Community Health Nursing: Epidemiology

The World Health Organization, define Health promotion as “the process of enabling people to increase control over, and to improve, their health. It moves beyond a focus on individual behavior towards a wide range of social and environmental interventions”. (www. WHO). Healthful diet and maintenance of physical activity promote and reduce the progress of chronic diseases and preserve functionality in elders. Everyone must pursue a good health or ideal health.

To achieve that, the individual or population must take into reflection individual characteristics and experiences, to determine the best methods to attain the best health and better quality of life. In 2008, the annual healthcare cost of obesity in the US was estimated to be as high as 147 billion dollars a year (Finkelstein 2009). Orange County Description Orange County is situated in Central Florida, is one of the biggest and longest developing urban areas in the State of Florida. The County covers 1,004 square miles, 13 municipalities, over 40 unincorporated areas.

Orange County is a county located in the U. S. State of Florida. It is the center of the Orlando-Kissimmee-Sanford Metropolitan Statistical Area. We have warm dry summers and mild winters with relatively rainfall averages of 7-10 inches. Air quality in Orange County is graded as good. According to Orange County drinking water report in 2012, drinking water is good. In 2010, the county had a population of 1,145,956 ( U. S Department of Commerce: Census Bureau). Orange County’s population has increased near 190,000 people or 21. 2 %.

This rate exceeds the 16. 2% expansion- rate for Florida. Over the past ten years, there was great city boost that reduced some of Orange County’s rural population. Today, Orange County has approximately 97% urban and 3% rural. Birth rate per 1000 people from 2000-2006 was 15. 6. Death rate per 1000 people from 2000-2006 was 6. 7. There are about 1,246 people per square mile in the urban area. The median age is 33. 3 years old. Orange County population is predominantly white with 49. 75%, followed by Hispanics with 27% and Black with 21. % and 4. 3% Asian. The median household income in 2013 is $40,970 (www. cflhealthymeausres). In 2013, 33,975 families below poverty level(www. cfl),25,326 families below poverty with children. 18. 5% of households lives in poverty, 25. 8% under 18 lives in poverty. In March 2013, unemployment is 6. 6%. Crime rate in 2012 was 7. 4%. 86. 9% persons aged 25 and older have a HS diploma, 30% have a bachelor degree or higher. 17. 5% uninsured in population between 18-64 years old, 11. 9% household with children lack of medical insurance.

Although Orange County is generally a healthy community, improvements must be made to encourage the elderly to become active to prevent progression of chronic diseases to maintain functionality. Improvement includes educating the elderly on improving physical activity which will decrease obesity, improve cardiovascular functions, and overall decrease progression of chronic diseases. Genogram Interpretation of the Community Community health assessment is aimed at depicting the health of the community, by revealing information about the health status, community health needs, resources, and epidemiologic issues of the population.

According to the genogram, the leading health issues in Orange County, are consequence from a number of reasons, which can be modified or controlled. Harmful personals behaviors such as overeating, smoking, deficient nutrition, lack of physical activity, substance abuse and unsafe sexual activity have a huge impact on individuals health. Economic, language and cultural issues are barriers to access and use of medical and preventive care. Income and unemployment are social factors that impact or limit the access to health services.

Uncontrolled factors such as inherited health conditions or increased vulnerability to disease has an influence on individual health. Based on U. S Census, Orange County population consists of 70% Whites, 27. 5% Hispanics, Of thes21. 7% Black/Afro American. Of these populations 33,975 families live below poverty level. Based on the Orange County Health Profile (2012), the leading cause of death in Orange County is Cancer and cardiovascular diseases. Overall obesity in Orange County is 27. 8%, 40. 1% Blacks, 27. 8%Hispanics and 27% Whites. In those 65 years and older 20. % have diabetes. Latest information reports there is considerable differences in the incidence of obesity by race/ethnicity. Efforts are being made to reduce these disparities by focusing interventions on subgroups with high prevalence of obesity.

The U. S Department of Commerce, estimates that Orange County is one of the fasting growing in the State of Florida. In 2010, the county had a population of 1,145,956 ( U. S Department of Commerce: Census Bureau). Orange County’s population has increased near 190,000 people or 21. 2 %. This rate exceeds the 16. % expansion rate for Florida. Community Diagnosis Obesity is one of the causes of many chronic disease. Obesity causes functional impairment, reduced quality of life, resulting in higher mortality. Successful management generates several gains including, disease prevention and decreased mortality.

Based on research performed by (Villareal, Patterson, Polonsky, and Klein, 2008), obesity and aging augment the risk of type 2 diabetes. They evaluated whether weight loss therapy improves pancreatic endocrine function and insulin sensitivity in obese older adult. Villareal et al. 2008 support that pancreatic endocrine function worsen with age and contributes to impaired glucose in obese older adults. The outcomes from this study reveal that lifestyle therapy (i. e. , diet-induced weight loss and increased physical activity) enhance both pancreatic β-cell, α-cell function, and plasma insulin clearance in insulin-resistant obese older adults. Therefore, moderate diet-induced weight loss in conjunction with regular physical activity, can ameliorate aging- and obesity-associated deterioration in pancreatic endocrine function in obese older adults who are at increased risk for type II diabetes.

Providing education for this population will help decrease the incidence of obesity, education on primary prevention will focus on teaching this population proper dietary and health habits to prevent obesity, Secondary prevention focuses on educating the population to adhere to medication regimen and dietary habits to prevent complications such as diabetes, cardiovascular disease, and high cholesterol that are associated with obesity.

Tertiary prevention focuses on educating these individuals on interventions such as rehab, keeping doctor’s appointments, and adhering to strict dietary and physical activities, These interventions will assist these individuals to maintain the highest level of functioning and prevent reoccurence and deterioration of the disease processes. Cultural Assessment According to the US Census Bureau (2010), 49. 5% males and 50. 5% females over the past decade.

Orange County is predominantly Catholics with 33%. General health status score of residents in this county from 1 (poor) to 5 (excellent) is 3. 5. Average weight of males is 190 pounds, weight of females is 154 pounds. Obesity among adults is 27. 8 % The two leading causes among Orange county population are cancer, 1576 deaths and heart disease with 1,481 deaths, 12 murders related to domestic violence. (FDLE crime report 1995-2012).

Unintentional drug overdoses have been rising at a frightening rate in Orange County this past ten years: Coroner report confirms early look an increase from 130 such deaths in 2003 to 226 in 2009, it appear that in 2010 the death toll point out at least 240 deadly overdoses, until final toxicological results are reveled. Between 2009-2010 104 newborns were treated for drug withdrawal. From 2009-2011, 869 cases of HIV infections were reported (Florida Department of Health. Bureau HIV). Orange County is currently seeing a rise in deaths among people with Diabetes in contrast with a decline in the state of Florida.

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