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Running head: AIR POLLUTION LEVELS 1

Air Pollution Levels in Oakland County

Aliscia Laliotis

University of South Florida


AIR POLLUTION LEVELS 2

Air Pollution Levels in Oakland County

According to the County Health Ratings website, there is a notably high amount of

pollutants in the air in Oakland County. The purpose of this paper is to evaluate the air pollution,

the effects it has on the community, and how to improve the community’s health in decreasing

the effect of air pollution. Resources will include information from county databases and peer-

reviewed articles.

Overview of Oakland County

Oakland County is located in the Southeastern part of Michigan. It’s only 45

minutes north of Detroit, Michigan. The population of Oakland County is just over one million.

The population of the state of Michigan is just under 10 million. That means Oakland County

houses 10% of Michigan’s residents (Health Rankings). The area is not known to be

overcrowded despite the large amount of residents. Subdivision developers utilize more space

between houses than what is typical in the Tampa Bay area. By doing this, they have allowed

residents to spread out more over the land and allowed more property per person.

Oakland County is known around this region for housing the suburban residents who

commute to Detroit for work. It’d be hard to pinpoint one poverty stricken location in Oakland

County. Eighty percent of the population had completed some college which is higher than “the

U.S. top performers”. The unemployment rate is 5%. The largest employers in the county are

Beaumont Hospitals, Fiat Chrysler Automotive LLC, and General Motors Company (Top

Employers/Industries, 2016). The major healthcare system is also the largest employer in the

county, Beaumont Hospitals. They have two locations. Troy Beaumont Hospital in Troy,

Michigan is a 520 bed hospital (Beaumont Hospital, Troy, 2017). Royal Oak Beaumont Hospital

in Royal Oak, Michigan is a 1,100 bed hospital. Royal Oak Beaumont Hospital also has a Level
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1 trauma center as well as a Level 2 pediatric trauma center (Beaumont Hospital, Royal Oak,

2017). The residents of Oakland County have two very prestigious hospitals to choose from.

Comparison of Local vs. State Populations

According to the U.S. Census Bureau, 9% of Oakland County residents are under the

poverty level (QuickFacts, 2016). Out of all of Michigan, 15% of the population are under the

poverty level (QuickFacts, 2016). Oakland County outperforms the state of Michigan by 3%

when it comes to residents with their high school diplomas. The county has 93% and the state

has 90% (QuickFacts, 2016). Nine percent of the state population does not speak English at

home. Fourteen percent of the county population does not speak Spanish at home. The access to

providers in Oakland County is 680 patients to one provider. The access in the state is not as

great at 1,240 patients to one provider (Health Rankings).

Analysis and Interpretation of Data

Identified Strengths

The data and statistics listed above prove that Oakland County outperforms Michigan in

many ways. There are other ways that the county outshines the state as well. Listed below

shows how Oakland County compares to Michigan and “the U.S. top performers” in terms of

access to physical activity areas, teenage pregnancies, and how many residents report poor or fair

health.

Access to areas that provide a place for physical activity is very important. People tend

to be more motivated to get active if there are exercise outlets in a close vicinity to where they

reside. Ninety-four percent of the Oakland County population has “adequate” access to physical

activity areas, while only 84% of Michigan has access. Even “the top U.S. performers” don’t do

as well as Oakland County in this area with only 91% having access (Health Rankings).
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Populations want their statistics of teenage births to be low. Teenagers typically don’t

have the resources to properly care for a newborn. They don’t have the capability of having an

established career without first graduating high school. Therefore, their means of providing for

their child is much less than an adult’s. Teenage births are at a low in Oakland County. Out of

one thousand females aged 15 to 19, only 15 will report a teenage pregnancy on average. In

Michigan, 28 and out of “the U.S. top performers”, 14 will report teen pregnancy pregnancies

(Health Rankings). Again, Oakland County outperforms the state and the nation.

In order for a person to be healthy, they typically have to feel healthy. When it comes to

residents reporting poor or fair health, Oakland County does very well, yet again, with fairly low

percentages. Only 11% of people report poor or fair health in the county. In Michigan, this

figure is 17% and in “the U.S. top performers” it is fourteen percent (Health Rankings).

Identified Weaknesses

Every county has their weaknesses. There are some health areas that Oakland County

does not perform very well. These areas include the amount of excessive drinkers, air pollutants,

and long commutes while driving alone.

Excessive drinking can be very dangerous for a person and for a community. The health

risks of heavy drinking of a person are very high. Excessive drinking effects the community by

putting others at risk out on the road. In Oakland County, 20% of the residents report that they

are binge or excessive drinkers. All of Michigan reports the same amount, but “the U.S. top

performers” only report 12% (Health Rankings).

Air pollution is a silent harmer. The residents may not even realize how bad their air

quality really is. Air pollution can have harmful effects especially to the asthmatic population.

Oakland County has an air pollution density of 10.6. The air pollution density levels of
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Michigan average at 8.7. “The U.S. top performers” have an air pollution density that is only 6.7

(Health Rankings).

Long commutes while driving alone may not seem dangerous, but if a large number of

people do it, they are adding significantly to the particulate matter making up the air pollutants.

Phone numbers are available along the interstates that provide more information about

carpooling. The state calls it their “Rideshare” program and people can sign up online (You are

here, MI). As mentioned earlier, many people living in Oakland County commute into Detroit

for work. The data supports this. 41% of commuters who drive alone commute for more than 30

minutes. The state reports only 32% who drive for more and 30 minutes. “The top U.S.

performers” only have 15% of people who drive alone that commute for greater than 30 minutes

(Health Rankings).

Identification of a Priority Health Issue

The priority health issue of Oakland County is the air quality. Air pollution is a trigger

for many asthmatics. Saunders, Middleton, and Rudge (2017) studied the effects on

environmental hazards on health in London. One of these environmental hazards was air

pollution. A factor that increased the harm in that area was high traffic levels. As mentioned

earlier, Oakland County houses a little over 10% of Michigan’s population. With such a large

amount of people, comes a large amount of traffic that gives off a large amount of nitrogen

dioxide, an air pollutant. Saunders, Middleton, and Rudge (2017) recognized that nitrogen

dioxide was the most harmful traffic-generated pollutant. This substance’s effect on the

community’s health was significant in their study. They attributed 180 cases of children with

wheezing and 900 cases of asthmatic children with bronchitis symptoms directly to nitrogen

dioxide. Out of the asthmatic children on Medicaid, 29% visit the emergency room one or more
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times annually in Oakland County. In the state of Michigan, this figure is 27% (Get Asthma

Help).

Air pollution doesn’t just affect asthmatics. It also affects others with respiratory

disorders. Blount et all. (2017) studied the relationship between high traffic levels and mortality

related to tuberculosis. In the study, the researchers discovered that there was increased

mortality rates from tuberculosis in areas that had higher traffic concentrations.

Discussion and Application of Community Health Models

Community health models are very important in recognizing where change needs to come

from for certain health issues. The Determinants of Health model illustrates health determinants

starting at the individual’s innate characteristics and works its way out to the socio-economic,

cultural, and environmental conditions. The model aides in addressing what level a population

based health issue originates and guides one to intervene in that area. The factors that impact the

community of Oakland County and the issue of air pollution are individual lifestyle factors,

community networks, and environmental factors. Individual factors include how much people of

the community choose to drive alone instead of carpooling into the city. Community networks

are provided with the “Rideshare” program, but are they advertised enough? Are public media

outlets informing the community on days where air pollutant particles are higher than usual?

Environmental factors are, of course, the actual density of air pollutants in the air that the

residents breathe in on a daily basis.

Population Diagnosis

Individuals with respiratory disorders in Oakland County are at risk for poor pulmonary

health due to the elevated amount of particulates of pollution in the air.

Community/Population-based Interventions
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Interventions from a public health nurse would aid the population of those with

respiratory disorders by recognizing the negative effects of air pollution and seeking to help the

situation by intervening. The first intervention would have to be to find how many individuals

are affected by air pollution in Oakland County by analyzing data. The “disease and other health

event investigation” component of the Intervention Wheel supports this intervention. It

reinforces the idea that data should be analyzed to find threats to the health of the population

(Savage, Kub, & Groves, 2016, p. 39). Another intervention the public health nurse should

implement is population education. The nurse would need to educate the community about how

air pollution affects respiratory health. The Intervention Wheel factor that supports this

intervention is “health teaching”. “Health teaching” needs to deliver information that would

change an individual or community’s behavior or beliefs (Savage, Kub, & Groves, 2016, p. 39).

The individuals would also be encouraged to contact their provider if they were to show signs

and symptoms of respiratory disorders which include wheezing, low oxygen saturation, and

difficulty breathing, to name a few. The component of the Intervention Wheel that supports this

intervention is “referral and follow-up”. Savage, Kub, & Groves (2016, p. 39) describes the

“referral and follow-up” process as being important because it urges people to seek out the

proper resources to improve their conditions.

Primary Level of Prevention

A primary prevention of decreasing the effects of air pollution on lung health would be to

decrease the air pollution amount. The recipient of the primary level prevention would be the

entire community. The intervention would be to implement “Ozone Action!” in Oakland

County. “Ozone Action!” days is an idea thought up by the Oakland County Health Division

and it involves the community taking action to reduce their contribution to air pollutants.
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“Ozone Action!” days are determined by the Oakland County meteorologists and are decided

based on the amount of air pollutants in the air on a given day. Residents are encouraged to

follow the “Ozone Action!” tips, which include, but are not limited to, refueling carefully by

taking care not to spill gas on the ground, reducing driving time, and avoiding vehicle idling.

Stakeholders include Oakland County health care providers because they would want to

encourage their patients to take part in improving the health of the community. Pulmonologists’

patients are affected the most by air pollution effects. Community members would be

responsible for implementing “Ozone Action!” duties and would benefit from the intervention.

Funding would become a concern in advertising “Ozone Action!” days at gas stations, on the

news, and in pulmonologists offices. Advertising and verbal communication would be the

primary ways of spreading the idea of “Ozone Action!” days. The role of the community health

nurse in implementing these ideas would include finding ways to educate the community on how

they could take action and how their actions would benefit community health.

Secondary Level of Prevention

The secondary level of prevention would be to screen individuals who are most

susceptible to the harms of air pollutants. The screenings would look for individuals with

asthma, chronic obstructive pulmonary disease (COPD), and/or lung cancer. The screenings

would involve interviewing individuals about having shown signs and symptoms of respiratory

disorders. Signs and symptoms would include shortness of breath, congestion, wheezing, and

coughing. The stakeholders of this intervention involving screening would include health care

providers primarily. Health care providers would be stakeholders because screening for

respiratory disorders would help their process of diagnosing which respiratory disorder the

individual has and finding treatment for that individual. Providers could then encourage those
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patients to limit their activity outside. Funding wouldn’t be a great concern because screenings

could be done in schools and in doctor’s offices by the community health nurse and would be

funded by insurance companies and government funding.

Tertiary Level of Prevention

The recipient for the tertiary level of prevention would again be the individual. The

intervention would involve dealing with the effects of air pollution on the affected individual’s

respiratory disorder. Individuals would be encouraged to limit their activity outside when the

particulate matter in the air was at higher levels. They would also be encouraged to keep rescue

inhalers on their person at all times possible and to take their respiratory medications as directed.

Stakeholders involved in this intervention would be the health care providers again. By

implementing these interventions, their patients would avoid risking their health. The

responsibility of the community health nurse would be to reach out to the individuals with

respiratory disorders and make sure they are taking their medications properly. Their means of

communication with the patients would be through home health visits, doctor office visits and

telephone communication. The funds necessary for this visit would be provided by the

individual’s insurance companies and therefore are not a great concern.

Development of Health Policy

The health policy to be put into place for Oakland County would be the intervention

listed above: implementing the “Ozone Action!” days. The impact of “Ozone Action!” days

would decrease the amount of air pollution in Oakland County. This intervention is considered

primary level prevention because it decreases the risk of air pollution triggering susceptible

individuals to experience respiratory distress.


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Since the idea of “Ozone Action!” days has already been introduced to Oakland County,

the focus would be on supporting it and furthering the outreach to the community. Advertising

outlets would be utilized to encourage the community to tune into the local weather stations and

determine if any given day is an “Ozone Action!” day. If so, they would be urged to limit their

contribution to air pollution. Even if they are not able to watch the weather station, they would

still be advised to take action. Specific actions they could take include taking care not to spill

gas on the ground, reducing driving time, and avoiding vehicle idling.

The stakeholders involved in this intervention would include the community members

and health care providers. Community members would invest their time and energy in taking

action against contributing to air pollution. Health care providers would want the community’s

lung health to be improved so they could have healthier patients.

Funding sources would be needed for advertising “Ozone Action!”. The community

health nurse would need to propose to the local news stations that meteorologists should include

the amount of particulate matter in the air on a given day and then urge their viewers to visit the

“Ozone Action!” website to find out how they could help. Hopefully, the news team would do

this for free, but if they require money, funding would have to be provided. Much of the air

pollution in Oakland County is caused by traffic. Another place to advertise would be at gas

stations. Funds for the advertising could be provided by community fundraisers, government

funding, or private donations.

Supporters of the health policy would include individuals with respiratory disorders.

They would support this idea because it affects them directly. Another supporter would be

health care providers. They would advocate for their patients’ health. Family members of
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individuals with respiratory disorders, also considered the community, would support “Ozone

Action!” because they don’t want their loved ones to suffer.

Opposing forces of the health policy could potentially include funding for the cause. If

funds from fundraiser, government funding, or private donation are not sufficient, “Ozone

Action!” wouldn’t reach much of the community. Another opposing force could be community

members who aren’t involved or care to be involved in community health. Many people need to

go on long car rides, enjoy sitting in their cars with air conditioning on, and/or don’t care to take

caution when filling their cars up at the gas station.

To put the policy action, the idea, “Ozone Action!”, would need to become well-known

in the community. Finding funding for advertising would be the first action taken. Oakland

County Health Division would need to be sought out to determine what they have done to spread

the word of “Ozone Action!”.

The community would benefit greatly from this health policy. Their respiratory health

would especially benefit. The amount of air pollution in Oakland County is much higher than it

should be. The county needs to be made aware of that fact and they need to be urged to do

something about it. Hopefully, by doing so, there will be less incidences of respiratory distress

caused by air pollution.

Conclusion

The primary weakness of Oakland County that needs to be addressed is the high amount

of air pollution. The air pollution is caused by the large amount of traffic in the area. The

particulate matter in the air has negative effects on the community’s health, especially to those

already at risk with respiratory disorders such as asthma, COPD, and lung cancer. The

community health nurses in Oakland County could improve the community’s health by backing
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the “Ozone Action!” plan by the Oakland County Health Division and furthering their ideas into

the county.

I picked Oakland County to discuss in this paper because I hope to move to Lake Orion,

Michigan, a city of Oakland County, someday in the future. I wanted to further my learning on

the health concerns of this community. I hope to be aware of the weaknesses of the county,

allow that knowledge to help me anticipate my patient population, and understand how to better

their health.
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References

Beaumont Hospital, Troy. (2017, August 19). Retrieved from

https://www.beaumont.org/locations/beaumont-hospital-troy

Beaumont Hospital, Royal Oak. (2017, August 19). Retrieved from

https://www.beaumont.org/locations/beaumont-hospital-royal-oak

Blount, R. J., Pascopella, L., Catanzaro, D. G., Barry, P. M., English, P. B., Segal, M. R., & ...

Nahid, P. (2017). Traffic-Related Air Pollution and All-Cause Mortality during

Tuberculosis Treatment in California. Environmental Health Perspectives, 1251-11.

doi:10.1289/EHP1699

Get Asthma Help. (n.d.). Retrieved October 21, 2017, from http://getasthmahelp.org/current-

michigan-county-asthma-statistics.aspx?ctyID=63

QuickFacts. (2016, July 1). Retrieved from

https://www.census.gov/quickfacts/fact/table/oaklandcountymichigan/IPE120216#viewto

QuickFacts. (2016, July 1). Retrieved from https://www.census.gov/quickfacts/MI

Oakland County Health Division (n.d.). Ozone Action Days. Retrieved from

https://www.oakgov.com/health/information/Pages/Ozone-Action-Days-.aspx

Saunders, P. J., Middleton, J. D., & Rudge, G. (2017). Environmental Public Health Tracking: a

cost-effective system for characterizing the sources, distribution and public health

impacts of environmental hazards. Journal Of Public Health, 39(3), 506-513.

doi:10.1093/pubmed/fdw130

Savage, C. L., Kub, J. E., & Groves, S. L. (2016). Public health science and nursing practice:

caring for populations. Philadelphia: F.A. Davis Company.


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Top Employers/Industries. (2016, October). Retrieved from

https://www.oakgov.com/edca/business/Pages/Top-Employers-Industries.aspx

You are hereMI Commute Sharing Rides Carpool. (n.d.). Retrieved from

http://www.michigan.gov/micommute/0,4623,7-214-53571_53815---,00.html

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