D025 Advocacy Policy Obesity PDF

Preview

Summary

Policy Brief...

Description

OBESITY: BE THE CHANGE

1

WGU D025 Essentials of Advanced Nursing Roles and Interprofessional Practice

October 30, 2020

OBESITY: BE THE CHANGE

2

C. Executive Summary (C1,2,3) Imagine being ten years old and taking medications to control your blood pressure. Imagine being 40years old and your children having to bathe you or clean you after each time you urinated or had a bowel movement because you were too large to reach appropriately. Imagine the embarrassment of not being able to fit into a car or through a doorway. This is real life for some people. Children of obese parents are at a greater risk of living an obese lifestyle. In our community, nearly half of the population are obese. This statistic includes adults and children. Healthy People 2020 set a goal for our nation to not exceed a 30.5% rate of obesity, but we have surpassed that into the 40% range (Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation, 2012). Our small community is higher than the national average for obesity. Change is needed not only for our community but in communities across the country. Our community can be an example for others to follow. Obesity is a major issue that deserves the attention of all. It is costing our country billions of dollars a year in healthcare and this number will only continue to grow if we do not enact change. Many citizens lack access to high-quality nutritious foods in our area. The two large chain stores are adjacent to each other on the same end of town. Think about the single mom with three kids who have no means of transportation. She is going to walk to the closest place to find food to feed her children and unfortunately that is probably a gas station or a fast-food chain. If we had a centrally located farmers market come into our community, I feel the impact would be significant. The market would offer discounts to our low-income residents and the elderly who struggle to buy food for their families. We would also be giving back to our local farmers by the consumption of their products. The market would bring outsiders into our city

OBESITY: BE THE CHANGE

3

and increases our revenue. The farmers market would bring educational materials on the food and preparation ideas to better educate our community. A farmer’s market will not be the only action that would decrease the obesity rates but would have a large impact on citizens learning to eat healthier and buying fresh fruits, vegetables, and meat. I want our town to be the example that others follow. We will lead our community to a happier healthier life. The policy change I am fighting for is to have a farmer’s market come into town within the next six months to improve the access to nutritious foods that are available to our community. You can have a part in making that happen. Approving this policy has many positive impacts in our community but could also positively affect our surrounding communities. Tell your friends, tell your families, encourage others to come to the market. You are a leader in our community, so lead by example. Let us not continue to sit back and watch the rates of obesity climb, let us not continue to watch the children of our society be burdened with obesity. We need to do something about the epidemic in our communities and across our nation. Be the change!

A1. Describe one SDOH that necessitates a policy change to optimize health in your community The SDOH I found to have a significant need for policy change is access to nutritious foods in our community. In my county, our obesity rate is 42%, double the rate of our neighboring counties that stand at 20% each (County Health Ranking Reports, 2020). This is not only a problem in our community, but worldwide. We live in a fast-paced world, everyone wants to keep moving and getting things done easier/faster, but this is not always the best way to live life. Fast food is quick, it is easy, but it is not the healthiest option. Going to the grocery store

OBESITY: BE THE CHANGE

4

requires a means of transportation and having to prepare a meal for you and your family. Unfortunately for our residents, our two local grocery stores are at the far end of town and directly across from each other. If a resident does not have the means to get there, the easiest thing for them is to walk to the closest place, and unfortunately, our town is inundated with fastfood chains.

A2. Three characteristics of the target population affected by the SDOH I. Twenty-four percent of the population in our county are inactive (County Health Ranking Reports, 2020). This is associated with many aspects: only having two public parks available, lack of education, increased screen time/electronic devices, one fitness gym in town with high membership prices, and a higher than average elderly population. II. Twenty percent of our children in the county live in poverty (County Health Ranking Reports, 2020). Living in poverty also affects other things in our daily lives, such as the affordability of food and transportation to obtain the appropriate nutritious foods. In addition to the percentage living in poverty and their financial means to obtain proper food, 53% of our school-aged children qualify for free or reduced lunches. According to the report, the percentage of low-income residents who do not live near the grocery store is 17%, while 18% lack overall access to food (County Health Ranking Reports, 2020). III. Twenty-seven percent of the population are uninsured, adults and children combined (County Health Ranking Reports, 2020). Unfortunately, uninsured citizens are less likely to get the recommended checkups and receive the education involved with those visits. Those who are obese are at a higher risk for many disease processes, and the lack of a primary doctor is significant.

OBESITY: BE THE CHANGE

5

A3. The policymakers that will receive the policy brief I. The Mayor, Misty Talbert, will be the first to obtain the policy brief. Being the Mayor of our city, she has established connections with businesses and locals that will be of utmost importance with moving the policy forward. II. The City Manager, Finley Degraffenried, will receive the policy brief as he and the city council will have a significant role in moving the policy forward. The city manager oversees all city staff and will provide us information on the best location to set up a centrally located farmer’s market. III. The County Commissioner, Kyle Matthews, will also receive the policy brief as he is involved with meeting the citizens' concerns and overseeing the activities involved in doing such. Being that he is over the entire county, he will have the insight to get other cities in our county involved with bringing in a farmer’s market to their area. IV. The superintendent of schools, Chane Rascoe, will receive the policy brief as he is in an influential position with our children. He can ensure educational materials are sent home with students regarding obesity, the complications of obesity, and information on the importance of nutritious foods. This information will also include details on the farmer’s market coming to our area.

A4a/b. Explain why the SDOH requires the policy maker’s attention Not having an existing policy in place in our community regarding access to nutritious foods is detrimental to our society. Our obesity rate in this county is twice that of our surrounding counties. If we currently had a policy regarding adequate access to nutritious foods,

OBESITY: BE THE CHANGE the two largest chain grocery stores would not have been allowed on the same far end of town across the street from each other. It seems more logical to have one at each end of town and to make access to the stores fair to all residents. The lack of access to nutritious foods has had many implications for adults and our children. The obesity rate among children is much higher in recent years than prior. According to www.childhealthdata.org, Texas children ages 10-17 from low-income families have an obesity rate of 32.2% (Texas State Fact Sheet, 2008). The issue for children is that their parents are purchasing the food they can eat, and if nutritious food options are not available to them, they have no choice but to eat unhealthy. Obesity is not an ethical/moral problem but a public health concern that urgently needs to be addressed. Adults and children alike are at risk for many health disparities when they are obese; diabetes, high blood pressure, and heart disease to name a few. Children are just as much at risk as adults for developing these chronic conditions. Teaching families how to eat nutritiously and providing those options should be of utmost importance in every community. To combat adult obesity, we must include our children because they are our future. The absence of a policy addressing this issue goes against provision 8.1 of health is a universal right.

6

OBESITY: BE THE CHANGE

7

A5. Complete the demographics table Demographics Table Lack of access to nutritious food Demographic Information (Provide 2 or more statistics/fact s associated with demographic s for SDOH in column to the right)

Risk Factors (Provide 2 or more statistics/fact s regarding risk factors associated with SDOH in column to the right).

Statistics/fact s

Summary of statistics/facts

17% do not live near a grocery store

With our grocery stores being on the same end of town, I am shocked this number is not higher. If they have no means of transportation , this makes it difficult to obtain food. For some children, school is the only place they eat due to their home circumstances.

www.countyhealthrankings.org

Lack of access to nutritious foods increases everyone’s chances of becoming obese. Obese children whose parents

https://www.ncbi.nlm.nih.gov/pmc/articles /PMC5943632/#:~:text= %20obese%20child%20is%2 0three,%2Dweight% 20child%20(24).

53% of children qualify for free or reduced meals at school, 20% of our community live at or below poverty level Obese children are 3 times more likely to develop hypertension than an average weight child.

Source for statistics/facts

https://health.gov/healthypeople/objective s-and-data/social-determinantshealth/literature-summaries/foodinsecurity

www.countyhealthrankings.org

OBESITY: BE THE CHANGE

8 are obese, also have a higher risk of obesity.

19% of young people aged 2 to 19 years old and 40% of adults are obese.

Trends in SDOH Over Recent Year(s) (Provide 2 or more statistics/fact s associated with trends in SDOH over recent year(s) in column to the right.)

Financial incentives at farmers’ markets in low-income neighborhood s show strong potential to improve diet quality. Exposure interventions at farmer’s markets to increase the sale of nutritious foods.

Obesity in the US costs our healthcare system $147 billion annually. A healthy diet can help bring this number down substantially. They offered a 40% fruit and vegetable incentive to those receiving federal benefits.

https://www.cdc.gov/chronicdisease/ resources/publications/factsheets/ nutrition.htm

https://www.ncbi.nlm.nih.gov/ pmc/articles/PMC4847109/

The https://www.ncbi.nlm.nih.gov/ interventions pmc/articles/PMC4847109/ allow taste testing of the products available, cooking demonstration , and food education.

OBESITY: BE THE CHANGE

9

B1. Develop two policy alternatives to address the SDOH I. Providing a mobile farmer’s market to come into our community three days a week to provide nutritious food options to our residents. The market would be centrally located in town to provide equal opportunity access by all residents. The market would accept all payment forms, such as federal government assistance, cash, or debit card. Discussion of possible price reductions for elderly or low-income receiving government assistance. An additional option that can be added later is the possible delivery of goods from the farmer’s market for residents who lack transportation. II. Prohibit the sale of any nonnutritious food and drink sales at any public school. The cafeterias are required to serve a nutritional meal for breakfast and lunch. The issue lies with selling the “snack bar” items such as pizza, chips, hotdogs, sodas, nachos, etc. For some children, the only food they can eat is at school. We should be providing the most nutritious options available. The availability of junk food increases the chances of obesity. A 10% increase in the schools that have junk food available to students increases their BMI by more than 2% (Junk Food Availability in Schools Raises Obesity, 2005). Children are at school eight hours a day, five days a week, and health promotion should be of utmost importance. Providing balanced nutritional meals for breakfast and lunch, having an active PE program, and providing diet and exercise education should be a part of their curriculum.

B2. Why is one of the policy alternatives preferred over the other in B1 The policy alternative I feel would have the greatest impact is implementing a local farmer’s market three days a week in our area. To be centrally located is of utmost importance

OBESITY: BE THE CHANGE

10

because both grocery stores are on the far end of town. In a study done recently, it found four barriers to obtaining healthy food. The four most commonly reported include the high cost of healthy foods, being too far away from where the healthy options are located, poor quality of healthy food, and lack of overall quality of the closest retail stores (Evans et al., 2015). A farmer’s market that is centrally located addresses all four of these concerns.

B3a/b. Explain how the desired policy will optimize health in the community and the financial costs and benefits of the proposed policy Increasing the amount of fresh fruits, vegetables, meats, and grains available to the community can only positively impact. Children and adults will learn to eat healthier. With the teaching and education provided at the market, people will become more comfortable with purchasing fresh items to use in their kitchen. The obesity rate could start to level off or show a downward trend as children get older and have learned proper nutritional habits to break the cycle. With the location being in the center of town, those with no transportation may reach the market by foot. The option of delivering goods from the market is also a possibility for those with no transportation. The price will be reduced for the elderly or those on government assistance, thus increasing the nutritious foods they can access. The worry of what something costs will not be an excuse for unhealthy eating. Not only does a farmer’s market provide nutritious options available to our residents, but it also provides income to our local economy and local farmers. The farmers will pay a small booth fee every six months to sell their products. Buying from local farmers is preferred over buying from big-name companies. The farmers need the sale at farmer’s markets for their families; large corporations do not.

OBESITY: BE THE CHANGE

11

B3c. Two ethical implications of the proposed policy on the population Under Provision 8, we have an obligation to reduce disparities and having a universal right to health. A farmer’s market addresses both of those ethical provisions. It reduces disparities and provides an equal opportunity regardless of race, ethnicity, economic class, means of obtaining nutritious food, etc. It also addresses the universal right of health and enjoying life regardless of race, economic status, or means for obtaining food. The policy addresses these issues in hopes of improving the overall health of our community.

B4. Barriers to the implementation of the policy There are many barriers that could potentially hinder the policy from moving forward. The first being finding an appropriate place to hold the farmer’s market three days a week. Higher poverty rates make it difficult to pay for services even if the cost is reduced. There is only one source of public transportation in our community that residents would have to pay to get to and from the market. Another barrier would be a significant drought that would result in fewer crops being available for sale. Another potential barrier would be a representative from the corporate office of one of the grocery stores protesting the farmer’s market. We also have a large percentage of the Hispanic population, lack of knowledge due to a language barrier could be a potential issue.

OBESITY: BE THE CHANGE

12

B5. Methods of communication you will use to introduce the policy to the policymakers. I. Set up an initial face-to-face meeting with an open forum question/answer session regarding the policymakers' desired policy change. Include the local radio station and newspaper. II. A video compilation of photos posted to Facebook, Instagram, and Twitter of abnormally obese individuals attempting to do everyday tasks such as tying their shoes, getting dressed, and even performing personal hygiene and the difficulties associated with each. In the video, we would also include speaking segments of a child living with diabetes or hypertension due to their obesity. III. Hand out flyers to the local schools to be sent home with the children educating their families on the farmer's market to provide fresh fruits and vegetables. IV. A slide show presentation with statistics from our county and surrounding counties regarding the obesity rate comparisons emailed to all of our stakeholders. V. Contact the local news station regarding the desired policy change. Ask if your story can be run on the local news channel for all to see.

B6. Potential results of inaction Inaction means just that, not acting on a particular issue. I feel that where our country rates in the world regarding obesity, inaction would not be an option. The adults in our communities continue to develop diseases related to their obesity. Children will begin developing these diseases, possibly at earlier ages. The cost to our healthcare system is already astronomical, and with inaction, those numbers will only drastically increase. Getting the

OBESITY: BE THE CHANGE

13

community on board with your policy will help in ensuring its success. The best way to avoid inaction is to set a goal as a team, avoid distractions, and make advancements in reaching your goal.

D. Reflection In being a change agent, you must first decide where there is an area that is lacking. After reviewing the statistics for my county, I knew exactly what I needed to address and it was the obesity rate as we are double that of our surrounding counties. I personally would love to have a farmer’s market available in our area and it was the first thing that came to mind. Local farmers struggle at different times of the year so not only would it be supporting them, but we would also have access to the freshest fruits, vegetables, and meat. Sometimes these items sit on the shelf for a while in larger grocery stores. I stayed focused on the goal and brought in a diverse group of stakeholders to participate in the policy change. The driving force for me was envisioning the betterment of our community for myself, my children, and our neighbors. There is a tremendous amount of work that goes into policy development and changing policies. This course started me on the right track, but I still do not feel I know all there is to attempt to change policy. I am somewhat shy, so I do feel I would have to become more comfortable speaking in front of a large group if I am going to try to influence policy change. I also need to get out more into the community to meet some of our local leaders...