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Running head: COMMUNITY

Community Assessment and Diagnosis

Hosnatul Ferdous
Athabasca University
Instructor: Yvonne Moore
NURS 434


Community Assessment and Diagnosis

According to Centers for Disease Control and Prevention (CDC) (2015), a community
health assessment (CHA) refers to a state, tribal, local, or territorial health assessment that
identifies key health needs and issues through systematic, comprehensive data collection and
analysis (para 1). The main purpose of the community health assessment is to identify the
positive and negative factors that have a huge impact on the health of the people and to develop
strategies for community health promotion (Vollman, Anderson, & McFarlane, 2012). In this
paper, I will conduct a partial community health assessment by using the Population Health
Promotion model. I will identify and provide rationale for the selected aggregate, provide
rationale for selecting the assessment model, present and complete an analysis of the assessment
data of the aggregate, and identify and provide rational for the community diagnosis based on the
Identifying Aggregate
Stamler and Yiu (2012) define aggregate as a group of people who share common
interests, demographics, cultural heritages, and socioeconomics and education levels. For this
assignment, I have chosen the overweight or obese children or adolescents. CDC (2015), defines
overweight as a BMI above the 85th percentile and below the 95th percentile, and obesity as a
BMI greater than or equal to the 95th percentile for children and teens of the same age and sex.
In Canada, the rate of obesity was 26% in 2004/2005 among children between 2 to 17 years of
age (Shields, 2006, as cited in Kuhle, 2013). The rate of overweight or obesity is somewhat more
common in boys than in girls (27 vs 25%), but in the recent year, the rate has been the same in
both sexes (Shields, 2006, as cited in Kuhle, 2013).The rate of overweight or obesity also varies


in different ethnic groups; 41% off-reserved aboriginal children are overweight or obese whereas
18% of Southeast Asian or East Asian children are overweight or obese (Shields, 2006, as cited
in Kuhle, 2013). Overweight or obesity rate is more among children from middle class families
than that of low income families (28% vs 25% in 2004/2005) ((Shields, 2006, as cited in Kuhle,
Nearly one third of children in Canada is considered have overweight or obesity
(Roberts et al., 2012, as cited in Kuhle, Doucette, Piccinini-Vallis, & Kirk, 2015). According to
WHO (2000), it is the greatest threat to public health in developed countries (as cited in Kuhle,
2013). Obesity has also been linked to serious health concerns including shorter life spans,
increased health care costs, and increased risk of certain illnesses such as diabetes and heart
disease. According to the Children Obesity Foundation (2015), in the recent decades, childhood
overweight or obesity has been increasing steadily in Canada. The statistics show that children
between the ages of two to 17 are mostly affected; among them, the rate of overweight and
obesity is almost double (from 14 percent to 29 percent) among youth, aged 12 to 17 years
(Public Health Agency of Canada, 2012, as cited in Children Obesity Foundation, 2015). There
are multiple causal factors, such as readily available poor-nutrient food (fast food), costs of
healthy food, and sedentary lifestyles, are associated with obesity, so an alteration of a single
factor by individual approach is not enough to address the issue; a combination of lifestyle and
behavioural modification is the key factor (Kuhle, Doucette, Piccinini-Vallis, & Kirk, 2015).
Without an early intervention, obese children are more likely to become obese adults; therefore,
it is important for health care providers to recognize, treat, and prevent obesity in children and
adolescents before obesity-related complications become severe and debilitating (Faguy, 2016,


Identifying Assessment Model

The Population Health Promotion model has been used for the community assessment. The goal
of the model is to promote health and improve sustainable health outcome of the community
by incorporating determinants of health, health promotion strategies, and primary healthcare
principles (Stamler & Yiu, 2012, p.215).
Rationale for Selected Assessment Model
The model is ideally used for assessing, planning, intervening, and evaluating the health of the
community (Stamler & Yiu, 2012). According to Registered Nurses Association of Ontario
(RNAO), the childhood or adolescent obesity is strongly related to the determinants of health
including socioeconomic status (poverty), Obesogenic environmental conditions (lack of
resources for physical activity or healthy eating), and individual-level conditions (biologic
influence) (2014).
Assessment Based on Determinants of Health
Socioeconomic Status
Children living in a lower socioeconomic status are more prone to develop overweight or
obesity. According to the Canada Community Health Survey (carried out by Statistics Canada)
(2006), the obesity rate is 37.8% higher in children living in a low income family compared to
6.2% in high income. The obesity rate is 10.5% higher in the children whose parents havent
completed high school than the children whose parents have completed high school (1.3%) (as
cited in Burton & Phipps, 2009).


To be healthy, it is important to eat more fruits and vegetables and be involved in

different physical activities; however, eating healthy as well as being physically active is less
affordable for a low income family (Burton & Phipps, 2009). The cost of high calorie food such
as pop, chips, and other high calorie snacks is more than the nutrient dense healthy food such as
fresh fruits and vegetables (Taylor, 2010). Taylor (2010) also noted that being physically active is
expensive. Often, low income families find it difficult to be involved in physical activities like
swimming, playing hockey, skating, or dancing; moreover, the lower-income neighbourhood
may not have enough parks and recreating facilities and may not be safe for their users (Oliver &
Hayes, 2005, as cited in Burton & Phipps, 2009).
Environmental Conditions
The environmental condition that is related to obesity includes food services in school
cafeteria and/or vending machines and playgrounds and recreational facilities in schools and
neighbourhoods where children can meet their daily physical activity requirement (RNAO,
2014). Promoting physical activities in school along with healthy food environment can enhance
childrens health and healthy weight gain (RNAO, 2014). According to the Obesity Canada
Clinical Practice Guidelines Expert Panels (2006) recommendation, to ensure a healthy physical
environment for children, it is important to assess the physical education programs offered by
schools along with their availability to the students and the quality and safety of the playground
and recreational facility (as cited in RNAO, 2014). In many communities, lack of a safe walking
or biking route to schools maybe a hindering factor for childrens healthy weight (CDC, 2012).
Along with the physical environment, RNAO (2014) also recommends an assessment of
a schools food environment to promote the health of the children; the healthy food environment
includes promoting Eating Well With Canadas Food Guide in school cafeterias or canteen to


determine options for healthy food choices and age appropriate serving size. The healthy food
environment also includes the community's accessibility and affordability of healthy food such as
fresh fruits and vegetables (Karnik, & Kanekar, 2012).
Individual-level Condition (Behavioral Factors)
Some behavioral factors including not performing regular physical activity and
consuming high calorie food can also play a major role in developing childhood overweight or
obesity; in other words, weight gain is common when the energy consumption is more than its
expenditure (Karnik & Kanekar, 2012) . Children with sedentary lifestyle are more prone to
develop overweight or obesity. The sedentary lifestyle includes watching television, playing
video games, and/or working/studying on computers (Karnik & Kanekar, 2012)).
Analysis of community assessment

There are 15 schools under the Grande Prairie Public School District (2016) and 15
schools under the Grande Prairie Catholic School District (2016). Among them, three
catholic schools, St. Clement, St. Patrick and St. Joseph High School, and two public
schools, Avondale and Hillside, have started the Grande Prairie Schools Snack Program
(GPSSP) where the students are provided healthy morning breakfast, fresh fruit
midmorning snack, and a nutritious emergency bag lunch (Huffman, 2015). The goal of
the program is to alleviate hunger and educate children about healthy lifestyle choices
(GPCSD, 2016, para 1). According to CDC (2015), students who eat school lunches
consume healthier food than those who dont; school lunch serves lunch lower in

unsaturated fats and salt and more fruits, vegetables, milk, and fibres.
There are some organizations in the city of Grande Prairie that facilitate health and wellbeing of children and youth in the community:


Be fit for life; Ever active schools; Alberta Health Services-health promotion
coordinators; Health and physical education council-regional representatives; Active for
life; Alberta healthy school community wellness fund; Healthy Alberta; ParticipAction-

get moving get living; Alberta active living partners (GPRC, 2016).
Children and adolescents should do at least 1 hour (60 minutes) or more of physical
activity each day. According to the stats, some 93% of parents are not ensuring their kids
get off the couch for at least 60 minutes a day. There are tons of activities that cost

nothing but your time and perhaps a little energy. (Rinne, 2012).
Average Family Income (2011 Census): $106,993 (City of Grande Prairie, 2016)
Unemployment Rate (May 2016): 7.8% (City of Grande Prairie, 2016)
The City of Grande Prairie has more than 600 acres of park areas that are operated and

maintained by parks operations (City of Grande Prairie, 2016).

According to Public Interest Alberta (2011), 63% of workers (>20 years of age) in
Grande Prairie are earning less than $12/hour and are trying to pursue the post-secondary
education to support their family (as cited in Haener, 2013).

Community Health Diagnosis

Risk of developing overweight or obesity in children or adolescents (2 to 17 years)
related to lack of healthy eating environment in schools is evidenced by only five out of 30
schools that are running the school snack program.
I came up with a deficit community diagnosis based on my assessment. The school snack
program facilitates the healthy eating environment for children by serving nutrient rich, low
calorie food; it also follows recommended dietary guidelines to reduce the risk of developing
overweight or obesity; on the other hand, school cafeteria or vending machine often serves food


high in calories, sugar, and fat (CDC, 2009). Therefore, having limited school snack programs
can be a risk factor for overweight or obesity.
Community health assessment is an important tool to facilitate health promotion of a
community. In this paper, I have selected overweight or obese children or adolescent as
aggregate because in Canada, the rate of obesity is increasing day by day. I have used the
Community Health Promotion Model and selected three health determinants to carry out the
assessment. The determinants include socioeconomic factor, environmental factor, and
behavioral factor. After analyzing the assessment data, I have made a deficit diagnosis which will
help me determine goals and interventions to promote the health of the community.



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