Running head: HEALTH IN ALACHUA 1

Health in Alachua County, Florida

Ashley Joseph

University of South Florida

HEALTH IN ALACHUA 2

Health In Alachua County, Florida

This paper will go into details about the health status of the population in Alachua

County. The main focus will be on the relatively high rate of sexually transmitted infections in

this particular county. Alachua county was picked for this paper because of the fact that it has

one of the highest rates of sexually transmitted infections in the state of Florida. The focus will

be on sexually transmitted infections because the spread of these infections can be decreased

with proper education, and increased access to treatment of the infections or condoms to help

prevent transmission. Hopefully, a better health policy and proper interventions will help

decrease the rate of sexually transmitted infections and improve health in Alachua County.

Overview of Alachua County

Alachua County is in northern Florida, and it is adjacent to Gainesville. The name

“Alachua” derives from the Native American language, and it means “sink” (City Town Info,

2017). The original habitants were the Timucuan Indians before the Spanish explorers visited in

the 16th century. These explorers were led by DeSoto. (City Town Info, 2017).

City Data states that this county is seventy-nine percent urban and only twenty-one

percent is rural. There were 263,496 individuals residing in Alachua County in 2016 (City Data,

2017). The dominant race in Alachua is white, as they make up 61.7% of the population (City

Data, 2017). The second dominant race is African American, even though this race only makes

up twenty percent of the population (City Data, 2017). Most of this county’s population is either

young adults or middle-aged, as the median age is 31 years. Three fourths of the population have

graduated high school, and ninety-one percent of adults over 25 years old have received a high

school degree or higher (City Data, 2017). When it comes to religious beliefs, 58.4% of the

population does not practice any religion, but 19.3% of Alachua’s population identifies as
HEALTH IN ALACHUA 3

Evangelical, which is the most common religion (City Data, 2017). The most common

industries are educational services and healthcare. In 2016, the median household income was

$45,304 (City Data, 2017). The top three employers of Alachua are the University of Florida,

Veterans Affairs Medical Center, and the Alachua County School Board (The Gainesville Sun,

2011). In 2016, about 23.5% of the Alachua residents were living in poverty (City Data, 2017).

The Veterans Affairs Medical Center, Alachua County Health Department, and the University of

Florida Health Services are the top healthcare systems available in this county. With this

background of Alachua, the paper will now compare this county’s population to the state of

Florida’s population.

Comparison of Local vs. State Populations

This section will explore the socioeconomic factors of the county of Alachua compared

to the state of Florida. When it comes to families living in poverty, the percentage is almost

twice as high in Alachua than in Florida; twenty-three percent of Alachua and twelve percent of

Florida live in poverty (County Health Rankings, 2017). According to County Health Rankings,

Seventy-five percent of Alachua County has graduated high school, which is similar to the

seventy-eight percent of Florida’s population who graduated high school. Only 1 percent of

Alachua is not fluent in English. On the other hand, six percent of Florida is not fluent in

English. Both percentages are low, but Florida’s total population is much higher than Alachua’s

total population.

When it comes to access to health care centers, the ratio is more favorable in Alachua

compared to the state. In Alachua county, there is one physician per six-hundred-eighty

individuals, one dentist per six-hundred-forty individuals, and one mental health provider per

200 individuals (County Health Rankings, 2017). In contrast, for every 1,380 people, there is
HEALTH IN ALACHUA 4

only one physician; there is one dentist per 1,790 individuals and one mental health provider for

seven-hundred-fifty individuals (County Health Rankings, 2017). This suggests that health care

is more accessible in this county compared to the state.

Analysis and Interpretation of Data

The next step of this paper is to analyze and interpret the strengths and weaknesses of

Alachua county. According to data collected from the County Health Rankings, the three

strengths of Alachua county are the following: lower levels of physical activity despite less

access to exercise opportunities, less teen births than the state average, and more available

healthcare access to physicians, mental health providers, and dentists. However, the following

are weaknesses of Alachua County: a relatively high rate of sexually transmitted infections,

lower high school graduate percentage, and a relatively higher percentage of alcohol-impaired

driving deaths (County Health Rankings, 2017).

Identified Strengths

One identified strength is that despite less opportunities to exercise, Alachua has only

nineteen percent of physical inactivity compared to twenty-three percent of physical inactivity in

Florida (County Health Rankings, 2017). This is a strength because studies have shown that

exercising can reduce the risk of non-communicable, but deadly, diseases such as coronary artery

disease, stroke, or Type 2 diabetes mellitus (Reiner, Niermann, Jekauc, & Woll, 2013).

Another strength is that this county has less teen births than the state average (County

Health Rankings, 2017). It is a strength because teen births may lead to a loss of education since

these girls will most likely drop out of high school and not continue their education, the CDC

states that thirty-four percent of teen mothers will not attain a diploma or GED (Suellentrop,

2010). According to the CDC, children from teen births also suffer from consequences such as a
HEALTH IN ALACHUA 5

greater risk of low birth rate, lower vocabulary, math and reading scores, and more likely to

experience neglect (Suellentrop, 2010). With a lower rate of teen births, this county does not

experience a high incidence of these potential issues. According to the County Health Rankings,

there are more available healthcare providers in Alachua than in Florida. This is a strength

because it means that there are more healthcare options and the population has easier access to

healthcare. The residents of Alachua have more autonomy when making healthcare choices

because there are more options and more availability.

Identified Weaknesses

Although Alachua has strengths, there are weaknesses as well. Alachua has a high rate of

sexually transmitted infections, 772.1, compared to 430.6 for the state of Florida (County Health

Rankings, 2017). This is a weakness because these various infections can decrease the quality of

life for these individuals. Some of these infections can have long-term consequences. The lower

rate of high school graduates (75%) compared to Florida (78%) is also a weakness because this

could indicate less education that could lead to less health knowledge. Less education could also

mean less income which would lead to having less money to pay for healthcare. There has been

thirty-one percent of alcohol-impaired driving deaths in the county compared to twenty-eight

percent in the state (County Health Rankings, 2017). One factor for this could be due to the fact

that 98.9% of adults in Alachua reported drinking alcohol in the past thirty days, which is higher

than average (City Data, 2017) The higher percentage for both of these risky behaviors has a

negative impact on the population health because it means there are more preventable deaths for

people that may have had healthy and long lives.

HEALTH IN ALACHUA 6

Identification of a Priority Health Issue

The priority health issue that will be focused on is the significantly high rate of sexually

transmitted infections. This is a priority because the spread of these infections could be

prevented or decreased, yet the rate is so high. It is also a priority because of the long-term

consequences on the health of affected individuals. The National Institute of Medicine states that

the general population is unware of the health consequences of sexually transmitted infections

(STIs) because of the stigma that prevents proper education and discussion, the fact that many

people are asymptomatic at first, and that the long-term consequences can occur years after the

initial infection so there seems to be no link. Some of these health consequences include, cancers

of the cervix, penis and vagina, pelvic inflammatory disease, infertility, ectopic pregnancy,

transmission to infants during birth, and possibly death.

Discussion and Application of Community Health Models

The Determinants of Health Model states that there are many factors that affect the

populations’ health: policymaking, health services, biology and genetics, cultural conditions,

living and working conditions, socio-economic factors, environment, social networks, education,

and individual behavior. This means that an individual’s health relies on more than just hospitals

and prescriptions. If the individual lifestyle includes risky behavior, they will be more likely to

have an STI from choosing not to use protection. If society does not want to give proper sexual

health education, the population will have more STIs due to deficit knowledge of proper

protection and symptoms to look for. If health services for sexual protection and STI testing are

not provided, individuals will continue to spread these infections without knowing.
HEALTH IN ALACHUA 7

Population Diagnosis

Teenagers and adults in Alachua County are at risk for sexually transmitted infections

due to risky behaviors, social stigma, and improper education. The Alachua County Department

of Health has stated that the main reasons for high STI rates in this population is due to the large

amount of younger people who are more likely to engage in unprotected sex, asymptomatic

individuals thinking they are not infected and spreading the disease, and social stigma causing

teenagers to fear getting tested. (Jackson, 2013). This is evidenced by the high rates of STIs in

this county, as Alachua is the fourth in the state for most STIs, and individuals of ages 15-24

made up seventy-five percent of the new cases of gonorrhea and chlamydia (Jackson, 2013).

Community/Population-based Interventions

There are different forms of interventions to prevent the spread of sexually transmitted

infections in Alachua County.

Primary Level of Prevention

The recipient of primary prevention is the entire community of middle schoolers and high

schoolers. The intervention will be giving proper sexual health education about what STIs are,

how to prevent getting them, and what the long-term consequences are. Health care providers are

stakeholders because they will be the ones giving accurate information and helping to set this up.

Public officials are stakeholders because they must have funding and be able to change the

education system to include this education as a requirement. Public schools may have issues

funding with tax money because it must be approved. Private schools would need help raising

money. The community nurse can help with giving the education and answering questions. The

county’s health department can also set up a mobile health truck and free STI screening days at
HEALTH IN ALACHUA 8

the state health clinic to provide education and testing for adults who are not in school. The

community nurse can research the best spots to meet the most people with the mobile truck.

Secondary Level of Prevention

The recipient will be community-wide. There will be more STI screening and treatment

fairs teenagers and young adults to help identify STIs and treat them before long-term

consequences can occur. Treating them early prevents them from worsening and spreading.

Community members are the stakeholders because they will be improving their health by

treating any STIs they may have. A funding concern is that this would have to be free or a

reduced cost for it to be enticing to the population. There would have to be a company or

organization to sponsor this. The county government can also work to allocate a proportion of

taxes to help with funding the free testing and cheaper treatment for all teens and adults in

Alachua. They would have to explain to taxpayers that with the high rate of STIs in this county,

this is something that may be necessary to tackle the dilemma. The community nurse can help

with the screening and administering the treatment.

Tertiary Level of Prevention

The recipient is the individual who is affected by an STI. They will have their physician

help with treating the consequences, but the community nurse can help with education on the

consequences and support them with the psychological burden. The nurse can give free condoms

to schools to prevent the spread of STIs and give education about preventing the long-term

consequences from occurring. The concern will be how the individuals fund their doctor visits

and how the treatment will be funded. The stakeholder would be the community members

because they would be treating STIs and treating or preventing long-term consequences.

Development of Health Policy

HEALTH IN ALACHUA 9

This is the proposed health policy for preventing the transmission of STIs. The policy

will decrease the amount of individuals who have STIs and decrease the amount of long-term

consequences in affected individuals. The focus will be on primary intervention. It will be a

requirement that all schools have sex education to teach the students about STIs, how to avoid

them, and how to prevent long-term consequences. The school will receive a monetary incentive

for this from the county health department. The health department is already working with the

county schools about educating students on STIs and safe sexual intercourse. For adults or

teenagers who are not in school, there will be monthly free STI testing days at a public health

clinic with vouchers for treating any current STIs. There will be free condoms available as well.

The desired outcome is less STIs and less long-term consequences. Stakeholders would be

community members receiving the education, legislators figuring out funding with taxes, and

public officials ensuring the education is occurring in all schools. Health care providers will be

supportive of this because they will have less STIs to treat and see less long-term consequences

that could have been avoided. Community members will be supporters of this because they will

have the education about STIs and will feel more in charge of their health. People with

conservative religious views may feel as though this education will be the green light for

promiscuous behaviors in teenagers, so they will oppose this. Some taxpayers may oppose their

taxes going toward this.

The plan will be to talk to the school board of this idea and going to the local government

for funding and approval. Then there must be certified educators to teach this as a presentation in

all schools. This will decrease the STI rates in Alachua county and provide teenagers who do not

always have private health care access information that they need. This will enhance the health

of the population because there will be less STIs and less long-term consequences or death.
HEALTH IN ALACHUA 10

Conclusion

The key points is that a significantly high rate of STIs could have been avoided with

proper health education and treatment. The policy will provide both. STIs are extremely

stigmatized, so this education and treatment will help decrease that so affected individuals feel

more comfortable getting help and have less emotional distress over their infection.

This paper is relevant to my nursing career because STIs are very common in this state,

so I may have many patients that suffer with one of these infections. Since pediatrics is my

preferred specialty, I will be able to talk to teenagers who may not have any knowledge of how

to avoid contracting an STI or how to know if they have one. I will be able to give them the

information they need and the support they need. In clinicals, I have had many patients who

suffered from sexually transmitted infections and the long-term consequences simply because

they did not have the education that they needed. Seeing them so emotionally distressed was so

hurtful. Being a patient advocate, I can help provide STI knowledge to get rid of the stigma and

help relieve the emotional distress that these individuals may experience.
HEALTH IN ALACHUA 11

References

Alachua, Florida - City Information, Fast Facts, Schools, Colleges, and More. (n.d.). Retrieved

October 19, 2017, from https://www.citytowninfo.com/places/florida/alachua

County Health Rankings. (2017). Retrieved September 07, 2017, from

http://www.countyhealthrankings.org/app/florida/2017/rankings/alachua/county/outcomes/overal

l/snapshot

Report, S. (2011, June 16). Top employers in Alachua County. Retrieved October 19, 2017, from

http://www.gainesville.com/news/20110509/top-employers-in-alachua-county

Alachua County, Florida (FL). (n.d.). Retrieved October 19, 2017, from http://www.city-

data.com/county/Alachua_County-FL.html

Reiner, M., Niermann, C., Jekauc, D., & Woll, A. (2013). Long-term health benefits of physical

activity – a systematic review of longitudinal studies. BMC Public Health, 13(1).

doi:10.1186/1471-2458-13-813

Institute of Medicine (US) Committee on Prevention and Control of Sexually Transmitted

Diseases. (1997, January 01). The Neglected Health and Economic Impact of STDs. Retrieved

October 21, 2017, from https://www.ncbi.nlm.nih.gov/books/NBK232938/

Suellentrop. (2010). The Costs and Consequences of Teen Childbearing. Retrieved November 2,

2017, from https://www.cdc.gov/nchs/ppt/nchs2010/29_suellentrop.pdf

Jackson, A. (2013, October). ‘Girl, I Don’t Know What Happened Last Night,’ Or Why Alachua

County’s STD Rate Is High. Retrieved November 02, 2017, from

HEALTH IN ALACHUA 12

https://www.wuft.org/news/2013/10/15/girl-i-dont-know-what-happened-last-night-or-why-

alachua-countys-std-rate-is-high/