D029 Task 1: Analyzing Population Health Data in Strafford Country
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Western Governors University
D029 Informatics for Transforming Nursing Care
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Date
Population Health Data Paper
Introduction
Strafford County, located in southeastern New Hampshire, is part of the metropolitan region commonly known as “The Seacoast.” This county benefits from its proximity to diverse natural attractions, including mountains less than an hour away, beaches within a 30-minute drive, and the major city of Boston, Massachusetts, approximately an hour south. Despite this attractive location, Strafford County ranks 8th out of 10 counties in New Hampshire, placing it in the lower middle range (25-50%) for both health outcomes and health factors (County Health Rankings & Roadmaps, 2024). This paper examines the population health data, sociodemographic characteristics, health trends, and proposes targeted interventions to improve public health in Strafford County.
Sociodemographic Profile
What is the demographic makeup of Strafford County compared to the United States?
Strafford County’s population in 2022 was estimated at 33,416, reflecting a growth rate of 2.0%, which is notably higher than the national growth rate of 0.5%. The county’s population is predominantly White (89.1%) compared to 75.5% nationally, indicating lower ethnic diversity. Less than 10% of the population identifies as minority groups such as African American, Asian, or Hispanic, whereas nationally, over 40% identify as minorities. Educational attainment is higher in Strafford County, with 96.4% of residents having at least a high school diploma compared to 89.1% nationally. Employment rates also exceed national averages, with 72.1% of the county’s civilian population aged 16 and older participating in the labor force, versus 63.0% nationwide. Poverty rates are lower at 7.6%, compared to 11.5% nationally, and the uninsured rate for those under 65 is 7.1%, also below the national figure of 9.3%. Additionally, Strafford County’s population density is considerably higher, with 1,224.9 persons per square mile compared to the U.S. average of 93.8.
Table 1
Sociodemographic Characteristics: Strafford County, NH vs. United States
| Population Characteristic | Strafford County, NH | United States |
|---|---|---|
| Population Estimate | 33,416 | 333,271,411 |
| Population Percent Change | 2.0% | 0.5% |
| Percent Under Age 18 | 17.0% | 21.7% |
| Percent Age 65 and Over | 16.5% | 17.3% |
| Percent Female | 50.3% | 50.4% |
| Percent White Alone | 89.1% | 75.5% |
| Percent Black or African American Alone | 1.3% | 13.6% |
| Percent Asian Alone | 4.0% | 6.3% |
| Percent Hispanic or Latino | 4.2% | 19.1% |
| Language Other than English Spoken at Home | 7.6% | 21.7% |
| Percent Houses with Computer | 95.7% | 94.0% |
| High School Graduate or Higher | 96.4% | 89.1% |
| Percent with Disability (Under 65) | 8.4% | 8.9% |
| Percent without Health Insurance (Under 65) | 7.1% | 9.3% |
| Civilian Labor Force Participation (16+) | 72.1% | 63.0% |
| Females in Civilian Labor Force (16+) | 66.0% | 58.3% |
| Per Capita Income (Past 12 Months) | $52,752 | $41,261 |
| Percent Persons in Poverty | 7.6% | 11.5% |
| Population Density (per square mile) | 1,224.9 | 93.8 |
Note: Data retrieved from County Health Rankings & Roadmaps (2024) and U.S. Census Bureau (2024).
Discussion on Sociodemographic Characteristics
Strafford County’s population is growing faster than the national average and enjoys higher educational attainment and labor force participation. The county has lower poverty and uninsured rates compared to the broader United States, reflecting relatively favorable socioeconomic conditions. However, the county’s limited ethnic diversity presents challenges in ensuring culturally competent healthcare and inclusive public health strategies. The high population density also suggests a greater demand for healthcare services and infrastructure.
County Health Outcomes
What are the trends in key health indicators in Strafford County?
Strafford County exhibits mixed trends in health outcomes compared to state and national averages.
Alcohol-Impaired Driving Deaths: The county shows fluctuating rates without a clear trend, sometimes lower or higher than the state and national figures. For example, in 2013, 56% of driving deaths in Strafford County were alcohol-related, significantly above state (36%) and national (31%) averages.
Sexually Transmitted Infections (STIs): Strafford County reports higher per capita STI cases compared to the state and national trends, though there has been a slight improvement since 2019. The long-term trend is worsening.
Uninsured Population: Although the uninsured rate is improving, Strafford County maintains a lower uninsured rate (8%-15%) compared to the U.S. (10%-18%).
Primary Care Physician Ratio: Strafford County has a higher patient-to-primary care physician ratio (approximately 1450:1) than both New Hampshire (1100:1) and the U.S. (1300:1), indicating potential access challenges.
Unemployment: No significant trend is noted, with rates rising during economic recessions and pandemics but overall showing improvement.
Children in Poverty: The child poverty rate in Strafford County remains consistently below the national average by 5-10%.
Preventable Hospital Stays: Strafford County is improving in this area, following similar downward trends seen statewide and nationally.
Health Factors Influencing Strafford County Compared to State and National Data
How do health factors in Strafford County compare to New Hampshire and the U.S.?
Table 2 summarizes key health determinants, illustrating areas of strength and concern in Strafford County.
Table 2
Health Factors Influencing Strafford County, New Hampshire, and the United States
| Health Factor | Strafford County | New Hampshire | United States |
|---|---|---|---|
| Percent Smoking | 16% | 15% | 16% |
| Access to Exercise Opportunities (%) | 91% | 84% | 84% |
| Percent Excessive Drinking | 22% | 20% | 19% |
| Primary Care Physicians (Population:Physician) | 1,580:1 | 1,120:1 | 1,310:1 |
| High School Completion (%) | 94% | 94% | 89% |
| Some College Completion (%) | 72% | 71% | 67% |
| Unemployment Rate (%) | 3.3% | 3.5% | 5.4% |
| Children in Single-Parent Households (%) | 19% | 19% | 25% |
| Social Associations (Per 10,000 population) | 7.2 | 10.3 | 9.1 |
| Children in Poverty (%) | 10% | 9% | 17% |
| Injury Deaths (per 100,000) | 94 | 89 | 76 |
| Children Eligible for Free/Reduced Lunch (%) | 27% | 21% | 53% |
| Air Pollution (PM2.5) | 6.2 | 5.3 | 7.4 |
| Severe Housing Problems (%) | 15% | 14% | 17% |
Note: Data from County Health Rankings & Roadmaps (2024).
What are the key successes and challenges identified in health factors for Strafford County?
Strafford County demonstrates particular strengths in access to exercise opportunities (91%), educational attainment, and lower unemployment rates compared to state and national figures. However, challenges include higher rates of excessive drinking (22%), an elevated patient-to-primary care physician ratio, higher injury death rates, and fewer social associations per capita. These areas should be prioritized by public health initiatives to improve overall county health.
Analysis and Proposal for Public Health Improvement
What major health concern requires immediate attention in Strafford County?
The rising incidence of sexually transmitted infections (STIs), particularly chlamydia, among adolescents and young adults aged 15-24 is a significant public health concern. Chlamydia often presents with minimal symptoms, facilitating undetected transmission and potentially serious complications if untreated, such as infertility (CDC, 2022). Despite a slight downward trend since 2019, Strafford County reports chlamydia rates approximately 50% higher than the state average, emphasizing the need for targeted intervention.
Proposed Program: “My Friend’s Place”
How can public health services address the STI challenge in Strafford County?
The proposed intervention is a discreet, youth-friendly clinic named “My Friend’s Place,” designed to provide confidential, anonymous, and easily accessible STI testing and treatment. The program would focus on education and prevention for adolescents and young adults, offering same-day testing and treatment, free condoms, and diverse educational resources tailored to various learning styles. The clinic’s inconspicuous presence aims to reduce stigma and encourage utilization.
Implementation and Stakeholder Engagement
Who should be involved in planning and executing the program?
Key stakeholders would include advanced practice nurses and supervising physicians to oversee clinical care, building managers for clinic location selection, pharmacists for medication compliance, lab technicians for timely test processing, social workers and nurse educators for patient support, and grant writers to secure funding. Later phases would involve IT specialists to develop a dedicated app and representatives of the target population (with guardian consent for minors) for feedback and improvement.
Public Awareness and Engagement Strategy
What strategies will promote awareness and increase utilization of “My Friend’s Place”?
Leveraging technology, the program will deploy a smartphone app featuring clinic locations, service descriptions, educational materials, and options to order free STI protection. Social media advertising on platforms popular with the target demographic—YouTube, TikTok, and Facebook—will be critical. Research indicates these platforms have the highest adolescent engagement rates, making them ideal for targeted messaging (Vogels, Gelles-Watnick, & Massarat, 2022; Auxier & Anderson, 2021).
Program Evaluation
How will the success of “My Friend’s Place” be measured?
Success metrics include tracking monthly clinic attendance and STI test outcomes through line graphs. Anonymous patient satisfaction surveys will assess perceived safety, ease of access, and areas for improvement, with results presented via pie charts. Long-term evaluation will involve monitoring county-wide STI trends compared to state and national data, with detailed breakdowns by specific STIs and counties to identify outbreaks and intervention effectiveness. This data will support ongoing funding applications and program expansion.
References
Auxier, B., & Anderson, M. (2021, April). Social media use in 2021. Pew Research Center. https://www.pewresearch.org/internet/2021/04/07/social-media-use-in-2021/
Centers for Disease Control and Prevention [CDC]. (2022). Chlamydia – CDC basic factsheet. https://www.cdc.gov/std/chlamydia/stdfact-chlamydia.htm
Centers for Disease Control and Prevention [CDC]. (2021). Sexually transmitted infections prevalence, incidence, and cost estimates in the United States. https://www.cdc.gov/std/statistics/prevalence-incidence-cost-2020.htm
County Health Rankings & Roadmaps. (2024). Strafford County. https://www.countyhealthrankings.org/explore-health-rankings/new-hampshire/strafford?year=2023
U.S. Census Bureau. (2024). QuickFacts: United States. https://www.census.gov/quickfacts/fact/table/dovercitynewhampshire,US/PST045223
Vogels, E., Gelles-Watnick, R., & Massarat, N. (2022, August). Teens, social media and technology 2022. Pew Research Center. https://www.pewresearch.org/internet/2022/08/10/teens-social-media-and-technology-2022/
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