Introduction
There has been a dramatic growth
of the number people in the city of Van Nuys, California who living with
obesity, a factor that has become a health issue. Providers are of the belief
that community and environmental factors play a big role in contributing to
these unhealthy habits. It is important to note that these conditions pose a
big health issue in terms of chronic conditions. Some of the chronic health
conditions that people living with obesity could be exposed to include stroke,
diabetes, asthma, blood pressure, as well and depression among others. These
conditions can lead to death prematurely and other chronic health issues,
something that reduces the quality of life. In the city of Van Nuys, California USA, obesity cases reported have
increased over the past 10 years, something that is of great concern since it
reduces the quality of life. In this paper I will be discussing on how this
issue can be prevented while using the city of Van Nuys, California USA, as my
area of focus.
This
paper is focused on providing a solution to the people of Van Nuys within a
period of ten years. Some of the things that nurses will do during this time are
to conduct a survey and identify the households that have been affected
immensely with the issue. This will call for an immediate solution. They will
also identify those that are prone to the issue, calling for a long-term
solution. During this time also, the nurses will conduct a sensitization
program to make sure that every adult is well knowledgeable on the issue. It is
expected that with the proposals indicated, the issues of obesity will have
been put to rest. The nurses will then partner with several organizations to
make sure that training and exercise programs are conducted. Nurses also will
make sure that the issue with dieting is implemented as per the strategic plan.
During this ten year period, it is expected that the knowledge on how obesity
among adults can be reduced will have reached as many people as possible. It is
also expected that the number of reported cases of chronic diseases will be
reduced by a great margin, and that the city of Van Nuys is able to boast of
high healthy standards. This is going to be done through well coordinated
activities involving the nurses, community, government, nongovernmental
organizations and many other parties, to see to it that the overall objectives
are met.
Assessment
I
decided to conduct my research in the city of Van Nuys. It is a district found
in San Fernando Valley, found in California State, Los Angeles County, and in
Los Angeles city. According to Los Angeles times in 2009, the area has a
population size of 103,770. A total of about 11, 542 people estimated per
square mile. In regard to ethnicity, the percentage of Latino people staying in
the area is high in the county. The income levels of the people of this city
are of median household, at about $41,134, despite the fact that this is low
for the county. Households that earn $20000 to $40000 are high for the county. The
city of Van Nuys has one of the best environments including social amenities,
schools and other facilities.
In
regard to the CDC Behavioral Risk Factor Survey, Van Nuys adult obesity stood
at 23.8%. According to F as in Fat, new study reports released in Washington DC
on September 18, 2012, it has been projected that by 2030, adult obesity in
California could hit a 46.6 percent. This is a fact that threatens American
future as far as health is concerned. Due to this there have been several
programs that have been established to make sure that the rate of adult obesity
in the state is reduced at all costs. One such program is The
California Obesity Prevention Program (COPP), which is a Centers for
Disease Control and Prevention (CDC) funded program within the Van
Nuys Department of Public Health (CDPH)
that works to increase physical activity, improve nutrition, as well as prevent
obesity among not only adults but all Van Nuys adults.
The program specifically targets to address both policy and environmental
strategies, which are related to obesity prevention target areas. These
include; increasing vegetable and fruit consumption, decreasing consumption of
energy dense foods, increasing physical activity, decreasing television
viewing, decreasing consumption of sugar sweetened foods, as well as increasing
breastfeeding initiation, duration and exclusivity (Leung & Villamor, 2011).
Health Concern
There
is a health concern over the increase in the rates of adult obesity. This is
because despite the fact that it affects the health and lifestyle of Van Nuys
adults, it could also cause harm to the economy of the US. Over the next 20
years, it has been projected that obesity among adults could cause 3,798,591
new cases of those with type 2 diabetes, 8,429,912 new cases of those with
hypertension and 8,429, 796 of those with coronary heart disease. Other health
concerns include 5, 571,995of arthritis and 1,251,371 new cases of cancer that
is related to obesity in Van Nuys alone
as seen in appendix 1
At the moment, more than 25 million of people
living in America have been diagnosed with type 2 diabetes, 27 million with
chronic heart diseases, 50 million have arthritis and 68 million hypertension.
To add on this, 795,000 Americans suffer from stroke each year. It is also reported that at least one in
every three deaths is due to cancer. The above mentioned are issues that are
related to obesity, physical inactivity and poor nutrition.
Basing
on the above data, it is important to note that the cost of treating obesity
related diseases could rise to $66 billion per year, recording an increase of
$48 billion by the year 2030. This is something that could also contribute to
economic loss of about $390 and $580 billion annually. Despite the fact that
adult obesity cost is hard to determine, estimates range from $147 and $210
billion each year.
Population of Interest
The
population of interest from the health concern described is adults aged above the
age of 60 years. Obesity as a health concern is linked to this group because of
the insufficient exercise that the group engages in. most of them at this age
are retired and they spend much of their time relaxing. Some of them also have
a minimal income to support them in regards to healthy eating, which to them
might be expensive (Food
Research and Action Center, 2011). They
do not also have an interest to follow instructions, or seek information on
healthy living, as outlined in appendix 5
Age Distribution
From
the year 1950 to 2000 the populations of adults in the state have increased to
4.7 million from 1.6 million recording an increase of about 194%. It is
expected that this increase will continue as the cohort age 60 years and above
grow to an estimated 12.8 million by the year 2050 as observed in appendix 1. This could form an increase
of 172 percent from the year 2000. In 2004, 5.1 million Van Nuys adults were
over age 60, representing 14.4 percent of the total 35.9 million state
populations. Of that number, 1.3 million
were over age 75 and 500,000 were age 85 and over, as illustrated in appendix 1.
Gender Demographics
At the
moment below the age of 45, males outnumber the females by a 5 percent margin.
By the time they reach the age of 60, females outnumber males by a percentage
of 40 and by three to one by the time they reach the age of 90. In 2010, the
ratio of men to women who were aged above 60 was 100/128. This means that older
women are at risk of poverty, social challenges and most importantly health. It
is also expected that they are most vulnerable to obesity related sicknesses.
It is however expected that the gender gap will reduce by the year 205o by 14
percent at the age of 65 and also falling to 50 percent among Van Nuys adults
aged above 90 years.
Socio economic demographics
In
regard to appendix 4, the average
income of Van Nuys adults who are elderly stands at $25,500. It is also
important to note that the poverty rates in Van Nuys are lower compared to other states, although
the numbers have been on the rise especially among the old. It is also expected
that many Van Nuys adults will work beyond the age of 65 because of
insufficient savings. Social security only accounts for 28% of the incomes of
older Van Nuys adults.
Education levels
It is
expected that between the year 2020 and 2050, the percentage of Van Nuys adults
with a higher education will remain static. This is contrast to the expected
increase of seniors without a high school diploma that stands between 20 to 24
percent.
Community Resources and Partners
Some of
the programs put in place to control the issue of obesity in Van Nuys include The California Obesity Prevention
Program (COPP), which works to improve nutrition increase physical activity,
and prevent obesity among all Van Nuys adults. Others include California Active
Communities, California Project LEAN (Leaders Encouraging Activity and
Nutrition), Network for a Healthy California, Safe and Active Communities
Branch, as well as School Health Connections among others.
Diagnosis
It is
important to mention that for efforts of obesity solutions in reduction of
obesity among the adults to be successful, there are important things that
should be implemented, which at the moment are not being addressed. Some of
these include adult education on the subject. Over the past years, there have
been efforts to introduce the subject in schools, in relation to how people can
be able to reduce the chances of being obese. These efforts have yielded fruits
in finding a solution to young children, with observation in their declining
numbers. For this reason, I think it is important for the same to be introduced
to adults. This can be done through forums, and workshops organized in the
communities by these organizations. With sufficient knowledge, it is possible
that the percentages can be on a decreasing trend, contrary to the present
increasing trends.
I also
think that these organizations are not doing enough when it comes to organizing
frequent training and work out sessions. I think it can be beneficial if the
organizations liaise with the government to provide training equipment for the
adults, do that they can use them when it comes to physical exercises. This is
an important step towards encouraging the adults to participate in the
programs. In addition to provision of the equipments, a sensitization and
motivation program should be put in place to make sure that many of the adults
are visiting these facilities.
Outcomes Identification
Having
implemented the recommendation discussed above, there are high chances that the
whole program of obesity reduction will be in the course of succeeding. One of
the most outstanding outcomes is the fact that the people will have known that
obesity is a problem that needs to be dealt with. They will also embrace the
fact that it is an issue within the society and not only a threat to their
lives but to the nation at large. Having
this kind of knowledge will make them to do everything possible to make sure
that a lasting solution is found, and the whole issue is settled. This will be
evident with the increase in the number of participants in the community
programs. This will also have an impact on the numbers of the obesity adults
being reported each year, and there could be a possibility that the numbers
will start having a download trend as far as percentages are concerned.
Planning
There
are many areas that can correlate to make sure that nursing actions to improve
the health concern are efficiently implemented. These will form specific
actions that nurses should do. These areas range from individual focused,
community focused to systems focused. Nurses will try sensitizing individuals
take it as a personal responsibility to make sure that they are able to adhere
to all the guidelines in regard to obesity reduction. This will be at the
individual level. They will also extend
the same to the community, where nurses will make sure that the community is participating
fully in providing a good environment for the implementation of the programs
and strategies as proposed at the system level. Nurses will also make sure that
the whole process involves policy development and enforcement, social
marketing, advocacy, community organizing, coalition building, collaboration,
consultation, counseling, health teaching, delegated functions, case
management, referral and follow-up, outreach, disease and health event
investigation as well as surveillance.
To
effectively implement the recommendations, it is important to have a plan in
place that will oversee the whole process. There are different players in the
whole issue that will be required to play a fundamental role in making the plan
a success. The nurses are directly responsible as far as education and
sanitizing the public on the whole issue is concerned. They should be able to
outline the issue i.e. obesity, in a well understandable way. They are also
tasked with coordinating participatory roles of different players in making
sure that the whole project turns out to be a success. The nurses have also a
duty to make sure that there is a friendly interaction with the community. They
should be able to present what they expect from the community and what they
should expect from the community with regard to this project. This will be
essential when it comes to support and motivation from them.
We can come up with a program where people can be educated on the issues,
considering the low levels of education in the state. We can also work with the
community together with the government to put some training venues, where
adults can be able to have some exercises (Ver Ploeg & Ralston, 2008). We can also decide to come up with forums where
people can be sensitized on the issue. I believe with enough knowledge, they
can be able to know the best ways to take care of themselves and avoid obesity.
The nurses might also work together with the community when it comes to
sensitization efforts. This can be done through games and sports. This is
because many people like to attend games and sports venues in the leisure. This
will help a lot in making sure that as many adults as possible have been
educated on the issue regarding reduction of adult obesity. Nurses can also
work with the community in making sure that they are adhering to the program
prescribed by nutritionists. It is very
important that they eat healthily, so that they avoid being obese and getting
chronic diseases. Nurses should also work closely with the community in making
sure that they are able to understand the household members of the people
living in Van Nuys. This could form a good foundation for understanding the
kind of treatment that they should roll out to those members. Households with
people above the age of sixty should be given maximum concentration and advised
accordingly in regard to dieting and exercises.
With these strategies in place, it is obvious that many partners will
want to participate in the efforts to solve the issue. One important partner
will be the government. Since this is a god project that not only involves
individual people, or a society, or a region, and it being a national issue,
the government will be ready and willing to help in whichever way possible.
Areas which they might help include facilitating the acquisition of the
equipments needed for the entire process to work. They can also be fundamental
when it comes to sensitization and education process. The government can also be helpful when it
comes to the registration process of the efforts. The private sector will also
be fundamental when it comes to provision of labor. We can opt to use
outsourcing for ground work personnel so that the whole process is efficient
and more so cheaper.
Other partners in this issue could be nongovernmental organizations, with
funding from donors and well wishers. They also form part of the most important
part in this project. This is because they will be beneficial in terms of
raising funds for supporting the activities of the nurses and the community at
large. The nongovernmental organizations could organize themselves basing on
the community or locality intended, in this case Van Nuys, but they can as well
extend and incorporate a national outlook. The community generally also forms
part of the partnership. This is because of the role that it plays in terms of
offering support for the activities of the project. They work hand in hand with
the nurses to make sure that the overall objectives intended to be met are
achieved.
The overall objectives for implementing these activities are to make sure
that the entire issue of obesity is settled, that as many people as possible
are educated efficiently on how they can be able to avoid being obese. This
will be a solution that will definitely be beneficial in the long run, since
the cost of medication is already high, and is projected to increase in the
coming years.
Reduction or stamping out obesity is beneficial in the sense that there
can be less spending when it comes to Medicare. It is important to note that
majority of Van Nuys residents do not have enough savings, by reducing these
cases means that the entire population will be able to save much, which can be
directed into other supportive or economic activities. It is also important for
me to mention that with these cases of obesity having been reduced, it means
that premature deaths can also be reduced, and less numbers of chronic diseases
can be reported. Generally by being able
to settle the issue of obesity, all objectives of this project will have been
met.
It is important to mention that the outcomes will come in stages. It is
not expected that the expectations will be immediate but in the long run, it
can be achieved. Basing on the increase in the number of adults, it is
important to target the minor population more, though the already affected are
equally important. By targeting the minors, will mean that long term solutions
will be on course. Once they have the adequate knowledge on the issues of
obesity, it is possible that in 60 years, a lot will have been done in regard
to reduction of obesity.
For short term it is important to see to it that obesity is reduced by
the same percentage it rises yearly. This can be achieved through intensive
exercise, and education on healthy eating, and lifestyle. Within the first 10
years of implementation, it is expected that some positive results will have
started showing up. Basing on data provided of obesity having to rise from 23
to 46 percent, the same can be reversed. The first step towards achieving is by
making sure that new cases are stopped and mitigated. Another step is to make
sure that strategies are in place to make sure those already affected are
educated on how they can overturn this.
Evaluation
For us to be able to ascertain if the program was a success there are
different tools of evaluation that we can use. Most of these tools are also
used by many institutions to determine whether their project was a success or
not. Continuous monitoring is essential in measuring any changes induced by
implementation as well as to ensure that the interventions have been effective
in improving the quality of output, perception and knowledge among health-care
workers. Some of the evaluation tools that could be used include observation
manual for monitoring the progress of the program, infrastructure survey,
perception survey for health workers, Knowledge Questionnaire for Health-Care
Workers, among other methods. With these tools it is possible to know if the
program is on the right track or if it is not.
Conclusion
In conclusion, I would say that adult obesity needs to be addressed, with
great concern. This means that strategies should be put in place and
implemented to make sure that the rising figures are brought back to a downward
trend. It is important to Increase investments in effective, evidence-based
obesity-prevention programs, fully support healthy nutrition in federal food
programs; and encourage full use of preventive health care services and provide
support beyond the doctor’s office. Having done this, it will also translate
to a reduction of some of the diseases that are related to obesity.
APPENDIX
Appendix 1
Projected Growth in Population
Age 60 and Over
2000-2040
By Age Groups
|
Age
Range
|
Total Population
(2000 Census)
|
Total Population
(2010 DoF Projections)
|
Total
Population
(2040 DoF Projections)
|
Total Population Change
|
Percent
Change
|
|
60-64
|
1,146,841
|
1,944,211
|
2,579,283
|
1,432,442
|
125%
|
|
65-69
|
984,535
|
1,388,990
|
2,488,577
|
1,504,042
|
153%
|
|
70-74
|
903,288
|
1,033,176
|
2,286,549
|
1,383,261
|
153%
|
|
75-79
|
779,347
|
799,244
|
1,960,630
|
1,181,283
|
152%
|
|
80-84
|
502,831
|
615,927
|
1,430,462
|
927,631
|
184%
|
|
85+
|
425,657
|
629,241
|
1,297,890
|
872,233
|
205%
|
|
Totals
|
4,742,499
|
6,410,789
|
12,043,391
|
7,300,892
|
154%
|
Appendix 2
Appendix
3
Appendix
4
Household
Income levels in thousands of 2000 dollars
Appendix
5
List Highlights of assessment
findings
For the research, I decided to conduct my research in the city
of Van Nuys. It is a district found in San Fernando Valley, found in California
State, Los Angeles County, and in Los Angeles city. According to Los Angeles
times in 2009, the area has a population size of 103,770. A total of about 11,
542 people estimated per square mile. In regard to ethnicity, the percentage of
Latino people staying in the area is high in the county. The income levels of
the people of this city are of median household, at about $41,134, despite the
fact that this is low for the county.
According
to Los Angeles times in 2009, the area has a population size of 103,770. A
total of about 11, 542 people estimated per square mile. In regard to
ethnicity, the percentage of Latino people staying in the area is high in the
county. The income levels of the people of this city are of median household,
at about $41,134, despite the fact that this is low for the county. Households
that earn $20000 to $40000 are high for the county. The city of Van Nuys has
one of the best environments including social amenities, schools and other
facilities.
The
main people targeted are the elderly aged above 60 years. This is the main
focus group because of some factors including vulnerability of these people
getting obese. Most of them are not employed, although some of them work beyond
the retirement age, since they have little savings to sustain them. These
people also do not involve themselves in physical exercises, meant to reduce
chances of them getting obese.
The
main issue of concern is the obesity menace, which leads to much loss of lives
because of diseases that come as a result. Most of the cases of people getting
obese are because of poor dieting, and lack of proper exercises to keep their
bodies fit and healthy (Guthrie
et al, 2007).
Community
Diagnosis
According
to research, it has been identified that the most vulnerable group are the old,
who practice poor eating habits. It is also important to note that those people
who are aged above 60 years who have no savings, and have little to live on.
This situation forces them to practice some poor eating habits.
References
Guthrie, J. F., Lin, B.-H., Ver
Ploeg, M., & Frazao, E. (2007). Can Food Stamps Do More to Improve
Food Choices? U.S. Department of Agriculture, Economic Research
Service. Economic Information Bulletin 29-1. (USDA Report)
Ver Ploeg, M., L. & Ralston,
K. (2008). Food Stamps and Obesity: What Do We Know? U.S. Department of
Agriculture, Economic Research Service. Economic Information Bulletin No. 34. (USDA Report)
Leung, C. W., & Villamor, E.
(2011).Is Participation in Food and Income Assistance Programmes Associated
with Obesity in Van Nuys Adults? Results
from a State-Wide Survey. Public Health Nutrition. 14(4):
645-52.
Food Research and Action Center.
(2011) A Review of Strategies to Bolster SNAP’s Role in Improving Nutrition as
well as Food Security. (Report)
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