Childhood obesity and diabetes: a community health assessment in Pueblo, Colorado

Obesity and Diabetes: A Community Health Problem

Many people do not consider obesity to be a deadly non-communicable disease -- and yet research shows that obesity is one of the main causes of death in American communities, and it is growing (Tabish, 2007). The community chosen for this paper is a typical, demographically diverse suburban Middle America community: the city is Pueblo, Colorado. The vulnerable population chosen here is the community's children. Children are especially vulnerable to the risk of obesity and by extension diabetes. This paper will review why this is so and what a community health nurse can do to help address the issue. The purpose of this paper will be to identify strengths, risks and barriers associated with this population's vulnerability to obesity and diabetes and what can be done to actively combat this problem.

Vulnerable Population Overview

Diabetes is a growing threat to communities around the world (Tabish, 2007). One population that is particularly vulnerable to diabetes, however, is children. Indeed, as Goran, Ball and Cruz (2009) point out, "obesity continues to increase in children and adolescents, and annual obesity-related hospital costs in 6- to 17-year-olds have reached $127 million per year" (p. 1417). Obesity and diet has been linked to diabetes by various researchers (Davis, 2008; Cunninham-Myrie et al., 2015), so this startling statistic regarding overweight children is an indication that the child population in America is vulnerable to the community health problem that is diabetes. In the Middle America suburban community, children are at risk of becoming obese and developing diabetes, as they do not have good exercises habits, good dietary habits, and do not play outdoors as much as children used to thanks to the increase in digital technology, video gaming, computer usage, and feeling of a lack of safety in neighborhoods in the community (Cunningham-Myrie, et al., 2015).

Observations from the windshield survey of this population indicate that children in this community do not frequent parks or playgrounds; very seldom is one seen riding a bicycle; very seldom are children seen playing in an outdoor sports activity. Sometimes a handful of children can be seen playing basketball but there is never an overwhelming number of children doing so at any one given time. Children in most cases when they are seen do show visible signs of being overweight. Economic conditions in the community have worsened over the years, which has allowed many neighborhoods in the community to show signs of wear and tear; up-keep is not as common as it once was, and many homes look unkempt. This gives neighborhoods the appearance of inviting crime and vandalism, according to Broken Windows Theory -- and as a result children are less likely to be active outdoors, according to the study by Cunningham-Myrie et al. (2015).

Strengths, Risk Factors, and/or Barriers

The strengths of this population are that they are still young and can have new and better habits ingrained into them over time through the right course of action -- namely education about how to take care of their bodies through exercise and diet (Davis, 2008). The best way to do this is to address these issues in schools in the community. Children can see how a good diet and a healthy amount of exercise can keep them from becoming obese and being put at risk for diabetes. The study by Cunningham-Myrie et al. (2015) was chosen for this portion of the paper because it sheds light on how a community environment can impact a child's health specifically as it relates to obesity and diabetes. The study is entitled "Associations between neighborhood effects and physical activity, obesity, and diabetes" and it examines how poverty, crime, and a lack of safety can negatively impact the child's health by reducing his or her tendency to want to participate in outdoors activities. The study shows that in neighborhoods that are economically depressed, there is a greater tendency for children to be obese: their food options are geared more towards unhealthy diets and their outdoor activity options are scant. The study is helpful in highlighting the role that the built environment plays in the health of children.

Community Health Problem Diagnosis

As Healthy People 2020 shows, diabetes (Topic Number 8) is a serious issues that need to be addressed. One priority community health problem that a community health nurse could positively impact, therefore, is to raise awareness about the relationship between community environments, safety, obesity and diabetes -- as everything is connected and poor upkeep at the one end can lead to a chain reaction that impacts children's health at the other. By making neighborhoods safer and more inviting, children can feel safer and families can do more to promote outdoor activity and get children exercising. One objective for Healthy People 2020 as it relates to diabetes and children is: "Reduce the annual number of new cases of diagnosed diabetes in the population" (Health People 2020, 2016).

Summary

In summation, the main points to remember are that obesity and diabetes are real issues affecting children (Tabish, 2007; Goran et al., 2009; Cunningham-Myrie et al., 2015). The community of Pueblo, Colorado, is in need of intervention to help introduce the child population to healthy diets through education and to active and safe exercise through programs like the YMCA. The risk that children in Pueblo face is that because of a poor and unsafe neighborhood environment they are not able to take proper physical care of themselves. The community needs to address this issue by attending to its environmental needs as well as to the educational (both intellectual and physical) training of its children.