Community Health Strategies the Leading

Community Health Strategies

The Leading Health Indicators are used to measure the health of the Nation. Each of the 10 Leading Health Indicators has one or more objectives from Healthy People 2010 that is associated with it. These indicators reflect the major health concerns that were present in the United States at the beginning of the 21st century. The Leading Health Indicators were selected on the basis of their ability to inspire action, the availability of data that can be used to measure progress and their importance as public health issues. The Leading Health Indicators include: physical activity, overweight and obesity, tobacco use, substance abuse, responsible sexual behavior, mental health, injury and violence, environmental quality, immunization and access to health care (What Are the Leading Health Indicators, n.d.).

Many of these issues are very popular in today's media, but the one that stands out as being talked about everywhere is that of overweight and obesity. It doesn't seem that you can turn anywhere without coming into contact with something that discusses the dangers of obesity or the treatment of it. The definition of obesity varies depending on what one is reading. Generally it is referred to as a chronic condition defined by an excess amount of body fat. A certain amount of body fat is necessary for the body to store energy, insulate itself, and provide shock absorption among other functions. The amount of body fat that is considered normal is between 25%-30% in women and 18%-23% in men. Women whose body fat is over 30% and men with over 25% body fat are considered obese. The calculation of body mass index (BMI) has also been used in the defining obesity. Body mass index (BMI) is equal to a person's weight in kilograms divided by their height in meters squared. Since BMI describes body weight in relation to height, it is strongly correlated with total body fat content in adults. On the BMI scale obesity is defined as 30 and above (Obesity, 2009).

Obesity has reached epidemic proportions in the United States over the years. One in three Americans is considered to be overweight or obese. The prevalence of obesity in children has increased dramatically with approximately 20%-25% of children either overweight or obese. Obesity is also increasing rapidly throughout the world, and the incidence of obesity nearly doubled form 1991 to 1998 (Obesity, 2009). About 31%, or about 59 million people, are obese, which is defined as roughly 30 or more pounds over a healthy weight. Almost 65% are either obese or overweight, 10 to 30 pounds over a healthy weight, which increases their chances of developing diabetes, heart disease, some types of cancer and a host of other health problems (U.S. Obesity Rate Rising, 2007).

The balance between calorie intake and the expenditure of energy determines a person's weight. If a person eats more calories than they burn or metabolize, the person will gain weight. If a person eats fewer calories than they metabolizes, they will lose weight. Therefore the most common causes of obesity are overeating and a lack of physical activity (Obesity, 2009).

Watson's theory deals with the caring actions that are taken by nurses as they interact with others. "The values and assumptions that form the basis for the theory of human caring reflect a metaphysical, phenomenological-existential, and spiritual orientation that draws upon Eastern philosophy" (Fawcett, 2002). The values include:

1. deep respect for the wonder and mysteries of life and the power of humans to change

2. high regard and reverence for the spiritual-subjective center of the person with power to grow and change

3. A non-paternalistic approach to helping a person gain more self-knowledge, self-control, and self-healing, regardless of the presenting health-illness condition.

The assumptions part of the theory deal with human life, nursing science, and the process of nursing. Watson's origin of human life is tied to notions that one's soul possesses a body that is not restricted by objective space and time. The lived world of the experiencing person is not well-known by external and internal notions of time and space, but shapes its own time and space. "Nursing is a human science of persons and human health-illness experiences that are mediated by professional, personal, scientific, esthetic, and ethical human care transactions. The process of nursing is human care" (Fawcett, 2002).

The main concept of Watson's theory is transpersonal human caring which is best understood within the concepts of three subsidiary concepts: life, illness and health.

Human life is defined as spiritual, mental and physical being which is continuous in time and space.

Illness is not automatically a disease. Illness is turmoil or disharmony with a person's inner self or soul at some level or disharmony within the spheres of the person, either consciously or unconsciously.

Health refers to the unity and harmony that exists within a person's mind, body, and soul.

Transpersonal human caring and caring transactions are those scientific, professional, ethical, creative and personalized giving-receiving behaviors and responses between nurse and patient that allow for contact between the subjective world of the experiencing persons through physical, mental, or spiritual routes or some combination thereof. The goal of nursing is to help people gain a higher degree of harmony within the mind, body, and soul. This generates self-knowledge, self-reverence, self-healing, and self-care processes while increasing diversity. Nursing interventions or carative factors that are involved include: humanistic-altruistic system of values, faith-hope, sensitivity to self and others, helping and trusting, human care relationships, expressing positive and negative feelings, creative problem-solving caring process, transpersonal teaching and learning, supportive, protective, and/or corrective mental, physical, societal, and spiritual environment, human needs assistance and existential-phenomenological-spiritual forces (Fawcett, 2002).

Using Watson's theory in order to address the problem of obesity it would be necessary for a nurse to look at the patient as a whole. It is necessary to treat a person's mind, body and soul in order to attain success. People who are obese are very vulnerable to the stigmas that society applies to them along with the health issues that arise. It is necessary to not only help these people to control their weight, but they also need help in dealing with the emotional issues that are also involved.