By: Sara Huber Mallory Gilbert Felicia Wright-Williams Corby Ash Newaygo County By: Sara Huber Mallory Gilbert Felicia Wright-Williams Corby Ash

Basic Facts of Newaygo County Located in western portion of Michigan Relies on tourism, agriculture and small manufacturing for economic support Great area for hunting, fishing, and camping because half of county is located in the Manistee National Forest Over 230 natural lakes and over 350 miles of rivers and streams within county (Newaygo County, 2013)

Analysis of Newaygo County: Strengths Active community foundations and public services that promote and support health Majority of residents report good or better health More residents graduate high school compared to MI and US averages Low violent crime rates compared to MI and US averages Lower rate of risky behaviors among adolescents (smoking, binge drinking, or marijuana use) compared to MI and US averages High rate of child immunizations High rates of adults immunized against pneumonia and flu Fewer low birth weight babies than MI and the US Lower Prevalence of cardiovascular conditions (heart attacks, angina, or coronary heart disease) compared to MI and US averages (Hill, Mullins, & Warner, 2011)

Analysis of Newaygo County: Weaknesses High unemployment rate High poverty rate Low life expectancy and higher mortality rate for men and women compared to MI and US averages Lack of programs for the underserved (low income, uninsured, and underinsured) Low number of primary care physicians for the population High incidence of diabetes and asthma compared to MI and US averages High rate of child abuse/neglect rates Death rates for cancer, Alzheimer’s, and respiratory diseases are higher compared to MI and US averages Majority of adult population is either overweight or obese compared to MI and US averages (Hill, Mullins, & Warner, 2011)

Analysis of Newaygo County: Weaknesses Continued High prevalence of cigarette smoking among pregnant women Higher displeasure with life than MI averages 1 in 5 adults have no health care coverages Transportation to health care is a barrier High proportion of hospitalizations paid by Medicaid Inadequate fruit/vegetable consumption among adults and children High prevalence of depression, with low community response Lack of dental services and mental health services, especially to underserved. (Hill, Mullins, & Warner, 2011)

Newaygo County Statistics Unemployment rate is 13.8% in Newaygo County; Michigan is 10.5% and United States is 9.2% Poverty rate is 16.0% in Newaygo County; Michigan is 16.1% and United States is 14.3% Medicaid paid births are 50.2% in Newaygo County; Michigan is 41.2% (Hill, Mullins, & Warner, 2011)

Community Resources The high unemployment rates, high poverty rates, and high amount of people on Medicaid in Newaygo County, can lead to difficulty accessing health care Fortunately most primary care providers within the county accept Medicaid Unfortunately most specialized care providers do not reside within the community, which makes it difficult for vulnerable populations (low income, uninsured, underinsured, and Hispanic) to access specialized care due to lack of transportation There is a lack of pediatric specialized providers within the community, as well as mental health treatment options (Hill, Mullins, & Warner, 2011)

Community Resources Community health nurses along with doctors within the community need to join together to provide people of the community with more primary care providers These primary care providers should be equipped to work with mental health patients to decrease their chance of hospitalization Leaders of the community along with community nurses should form a committee to brainstorm ways to transport community members to out of county doctors appointments either via bus or taxi

Theory of Reasoned Action According to the theory or reasoned action a person’s behavior is determined by their intention to perform that behavior, including their attitudes and the influence of their environment (Harkness & DeMarco, 2012). Since most people of the community perceive their health as good or better, they will want to continue their health or improve it, especially when the community is attempting to make improvements in the access to healthcare.

Problem Statement Risk of: lower life expectancy Among: Newaygo County residents Related to: lack of access to health care As demonstrated by: “One in five (19.3%) Newaygo County adults aged 18-64 have no health care coverage and slightly more than one in ten (11.4%) have no personal health care provider. Also, more than one in ten (13.9%) were denied health care access in the past year due to health care costs” (Hill, Mullins, & Warner, 2011).

Problem Statement Risk of: higher mortality rates Among: Newaygo County residents Related to: higher poverty rates As demonstrated by: “More than one in five families with children in Newaygo County live in poverty. This proportion rises drastically for single female families where over half (53.3%) with children under 18 years of age live in poverty. Moreover, this is noticeably higher than in Michigan or the U.S” (Hill, Mullins, & Warner, 2011).

Planning & Intervention Increase access to vital services and income improving benefits in order to lessen poverty’s most immediate effects Provide ways out of poverty that encourage education, employment, financial literacy and asset-building

Planning & Intervention Provide social and educational support to the children and families in order to prevent the inheritance of poverty from generation to generation. Focus on the development of jobs for adults with the greatest obstacles to employment. Increase the access to public benefits for the vulnerable population for all essential services.

Planning & Intervention The best pathway out of poverty is a well-paying job. To get back to prerecession employment levels, we must create jobs. At the current pace, however, we will not get there until July 2018. To kick-start job growth, investments should be made in job-creation strategies such as rebuilding Newago infrastructure; developing renewable energy sources; renovating abandoned housing; and making other common-sense investments that create jobs, revitalize neighborhoods, which will boost the economy. Vallas& Boteach, 2014

EVALUATION OF RESOURCES The Newaygo County Community Collaborative (NC3) is the official State-indorsed community collaborative serving Newaygo County. NC3 is made of representatives of education, governments, employment training, healthcare, human services and other agencies concerned about the quality of life in Newaygo County (Newaygo County Community Collaborative, 2015). The NC3 is appropriate because it focuses on improving lives of children and families. The NC3 is adequate because when the information is shared from local, State and Federal levels that could impact support of local programs and service funding. The NC3 is effective because it supports many efforts among community agencies such as; Great Start, Homeless Continuum of Care and many more. (Newaygo County Community Collaborative, 2015)

(Newaygo County Community Collaborative, 2015) EVALUATION (example) LIFE EXPECTANCY Changes over the period from 1985 to 2013 were in the middle at 50% for females and 25% for males. The national average was an increase of 3.1 years for females and 5.5 for males PROVERTY In 2012 female and male poverty was in the middle at 50% compared with the Michigan average. (Newaygo County Community Collaborative, 2015)

EVALUATION OF RESOURCES CON’T Live Well Newaygo County WE CAN! College, Career and Credentials Access Network, and Michigan Works The goal – A collaborative effort aimed at increasing Newaygo County residents” secondary education to 60% by the year 2025. Currently, 25% of Newaygo’s residents have begun or completed secondary education Newaygo County community(Newaygo County Community Collaborative, 2015). Primary Care Providers Healthy People 2020 objectives has targeted an increase in health services. No target has been identified as of yet Access to Care. Live Well Newaygo Strategic focus: Increase access to health care, Increase health literacy across the county, collaborative initiative that emphasizes prevention and management of chronic disease. Uninsured Healthy People 2020 target for percentage of uninsured individuals is zero percentage of total coverage. Live Well has an assigned program that will assist the residents in preparing documents for the application of the Federal Healthcare Program. After re-evaluation, new task forces or groups will be recommended as needed.

References Harkness, G.A. (2012). Community and Public health nursing practice: Evidence for Practice Wolters Kluwer/Lippincott, Williams & Wilkins: Philadelphia Hill, M., Mullins, M., & Warner, L. (2011). Newaygo county health and health care landscape. Retrieved from http://www.spectrumhealth.org/documents/Newaygo_County_CHNA_Report.pdf Newaygo County. (2013). County of Newaygo. Retrieved from http://www.countyofnewaygo.com/Welcome.aspx Newaygo County Community Collaborative. (2015). Newaygo County Community Collaborative. Retrieved from http://www.newaygocountycc.org/ Vallas, R., & Boteach, M. (2014). The Top 10 Solutions to Cut Poverty and Grow the Middle Class. Poverty News Alerts. Retrieved from https://www.americanprogress.org/issues/poverty/news/2014/09/17/97287/the- top-10-solutions-to-cut-poverty-and-grow-the-middle-class