Case Study of Community Health Nursing

Community Health Nursing

Galveston, Texas is a city in South Texas that is mostly water and resides in the Gulf of Mexico. The city itself has a relatively small population, but it is close to Houston which is one of the largest cities in the United States. The city, being close to the Gulf is a prime candidate for hurricanes, and it has seen some devastating storms since its inception. This paper examines the community health characteristics of this small American city from the perspective of economic development, safety, culture and disaster preparedness, and then provide an assessment and a diagnosis.

Community Assessment


It may seem that it is difficult to link health and economics, but there are actually a number of correlations that can be made. One of these is that a person who is comfortable with the amount of wealth they have accumulated is more likely to be healthy. The main reason for this seems to be that this type of person has less to worry about and is able to make healthier decisions regarding level of care. Demographics speak to the fact that Galveston, in general, is in a county that is economically better off than the average Texas county. However, the city is not so fortunate. According to Nolen, et al., (2011), the population of the city dropped dramatically in the last seven years. Most of the population drop was due to hurricanes Katrina and Rita. These both occurred in 2005 and were devastating to the entire Gulf Coast region of the United States. The economy of the city declined with the population. Currently, more than 23% of the population of the city is at or below the poverty level, and it is difficult to find work in the area. Since many of the businesses have either left the city or seriously reduced workforces, there is little for the remaining people to do.


The economy and the population of the city have decreased in recent years, but Galveston remains a safe city relative to other Texas cities. The area has some amount of crime, but, for the size of city that it is, Galveston is actually relatively safe. The issues that Nolen, et al., (2011) report points out have to do with noise pollution from various festivals and fairs, and the industrial activity that has recently restarted in the community. Since it is a small city, albeit in a much larger country near a metropolitan area, Galveston does not have the crime-related issues of a larger area.


The State of Texas has a very large Hispanic community that is largely Mexican. However, the city of Galveston actually looks more like the rest of the United States than other cities in Texas. The Hispanic population is relatively low compared to other Texas cities, and other populations run at roughly normal rates (Census Bureau, 2012). The City of Galveston does have a thriving Mexican-American culture notwithstanding the numbers, but there are also a number of festivals in the area that celebrate other cultural communities in the area.

Disaster Preparedness

This area of the health assessment may be the most comprehensive since the area is very susceptible to hurricanes and other water related problems. There are very few other disasters that could so significantly affect the area since it is not in the tornado belt, does not have a large amount of snow, and has never had a large earthquake. The city has developed a plan that includes a tiered evacuation and reentry plan, housing insurance breaks for low-income families so that they can make sure to have housing if a disaster occurs, provide for mental health services to quickly reassert themselves, and provide communications with citizens regarding the disaster Nolen, et al., (2011).


The City of Galveston meets the statistical norms of the rest of the country with regard to birth and death rates and other similar demographics data, but the area still has not fully recovered from the effects of large storms that happened in 2005. Because the population decreased so dramatically, crime has risen to some degree, there is more evidence of decay, and the city seems to be waiting for the next large storm to arrive. Many of the health centers and hospitals have left the city and moved to the more suburban areas of the county in consequence to the movement of the population. This has made it more difficult for people within the city to receive adequate healthcare.


See Appendix A

Genogram Interpretation

The City of Galveston is the focus of this analysis, but the city lies within the larger County of Galveston in Texas. The two do not have a great deal to do with each other, thus the curving, light-colored line. The City is very concerned with all mean of safety and especially as that relates to disaster preparedness, and these two are very much interconnected. The City is less concerned with culture because the inhabitants do not have the strong cultural heritage of the county residents. Health seems to be an afterthought because a the greater concerns are unemployment and safety.

Community Diagnosis

Galveston, Texas is a small community, but one that has been hit hard, at times, by both natural phenomena, and man-made problems. The community has a decent health record because crime has been relatively stable and the community has had enough experience with large storms (disasters) that they have developed an effective plan. These issues taken together though can have an enormous effect on the health of the populace. It is difficult to look at the current state of the city and not be concerned.

Due to hurricanes Rita and Katrina, the population has dramatically decreased in size and this means that there are fewer local health care centers for residents. Even if a hospital or health care facility is relatively close, it may still be too far away for an elderly person or a child who needs care and cannot find transportation. The decrease in population also means that there are fewer jobs in the city, besides the docks, so crime has increased. The latest figures prove that it could become a real problem very shortly (Census Bureau, 2012). These may not seem to have direct effects on health, but they do. Because of these factors, there is an increasing illness in the community that must be taken care of.

Recently, the city conducted a survey and the local University of Texas extension center wrote a healthcare proposal for the region (Nolen, et al., 2011). The suggestions ranged from trying to build sustainable jobs for the region to giving the people of the community a voice in how changes can be made to the community. The people who wrote the assessment were worried that with its present course the city could face a major health crisis if it is not stalled immediately.


Census Bureau. (2012). Quick facts: Galveston County, Texas. Retrieved from

Nolen, L.B., Miller, C.M., Prochaska, J.D., & Tarlekar, S. (2011). Health impact assessment of the City of Galveston’s draft comprehensive plan, Center to Eliminate Health Disparities at the University of Texas Medical Branch, Galveston, Texas. Retrieved from

Appendix A

Galveston Community Genogram

Disaster Preparation

The City of Galveston







Galveston County Relations

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