Running head: COMMUNITY HEALTH ASSESSMENT

Community Health Assessment

The War on Obesity
Adeline Nkamanyang, Allison Nystrom,Ashley Conner,Emma Pelton,
Sarah Wenger and Tabitha Cole
Old Dominion University

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Community Health Assessment: The War on Obesity

The state of Virginia is at risk for increasing rates of obesity related to inadequate
community health resources as evidenced by an increase in the rate of obesity from 18.7% in
2000 to 28.5% in 2014 (Levi, Rayburn, Martin, & Segal, 2015). Thus, as a member of the
Hampton Roads Community and an active member of the healthcare team, it is important to
address the health concerns in the area and provide resources for support. According to the
Virginia Department of Health, 22.7% of the adult population in the state of Virginia is
considered obese. Obesity can put the population at risk for countless other health problems
including cardiovascular disease, diabetes, or stroke. In addition to putting the population at risk
for other diseases, people who are obese can pay an average of 1,429 dollars more than someone
of normal weight (Center for Disease Control and Prevention [CDC], 2015). Addressing the
obesity rates will help to create a stronger and healthier community and prevent further
complications or health issues. The next step in helping to address this problem is to assess the
community population and its needs. Current resources such as community gyms, nutritionists,
weight loss clinics, and other educational opportunities need to be identified and accessed to help
get the community involved. As a member of healthcare team it is important to advocate for the
community and to provide the resources needed to be successful in addressing the problem.
Assessment
The level of aggregate selected is obese adults in the state of Virginia. Currently, within
this chosen state, the obesity rate for adults is 28.5%. Virginia is ranked 31st in the obesity rate
in the nation, according to The State of Obesity: Better Policies for a Healthier America (Levi,
Rayburn, Martin, & Segal, 2016). Obesity was chosen due to the fact that obesity rates in adults
have doubled since 1980, and have tripled in children. The rise in rates have significant health

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consequences, contributing to more than 30 serious health diseases, which in turn leads to a great
strain on the healthcare system (Trust for Americas Health, 2016). Obesity does not affect one
race, one gender, or one age group. Obesity can affect any and all people. The obesity rate for
men and women is similar. For men the obesity rate is 27.3% and women are at 27.5%. For race
African Americans have a higher rate at 38.9%, compared to Caucasians at 26.1% and Latinos at
24.5%. When looking at age 18-25 is 20%, 26-44 is 26.6 %, 45-64 is 34.3% and 65+ is
26.9% (The State of Obesity, 2016). Being overweight usually has a direct connection with
eating too many calories and not getting enough physical activity to use up those calories
(Council on Virginias Future, 2016). According to the information, between the ages of 45 and
64, people appear to be less active in their lifestyles, causing them to be overweight and obese.
For supra-system influences on obesity, it is more geared towards environmental factors versus
biological factors. High fat food, fast food consumption, watching television while eating,
super-sized portions, convenience, inexpensive foods that are packaged and high calorie intake
all contribute to obesity in the U.S. (Brantley, Myers, & Roy, 2005). All of these things are a
major contribution to obesity in Virginia; if this continues to be the standard of life, the obesity
rate will continue to increase and health will decrease ultimately leading to more healthcare cost.
Comparison of Health Status
Obesity is a risk factor for heart disease, Type 2 Diabetes (once known as adult-onset or
noninsulin-dependent diabetes), stroke, and some types of cancer. In particular, diabetes and
obesity have become a very prevalent combination (U.S. Department of Veterans Affairs
[USDVA], 2015). An adult is considered obese if his or her body mass index (a measurement of
fatty to lean tissue) is thirty or above. If Virginia could reduce the average body mass index
(BMI) of its residents by just five percent, for example, the state could help prevent thousands of

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cases of Type 2 diabetes, coronary heart disease and stroke, hypertension, cancer, and arthritis
(Council of Virginias Future, 2016). While our home state of Virginia does not hold the first
place award for the highest percentage of obesity, we still have a very unhealthy state. In Virginia
alone, the annual obesity-related healthcare costs were $1.6 billion in 2003. In the United States,
as a whole, obesity is the second leading cause of death with an astonishing number totaling
approximately 300,000 every year (Virginia Foundation for Healthy Youth, 2012). Thus, with
numbers and statistics such as these, it should go without saying that the importance for
decreasing obesity in our nation is of utmost importance and is a life or death situation.
As mentioned previously, obesity in the state of Virginia is one of the leading causes
health problems such as: hypertension, Type 2 Diabetes, arthritis, heart disease, and obesityrelated cancer. It is important to point out that of these diseases, hypertension and diabetes hold
the highest incident rates in this state. In 2013, Virginia ranked 21 out of the 51 states with a
number totaling 1,512,608 of hypertension cases. In 2014, diabetes was not too far behind,
placing at 28 out of 51, and totaling 644,975 cases (The State of Obesity, 2016). These
astronomical numbers should make us all stop and question why individuals are struggling so
intensely with obesity in our home state. Clearly, the answer is found in our busy day-to-day
lives in a technologically advanced society. We strive on the quick and easy conveniences of fast
food; we are motivated by high calorie lattes and caffeine infused energy drinks; busy schedules
make it a difficult task to break away from technology long enough to involve ourselves with
outdoor physical activities. Nevertheless, the previously mentioned statistics should demonstrate
the importance of developing a plan to incorporate healthier lifestyles in our everyday lives.
Planning an Intervention

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Obesity continues to be one major health hazard that is plaguing not only the state of
Virginia but also the entire country. There are many public health programs aimed at reducing
the rate of obesity, but its continuous rising level is disheartening. Therefore, there is a great
need for interventions. These interventions should include, but are not limited to the following:
to enhance good health in both children and adults and to reduce the obesity-related chronic
illnesses like diabetes, through diet and the maintenance of a healthy body weight; to mobilize
families, schools, and communities, and create opportunities for them to choose lifestyles that
will promote a healthy weight; to increase healthy eating habits and provide opportunities for
physical activity to the general public. Daily physical activities should be integrated into the
curriculum of all schools in the country from pre-K to grade 12 by the end of 2020, and at least
50% of Americans should be fully involved in recommended physical activities weekly. By
December 2020, at least 80% of Americans should be able to prepare and eat their main meals at
home for at least five out of the seven days of the week, and 50% or more adults, adolescents,
and children should be consuming five or more daily servings of fruits and vegetables in the next
one year. There should be no further increase in the number of obese individuals in various
ethnic groups by the end of 2020. By the end of 2020, each community in America should have
a free public recreational facility with trainers freely open to the general public.
Of course, making physical activity a daily habit is largely dependent on the environment.
Neighborhoods, streets, buildings, parks, and paths also play a major role in determining the
level of physical fitness of individuals. Just as our lack of physical activity is a major contributor
to the obesity epidemic, creating an activity-friendly environment is one way to help turn around
the epidemic (Ding, Sallis, Kerr, Lee, & Rosenberg, 2011). Another environment consideration
is creating work sites that provide employees with easy access to attractive stairways, onsite

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gyms, policies that can encourage exercise breaks during the workday, compensation for
employees who join gyms as well as offer health insurance incentives for physical activity. Also,
streets should have sidewalks and protected bike lanes to make it easier, or to encourage people
to take walks or to ride bikes, rather than driving to short distances. Walkable neighborhood
with sidewalks, crosswalks, stores, and leisure destinations has a positive effect on physical
activity, and in turn, body weight (Ding et al., 2011). Even access to public transport can
encourage physical activity since people have to walk to and from bus stops or train stations.
Evaluation of Interventions
Since Virginia is ranked 31st in obesity, Virginia has a State Nutrition, physical activity
and obesity profile (CDC, 2012). Within the profile, it has taken into account that there were not
healthy alternatives for high school children in vending machines. Virginia implemented mini
grants to help with the war on obesity. Portions of the mini grants were for safe walkways to
schools. Several of the schools purchased bike racks so students could ride to school and have a
safe place for their bikes. The rest of the mini grants were for healthy choices in the vending
machines and to have nutritional input into what should be placed in the machines. Virginia has
also implemented that mothers who are breastfeeding should have a private room for pumping at
work and for childcare facilities to become breastfeeding friendly. There is a correlation between
breastfeeding and not becoming overweight (CDC, 2016).
According to Healthy People 2020, one study showed that by reducing screen time and
adding interventions such as education and support, the United States and several other countries
were able to decrease the median of body mass index (BMI) by 0.9 (The Community Guide,
2013). During this study, it was determined that by reducing screen-time (television, computer,
games and phones) and involving family time with outdoor activities, it would help with social

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interactions and help promote physical activity in children thirteen and younger. By teaching
children at an early age nutritional values and allowing children to help in the kitchen, this will
get their minds engaged in healthy choices from an early age. Schools are working on their
nutritional values of food served, but there is a need for recreational activity more than a twentyminute recess before or after lunch. In the primary school in Greene County, the children only
have physical education once every three days. By 2020, there should be physical education in
all schools daily besides recess in the elementary schools.
There are programs that have grown in popularity in recent years; one example is Curves,
which is a thirty-minute workout circuit for women. In 2012, they created Curves Complete,
which is the total workout system along with customized meal plans and a certified coach to help
along the way. In 2014, Jillian Michaels the well-known fitness guru became part of the Curves
workouts to help women with their goals and prevent plateaus. There are now gyms that are
open 24 hours so people can go during times that fit into their schedules. As the world is
changing to conquer obesity through scientific research, the basics for weight loss start at home.
Therefore, it is essential to focus on the people that cannot afford to purchase fresh vegetables
and healthy choices. There are a few communities that have community gardens but more needs
to be done. Each state should allot a certain amount of money from the budget to help the areas
in the state that would benefit from a community garden or even a healthier food pantry, which
are already supplied by the communities.
To evaluate the effectiveness of the previously mentioned interventions, health
departments all over the state carry out studies in order to assess their regions health status. This
information is then gathered and submitted to a central location such as The Center for Disease
and Control. From this point, the results are analyzed and statistics are reported. Generally this

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evaluation is an ongoing process, and it usually generates results once every few years. The final
results will determine if the rate of obesity has increased, decreased, or stayed the same (CDC,
2014).
Recommendations
The proposed interventions to reduce obesity in Virginia include increasing physical
activity as well as creating an environment for healthy eating, which involves educating the
public and reducing the number of times families eat out a week, especially at fast-food
restaurants. In order to carry out the suggested interventions it will be essential to collaborate and
partner with individuals in the community, community leaders, health care providers and local
health organizations. Promoting and implementing change requires motivation and active
commitment from the community (Anderson & McFarlane, 2015, p. 88). Community health
nurses are responsible for empowering communities, which in turn will help develop community
partnerships and promote change (Anderson & McFarlane, 2015, p. 91). Since the interventions
require long-term work, an open dialogue with the community will need to be formed that
creates a platform for individuals to become involved with projects.
Conclusion
The obesity epidemic in the United States continues to be a major concern. As the obesity
rates in Virginia continue to rise, interventions need to take place in order to prevent the longterm adverse effects of obesity on community health. We have presented statewide interventions
that should take place including creating an environment for increased physical activity for both
children and adults. This includes requiring daily physical activity for children in schools and
programs that encourage physical activity during the workday. We also recommend that the
number of meals eaten out should be reduced to only twice per week and the amount of

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vegetables and fruit should be increased to the recommended daily intake. Due to the large scope
of these interventions, the full implementation would not be until 2020. Successful
implementation requires empowerment of the community and collaboration with community
leaders, motivated individuals, health care providers and community health organizations. If the
recommended interventions were successfully implemented we are confident that the obesity
rates in Virginia would be significantly reduced. Community health nurses are the foundation for
change, but the community has a whole must become empowered in order for change to actually
occur.

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References

Anderson, E.T. & McFarlane, J. (2015). Community as Partner: Theory and Practice in Nursing
(7th ed). Philadelphia, PA: Wolters Kluwer
Brantley, P.J., Myers, V.H. & Roy, H.J. (2005). Environmental and lifestyle influences on
obesity. Journal of the Louisiana State Medical Society, 157(1), 19-27. Retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/15751906
Center for Disease Control and Prevention (2012). State Nutrition, Physical Activity, and
Obesity Profile. Retrieved from
http://www.cdc.gov/obesity/stateprograms/fundedstates/pdf/Virginia-State-Profile.pdf
Center for Disease Control and Prevention (2015). Adult Obesity Facts. Retrieved from
http://www.cdc.gov/obesity/data/adult.html
Center for Disease Control and Prevention (2015). Surveillance Systems. Retrieved from
http://www.cdc.gov/obesity/data/surveillance.html
Council on Virginias Future (2016). Obesity. Retrieved from
http://vaperforms.virginia.gov/indicators/healthFamily/obesity.php
Curves (2016). About us. Retrieved from https://www.curves.com/about-curves
Ding, D., Sallis, J.F., Kerr, J., Lee, S., & Rosenberg, D.C. (2011). Neighborhood environment
and physical activity among youth a review. American Journal of Preventative Medicine,
41(4), 442-55.
Levi, J., Rayburn, J., Martin, A. & Segal, L.M. (2015). The State of Obesity:
Better Policies for a Healthier America. Washington, D.C. Retrieved from
http://stateofobesity.org/files/stateofobesity2015.pdf
The Guide to Community Prevention Services (2014). Obesity prevention and control:

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Behavioral interventions that aim to reduce recreational sedentary screen time among
children. Retrieved from http://www.thecommunityguide.org/obesity/behavioral.html
The State of Obesity in Virginia. (2016). Retrieved from http://stateofobesity.org/states/va
Trust for Americas Health (2016). Obesity. Retrieved from http://healthyamericans.org/obesity/
U.S. Department of Veterans Affairs (2015). VA Research on Obesity. Retrieved from
http://www.research.va.gov/topics/obesity.cfm
Virginia Foundation for Healthy Youth (2012). Obesity reduction and prevention. Retrieved
from http://www.vfhy.org/statistics/obesity
Virginia Department of Health (2016). Health Equity Statistics. Retrieved from
http://www.vdh.virginia.gov/OMHHE/healthequity/statistics.htm
Weight Watchers (2016). Our approach. Retrieved from
https://www.weightwatchers.com/us/our-approach

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Honor Code
I pledge to support the Honor System of Old Dominion University. I will refrain from any form
of academic dishonesty or deception, such as cheating or plagiarism. I am aware that as a
member of the academic community it is responsibility to turn in all suspected violators of the
Honor Code. I will report to a hearing if summoned.
Name: Tabitha Cole, Ashley Conner, Adeline Nkamanyang, Allison Nystrom,Emma Pelton and
Sarah Wenger
Date: July 17, 2016