.  Medical Clinics ,  99 (2), 391-403. 

Mossialos, E., Wenzl, M., Osborn, R., & Sarnak, D. (2016).  2015 international profiles of health care systems . Canadian Agency for Drugs and Technologies in Health, New York: Routlege. 146-180. 

Osborn, R., Squires, D., Doty, M. M., Sarnak, D. O., & Schneider, E. C. (2016). In new survey of eleven countries, US adults still struggle with access to and affordability of health care.  Health Affairs ,  35 (12), 2327-2336. 

Rose, L. (2018).  Healthcare for the Elderly  (Doctoral dissertation, UC Santa Cruz), Oxford: Oxford University Press, 120-136. 

Schwartz, D. M., Fong, Z. V., Warshaw, A. L., Zinner, M. J., & Chang, D. C. (2017). The hidden consequences of the volume pledge: “no patient left behind?”  Annals of surgery ,  265 (2), 273-274.