Community assessment of Georgetown, Delaware focusing on health disparities

Community Assessment

Demographic Data

General Description

Georgetown is the county seat of Sussex County in Delaware. Georgetown is considered part of the Salisbury, Maryland-Delaware metropolitan statistical area. It shares no boundaries with any major metropolitan area, as Georgetown is located in a rural region. It is known as the Deep South of Delaware because it is historically and culturally connected with the south (Georgetown Chamber of Commerce Business Directory, 2013). Georgetown is technically a town, not a city. According to the United States Census Bureau (2012), Georgetown has a total area of 4.1 square miles of land bring a total of 11 km2. As of the 2012 census, the population of Georgetown is 6,628.

Georgetown is divided into seven administrative departments that work in conjunction with the town manager to serve the needs of the community (Town of Georgetown, 2013). These seven departments include finance, administration, planning, police, public works, wastewater, and water. The mayor of Georgetown is currently Mike Wyatt, and he is aided by a city council including Stephen M. Harstein, Sue H. Barlow, Bill West, and Linda J. Dennis. Each of the town council members oversees a specific ward of the community.

Historically, Georgetown is considered unusual due to the fact that among all Delaware municipalities the town is built around a circle. In the circle sits the town hall, the state and county buildings, and also the historic Sussex county courthouse, which was restored in 1976 and currently managed by the Georgetown Historical Society. Apart from that, there are offices, stores, commercial warehouses, banks, and hotels located around the town. The business owners in Georgetown, as well as the owners of companies that perform important contract work related to agriculture, real estate development, and engineering comprise the unofficial leaders of the community. This is because of the influence they have on maintaining infrastructure and the economy. Georgetown has a strong thread of political conservatism running through the community's white population, but the region is culturally diverse giving rise to a multitude of different voices.

The topography of Georgetown has naturally scenic features such as streams, swamps, canals, parks, bridges, and reservoirs. The most prominent are Lake Waples Pond located at northwest of the town, the Pinelands Nature Trail, the Bay Forest and Bethany Bay, and Emerald Pond. Because of its geographic position, Georgetown was divided during the Civil War and had notably mixed loyalties (Georgetown Chamber of Commerce Business Directory, 2013). The most important annual festivity in Georgetown is Return Day, which is held every Thursday after Election Day in November. The festival celebrates the election with food and festivities as well as a symbolic "burying of the hatchet." Burying the hatchet represents the unity of the community in spite of any political animosity that might otherwise divide it. Thus, Georgetown continues to learn from the past, while also putting the past behind and embracing the future of the community. The future of the community depends on the successful integration of its Latin American community.

C. Environmental Characteristics

Land use is protected for various reasons in order to maintain the quality and quantity of groundwater supplies. Georgetown source of community water supply is ground water that is supplied by five licensed water operators to ensure good quality water to every resident. The companies maintain all service connections and water mains with an average daily flow of 720,000 gallons per day filtering through three water plants being tested 7 days per week.

The sewage, sanitation and waste disposal in Georgetown ensures the environment and premises are maintained in a clean, safe and sanitary condition free from any accumulation of rubbish or garbage. The town Wastewater Reclamation Facility provides treatment and land disposal for Georgetown and nearby suburbs. The Public Works Department has responsibility of street cleaning with the street sweeper, street repairs such as pot holes or other hazards, parking meter repairs, street sign maintenance, storm water drainage, building and ground maintenance, and park maintenance.

The housing code of Georgetown secures the interest and purposes of public safety, health and general welfare through structural strength, stability, sanitation, adequate light, ventilation and general safety from fire and other hazards. Housing units in the region are mostly houses and condos. There are about 2000 housing units in Georgetown (United States Census Bureau, 2012). The estimated median house or condo value in 2011 was $244,343, as of the 2012 census.

Georgetown has effective protective services that are provided by the police. The community also has sufficient emergency services like the Georgetown fire company, the American Legion Ambulance, and the Sussex County Emergency Operation Center. Dart is the main provider of transportation, while LaRed health center does provide transportation for some of their clients too. 75% the population of Georgetown drives a car; 20% of residents have carpooled.

Georgetown's WZBH radio is a major media network, which helps with emergency alert systems as well as broadcasting. Community service and charitable organizations like the Boys & Girls Clubs, Cheer Community Center for seniors, and Big Brother Big Sister.

Georgetown has virtually no murders, with one occurring in the past decade. However, theft is not uncommon with 252 recorded thefts in 2011 (City Data, 2013). As many as 146 sex offenders are registered in Georgetown, Delaware (City Data, 2013).

D. Health Status Indicators

In 2010, there were 11, 682 live births in the state of Delaware, and 2283 in Georgetown (State of Delaware Health Statistics, 2013). Mothers under 20 years old are more likely to smoke while pregnant than any other demographic cohort. Number of live births per mother is higher for whites than blacks or Hispanics. Delaware has a relatively high rate of infant mortality, and is higher than the national average. However, Sussex County does not have the highest infant mortality rate in the state. Infant mortality rates among African-Americans have dropped recently. The State of Delaware Health Statistics (2013) indicates that fetal malnutrition and short gestation periods are causing the high infant mortality rates.

Cancer mortality rates in Sussex County are 171.3, with the black community suffering more deaths from cancer than the white community (State of Delaware Health Statistics, 2013). Heart disease is a significant issue in Sussex County, with 508 deaths occurring annually. Chronic lower respiratory diseases account for 137 deaths per year. Chronic respiratory diseases including tuberculosis account for 441 deaths per year in Delaware.

La Red Health Center (LRHC) is the primary provider for the Georgetown community, and is currently the only federally certified health care center in Sussex County. The National Committee for Quality Assurance, (NCQA) recently recognized LRHC as a Patient-Centered Medical home, (PCMH). La Red specializes in a number of key areas including Prenatal and Perinatal Care, Vaccine-Preventable Disease Immunizations, Childhood Immunization Outreach, Well-Child Services, Blood Screenings, Cancer Screening, Diabetes Prevention and Management, HIV/STD Prevention Outreach, Testing and Counseling, Oral Health, Behavioral Health, Transportation Services, Translation/Interpretation Services, and Prescription Assistance. In conjunction with Sussex Tech, La Red has a comprehensive wellness center that caters for the community. Other hospitals nearby include Beebe Hospital in Lewes, Milford memorial Hospital in Milford, and Nanticoke in Seaford.

II. Analysis of Data

Health problems perceived by the nurse include poor nutrition, diabetes, obesity, cancer, tuberculosis and heart disease. The local residents often do not recognize the extent and severity of the health problems, especially tuberculosis, heart disease, poor nutrition, and obesity. Community leaders and leading health professionals do recognize the severity of the problems affecting the residents of Georgetown, Delaware.

Poverty in the community prevents adequate access to health care services in Georgetown. Especially among non-whites in Georgetown, poverty impacts when the individual seeks care. This means that many health problems develop further than they would if preventative measures were taken. Therefore, health prevention is the most important feature of a proactive community health program in Sussex County.

Currently, there are some actions being taken to raise awareness about the importance of good nutrition and lifestyle choices. However, more needs to be done by targeting the populations that are most at risk including the Hispanic population and the African-American population. Directing health care services and preventative programs for at-risk communities remains the most important challenge facing healthcare workers in Georgetown. There are adequate resources to generate a simple public awareness campaign that takes into account language and cultural needs.