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Wexford County Assessment Kim Fulmerhouser Erica Gamble Rachel Hodges Desirae Naessens Derek Sibley Jana Snider Stephanie Twait Ferris State University

WEXFORD COUNTY ASSESSMENT Wexford County Assessment In the United States, health care costs are continuously increasing and so are the rates of obesity. The new US Affordable Care Act has hopes of reducing health disparities and

promoting health by utilizing community health nursing (Krantz, 2013, 19).Obesity is defined as a BMI of 30 or greater (Harkness, 2012, 99); in 2009-2010 35.7% of American adults were obese and 16.9% of children and adolescents were obese (Ogden, 2012, 1-2). Obesity is a contributing factor to a plethora of additional health problems, including 4 of the top ten leading causes of death: stroke, type 2 diabetes, heart disease and some types of cancer (Harkness, 2012, 99). Obesity is on the rise in Michigan and in order to begin decreasing the rate of obesity we must start on a small scale. Community based nursing focuses on promoting and maintaining health of a specific community (Harkness, 2012, 3), for example Wexford County located in Michigan. As with all counties, strengths and weaknesses can be found in many different categories. Wexford County has many different strengths. One strength attributed to this county is the rate for receiving vaccinations. Children of all ages, here, have a higher rate of receiving them, than in Michigans totals. Also, 6.2% of people in Wexford have no healthcare provider as compared to Michigans 13.2% of all people (Wexford, 2011, 5). Wexford County has areas of weakness as well. In 2011 Wexford County had an obesity rate of 37% compared to Michigans overall obesity rate of 35.6% (Edwald, 2011, 20). There are many possible causative factors leading to the incidence of obesity in Wexford County. Possible contributing factors include the fact that 80% of Wexford citizens report having an inadequate intake of fruits and vegetables (compared to Michigans 78%) (Wexford, 2011,

WEXFORD COUNTY ASSESSMENT 26). We also discovered a poverty level of 17% of those living in Wexford (compared to Michigans 14%) (Wexford, 2011, 9).Typically, the cheapest foods are the ones that make you fatter and when you are in a poverty stricken area, cheap foods may be all the community can access (Wagenvoord, 2004, 34). Finally, a reported 27% of people in this county report not exercising as compared to Michigans 23 % (Wexford, 2011, 27). Our main focus in reducing obesity is to decrease negative health behaviors and provide citizens with the positive outcomes that may result in a change in behavior. A model that demonstrates this is the Health Belief Model. The model was designed to provide insight into why people behave in certain ways regarding health matters by examining factors that affect the process of decision making (OConnell, 1985, 344). This model demonstrates ways that we

could address the community by providing citizens with possible benefits when health initiatives are taken. The health belief model can also help us determine what barriers are affecting Wexfords citizens from taking actions to achieve and maintain their health. In our assessment of Wexford County we came across many resources that promote unhealthy behaviors. For example there are 30 fast food chains in Wexford (Find The Data, 2013). There are health and fitness clubs located in the city of Cadillac but for people lacking transportation, living in poverty or rural areas, being a member of these clubs is not realistic. In order to promote a healthy lifestyle to all people in Wexford County, we need to be able to connect with people of all different cultures, social and economic classes. Promoting healthy lifestyles in large employers like Mercy Hospital in Cadillac, or Four Winns, as well is faith based organizations, and local school districts would help reach a wide variety of people in the county. We arent solely focusing on one age group or one major employer/school, more

WEXFORD COUNTY ASSESSMENT trying to address as many people in this community as possible. There have already been health initiatives attempted in Wexford County, for example the Live Well campaign that promoted a healthy lifestyle competition between Wexford, Manistee and Newaygo County. Of the three counties, Wexford lost the least amount of weight collectively (2013). In order to make a positive and successful impact with reducing obesity in Wexford County, we first created a community based diagnosis: Risk for obesity among all persons in Wexford County related to poverty, inadequate nutrition, and a lack of exercise as demonstrated by an increase of 7% in obesity between 2008 and 2011. After a complete assessment and the

creation of our diagnosis, we then created interventions. These interventions weve came up with for Wexford aim to reach as many citizens of this community as possible, in many different settings and ways. Ultimately, these interventions will help to reduce the prevalence of obesity in Wexford County in the years to come.

WEXFORD COUNTY ASSESSMENT References Edwald, D. (2011). Community health needs assessment wexford/missaukee counties[PDF Document]. Retrieved from Munson Healthcare Online Harkness, G. &DeMarco, R. (2012).Community and public health nursing: Evidence for practice. Philadelphia, PA: Lippincott Williams & Wilkins Find The Data. (2013). Obesity rates & fast food consumption by county [Data Set]. Retrieved from Krants, M., Coronel, S., Whitley, E., Dale, R., Yost, J., & Estacio, R. (2013).Effectiveness of a community health worker cardiovascular risk reduction program in public health and health care settings.American Journal of Public Health, 103(1), e19-e27.

OConnell, J.K., Price, J. H., Roberts, S. M., Jurs, S.G., McKinley, R.(1985) "Utilizing the health belief model to predict dieting and exercising behavior of obese and nonobese adolescents" Health Education and BehaviorJournal. 12(4), 343-51. Ogden, C. L., Carroll, M. D., Kit, B. K., Flegal, K. M. (2012). Prevalence of obesity in the United States, 2009-2010 [Data Set]. Retrieved from Wagenvoord, H. (2004). The cheapest calories make you the fattest. Sierra, 89(5), 34-35. Wexford County. (2011). Health Profile Chartbook 2011.Retrieved from Adobe Reader

WEXFORD COUNTY ASSESSMENT Document. (2013). Live well expo launches campaign in wexford county. Live Well. Retrieved from