Running head: EFOLIO 1

eFolio- Essential VII

Julie Miller

Frostburg State University

EFOLIO 2

eFolio- Essential VIII

Baccalaureate Essential VII, Clinical Prevention and Population health, examines the role

of the Baccalaureate prepared nurse in the context of population-focused nursing.

Populationfocused nursing involves identifying determinants of health, prioritizing

primary prevention when possible, actively identifying and reaching out to those who

might benefit from a service, and using available resources to assure best overall

improvement in the health of the population (ANA, 2007).

The nursing process plays a critical role in Population heath, and all of the elements of the

nursing process such as assessment, planning and implementation rely on collaboration with the

community and other healthcare workers and agencies. An in-depth assessment of the population

of interest is necessary to provide appropriate, evidence-based interventions, and also to respond

to disasters or emergency situations.

Exemplar

In the Population-Based Nursing Practice class in the RN to BSN program, the

assignment that best reflects clinical prevention and population health was the community health

assessment (Appendix A). This assessment required the use of information technologies to

acquire accurate, current data on the chosen community. A “Windshield Survey” was also done

by driving through the community and inspecting the physical environment, such as the

condition of homes, sidewalks and streets in the area. The Windshield Survey provided an

opportunity to observe the residents of the town and their activities. Personal interviews of

community members provided another insight into the community. After completing the

community health assessment, Community Diagnoses and suggested interventions were

developed in conjunction with the Healthy People 2020. This assignment posed a challenge

EFOLIO 3

because it was very time-consuming, but it also made me realize how comprehensive a

community health assessment needs to be in order to accurate and provide interventions that will

meet the needs of the community.

Reflection

The community health assessment reflected many of the key components of Essential

VII. These included: use of technology in population-focused care and use of biostatistics,

population assessment, population-focused interventions, and communicating and sharing

information and the need for appropriate evidence-based interventions (AACN, 2008). In order

to implement interventions, an assessment of community resources, such as health care facilities

and agencies must be done; this allows collaboration with these providers. The core concept of

population nursing is to “Advocate for social justice, including a commitment to the health of

vulnerable populations and elimination of health disparities” (AACN, 2008, p. 25). Only through

a thorough community health assessment, can the nurse recognize the vulnerable members of the

community and act as an advocate for these individuals.

EFOLIO 4

References

American Association of Colleges of Nursing, (October 20, 2008). The essentials of

baccalaureate education. Washington, DC: Author.

American Nurses Association (2007). Public health nursing: Scope and standards of practice.

Silver Spring, MD: Author.

EFOLIO 5

Appendix A

Community Health Assessment

Julie Miller

Frostburg State University

EFOLIO 6

Abstract

A community health assessment is much more than data collection. It is looking at the

community from various aspects and discovering the strengths and needs of the community. A

Windshield Survey is invaluable when performing a community assessment because the

assessment is no longer just about numbers; it is about the residents of the community, the

environment they live in, the challenges presented by the location, and the benefits of living

there. Personal interviews with community members provide another level of insight into the

needs of the community. The nursing process is used when evaluating needs and determining

objectives and interventions that will best meet these needs. The town of Grantsville was the

community I chose to research.

Grantsville is an area rich in history. Daniel Grant purchased the land that is now

Grantsville in 1795. George Washington and General Braddock passed through this area in 1755,

and the Braddock Road was constructed along the same passage. The National Road (Alternate

Route 40) was built along the Braddock Road and was the first federally funded highway in the

United States. The Casselman Bridge, a popular tourist attraction, was built in 1813 and is now a

State Park (Directory, 2013). Grantsville is a lush agricultural area and the town of Grantsville is

home to 766 individuals, as well as a tourist destination for travelers.

EFOLIO 7

Community Health Assessment

Location

Boundaries and Topography

The town of Grantsville is located in Western Maryland, within the north central aspect

of Garrett County with a Northern Longitude of -79.16 and Latitude of 39.7; it is 0.98 square

miles (United States Census Bureau, 2013). The town of Grantsville is 20 miles west of

Cumberland, MD and 30 miles northeast of Oakland, MD. Grantsville is less than one half mile

west of the Casselman River. Within the town limits, Grantsville’s topography is mildly sloping

with elevation ranges from 2,450 feet at the southwestern aspect of town and 2,220 feet at the

east side of town. Alternate Route 40 (which runs east/west) goes through Grantsville and is

called Main Street within the town. On the west side of town, Route 495 links from Route 40 to

eastern Deep Creek Lake, MD, and Route 669 runs from Alternate Route 40 to Springs,

Pennsylvania (“Town of Grantsville, 2009).

Environmental Controls

Waste Disposal. For a monthly fee to the residents of Grantsville, a private contractor,

through the town of Grantsville, collects trash weekly from town residents and hauls it to a

landfill near Oakland, MD. The residents are not required to recycle. (Town of Grantsville,

2009). Residents also have the option of purchasing a refuse permit for fifty dollars/year. This

allows them to use ay refuse and recycling location in Garrett County; the closest location is

EFOLIO 8

located on Alternate Route 40, less than two miles east of Grantsville. Garrett County residents

are able to recycle at these sites with no charge (“Solid waste and, 2013). To the east of town is a

Waste Water Treatment plant that has a maximum capacity of 600,000 gallons per day; the daily

usage is typically 100,000 gallons. (“Town of Grantsville, 2009).

Water Supply. The town of Grantsville’s water supply comes from four wells and four

springs located west of Grantsville. The town of Grantsville runs the water treatment plant,

which uses chlorination; they also contract with Maryland Environmental Service for backup as

necessary (“Town of Grantsville, 2009).

Air Pollution. The Air Quality index in 2010 was 3.82, which is much better than the

national average of 31.96. The level of Sulfur Dioxide was 2.58 ppb, which is about average;

within the town limits, there are five Sulfur Dioxide monitors. The nearest Carbon Monoxide

monitor is 7.7 miles from Grantsville. The Carbon Monoxide level was measured at 0.161 ppm;

this is less than one-half the national average of 0.334ppm ("Grantsville, Maryland," 2013

Climate. Grantsville receives over 80 inches of snow each year. Snow removal on side

streets is taken care of by the town of Grantsville; Alternate Route 40 (Main Street) is plowed by

State Roads and Garrett County snow removal vehicles (“Town of Grantsville, 2009).

Type of Housing and Overall Condition

According to the U.S. Census Bureau (2007-2011), there are 378 homes in the town of

Grantsville. 202 homes are owner occupied and 176 are renter occupied (USCB, 2013). Sixty-

four percent of those homes are family households. “A family household is composed of persons

related to the householder by birth, marriage, or adoption” (“Town of Grantsville, 2009,

Appendix, p. 16). There are three housing complexes in Grantsville that were developed with

government funding/assistance. These complexes contain 18 to 36 units and house senior,

EFOLIO 9

disabled, and low to moderate-income families. According to the Town of Grantsville

Comprehensive Plan, although the majority of homes were built prior to 1980, they are “well

maintained” with very few exceptions (Town of Grantsville, 2009). This was also noted in the

windshield survey.

Population

Population Profiles

According to the 2010 census, the population of the town of Grantsville, Maryland was

766 ("USCB, 2010)

Age. Of the town population, 25.6% were between the ages of 0-19, 31.9% were between

the ages of 20-44, 22.7% were between the ages of 45-64 and 19.8% were over the age of 64

(USCB, 2010) (Appendix B).

Sex. Males made up 47.1% of the population and females accounted for 52.9% of the

population (USCB, 2010) (Appendix C).

Race/Ethnicity. Of the 766 residents of the town of Grantsville, 98.3% were Caucasian,

0.1% were African American, 0.4% were American Indian and 1.2% identified as two or more

races; there were no Asians or Pacific Islanders listed in the town’s census. Twelve individuals

(1.6%) identified as Hispanic (USCB, 2010) (Appendix D).

The Amish and Mennonite community live in farmland surrounding the town of

Grantsville, and use retail and medical services within the town; they also sell produce and wares

at the Grantsville Farmer’s Market and local tourist shops (“Town of Grantsville, 2009).

EFOLIO 10

Birth and Death Rates. Birth and death rates were not available for Grantsville, so data

was retrieved from Garrett County statistics. During the time period of 2000-2006, the birth rate

per 1,000 populations was 10.3 and the death rate during the same time frame was 8.3 per 1,000

(“Garrett county, Maryland”, 2013). During the time frame of 2009-2011, the age-adjusted

death rate for heart disease and malignant neoplasms did not differ significantly from the

Maryland average (GCHD, 2013).

Leading Cause of Morbidity and Mortality. Data from Garrett County was used since

none was available from the town of Grantsville, MD. The leading cause of death in 2011 was

malignant neoplasms (31%), followed by heart disease (25%), and chronic lower respiratory

disease (10%) (GCHD, 2013) (Appendix E). In the Status of Health report, issued by the Garrett

County Health Department in 2013, key indicators were identified as priorities in

morbidity/mortality in Garrett County. These issues included: youth and adult tobacco use,

obesity, heart disease, adult influenza vaccine rates, and adults without health insurance (GCHD,

2013).

Population Stability. The population of Grantsville has grown from 619 in the year 2000, to 766

in 2010. In 2000, 53% of Grantsville residents lived in the same home that they resided in in

1995 (“Town of Grantsville, 2009).

Socioeconomic Status

The 2011estimated median household income in Grantsville was $47,814. This is much

lower than the Maryland median estimated income of $70,004 (USCB, 2010). According to

Grantsville’s Comprehensive Plan report, “Grantsville had a higher percentage of the population

below the poverty level (22.2 percent) than Garrett County (9.8 percent) and than Maryland as a

whole (6.1 percent)” (“Town of Grantsville, 2009, p. 21). The number of households receiving

EFOLIO 11

public assistance was 4.1%, which is higher than Garrett County and the state of Maryland

(“Town of Grantsville, 2009).

Occupations. Within the town limits, the Flushing Shirt Company is the number one

employer, followed by Goodwill Nursing Home, Grantsville Elementary School, and the

Casselman Hotel and Restaurant (Directory, 2013). The town of Grantsville has strong

agricultural base, and farms in the surrounding areas supply milk, corn, soybeans, hay and

sunflower seeds (Mast, 2013).

Several businesses, such as the Beitzel Corporation (contracting/fabricators) and

Clayburn Refractory Company are located within five miles of Grantsville; both of these

businesses have over 100 employees. A 110-acre industrial park located less than one mile from

Grantsville. This industrial park houses six businesses like New England Truss Company and

Closet Maid (Garrett County Chamber of Commerce, 2013).

Employment Level. Education and health care are the top occupations of the residents of

the town of Grantsville, followed by retail, construction, and accommodation and food service.

The majority (79.5%) of workers receive private wage/salaries, 14.4% are government workers,

and 6.3% are self-employed (USCB, 2010) (Appendix F).

Educational Status. Of the Grantsville population over 25 years of age, 6.5% have less

than a ninth grade education, 10.8% have a ninth to twelfth grade education with no diploma,

32.5% have a high school diploma, 18.3% have had some college, and 31.9% have a college

degree (USCB, 2010) (Appendix G).

Social System

Adequacy of Facilities

EFOLIO 12

Educational. Grantsville Elementary School has 220 students (kindergarten through fifth

grade) with an average of 10.5 students per teacher. Of these students, 99% are Caucasian and

1% identify as two or more races. The third grade math scores were 87%, which is 1% below the

state average and reading scores were 90%, which was 5% above the state average. Seventy-five

percent of the students are eligible for free or reduced lunch (“Grantsville elementary,” 2013).

Grantsville Elementary received a seven out of ten rating from “Great Schools” ("Grantsville

elementary school," 2013).

Middle and high school students travel by bus to Northern Middle and High School in

Accident, Maryland, which is 15 miles from Grantsville. There are four colleges/universities less

than 45 miles from Grantsville: Frostburg State University, Allegany College of Maryland,

Garrett Community College (GCC) and West Virginia University (Grantsville, Maryland, 2013).

GCC has a Northern Outreach Center in Grantsville that provides non-credit courses (Garrett

Community College, 2013).

Recreational. The town of Grantsville has a park consisting of several pavilions, a stage,

four basketball courts, four tennis courts, two softball fields, an oval path for walking/running,

two children’s playgrounds, and restroom facilities. This was noted during the windshield

survey. The park is open year round, but is utilized by the community from May to August.

During this time, the community hosts events such as concerts, Grantsville Days, the Western

Maryland Truck Show, Farmer’s Market, and the circus (Directory, 2013). The town of

Grantsville maintains the park (“Town of Grantsville, 2009).

Grantsville Elementary is the only facility in the town of Grantsville that is available for

indoor recreational activities. There is an athletic field at Grantsville Elementary School that can

be used for sporting events (“Town of Grantsville, 2009).

EFOLIO 13

New Germany State Park is five miles south of Grantsville and Big Run State

Park is 16 miles from Grantsville. The Casselman River Bridge State Park is a local tourist

attraction and is located east of Grantsville. The Deep Creek Lake area is 20 miles from

Grantsville (Directory, 2013).

Religious Resources. There are three churches within the town of Grantsville: one

Lutheran church, one Assembly of God church and one nondenominational church. In Garrett

County, the Christ Lutheran Church in Oakland, Maryland distributes clothing through the

House of Hope, and St. Ann’s Catholic Church (one mile west of Grantsville) serves as a

countywide food distribution center for the Catholic Charities. The Lighthouse World Outreach

Center, located one mile south of Grantsville, also collects and distributes food to needy families

in the area (Calis, 2013).

Service Clubs. The Lions Club is an active organization in Grantsville and meets twice a

month. They fundraise throughout the year and support local projects such as college

scholarships and providing funds for eye examinations, eye glasses (“Grantsville lions club,”

2013).

Daycare. There are no licensed daycare providers within the town of Grantsville, but

there are two providers within five miles (Child Care Center US, 2013).

Adequacy of Provisions

Transportation. The Garrett Transit Service serves Grantsville. This is a “demand-

response” system that requires several days’ notice. There are no fixed routes and charges for

transport are based on distance. Senior citizens, handicapped individuals and youth under the age

of twelve receive a reduced fare. The nearest Greyhound bus station is in Hagerstown, Maryland

(70 miles), and the closest taxi service is in Cumberland, MD (23 miles) (“Town of Grantsville,

EFOLIO 14

2009). The Bay Runner Shuttle provides transport for a fee to Baltimore bus, Amtrak and BWI

airport. The shuttle service runs daily from the Pilot Travel Center, which is less than three miles

from the town of Grantsville. Charter services are also available through Bay Runner Shuttle

(“Bay Runner Shuttle, 2013).

Safety. The Garrett County Sherriff’s Department and the Maryland State Police provide

Law enforcement for the town of Grantsville depending on the nature on an incident and the

proximity of a responding officer(s). A sheriff’s deputy patrols Grantsville when on duty and the

Maryland State Police patrol interstate 68 (“Town of Grantsville, 2009).

Grantsville has a Volunteer Fire Department that has approximately 50 members who

respond from their homes or places of work. “The company maintains two engines and a brush

truck, two tankers that each carries 1,600 gallons of water, and a heavy-duty rescue vehicle”

(“Town of Grantsville, 2009, p. 28).

The Northern County Rescue Squad is located in the town of Grantsville and has 60-70

volunteer members. Many of these volunteers have their emergency medical technician

certification and several are paramedics. From 6 p.m. to 6 a.m., the rescue squad has assigned

crews; from 6 a.m. to 6 p.m., volunteers respond from their homes or places of work.

Adequacy of Services and Providers

Healthcare Services. An Outreach Center of the Garrett County Health Department is

located on the west side of town. The Outreach Center provides services such as WIC, mental

health, and addiction services. The Garrett County Department of Social Services is located

within the same building. Although there is a full-time receptionist, services are rendered on a

part-time basis (“Town of Grantsville, 2009).

EFOLIO 15

A senior center is located near the park and provides hot meals on site Tuesday through

Thursday; the center workers also provide “Meals on Wheels” Tuesday through Thursday. When

schools are cancelled due to inclement weather, the senior center is also closed. The senior center

provides crafts, quilting, exercise classes, entertainment and demonstrations (Durst, Director of

Garrett County Senior Centers, 2013).

Healthcare Facilities. Within the town of Grantsville, there is a satellite laboratory of

Western Maryland Health System located on Main Street in the Casselman Ventures Building.

Goodwill Retirement Community in Grantsville offers retirement homes, assisted living and a

107 bed skilled nursing home (Directory, 2013).

Healthcare Providers. Dr. Robin Bissell, M.D. has an office in the Grantsville Medical

Center. She provides same day appointments for acute and chronic care needs. Her office is open

Monday through Thursday. Dr. Terry Dornburg, D.D.S., provides family dentistry Monday

through Thursday; he is also located at the Grantsville Medical Center. Dr. Ronald Gillum, DC is

a chiropractor that practices on a part-time basis in Grantsville. Medical Rehabilitation Systems

is located four miles west of Grantsville and provides physical therapy services Monday through

Friday (Directory, 2013). Grantsville has two hospitals within a 30-mile radius; Western

Maryland Hospital to the east and Garrett Memorial Hospital to the south. To the west of

Grantsville, West Virginia University Health Systems and Mon General Hospital are less than an

hours drive (Garrett County Chamber of Commerce, 2013).

Windshield Survey

A windshield survey was done on October 20, 2013. The town of Grantsville is an

inviting town with a sense of history. Along Main Street, businesses include: a pharmacy, a

barber, two banks, an insurance agency, a liquor store, a hobby shop, an antique store, a

EFOLIO 16

museum, a post office, two convenience stores, a pizza shop, and the Casselman Restaurant and

hotel and an apartment building that also houses a print shop and a needlework shop. Most of the

houses along Main Street appear well maintained, but older. There are sidewalks along both

sides of Main Street that look new and in good shape.

The side streets of Grantsville do not have sidewalks, and individuals walking along the

roads have to walk on the roadway to get around parked cars. Several businesses have hitching

posts for their Amish customers who ride to Grantsville in a horse and buggy.

There are various businesses on the side streets of Grantsville like the Newman Funeral

Home and Car Quest Auto; the library is located on the west side of town. The library is near the

park and is new construction. There are many newly constructed, large homes located near the

library.

The community park appears to be the hub of the neighborhood, with youth and families

using its facilities. In the evening, there were people walking their dogs, playing basketball,

baseball or tennis, and children playing on the playground. Several teens were observed smoking

near the basketball courts. One family was having a picnic meal at one of the pavilions. Three

children were riding bicycles in the park and they were wearing bicycle helmets. Two young

women were walking on the walking path around the park. Several adults in Grantsville

appeared overweight and one child appeared obese. No suspicious activity for drugs was

observed.

Community Health Diagnoses

Diagnosis #1

Increased body fat related to lack of physical activity as evidenced by number of

overweight individuals in the community. This community diagnosis is a top priority because it

EFOLIO 17

affects the entire community, regardless of age, gender or race. Obesity has been recognized as a

national health issue and needs to be addressed at the community level. The Garrett County

Health Department identified obesity as an issue with morbidity and mortality in Garrett County

(GCHD, 2013). Residents in Grantsville have the opportunity to use the park for leisure

activities, but have no recreational facility available in the community. In cold weather months,

when outdoors exercise is difficult, a recreational facility would help address this issue. This

aligns with the Healthy People 2020 objective PA-2.2: “Increase the proportion of adults who

engage in aerobic physical activity of at least moderate intensity for more than 300

minutes/week, or more than 150 minutes/week of vigorous intensity, or an equivalent

combination” (“Physical Activity,” 2013). Healthy People 2020 objectives related to increased

physical activity link to The Community Preventative Services Task Force, which recommends

“enhanced access to places for physical activity.” The task force cited ten studies that showed

decreased body fat in community members who were given access to a recreational facility

(Community Preventative Services Task Force, 2013).

Diagnosis #2

Potential for respiratory illness/disease in adolescents related to smoking as evidenced by

increased number of smoking-related illnesses. A Healthy People 2020 objective is TU-2:

Reduce tobacco use by adolescents (“Tobacco use,” 2013). This diagnosis was identified as the

second priority due to the Garrett County Health Department’s 2013 health status report; tobacco

use was identified as an issue that needs addressed in Garrett County. Also, malignant neoplasms

were the leading cause of death in Garrett County (GCHD, 2013). Community guide

recommendations suggest: “Mass media campaigns are recommended for increasing tobacco use

cessation based on strong evidence of their effectiveness in reducing tobacco use among

EFOLIO 18

adolescents when implemented in combination with tobacco price increases, school-based

education, and other community education programs” (Preventative services: What,” 2013).

Signage in the community promoting healthy behaviors and discouraging tobacco use combined

with anti-smoking education in the school setting and community programming may influence

adolescents in their choices about tobacco use/cessation. The messaging could also be effective

with adults and youth in the community as well.

Diagnosis #3

Decreased physical activity related to lack of sidewalks to safely walk on as evidenced by

few elderly individuals walking in Grantsville. This relates to the Healthy People 2020 objective

PA-1: Reduce the proportion of adults who engage in no leisure-time activity (“Physical

activity,” 2013). This is the third priority community diagnosis because physical activity is

essential to the health and well being of the community, this is especially true in the elderly who

may want to participate in physical activity like walking, but do not feel safe walking on the

road. The Garrett County Health Department’s 2013 status report concluded by saying Garrett

County needs to empower it’s residents to lead a healthy lifestyle (GCHD, 2013). The

Community Guide Recommendations suggest the use of urban design to change the physical

environment, and in turn, promote physical activity (The effectiveness of,” 2013). An example of

this would be putting sidewalks on the side streets of Grantsville. This would not only promote

physical activity, but it would also provide a safer environment for the community.

Conclusion

Grantsville is a thriving community that has seen recent improvements like a new library

and Outreach Center in the town. In spite of a lower socioeconomic status than the Maryland

average, Grantsville is well maintained and has a stable population. This town has strong

EFOLIO 19

community resources such as volunteerism in the fire department and ambulance service,

outreach programs through the Garrett County Health Department, and local churches who

distribute food and clothing to the needy. This sense of community contributes to the health and

well being of Grantsville’s residents and is something to be commended.

EFOLIO 20

References

Bay runner shuttle. (2013).

Retrieved from https://bayrunnershuttle.com/west/rates_schedules.asp?loc=grantsville

Calis, F, Catholic Charities. (2013, November 6). Interview by J Miller. Local churches and

services provided.

Child Care Center US. (2013). Home and group home daycare in Grantsville, Md.

Retrieved from http://childcarecenter.us/maryland_homecare/grantsville_md_city

Community Preventative Services Task Force. (2013, October 25). Environmental and policy

approaches to increase physical activity: Creation of or enhanced access to places for

physical activity combined with informational outreach activities.

Retrieved from

http://www.thecommunityguide.org/pa/environmental-policy/improvingaccess.html

Directory of the greater Grantsville business association, 2013.

Durst, R, Director of Garrett County Senior Centers. (2013, November 6). Interview by J Miller.

Grantsville Senior Center.

Garrett Community College. (2013). Northern outreach center.

Retrieved from http://www.garrettcollege.edu/getstarted/findaclass/cewd/noc

Garrett County Chamber of Commerce. (2013). Community profile & membership directory.

Cumberland, MD: Alliance Publishing and Marketing, Inc.

Garrett County Health Department. (2013). Status of health 2013.

EFOLIO 21

Retrieved from website: http://www.garretthealth.org/status of health/status

2013/2013StatusofHealth.pdf

Garrett County, Maryland. (2013).

Retrieved from http://www.city-data.com/county/Garrett_County-MD.html

Grantsville, Maryland. (2013).

Retrieved from http://www.city-data.com/city/Grantsville-Maryland.html

Grantsville elementary. (2013).

Retrieved from

http://www.schoolstats.org/MD/GRANTSVILLEELEMENTARY/240036000668

Grantsville elementary school. (2013).

Retrieved from http://www.greatschools.org/maryland/grantsville/706-Grantsville-

Elementary-School/

Grantsville lions club. (2013).

Retrieved from http://e-clubhouse.org/sites/grantsvillemd/

Maryland Department of Planning, (2009). Town of Grantsville comprehensive plan.

Retrieved from

http://www.grantsvillemd.us/Grantsville Comprehensive Plan 2009.pdf

Mast, B. (2013, October 20). Interview by Miller J. Grantsville agriculture.

Physical activity. (2013, August 28).

Retrieved from

http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=33

EFOLIO 22

Preventive services: What works to promote health? (community guide recommendation. (2013,

March 29).

Retrieved from http://www.healthypeople.gov/2020/topicsobjectives2020/ebr.aspx?

topicId=41

Solid waste and recycling home. (2013).

Retrieved from http://garrettcounty.org/solid-waste-recycling

The effectiveness of urban design and land use and transport policies and practices to increase

physical activity: a systematic review. (community guide recommendation). (2013, March

29).

Retrieved from http://www.healthypeople.gov/2020/topicsobjectives2020/ebr.aspx?

topicId=33

Tobacco use. (2013, August 28).

Retrieved from

http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=41

United States Census Bureau. (2013, November 08). Geography: 2013 U.S. gazetteer files.

Retrieved from

http://www2.census.gov/geo/gazetteer/2012_Gazetteer/2012_gaz_place_24.txt

United States Census Bureau. (2010). Community facts.

Retrieved from Town of Grantsville Comprehensive Plan

United States Census Bureau. (2013). Tenure.

Retrieved from http://www.census.gov/easystats/

EFOLIO 23

Appendix A

EFOLIO 24

Appendix B

0-19

20-44

45-64

64 & over

0 5 10 15 20 25 30 35

Age of Grantsville Population2010

Percent

Age

Appendix C

EFOLIO 25

Male47%

Female53%

Sexes in Grantsville, MD2010

Appendix D

EFOLIO 26

Caucasian African American American Indian 2 or more races0.0

20.0

40.0

60.0

80.0

100.0

120.0

98.3

0.1 0.4 1.2

Races in Grantsville2010

Perc

ent

Appendix E

EFOLIO 27

31%

25%

10%

8%

8%

5%

5%

8%

Causes of Death in Garrett County2011

Malignant neoplasmsHeart diseaseChronic lower respiratory diseaseAlzheimersCerebrovascularDiabetesAccidentsOther

Appendix F

EFOLIO 28

Private wage/salaries Government workers Self-employed0

10

20

30

40

50

60

70

80

90

79.5

14.4

6.3

Employment of Grantsville Residents2010 (over age 25)

Perc

ent

Appendix G

EFOLIO 29

6.50%

10.80%

32.50%

18.30%

31.90%

Education Level of Grantsville Residents 2010

< 9th grade education9th-12th grade education with no diplomaHigh school diplomaSome collegeCollege degree