Name
Western Governors University
D029 Informatics for Transforming Nursing Care
Prof. Name
Date
Strafford County is located in southeastern New Hampshire, within the metropolitan region known as “The Seacoast.” This area offers residents easy access to natural recreational spots, including mountains within an hour’s drive, beaches about 30 minutes away, and Boston approximately an hour south. Despite these geographic advantages, Strafford County ranks 8th out of 10 counties in New Hampshire for health outcomes and health factors, placing it in the lower middle tier statewide (County Health Rankings & Roadmaps, 2024). This paper analyzes Strafford County’s population health data, demographic characteristics, health trends, and proposes targeted public health interventions to improve community well-being.
Strafford County’s estimated population in 2022 was 33,416, experiencing a 2.0% growth rate, which surpasses the national growth rate of 0.5%. The population is predominantly White (89.1%), indicating less ethnic diversity compared to the national average of 75.5%. Minority populations such as African Americans, Asians, and Hispanics account for less than 10% of Strafford’s population, while nationwide minorities comprise over 40%.
Educational attainment in Strafford County is notably high, with 96.4% of residents holding at least a high school diploma, compared to 89.1% nationally. The county also has a strong labor force participation rate of 72.1% among individuals aged 16 and older, exceeding the U.S. average of 63.0%. Poverty rates are lower at 7.6% relative to the national rate of 11.5%, and the uninsured population under age 65 is 7.1%, below the national average of 9.3%. Additionally, Strafford County’s population density is significantly higher, with 1,224.9 persons per square mile, far above the U.S. average of 93.8.
Comparison Table: Population Characteristics of Strafford County 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 sourced from County Health Rankings & Roadmaps (2024) and U.S. Census Bureau (2024).
Strafford County’s demographic characteristics highlight a community experiencing faster population growth, higher educational achievements, and stronger labor force engagement than the national average. Economically, the county benefits from lower poverty and uninsured rates, suggesting relative financial stability. However, the limited ethnic diversity may pose challenges for culturally competent healthcare delivery and inclusive public health programming. The notably high population density underscores the importance of maintaining robust healthcare infrastructure and services to meet increasing demands.
Health outcomes in Strafford County show varied patterns when compared to state and national data. Alcohol-impaired driving fatalities have fluctuated over time, with a troubling spike in 2013, where 56% of such deaths involved alcohol—substantially higher than the state rate of 36% and the national rate of 31%.
Sexually transmitted infections (STIs) are notably more prevalent in Strafford County compared to New Hampshire and U.S. averages, though a slight decrease has been observed since 2019. The uninsured population has improved but remains below national averages, fluctuating between 8% and 15%, whereas the national range is 10% to 18%.
Access to primary care is strained, with approximately 1,450 patients per primary care physician in the county, exceeding New Hampshire’s 1,100:1 and the national 1,300:1 ratios. Economic indicators like unemployment show improvement following broader economic cycles. Child poverty rates consistently remain lower than national figures by 5 to 10%, and preventable hospitalizations have been decreasing, reflecting positive statewide and national trends.
The following table presents key health determinants across 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).
Strafford County demonstrates strong performance in areas such as access to exercise opportunities (91%), educational attainment, and low unemployment rates. Conversely, the community faces challenges including elevated rates of excessive alcohol consumption (22%), a high patient-to-primary care physician ratio suggesting limited healthcare access, increased injury-related deaths, and fewer social associations per capita. Addressing these issues is crucial to improve overall public health outcomes.
One pressing health concern is the rising incidence of sexually transmitted infections (STIs), particularly chlamydia among adolescents and young adults aged 15 to 24. Chlamydia often presents with minimal symptoms, leading to underdiagnosis, continued transmission, and serious complications such as infertility (Centers for Disease Control and Prevention [CDC], 2022). Although rates have slightly declined since 2019, Strafford County’s chlamydia incidence remains approximately 50% higher than the state average, indicating an urgent need for targeted interventions.
To tackle the STI issue, the establishment of a confidential, youth-centered clinic named “My Friend’s Place” is recommended. This clinic would provide anonymous, accessible STI testing and treatment services specifically designed for adolescents and young adults. Key features would include same-day testing availability, free distribution of condoms, and educational materials tailored to diverse learning styles. The clinic’s discreet location would aim to reduce stigma and encourage utilization among young people.
Successful implementation requires a multidisciplinary team comprising advanced practice nurses and supervising physicians for clinical care, building managers for site logistics, pharmacists to ensure medication adherence, laboratory technicians for timely testing, social workers and nurse educators for patient support, and grant writers to secure funding. Future program phases should involve IT professionals to develop a dedicated mobile application and incorporate representatives from the target population—under appropriate guardian consent—to provide ongoing feedback and guide program development.
To enhance awareness and engagement, the program will leverage digital technologies, including a smartphone app providing clinic information, educational resources, and free STI protection ordering options. Social media campaigns targeting platforms popular among adolescents—such as YouTube, TikTok, and Facebook—will be critical for outreach. Research indicates these platforms are effective for reaching and influencing adolescent health behaviors (Vogels, Gelles-Watnick, & Massarat, 2022; Auxier & Anderson, 2021).
Evaluation metrics will include monthly clinic attendance numbers, STI test results tracked over time (illustrated with line graphs), and anonymous patient satisfaction surveys (represented with pie charts). Longitudinal data will analyze changes in county-wide STI rates compared to state and national benchmarks, including breakdowns by specific infections and geographic hotspots to identify outbreak patterns and evaluate intervention impact. This information will support continued funding and potential program expansion.
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/
