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Caring for Populations: Assessment and Diagnosis

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Caring For Populations: Assessment and Diagnosis
Jacqueline West
Chamberlain College of Nursing
NR443 Community Health Nursing
Winter 2013

Caring for Populations: Assessment and Diagnosis According to the National Center for Health Statistics (NCHS), more than one-third of adult Americans were classified as obese in 2010 (Ogden et al, 2012). Obesity on a national level tends to effect men and women equally. The NCHS also states that 17% of children and adolescents were obese in 2010. Being that obesity is a risk factor for many diseases, mainly cardiovascular disease and diabetes, the purpose of this paper is to assess obesity in a selected community. Understanding the correlation between obesity, communities’ resources and risk factors, and other chronic diseases could lead to community education and more importantly disease prevention. For the purpose of this paper the community selected is Rock Hill, South Carolina. This is a small city located south of Charlotte North Carolina. Rock Hill is convenient to many school, hospitals, churches, and parks. According to the city of Rock Hill’s official webpage (www.cityofrockhill.com) the city has thirty-one parks, four recreation centers, sixteen gyms/healthclubs, and approximately 400-acres of open natural space for exploration. According to the Census Bureau’s webpage, in 2010 Rock Hill’s population was 66,154 people and the median household income was $38,331. Whites accounted for 52.3% of the population, blacks 38%, and Hispanic 5.7 percent. Only 9% of the population was educated at a graduate level, 24% at a bachelorette level, and 75% of Rock Hill’s population had a high school diploma or higher. In 2011 the crime level was at 410.8, with 319.1 being the national average. The unemployment rate for Rock Hill in August of 2012 was 13% compared to the rate for the state of South Carolina at 9.4 percent. Rock Hill’s water and air quality was better than the national average. Unfortunately 20% of Rock Hill’s residents were living in poverty in 2009. The obesity rate for adults in Rock Hill is 28% with 8.8% being diabetic. The adult obesity rate for South Carolina is 29.4% with 10.6% being diabetic. Astoundingly Rock Hill has forty-six fast food restaurants according to the city’s website. Rock Hill is a city of more than 65,000 people. The economy of the city is currently retail and manufacturing. There are many newly constructed retail stores, malls, and outlets in Rock Hill. Piedmont Medical Center is a 288-bed hospital located in Rock Hill. There are many physicians offices located throughout the city. During the day the streets and highways of Rock Hill are busy including bus services and pedestrian traffic. At night the streets are still busy, however the amount of pedestrian activity is much less. Law enforcement is always present, no matter what time of day it is. Housing varies dramatically throughout Rock Hill, with most homes being single family and middle class. There are a couple sections of town occupied by multi-family homes that appear substandard. Outside of the city limits there are many agricultural residential areas. As Rock Hill borders the Catawba River and Lake Wylie there are also large single family residences that one may refer to as mansions. Upon completion of the Window Survey it is noted that may people are being active throughout the day. Two of the busiest parts of Rock Hill have walking/bicycle trails and they appear to be in constant use during daylight hours. However, as mentioned previously Rock Hill has 46 fast food restaurants and during the survey it is noted that these restaurants are usually occupied by more than five individuals. Unfortunately, it is also observed that whether people are being physically active, walking casually on city sidewalks, or visiting retail shops the majority of them are overweight if not obese. Upon assessment of collected data in addition to the Windshield Survey obesity is an issue in Rock Hill. Twenty-eight percent of the population figures to be approximately 18,500 obese adults. The availability of less than nutritional food choices may be easy to blame at first, however one must also consider all of the good health options the community has to offer. As obesity is a precursor to diabetes and 8% of Rock Hill’s population is diabetic, it is urgent that the community become educated about what they are putting into their bodies. With a median household income of less than $40,000 many families will find it less expensive and more convenient to make unhealthy food choices. According to the South Carolina Department of Health and Environmental Control (SCDHEC) 86.4% of the people in Rock Hill in 2009 did not meet fruit and vegetable recommendations, 82.6% of South Carolinians fell into this category, as did 76.6% of Americans in general. In addition, 52.5% of people in Rock Hill did not meet physical activity recommendations, 30.3% on a state level and 49.4% on a national level. South Carolina DHEC states that in 2000 less that 18% of Rock Hill’s adult population were overweight/obese, by 2005 that number was up to 23.4%. The problem is obviously escalating into a soon to be epidemic if people do not start taking charge of their bodies and decisions. There is no question that the decline in the economy had an effect on people’s ability to afford better foods. Moreover, with such a sharp increase in unemployment it would not be hard to imagine that a person’s focus was taken from their health and transferred totally on maintaining some financial security.
The City of Rock Hill has done many things for the community to increase the availability of physical exercise. A tennis club was started in 2007 that lead to a large tennis complex being built in the heart of Rock Hill. A large soccer park, including the second 3-mile walking trail was completed in 2008. The local YMCA added a facility (totaling three in Rock Hill) as well as an aquatic center. The local hospital also has increased its efforts in community education. Going to www.piedmontmedicalcenter.com will lead to a wide variety of educational classes related to most aspects of health at no or low cost. In summary, Rock Hill South Carolina does have a concerning issue with obesity. The rate of adult obesity is increasing as children are more overweight/obese and are not being taught good habits or shown good examples. On the other hand it is evident that the community and its leaders have taken a proactive stand against obesity. Community education needs to continue, starting in schools as well as at home.

References

Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity in the United States, 2009–

2010. NCHS data brief, no 82. Hyattsville, MD: National Center for Health Statistics.

2012.

South Carolina Department of Health and Environmental Control. (2011, April). 2010 York

County Profile Nutrition, Physical Activity, and Obesity. Retrieved from

http://www.scdhec.gov/health/epidata/docs/obesity/York.pdf

United States Census Bureau. (2012). State and county quickfacts. Rock Hill South Carolina.

Retrieved from http://quickfacts.census.gov/qfd/states/45/4561405.html

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