The Marion County
The research on tobacco prevention was in Marion County in Indiana State, which is one of the counties found in the United States of America. Marion County found in Indianapolis states with Indian being the capital of the Indianapolis State, which is the largest city in the whole region. The county covers approximately 403.01 square miles or 1,043.8 kilometers square. The county is 98.34% covered by land and the rest 1.66% is water. The population in the county as seen in the previous census reflected a 903,393 figure rendering it as the 55th most inhabited county among all the counties in the six states. The census also ranked the county as the biggest one in the United States. The demographics of the Marion County according to the recent census conducted in the states it is evident that the county has registered an increase in its population. During the 2000 census, the county had 860,454 people living there, 352,164 housing facilities and 213,411 families living in the county. The density of the area at that time was 2,172 in every square kilometer. The housing facilities were approximately 387,183 with a mean density of 377 per kilometer square. The ethnic composition of the county was made of Whites contributing to 70.49%, Native Americans formed 0.25%, and blacks composed of 24.17%. The other people of different ethnicities were Asians who formed 1.43%, the Hispanic and the Latinos formed 3.87%, pacific islanders had the least percentage of 0.04 while the German, Irish and the English ancestry formed 17.0%, 9.0% and 7.3% respectively. The average household in the county ranges within 2.39 and 3.03 and it is common to find an elderly person living alone. The incomes for most folks in the falls between $40,421 and $49,387 with men $36,503 compared to the women who earned $27,846.
The social environment in Marion Country comprises of high school graduates who form 81% of the social environment. There are many schools in the county and the students in colleges from 58%. Unemployment rates are not very high, as only 10.0% of the people in the county do not have any form of income earning activity. There are high numbers of crimes reported to the security department and this may be because of the poverty among some children and single parent family set ups. The physical environment comprises of factors like the recreational facilities, fast food restaurants and air pollution days that help the people come together to fight global warming and pollution activities. The number of households is 41,608 and 32 schools.
Profile of the health status in Marion County
The health status of the people living in the Marion County is not a detailed one as it comprises of three columns each describing the different prevalence of diseases. The first one is the tobacco smoking prevalence rates where the county recorded a 26% level of tobacco smoking in the county level, 21% in the Indiana state research and recorded 17% at the national rank. The other health pre valence is on obesity that is a common weight problem in the county. The prevalence rates of obesity as in 2010 were 30% in the Marion County level, 30% and 27% in the Indiana state and in the national stage respectively. The other prevalence is the level of physical activities among the residents. The level of physical inactivity in the county level was at 26%, 27% in the Indiana States and 24% in the national levels (Rabin & Sugarman, 2001).
The county is on the 89th mark on the rankings of Indiana States counties where health is of concern. The factors considered in ranking are things influencing the health of the residents such as the social, economic and environmental factors. The percentages above show that the rates of tobacco abuse are high in this county as compared to the state and the national levels. The obesity levels are also high with around 30 percent of the population categorized under the overweight category. The physically inactive are at bar with those in the state, but is higher as compared to those in the national level.
Background in relation to (2010)
This is a program launched on December 2010 by the health department in an effort to prevent diseases, improve health and promote healthy living. This program has long been in existence with the public health providing an in depth objectives that seek to improve the health of the nation. This is through a ten-year long objective plan that guides people on the best health decisions that can make positive health impacts on their lives. The tobacco abuse in the Marion County is one of the health concerns of the Healthy People2020 program and the proof is with the data showing the rates of tobacco abuse in the county. The Tobacco LHIs is one of the programs and objectives of the 2020 health program. The programs identify smokers to be adults, adolescents, and even young children who at most times inhale second hand smoke (Malone, 2006). The program identifies the health risks associated with smoking and tries to put in measures that reduce the rates of illness, disabilities associated with tobacco, deaths and exposure to others. The program uses three approaches to tackling the tobacco issue and the first one is prevalence rates where they focus on reducing the use of tobacco among the youths. The second approach is improving of health systems to increase its accessibility and affordability in an effort to increase the use of termination services and treatments available. The other one is changing the social and economic environment in order to reduce exposures to smoke and tobacco access.
The national health data shows that the levels of tobacco abuse among the Marion County residents is high with 440,000 deaths resulting from smoking in the US. The CDC shows it causes many health problems especially lung and heart diseases for long time smokers. Many smokers have developed respiratory infection, ulcers, and bronchitis, stillbirths, premature newly born and early menopause for women smokers. This shows the serious effects of tobacco smoking to people and the long-term effects for second hand smokers who are exposed to smoke. The college reports show that students who smoke are at a higher risk of developing bacterial meningitis and asthma when compared to the non-smokers. Women smokers who have the human papilloma virus are at a higher risk of developing cervical cancer. Research shows that 1.7 students in college with smoking addiction will die prematurely. The second hand smoke has its negative impacts on the health of those exposed with 3000 dying annually from lung cancer and 35,000 dying of heart diseases. Children are the once at a high risk because they are more susceptible as compared to adults. They end up developing asthma and decreased functioning of their lungs. This forms 43 percent of children brought up in homes where a family member smokes. This data shows that tobacco abuse has serious implications on the health of both smokers and non-smokers. CDC shows that smoking increases the chances of getting coronary diseases 4 times and the chances of stroke 4 times and men are 23 times at risk of developing lung cancer as compared to women whose risk is 13 times.
Population of Interest
The people most affected by the tobacco addiction problem in Marion County are the youths in college. The youths aged between 18-24 years who are at their first years and some at other levels of college. The smokers are mostly men who develop the habit before joining college while some are initiated into the habit during their freshman and they end up becoming hardcore tobacco smokers. The students do not have any economic activity that helps them raise money. They use the pocket money given by parents and the funds from student aids. The students who have gone through the high schools and are now at college tend to abuse tobacco at a higher rate and most of the students begin smoking after joining campus (Warren, Jones, Eriksen & Asma, 2006).
The students who smoke tend to have many health problems as compared to the non-smokers with many of them at a higher risk of developing mental disorders. This puts the students at risks of attempting suicide because the nicotine in the tobacco the brain. The student smokers are 5 times at risks of trying to commit suicide as compared to non-smokers. The students who smoke have at one point thought about committing suicide or some have even attempted doing it. The smokers are also vulnerable to depression and anxiety disorder because of smoking regularly and they tend to be aggressive especially when they are graving for a smoke. The youths are also 6.8 times at risk of developing agoraphobia that is even higher at heavy smokers. The students are also at risk of getting sexually transmitted diseases as compared to non-smokers because they have two or more sexual partners in a single month. This is evident in the data provided by CDC that shows that of the 15 million college students 1.7 million who smoke will die prematurely because of health complications caused by smoking tobacco (Sarna&Bialous, 2005).
Community Resources and Partners
Many community programs seek to implement tobacco prevention in Marion County. The N-O-T stands for Not on Tobacco and is a cessation program for youths. It uses “cold turkey” mechanism to stop tobacco abuse, provides counseling on stress management, and guides the youths on recovery process, (Malone, 2006). It works with youths using the anti-tobacco movement that seeks to create concern among the peers and reduce tobacco abuse among the youths through activism. It aims at educating the youth on the effects of smoking, reducing smoking rates, increase activism, fight the impact of tobacco processing, increase community participation. TATU stands for Teens against Tobacco Use and gives the youths training on how to be tobacco free, and they use advertisements and promotions to reach the youths. The programs focus on creating a community free tobacco that will eliminate the risks associated with health problems and deaths from tobacco smoking. The Tobacco Prevention Services has its objectives set on creating a tobacco free zone in all the parts of Marion County (Sarna&Bialous, 2005). The activities they engage in include funding of coalitions, engaging youths in training programs and providing platforms for change in the attitudes towards recovering tobacco addicts.
The community partnerships are playing a big role in handling the tobacco problem, but they are focusing too much on those addicted and forget about those who can possibly begin smoking. All the programs focus on the addicts and in the process leave the young children who are at risk of beginning to smoke especially because of peer pressure. The other aspect they are leaving out is follow up programs to check whether those who reform stick to the new habits and do not fall back into addiction.
Goals for improvement
The programs that deal with the tobacco prevention have many goals that help them make an impact among the youth. Their goals includes increasing the prices for a unit of tobacco, educating the community on the effects of tobacco smoking using the media, mobilizing the community to participate in prevention programs, increase cessation by lowering its costs, reducing second hand smoke exposure to young children and implementing smoking bans (Snell, 2005)
Nursing actions to improve tobacco prevention
Nurses play a vital role in tobacco prevention and they can do this by surveillance, which has a number of processes that will help them find out more about the problem and identify the best methods of intervention. This entails disease and health investigation on the effects of tobacco among the youths and how to handle the problem. The second step would be to prepare an outreach program where the users of tobacco in the city especially the teenagers were the main target. Outreach programs require isolation of individuals who are hard-core addicts. After this the nurses need to do intensive screening to identify who among the young people have health related problems that arise from tobacco smoking. Case finding is another procedure needed to effectively handle the tobacco addiction among the youths. This process involves getting to know the teenagers well and making sure you get all the background information that can help you identify the risk factors and how best to handle the tobacco addiction. Referral and follow is another thing that nurse can do to make sure that those teenagers who have serious health problems get medical attention, for those discharged that they quit smoking, and follow a healthy lifestyle. Case management is about identifying the underlying causes for tobacco abuse and looking for ways to tackle the issues. The nurses participate in different community programs and actions to help patients quit smoking, supporting tobacco control programs and promoting a tobacco free smoke environment. The other action to help in the tobacco prevention program is provision of leadership skills in conjunction with other health care providers to help lead the other members of the public in eliminating the tobacco threat (Bellenir, 2007).This is important if the nurses are to find the underlying cause of the problem and solve it. Nurses need to delegate functions, do counsel ling, programs collaborate with help groups in the region by providing scientific evidence to the public on the effects of tobacco smoking to the health of the smoker and those around him or her. The nurses can also form coalitions with the youths to provide education and training on how to handle the health challenges associated with tobacco smoking. They need to build social programs and enforce policies by working with the environmental departments to create restrictions and policies that restrict public smoking and bans on smoking in workplaces. The nurses can also restrict use of tobacco by limiting the promotions and advertisements on tobacco use and strengthen the labels warning smokers on the health effects (Bellenir, 2007).
Evaluation of progress
Evaluation of the progress entails the use of systematic reviews that will give transparent ways of getting information, combining, and appraising the results of the programs. The reviews provide in-depth information on the effects of the programs to the community and the results that will help gauge the impact of the program to the whole public. This can be through regular monitoring where tobacco addicts are monitored to see if they change their behaviors. Surveys can also be done to see whether the programs are providing any positive change in the county.
Conclusion
The community health in concern with tobacco addiction seemed like a minor problem and I thought the locals and the state were not doing enough to safe the youths who were becoming hardcore smokers. However, the field study portrayed a different picture. I have to see that the number of people struggling with tobacco abuse was many and it dawned that I had little knowledge on the real situation. The field study helped me see that there are many efforts by different parties to help eliminate the problem that has cost many people their lives. The efforts by the youths in particular changed my view of how irresponsible youths are and now I know that youths are at the forefront in fighting the problem. The intervention programs put in place by the states and the local people also portrays a unique unity where everyone focuses on helping the youths get rid of the addiction problem.
References
Bellenir, K. (2007). Tobacco information for teens: health tips about the hazards of using cigarettes, smokeless tobacco, and other nicotine products : including facts about nicotine addiction, immediate and long-term health effects of tobacco use, related cancers, smoking ce. Detroit, MI: Omnigraphics.
Malone, R.E. (2006). Nursing's involvement in tobacco control: Historical perspective and vision for the future. Nursing Research, 55(4, Suppl), S51–S57
Rabin, R. L., &Sugarman, S. D. (2001).Regulating tobacco. Oxford: Oxford University Press.
Sarna, L., &Bialous, S. (2005).Tobacco control in the 21st century: A critical issue for the nursing profession. Research in Theory and Nursing Practice, 19(1), 15–24.
Snell, C. (2005). Peddling poison: the tobacco industry and kids. Westport, Conn.: Praeger.
Warren, C.W., Jones, N.R., Eriksen, M.P., &Asma, S. (2006). Patterns of global tobacco use in young people and implications for future chronic disease burden in adults. Lancet, 367(9512), 749–753.
Appendix
Profile of the health status in Marion County
The health status of the people living in the Marion County is not a detailed one as it comprises of three columns each describing the different prevalence of diseases. The first one is the tobacco smoking prevalence rates where the county recorded a 26% level of tobacco smoking in the county level, 21% in the Indiana state research and recorded 17% at the national rank. The other health pre valence is on obesity that is a common weight problem in the county. The prevalence rates of obesity as in 2010 were 30% in the Marion County level, 30% and 27% in the Indiana state and in the national stage respectively. The other prevalence is the level of physical activities among the residents. The level of physical inactivity in the county level was at 26%, 27% in the Indiana States and 24% in the national levels.
The county is on the 89th mark on the rankings of Indiana States counties where health is of concern. The factors considered in ranking are things influencing the health of the residents such as the social, economic and environmental factors. The percentages above show that the rates of tobacco abuse are high in this county as compared to the state and the national levels. The obesity levels are also high with around 30 percent of the population categorized under the overweight category. The physically inactive are at bar with those in the state, but is higher as compared to those in the national level.
