Health Education Plan for Rural Older Adults in North Dakota

Introduction

Populations in rural areas grapple with poorer health outcomes due to challenges such as greater resource constraints and shortages of health care personnel and facilities, with vulnerable populations being the most affected. This is particularly true for rural populations in North Dakota (Molmen et al., 2013). Constituting a substantial portion of the overall state population, older adults (aged 65 and above) in rural areas are particularly affected by the troubling health care situation in the state, especially in terms of smoking, alcohol consumption, and obesity. Education provides a valuable tool through which the behavioral health of older adults in rural North Dakota can be addressed. This paper presents an educational plan for reducing the prevalence of smoking, alcohol consumption, and obesity in older adults in rural North Dakota. The plan describes the demographic characteristics of the community, the health care needs of older adults in the community, the role of education in addressing those needs, and strategies for implementing the educational intervention.

Target Population, Demographic Characteristics, and Health Care Needs

Older adults in rural North Dakota are the target population for this plan. North Dakota as a whole has a population of approximately 673,000 people (51% male and 49% female; 90% white and 5% Native American) as of 2010 (Molmen et al., 2013). The state is one of the least densely populated in the U.S. Approximately 52% of the state's population resides in rural areas — defined as areas with fewer than 50,000 people. More specifically, 29% live in rural areas with fewer than 10,000 people (Molmen et al., 2013). Rural areas in North Dakota are characterized by a higher incidence of poverty and lower health care coverage compared to urban areas and much of the rest of the country. In 2009, the poverty rate in rural areas stood at 14% (compared to 12% in urban areas), while the proportion of the uninsured population was 10.1% (compared to 8.9% in urban areas) (Molmen et al., 2013).

Rural North Dakota has historically experienced an acute shortage of primary health care providers as well as an uneven distribution of health care facilities (Molmen et al., 2013). The majority of providers and facilities in the state are located in urban areas. This explains the poor health outcomes exhibited by North Dakotans compared to the rest of the country, especially with respect to obesity, smoking, and drinking. The population most affected is the rural population, which is largely characterized by older, poorer people with little or no insurance coverage. North Dakota is home to one of the highest proportions of senior citizens in the U.S. Statistics indicate that 11.8% of adults over 65 years in rural areas in North Dakota smoke (Molmen et al., 2013). Within the same population, prevalence rates of 42.8% and 67.9% are reported for alcohol consumption and obesity, respectively (Molmen et al., 2013).

The prevalence of behavioral risk among older adults in rural North Dakota is quite concerning. This is particularly significant given the increasingly aging population of the state (Molmen et al., 2013). More fundamentally, smoking, alcohol consumption, and obesity are vital risk factors for chronic conditions such as diabetes, cancer, and heart disease in older adults (Kwon et al., 2016). As the prevalence of smoking, alcohol consumption, and obesity increases, the risk of chronic disease increases as well. Chronic disease can significantly reduce quality of life and increase the risk of mortality (Kampmeijer et al., 2016). This underscores the importance of improving the behavioral health of older adults in rural North Dakota.

Conclusion

Overall, older adults in rural North Dakota exhibit higher smoking, alcohol consumption, and obesity rates compared to their counterparts in urban areas as well as the majority of the rest of the country. This challenge is further compounded by the scarcity of health care facilities, poverty, and lack of health care coverage in the state. Education provides a powerful tool through which the behavioral health of older adults in rural North Dakota can be promoted. Through printed media, coupled with face-to-face communication and telephone or text follow-up, community nurses can encourage older adults to avoid smoking, consuming alcohol, and eating unhealthy diets. The importance of addressing behavioral health in older adults is underscored by the state's increasing aging population. Inadequate knowledge of behavioral risks means that more senior adults will remain at risk of chronic disease, with those who are poor or living in rural areas being the most affected. This can be reversed through education.