I. Introduction
The purpose of this paper is complete “windshield” community survey, in which an assessment of many different aspects of the chosen community was to take place in order to determine potential or prevalent public health concerns. This particular survey is a report on Batesville, Indiana, a small town in southeastern Indiana in which I was born and raised. The following information was collected between May and August of 2018, as well as through several online resources which will be cited at the end of this document.
II. Place
Batesville, Indiana is a town of around 6,600 people (census.gov) in southeastern Indiana off of Interstate 74 that runs between two counties, Franklin and Ripley. It is an industrialized yet rural town that is surrounded by large farm areas, primarily corn, soy, and pig farms, but is a short, fifty-minute drive from Indianapolis, Indiana’s capitol, and forty-five minutes from Cincinnati, Ohio. Batesville is spread out over 5.82 square miles (Citydata.com) and has many distinct areas, including an industrial park with factories and distribution centers, a downtown, residential neighborhoods, and a dense area of restaurants and shopping right as one exits off of the interstate. Open areas are numerous, as the town is not heavily populated. A large park is located near the center of the downtown area that is an attraction for many people of the town. There are two tennis courts, a fenced-in dog play area, lots of play equipment for children, including slides, swings, jungle gyms, climbing areas, see-saws, and many more, a large pavilion in which outdoor music and community events are held, three smaller pavilions that can be rented out for smaller events, a half-mile walking path around a the town reservoir, two full basketball courts, a baseball field, a frisbee golf course, a walking path that leads to residential areas, and a bike path into town. There are also smaller parks in each neighborhood throughout town, which include several swing sets, slides, and smaller play sets. The downtown square has a small green space with fountains and flowers during the warmer months that residents can enjoy as they walk throughout that area. A large, wooded area is located on the outside of downtown and features a paved biking and walking path, which is accessible for those in wheelchairs, as well as several dirt paths for biking. This plot of land allows the residents a space to enjoy nature while getting exercise. There are very few vacant lots and undeveloped space, as one building is destroyed another one is quickly built in its place, and the farms on the outskirts of town are slowly being developed for commercial reasons, including new restaurants, medical offices, nursing homes, and distribution facilities.
There are many residential areas and types of residences, both in the downtown area and outside of it. Batesville itself has seven distinct neighborhoods, with different names, bylaws, and residential councils. These neighborhoods contain mostly traditional family housing, either ranch houses with two to three bedrooms or large, two-story houses with four to five bedrooms. Most of these houses have been built in the last twenty years, so they are relatively new. Some of these neighborhoods are nicer than others, as two of these neighborhoods have community clubhouses and private pools for the residents, as well as stricter rules. There are many other houses outside of these neighborhoods, including smaller houses and farmhouses on the outskirts of town, as well as many houses in the downtown area. These houses in this area are around fifty years old, or older, and are traditional, mostly brick homes. There are also low-income housing spaces, as well as housing set aside for mentally and physically handicapped and elderly. These housing spaces are located in the downtown area. Some of them are new and some of them are in older buildings but recently refurbished. Batesville also has many apartment buildings, in which many lower-income families live.
There are not many commercial spaces in Batesville. Right off of the interstate, there is a small shopping area with a few stores that are marketed for smaller towns. These stores, which carry clothes, shoes, and other goods, have prices that are comparable to what can be found at bigger department stores, but selections that are much smaller, which makes shopping for specific items or special sizes difficult. Kroger is near this shopping area, which is the go-to grocery store for the area, as people come from as far as forty minutes away to shop there. This Kroger branch was built only ten years ago and was remodeled three years ago, so the store is very new and up-to-date, with reasonable prices and a large selection of food. In the downtown area, there are not as many shops as in previous years. There are a few small, family-owned businesses, which include clothing alterations, a thrift store, a clothing boutique, a technology store, a florist, and a mattress store. Many of these stores do not have wide selections, so not many residents shop at these places.
Streets and roads in the city are very well upkept and when it snows, the roads are cleared off very quickly. During the summer time, all of the streets downtown are lined with hanging baskets of flowers, seasonal banners, or American flags. There one form of public transportation, which is a company that owns a few buses and picks residents up wherever the residents are if they call a specific number. The wait time can be up to an hour and the rates are relatively expensive, as they are two dollars for zero to five miles and twenty-five cents for every additional mile after five (Lifetime-resources.org). If one has to use this method of transportation every day, the expenses could add up quickly. However, this service accepts Medicare and Medicaid and offers discounts to senior citizens and those who are disabled, so it is a useful mode of transportation for those who cannot drive themselves. This method of public transportation is used primarily by the elderly to attend medical appointments.
The town as a whole is doing better in the past five years than in the previous five. Batesville used to be a very busy town, as a formerly prominent railway used to run through the town. As well as the railroad business, Batesville was home to nationally recognized companies, such as the Batesville Casket Company, which made both Michael Jackson’s and Aretha Franklin’s caskets, the Romweber furniture company, which made high-quality walnut furniture, and, most notably, Hill-Rom, a company which makes hospital beds and equipment that are now used all throughout the United States. Romweber stopped making furniture around fifty years ago, which stunted the town growth a significant amount. In addition, as many companies throughout the United States exported the production of their goods to foreign countries, Hill-Rom followed suit, which led to a closure of many factories and cutting of jobs in Batesville in the early 2000’s. A few jobs related to Hill-Rom are still taking place in Batesville; however, even the CEO no longer lives in town. Batesville Casket company still makes some of its goods in the city, but much of the production has been sent overseas as well.
While there has been a steady decline in the big businesses in Batesville over the past fifty years, things have seemed to turn around in the past five. Distribution centers for online companies have been built near town, the old and beautiful brick factories have been turned into housing, marketplaces, event venues, and office buildings, and many who work in Indianapolis and Cincinnati and are looking for a quieter, slower-paced lifestyle for themselves and their families have started to move to Batesville, as the commute to either large city is not incredibly long. Batesville is also a part of the Indiana Main Street Project, which is a project enacted by the state to revitalize and improve downtowns throughout Indiana and has made the town more welcoming to visit and live in. This project has provided everything from new building facades and awnings to funding for events which encourage residents to come to the downtown area and support the local businesses (batesvilleindiana.us).
In addition, Batesville has seen an increase in facilities which do not fall into any of the previous categories. In the past ten years, a ballet studio, a music studio, two personal training centers and gyms, an art studio, a yoga studio, and a large coffee shop have opened and have provided an increase in activities for the town. For these reasons, as well as the reasons listed previously, the town is believed to be on its way back up.
III. People
The population estimation according to citydata.com is around 6,541 as of 2014. There are not many options of places for residents to “hang out” in town; however, the coffee shop, located in the heart of downtown, a renovated brick building which was previously furniture store, is a popular location for many. This coffee shop has indoor and outdoor seating, as well as a separate meeting room. During the morning, it is a meeting spot so many people, including business owners, nonprofit board members, old friends, and even the local police force. Once school gets out, many older school-aged children come to read, do homework, or meet up with their friends. Trivia nights, musical guests, and local art installations bring the community in as well. Other than this coffee shop, there are not many locations for residents to meet up with each other or do leisurely activities, other than restaurants or parks
Batesville residents are well-off financially as a whole. The estimated median household income is $55,167, which is $3,000 higher than the average for the state of Indiana, according to citydata.com. Due to the large businesses that were previously and are currently in town, board members, CEOs, and other businessmen and women who have a large salary live in town. However, as an industrial town with factories, distribution centers, and other lower-end jobs, 8.5% of people in Batesville who are on or near the poverty line (census.gov). Cost of living in Batesville is 80.6 (citydata.com), which is low compared to the national average of 100, so even if residents of the town do not make a significant of money, they can still afford to live decently.
Batesville is not racially diverse at all. The town is 95.9% Caucasian, 0.8% Hispanic, 2.5% Asian, and 0.8% African American (census.gov). The Hispanic community in town is very close, as they attend Spanish masses together and live in the same area of town. A large portion of the Hispanic community is involved in running a Mexican restaurant in town. The Asian community is also very small but close and there are two Chinese restaurants in Batesville.
The average age of Batesville is 42.8 years old and there is a male to female ratio of 48.1 to 51.9% (citydata.com). Not very many young adults live in Batesville, nor are they moving into the town. The majority of the population is either young families or middle-aged to elderly people. Batesville is a primarily Catholic town, as 27.2% of its residents identify as Catholic (citydata.com). While there is only one Catholic church in Batesville, there are three in the surrounding area, all about a ten-minute drive away. While many residents identify as Catholic, there are many churches from other denominations in Batesville. Four Baptist churches, three Lutheran churches, three nondenominational Protestant churches, one Methodist church, and one Assembly of God church are all within the city limits. These churches are used for many different community activities, as meeting spaces are not numerous. One of the nondenominational Protestant churches is used frequently for Alcoholics Anonymous meetings, drug addiction recovery meetings, and other community events. Another nondenominational church is attached to the coffee shop in town and is accessed by sliding doors on the far wall, which is sometimes opened for events which require more seating.
Most of the political talk in Batesville concerns local politicians, as residents consider themselves involved in this. However, on larger-scale elections throughout the state or the nation, Batesville tends to vote more Republican than Democrat. In the 2016 presidential election, 75.9% voted Republican and only 19.1% voted Democrat (citydata.com). While political party affiliations do not vary much, the occupations throughout the town do. From CEOs of large companies to liquor store cashiers, the job opportunities are broad for a small town. A large nonprofit healthcare system is located in the city, which provides many jobs for its residents. Many doctors and nurses work here, but there are numerous other jobs at the hospital, including receptionists, business managers, cafeteria workers, human resources, maintenance and grounds, and so many more. Hill-Rom employs one-thousand eight hundred (batesvilleindiana.us), which makes it the biggest employer in town and is closely followed by Batesville Casket Company, which employs a little over one-thousand. Batesville also has many jobs for those without a secondary education, as 31.3% of the population only have their high school diploma and no further education (census.gov), such as Kroger, distribution plants for various goods, factory jobs, and many others. Estimated median income in 2016 for households was around $53,000 (census.gov).
IV. Community System
Batesville is about as healthy as the state of Indiana, with a general health condition of 53.1%, compared to 55.3% in the state (citydata.com). The average BMI of the town is 28.8, which is within the overweight range (citydata.com). The obesity rate is 28.1%, which is over 1,800 people (citydata.com). There are several walking and biking trails throughout the town; however, outdoor activities in the city and surrounding areas are not numerous.
Batesville has one hospital within the city limits, which houses an emergency department, radiology services, surgery, cardiology, diabetes care, laboratory, sleep medicine, inpatient care, pediatric care, and OB/GYN services (mmhealth.org). A physician center houses outpatient offices for the physicians that work within the health system. Next door, an outpatient center offers space for specialists that the health network has contracts with to come a few days a week, offering a closer alternative for ear, nose and throat treatments, endoscopies and colonoscopies, audiology, gastroenterology, wound care, and urology. A cancer center attached to the outpatient building offers chemotherapy and radiological therapy and operated five days a week. Rehabilitation, orthopedic specialists, occupational health, dietary services, home care, and hospice are also all offered in separate buildings throughout the town. If residents need specialty care outside of what is offered in town, they must travel to either Cincinnati or Indianapolis. An organization that provides mental health services is outside of the prominent health network and offers rehabilitation from addictions, mental health counseling, crisis services, and inpatient and outpatient health services. A dialysis center is located in the city, as well as one assisted living center and two nursing homes. In addition, the Cincinnati Children’s Hospital has an outpatient clinic located in Batesville and is constructing a brand-new building for this clinic. This branch serves the community and surrounding areas and is an alternative to driving forty-five minutes into Cincinnati.
The local YMCA provides a place for residents to exercise and participate in recreation, but they must have a membership to use the facilities. A paved, one-mile, outdoor walking track and large, grassy field are located right outside of the YMCA building and are open to anyone who wishes to use them. Another source of entertainment in town is a one-screen movie theatre, which only shows movies on the weekend. Batesville also has a public pool, which is open from Memorial Day until Labor Day and charges an admission fee, either per visit or a season membership. Two country clubs with 18-hole golf courses are located in the city, as well as a twelve-lane bowling alley. A science education center for children of all ages is currently under construction, which will offer a source of education and entertainment for families in the future.
There is one public school system in Batesville, with four separate schools. The primary school teaches preschool through second grade, the intermediate school teaches third grade through fifth grade, the middle school teaches sixth through eighth grade, and the high school teaches ninth through twelfth grades. This school system is considered to be one of the best in the state, as it has been ranked a four-star school quite a few years in a row and the graduation rate from the high school is 97.2%, compared to the state average of 84.1% (batesvilleinschools.com). The public school system also established a one-to-one student-technology ratio several years ago, meaning that every student who attends the schools rents a piece of Apple equipment each school year instead of paying for books. This has allowed for many new learning opportunities and provides preparedness for the future for its students. Students of lower-class families now have access to their own technology during the school year, which they are able to take home with them every night and allows for these students to continue learning and having access to more resources outside of school.
One private school that teaches preschool through eighth grade is linked to the Catholic parish and has an expensive tuition fee. A branch of one of Indiana’s community colleges, Ivy Tech, is located in Batesville, which provides many residents with an alternative to four-year bachelor’s degrees by providing associate degrees in many different fields, from dentistry assistant to phlebotomist and from mortuary science to supply chain management (ivytech.edu). The community college also has a legal agreement with the local public high school, in which upperclassmen are offered college classes while still in high school. Some of these classes are taken at the public school, taught by teachers who have received their accreditation through Ivy Tech, and some of them are taken at the community college, taught by professors. These classes are offered at no additional cost to the students, which allows high school students to gain college credits for free and helps them to get ahead when they attend any form of secondary school. Many colleges in Indiana accept these credits and some students have graduated high school as a sophomore, by credit, in college.
Other services throughout Batesville include many different organizations. Young Life, a nationally renowned Christian organization, has a chapter located in town for middle schoolers, as well as high schoolers, and this group meets weekly during the school year and provides an outlet for older school children to make friends and grow in their relationship with Jesus Christ. Boy Scouts and Girl Scouts also have local chapters in Batesville, as well as Lion’s club and Kiwanis, which all provide ways for local residents to get involved in the community. A local food pantry provides food every Wednesday afternoon to those who are financially struggling. There is a women’s shelter for those who are victims of many forms of abuse and need a safe house, which is utilized frequently and that the community raises many funds for, as it is a nonprofit. Soccer and Baseball clubs are seasonal sports clubs open to the public to get children involved in sports and physical activities. A coalition to promote a drug-free community has also been established, as underage drinking and illegal drug use are prevalent in Batesville. In high school, many students binge-drink on the weekends in their basements or barns. Illegal drugs, specifically heroin, are also a large problem. While I was in middle school, three teenagers from the community died from heroin overdoses. Many other overdoses have occurred since then.
As previously mentioned, there are very few stores in Batesville, so many residents turn to either online shopping or going in to a bigger city with more options, such as Indianapolis or Cincinnati. Supporting local businesses is something that is stressed; however, small selections of goods do not always allow for this economically sustainable practice. While shopping is scarce in Batesville, restaurants and fast-food are not. Since the city is located right off of a well-traveled interstate and is halfway between two large cities, eleven fast-food chain restaurants have been built by the exit, which brings in many passersby. Seven pizza chains are located within the city limits, as well as five sit-down restaurants. Transportation in town is by car primarily, as an interstate and two state highways run through the town. Some residents walk or bike during the warmer months around the downtown area, as there are sidewalks in that area, but few in neighborhoods. There is a significant lack in sidewalks from the downtown to the commercialized area, so those who work there and cannot afford a car for transportation must walk along busy state highways.
Word of mouth information is very prevalent in Batesville since it is a small town. Residents like obtaining information straight from the source, so they often email, call, or talk in person to city officials. However, what the residents do not get from these sources, the get from the local newspaper or the local radio station. The local newspaper publishes a paper twice a week but also has a website, which keeps residents up-to-date on important information in between papers. Batesville’s residents are much more invested in local news than they are in the national news, so talk of a new stop sign or a pothole in a road is commonly overheard in public areas, or from one’s grandparents.
The government in Batesville is comprised of a mayor, five council members, judge, and treasurer. The city council meets once a month and councilmembers are elected every two years (batesvillein.us). Many of the members of local government are Republicans, which follows the trend of how citizens vote on a national level as well. Twelve police officers, including a detective and a school-assigned police officer, make up the police force. There are six registered sex offenders in Batesville and the crime rate in 2016 was 120.7, compared to the national average of 216.0 (citydata.com). The most common form of crime is theft, followed by assaults, then burglaries, and then auto thefts. The fire department is run by twenty-six volunteers, with only one full-time firefighter, the chief (batesvillein.us). There are twenty-two emergency medical services staff members, who do twenty-four-hour shifts on which there are two to three staff members present (batesvillein.us). Residents have always felt safe and protected in the community and continue to, despite the recent increase in home thefts, as seven have occurred in the past three weeks.
V. Conclusions
A major health problem in Batesville is the usage of drugs, specifically heroin. Batesville is along a large illegal drug trafficking route, which runs from Chicago to Cincinnati. Another community health problem is underage binge-drinking, as many teenagers state that there is nothing else to do for entertainment in the city on late, weekend nights. Sedentary lifestyles and poor nutritional choices due to a lack of proper health education, as well as poverty, contribute to a significant obesity rate and a decline in the lack of overall community health. A potential risk in the community is a lack of sidewalks, which could make for a difficult commute to work for those without cars. An inadequate amount of public transportation may also be a possible risk for the community, as those without cars of their own may not be able to get to necessary places.
Community health nursing diagnoses include 1. Risk for Injury related to use of illegal drugs and underage binge-drinking of alcohol and 2. Readiness for enhanced knowledge of proper diet, activity, and general health management. The first can be achieved through better education in school-aged children about the risks of illicit drug use, as well as binge drinking. Providing activities for middle and high-schoolers on weekend nights may also decrease this activity in younger children. More advertising and community involvement in the coalition could improve this situation in the older populations. The second may be achieved through adequate and increased education for all ages. Better nutritional and exercise education in schools could establish healthy habits while children are still young and may be carried over into their adult years. Classes for adults should be offered for free at public buildings, as well as groups with incentives to lose weight. Hypertension, diabetes, hypercholesteremia, and body mass index screenings should also be made available to the public. These are just a few interventions that may be taken by a public health nursing professional to prevent and improve these community health problems.
VI. Summary
In conclusion, Batesville, Indiana, is a good city to live in for many reasons. While it is a small, rural town, it has sufficient services, large parks, residential buildings for all income levels and families, ample medical services, well-kept streets, and highly-ranked public schools. Transportation and diversity are lacking in the community, as well as forms of entertainment and leisure; however, with Cincinnati and Indianapolis only about an hour away, a wide variety of activities are within a short drive. Batesville has its share of community problems, from illicit drug use to underage drinking, but it is a relatively safe and healthy place to live.