Assessment and Evaluation Acivities

Assessment and Evaluation Activities

Leslie Reali

Kaplan University

Community Health Assessment

HA560

Susan MacCready

April 18, 2016

Assessment and Evaluation Activities

United States Census Data on Florence County in the state of South Carolina

State: South Carolina

County: Florence

Population:

The table below shows the population of Florence County in the State of South Carolina as of 1st July 2014. Senior citizens are individuals aged 65 years and above while children are individuals of 18 years and below.

Health Assessment

Among the goals of the campaign, dubbed ‘Healthy People 2020’ in America is to eradicate or at least tone down obesity. Obesity and especially that which arises during childhood is one of the greatest challenges in the health sector in the United States of America. This is because of the adverse effects it has on health. From the health assessment, it is evident that the rates of childhood obesity in Los Angeles increases yearly. This is a reflection of the current situation countrywide. From the assessment, it is apparent that parents and the community at large are not keen at what their children eat and whether they take part in physical exercise. These two are major contributors to childhood obesity.

Childhood obesity was more rampant among boys as compared to girls. Lack of engagement in physical activity and consumption of fast foods were among the major risk factors found to lead to childhood obesity. The role of parental guidance and schools in fighting childhood obesity was evident. The introduction of mandatory physical activity and education on healthy eating was one of the ways proposed to fight obesity in schools. Regulation of the advertisement and sale of fast foods by restaurants through policy making by relevant institutions of government was another possible solution to childhood obesity.

Childhood Obesity

Obesity is the state of increased body weight caused by accumulation of adipose tissue to an extent, which leads to adverse effects on the health of an individual. The causes of obesity relate to changes in diet, physical activity, emotions and habits. Obesity is more common in the younger generation seen in the number of children who are obese. Increased consumption of fatty food is one of the societal changes in diet that have led to childhood obesity in the United States of America. Measurement of fat accumulation that leads to obesity is by calculating the body mass index, which is an expression of weight in relation to height.

Obesity leads to more than just a bulging waistline. There are several health risks associated with obesity including coronary heart disease, type 2 diabetes, asthma, hypertension and sleep apnea. These medical conditions have long-term consequences and lead to increased morbidity and mortality due to obesity. In addition, obesity reduces the quality of life as it makes it difficult for an individual to undertake normal daily activity (Wolin et al, 2009). As a result, the amount of finances spent on health related issues per family in the recent past, has increased greatly due to obesity-related illnesses.

Several factors contribute to obesity. The individual, the parent or guardian to a child plays a big role. These parties choose what to eat, whether to exercise or not and whether to get rid of the sedentary life which includes long hours of watching television and playing video games. The role of genetics in obesity is one that is inevitable but is controllable through lifestyle modification. The responsibility to eradicate obesity and achieve a healthy nation is on the individual, schools, policy makers who can regulate sale of fast foods and the public health sector, which can educate the public and lay strategies to eradicate childhood obesity.

Data Collection Methods for the Assessment of Childhood Obesity

To carry out health assessment on childhood obesity, data will be collected from children (individuals below 18 years of age), especially school going children. Data collection from children will be mainly in schools, day care centers. There will be data collection from parents and guardians will be to supplement the information obtained from the children. Methods used in data collection will include site visits, interviews, self-administered questionnaires, focus group discussions and information from health provider registries.

Distribution of designed questionnaires suitable for the assessment in schools to children, to collect their demographic data, to obtain information on their eating habits, engagement in sedentary activities such as watching television and playing video games, their take on physical exercise and how often they exercise. The questionnaire may contain a section to record their weight and height and estimate their Body Mass Index (BMI) and to assess their knowledge on obesity. Distribution of suitable questionnaires to parents and guardians to assess their knowledge on obesity and its prevention, and to establish whether they pay keen attention to what their children eat and whether they exercise will be important. There will be assessment of adverse effects of obesity on health and other risk factors that predispose to obesity.

Focused group discussions and focused group discussions with a key informant will be in schools and in the community whereby a random sample of school going children and community members from the community will take part. The researcher will lead the discussion on obesity, laying emphasis on variables relevant to the research, including eating habits, physical exercise and knowledge on obesity among the school-going children. This method of data collection will facilitate immediate feedback and will give room for interaction and follow up questions. Site visits to schools and day care centers will be important to find out the types of food consumed by school going children and the amount of physical exercise they engage in. This will contribute to the information obtained during the study.

A suitable interview guide for interviews with the school-going children will enable collection of first-hand information from the children. Interviews with parents or guardians picking their children from day care centers or from school will also be important. Health registries in children hospitals or pediatric departments will contribute information on the height and weight of children to facilitate the calculation of body mass index, which is a measure of obesity. This way, the study will be able to establish the statistics on the rates of obesity. The health registries will also provide information on the presence of adverse health effects of obesity among children of BMI that qualifies them as obese.

Health Assessment Information

Demographic Information

Florence County is located in the eastern part of the state of South Carolina. It is composed of ten communities where Florence is the largest city. The county is composed of a diverse population with various proportions in terms of gender, race and age. This population occupies an area of about 804 square miles.

Population

The total population of Florence County was 139, 231 according to census data as of July 2014. The population and size of area occupied by a community influences health though the direct impact on housing, water supply and sanitation.

Sex

The population of Florence County was composed of 74,071 females which translates to 53.2% of the population and 65,160 males which translates to 46.8% of the population as of July 2014

Age

The population of Florence County that was below 18 years of age as of July 2014 was 24.2% of the population in 2014, totaling 33,694. The population of senior citizens defined as individuals of more than 65 years of age was20, 885 with a percentage of 15% of the total Florence population. Age distribution affects the outcome data of population health. The total percentage of individuals on both extremes of age affects the planning of healthcare delivery and the choice of health intervention and promotion programs and activities to roll out.

Disabled individuals

The health needs of individuals with disability may vary a little from those of the rest of the population. There should be assessment ad consideration of health needs of this population. Individual under the age of 65 who lived with disability between 2010 and 2014 were 12.3%. This is a total number of 17,125.

Race and ethnicity

Racial discrimination and bias greatly affects the health seeking behavior, quality of care received and health risks of minority populations. It is important to consider this population in order to improve overall health of the county residents. There are several racial groups living in Florence County. The percentage of the white population was 54.7% that was 75,324 individuals. The African American population was 42.2%, or 58,755 African Americans. American Indians were 5,557 having a percentage of 0.4 of the total population. Asian were 1.5% of the total population thus the number of Asians was 2088. Native Hawaiian and other pacific islanders were not present in South Carolina in 2014

Nutrition

Nutrients obtained from intake of a healthy balanced diet are key in reinforcement of the immune system and for development of a healthy body. Residents of Florence County have a diet that consists of mainly solid fats, sugars and refined grains. This is in the form of fast foods, snacks and cereals. The amounts of fruits, milk and vegetables in the diet of most residents is very minimal, almost nil. 86.0% of adults in Florence County admit to not meeting the fruit and vegetable recommendation. Of these adults, 82.5% of whites and 81.9% of blacks admit to not meeting fruit and vegetable recommendation. The number of Farmers markets in Florence county as of 2010 were only three. As of 2009, there were no farm to school programs in Florence County. Failure to regulate types of food sold and consumed in schools contributes greatly to obesity.

Physical inactivity

Physical activity in form of normal walking around and physical exercise is essential in the achievement of a healthy body. Most residents, especially children and adolescents admit to spending most of their time watching television or playing videogames. Less than 50% of adults and children get sixty minutes or more of physical activity daily 57.2% of adults admit to not meeting the physical activity recommendation. Most parents and guardians admit to not regulating the amount of time their children spend watching television or playing video games. Site visits to schools also reveal that schools have time for physical activity in their schedule, but this is not functional. As of 2010, 63.3% of Whites and 55.9% of blacks did not meet the physical activity recommendation.

Overweight and obesity

School going children, especially boys and a few girls admit that their peers at some point in life have called them ‘fat’. 20.3% of children who are currently considered obese and 35.4% of adults who are obese . Most residents also admit that the doctor has asked them to watch their weight on one routine medical checkup or another. This is a clear indication that the rates of obesity in the county and the country is soaring and it needs to be in check. 31.4% of adults in Florence County were obese as of 2010. Of these adults, 24.9% of whites and 33.5% of blacks were obese. The prevalence of obesity among females as of 2011 was 46.5%, while prevalence among males in Florence County was 34.9%.

Chronic conditions

Obesity has serious and costly adverse health effects that may cause death. These are chronic conditions including type 2 diabetes mellitus, asthma, hypertension, coronary heart disease and sleep apnea. Residents of Florence County report a positive family history of at least one of these conditions. Health registries also provide similar information. These conditions are also among the major leading causes of death in hospitals in this century. These conditions are preventable with an aim to preserve life and cut costs of healthcare.

Evaluation

From the health assessment information, it is evident that obesity, and especially childhood obesity is a major problem in Florence Count, South Carolina. It is evident that the diet consumed by residents of Florence does not meet recommended diet, and that physical inactivity is common. It is also apparent that overweight and obesity is a big problem and is rampant among all age groups, sexes and races. The consequences of obesity including chronic illnesses and death appear to be common and there is need for intervention in order to save lives and cut healthcare costs. Reducing obesity rates will reduce overall morbidity and mortality. The fight against obesity and the walk towards achieving the Healthy people 2020’ goal involves various parties. For a successful venture, the individual, parents or guardians of children, the government, the department of health services in Florence County, farmers and schools should be involved.

Program Evaluation Worksheets.

References

(2015). (IHME), US County Profile: Florence County. Institute for Health Metrics and Evaluation, Seattle.

(2011). 2010 Florence County Profile. Nutrition, Physical Activity and Obesity. DHEC Bureau of Community Health and Chronic Disease Prevention, Division of Nutrition, Physical Activity and Obesity. Retrieved from http://www.scdhec.gov/health/chcdp/obesity/

(2013). 2013 Florence County Fact Sheet. Fact Sheet. Retrieved from https://www.scdhec.gov/Health/docs/Epi/obesity/Florence.pdf

Edberg, M. (2015). Essentials of Health Behaviour. Burlington: Jones & Bartlet Learning.

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Kumar, V., Abbas, A. K., & Aster, J. C. (2013). Robbins Basic Pathology. Elsevier Saunders.