Transcript Slide 1

Kettie Chapeyama, Amanda Labarge,
Chinyere Portee, Kelly Pasch,
and Debra Weaver
Analysis
-HOST: Risk factors include having parents who also were
obese, low socioeconimic status, and unemployment
-AGENT: Genetics, and foods with chemicals and sugars are
argued to be agents of obesity in adults.
-ENVIRONMENT: Unemployment rate in Mecosta county is
11% and estimated median household income in 2009 was
$26,395. Acccess to healthcare is limited by income and health
insurance coverage. There is a large amount of available
providers in Mecosta County.
Analysis Cont.
 The obesity rate of Mecosta County is 5% higher then
the benchmark
 Others factors contributing to an increase in obesity
include low household income levels ,use of expensive,
unhealthy convenience foods, lack of organized
recreation for adults, and lack of obesity prevention
programs.
 This problem effects all ages in Mecosta County,
however our data focuses on adults.
Source: County Health Rankings (2011).
Analysis Cont.
 The obesity rate of 30% in Mecosta County shows a need to
address the obesity epidemic.
 Community Nurses need to focus on primary prevention,
secondary prevention and teritiary prevention of this
problem. However, educating and implementing startgeies
to increase healthier eating and exercsie would be the most
beneficial.
 The local health department, park and recreation, service
groups, and Ferris State Univeristy are all groups that
should get involved in the obesity problem in Mecosta
County. This collaboration would be very beneficial to the
obese and potential obese.
2011 Mecosta County, Adult
Obesity
 Summary Data-
Range in Michigan
(Min-Max): 26-36%
Overall in Michigan: 31%
National Benchmark: 25% (90th percentile)
Mecosta County
Percent obese-30%
Ages-25 yrs.-35yrs
Source: County Health Rankings (2011).
Source: County Health Rankings (2011).
Defining Overweight and Obesity
Overweight and obesity are
both labels for ranges of
weight that are greater than
what is generally considered
healthy for a given height.
Source: Centers for Disease Control and Prevention (CDC) (2010).
Definitions for Adults
 For adults, overweight and obesity ranges are
determined by using weight and height to
calculate a number called the "body mass index"
(BMI). BMI is used because, for most people, it
correlates with their amount of body fat.
 An adult who has a BMI between 25 and 29.9 is
considered overweight.
 An adult who has a BMI of 30 or higher is
considered obese.
Source: Centers for Disease Control and Prevention (CDC) (2010).
Health Effects of Overweight and
Obesity
 Research has show that as a person’s weight increases to the levels of










“overweight” and “obese” the risks for the following increase:
Coronary heart disease
Type 2 diabetes
Cancers (endometrial, breast, and colon)
Hypertension (high blood pressure)
Dyslipidemia (for example, high total cholesterol or high levels of
triglycerides)
Stroke
Liver and Gallbladder disease
Sleep apnea and respiratory problems
Osteoarthritis (a degeneration of cartilage and its underlying bone
within a joint)
Gynecological problems (abnormal menses, infertility)
Source: Centers for Disease Control and Prevention (CDC) (2011).
2010 Adult obesity
2008 Age-Adjusted Estimates of the Percentage
of Adults Who Are Obese in Michigan
Source: Centers for Disease Control and Prevention (CDC) (2008).
Risk Factors for Premature Death:
Mecosta County, MI
nrf No report, survey sample
less than 50
Source: Community Health Status Indicators (CHSI) (2009).
Michigan 2010 Critical Health
Indicator-Obesity
Source: Michigan Department of Community Health (MDCH) (2010).
Michigan 2010 Critical Health
Indicator-Obesity
Source: Michigan Department of Community Health (MDCH) (2010).
Self-reported prevalence
of obesity* among adults
--- Behavioral Risk Factor
Surveillance System,
United States, 2000, 2005,
and 2009
The Caloric Balance Equation
•Overweight and obesity result from an energy
imbalance. This involves eating too many calories
and not getting enough physical activity.
•Body weight is the result of genes, metabolism,
behavior, environment, culture, and
socioeconomic status.
•Behavior and environment play a large role
causing people to be overweight and obese. These
are the greatest area for prevention and treatment
actions.
Source: U.S. Department of Health & Human Services (2001).
Contributing factors to Obesity
Genetics
Environment
Choices in Eating and
Physical Activity
Diseases and Drugs
Source: Centers for Disease Control and Prevention (CDC) (2009).
Public Policy
 In 2009, the CDC initiated the Common Community Measures for Obesity
Project (the Measures Project) to assess the implementation of policy and
environmental changes at the community level.
 The goal of this project was to identify and recommend a set of obesity
prevention strategies and suggested measurements that the local governments
and communities can use to plan, implement, and monitor initiatives to
prevent obesity.
 In 2004, the Healthy Lifestyles and Prevention American Act or HeLP America
Act was introduced into Congress. The purpose of the bill is to improve the
health of Americans and minimize health care by restructuring the Nation’s
healthcare system towards prevention, wellness, and self care
 Also in 2004, the Healthy Lifestyles Act of 2004 was introduced. Its purpose
was to provide for the implementation of physical activity and nutrition in
schools, worksites, and communities to help in the prevention of obesity for all
Americans.
Source: Centers for Disease Control and Prevention (CDC) (2009).
Public policy cont.
 The Labeling Education and Nutrition Act (LEAN) of 2009-amends the Federal
Food, Drug, and Cosmetic Act to authorize a food service establishment to
provide nutrition on a food item: 1. providing calories and nutrient information
required for food for human consumption.
 In 2006, the Food and Drug Administration (FDA) required food
manufacturers to list trans fat on Nutrition Facts with saturated fat, and
cholesterol (1993). (Congressional Research Service Summary, 2009).
 The Michigan Department of Community Health developed the Nutrition,
Physical Activity and Obesity Program. Its goal is to prevent and control
obesity and other chronic diseases through healthy eating and physical activity.
The program has 6 principle targets: Increase physical activity
·
Increase the consumption of fruits and vegetables
·
Decrease the consumption of sugar-sweetened beverages
·
Increase breastfeeding initiation, duration and exclusivity
·
Reduce the consumption of high-energy-dense foods
·
Decrease television viewing (Michigan Department of Community
Health (MDCH), 2010).
Public policy cont.
 The Local Advisory Group Project is a project within Building Healthy
Communities Program that provides funding to local health departments to
incorporate nutrition education and physical activity promotion (MI Healthy
Communities, 2010).
o
Source: Centers for Disease Control and Prevention (CDC) (2010).
Nursing Diagnosis
Risk of Obesity among
adults in Mecosta
County related to lack
of knowledge.
Plan
 Partner with local community-based
organizations such as the Hospital,
businesses, Ferris State University, and
government agencies to hold a health
fair that offers obesity prevention, BMI
screening, nutrition information and
physical activity education.
Interventions
Hospital
 The Community Health/public Nurse is to meet with the
administration of the hospital to develop obesity education
brochures emphasizing nutrition and physical activities. These
should be posted in common areas and patients rooms.
 Educate the nurses on supporting the community by
encouraging patients to eat the right diet provided in the
hospital. This can be evaluated according to the menus ordered
from the hospital kitchen at the end of the year.
 Use of educative channels or videos on diseases that are a result
of obesity on prevention and promotion. Nurses to evaluate the
patients after hospital stay to monitor response.
 Encourage and educate patients the importance of exercises such
as walking for 30-60 minutes a day, working in the yard, or doing
chores in the house.
Food Pyramid
Source: United States Department of Agriculture (USDA) (2010).
Businesses
 The Community/Public Health Nurse in collaboration with the Bureau of Food
Safety and Community Sanitation who are responsible to monitor the food
handlers should work together to implement and educate food handlers in
Restaurants to incorporate healthy nutrition by providing health menus of
low in fat, cholesterol and calorie. This should be evaluated at the period of one
year for effectiveness of the menu change
 Advertising by menu labels, server pins, window decals, posters, and comment
cards will enhance customers to order the right menus and discourage them
from fast food once reasons are stated on the advertising labels.
 Grocery stores and food markets can post brochures about nutritious foods
such as fruits, vegetables, calories, and cholesterol.
Ferris State University, Community
Health Department and the
community.
 Collaborating in organizing a fair with schools and the
community within Mecosta county to focus on the
prevention and management of obesity.
 Include education about the Food Pyramid and healthy
foods such as locally grown vegetables and fruits,.
 Education about free physical activities. Examples include
walking the dog, running, playing sports, and swimming,
with a goal of increasing the amount and duration of
exercise. These activities promote long-term weight loss in
adults.
Source: New York State Department of Health (2011).
• The information about screening places, such as the Dept. of Health to
know whether one is overweight or obese by using Body Mass Index
•School, parents, community and government agencies work together,
with schools to see that students are provided with the right nutrition
and that school activities are maintained and after school activities are
initiated.
•There should be follow up after a year at the next county fair.
•Provide education on building, strengthening, and maintaining
supportive social network.
•education on increasing physical activity and availability of places where
people can safely walk for leisure such as work, schools, and shopping
malls.
Source: New York State Department of Health (2011).
EVALUATIONS
 The brochures will be given out to the community and
the patients will then be asked about the brochures
and if they where informative and helpful and then the
nurse can evaluate with the patient by evaluating their
knowledge of diets and obesity.
 Patients in the hospitals should watch a video on
obesity and then answer a few questions related to
obesity and the nurse can review and go over the
questions to assist the patient in further
understanding; repetitiveness helps people retain the
information a little more.
Evaluations
The fast foods restaurants should have surveys completed after this
information is posted to check their sales of certain foods that are
high in calories or is there and overall decrease in sales. This should
be done at 3 months to see initial shock then at 6 months then 1
year.
With grocery stores they make it hard for people to afford healthy
foods and with this they should reduce the prices of healthy foods
or have an increase in sales in these foods to make them more
accessible to people. This should be passed to the manufacture to
promote them to reduce the prices. This could be evaluated by the
increase in sales and surveys that the grocery store can give on
receipts like business’s do.
Evaluations
 If companies made the labels a little easier for a normal
person to understand then maybe people could adjust their
diet plans a little better and accordingly. When companies
do this and people actually are able to understand what
they are eating, we then survey those manufactures about
their sales if there are increases in sales or decrease’s.
 With the schools having health fairs they can have
volunteers doing surveys which ask questions on things
that where helpful and also getting personal information
and asking if they can follow up in 3 months to see if
progress was made with information that was gain from the
health fair. Also the health fair could have free gym
membership as door prizes to get people motivated if they
win to put them on the right track.
References
Centers for Disease Control and Prevention (CDC). (2011). Healthy weight-it’s not a diet, it’s a
lifestyle! Retrieved from http://www.cdc.gov/healthyweight/effects/index.html.
Centers for Disease Control and Prevention (CDC). (2010). Overweight and obesity. Retrieved
from http://www.cdc.gov/obesity/defining.html.
Centers for Disease Control and Prevention (CDC).(2009). Causes and consequences. Retrieved
from http://www.cdc.gov/obesity/causes/index.html.
Centers for Disease Control and Prevention (CDC). (2009). Morbidity and mortality weekly report.
Retrieved from cdc obesity.pdf.
Centers for Disease Control and Prevention (CDC). (2008). National Diabetes Surveillance System.
Retrieved from http://apps.nccd.cdc.gov/DDTSTRS/default.aspx.
Centers for Disease Control and Prevention (CDC). (2004). Federal Obesity-related legislation.
Retrieved from http://www2a.cdc.gov/phlp/Federal_obesity.asp.
Community Health Status Indicators (CHSI). (2009). Risk factors for premature death: Mecosta
County, MI. Retrieved from
http://www.communityhealth.hhs.gov/RiskFactorsForPrematureDeath.aspx?GeogCD=26107&
PeerStrat=32&state=Michigan&county=Mecosta.
References cont.
Congressional Research Service Summary (2009) H.R. 1398 Labeling Education and Nutrition Act
(Lean). Retrieved from http://www.govtrack.us/congress/bill.xpd?bill=h1111398&tab=summary.
County Health Rankings. (2011). 2011 Health outcomes-Michigan. Retrieved from
http://www.countyhealthrankings.org/sites/default/files/state/downloads/2011%20Health%2
0Outcomes%20-%20Michigan.png
County Health Rankings. (2011). 2011 Mecosta, Michigan Adult Obesity. Retrieved from
http://www.countyhealthrankings.org/michigan/mecosta/11.
Food and Drug Administration (FDA). (2006). Trans fat now listed with saturated fat and
cholesterol on the nutrition facts label. Retrieved from
http://www.fda.gov/Food/LabelingNutrition/ConsumerInformation/ucm109832.htm
Michigan Department of Community Health (MDCH). (2010). Michigan critical health
indicators. Retrieved from http://michigan.gov/mdch/0,1607,7-132-2946_5093-17501-,00.html.
Michigan Department of Community Health (MDCH). Nutrition, physical activity and
obesity program. Retrieved from http://michigan.gov/mdch/0,1607,7-1322940_2955_2959_3208-148846--,00.html.
References cont.
MI Healthy Communities. (2010). Michigan Nutrition Network. Retrieved from
http://mihealthtools.org/mihc/MichiganNutritionNetwork.asp.
New York State Department of Health. (2011). New York Strategic Plan for Overweight and
Obesity Prevention. Retrieved from
http://www.health.state.ny.us/prevention/obesity/strategic_plan/docs/strategic_plan.pdf.
New York State Department of Health. (2011). Obesity prevention. Retrieved from
http://www.health.state.ny.us/prevention/obesity/.
United States Department of Agriculture (USDA). (2010). Food guide pyramid. Retrieved from
http://www.the-food-guide.com.
United States Department of Health & Human Services. (2001). The Surgeon General’s Call to
Action to Prevent and Decrease Overweight and Obesity. Retrieved from
http://www.surgeongeneral.gov/topics/obesity/.