Analyzing an At Risk Population

Analysis and Application
An Existing At-Risk Population
Obesity has been a major health issue in the United States that leads to numerous diseases. The obesity rates have been on the upward trajectory over the past few years. According to Hales, Fryar, Carroll, Freedman, and Ogden (2018), the rates of obesity have increased from 33.7 percent to 39.6 percent in the past decade. Obesity is defined as having a body mass index (BMI) that is 30 or greater (Hales et al., 2018). Severe obesity is defined as having a BMI that is 40 or greater. This is attributed to the lifestyle changes of people and the over-reliance on fast foods. especially in America, junk food is far cheaper than healthy alternatives. This makes it attractive for low-income families, which contributes to the increased obesity rates for middle to low-income groups. With the increased work schedules, people are finding it hard to maintain healthy lifestyles and they have little time for exercise. This results in them living sedentary lives and eating unhealthy meals. Increased urbanization has been mentioned to be a factor too. The nature of work has dramatically changed. Currently, there is little requirement for physical activity in the work environment. Technological advances have made production much easier and less human effort is needed. This means that people are not required to perform as much physical activity as was in the past. Extended working hours and long schedules have ensured that people no longer have spare time for any physical activities.
Obesity is the leading cause of certain chronic diseases like diabetes, stroke, heart disease, and certain types of cancer. While these are all preventable, they can be fatal and they have resulted in premature death. The groups that are at high risk of obesity have been identified by Finkelstein, Trogdon, Cohen, and Dietz (2009) as Hispanics with a rate of 47%, followed by non-Hispanic blacks 46%. Non-Hispanic whites and non-Hispanic Asians had 37.9% and 12.7% respectively. Annually, there are between 100,00 - 400,000 deaths that are attributed to obesity in the United States. Obesity has also increased the use of healthcare and health expenditures costing the society approximately $118 billion in direct and indirect costs. This is even higher in terms of health care costs that are associated with smoking. The rates of obese women have been increasing with each passing year and women have far higher rates as compared to those of men.
Health Risk Within This Population
Obesity has been shown to contribute to numerous diseases. Type 2 diabetes is one of the diseases where nursing practice can have an impact. While obesity is not the main cause of type 2 diabetes, individuals who are obese or overweight have a high risk of developing the disease (Abranches, de Oliveira, da Conceição, & Peluzio, 2015). Type 2 diabetes is a disease where the levels of blood sugar are above normal levels. Having a high blood sugar level could result in heart disease, kidney disease, amputation, blindness, and stroke. Diabetes has been shown to be a leading cause of death, especially in the United States. Over 87% of adults who have diabetes have been found to be obese or overweight. While the correlation between overweight and diabetes is not clear, this fact should not be overlooked. It is assumed that by a person being overweight there are cell changes that take place, which make the individual resistant to the insulin hormone. Insulin resistance means blood sugar is not taken up by the cells, which results in a high blood sugar level in the body. Therefore, it is vital that nursing practice intervenes and offers advice to individuals who are considered to be overweight or obese.
Nurses can educate the population regarding the impact of being overweight or obese. Teaching the population on the benefits of living a healthy lifestyle and eating healthy foods will be beneficial to the population. This will also reduce the prevalence of obesity within the population and reduce the development rates of type 2 diabetes. Diabetes is a preventable disease and all that is needed is for a person to lead a healthy lifestyle (García-Jiménez et al., 2016). With nurses educating people on what they can do to avoid developing this disease, the rates of the disease can be reduced. The most at-risk population has been identified as the middle to low-income group. There is a need to identify the most at-risk population in order to target them. With the continued increase in obesity for women it is vital to target women in the intervention. Women are a vital variable and if they can understand the negative effects of obesity, they too can change their lifestyle and that of their family. Reaching out to women will ensure that there is a positive change within the population. Encouraging women to adopt new lifestyles can also result in better outcomes for the population.
Potential Obstacles
Considering that the most affected population is the low-income group and this group does not have health care cover or insurance. It is hard for any nursing intervention to reach to them. Most of them will not visit hospitals or health care facilities for fear of incurring huge medical costs and since they do not have the necessary coverage, they prefer to self-medicate (Roberto et al., 2015). Health care is costly in the United States and this is a huge deterrence for certain population groups. All the information that has been uncovered regarding the prevalence of obesity has been through self-reporting. Reaching out to this population is hard and nurses have to go to the community areas in order to educate and advise them on the benefits of leading healthy lifestyles. The few who actually visit the health care facilities are unwilling to listen since they think they will be charged extra for the training or education. The income levels of this population make it hard for them to afford a decent meal and they are left with fast food. Therefore, the intervention is hindered since the population cannot adhere to the recommended dietary needs. Some of the population members have to work two jobs to survive and they are left will little time for physical activity since they are tired from work.
Nurses are also hindered since there are fewer nurses available to offer care to the patients. This means that nurses do not have adequate time to sit down with all the obese patients who visit their health care facilities. Educating and advising them becomes difficult since obese patients are merely given pamphlets that are aimed at encouraging them to lead healthy lifestyles. Without the personal touch and follow up it is hard to increase the health promotion activities and this results in a continued increase in the number of people who are getting obese day by day. Nurses could also be encouraged to visit the communities where they work in order to reach out to the population and educate them. However, this is not possible and can only be done during a nurse's own free time. Without enough nurses, health care facilities cannot risk sending out some of their staff to offer community education. This is because they will be shorthanded at the facility and this can lead to a bigger crisis.
Stakeholders, Individuals, and Agencies
Health care facilities are the number one stakeholder that one should consider partnering with in order to implement the educational policy. This is because most people will visit and trust a health care facility that is close to them for any medical needs. Therefore, it is easy for the health care facility staff to offer education to the patients they consider to be overweight and at risk of getting obese. The facilities could also reach out to the community where they operate and have training that is aimed at educating the population on the hazards of obesity (Seidell & Halberstadt, 2015). This way the community will get the necessary advice and the facilities can also have an obese center where people can visit to get recommendations on dietary and physical activity changes that they need to make. Community leaders are other stakeholders that one can use to reach out to the communities. These are individuals who are well known within the community and they are considered leaders and advisors for the community. Taking them through training on the effects of obesity and how they can tackle this will ensure that they are able to send out the same message to the community members. These leaders will also offer the necessary insights into the community problem. The community might be unable to meet some of the needs due to a lack of facilities for exercising or play areas. This could be discussed and solutions developed that would be suitable for the community.
Advertising agencies working within the county can be approached to offer their services for free to the community. Seeking their services can allow for the message to be shared in different platforms and this would reach as many people as possible. Advertising agencies can also offer this as part of their CSR activities, which would mean it would be free. Having billboards and advertisements in print and radio will ensure that the message is shared across and the potential of it reaching the desired population is increased.


References
Abranches, M. V., de Oliveira, F. C. E., da Conceição, L. L., & Peluzio, M. d. C. G. (2015). Obesity and diabetes: the link between adipose tissue dysfunction and glucose homeostasis. Nutrition research reviews, 28(2), 121-132.
Finkelstein, E. A., Trogdon, J. G., Cohen, J. W., & Dietz, W. (2009). Annual medical spending attributable to obesity: payer-and service-specific estimates. Health Affairs, 28(5), w822-w831.
García-Jiménez, C., Gutiérrez-Salmerón, M., Chocarro-Calvo, A., García-Martinez, J. M., Castaño, A., & De la Vieja, A. (2016). From obesity to diabetes and cancer: epidemiological links and role of therapies. British journal of cancer, 114(7), 716.
Hales, C. M., Fryar, C. D., Carroll, M. D., Freedman, D. S., & Ogden, C. L. (2018). Trends in obesity and severe obesity prevalence in US youth and adults by sex and age, 2007-2008 to 2015-2016. JAMA, 319(16), 1723-1725.
Roberto, C. A., Swinburn, B., Hawkes, C., Huang, T. T., Costa, S. A., Ashe, M., . . . Brownell, K. D. (2015). Patchy progress on obesity prevention: emerging examples, entrenched barriers, and new thinking. The Lancet, 385(9985), 2400-2409.
Seidell, J. C., & Halberstadt, J. (2015). The global burden of obesity and the challenges of prevention. Annals of Nutrition and Metabolism, 66(Suppl. 2), 7-12.