Intervention and evaluation of obesity in Richmond, Virginia

Richmond Virginia

Richmond is the capital of the state of Virginia. Its mild climate has made it attractive to visitors and residents alike, and makes outdoor physical activity pleasurable, as summers are not prohibitively hot and winters are not prohibitively cold. Although Richmond is a city, the state boasts many farms and wide, open spaces.

The city has prospered in recent years: information technology, investment banking, and large corporations such as DuPont and Kraft foods have established a base in the city.

Richmond, Virginia has a strong profile in the field of healthcare: Eighteen general and specialized hospitals employ 2,000 physicians in the area.

Although it was once part of the Confederacy, contemporary Richmond is extremely diverse.

The ethnic, demographic breakdown of the city (2000) is as follows

White: 75,744

Black or African-American: 113,108

American Indian or Alaska Native: 479

Asian: 2,471

Native Hawaiian or Other Pacific Islander: 157

Hispanic or Latino: 5,074

Source: Richmond. (2010). City Data. Retrieved February 12, 2010 at http://www.city-data.com/us-cities/the-South/Richmond.html

Obesity rate

In 2008, Virginia ranked 20th lowest in the country in terms of its obesity rate.

Lowering the childhood obesity rate has been a priority for the state and met with relative success, compared with other states in the region.

The 2007 National Survey of Children's Health found that 31% of Virginia's 10-to-17-year-olds were overweight or obese, an increase since 2003 of 1%. While a reduction would have been ideal, this figure still puts Virginia just under the national average of 31.6%. The state is 23rd highest in the country in terms of its percentage of overweight or obese children.

Trust for America's Health conducted a study of state and federal government actions in public schools. Virginia met three of its eight Obesity-Related Standards in School. Virginia requires physical education, health education, and supports farm-to-school programs where fresh local produce is directly supplied to many schools.

However, Virginia school lunches overall do not exceed the minimum USDA requirements. Corporate or processed foods with low nutritional density are still available through vending machines or in other ways on school grounds. There is still easy access to such foods within or near too many schools. There is a lack of collection of BMI and student-related health information, and a lack of screening students for diabetes.

Source: Obesity. (2009, August 4). Council on Virginia's Future. Virginia.gov. Retrieved February 12, 2010 at http://vaperforms.virginia.gov/indicators/healthFamily/obesity.php

Risk factors, barriers, and goals

Risk factors: An overly tolerant attitude towards 'corporatized food'

A lack of health data on students

Barriers: Many schools allow vending machines or use corporate 'junk food' to fund school activities

There is parental resistance to tracking student BMI for fear of embarrassing children

Goals: Reduce obesity amongst children

Continue to increase physical activity amongst students, using the resources of Virginia's natural environment

Use the resources of healthcare providers in the area to conduct educational and intervention campaigns

Try to mobilize student support to increase healthy food in schools and reduce the presence of junk food in vending machines, cafeterias, and for school fundraisers

Improve tracking of student health data

Interventions

Reduce the presence of corporatized food: In line with the Dorothea Orem's Theory of Self-Care, a healthy environment must be created for the student body, with the student body's collective consent. Healthy food cannot be imposed from the top down, or students will see junk food as 'forbidden fruit.' Students must be solicited for their input in creating new cafeteria menus. They can work to formulate substitutions for traditional fundraisers like on-premises vending machines and selling candy bars. Staging a 'recipe contest' for different healthy recipes city-wide, with rewards for the school of the winner, might be one way to show students that eating healthier is a struggle they must engage in, alongside adults. Students must be encouraged to engage in healthy eating and weight loss strategies to facilitate their own health or they will use junk food and circumventing PE classes as a means of rebellion.

Source: Bruce, Emily. (2010) Dorothea Orem's Theory of Self-Care. PowerPoint. Retrieved February 12, 2010 at www.nipissingu.ca/faculty/arohap/.../DorotheaOremTheory.pp

Increase data about students: Parents naturally fear that keeping track of students' BMI and screening children for diabetes will stigmatize their sons and daughters. Parents must be encouraged to see this data-tracking program as wellness promotion. Ideally, the parent should be included in the process of assembling data to ensure that the data is not used against the student, but as a method of health promotion and caring.