Paradoxical Case of Poverty and Obesity – Population Disparities Essay

Paradoxical Case of Poverty and Obesity – Population Disparities Essay

The Population Disparities Regarding Obesity in Duval County, Florida and A Social Media Campaign to Mitigate it: The Paradoxical Case of Poverty and Obesity.

 (B) Community Health Nursing Diagnosis Statement

The nursing diagnosis for this paper is the increased risk of obesity among adults in Duval County. This is related to, amongst other reasons, low physical activity and an insufficient intake of fruits and vegetables. The evidence for this is demonstrated by the above average Body Mass Index (BMI) rates in Duval County and Florida in general. The BMI being a ratio, a BMI of up to 25 is considered to be normal. A figure of between 25 and 30 is however regarded as overweight. While a ratio of above 30 is obesity. Figures from recent surveys show that obesity is on the rise in the United States of America. Many American citizens are afflicted by this public health scourge that appears to be a result of lifestyle habits coupled with socio-economic status. Paradoxical Case of Poverty and Obesity – Population Disparities Essay

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(B1) Health Inequity/Disparity

According to Braveman (2014), health disparity can be defined as a difference in the health data between two sets of population demographics that can only be explained by socio-economic differences or other similar social barometers. In the United States, it has been observed that obesity and overweight is becoming a serious public health issue that is becoming more and more prevalent. However, this prevalence has been observed to follow a particular socio-economic pattern. Paradoxical Case of Poverty and Obesity – Population Disparities Essay. Those that are poor and unable to afford healthy and nutritious meals have been shown to suffer more from the phenomenon of overweight and obesity. The reasons for this have not yet been fully elucidated. Some of the reasons that have been forwarded as possible causes are the inability of persons from poor communities to access fresh produce such as fruits and vegetables. Another reason put forward has been that in the neighborhoods that poor Hispanic and Black Americans live; there is not enough security such that no one can safely jog outside their home without being mugged or robbed. Duval County in Florida is not exempt to this statistical reality. Obesity in Duval County is among the health issues making Black and Hispanic communities be unable to visit a doctor because of cost (Verité Healthcare Consulting, LLC, 2015). Paradoxical Case of Poverty and Obesity – Population Disparities Essay.

To appreciate this health disparity in the American population, it may be necessary to divide the population into subpopulations. Let us consider the population of adolescents, for instance. Babey et al. (2010) have stated that the increase in obesity noted in the United States is greater among Hispanics and African Americans. In the study that they conducted, they tested the hypothesis that the prevalence of overweight and obesity has gone up among the population of low socio-economic class adolescents as opposed to more affluent American adolescents. The other thing that they studied was whether income disparity in obesity also varies by gender (Babey et al., 2010). They examined data from a sample of 17,535 adolescents who participated in the California Health Intervention Survey conducted between 2001 and 2007. They found that obesity prevalence rates significantly went up among adolescents from poor American families. As for those adolescents from more well-to-do American families, the researchers did not find any statistically significant rise in obesity prevalence. Paradoxical Case of Poverty and Obesity – Population Disparities Essay. They therefore concluded that obesity and overweight more than doubled among poor American adolescents during the period of the survey.

Frederick et al. (2014) also studied changes and prevalence patterns of obesity among US adolescents aged between 12 and 17 years, by socio-economic status. They utilised data from the 1988 to 2010 National Health and Nutrition Examination Surveys and the 2003 to 2011 National Survey of Children’s Health. Their results revealed a most important disparity, just like in the findings of Babey et al. (2010). They found that the prevalence of obesity among adolescents from low socio-economic Americans was rising, while at the same time dropping among the population of adolescents from richer families (Frederick et al., 2014).  These same findings were found to be true by Zhang & Wang (2004) and Wang et al. (2011) Paradoxical Case of Poverty and Obesity – Population Disparities Essay.

(B1a) Primary community and Prevention Resources

In the community of Duval County, my experience showed that despite the several challenges that are prevalent in the community, some preventive measures can still be taken against obesity and overweight. Chief amongst these is a deliberate change in the lifestyle of the person affected. They can decide to stop eating junk food and take the most available healthy alternatives. One of the challenges that have been identified in this approach is that many of the victims are actually not able to afford these healthier food alternatives. What they have been advised is that they should just start making it a habit by buying the healthy food whenever they can. That way, they will make it a habit and before long, they will find themselves setting aside some money only for the buying of healthier food alternatives. Another preventive measure identified was the habit of taking regular exercises which do not necessarily have to be heavy in nature. As a matter of fact, it was found that just walking regularly (isotonic exercise) is enough to keep obesity and overweight at bay (Shaw et al., 2006). In passing this message forward, the resources available in the Duval County include family nurse practitioners and family physicians who are the resource persons that are able to influence behavior change by health education. They are also able to influence the course of obesity and overweight by making an evidence-based decision to always recommend exercise to obese and overweight persons that they see, even if they come with other disease conditions. Paradoxical Case of Poverty and Obesity – Population Disparities Essay

(B1b) Underlying Causes

            As already discussed in an earlier section above, the underlying causes of obesity and overweight are the non-consumption of healthy foods and the lack of exercise in the affected population. Most of the poor Americans that are affected by overweight and obesity eat very unhealthy junk food. However, a close examination of why this is the case shows that they do this majorly because they cannot afford the healthier alternatives of foods that are available in the market. But this is only in the event that they actually have access to these healthy alternatives. The most common situation, however, is that in which the poor Americans have absolutely no access to healthy foods, even if they hypothetically had the money to buy it. This state of affairs can be explained by several observations. The first one is that the retailers that sell healthy foods have an inherent bias for wealthier neighborhoods as opposed to poorer ones. This could have been informed by either solid market research or anecdotal observations. The market research could have confirmed what has already been mentioned above. That poor Americans, because of low purchasing power, prefer mass-produced junk foods rather than clean healthy alternatives. However, if it is the anecdotal observations and experiences, then the possibility is that these businesses have given in to bigotry and discrimination based on economic status Paradoxical Case of Poverty and Obesity – Population Disparities Essay. More fundamentally, though, is the fact that insecurity in the neighborhoods in which the poor populations of Americans live is a turn-off to serious businesses. As a result, retailers who sell healthy foods will be difficult to find in neighborhoods that have rampant insecurity. All these factors therefore combine to make obesity and overweight very common among the poor populations of Americans.

(B2) Evidence-Based Practice

            Research studies show, as already demonstrated above, that obesity in America shows a very clear pattern of disparity between the rich and the poor. It would be expected that obesity would affect the rich because of overfeeding. However, the paradoxical reality is that obesity is actually affecting the poor because of their poor nutritional choices. This brings to the fore the fact that it is not the quantity of the food that matters, but the quality of the same. The well-to-do Americans have learnt that nutritious food is better than junk food. They therefore frequently treat themselves to good food. But this is because they have the disposable income that can allow them to do this. The poor, on the other hand, have limited choices. To begin with, even if they wanted to buy healthier foods, they may not have the opportunity to do so as the retailers of the same have geographically discriminated against their localities based on both race and socio-economic status. However, the overriding reason is that the poor people in the poor neighborhoods cannot afford healthy foods on a regular basis.

Relevant research studies that have been referred to in relation to this problem are studies by Babey et al. (2010), Frederick et al. (2014), Wang et al. (2011), and Zhang & Wang (2004). All these studies came to the conclusion that obesity and overweight shows a significant health disparity between the rich and the poor of America. To be precise, the poor of America disproportionately suffer from obesity as opposed to the more affluent Americans. Reasons have been given as purchasing power and knowledge that healthier foods are better than junk foods. As a matter of fact, the more well-to-do Americans happen to be better educated than the poor Americans. Because of this alone, the well-off Americans appreciate the value of healthy foods and thus practice this by buying frequently the healthier foods. The poor, lacking education and knowledge, find themselves settling for the poorer choice of junk and unhealthy foods. Paradoxical Case of Poverty and Obesity – Population Disparities Essay.

(B2a) Identification of Data

Nationwide, obesity and overweight is a very big problem in America. However, as has been demonstrated above, some communities experience the problem more than others. Unfortunately, these communities happen to be those that live on the edge of or below the poverty line. They are effectively below the federal poverty levels. Studies have shown that these are mainly Black African Americans and Hispanics (Latinos). According to recent data from Duval County, Florida (2012), 28.4% of the adult population in Duval County is obese (that is they have a BMI of equal to or more than 30). At the same time, 36% of the same population are considered to be overweight (meaning they have a BMI of between 25 and 30). Going by the national figures, the figures for Duval County are actually way above the national average for both obesity and overweight (Duval County Florida, 2012). This shows that there is a significant problem of obesity and overweight in the community that needs urgent redressing. More importantly, however, the problems of obesity and overweight need to be actively addressed in Duval County for one other important reason. This is that the two are associated with significant morbidity and mortality. Obesity and overweight are associated with the development of type II diabetes mellitus, cardiovascular disease, and fertility problems (Hammer & McPhee, 2018). This means that the two conditions contribute significantly to the public health burden and must therefore be reduced at all costs. Paradoxical Case of Poverty and Obesity – Population Disparities Essay.

(C1) Social Media Campaign Objective

In order to mitigate the impact of obesity and overweight in my community in Duval County, Florida; harnessing of the current technological innovations may be helpful. As result, the objective has been set that every young person between the ages of 12 and 18 must be reached by the message about the need to reduce the rates of obesity and overweight in Duval County, Florida by the end of June 2020 (a period of three months). To achieve this, the social media platform that is Facebook has been chosen as the appropriate vehicle with which to reach this population demographic. The choice of this population demographic has been informed by several salient factors. First, the studies reviewed in this paper clearly show that this very age group (adolescents) are the ones that have been very severely affected by the scourge of obesity. Paradoxical Case of Poverty and Obesity – Population Disparities Essay. Secondly, this is the population that mostly uses social media to communicate and interact with the outside world. Third, it is this population that is influential in the family context as even the parents listen to what they advocate for, because of the same reason of being technologically savvy and informed. Targeting this population, therefore, is expected to yield better results than if the parents were the ones that were targeted.

To carry out this strategic communication, health workers in the Duval Community (particularly nurse practitioners concerned with providing primary health care) will be engaged to draft health information about obesity and overweight. After this, several youth who are also in the same target age group will be given the information to disseminate. It is expected that this information will be shared widely among the teenagers within the three months to reach each and every one of them. Also, a Facebook page will be created specifically for this social media campaign. This page will be promoted, meaning that adverts will be paid for to facilitate the dissemination of the message to the population within the geographical area of Duval County, Florida. v

(C2) Social Marketing Interventions

Two social marketing interventions that this strategy is expected to utilise are direct marketing and word-of-mouth marketing. Direct marketing involves the targeted promotion of the messages as has been elucidated above. This means that each and everyone within Duval County with a Facebook account will randomly get the message originating from the Facebook page set to educate about the dangers of obesity and overweight. On the other hand, word-of-mouth marketing relies on the fact that those who will have already seen the message on their Facebook walls will inform others or show them what the message is. This is expected to be spontaneous since friends of the obese teenagers would naturally be eager to help them defeat the condition.

(C3) Description of Social Media Platform

As has been explained above, the social media platform Facebook was chosen because it is the most widely used among the population of concern than any other social media platform or application. Compared to Twitter, Snapchat, Instagram, and Telegram; Facebook has a near universal usage in any given population in the world. It is because of this that the creation of a Facebook page was deemed fit to disseminate the health information about obesity and overweight in Duval County. The hope is that through the sharing button available on Facebook, many of the targeted teenagers will share the story and information to their peers (especially those that are obese), who will in turn also share the same information. Within no time, the intended information will have reached almost everyone that it is supposed to reach. Paradoxical Case of Poverty and Obesity – Population Disparities Essay.

(C3a) Benefits of Social Media Platform

The benefits of social media platforms in the dissemination of health information are immense. For instance, Facebook gives the option of writing unlimited text in addition to adding audio and video media. This is actually one of the most attractive features of the application that make it preferable apart from its wide reach. Others like instagram are mostly based on visual depiction of information such as photos and portraits. If this same information were to be shared via instagram, a poster-like message would need to have been created and posted as a photograph. This, however, would have made it difficult to include detailed information such as is possible with Facebook. As for Twitter, the limited text that one can write would mean that the health message is heavily summarised. This is not desirable, given that the target population is supposed to get clear and self-explanatory information concerning obesity and overweight without having a healthcare expert in front of them.

(C4) Benefit to Target Population

From the information elucidated above, there are many benefits that the target Duval County population will get from this social media campaign about reduction of obesity prevalence. To begin with, they will be able to have the expert information they need to separate fact from fiction. One of the most dangerous things concerning health matters is misinformation. With the correct information, therefore, the population will be able to take the necessary measures such as eating healthy and working out by way of isotonic exercise (walking). Paradoxical Case of Poverty and Obesity – Population Disparities Essay

(D) Best Practices for Social Media

The best practices for social media centre on ethics and morality. In saying this, it is worth noting that social media is not regulated like mainstream media. As such, it is upon the person using the social media platform to exercise self censorship. However, Facebook, for instance, also exercises censorship if another user happens to report your post by finding it offensive. The same situation pertains with Twitter, Instagram, and Telegram. In the case of healthcare information, it is imperative that the information given there is factual to avoid misleading the masses. Doing otherwise would put the lives of many persons at risk, something which is immoral, unethical, and illegal.

(E1) Stakeholder Roles and Responsibilities

Some of the stakeholders in this Facebook social media health campaign on obesity include the contracted family nurse practitioners, Facebook, the teenagers who originate the message, and the innovator who came up with the idea. Respectively, their roles are to draft factual health information on obesity, to advertise the information, to share the information to as many friends as possible, and to involve as many players as possible.

(E2) Potential Public and Private Partnerships

Public Private Partnerships (PPPs) are important in that they help to pull resources together in the hope of realising a common objective for public good. In the case of this social media campaign, the financial outlay was a bit significant. Therefore, the PPP opted for was that involving a local university and the public health department of Duval County. It is these two that provided the funding for the project.

(E3) Timeline

The timeframe will be three months (implementation). Planning and evaluation will take a month each. Put together, the whole project will take five months. Paradoxical Case of Poverty and Obesity – Population Disparities Essay

(E4) Evaluation

Evaluation will involve carrying out a cross-sectional survey using a questionnaire as a data collection tool. Sampling will be random and the exercise will take place during the evaluation month (fifth month). The objective will be to obtain data on obesity and compare it with pre-intervention data to assess effectiveness of campaign.

(E5) Cost of Implementing the Campaign

The estimated cost of this project from planning to evaluation is expected to be USD 5,000.

(F) Reflection on Social Media Marketing

The community health nurse can harness the power of the social media to effectively and affordably pass on health information to a target population. She can for instance sponsor a message on a Facebook page and this will be made to appear on the wall of everyone within the geographical locality she specifies.

(F1) Reflection on Future Nursing Practice

Technology cannot be evaded in the 21st century. Nursing, like all other professions, must therefore use it to its advantage. In future nursing practice, I foresee myself using social media to carry out research affordably in the area of clinical inquiry to enrich evidence-based nursing practice. Paradoxical Case of Poverty and Obesity – Population Disparities Essay

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References

Babey, S.H., Hastert, T.A., Wolstein, J. & Diamant, A.L. (2010).  Income disparities in obesity trends among California adolescents. American Journal of Public Health, 100(11), 2149-2155.

Braveman, P. (2014). What are health disparities and health equity? We need to be clear. Public Health Reports, 129(Suppl 2), 5–8. Doi: 10.1177/00333549141291S203

Duval County, Florida (2012). Community health assessment and community health improvement plan. Retrieved 15 March 2020 from http://duval.floridahealth.gov/programs-and-services/community-health-planning-and-statistics/_documents/chip.pdf

Frederick, C.B., Snellman, K., & Putnam, R.D. (2014). Increasing socioeconomic disparities in adolescent obesity. Proceedings of the National Academy of Sciences, 111(4), 1338–1342. https://doi.org/10.1073/pnas.1321355110

Hammer, D.G., & McPhee, S.J. (Eds). (2018). Pathophysiology of disease: An introduction to clinical medicine, 8th ed. New York, NY: McGraw-Hill Education. Paradoxical Case of Poverty and Obesity – Population Disparities Essay

Shaw, K.A., Gennat, H.C., O’Rourke, P., & Del, M.C. (2006). Exercise for overweight or obesity. Cochrane Database of Systematic Reviews, 4(CD003817). DOI:10.1002/14651858.CD003817.pub3.

Verité Healthcare Consulting, LLC (2015).  Community health needs assessment. Retrieved 15 March 2020 from https://ufhealthjax.org/community/documents/chna-2015.pdf

Wang, C.Y., Gortmaker, S.L., & Taveras, E.M. (2011). Trends and racial/ethnic disparities in severe obesity among US children and adolescents, 1976–2006. International Journal of Pediatric Obesity, 6(1), 12–20. https://doi.org/10.3109/17477161003587774

Zhang, Q., & Wang, Y. (2004). Socioeconomic inequality of obesity in the United States: do gender, age, and ethnicity matter? Social Science & Medicine, 58(6), 1171–1180. https://doi.org/10.1016/s0277-9536(03)00288-0    Paradoxical Case of Poverty and Obesity – Population Disparities Essay

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