WK8DCRNURS6561N-2
Cynthia L Williams
Walden University
Direct Care Roles in Health Promotion & Disease Prevention Across the Life Span
NURS-6561N-2

October 19, 2015

Community Needs
In week 6, I discussed my community of Louisville, KY. In that discussion I focused on the obesity and tobacco use rates in the state of Kentucky. These health issues contribute to the mortality and morbidities in Kentucky. In the 2014 Louisville Metro Health Equity Health Report, 51.7% of individuals in Louisville were pre-diabetic or diabetic in 2011 according to the Behavioral Risk Factor Surveillance System (BRFSS), (Arno & Rock, 2014). Obesity and diabetes are correlated health statuses and are often referred to as “DIABESITY”, (A. Hollier, personal communication, October 21, 2015). The dietary lifestyles of adults and youth in Louisville combined with the lack of physical activity reflect in the overwhelming statistics of diabetes.
Smoking complicates every disease process. As of 2014, 26.2 % of adults, 18 years old and over are currently smoking, (Center for Disease Control and Prevention [CDC.gov], 2014). These lifestyle choices, disease processes and practices increase the risk of developing heart disease and stroke, (Arno & Rock, 2014).
Strategies for Implementation
Effort to improve the health state of the community, seem monumental when every patient is suffering from diabetes, smoking, lack of physical activity, dyslipidemia or has had some type of ischemic attack. Prevention is the most effective intervention that improves the outcomes of individuals and reduces the progression of disease processes, thereby reducing the degree of disability and suffering.
One strategy that providers can implement is education with every patient encounter. In the first few minutes of every visit review smoking status, current diet, and physical activity participation. Provide the patient with tools to making healthier food choices, and encourage them to commit to walking 10,15, or 20 minutes a day. Promote small changes in lifestyle gradually so the changes are not drastic, which is counter productive to success. Whenever the patient is ready to quit smoking, inform them of their options to assist with smoking cessation. These small changes can promote weight loss, and have an impact on hypertension.
Another strategy for the Louisville community is to employ healthier food choices in all the areas of the city. In the west end of Louisville, where “DIABESITY” is at high percentages, sugar free items are not readily available, yet high carb, and inexpensive items are unavoidable. The healthy food stores, and healthier food choices in commercial grocer chains are in the more affluent areas of Louisville. This is a marketing ploy as grocers provide what sells, but if the consumer/patient knew what healthier food options would aid in improving their health the demand/supply effect will be implemented. In the meantime the provider should promote healthy eating by teaching the patient about foods with a high glycemic index and low carbohydrate foods, and how shop with a healthy focus.
Limiting Challenges
To ensure the success of these strategies, providers have to be on one accord in improving chronic disease and preventing morbidities. Collaborating with community partners and stakeholders to educate smaller communities and encourage grocers to provide healthier foods, such as the Louisville Urban League. This particular community partner has a vested interest in the Louisville community, in particular the west end of Louisville.
Conclusion
Overturning years of historically embedded lifestyle habits and choices cannot be eradicated overnight. For the provider, this may be one patient at a time. Making an impact on the community by promoting disease prevention, health screenings, and having compassion in caring for patients. Make sure patient understand the critical state of “DIABESITY”, and the implications of the health state and risk. Encourage them to make small changes, and make lifestyle. References

Arno, C. A., & Rock, P. (2014). Louisville metro health equity report 2014:The social determinants of health in Louisville metro neighborhoods. Retrieved from http://louisvilleky.gov/sites/default/files/health_and_wellness/che/health_equity_report/her2014_7_31_14.pdf
Center for Disease Control and Prevention. (2014). State Tobacco Activities Tracking and Evaluation: Kentucky [State Highlights: Tobacco Use - Survey Data - Current Smoking (Adults)]. Retrieved from http://nccd.cdc.gov/STATESystem/rdPage.aspx?rdReport=OSH_STATE.Highlights&rdRequestForwarding=Form&rdDashboardTabs=HLR_TOB_Adult