Diabetes, particularly Type II diabetes, is a growing problem in the United States as a whole. Orange, New Jersey is a township that is located in Essex County and has a population of approximately 30,134 individuals (Essex County, 2006). Many people outside of the health field think of obesity as a relatively minor problem, but in reality, obesity is a very significant problem in cities around the United States; communities are the ones who pay the price for poor lifestyle choices in many places, and Orange, New Jersey is no exception to this rule. For the purposes of discussion in this document, the term “diabetes” will be used to describe Type II diabetes mellitus—a type of insulin insensitivity that is linked closely with obesity and lifestyle (Institute for the Elimination of Health Disparities, 2016; Healthypeople.gov, 2016).
The New Jersey Department of Public Health (2016) notes that diet and exercise are fundamentally important in the fight against diabetes and obesity. Because diabetes and obesity are so closely linked in many individuals, tracking obesity and diabetes rates can provide researchers with important insight into how important this problem is for Orange, how the population is most affected, and what disadvantages the community will face if the issue is not corrected as soon as possible.
The current research suggests that diet and activity level are closely linked with an individual’s obesity level, and thus, also closely linked with an individual’s likelihood of developing diabetes (New Jersey Department of Health and Human Services, 2016). There are factors beyond activity level that contribute to the develop of diabetes as well, however; the Institute for the Elimination of Health Disparities (2016) writes, “Diabetes disproportionately affects ethnic and racial minorities. In 2004, non-Hispanic blacks had the highest age-adjusted prevalence rate of diabetes at 11.5%, followed by Hispanics at 7.2%, and non-Hispanic whites at 5.3%” (Institute for the Elimination of Health Disparities, 2016). This racial disparity is particularly important for Orange because of the demographics of the township: 71% of the township of Orange identifies as non-Hispanic Black (Essex County, 2006).
Obesity has huge negative consequences for the community. When a community has an obesity problem, that community is also likely to have a problem with diabetes and other obesity-related conditions like heart disease; communities that are overweight or obese are also more likely to need extensive medical services, particularly for people who are elderly and geriatric. As people with diabetes age, they have much stricter health needs than their counterparts (Gary et al., 2009).
The problem of obesity is compounded when there are many young people who are exhibiting signs of being overweight or obese as there are in Orange, New Jersey: although even moderate obesity can cause significant problems at a young age, the real concern is the community strain on health resources that is likely to occur as these young people get older (Gary et al., 2009). In fact, most young people who struggle with their weight are likely to remain overweight or obese as they get older—this means that even young people who are only overweight may someday become obese, and will become a significant strain on the medical system in the region.
The vast majority of individuals in Orange are Democratic, and the politics of the community tend to be quite uniform (Essex County, 2006). Of course, politics play little role in the development of an obesity epidemic or diabetes; however, politics do play a significant role when considering how a community as a whole will deal with a problem like an obesity epidemic or a growing number of individuals with diabetes who are putting a strain on the medical system. Because the community is relatively small, its success or failure in developing a solution to this particular problem is linked closely to the successes and failures of the other communities in the area. The community can begin to implement changes in the school system to attempt to stave off the problems associated with obesity in children, as to protect the future of the township.
The first goal for the township of Orange is to continue the downward trend in obesity that the township demonstrated from 2011 to 2013 (New Jersey Department of Health and Human Services, 2016). The ultimate goal will be to eliminate childhood cases of obesity and diabetes entirely—however, this goal is one that is a long-term goal, and one that could just as easily be applied to nearly every community in the United States (Gary et al., 2009).
The three behavioral objectives for this particular goal are as follows: first, the community should strive to reduce the number of instances in which individuals with diabetes must actively seek care for their condition. In short, individuals who are already suffering should be provided with the tools necessary to participate in self-management of their disease. Second, the community should implement activity programs for young people to reduce the rate of obesity within the community; this will ensure that fewer children are diagnosed with the disease, and the strain on the medical system is lessened. Finally, at-risk individuals within the community must be recognized and provided with the appropriate medical support and intervention necessary to reduce their risk of diabetes and of complications associated with obesity, such as cardiovascular disease.
The primary prevention strategies for obesity and diabetes involve the first behavioral objectives: the goal is for the community to influence the children and families into making better decisions and developing more effective strategies for care. The secondary prevention strategies involve targeting children who are already showing signs of being obese or overweight and ensuring that these children have interventions and resources necessary to prevent them from developing diabetes; finally, the tertiary interventions for this community would constitute the treatment of obesity by medical professionals and clinicians.
Luckily, the mechanisms of obesity and diabetes—and the preventions of these diseases—are quite well understood. Children need access to healthy food in schools, and they need to be able to participate in active play. Changing school lunches may require significant investment on the part of schools, but without this investment, children will struggle to remain healthy. Allocating even $10,000 per semester into training children to be active and eat healthily is likely to make a difference. The evaluation criteria for this program is quite simple, and it will be relatively inexpensive to track: tracking BMI, weight, and obesity rates in schools is something that can be done by medical staff within the school with relative ease. The schools will be evaluated on the effectiveness of their programming for students and the rate of change that is observed in obesity rates and diabetes rates.
References
Essex County. (2006). Essex County Community Health Plan. Retrieved 23 February 2016, from http://www.essexregional.org/CHIP%20final%202.pdf
Gary, T. L., Batts-Turner, M., Yeh, H. C., Hill-Briggs, F., Bone, L. R., Wang, N. Y., & McGuire, M. (2009). The effects of a nurse case manager and a community health worker team on diabetic control, emergency department visits, and hospitalizations among urban African Americans with type 2 diabetes mellitus: a randomized controlled trial. Archives of internal medicine, 169(19), 1788-1794.
Healthypeople.gov,. (2016). HP2020 Objective Data Search | Healthy People 2020. Retrieved 23 February 2016, from http://www.healthypeople.gov/2020/data-search/Search-the-Data?f%5B%5D=field_topic_area%3A3514&ci=0&se=0&pop=
New Jersey Department of Health and Human Services. (2016). NJSHAD - Nutrition, Physical Activity, and Obesity Surveillance Indicator Report Categorized Index. Www26.state.nj.us. Retrieved 23 February 2016, from https://www26.state.nj.us/doh-shad/indicator/CatNPAO.html
