Working with Families to Prevent Obesity - Case Study Example

Health Campaign – Part II Introduction Previously overview of obesity in Harris County shows seriousness of the situation. The problem is tightly related to various spheres of life of Hispanic and African-American students and women. High obesity rate is unprofitable for local businessmen and employers, because qualified specialists and manpower, which will not be able to perform specified scope of work due to obesity-related physical disability, lack of expensive reasonable accommodations or numerous days-off, will hardly be appreciated. Local schools also do not draw sufficient attention to food safety and physical activity, though according to the overview results they mainly impact academic achievements of students from the target groups. Harris County Hospital District, official authorities, HCPHES, school administrations and volunteers from the target communities certainly try to change the situation for better. Nevertheless, their efforts are uncoordinated and not widely-advertised, that’s why local Hispanic and African-American communities are not involved in it properly. Thus, to improve current situation in Harris County an efficient Health Campaign is required. 1. Baseline for the Health Campaign To establish this Health Campaign detailed statists is required, because organizes should be well-aware of quantity of the target groups, its basic needs, socio-economic status, health-related problems etc. In 2009 Harris County population included circa 4,070,000 residents; absolute majority (98%) lives in urban zone. Thus, large distances and transportation will not hamper arrangement of the health campaign. Both African-American (18.5%) and Hispanic (32.9%) communities make 50% of total population, that’s why the campaign must be large-scale and involve all abovementioned interested parties. (Appendix A) “According to the US 2005 American Community Survey, both the HA (14%) and the AA (12%) populations are represented as minorities.” (Talpade, 2008) Using CDC BRFSS, the campaign organizers can make a brief comparative analysis of general health status in the county with Healthy People 2010 objectives. As for improvement of daily ration and weight management, average weight of men makes 190 pounds, for women – 159 pounds. (CDC BRFSS, 2004) It means that obesity rate in the county is above average US obesity rate. 57% of residents drink alcohol more than twice per month and 40% smoke quite regularly. Thus, majority of members of African-American and Hispanic communities do not follow healthy diet and prefer fast-food or semi-finished products from the supermarkets. Organizers of the Health Campaign must pay attention to healthy lifestyle, food safety, correct nutrition and balance of vitamins. The objective of daily physical activity promotion implies regularity of physical training of exercises among Harris County population. According to CDC, 72.7% of residents engage in for exercise several times per months; they cover morning exercises, jogging, cycling, long walks, exercises in gym or on home gyms, aerobics, dancing, physical activity related to household/work etc. At the same time, high overweight/obesity rate shows that such physical activity is irregular and insufficient to improve the situation. Professions of local African-American and Hispanic women usually imply hard physical labor, because they do not have proper education or qualification. Such physical activity is not based upon correct load of muscles. “For all racial and ethnic groups, 24% of persons with less than a high school education are obese compared of those with high school diplomas, and women of lower SES are 50% more likely to be obese than those with higher incomes.” (Dart, Frable and Bradley, 2005) African-American and Hispanic American students often short of daily physical activity at schools/colleges. Food safety requirements also are not followed properly. They majority of African-American and Hispanic American families belong to low SES. Over 60% of women from the target group are uninsured. Therefore they can hardly afford regular visiting of health care specialists and, as a rule, appeal to basic specialists such as dentists, otolaryngologists, pediatricians. For example, 64.8% of Harris County residents visit dentist for preventive examination at least once a year. (CDC BRFSS, 2004) The target communities often do not get qualified assistance from physicians, dietitians, cardiologists, physiologists. Their children and adolescents can rely on health care services at educational institutions. 2. Obesity Statistics in African-American and Hispanic Communities Obesity-related statistics is conditioned with biological, socio-economic, cultural, environmental factors. Lyn Dart, Pamela Frable and other specialists (2005) analyzed overweight/obesity problem in African-American and Hispanic communities of Forth Worth, Texas. In the county prevalence of overweight/obesity among these ethnic groups is usually higher than among Non-Hispanic Whites. Although obtained results do not reflect the situation in Harris County, they identify similar tendencies and obesity rates. In Texas racial-ethnic differences among children and teenagers are scientifically proved. According to Dart’s survey, they make 12% for Non-Hispanic Whites, 22% for Hispanic American and African-American. Obesity rate among 7-years-old African-Americans approximately makes 25%. Thus, these children are genetically liable to obesity and obesity-related diseases. The above target communities have higher prevalence of obesity-related chronic diseases, i.e. type 1 / 2 diabetes, hypertension, elevated cholesterol. PE teachers claim that movement disorders and asthma are additional difficulties provoked by shortage of physical activity in the curriculum of Harris County. “Diabetes prevalence in Hispanic Americans is nearly double that of White Americans and approximately 70% higher in African Americans.” (Dart, Frable and Bradley, 2005) The rate of type 2 diabetes among obese Hispanic American and African-American children and adolescents grows, though only adults have preliminary been afflicted with it. In accordance with Strategic Plan of the Prevention of Obesity in Texas, life expectancy of teenagers, who have been afflicted with type 2 diabetes (T2D) before 15 years, makes only 27 years and for the afflicted in the range of 15 – 19 years – 23 years. Thus, this tendencies increases youth mortality both on the national and state levels. Premature death of the obese residents can be conditioned with other diabetes-related complications such as amputations, kidney disease, blindness, dental illnesses, BP etc. “The average yearly health care cost for a person with diabetes was $13,243 in 2002 compared to $2560 for a person without diabetes.” (Urrutia-Rojas and Menchaca, 2006) High mortality from of obesity-related chronic diseases absorbs a large share of US federal budget. In 2002 complications, related to T2DM, costed US budget $132 billion. Thus, organizers of the above health campaign should draw attention of the target ethnic groups to regular visits of health care specialists, preventive examinations, diets and proper care for their younger generation. 3. Community-Based Approach The health campaign must meet requirements and peculiarities of the target communities. Such experience can be borrowed from activity of Cornerstone Community Center (CCC), Tarrant County, which applied similar approach to the communities of Fort Worth. It was based upon 12-week session for group, consisting of three hundreds participants of different age, sex and SES. Participants were screened for Healthy Weight (HW) and their biographical data were analyzed and completed in a single database. Heath care professional and students were hired for conduction of daily sessions. On the one hand, target communities of Harris County are much larger, that’s why the health campaign scale should be broadened. It should cover Internet resources, advertising through mass media, numerous daily sessions in Houston, Pasadena, League City, Missouri City etc. Local health care specialists and employers should render an overall assistance to the campaign, propagating healthy life style and physical activity. Advertising through mass media and Internet is an initial step of community-based plan. It will allow drawing attention of Hispanic American and African-American populations to obesity and its disadvantages. Officials should distribute information in public hospital of Harris County Hospital District, schools and colleges. The campaign should provide multicultural services and all information should be available both in English and Spanish. HCPHES can wider propagate its programs CATCH and the Built Environment among the target communities. The second step implies arrangement of several groups under survey in order to estimate average obesity-related parameters of the above communities. These are procedures for general health status, probable genetic inclination to overweight/obesity, daily norm of physical activity, usual ration, level of healthy literacy, SES. Estimation of overweight/obesity should be based on standard criteria applied in CCC research, i.e. HW, BMI, waist-to-hip ratio (WHR), bioelectrical impedance analysis, waist circumference (WC). The obtained results will help to identify medium obesity rate and obesity-related chronic diseases within the target groups and communities, which can be compared to national level. The third step is participation of the above groups in daily sessions built up as an educational course with theoretical and practical classes. The majority of the group members have low SES, that’s why “all forms and educational materials were in English and Spanish and were developed at the 4th to 5th grade reading level”. (Dart et. al., 2005) On expire of the sessions the participants’ achievements and outcomes should be summed up and compared to locally identified objectives of Health People 2010 stated above and similar governmental documents. For instance, obtained dietary improvements of groups are analyzed to complete 2000 Dietary Guidelines for Americans. Hispanic Americans and African-Americans of various age/sex groups will get proper recommendations and prohibitions. Cultural factor connected with ethnic cuisine, daily ration, physical activity and apprehension of overweight/obesity will be taken into account. Institutional leadership role in this campaign involves overall organization of the campaign. They develop advertising campaign, recruit qualified health care staff with cultural/linguistic competence and select appropriate locally identified objectives. Institutions provide space and financing of the health campaign. As for leadership role of the target communities, they will demonstrate level of enthusiasm and concernment in the process. Hispanic American and African-American women should be eager to take part in this program in order to take part of their children properly, avoiding obesity and related diseases. Increase of health literacy also is a good motivation for them. 4. Economic Factors, Intervention and Social Marketing Financing of the health campaign should be provided by state bodies (US Department of Health and Human Services), public organizations (HCPHES), employers of Harris County, local health care organizations and volunteers. Ben Taub General Hospital and Children’s Center, Quentin Mease Community Hospital should promote/advertise the forthcoming health campaign and health-improvement programs. Specialized community health centers for Hispanic residents El Franco Lee, Casa de Amigos, for African-Americans – Martin Luther King Jr. will provide culturally competent medical staff and space for daily sessions. Intervention strategies should be applied in the form of questionnaires, social polls in the supermarkets, cafes, school canteens. PE teachers can organize additional lectures on safe nutrition, usefulness of physical activity and provide students with supplementary brochures for reading at home. Family discussion might improve their understanding of the material. Employers should propagate health way of life through daily ration, breaks for exercise, days of no-smoking, sport competitions (table tennis, badminton, chess), small bonuses. As it has been above, health care insurance for obese employees is much higher, that’s why health-improving promotion can change situation on social market of Harris County within the following decades. Conclusion Successful Health Campaign should be supported by various organizations and volunteers from local Hispanic and African-American communities. It should combine statistical analysis and scientific research. Multicultural services are of primary importance. Obtained results must be officially applied in practice for support of locally identified objectives (2000 Dietary Guidelines for Americans, HP 2010 for Hispanic and African-American students). Local community health centers and schools should promote obtained results in practice. Bibliography 1. Budd, M.G. and Volpe, S. L. (2006). School-Based Obesity Prevention: Research, Challenges, and Recommendations. Journal of School Health, 76 (10), 485 - 492. 2. CDC Behavioral Risk Factor Surveillance System, (2004). BRFSS Survey Data 2004. Retrieved from: http://www.cdc.gov/BRFSS/ 3. Dart, L., Frable, J. P., Bradley, J. P. and Bae, S. (2005). Working with Families to Prevent Obesity: a Community-campus Partnership. Journal of Family and Consumer Sciences, 97 (2), 20 - 27. 4. Griffin, S., Anding, J., Hill, D., Hill M. and Chesley. D. (2004). Strategic Plan for the Prevention of Obesity in Texas: 2005 – 2010. Retrieved from: http://www.dshs.state.tx.us/obesity/pdf/strategic_plan.pdf 5. Talpade, M. (2008). Hispanic versus African American Girls: Body Image, Nutrition, and Puberty. Adolescence, 43 (169), 119 - 125. 6. Urrutia-Rojas, X. and Menchaca, J. (2006). Prevalence of Risk for Type 2 Diabetes in School Children. Journal of School Health, 76 (5), 189 - 196. Appendix A Ethnic Scale of Harris County Read More