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Community Assessment Project

WINDSHIELD SURVEY FEB 19, 2012 • NURSING 4110, ETSU • SHERRI KING

City of Pigeon Forge


Courtesy of the city of Pigeon Forge

Thousands of tired, nerve-shaken, over-civilized people are beginning to find out that going to the mountain is going home; that wildness is necessity; that mountain parks and reservations are useful not only as fountains of timber and irrigating rivers, but as fountains of life. - John Muir


Community Assessment Project

WINDSHIELD SURVEY FEB 19, 2012 • NURSING 4110, ETSU • SHERRI KING I - Assessment General Community Review General overview .................................4 Housing .....................................................5 Environment ...........................................6 People.........................................................9 Transportation ....................................13 Community development ..............10 Safety ..........................................................8 Community Health Review Healthcare ............................................14

II - Conclusions .............................................. 19 III - Nursing’s Role ......................................... 20 Bibliography .........................................22 Courtesy of the city of Pigeon Forge

City of Pigeon Forge


GENERAL OVERVIEW

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History

Geography

Courtesy of the city of Pigeon Forge

he name Pigeon Forge comes from an iron forge built by Isaac Love (1783-1854) sometime around 1820. The name of his forge referred to its location along the Little Pigeon River. The original location of Isaac’s mill is now the Old Mill. When the first EuroAmerican settlers arrived, they observed flocks of Passenger Pigeons that frequented the river banks, hence the name “Little Pigeon River” (city-data).

Pigeon Forge is a city in Sevier County, Tennessee. It is located in East Tennessee just one hour from the North Carolina border in the Southeastern United States. It is situated five miles north of the Great Smoky Mountains National Park. Pigeon Forge is located at latitude 35,793946 and longitude - 83,564124, on the West Prong of the Little Pigeon River. Pigeon Forge is a narrow valley along this river between Sevierville and Gatlinburg. Its elevation is 1,001 feet. High ridges surround Pigeon Forge on three sides, with Pine Mountain to the west, Shields Mountain to the east, and Cove Mountain to the south (city-data). Pigeon Forge is primarily a tourist resort. U.S. Route 441, known as the “Parkway” runs through the middle of Pigeon Forge en route to Gatlinburg and the Great Smoky Mountains National Park, and onward to Cherokee, North Carolina. Route 321 known as Wears Valley Road connects the town to Townsend to the west. Upper Middle Creek and Veterans Boulevard connect Pigeon Forge to Dollywood and other rural areas of eastern Sevier County. It is a centrally located tourist “hub” of Sevier County (city-data).

Population

The population of Pigeon Forge stands at 6,204 as of July 2008. This has been an increase of approximately twenty-two percent since the census taken in 2000. The diagram below illustrates the male and female population as well as median age compared to the whole state of Tennessee (city-data).

Courtesy of City-data.com

This growth factor over the last eight years is contributed to the 9,044,010 visitors  • Windshield Survey


to the Great Smoky Mountain National Park. Most of these people pass through Pigeon Forge (Pigeon Forge development). To keep up with the demand, expansion of shopping outlet malls and tourist attractions, such as Dollywood, continually grow. These type businesses continue to “add on” to their properties creating need for more employees. Many residents have moved to the area from different countries. The graph below compares foreign residents compared to the state average (city-data).

Housing

Courtesy of City-data.com

The table below breaks down the household population (profiles).

Courtesy of nationalrelocation.com

Available housing is not a problem for this area but affordable housing is. The majority of new developments are focused on cabin style rentals that are designed for short term lodging for tourists. On average, forty-six percent of Pigeon Forge residents own a home, thirty percent rent with twenty-three percent vacancies (realestate). The average household size is 2.5 people, with an average of 4.9 rooms in the household. The median age of housing structure is twenty-six years old (public school review). Most houses are well and/or extremely well kept, but like all cities, there are areas of run down trailers and old homes in need of repair. But one has to be looking for these homes to find them. The average price for a home in Pigeon Forge has declined from $225,000.00 in 2007 to $142,000.00 in 2009. The median real estate property taxes are also lower on average at $377.00 as compared to the state average of $715.00 (city-data). The biggest vacancies observed are commercial buildings. The recession we are experiencing has closed the doors of many small businesses due to the high rent prices and lack of paying customers, mainly tourists. The largest vacancy is a property located in the heart of Pigeon Forge called “Belle Island”. It is ninety percent completed, yet stands like a ghost town. It remains to be seen what the plan is for such a large property.

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ENVIRONMENT

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ne can’t help but notice the beautiful backdrop of majestic mountains of the Great Smokies as one enters Pigeon Forge. It is a bustling town with many sounds and smells. Souvenir shops, miniature golf courses, restaurants, bungee jumps and other amusements

stretch for miles along the main parkway running through the heart of Pigeon Forge. With no major industrial areas, tourism is Pigeon Forge’s life’s blood. But with all of the tourism in Pigeon Forge comes a special set of environmental factors which affect the community, and ultimately a person’s health within that community. One of the major environmental concerns is air quality. The height and physical structure of the mountains, combined with predominant weather patterns, tend to trap and concentrate human-made pollutants (i.e. automobiles) in and around the national park (nps.gov). Along with this comes another air quality problem—ozone pollution. Ozone is a powerful respiratory irritant for humans. Research shows that ozone can cause coughing, sinus inflammation, chest pains, a  • Windshield Survey

scratchy throat, even permanent damage to lung tissue and reduced immune system functions. Children, the elderly, people with existing health problems, and active adults are most vulnerable (nps.gov). More UV-ray sun exposure, as well as acid rain, acid clouds, and nitrogen overload are other negative effects of ozone pollution (nps.gov). In the past, another concern for the community has been waste management. How does a community of 6,000 plus residents deal with the waste and trash from millions of tourists? The Sevier Solid Waste, Inc. (SSWI) Co-Composting Plant is an example of how the world can take advantage of waste-to-energy technology with a state-of-the-art solid waste disposal facility (practical environmentalist). More than 300 tons of trash is produced locally each day. The breakdown of organic and other biodegradable materials results in material that is sold as compost. Not only does this plant create useful compost, but pyrolysis units also burn trash to produce electricity. All of this helps to reduce the amount of trash being sent to landfills thereby reducing the amount of carbon dioxide emitted by large landfills, which ultimately helps to reduce global warming (practical environmentalist). This is something Pigeon Forge and Sevier County as a whole can be proud of! Another area of close monitoring in the environment is water quality for the community. The Water Plant in Pigeon Forge can treat 12,000,000 gallons of water per day. The city storage system holds 6,650,000 gallons of water and the city also inspects the plant 365 days a year (city). Each year an Annual Drinking Water Quality Report is printed and presented informing the citizens of the community the details of the report. Although considered safe, some people may be more vulnerable to contaminants in drinking water than the general public.


Immuno-compromised individuals as well as some elderly, and infants can be particularly at risk for infections (city). Public opinion polls consistently document that Americans value water quality. Although U.S. waterways have become cleaner because of pollution controls on industrial discharges and sewage treatment plants, extensive water quality problems remain (scorecard). The west prong of the Pigeon River runs through Pigeon Forge and is thought to be contaminated due to all of the run-off from the cabins in the mountains. This is a concern for government officials and citizens alike. The Public Works Department of the city of Pigeon Forge over sees building inspection, streets, sanitation, fleet maintenance, utility, water plant and wastewater plant. The office also works on capital projects with engineers and contractors, such as road widening projects, water and wastewater plant expansions, water and sewer construction projects and other city improvements (city). Some of these improvements are Pigeon Forge’s two parks. Both of which have plenty of green space for the enjoyment of locals and tourists alike.

2002 Rankings: Major Chemical Releases or Waste Generation in SEVIER County* Cleanest/Best Counties in US Percentile Dirtiest/Worst Counties in US 100 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% % Total environmental releases: Cancer risk score (air and water releases): Noncancer risk score (air and water releases): Air releases of recognized carcinogens:

Air Quality Air Quality Rankings: Health Risks, Exposure, and Emissions

Cleanest/Best Counties in US Percentile Dirtiest/Worst Counties in US 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Carbon Monoxide emissions: Nitrogen Oxides emissions: PM-2.5 emissions: PM-10 emissions: Sulfur Dioxide emissions: Volatile Organic Compound emissions: Air Quality Index: Ozone 1-hour average concentration: Ozone 8-hour average concentration: Person-days in exceedance of national air quality standard for ozone (8-hour):

Courtesy of www.scorecard.org

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PEOPLE

Courtesy of areaconnect.com

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Diversity

them along for a shopping trip that the child did not seem to want to be present for. This group seemed to be of lower class, because of the way they were dressed and the behavior presented. The majority in this population were between early twenties to late thirties. There were 13 elderly in attendance that morning. According to MuniNet Guide, the average ages of residents are 37.5 years old.

he people of Pigeon Forge are mostly of Caucasian decent. According to National Relocation.com, Pigeon Forge has a population of 6,082, with 80% Caucasian, 3% Latino, 1% Asian, 0.07% African American, and 0.02% other ethnic groups (schools.national). Diversity Out of one hundred people shopping at local grocery store Kroger on a recent Saturday morning, 58 were Caucasian, 35 were Latino, 3 were Asian, and 4 Pigeon Forge Ethnicity Statistics were of other (unknown decent). 4,868 White These numbers include 32 children 37 African American with their families, 52 women, and 188 Hispanic or Latino 16 men. All were speaking English 73 Asian or Spanish. Of these 100 families, the dress, 47 American Indian or Alaska Native demeanor, and age varied greatly. 4 Hawaiian / Pacific Islander Some were well dressed, most 113 Other were average shoppers, and a few were dirty, scruffy and in pajamas. Shockingly many parents were Occupations yelling and fighting with their children, dragging According to the most recent government statistics, there are 40,585 Pigeon Forge jobs. Crime Statistics for Pigeon Forge Jobs in Pigeon Forge’s Private Sector make up the majority of employment with 35,953 jobs in the Pigeon Forge surrounding area (Sevier County). This accounts for 88.59% of the Pigeon Forge jobs market. The rest of the market comprises local government employment totaling 4,217 jobs, which is 10.39% of the Pigeon Forge workforce. State government and federal government make up 33 (0.08%) and 382 (0.94%) Pigeon Forge jobs respectively (jobs.aol.com). To get an idea of the opportunity, there are 2,607 employers in Pigeon Forge. The private sector includes 2,573 firms, which make up 98.7% of companies hiring in Pigeon Forge. In other sectors, 17 local government employers (0.65%), 4 state government employers (0.15%), and 13 federal government employers (0.5%) hire workers in the Pigeon Forge vicinity (jobs.aol.com). Even though there are so many jobs available in the community, the unemployment rate is an overwhelming 14%. The Tennessee average is at Windshield Survey • 


10.7% and the United States average is 8.5% Community Development Services (Best Places.com). According to these statistics many of the Pigeon Forge jobs must be taken by Education employees from the surrounding communities, The schools in the City of Pigeon Forge are part rather than the local residents. of the public Sevier County School System. According to Job.aol.com, the average Pigeon Forge High School serves grades 9-12 household income for the community is $37,848, although there are conflicting statistics on this fact and has an enrollment of 794 students. Pigeon Forge Middle School incorporates grades 5-8 (jobs.aol.com). At NationalRelocation.com, 404 and 619 students are currently enrolled. Pigeon households have an income between $15,000 and $24,999. This website also states that 358 families Forge Primary includes grades Pre-K-4 and 660 students are enrolled (schools.national). All of have an annual income between $35,000 and these schools are in great condition and have $49,999, however (schools.national). outdoor recreation areas for the children. There are not vocational, adult education or community Churches colleges available within the city; however, There are six main places of worship within the community. Holy Cross Catholic Church is a large, citizens only have as far as the City of Sevierville to go for these services. At the local community well-maintained building, with a congregation of college, Walters State, there is a great Nursing 329 members. Conner Heights Baptist Church Program available. is an older, small church with 152 members. All three public schools in the community First United Methodist is a quaint, old building have a Registered Nurse on the premises. with 280 full-time members, and a regular There are Special Education Teachers that attendance of tourists in the community. Mount assist disabled children at all of the represented Zion Baptist is a small, well-kept building which schools. If medication is required, the R.N. at the boasts 79 members. Henderson Chapel has a school will administer (Ownby). Pigeon Forge small, brick building that is in a bit of disarray. The membership has not been established. Middle Primary also has a program called Tele-Med available. This is a computer based program Creek United Methodist Church is a large, white, set within the nurse’s office. If a child is sick at well maintained building with a membership of school the nurse, with parental permission, can 272. The statistics show that 50% of residents Churches contact a Nurse Practitioner who can “see” the have some form of religious affiliation and 44% of child through virtual computer technology. The Pigeon Forge of a Protestant faith Nurse Practitioner can then diagnose the illness (Best Places.com). and prescribe treatment and/or medication as necessary. The program is enjoying a great success since its debut in Religion Pigeon Forge, TN United States spring 2009, due to its success the Percent Religious 50.15% 50.03% school has seen a reduction in absent Catholic 2.22% 21.92% children due to illness (Ownby). Protestant 44.82% 19.12% According to Paige Ownby, LDS 0.49% 1.57% R.N. at Pigeon Forge High School, Baptist 33.27% 8.16% there are several wellness programs Episcopalian 0.38% 8.12% available at these schools. All Pentecostal 4.20% 1.89% schools in the Sevier County School Lutheran 0.50% 2.81% System have regular wellness Methodist 5.79% 3.84% checks for students and staff that Presbyterian 0.68% 1.33% include: height and weight check, Other Christian 2.60% 4.66% blood pressure screening, and Jewish 0.00% 2.16% regular checks for head lice. Vision Eastern 0.02% 0.05% and hearing screenings are also Islam 0.00% 0.54% 10 • Windshield Survey


performed on a regular basis. One disappointing reality presented by Mrs. Ownby is that the middle and high schools no longer provide a sex education class to students (Ownby). An unfortunate result of this mistake is that ten high Education school girls are currently pregnant, the parents are responsible for the sexual education of their children, but the schools should incorporate this important teaching into their curriculum.

graph is a representation of the education levels of all current citizens of Pigeon Forge (schools. national).

Community Pride

Throughout the community there is evidence of community involvement. Proud parents display bumper stickers and yard signs boasting of their children’s achievements in Pigeon Forge Education sports and academics. 430 Less than 9th Grade There are political signs in yards 614 Some High School supporting local, 1,110 High School Graduate county, and state 700 Some College representatives. According to Sevier 165 Associate Degree County.org, there are 251 Bachelor's Degree a few notable clubs 112 Graduate Degree in the Pigeon Forge area. These include: 69.1% Percentage High School or Higher Lions Club, Pigeon Forge Rotary Club, Courtesy of nationalrelocation.com Pigeon Forge Chorus The major area of concern at these public Club, and Pigeon Forge Hotel/Motel Association schools is nutrition. At the primary school (seviercounty.org). There is also a community 75% of the children are on the free or reduced center that has a library, bowling center, workbreakfast/lunch program. At the middle and out facility, indoor and outdoor pool, and a high schools the number is only slightly less at community park, with a walking trail, baseball, 65%-70% utilizing this program (Ownby). The basketball, and tennis courts. Patriot Park is high school and middle school also have soda within the city limits and has a half mile walking and vending machines available for students, with obesity on the rise in the United States; this is an unnecessary temptation for these children. Paige Ownby states that 85%-90% of students graduate from Pigeon Forge High School (Ownby). The amount of these successful students who go on to attend a higher education facility is approximately 45% (schools.national). Sophomores, juniors and seniors in the high school are encouraged to apply for scholarships through the counselor’s office. This Windshield Survey • 11


track and the Trolley Station for the community (City of Pigeon).

Boys & Girls Club

Perhaps the most important club in the city, due to the shaping of our youth, is the Boys & Girls Club. Located on the Municipal Complex, the club offers an after school program, that includesBoys transportation from the area schools and & Girls Club a summer program. The mission of the Boys & Girls Club is “To serve the community by helping

Five core program areas are highlighted to provide education and activities for members. These include: Education and Career Development, Health and Life Skills, Sports, Fitness and Recreation, The Arts, and Character and Leadership Development. The members of all the Smoky Mountain branches boast a 99% high school graduation rate and an average GPA of 3.0. In the Pigeon Forge branch 80% of members are in the free or reduced food program at school. The club sponsors field trips throughout the year

Boys & Girls Club Pigeon Forge Branch 100 80 60 Club Members

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Free/Reduced Lunch

20 0 Ages 6-10

Ages 8-9

Ages 10-12 Ages 13-15 Ages 16-18

our youth build character, develop social skill, inspire dreams and instill leadership qualities. To inspire and enable all young people, especially those who need us most, to become productive, responsible and caring citizens. The Pigeon Forge branch has a membership of 269 children with an average daily attendance of 83. (Dove). The Pigeon Forge Branch has won “Best Small Club Program in the World” in back to back years (2001-2002). From 1997-2009 the branches of the Smoky Mountains have been honored with the award for the “Best Program in the State of Tennessee” and has received two “National Marketing Awards.” The teen center director, Melissa Dove, was recognized as the “Teen Advisor of the Year” in 2002, and has since become the Pigeon Forge Branch Director (Dove).

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with a trip planned almost every day during the summer (Dove). The standard fee to attend the club is $180 for the spring and fall semesters, this includes an after school snack and busing form City schools. The summer program runs for eleven weeks 7:00AM-6:00PM, and has a fee of $385 which includes breakfast, lunch and a snack each day. Scholarships are available through the branch director for families in need. The average cost to operate the facility is $1000 per child for an entire year, with the average family paying $785 per year. The difference in cost is made up through donations from local businesses and a sponsorship of The United Way (Dove).


TRANSPORTATION

trolley headquarters are located. One route goes into Sevierville to the courthouse where it stops along the way at Walmart, Kmart, and the Tanger Five Oaks shopping area. The trolleys also travel

Courtesy of the city of Pigeon Forge

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here are a few different types of transportation available to the citizens of Pigeon Forge. The majority of the citizens own a car or at least have access to a car. The average commute for citizens of Pigeon Forge is 20 minutes one way, each day. Of these commuting citizens, 81% drove a car, 13% carpooled and less than 1% rode a trolley or bus, 2 % walked and 3% worked at home (citydata). There are numerous cab companies that service the city of Pigeon Forge, but none that are actually located within the city limits. There is no bus line in Pigeon Forge, but there is a trolley line that runs the length of the Great Smoky Mountains Parkway from the Sevierville Events Center to the Gatlinburg trolley stop at the city limits. The trolleys also run down Teaster Lane and across the parkway to Wears Valley Road where it services campgrounds where numerous citizens reside in campers. The trolley also has a route down Veterans Blvd. as far as Dollywood and back to Patriot Park where the

down Pine Mountain Road to various hotels and campgrounds; many people who live along this road can utilize the trolley as a mode of transportation (Pigeon Forge Trolley). While the trolleys don’t go directly to the hospital on Middle Creek Road or any specific doctor’s offices, they can get a patient close. The minor ER and urgent-care center in Pigeon Forge is less than a five minute walk from a trolley stop, and three other doctor offices are directly on the parkway, where a trolley drives right by. The trolleys run March thru October 8:30 a.m. to midnight. During November and December the trolleys run from 10am-10pm, with the exception of Thanksgiving, Christmas Eve and Christmas Day. There is no trolley service in Pigeon Forge during the months of January and February (Trolley). Pigeon Forge residents have the option of transportation for hire with numerous cab companies and individuals who offer transportation to medical appointments for the elderly who are unable to drive themselves. Numerous churches supply church vans/buses that they use to pick up people for church. The Sevier County Senior Center Windshield Survey • 13


has a program called “Sevier County Seniors on the Go.” This program provides transportation for elderly to anywhere they need to go within the county, except for medical appointments. This service, will take them on errands such as the grocery store or the pharmacy, and also the senior center, so they can enjoy some social time. The senior center does have some volunteers that will transport the elderly to doctor’s appointments, but it is very limited. The cost is $5 round trip and the citizen has to call to set up the transportation, before they actually need it (Ashley, personal communication by phone, March 16, 2010). There is also an East Tennessee Health Resource Agency (ETHRA) program located in Sevierville that services Pigeon Forge citizens. They transport people who are unable to drive to medical appointments; someone who needs this assistance will need to schedule forty-eight hours in advance. ETHRA drivers will transport citizens to appointments within Sevier county and other surrounding counties (ETHRA). The nearest airport is McGhee Tyson in Knoxville which is approximately forty miles from the Pigeon Forge area. The closest major bus line is the Greyhound bus stop in Knoxville, which is approximately twenty miles from the Pigeon Forge area. The closest interstate is I-40, fourteen miles from Pigeon Forge (Google maps). The Parkway, which is the main road through Pigeon Forge, is a four-lane divided highway that is in good condition. There are plenty of traffic lights to regulate traffic flow and during heavy traffic

days, local police force will also assist with traffic direction. The side roads in Pigeon Forge are mostly two lanes through neighborhoods, some are rather

The Parkway, which is the main road through Pigeon Forge, is a fourlane divided highway that is in good condition. There are plenty of traffic lights to regulate traffic flow. bumpy with potholes, while others are in good condition. The cars owned by the local residents are very numerous in type. You might see a junker parked in someone’s driveway or yard, but you will also see the newest models of Ford Mustangs or Chevy Corvettes driving down the road. Because of the variety of people who live here, along with the various jobs people can have, you see an eclectic variety of possessions. Many cars are in good running condition and of the newer models, but there are also many cars that are in poor condition and of older models. There is one used-car dealership in Pigeon Forge and seven different automobile repair shops. There are four new/used car dealerships in the Sevierville area, that supply service to the entire county (Google maps).

HEALTHCARE

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ithin the city limits of Pigeon Forge, there are very few healthcare facilities. There are five doctor’s offices, one physical therapy center, an ophthalmologist, a dentist and a minor ER/urgent-care clinic. There are two day-care centers and one rehabilitation center that also doubles as a nursing home. No assisted living centers or hospice care are within the city limits, but there are several of each in Sevierville (about 5 miles from the Pigeon Forge area). There are no specialist doctors or nurse practitioners in the city limits of Pigeon Forge but there is a plethora of doctors, nurse practitioners and osteopathic 14 • Windshield Survey

doctors in the Sevierville area on Middle Creek Road near the new hospital (Yellow Pages). This area is about 5-6 miles from Pigeon Forge (Google maps). The minor emergency clinic is located in central Pigeon Forge. It offers treatment for numerous injuries with little or no waiting time. The doctor categorizes himself as an “oldfashioned doctor…a ‘doctor at your door’” who still makes house-calls to those who are unable to leave their home. They also offer treatment for those who are addicted to drugs of different types. They do not just use medicines for


treatment, but also therapy. This center is very convenient for the working adult with hours of 2-8 p.m., Monday-Saturday. They also supply two different numbers for reaching the doctor in case of an emergency. When I called their regular office number to ask about their hours, I received a voicemail message, that stating their hours. Because I received the information I needed, I did not leave a message, but about an hour later, the doctor called me back to make sure everything was alright and ask what I needed. They also offer around the clock emergency hours if ever needed (ampm-er). In Sevierville, on Middle Creek road, Covenant Health has built a new hospital, Leconte Medical Center. This new hospital boasts an expanded emergency room, intensive care unit, women’s center, Thompson Cancer center, diabetes center, cardiology rehab, wellness center, sleep center, surgery and therapy centers. This hospital is very accessible to the citizens of Pigeon Forge and is a great addition to the healthcare needs of the county (Leconte). The county health department is located in the county seat of Sevierville about six miles from Pigeon Forge. They offer vaccines, WIC, food stamp programs, and reporting statistics of communicable diseases. In Sevierville, about one-half mile from a trolley stop, is the Mountain Hope Good Shepherd Clinic. This clinic offers medical and dental services, with the fees based on your income; if you can’t pay, they will still treat you. They employ a doctor, nurse practitioner, LPN, RN, dentist and dental hygienist. They also offer a Pharmaceutical Assistance Program, which helps their patients meet criteria to sign up for reduced prices for the prescriptions (Mountain Hope). There are many different outreach/support groups in the Pigeon Forge area. There are several Alcoholics Anonymous meetings each month, a half-way house, and 1-800 hotlines for domestic abuse. There is a Narcotic Anonymous meeting at a church in Gatlinburg which is about seven miles from Pigeon Forge. There is

a resource known as SafeSpace in Sevierville for victims of domestic abuse and battered women. This is close to the hospital, placing it about 6 miles from Pigeon Forge. There is a county senior center which services the entire county and is about eight miles from Pigeon Forge (Sevier County). There are numerous ministries in the Pigeon Forge area or that cover citizens living in Pigeon Forge. Smoky Mountain Area

Rescue Ministries provides food, assistance with housing, clothing, counseling and prayer support, assistance with transportation, job skills and job placement and they provide school supplies and clothing to children of the Sevier County area (SMARM). The Sevier County Food Ministries, located approximately eight miles from Pigeon Forge, provides food with no questions asked to citizens of the entire county, including Pigeon Forge. There is a Meals-on-Wheels program that is generated from the Sevier County Senior Center. It also covers citizens, under the age of 60, throughout the entire county. The senior center also offers a program called J&L food program, that services the citizens over age 60; they deliver frozen meals once a week to the older adults, while the Meals on Wheels delivers hot meals every day. Both of these programs are completely led by volunteers, from the cooking of the food to the delivery (Ashley, personal communication by phone, March 16, 2010). Windshield Survey • 15


Disease Prevalence in Pigeon Forge and Sevier County

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he prevalence of drug and alcohol abuse is hard to specifically pinpoint in one general area. According to the Office of National Drug Control Policy, Tennessee is one of five states in the “marijuana belt,” mostly in the Appalachian region which encompasses Pigeon Forge, Tennessee (Kedia, S.). Sevier County is on the list of High Intensity Drug Trafficking Areas in Tennessee (White House). If the arrest reports indicate anything, they show the high amount of drug and alcohol use in Sevier County. In 2000, there was 375 arrests on drug charges, 418 on DUI, 843 on Drunkenness and 116 on liquor law violations, due to the fact that liquor was illegal in two out of three cities in the county, including Pigeon Forge (Fed Stats). Liquor by the drink is still unavailable within the city limits, along with a no-open bottle law in Pigeon Forge. Approximately 31% of citizens use marijuana, 60% use alcohol, and 22% use cocaine (Kedia, S.). The Pigeon Forge Police Department has a program called “Drug Abuse Resistance Education” (D.A.R.E.) which educates kids in the local schools on the dangers of drug abuse. They enforce alcohol laws within the city limits, and send in cadets to verify bartenders are asking for identification on everyone, especially minors, before serving alcohol. Tobacco use in Tennessee is higher than the national average of 20.6% (CDC, tobacco). Approximately 27% of Pigeon Forge residents smoke regularly (County Health Rankings) compared to the state average of 22.6% (CDC, tobacco). In October of 2008, Tennessee voted to pass a law prohibiting all smoking in public buildings, unless you restricted guests to being older than 21 years of age. This decreases the amount of second-hand smoke a non-smoker would have to breathe in by eating out at their favorite restaurant. The local hospital offers Freedom from Smoking classes aimed at helping anyone stop smoking. It is an eight-week program costing only $50 per person which is refunded 16 • Windshield Survey

at the end of the eight weeks if you attend the sessions. This program is designed by the American Lung Association and provides peer support along with helpful quitting techniques (Freedom From Smoking).

The average life expectancy of someone living in Pigeon Forge is 75.9 years old. Of the 6,200 people residing within Pigeon Forge, 14.9% view themselves as having fair/poor health. The prevalence of unmarried pregnancies in Sevier County is 42%, while the prevalence of pregnancies in women aged 15-19 is 7% of the population of women in that age group. Of live pregnancies the percentage of teen pregnancies is 13% (Health.State.TN). Within the county, 8.7% of live births resulted in a low birth-weight baby (U.S. Department of Health). The local crisis pregnancy center, Women’s Care Center, offers “Earn While You Learn” parenting classes for before and after having a baby. They offer free pregnancy tests and counseling if the test comes back positive. They have a clothing and supply closet where underprivileged mothers can receive diapers, formula and clothes for no charge, after earning points at the parenting classes. There is no form of abstinence or sex education in Pigeon Forge High School. The average life expectancy of someone living in Pigeon Forge is 75.9 years old. Of the 6,200 people residing within Pigeon Forge, 14.9% view themselves as having fair/poor health. The


Courtesy of the city of Pigeon Forge

leading cause of death in the city of people under the age of 1 is birth defects, age 15-44 is injury; of people aged 45-65, 35% will die of cancer and another 35% will die of heart disease (U.S. Department of Health). Between the years of 2002-2006, 2113 cases of cancer were reported, the majority of those being prostate or breast cancer, and lung cancer (Li, Q.). Covenant Health offers free screenings each year to citizens of Sevier County and this year, it is actually at the Pigeon Forge Community Center. They offer free screenings of Blood Pressure, Bone Density, Body Composition, Carotid Artery Screening and Heart Rhythm along with affordable blood tests covering everything from Blood Chemistry Profile, Complete Blood Count, Prostate Specific Antigen, Thyroid Stimulating Hormone, High Sensitivity C-Reactive Protein, and Hemoglobin A1C. For the uninsured of the city, this is a very helpful resource to determine if they need to have further testing (Sevier County News). Obesity has become a major problem throughout the whole country, encompassing 25.6% of people. In Pigeon Forge that number is slightly higher than the national numbers at 29.7% (CDC, obesity). This problem affects every aspect of a person’s health, their heart, joints, blood vessels, liver and kidneys, etc. Due to the numerous varieties of trees and flowers in the area, seasonal allergies are a great problem, that lead to a high prevalence of asthma. An estimated 12.4% of citizens encounter asthma symptoms each year (CDC, asthma). The state is implementing a program to alleviate asthma in the state, but as of yet, no progress has been made.

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Conclusions • Pigeon Forge needs a tourist-based clinic, which caters to the vacationer who becomes injured or sick while on vacation. The clinic would need to be located in the heart of Pigeon Forge, in a convenient location for tourists and operated on a fast track system. This facility would also need to have extended hours, especially on the weekends. • There is obesity in the community, mainly in children, that we see as an important area to address. Children need to be taught the importance of exercise coupled with proper nutrition, especially at school. This would also include diabetes education. We feel that it is important to start teaching young children in hopes that they will be spared from a lifetime of health problems. • Drug use among the adult population, like in every community, must be reduced to improve the health of the community. The “D.A.R.E.” program has been successful amongst middle school age children, and substance abuse education should continue through high school emphasizing the dangers. • The high school pregnancy rate is very high, due to the lack of abstinence/sex education in the schools. Outdated school lectures need to be brought into a 21st century style of teaching—a style with a learning edge that gets results. • Air quality in this area, is often in the orange range which affects those with seasonal allergies and asthma. The moisture or “smoky” mist that so often describes the Great Smoky Mountains, traps pollutants which seems to stick around longer than in most cities. • High incidence of smoking among the citizens is also a major health problem of this area, which affects all apects of health. • The lack of public transportation to medical facilities is also a problem to consider. Pigeon Forge needs to implement local transportation via the trolley system to Leconte Medical Center, even if operation times are limited.

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Nursing’s Role

A

fter meeting with Dr. Keith Whaley, Pigeon Forge former mayor, I gained insight into healthcare needs in the community. He felt that nursing roles within the community would be best utilized through more healthcare screenings and education to the citizens and their children. Education needs to be focused most on diabetes awareness, physical activity for children, and preventative healthcare. • To combat the obesity among children, I need to implement nutritional education into the school programs. A good exercise program during P.E.

class, healthy options in the cafeteria would be great additions to a child’s development. Implementing exercise and health assessments on a regular basis at the Boys and Girls Club will help reinforce healthy behavior for lifetime. Removing vending machines from the hallway or at least removing the soda drinks and candy bars from them and replacing them with water, vitamin waters, and granola bars. An important nursing role would be to teach the teachers. There are many over weight and/or unhealthy teachers standing in front of the class who make a huge impact on their students. A teacher can be the key to keeping snack time full of carrots sticks and apples as opposed to desert snack pies and cakes. Since obesity is linked with type II diabetes, nurses could also have blood glucose testing on high-school age students who volunteer for the test, with parental consent. The nurses could check before and after they eat for pre-diabetes symptoms. It be used as a teaching tool, to educate the students about diabetes. • An abstinence/sex education should be brought back into the schools. There is a program in the other Sevier County high schools ran by a non-profit group in Knoxville. Nurses should work with them to bring that program to the Pigeon Forge High School and possibly volunteer their time to help with the teaching. If that is not possible, then it should be implemented into the health class or the school nurse. Sex education should be done with an edge of social media like Facebook and Twitter. This style of communication amongst teenagers is the rawest form of teens “opening up” and expressing themselves to their peers very freely. This is where the class should start, with follow up in a classroom setting. Testimonies of pregnant teen mothers also will connect well with


her peers. Implementing young teen fathers to share their stories would expose a different point of view as well. Using driver’s education as an example, Driver’s Ed takes a whole semester, Monday through Friday, for 90 minutes a day. That is about 135 hours of driving instructions. At the end of the semester, the teacher hopes the teenager is a safe driver and is wise on the road, keeping him and others safe from harm. Sex/abstinence education should be just as important and be given as much time to keep teens safe and wise sexually. The position of a nurse should be to take a sex/abstinence program to the school superintendent’s office. He/she needs to be available for implementing the approval process and then supervise training as well as teaching in the high school. Myself a nurse, I should ask the local city government to place a trolley stop at the new hospital so that the citizens of Pigeon Forge with no form of transportation can still get to the hospital and medical facilities in that area for doctor appointments or visiting friends and loved ones. The trolley pick-up could be at the trolley station at Patriot Park, which can be accessed from any other trolley in the city. • The best implementation for health related to the compromised air quality, is to hold city workers and public school teachers accountable and to evaluate what the range warning is for that day, keeping asthma students in the best possible environment. • Smoking prevention programs and education taught in the schools, again using cutting edge approaches should be considered to combat the high incidence of smoking in the community. • A drug prevention program should be implemented among high school students and adults in the community. Any law that would help keep drugs out of the home where children are exposed would be high on the list. I feel the community center should have an open policy to all middle and high school students regardless of financial inability to pay the cover fee to enter the community center. This would provide them a safe place to “hang out” and may discourage unhealthy behavior.


www.lecontemedicalcenter.com/?id=1831cfsid=2 Li, Q., Whiteside M.A. Cancer in Tennessee, 2002-2006. Tennessee Department of Health, Office of Cancer Surveillance. Nashville, TN, June 2009. www.mountainhope.org www.muninetguide.com/states/tennessee/municipality/Pigeon_Forge.php www.nps.gov/grsm/naturescience/air-quality.htm www.theonion.com/content/amvo/tennessee_unemployment_hits_10_7 Phone book pigeonforge.areaconnect.com/crime1.htm www.pigeonforgedevelopment.com/BS2008/VisitationtoGreatSmokyMountainsNationalPark.pd www.pigeonforgetrolley.org/rideguide www.practicalenvironmentalist.com/uncategorized/sevier-county-tennessee- municipal-compostingchamp.htm www.profiles.nationalrelocation.com/Tennessee/Pigeon%20Forge/ www.publicschoolreview.com/school_school_id/74915 www.realestate.com/TN/Pigeon-Forge/local-info.aspx realestate.aol.com/neighborhoods-Pigeon_Forge-TN-37868/Pigeon_Forge/id-37868 schools.nationalrelocation.com/Tennessee/Pigeon%20Forge/ www.scorecard.org/env-releases/water/index_iwi.tcl www.seviercounty.org/index.php?option=com_content&task=view&id=46&ltemcd=65 www.seviercountynews.com/?p=11288 www.seviercountytn.org/index.php?option=com_content&task=view&id=52&Itemid=69 www.smarm.org U.S. Department of Health and Human Services, (2000). Community Health Status Report: Sevier County, Tennessee. www.communityhealth.hrsa.gov www.whitehousedrugpolicy.gov/hidta/appalachia.html Windshield Survey • 23



ETSU Windshield Survey