improving the healthcare outcomes for children and adults living with obesity (population at risk) in Wayne County, Michiga
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Community Assessment
Maria Pribe
Walden University
Obesity in Wayne County, Michigan
children and adults are vulnerable populations
obese children and adults have low-income
45.9% of Wayne County population is obese (Teixeira et al., 2015)
obesity is linked to overweight, heart disease
Figure 1.0. Bar graph showing income distribution of counties
Source: https://www.pittcountync.gov/Archive/ViewFile/Item/140
Obesity in Wayne Count is a public health problem, especially among children and adults. Children aged 10 to 17 and adults with over 20 years are vulnerable to obesity. Children and adults with obesity make 45.9% of the total population, and most of them come from low-income populations where health disparity is a prevalent issue. Health determinants in Wayne County include education, poverty, income, housing, and discrimination (Teixeira et al., 2015). The obese population does not have access to clean water and live in slums, where air pollution is dominant. More than 17% of adults in Wayne County lack health insurance coverage. Blacks are poorer compared to their white counterparts and have increased chances of having obesity.
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Results comprehensive assessment
poor diet, lack of physical activity
Wayne County ranks position 5th in Michigan (Tholen et al., 2019)
beaches, hiking trails, bike paths remain underutilized
obesity leading factor is unhealthy eating habit
the Michigan Department of Community Health (MDCH)
Obesity is prevalent as a result of poor eating habits and lack of physical activity such as walking, soccer-playing, climbing the stairs, and gardening. Most of the roads are tarmacked, and residents of Wayne Count prefer driving than walking. These residents deny themselves an opportunity for physical activity, thus becoming vulnerable to overweight. Wayne County is among the topmost counties of Michigan where obesity among children and adults is a health problem; it is ranked 5th position (Tholen et al., 2019). Wayne County is a healthy county, but most of the resources for improving physical fitness, such as hike trails, bike paths, and beaches, remain unutilized. The primary obesity leading factor is unhealthy eating, where people do not take fruits and vegetables to control obesity. Collaboration with MDCH aids the approximation of the number of obese children and adults in Wayne County.
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the State of Childhood Obesity website
the Bridge Michigan Health Watch
Physical activity (PA) assessment
Wayne Metropolitan Community Action (WMCA)
The State of Childhood Obesity website provides information and data on the prevalence of obesity in Michigan state. It is a public health-based organization that aims at helping all children to grow up healthy. Another useful website that assisted in locating obesity prevalence in Michigan is Bridge Michigan Health Watch. The website presents obesity epidemiology in Michigan state. Approximately 2.5 million adults and more than 400 children in Michigan State are obese (Tholen et al., 2019). Physical activity assessment involves the measure of movement intensity, type, and duration. An assessment in people without obesity is critical for early diagnosis of disease and influences weight management and related interventions. Marginalized races such as blacks are the at-high population to obesity as WMCA empowers low-income citizens and strengthen communities to access quality healthcare.
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Evidence-based nursing interventions
Vida Saludable intervention:
The community is engaged in developing this intervention, which is a two-phase-based program (Salerno et al., 2018).
The nutritional perspective is equally prevalent in public health with cultural dimensions of nutrition as protective of obesity is interesting (Salerno et al., 2018).
Windshield survey
Daily physical activity Measurable interventions such as daily walking and cycling to and from work can help in changing the dominance of obesity within the community (Teixeira et al., 2015).
Vida Saludable is a culturally-based intervention for obesity in Wayne County. The first phase is biweekly interactive group lessons for obese adults. The theme of the lesson is based on the emphasis on healthy eating, such as fruits and vegetables. The second phase is based on healthy drinking strategies to reduce juice, soda, and sugary drinks. Windshield survey reveals data and information on population at-risk (children and adults) and ways to combat the prevalence (Perez-Sanz, 2019). On the other hand, daily physical activity involves a regular walk and gym, which discourages the use of cars for short distances. Children who walk to school daily have reduced chances of having obesity, while adults walking to and from the workplaces remain healthy since daily walking helping in reducing weight.
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Assessment and windshield survey within Allen community
number of obese adults within the village
overweight individuals
obesity causing factors in Allen Village community
approach for addressing obesity prevalent
A quarter of adults in Allen Village are obese. For every five members of the community assessed, one is overweight. Overweight is a primary measure of obesity since individuals who are overweight are regarded to have obesity (Teixeira et al., 2015). Diet is obesity, causing factors for obesity evaluated, and families depend on pro-obesity foods such as fast food. Allen Village community enjoys good infrastructure such as railways and tarmacked roads.
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health’s determinants in Wayne County
prevalent health problems in Wayne County
Social determinants influence healthcare outcomes and consist of all that makes people healthy and others unhealthy. These determinants are conditions in which individuals are born, grow, work, and live. The interaction between Wayne people and their environment worsens undesirable health outcomes. Poverty cannot enable people to maintain a good dietary pattern, thus worsen obesity, especially among adults and children from marginalized groups (Koh et al., 2018). The most prevalent issue identified is the lack of health insurance coverage. The healthcare outcomes for the community is improved through solving the current health problems and finding a long-term solution to obesity. Insured teenagers in Wayne County are likely to be healthier and have low rates of avoidable hospitalizations and childhood deaths than their uninsured children.
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Short term and long term goals with evaluation
Short-term goals
mobilize and educate residents twice a week
advocate for implementation of nutrition rules
advocate for physical education in schools
Creating awareness to educate citizens of Wayne County facilitates a better understanding of the obesity issue. Most of the people are not aware of the healthy practices for maintaining and controlling obesity. In most households, the families use fast-foods that contain large content of fat and sugar. The families have abandoned fruits and vegetables that help in preventing obesity (Koh et al., 2018). There is a need to champion the implementation of nutrition roles at healthcare facilities to educate patients on healthy eating habits. In schools, children spent their free time in classes rather than physical education. The school timetables lack physical education lessons. There is a need to push for the introduction of such lessons to help children engage in physical activity to minimize their chances of obesity.
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long-term goals
weight maintenance during an adult age
opening of community-based gym facilities
Obesity prevention among children and adults in Wayne County involves weight maintenance. During adulthood, community members should practice weight maintenance. The weight maintenance is achieved through avoiding gradual, incremental weight gain with increasing age (Perez-Sanz, 2019). Adults are advised to avoid fat accumulation around the abdomen. Weight increase with an increase in the number of years is a risk factor to obesity. At the community level, there should be the opening of pubic gym facilities that are accessible to all members of the public. This goal aims at promoting physical activity among the people. Gym activities maintain a healthy community since people who cannot afford to pay for the gym have free access to community gym. It also helps in bridging healthcare disparity between low-income populations and the high-income population.
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obesity is linked to chronic diseases
older women are more vulnerable to obese than older men
genetics also lead to obesity
high cost for obesity treatment
Obesity is associated with more than 60 chronic diseases. Most of the people in Wayne County with obesity have the risk for dozens of diseases and conditions. some of the evident chronic diseases are stroke, cancer, and heart disease. The diseases make obesity costly, and citizens of Wayne County cannot afford expensive medical costs. Obese children and adults pay more out of pocket than people who do not have obesity (Kan et al., 2017). Genes play a significant role in the prevalence of obesity and influence intervention approaches. Obesity is inherited and cannot be controlled through healthy eating habits such as the introduction of salad bars in schools. Only traditional forms of treatment can cure inherited obesity among children and adults, but not medical sciences.
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Ideas presentation
Doctor Rebecca Craig, MBA, Wayne Memorial Hospital
obesity prevention needs social change
applicable strategies require broad actions
social systems influence obesity interventions
The control and prevention of obesity in Wayne County require a clear framework that addresses complex health issues. Developed multifaceted strategies should promote public health by providing care alternatives to communities. Alternatives may include integration across all levels, such as policy and legislative levels. These levels should ensure care policies and laws match with changes in fostering effective interventions such as eating styles in healthcare settings. Broad actions such as community-based obesity prevention aim at restricting or limiting the availability of fast-foods and high-calorie in schools, restaurants, and homes. social structures or systems such as universal, indicated, and selectively determine the effectiveness of the intervention at different levels of the community. Intervention at the universal system targets the entire population, at the selective level, it is directed toward the population’s sub-group and indicated system target at-risk population.
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Role healthcare leader in the community
ensuring the provision of community-centered healthcare services
Healthcare leader operates in a modern playing field that needs changing the models by having community-based care. A care provider ensures that health issues that target the community are identified and understood. Effective interventions for improving community health are found. Social changes under effective interventions are possible. A leader maintains that community healthcare system has adaptive response through the clear defined challenges. The promotion of a healthy population is integrated with the health care leader’s role in building community-based care services (Tholen et al., 2020). The role involves medical education given to all patients and management of care facilities as well as patients at all interdisciplinary levels. A healthcare leader exercises honesty and observes ethical considerations while discharging the duty to meet the broader needs of the people.
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Obesity statistics
the overall ranking of the State of Michigan
reported percentage of obese people
percentage of obese adults in State of Michigan
percentage of obese children in the State of Michigan
Figure 1.2. A graph showing obesity prevalent by age and percentage
Michigan is ranked 18th as a country with the highest rate of obesity in the world. The problem has risen by 21.8% among adults from 2001 to 2008. In the United States, it comes to number 8 as a state with the highest prevalence rate of obesity. In 2008, 65.3% of adult citizens in Michigan are either obese or overweight (Tholen et al., 2019). Approximately 35.2% are overweight, while 30.1% are obese (Kan et al., 2017). Obese children between 10 to 17 years old make 18.9% and rank Michigan position 5 out of 51 states in the U.S. Adult obesity is 33.0% and lists Michigan number 19 out of 51 countries in the U.S. At least 78.3% and 78.3% of Michigan adults and children do not consume adequate vegetables and fruits, respectively.
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References
Tholen, S., Kovary, K., Rabiee, A., Bielczyk-Maczyńska, E., Yang, W., & Teruel, M. N. (2020). Flattened circadian glucocorticoid oscillations cause obesity due to increased lipid turnover and lipid uptake. bioRxiv.
Perez-Sanz, S. (2019). The problem of obesity among high school students in Michigan State House District 101. Public Health Review, 2(1).
Koh, K., Grady, S. C., Vojnovic, I., & Darden, J. T. (2018). Impacts of Federally Funded State Obesity Programs on Adult Obesity Prevalence in the United States, 1998-2010. Public Health Reports, 133(2), 169-176.
Kan, K., Lichtenstein, R., Famulare, M., Jensen, A., Kowalski-Dobson, T., Pettway, J., ... & Patel, M. (2017). Health Insurance Enrollment of Children and Young Adults in Wayne County, Michigan: A Qualitative Evaluation. Journal of Health Disparities Research and Practice, 10(4), 9.
Teixeira, P. J., Carraça, E. V., Marques, M. M., Rutter, H., Oppert, J. M., De Bourdeaudhuij, I.,... & Brug, J. (2015). Successful behavior changes in obesity interventions in adults: a systematic review of self-regulation mediators. BMC medicine, 13(1), 84.
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