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China had the most installed generating capacity in the world in 2011, at 1,073 gigawatts, slightly higher than the United States. About 80% of China's electricity generation came from conventional thermal sources, primarily coal, in 2011. Both China's electric generating capacity and its electricity generation doubled between 2005 and 2011. China was the largest producer and consumer of coal in the world in 2011, and accounted for almost half the world's coal consumption. China was the world's second-largest consumer of oil and liquids in 2011, as well as second-largest oil importer (trailing the United States in both categories). China's total oil consumption is slated to continue increasing; EIA forecasts that growth in China's demand for oil will represent 64% of projected world oil demand growth during 2011-2013.
Use and production of natural gas in China is rapidly increasing; natural gas production more than tripled over the last decade. While renewables made up a small fraction of the country's total electricity generation, China was the world's leading producer of hydroelectric power in 2010, and the second-largest producer of electricity from wind power. This toolkit provides guidance for conducting assessments of community needs and resources.
Describe what matters to key stakeholders, including:Who else cares about the issue (the stakeholders) and what do they care about? The purpose of this section is to provide factual information about the county's population, economy, and health status.
The projections are based on a specific set of assumptions and will be valid only if the assumptions hold. The population of Ottawa County has declined since 1940, and this trend is projected to continue.
The rate at which the average age of the population is increasing is expected to become even more rapid.
Ottawa County is located in the north-central region of the state and encompasses 721 square miles. A preliminary review of employment in Ottawa County suggests that the health care industry is one of the larger employers and thus a significant segment of the economy. Ottawa County has experienced a declining population that is typical for many of the rural counties of Kansas. Ottawa County received a grant from the Kansas Health Foundation to explore how health services might be improved.
In the survey, people were asked to rate how important each issue was, and how satisfied they were with how the issue was being addressed in the County. Relative Strengths:The surveys were collected, entered into a database, and analyzed to determine a) what issues were important to citizens of the county, and b) how satisfied citizens were with how the county deals with these important issues. Items with high importance and satisfaction ratings are considered strengths -- they're important, and the community is doing a good job in dealing with them. Of people who filled out the survey, there was a 93% average rating on the importance scale (it would be 100% if all respondents rated it very important). Of people who filled out the survey, there was an 81% average rating on the importance scale. Implications: Why are these aspects of the community (like recycling) considered to be problems?
Using these data on the strengths and problems of community health issues in the County, citizens may wish to set up committees or task forces to address one or several of the most burning issues. Transportation is available for people who may need special assistance, such as older adults and people with disabilities.
Employers give bonuses or time off to employees who attend classes designed to promote exercise, stress management, and a healthy diet. Health care providers assess and counsel patients about their physical fitness as a normal part of routine physical examinations. The Kansas Department of Health and Environment has set as one of its goals to assure access to complete public health services to all the citizens of Kansas. In urban areas, these types of services have traditionally been performed by public health departments. This model assumes that economies of scale are the primary variable in service delivery and does not take into consideration factors such as geography or the ability (or necessity) to perform traditional public health department functions through alternative mechanisms. With the exception of its school health service, this department primarily serves the very young and the elderly in the county. The Public Health Department is primarily funded through public sources: over 50 percent of its 1994 revenue came from a single mil of county funds and over 20 percent from grants, many of which come from state and federal programs. Table 22 also shows how local tax dollars support the services of the Public Health Department. Next to School Health, Adult Health visits constitute the second most frequent type of patient care for the Ottawa County Public Health Department.
With the exception of School Health, this agency primarily serves the very young and the elderly in the county. Over 50% of the 1994 revenue for the health department came from public funds in the form of the county mil levy. 20% of the 1994 revenues came from grants - many of which also come from the state and federal governments. The only other source of funds for this agency in 1994 was the Medicaid program and what fees could be collected from clients who were not covered by categorical grants or the Medicaid program. The Ottawa County Public Health Department was commended for its services and the caring attitude of its personnel.
The health department was described by other providers as cooperative and in need of additional resources. The Hospice program of the health department was described as an important community resource. Ottawa County is under served with rural water districts, which means many of the rural residents are on private wells.
Some areas of the county are remote and distant from access to health services - they are only served by the health department. Low income families that are not eligible for public funds do not access care when they should and when they do, the care they need is more costly. More information on AIDs prevention and care including a support system for those people in the community caring for AIDs patients is needed. Unsafe water supplies and improper septic waste disposal are threats to the local system of health care. Knowledge of the current health status of the community is the first step in identifying health problems and developing a plan to deal with those problems.
During the period of the above ranking, Ottawa County had the 13th highest age adjusted average death rate in Kansas.
The way in which we chose to live (that is, lifestyle) has an important role in determining the length and quality of life. While the study was not county-specific, the information does take on greater significance when the five leading causes of death in Ottawa County are considered.
These indicators suggest that Ottawa County is an area where the health risks are somewhat lower than the health risks in the state as a whole. The needs assessment ultimately identified 11 different areas of concern to Wyandotte County residents. Wyandotte County residents are concerned about abuse, neglect, and support for families and individuals. Focus Groups were conducted to gather community feedback on the 11 broad issues addressed by the Needs Assessment Survey.
Focus Group participants also discussed a wide range of potential solutions to the problem of abuse, neglect, and support for families and individuals. A Service Providers' Forum gathered information from approximately 60 members of the Wyandotte County Social Service Alliance on issues from the Needs Assessment Survey. Ultimately, this yielded a list of assets within the Grand Boulevard neighborhood mapped by organizational type, function(s), community activities implemented, and willingness to engage with future community building and economic development activities.
There is great concern in the United States about the current and future health of civil society. This study inventoried local citizens' associations which were defined as face-to-face local organizations whose essential work is done by members who are unpaid. Though no list of a community's associations can ever be regarded as complete, the inventory of Grand Boulevard's associational life represents at least an indicative snapshot of the neighborhood in 1995. One way of categorizing the 319 groups is depicted on the "Associational Map of Grand Boulevard" (Table 1). The database of local associations created by the mapping process which includes their addresses, phone numbers, and names of leaders allows community leaders to build relationships with the local associations, and to explore ways in which they can contribute to building the community. In a parallel result, an extensive set of questions aimed at discovering how local associations might have been involved in direct economic development activity or in supporting the vitality of the local economy or in job training and placement, revealed very little previous activity.
Lack of employment opportunities for people with disabilities continues to be a significant problem, especially in rural communities. The Research and Training Center on Disability and Rural Communities developed the Rural Community Economic Project in response to the lack of employment opportunities for people with disabilities living in rural communities.


During Phase 1, the Utah State Vocational Rehabilitation (VR) Program regional office played an active role in the project.
During the assessment process, the Community Advisory Panel provided knowledge and credibility to the project. Emery County had a population of 10,892 at the time of the assessment and nine principal towns including the county seat. Information was collected using an interview process that revealed tremendous strength in the history and heritage of the local people. To gather information for the community assessment portion of the project, a total of 59 locally owned business owners were interviewed. Residents and business owners reported being proud of the beautiful natural environment, rich Indian and pioneer heritage, and small town lifestyle. Some expressed concerns included a lack of transportation to this isolated region and the high cost of gas.
Interviewees thought the attitudes of community members could be addressed through education and increased awareness among community members about the benefits of economic development activities. Community stakeholders involved in the project included the Emery County Economic Development agency, Vocational Rehabilitation, Chamber of Commerce, and local businesses.
The community stakeholders hoped that economic development would help people with disabilities become self-employed. The assessment process identified numerous issues with the most relevant being the economic stability of the community. To look at data regarding economic stability, it was necessary to obtain unemployment rates over time and see how these unemployment rates corresponded to events that impacted the economy.
Business owners described several barriers to business expansion, many of which relate to the employment difficulties.
The resources for addressing the problem included the natural environment, low cost of living, quality of life, and hard-working residents.
As a part of the assessment process, the Study Team also developed a list of 32 new or existing businesses with potential for development or expansion. In Phase 2, the Community Advisory Panel expanded in response to the recommendations and created what would become the governing body for the South Eastern Utah Small Business Investment Fund.
China's economy, which has grown at an average real rate of about 10 percent per year over the last 10 years, is a key driver of the increase in energy consumption, both in China and internationally. The projections should be regarded as an estimate of the future population based on a continuation of current trends. The trend toward a population that is growing older on average is very significant for health and human services planners. The county is considered to be 100% rural with a population density of 7.8 people per square mile. Nine percent of the population are below the poverty level, and 39% are below 200% of the poverty level.
The strength index is a measure of the economic prosperity of each of the 105 counties in Kansas. The factor is a measure of how well a community is attracting or losing business to other places.
These figures indicate that a significant portion of the population is going outside of the county to meet its retail needs. A significant portion of the retail business and thus the county wealth is leaving the area.
In addition, the survey was printed on an entire page of the local newspaper (circulation approximately 1,600).
There was a 40% satisfaction rating (If all people gave it the lowest possible score, the satisfaction rating would be 0%).
What might be done to work with others in the community to improve issues that are considered problems? In smaller rural communities, services such as clinical services, health screening, women's health, EPSDT, immunizations, and the like, are often carried out in the primary care clinic. In rural areas, which do not have a large population base, these alternative mechanisms are often critical. The largest program was school health with 2,027 visits, followed by Adult Health visits at 1,715.
As federal and state sources of grant funds become more difficult to obtain, this department will depend to an even greater extent on local dollars to provide needed services. In order to make comparison possible, the diseases are reported by incidence rate per 100,000 people, based on the average number of cases per year between 1987 and 1991. The Kansas Department of Health and Environment has done a study of Kansans that focused on a number of factors which are recognized to be of high risk. Physical inactivity, obesity, smoking, hypertension (high blood pressure), and high blood cholesterol all contribute to heart disease. Community programs designed to bring about or assist individuals with changing these factors are increasingly common. These identified issues included abuse, neglect, support for families, basic needs, basic skills, and child youth and development. In general the number of reports of child abuse and neglect cases has declined slightly in Wyandotte County. Participants explored a wide range of issues related to abuse, neglect, and support for families and individuals. In south Chicago, the Institute for Policy Research developed an assets map of the Grand Boulevard neighborhood to identify strengths within the community. While definitions of civil society are diverse, almost all analysts include local citizens' associations as a vital expression of civil society and civic culture.
The map identifies ten different clusters of groups in the community, and provides an introduction to the ways in which citizens in Grand Boulevard organize their energies and commitments. These interviews revealed a rich and varied set of current involvements, many of which have impacted the community's life. But what the surveys do reveal, in question after question and category after category, is the consistent willingness of the association's leadership to seriously consider doing more. Self-employment and small business development often can be the only viable employment option for people with disabilities in rural areas, but these areas also often lack economic development support.
The Project worked with a community in Emery County, Utah to build the capacity of state vocational rehabilitation agencies and also to build skills of people with disabilities to identify business development and employment opportunities. The VR contact identified project leaders, organized the Community Advisory Panel, and served as a community liaison. The council consisted of elected officials, business owners, agency representatives, and other interested citizens.
The assessment also revealed strength in the natural environment, which is not only beautiful, but contributes to the productivity and job base for the people such as mining in the mountains and open farmland for agriculture and ranching. Because the project purpose is economic development, the focus of the assessment was on business owners.
They stated that this rural, small town lifestyle contributes to strong families and high quality of life. Creating ways to get community members involved in economic development so that they see the benefits was suggested as a possible solution to this concern.
These stakeholders wanted to know the concerns of local businesses related to economic development and their perceived barriers.
They wanted to see expanded businesses and economic development that would benefit everyone in the community. Numerous anecdotes and perceptions about the lack of jobs resulting from changes in the mining and power production industry also surfaced, as did comments on competition from outside communities and the political environment. Other community assets, which developed from or were strengthened by this project, included the Community Advisory Panel, the Vocational Rehabilitation program, and the Study Team.
They were grouped as "most viable," "have potential," or "would face significant challenges." Only five were identified as facing significant challenges. In short, this fund was used to develop 79 small businesses that, in turn, created 192 jobs over just a three-year period.
The information is the basis upon which community leadership can undertake the planning process. The northeast and southwest regions of the state are projected to have an increase in population, while the number of people living in the northwest and southeast regions are projected to decrease. The assumptions and the future population would be influenced by change such as natural disaster, war, epidemic, or the economy.
Tertiary care hospitals are located 111 miles to the south in Wichita and to the east 123 and 188 miles in Topeka and Kansas City, respectively.
Nine percent of the population are eligible for Medicaid, and 7.2% are Medicaid recipients. The index is derived from calculations using county wealth, personal income, and county employment for a period from July to June. It is used to compare the magnitude of business activity in a county to the level of business activity in the state of Kansas on a per capita basis. Surveys were hand-distributed to numerous sites in the County, including Senior Centers, business clubs (such as the VFW and Lions), at the local hospital and Emergency Medical Service site, and at a festival in Minneapolis, the county seat. Listening sessions around the community can help answer these and other important questions about the relative problems in Ottawa County. While the regulatory, educational, and planning components of the public health mission are the domain of the public health department, the entire community should be a part of the planning and decision-making process concerning these activities.
The Public Health Department employed a total of 15 people in 4.1 full time equivalent positions in 1994. The age break down of those who have used public health services (excluding home health) is listed in Chart 3. Some are based on occurrence of disease, some on lifestyle choices, and others on behavioral outcomes. A reduction in the number of people with these risk factors could be expected to have a positive affect on individual and community health.
Secondary sources of data that informed their assessment included data from the U.S Census of Population and Housing and data from the Kansas City Business Journal. For each of these concern areas they used various methods to measure the problem, such as surveys, secondary data, and small group forums.
Issues related to abuse, neglect, and support for families and individuals were rated "important" to "very important" by respondents to a needs assessment survey, who were in general "neutral" to "unsatisfied” with how the issues were being addressed in the community.
Participants represented a variety of human service organizations from County, State, and private sectors. They began by collecting written materials about local organizations, including newspapers, newsletters, and membership and contact lists.


Recently there have been studies and reports indicating a decline in civil society measured by associational membership These studies represent the conclusions drawn from data that are aggregated and reported by central sources. In 1989,82 percent of children in the neighborhood lived in families with a cash income below the poverty line. However, the primary work of the group is carried out by the citizen members rather than professional or paid workers. The Associational Map reflects also the particular nature of the Grand Boulevard community.
More than half of the groups surveyed, for example, report having worked on "neighborhood projects," including those supporting youth, senior citizens and families, and those aimed at beautifying the neighborhood, and at improving neighborhood health and safety.
The Rural Community Economic Development Project was developed to address employment issues of people with disabilities through rural economic development while exploring the leadership roles that people with disabilities and rehabilitation professionals might take in the process. The project took place in two phases: Phase 1, community assessment, and Phase 2, in which the recommendations from the assessment process were put into practice. Two local people with disabilities were identified and trained as project leaders, and they, in turn, recruited and trained four additional people to conduct the assessments.
They interfaced with the community regarding the assessment process to provide validity and provided feedback to the Study Team during and after the assessment process. Historically, the economy was built on ranching, agriculture, and coal mining used for power generation.
The problems include the up-and-down cycles of the local economy prompted by periods of lay-offs and hiring at local power plants and mines.
The Study Team asked business owners about community strengths and sources of pride that could contribute to economic development as well as specific concerns and obstacles to economic development. Business owners reported that major businesses are not hiring locally, and many local residents were not shopping locally.
Though business owners were the focus of the assessment, other stakeholders were informally interviewed and included in the assessment process. This list was presented to the community at a public event as part of the final report and recommendations from the assessment. The project shows tremendous potential to remain strong and continue to produce economic growth in the community.
It is particularly important to understand that the population trends in an area are influenced by the economic conditions in that area and that those conditions can be altered significantly by the population living in the area as well as by outside forces. Six percent receive food stamps, and 1.9% receive Aid to Families with Dependent Children (AFDC). The strength index for Ottawa County for 1992-93 was 2.32, placing the county 86th in a ranking of the 105 counties in the state. A small group of citizens developed a survey on community health issues encountered by Ottawa County citizens. In addition to the services provided by employees, some services are offered through contract.
Both smoking and obesity increase a person's risk of developing coronary heart disease; in fact, smokers are two to three times more likely to developing heart disease than non-smokers.
Designing programs to modify these behaviors offer health and human services planners one of the best opportunities. They determined the percentage of population by age group, race and ethnicity, per capita income, and percentage of households by income groups. For the issue area of abuse, neglect, and support for families, the United Way began characterizing the level of the problem. Discussions with community members and service providers indicated that abuse, neglect, and support for families and individuals are associated with families "falling through the cracks." Participants noted that counseling is expensive and underutilized, and adults lack support to parent effectively. Participants discussed the dimensions of each problem, and gaps in service, and were asked to posit solutions regardless of how much money they would cost. They then interviewed local leaders in multiple sectors to help add to the list of organizations and associations. They do not include data regarding those associations that are not connected to central data collection systems.
This definition excluded from the survey, therefore, local not-for-profit and governmental agencies as well as businesses. Further interviews conducted by local residents might well have uncovered more of these less visible groups.
Many of these projects represent the associations' experience entering into relationships that provide help, support, and mutual care to those in need.
Phase 1 of the project involved a community assessment of two rural areas of eastern Utah and northern Vermont. At the time of the assessment, coal mining, coal transport, power generation, and transmission dominated the local economy, and the unemployment rate was 8% with 3,218 residents in the workforce.
The National Institute on Disability and Rehabilitation Research funded the Study Team who completed the assessment process. The listed "viable" and "potential" business opportunities served as a starting point for economic development for Emery County, which led to Phase 2 of the project.
These figures are approximately the same as the average of the other counties in the north-central region but are lower than for the state as a whole. Listening sessions around the community can help answer these and other important questions about the relative strengths in Ottawa County. While the data in this section is the most recent available, it is often dependent upon information collected as long five years ago. They then compared these data figures with five other counties in the Kansas City Metropolitan area.
This was done by using the "Metro Kansas City: The Status of Children in the Five-County Area Report Card" to determine the number of reports of child abuse and neglect for three previous years.
Potential solutions suggested by community members and service providers included providing help in the home, providing support and information to families through churches and hotlines, and providing information on available resources. In order to better understand the actual current status of associational life, as well as the functions they perform, we need to begin by gathering primary data at the local level.
The 1989 income figure represents a 30 percent decline in family income, after adjusting for inflation, since 1979. Nevertheless, the number and variety of associations uncovered in Grand Boulevard is significantly larger than most residents or experts expected. The large number of religious congregations, and of associations connected to local churches reflects the importance of religious institutions in the life of Grand Boulevard.
However, many fewer association leaders reported that their groups had already been involved in working on neighborhood issues, as opposed to mutual care projects.
Business owners cited defeatist attitudes, apathy, lack of communication, and resistance to change as barriers to economic development efforts.
In those counties where the population is growing slowly or actually decreasing, the proportion of older citizens can be expected to increase at a faster rate. Care must be exercised in evaluating the data because the numbers in each category are often quite small and a small change can make a relatively large change in the percentages. Cerebrovascular disease is closely related to hypertension, and smoking also affects the health of the blood vessels of the brain. This report summarizes a recent exploration of the nature and extent of the associational life of the Grand Boulevard community on Chicago's South Side.
The shifting of manufacturing employment out of Chicago and the growth of the suburbs have hastened the decline of the community .The unemployment rate increased from 24 percent to 34 percent during the eighties.
The process began by gathering all of the written materials that could be found, including items from newspapers and newsletters, as well as membership and contact lists from local institutions, and from both public and nonprofit groups. Whether teen pregnancy, child abuse, drug abuse, domestic violence, youth groups, or issues facing people with disabilities or those who had been in prison -these pressing issues have not, for the most part, engaged the efforts of local associations. This population and age shift is caused largely by the migration of young people with their children away from rural communities to urban areas. Reference indicators for the state of Kansas are included to provide a comparative perspective. The use of alcohol and the non-use of safety belts are often associated with unintentional injury.
They then measured the community's perception of the problem by administering a Needs Assessment Survey, in which they had community members rate both the importance of these issues and their satisfaction that the community was addressing those issues effectively. Participants at the Forum discussed abuse, neglect, and support for families and individuals in Wyandotte County and explored gaps in services.
In addition, the project surveyed a representative sample of those citizens' associations' leaders concerning their current activities and their willingness to undertake further specific community building and economic development activities. Between 1970 and 1990, Grand Boulevard's population halved, and, in the same period, almost 10,000 housing units were lost. The second step involved more than 45 interviews with local community , civic, religious, governmental and political leaders.
A process that will track these and other benchmarks is critical to an ongoing community health assessment and planning program.
These explorations focus on associations because they are the naturally existing community organizations for empowering individuals and mobilizing their capacities. During these discussions, leaders were asked to edit the existing inventory and to add groups not yet listed. The United Way divided the community into four geographic areas and residents were invited to attend. The loss of population and housing stock, and the concentration of high-rise public housing, impose strains in addition to those of poverty.
A block-by-block field survey of the Grand Boulevard neighborhood then yielded both more specific associations, as well as a working map of the neighborhood 's distinct characteristics such as patterns of public and private housing and differences in residents' income levels.
Grand Boulevard residents, despite these depressing economic figures, have organized to rebuild their community The community is the home of creative and vigorous community organizations, and is part of an ambitious economic development scheme, the Mid-South Plan, to reinvigorate that part of Chicago.
Finally, using this working map in Grand Boulevard, 100 stratified phone surveys were conducted asking residents to add groups to the inventory.
The United Way also gathered primary data through a service providers' forum, in which they gathered information from 60 members of the Wyandotte County Social Service Alliance regarding gaps in service and potential solutions. The telephone survey targeted residents of four different subsections of Grand Boulevard, asking them about the associations in which they were involved as well as the issues and activities that interested them. The survey uncovered many new groups in each section of the neighborhood, as well as some interesting variations in the types (not the numbers) of groups with which residents in each area are affiliated.



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