Professional Documents
Culture Documents
Aliscia Laliotis
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.
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.
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
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,
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
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).
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.
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
Population Diagnosis
Individuals with respiratory disorders in Oakland County are at risk for poor pulmonary
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
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
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
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.
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
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
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
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
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
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
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
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 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
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
https://www.beaumont.org/locations/beaumont-hospital-troy
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., & ...
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
https://www.census.gov/quickfacts/fact/table/oaklandcountymichigan/IPE120216#viewto
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
doi:10.1093/pubmed/fdw130
Savage, C. L., Kub, J. E., & Groves, S. L. (2016). Public health science and nursing practice:
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