By Jill Lovano Emily Cornell Jennifer Housel Angela McColl Kalkaska County By Jill Lovano Emily Cornell Jennifer Housel Angela McColl This is a group PowerPoint presentation on Kalkaska County by Jill Lovano, Emily Cornell, Jennifer Housel, and Angela McColl.  Kalkaska County is located in northern region of the lower peninsula of Michigan.  The following slides will provide a community assessment and analysis of Kalkaska County.  Next a community health diagnosis is identified along with goals, objectives, and interventions to reduce health related risks in the community. Finally,  the effectiveness of the interventions are evaluated. 

Assessment of Community Population 17,099 16.2% of population lives below poverty level 39.8% of the population are overweight (having a BMI between 25 and 29.9 29.5% of population is obese (BMI of 30 or greater) 22.5% of the population lacks physical activity 31.4% of the population smokes 76.9% of the population has an inadequate intake of fruits and vegetables (Health Profile Chartbook, 2013) According to statistics, the county of Kalkaska has 17,099 residents.  16.2% of the population lives below poverty level, this is only slightly better in comparison to the average for state of Michigan.  While Michigan statistics show 30.1% of state residents weighing in as overweight, Kalkaska tips the scale with 39.8% of their community residents having a BMI between 25 and 29.9.  An ideal BMI is between 18.5-24.9. Furthermore, 29.5% of the population is categorized as obese, with a BMI of 30 or greater. These large numbers are directly related to the data on lifestyle risk factors. According to statistics gathered in 2013 from the district health department, more than 22.5% of the population is lacking physical activity, 31.4% of the population are current smokers, and a surprising 76.9% of the population has an inadequate intake of fruits and vegetables.  Having the recommended servings of fruits and vegetables per day may help reduce the risk of heart disease. 

Analysis of Findings Kalkaska County’s leading cause of death is Heart disease Statistics show that residents are overweight, smoke, lack fruits and vegetables, and do not exercise These are all factors that can contribute to Heart disease Weight loss of 5-10% of body weight can reduce blood pressure and blood cholesterol levels (Eckel, R. & Krauss, R., 2014). Statistics from Kalkaska County reveal heart disease as the leading cause of death.  Residents are overweight, obese, smoke, are sedentary, and consume unhealthy diets.  All of these factors contribute to the risk of heart disease.  In order to reduce this risk, residents need to make lifestyle changes.  These changes include weight loss, blood pressure and cholesterol monitoring.  According to the Journal of the American Heart Association (2014) weight loss as little as 5-10% can reduce both blood pressure and blood cholesterol levels. 

Community Diagnosis Risk of heart disease among residents of Kalkaska County related to obesity as demonstrated by 29.5% of population with BMI of 30 or greater A community diagnosis has been made for Kalkaska County after analyzing the data.  Risk of heart disease of residents of Kalkaska County related to obesity as demonstrated by 29.5% of the population with a BMI of 30 or greater.  In order to reduce the incidence of heart disease, the obesity statistics of the county must be recognized.  Diet and exercise are two obvious interventions for weight loss.  

Goals and Smart Objectives The percentage of residents with a BMI of less than 25 in Kalkaska County will increase by 50% in the year 2015 compared to 2013. The percentage of reported cigarette smoking in Kalkaska County will be less than 10% in the year 2015 compared to 31.4% in 2013. The number of individuals living below poverty level in Kalkaska County will be reduced by 20% from 16.9% in 2013 to 13.5% or less in 2015. The number of individuals living an active lifestyle in Kalkaska County will increase by 20% from 77.5% in 2013 to 93% or higher in 2015. The number of individuals in Kalkaska County who consume adequate amounts of fruits and vegetables will increase by 50% from 23.1% in 2013 to 34.65% in 2015. As previously stated, 29.5% of residents in Kalkaska County have a BMI of 30 or greater.  A BMI this high is considered to be obese.  An ideal BMI is between 18.5-24.9.   Therefore, a goal has been set to increase the percentage of residents in Kalkaska county with a BMI of less than 25.  Ideally, the county will increase the percentage of residents with a healthy BMI by 50% in the year 2015 compared to 2013.  The next objective is to reduce smoking.  In 2013, 31.4% of Kalkaska County residents engaged in this lifestyle risk behavior. This percentage is far greater than the average for state of Michigan.  A goal has been set for the percentage of reported cigarette smoking in Kalkaska County to be less than 10% in the year 2015.  The third objective is to improve the demographics of Kalkaska county.  Healthy lifestyle choices and demographics go hand in hand. The goal would be to reduce the number of individuals living below poverty level by 20%.  In 2013, 16.2% of the population was living below poverty level.  The goal would be to reduce this number to 13.5% or less in 2015.   Next, the number of individuals living an active lifestyle needs to be increased by 20%.  Exercise will also help the first goal of weight loss and BMI reduction.  In 2013 77.5% of residents reported leisure time physical activity.  This number should be improved to 93% or higher in 2015. Finally, the number of individuals in Kalkaska County who consume adequate amounts of fruits and vegetables needs a big improvement.  The goal is to increase the percentage by 50%.  In 2013 only 23.1% of residents were getting their daily servings.  We hope to improve this number to 34.65 in 2015.

Evidence-based Interventions Primary Prevention- Nutrition Kalkaska County community will offer farm markets with affordable prices twice a week. Community venues will offer healthier affordable food choices. Increased access to fruits and vegetables. Kalkaska County will provide connections for community members with local farmers. (BMC Nursing, 2012, p. 8)   Physical Activity Kalkaska County will improve access and utilization of recreational facilities. Kalkaska County will offer affordable community fitness programs. Kalkaska County will promote access to the city’s walking and biking trails. Promote buddy system fitness programs and activities within the community.(BMC Nursing, 2012, p. 8)

Evidence-based Interventions Secondary Prevention- Education Community education on healthy and affordable food choices Community education on benefits of preparing home cooked meals verses eating out. Community education on heart disease and prevention through weight management by proper nutrition.   Educate on all controllable risk factors of heart disease, such as managing diabetes, cholesterol, blood pressure, weight, stress, and smoking.   Counseling Kalkaska County will provide counseling and programs on controllable risk factors for heart disease and how to promote a healthy lifestyle. Kalkaska County will offer counseling on eating habits and maintaining a healthy BMI. Kalkaska County will offer counseling physical fitness and active lifestyles. Kalkaska County will offer counseling on how to access the fitness programs, buddy system, and connections to local farmers. (Xanthos et al. 2010, p. 1475)

Evaluation Plan will be evaluated by individual reports of lower cholesterol levels and reduction in weight Assessments of individuals smoking status, diet, alcohol intake, and physical activity will be done periodically to evaluate the effectiveness of the plan

References Eckel, R. & Krauss, R. (2014). American heart association call to action: Obesity as a major risk factor for coronary heart disease. Journal of the American Heart Association. Retrieved from http://circ.ahajournals.org/content/97/21/2099.full Health Profile Chartbook (2013). Kalkaska County. District Health Department #10 Retrieved from http://dhd10.org/dhd10-community-statistics Is there scope for community health nurses to address lifestyle risk factors? The Community Nursing SNAP Trial. (2012). BMC Nursing, 11(1), 4-12. doi:10.1186/1472-6955-11-4 Xanthos, T., Pantazopoulos, I., Vlachos, I., Stroumpoulis, K., Barouxis, D., Kitsou, V., & Papadimitriou, L. (2010). Factors influencing arrival of patients with acute myocardial infarction at emergency departments: implications for community nursing interventions. Journal Of Advanced Nursing, 66(7), 1469-1477. doi:10.1111/j.1365-2648.2010.05301.x