Health Advocacy Campaign on Obesity and Hypertension in West Virginia

Introduction

Health advocacy takes into account direct service to a person or household as a whole, in addition to activities that facilitate the promotion of health and accessibility to healthcare among communities and the broader general public. Joining together science, ethics, and politics, advocacy is self-initiated, evidence-based, deliberate action that health professionals can undertake to aid in the transformation of systems and improve the environments and policies that shape their patients' behaviors and choices — and, ultimately, their health. It helps guarantee access to care, direct the system, mobilize resources, address health disparities, influence health policy, and generate systemic change (Hubinette et al., 2017).

Provision 7 of the ANA Code of Ethics states that nurses, in all of their professional roles and settings, advance the profession through research, scholarly inquiry, professional standards development, and the creation of both nursing and health policy. Provision 8 asserts that the nurse works in tandem with other health professionals and the general public to safeguard human rights, promote health diplomacy, and reduce health disparities. Provision 9 asserts that the nursing profession, collectively through its professional entities, must communicate nursing values, sustain the integrity of the profession, and integrate principles of social justice into nursing and health policy (American Nurses Association, 2016). The main objective of this paper is to develop a health advocacy campaign addressing obesity and hypertension among adults in the state of West Virginia.

Obesity is a mounting global health concern, with a rapidly increasing prevalence of morbid obesity being observed worldwide. Obesity is linked to heightened cardiovascular risk and early onset of cardiovascular morbidity. The escalating obesity epidemic is a major source of unsustainable health expenditures and morbidity, as well as mortality owing to hypertension, type 2 diabetes mellitus, dyslipidemia, certain cancers, and severe cardiovascular diseases. Chriqui (2013) asserts that if current trends in obesity continue, annual medical expenses attributable to the condition could increase by approximately $48 to $66 billion per year by 2030.

Population Health Issue: Hypertension and Obesity

Similarly, hypertension is a major adverse health metric with serious health consequences. At present, hypertension is the leading contributing factor to global disease burden, and the direct and indirect costs of its treatment are exponentially high (Leggio et al., 2017). Obesity and hypertension are closely associated: statistics indicate that approximately 58 to 65 million adults in the United States suffer from hypertension, and the proportion of individuals with obesity continues to rise. According to the World Health Organization (WHO), globally there are 2.3 billion adults who are overweight and more than 700 million who are obese (Jiang et al., 2016).

According to Chriqui (2013), obesity is a complex issue requiring large-scale, population-centered solutions. Public policy approaches are pivotal tools in obesity prevention and reduction efforts, as they can benefit all parties involved rather than simply altering the behavior of one individual at a time. Increasingly, the public health community is advocating for a systems-based approach to obesity prevention that identifies the policy, environmental, and individual-level factors that influence behavior and outcomes.

Rates of obesity and overweight among children and adults in the United States have risen more than threefold over the past 30 years. West Virginia has a population of more than 1.8 million people. According to data from the Behavioral Risk Factor Surveillance System (BRFSS), the rate of obesity among adults in the United States currently exceeds 35 percent in 7 states, 30 percent in 29 states, and 25 percent in 48 states. Specifically, the state of West Virginia currently has the highest rate of obesity in the nation, at 38.1 percent (State of Obesity, 2018).

Target Population: Obesity and Adults in West Virginia

The obesity prevalence in West Virginia has been consistently higher than the national average since state-level monitoring began through the CDC's Behavioral Risk Factor Surveillance System (BRFSS). In 1990, the West Virginia adult obesity rate was 15 percent, compared to a national rate of 11.6 percent. A decade later, the state rate was 23.2 percent compared to the national rate of 20.1 percent. Obesity rates have increased in nearly all of West Virginia's 55 counties over the past 17 years, with the highest prevalence found in the southern and western regions of the state, as well as in the Eastern Panhandle (State of Obesity, 2018).

Overweight is defined as having a Body Mass Index (BMI), or weight-to-height ratio, greater than or equal to 25 and less than 30, whereas obesity is defined as having a BMI equal to or greater than 30. Approximately 13 percent of the global overweight and obese population resides in the United States. About 160 million Americans are either overweight or obese. Approximately 75 percent of males and more than 60 percent of females in the United States are overweight or obese, and roughly 30 percent of boys and girls under the age of 20 are either overweight or obese (Murray, Ng, & Mokdad, 2018). The highest prevalence of obesity and overweight among adults was found in men aged 50 to 54 at 80 percent, and women aged 60 to 64 at 73 percent. Among Americans under the age of 20, the highest prevalence was found in children aged 10 to 14, with boys at 38 percent and girls at 37 percent (Murray et al., 2018).