Community and Public Health Nursing Reflection

Maricopa community schools are the local schools for the Gila River Indian Community. Native American children attending these schools are generally obese and do not participate in extra-curricular activities. The Leading Health Indicator (LHI) that applies is Children and adolescents who are considered obese. Recognizing this LHI, nursing diagnoses can be generated followed by nursing interventions and finally a community health partnership that will positively influence obesity. Also, while exploring these various steps, examples of how nursing can advocate community change will be shown. However, the role of community and the epidemiological influences within the community must be discussed first. Individuals can only be as healthy as their community allows.

Native Americans live on a reservation in a rural removed from the Maricopa community and its convenience. Native Americans, especially the children, are part of the Maricopa community due to their presence in schools, the casino, and employment with various Maricopa businesses even though their residence is outside of the Maricopa geographical region. Maricopa has various parks, sidewalks, recreational programs, as well as grocery stores that promote healthy living. Unfortunately, Native Americans can’t partake in these facilities due to geographical limitations. Native Americans do have a central health clinic on the reservation but it is the only one. Public nursing and community health partnerships can help identify where changes can be made along with services provided to promote better health. Native Americans are different than the other cultures living in Maricopa.

Maricopa is already culturally diverse but the Native American populace is unique in some of their health challenges, especially with obesity. For example, “Native Americans face some of the highest rates of obesity and diabetes in the world. Native American children tend to watch more television and spend less time playing sports than white children, this is likely not the principle contributor to obesity” (Wharton, 2004, pg. 154). Native Americans are also theorized to be genetically predisposed born with more adipose fat which is never lost and increases throughout adolescence, leading to obesity in adulthood (Richards & Peterson, 2006, pg. 88). Furthermore, their diets tend to be high in saturated fat and sugar (88).

These epidemiological influences are worsened because of the lack of facilities available on the reservation. Utilizing this information, the following nursing diagnoses can be made regarding Native American obesity; deficient community health, imbalanced nutrition, and sedentary lifestyle. First, a healthy community “is described by the U.S. Department of Health and Human Services Healthy People 2010 report is one that continuously creates and improves both its physical and social environments, helping people to support one another in aspects of daily life and to develop to their fullest potential” (Healthy Places). In order to address the deficient community health, a community health event could be planned that checks weight, height, cholesterol and blood glucose levels.

Also, at this event, education about health promotion and disease prevention would be beneficial in addressing the diabetes and obesity so prevalent within the Native American populace. Imbalanced nutrition can be because the body is not getting enough nutritional vitamins and minerals or because the body is getting too much fat and sugar intake. Due to the high volume of Native American children in the Maricopa school system and the poor economic status of many Native American families, schools need to provide healthy meals for students. Furthermore, the school could also monitor lunches brought in by students and provide healthy alternatives. Also, if an after school program is developed; a dietician could provide healthy food options such as snacks, food education materials like calorie sheets, meal planning, and food alternatives for families.

Sedentary lifestyle can be changed by implementing an after school program. Different activities, games, and sports would be provided which would encourage exercise, socialization, and safety. This time could also be utilized to teach different games and sports that can be done at home. Involving the Native American community to change their habits would be best done by collaborating with Native American leaders and health professionals. Native American leaders would be excellent role models for children and the community as a whole. Collaborating with the Maricopa community would also generate interesting cross-cultural health events and activities.

Also, during these events, culture could be promoted in a healthy way such as traditional Native foods prepared in a healthy way and cultural dancing encouraged. Another resource would be to contact Community Partnership of Southern Arizona. They provide healthcare clinics, have people available to answer community specific questions, provide referrals to services, and have a directory of community resources that are available.

Obesity is the LHI of Native American children living just outside Maricopa but attending school within the Maricopa School District. The Reservation’s distance from Maricopa community facilities along with diet and epidemiological factors like diabetes all contribute to Native American obesity. By combating deficient community health with a community health event, educating and correcting imbalanced nutrition at the school, and eliminating a sedentary lifestyle by implementing an after school program, changes can be made. The Native American community will respond to Native leaders encouraging change. Culture events such as festivals would be an excellent opportunity to implement and highlight some of these healthy changes.

References
Centers for Disease Control and Prevention. (2000). Healthy places. Retrieved from http://www.cdc.gov/healthyplaces/about.htm#Healthy%20Env Richards, T. J., & Patterson, P. M. (2006, August). Native American obesity: An economic model of the “Thrifty Gene” theory. American Journal of Agricultural Economins, 88(3), 542-560. Retrieved from http://www.jstor.org/stable/3697748 Wharton, C. M. (2004). Beverage consumption and risk of obesity among native americans in arizona. Nutrition Reviews, 62(4), 153-9. Retrieved from http://search.proquest.com/docview/212348616?accountid=458