Community Assessment

An assessment of the Gruene community was conducted utilizing the community as a partner model. This included eight major community subsystems analyzed utilizing data from the windshield survey, data collection, and interviews with community members. The community of Gruene is comprised of census tract 3105 and a detailed analysis, diagnosis, planning, intervention, and evaluation was performed. The process was conducted in an effort to determine any potential health needs of the community, as well as its strengths and weaknesses. Community Core Gruene lies entirely within the city limits of New Braunfels.

It was annexed by New Braunfels in 1979. New Braunfels is in the county seat of Comal County at the foot of the Texas Hill Country. The total population is 8,965 (American Factfinder, 2011). The Gruene water tower is the most identifiable sign for the city. The Guadalupe River runs through the northwest border of Gruene. Gruene has been designated a Historic Town by the State of Texas.

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The name of the town is pronounced like the color “green”. Henry D. Gruene, the towns’ founder, originally bought land for a cotton farm in 1872 with his father and brothers.

There is a great deal of effort put in to preserve the history of the early settlers and lots of exhibits of this in the community. Mainly it reflects the German and Hispanic or Texan cultures. New Braunfels is also a recreational area due to the rivers and the culture also reflects the tourism industry from the rivers. According to the New Braunfels Chamber of Commerce, there are over thirty religious denominations and more than seventy churches in the city. There are large Protestant, Catholic, Lutheran, Methodist and Baptist congregations.

The churches and their communities are an important part of supporting the community. There are over six museums, as well as local community theatres and art galleries as well as a Symphony. The businesses and residents of New Braunfels have an interest of restoring and renovating the city. It is very well maintained as are the majority of homes and businesses. As New Braunfels is a growing community, there are many different races. However, the population consists mainly of German descendants as well as a large Hispanic community.

The census tract consists of 90% white race, 2% black, and less than 1% Asian. It is noted that almost a quarter of the population identifies themselves with Hispanic ethnicity. The average household size is 2. 66, which is comparable to the average household size in the state of Texas (2. 74). There are many different age groups, but the largest population percentage falls in the 20-44 year-old age range. Subsystems Within the health and social services subsystem, the city largely relies on the health care services provided within the city of New Braunfels.

There is one hospital located within New Braunfels, Christus Santa Rosa. There is also a Baptist Hospital that is currently being built with an unknown completion date. It is noted within the census tract that there are two ancillary health care services; the Sundance Center for Cancer Care and the Warm Springs Rehabilitation facility. Clinics, practitioners’ offices, public health service, home health agencies, nursing homes, social services, and mental health services are all provided within New Braunfels. For more specialized services, San Antonio and Austin provide many options.

The main source of employment appears to be within the tourist and restaurant industry. There are no large factories or corporations within the city of Gruene. There is no public transportation system provided. The streets are well-maintained and provide bicycle paths and sidewalks. Because the city is rapidly growing as a tourist attraction, it is often congested and often requires a police officer to direct traffic at the intersection of Gruene and Hunter roads. There are handicap parking spots available, but it appears as though it would be challenging for disabled persons to navigate the city.

Throughout the neighborhoods and streets, there is a large presence of political banners concerning a bill to ban open containers on the river. There is equal representation of those who are for the ban and those who are against. The Herald-Zietung is a local paper that serves New Braunfels and Comal County. The televised news channel viewed by residents of New Braunfels is KSAT and KABB news in San Antonio, Texas. KNBT 92. 1 is the number one radio station for New Braunfels and surrounding areas. The city of Gruene is within Comal County Independent School District and New Braunfels Independent School District.

Sports programs are offered through the public middle and high schools. There are four private schools in the area. The New Braunfels’ Public Library offers information services, magazines, meeting and study rooms, photo-copiers, public access computers, test proctoring, and wireless internet. The library also has a program for homebound members where staff delivers books and other materials to their homes. The Guadalupe and Comal Rivers provide recreation for numerous tubers during the spring and summer.

New Braunfels is also home to Schlitterbahn, the world’s largest water park. The McKenna Museum offers entertainment for children with indoor and outdoor exhibits. Children can exercise while participating in gymnastics classes or camps at Activity Tree. Landa Park, located in New Braunfels, is a 51-acre park available for recreation. There is also a YMCA facility that offers sports, aquatics, afterschool care, summer camp, and family entertainment. Perceptions The city appears split politically over the debate to ban or not to ban open containers on the river.

Some feel the tourism would suffer if the ban was passed, while others are eager to clean up the river despite the consequences to the economy. The citizens feel the strengths of the community are the tourism, close-knit relationships, and the community togetherness. A high school nurse explained that sex education was a weakness of the community, as she treats 30 students currently for teen pregnancy-related issues. The Christus Santa Rosa health care facility provides 24/7 emergency services to the residents of Gruene and the surrounding area.

This 132-bed facility has been committed to the community for over 55 years. Not only does it provide health care, it also provides the community with more employment opportunities. There are no free clinics available within the community. There is also a lack of rural health services for those who live further from Christus Santa Rosa. There is no public transportation and this is one area that needs to be improved upon. Also, there seems to be a concern of lack of public screening services for children that are taught in the home-schooled environment.

Health Disparities There are very few obvious health disparities in the census tract. Although the poverty status in Gruene is only 10% as compared to the state of Texas (12%), there is a large percentage (73%) of children under the age of 5 in single female head of households that live below the poverty line. This suggests a possible health disparity related to the economic status of this population. Another possible health disparity could be the lack of public transportation. Individuals without means of private transportation could be hindered in seeking health care.

Analysis of Community Assessment Data Included in the community strengths, is a significantly lower teen pregnancy rate. Gruene lies in Comal County and its pregnancy rate is 16% lower than in the state of Texas, which 64%. Another strength of the census tract is the median household income level ($41,109), which is derived from actual earnings and not supplemental services or public assistance. The biggest concern for the residents to change or improve their community seems to lie in the recent legislative proposal (2011-65 ordinance) for container use on the rivers.

This proposal is centered on banning open containers on the rivers that lie within the census tract. The empty containers seem to have created an environment concern for some of the members of the community and this seems to have caused a division. The members of the community appear to be satisfied overall with health resources and recreational facilities/resources. A small percentage of the community expressed concern about the lack of sexual education for teenagers. They would like to see more sexual education, not only in the public schools but also available within the community.

Nursing Diagnoses After careful review of the community, the data, and interviews, the following nursing diagnoses were developed to help clarify the problems in the community to identify interventions to improve community outcomes. Increased risk of increased teen pregnancy among the teenage population related to lack of sexual education as manifested by a 48% teen pregnancy rate within Comal County. A long-term goal would be to reduce the teen pregnancy rate from 48% to 30% after two years of sexual education by the fall of 2013.

A short-term goal is, after participation in small group instruction, students can verbalize appropriate ways to prevent pregnancy through abstinence and contraception. Increased risk of lack of appropriate vision, hearing, and BMI screenings among home-schooled children as related to limited resources as demonstrated in the lack of requirement for home-schooled children to attend annual screenings. A long-term goal could be to implement an annual community screening for public, private, and home-schooled children within the census tract by the start of the next school year.

Our short-term goal is to conduct a vision, hearing, and BMI screening for home-schooled children in the census tract. Conclusion The census tract of Gruene, Texas, is nestled in the city of New Braunfels. Tourism provides a strong economic basis during the spring and summer months for the community. This tight-knit community, although not suffering from economic disparities as a whole, has a significant population (73%) of young children living in poverty. The community expressed a need for sex education and additional screenings for children not in the public school systems.

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