Research Articles Base: Health Report Samples

Report on a health facility visit

INTRODUCTION: Hong Kong Sheng Kung Hui Welfare Council was established in 1973. The development is not very long but the Council inherits the social welfare teaching from Hong Kong Anglican Church that has been based on almost for 160 years, in which the Council learned to allocate the gained resources to render the social service to help the deprived groups lead a respectful life and explore more of their potential. Also, the Council promotes the support and caring spirit among the members of the society including commercial organizations, groups and schools, individuals and volunteers, joining hands to build a caring society. The Council provides diversified service to the society, and the service targets come from all ages and levels between infant from natal and elders of over 100 years old. Currently, there are over 200 service units of the Council distributed over the Hong Kong and Macau which form a comprehensive service network. History: Responding more effectively to the societal needs, the Church officially set up the Council in 1973 worked as a welfare arm of the Church, being responsible for co-ordination, development and provision of different social services. The Council succeeded from the Church which played the prophet role in the society and started providing suitable services, for example the youth service in the 70s, the child and elder services in the 80s, the integrated service and quality management in mid 90s. Also, the first innovated Tung Chung Integrated Services was pioneered by the Council. Meanwhile, the Council is the very first organization who implements the Total Quality Management in the social welfare sector. In late 90s, the new arrivals from the mainland and employment counselling service are the main work focus of the Council. The first New Immigrant Integrated Service Centre and the Youth Integrated Employment Service Centre were also established by the Council. Until the 21st Century, the Council also provides the elderly service to meet the pressing needs and develops the rehabilitation service to meet the society needs. Vision and Mission: “Individual Caring, Overall Concern” is the service pledge of the Council which encourages the co-workers to work hard and drives the Council to become one of the most pioneered social welfare organizations. It is aimed at enabling the Council to understand the needs of the deprived groups in advance so as to take the lead to co-operate with the members of each stratum and groups and provide the quality service for the needy. The Prayer of St. Francis is the motto of the co-workers, also the song of the Council. The co-workers do not only sing the song but also put it into practice. Aims and Objectives: It’s aim is to provide for mutual information, help and counsel between the organizations, schools and panishes. Initiate any new projects that may be necessary to meet new needs and opportunities. Assist individually and the agencies, to apply for government subvention, Community Chest allocations and other respective funding resources. Furthermore, recommend working guidelines, for all member agencies in accordance with the approval of the Executive Committee. Clinical Services: There were over 200 service units in Hong Kong and Macau, including member agencies and direct services units. The services nature are distributed as child care service, children and youth service (children and youth integrated service, school social work service), family and counseling service (marriage and counseling service), rehabilitation service (employment service), community service, wellness service, elderly service, training, and other services such as consultancy service and adult education. Rehabilitation Service: As I was arranged to visit the Rehabilitation Service in DAC Cum Hostel, it is a home-based training and support service by providing various services (training, hostel and community care service) for the mentally handicapped and other disabled person. The environment of the hostel is comfortable and the staffs are nice. Their work is meaningful, the rehabilitation service helps the needed person lead a life with dignity as develop their potentials and take part in the community affairs. The services include daily living care, life skills training, door to door household training activities, health care and body check, counseling service, occupational therapy service. The service also provides community supports network service for family and carers which include educational and social activities, volunteer network, hotline, nursery and short-term hostel service. Organizational and Management Structures: The structures of the Council is a Bureaucratic structures. The head of the Council is from the General Synod, then Welfare Council and Executive Committee. The Executive Committee is formed by many functional sub-committees. And then the Director, below the director, it is a divisional structure. The Regional Director (East kowloon, West kowloon, Hong Kong Islands, and New Territories), the Head Office, the Corporate Development Director, the Services Director, and the Member Agencies. The Head Office includes three main departments which are very important for the Council, which are Financial Department, Human Resources and Administration Department, and the Development Department. And the Corporate Development Director support the Council to maintain high quality of services, this branch includes the Quality Management Director, Training and Development Director, the Chief Information Officer, the Service Coordinator, the Communications Department, the Corporate Legal Services Department. For the Regional Director, the Services Director, and the Member Agencies, it is the operational parts of the Council, to provide the clinical health care services for the public. Models of Management: The Council has been adopting the integrated approach to integrate the independent specialized service operations, so that integrated management approach is used to provide one-stop service for the service users. The Council adopts a macro view to integrate the quality management, the contents mainly divide into 3 parts: strategy, management system and result. Starting from making the strategies to carrying out the management system in which each of the system can be integrated to be a master system. When implementing the policies in the system as a whole, the quality documents become the main support. Also, the quality management is one of the important sections which encourages participation of the co-workers. Traditional management functions are described as planning, organizing, leading and controlling. Strong management skills have been highly valued within health care organizations. However, more recently the demand for leadership skills has prominence. Transformation is an appealing notion in terms of bringing about innovation and change, from traditional management functions towards collaborative management. Social changes, technical updated, economic factor, political and environmental reason, in healthcare system generally, to consider the opportunity to shape the system itself. It is suggested that to building shared visions, creating positive working environments, fostering creativity and innovation, and transcending traditional perspectives (Daly, 2004). The Council started from 2003 also setting up a crisis group to manage the sudden crisis. They have 2 kinds of crisis management: central crisis management, and self-suicide and infectious control management. On the other hands, the Council promotes staff’s awareness of occupational health and safety. The injury rate was greatly reduced and with an encouragement result. Management change and Quality Systems: The Council provides diversified social service and also values the service quality. Since 1980s, the Council has gradually set up the quality service culture. In 1996, the Council was pleased to join a programme called “quality journey”, and carried out the total quality management and kept improving persistently. During the process of re-organising the management structure, the Council received the subsidy from Hong Kong Social Welfare Department “Business Improvement Project”. Therefore, the Council started to restructure in 4 aspects: service operations, human resources, financial resource and content flow. Setting up the Regional office to coordinate community based service planning and implementation, in order to provide higher quality social service. The Quality Department lead by an experienced director who implemented the quality management, dedicated to enhance the service quality of each service unit as well as to provide professional consultancy service for the field. The Department also successfully helps the unit get accredited and won various awards. In order to uphold the principle of being valuable, the effectiveness of the service is required to be measured. Having measured, the service would be allocated the resources according to their performance. To measure performance, the general practice is to choose some recognized indicators. The Council started from 2001 implemented the measurable indicators which further reveal the efficiency of the quality management. To further carry out the quality management plan, the team provides tailor made quality management training and consultancy service for China, Macau and Hong Kong. They include ISO9001:2000, Environmental management, Occupational safety quality management etc. which all contribute to experience the efficiency of the total quality management. Human Resource Management: There is a Human Resources and Administration Department under the Head Office in the Council. And the Department mainly responsible for the recruitment of the staff, providing its members with payroll and benefits, and administrating their work-life needs. By responding and developing the harmonious culture between employers and employees, the Council joined the “The Employer of The Year Award 2004”. The judging panel of the organizer based on nine distinct employer elements and randomly chose over 100 staff members from the Council for the final selection. Love and care are what the council have been sustaining, and won the recognition from the judging panel in the selection process. The Council conducted the staff satisfaction survey in January 2005, total 1384 questionnaires have been issued to staff with a return rate of 86%. The questionnaire included six domains, namely planning and communication, role of staff, agency culture, agency operation, supervisory relationship and training. The overall satisfaction rate is 72.4%. Financial Management: There is a Financial Department under the Head Office in the Council. The department mainly is to manage the financial affairs, particularly the differences between income and expenditure. According to the Financial Report of 2004/2005, the incomes of the Hong Kong Sheng Kung Hui Welfare Council are mainly from the Social Welfare Department Subvention (70%). And others incomes are from Lotteries Fund, Jockey Club, Community Chest, and Fee Assistance. The total incomes are HK$ 459, 813, 498 for the whole year. And the expenditures are distributed all to the clinical services (child care service, children and youth service, family and counseling service, rehabilitation service, community service, wellness service, elderly service, training, and other services). The total expenditures are HK$ 446,361,766 for the whole year. Discussion and Comments: Hong Kong Sheng Kung Hui Welfare Council was established in 1973. And over the thirty years, the organization pace and related to the organization performance, led to an emphasis on building the adaptive capacity of people, structures, processes and organization strategy. Change is a natural and continuous process according to the open systems theory. Hong Kong Sheng Kung Hui Welfare Council is process a transformational change. During the process of re-organising the management structure, the Council started to restructure in 4 aspects: service operations, human resources, financial resource and content flow. Setting up the Regional office to coordinate community based service planning and implementation, in order to provide higher quality social service. According to Lloyd, Johnstone & Dwyer (2002), the organizational development approach emphasis democratic and humanist values, participative processes, a spirit of inquiry and a focus on personal and organizational growth. It relies on a climate of trust, openness, and commitment to the organization’s mission and values. Organizational development methods revolve around participative and democratic decision-making, education of organizational members and a focus on the primacy of organization goals. Organizational development methods have been criticized for having too strong a focus on structural redesign, and for the amount of time required to effect change in this participatory style. For the organization environment, as it developing the harmonious culture, the staff satisfaction survey can show that most of the staffs have job satisfaction. According to Mickan and Boyce (2002), human resource theory adopts a closed system perspective on empowering individuals to be responsible for maintaining and improving their work. This theory highlights the way in which individuals can contribute their full creative potential towards an organization, with the appropriate and supportive structures and management processes. Health care organizations can empower and motivate individuals to provide quality patient care, through supporting continuing personal development. Performance management systems are used to motivate and manage employees. Managers often emphasis the importance of developing interpersonal communication and collaboration skills to maximize individual’s motivation and contributions. Given sufficient training and autonomy, employees can identify and solve their own problems. So to achieve continues quality improvement. Conclusion: Hong Kong Sheng Kung Hui Welfare Council was one of the most prominent social welfare organizations, also being the one which provides with the most comprehensive social welfare services organization under the Anglican Communion. The vision of the Council is “Individual Caring, Overall Concern”. The Prayer of St. Francis is the motto of the co-workers. Currently, there are over 200 service units of the Council distributed over the Hong Kong and Macau. The incomes of the Hong Kong Sheng Kung Hui Welfare Council are mainly from the Social Welfare Department Subvention. And the expenditures are distributed all to the clinical services. In 1996, the Council was pleased to join the programme called “quality journey”, and carried out the total quality management and kept improving persistently. The Council started to restructure in 4 aspects: service operations, human resources, financial resource and content flow. Setting up the Regional office to coordinate community based service planning and implementation, in order to provide higher quality social service. The Council process the transformational change, and it make real difference. Afterward, Hong Kong Sheng Kung Hui Welfare Council won various awards. As leading change requires vision, courage, creativity, effective communication and a clear plan. The Hong Kong Sheng Kung Hui Welfare Council as a health care organization in Hong Kong is very successful. Credit:ivythesis.typepad.com

Report on a health facility visit

INTRODUCTION: Hong Kong Sheng Kung Hui Welfare Council was established in 1973. The development is not very long but the Council inherits...

Diabetes is a notorious epidemic which affects mostly the elderly people

LITERATURE REVIEW – IMPACT OF DIABETES ON PHYSICAL FUNCTION IN OLDER PEOPLE   Diabetes and Physical Disability                (2005) states that diabetes is a notorious epidemic which affects mostly the elderly people. Disability affects about 20 to 50% of the diabetic population whereby 2 to 3 persons with diabetes are more likely to be disabled than non-diabetics. Disability is defined in relation to its impact on the individual either functionally, medically, anatomically or emotionally. As such, diabetes is associated with disability is several processes which may lead to temporary impairment that is associated with physical and social limitations. In physical disability in diabetics in particular, there are multiple factors which implicate in the pathogenesis of such including cardiovascular disease, obesity, stroke, visual impairment, peripheral nerve dysfunction, peripheral arterial disease, falls and depression. With this said, structured exercise programs and weight lost programs could improve the physical ability of older people with diabetes.   According to (2005), physical disability is increasingly being recognized as both challenge and consequence for older adults with diabetes. The effects of diabetes on disability greatly differ between middle-aged and older adults. The characteristics of associating diabetes with physical disability as well as the extent to which the effects of diabetes to physical functioning covers gaps which implicate appropriate diabetes management. Based on the data from two parallel national panel studies, the researchers was able to conclude that diabetes was strongly associated with subsequent physical disability in middle aged and older adults.(2005) made use of composite variable that combines activities of daily living, mobility, and strength tasks. One of the significant predictor of disability in both groups lies in the control of socioeconomic characteristics and other diabetic-related conditions. As such, there is the necessity to prevent and mitigate disability as an important diabetes-related health outcome in middle aged and older adults.               According to  (2006), diabetes increases the risk for mobility limitation among older adults with diabetes. The author advised that the monitoring of prevalence of diabetes is crucial especially because inherent to the medical disorder are risks factors centering the burden of mobility limitation.  (2006) said that the prevalence of mobility limitation among adults with diagnosed diabetes was greater than those without diagnosed diabetes and that the odds of mobility limitation were greaterfor adults with diagnosed diabetes. Commonly, mobility restraints were related to walking a quarter of mile and walking up to 10 steps. Older adults with diabetes (33%) were reported having difficultieswalking a quarter of a mile and difficulties walking up 10 steps.                (2005) aver that the already high and increasing prevalence of diabetes amongolder adults will make ageing-related outcomes like physicaldisability an increasingly important complication of diabetes. For them, disability is a key indicator of both overall morbidity and success of public health initiatives especially for diabetic older adults. Diabetes is always associated with increased risk of disabilities in mobility and in instrumental and basic activities of living. Higher disability among older patients with diabetes is also associated with comorbidities such as multifactor withneuropathy, peripheral arterial disease, coronary heart disease,depression, obesity, visual impairment, and physical inactivity as these factors impose greater risk and effects of disability. The existence of interventions varies from exercise programs, identification and treatment of depression, long term prevention of disability by means of glycerin and risk factors for cardiovascular disease. (2005) proposed that the prevention of disability will depend on the combination of secondary and tertiary prevention along with preventing diabetes at the onset.      (2002) assert that diabetes is now a global epidemic; however, physical ability and cognitive decline are two underappreciated diabetes-related problems. In industrialized countries, most especially, diabetes is more among the elderly people due to the ageing of the overall populationas well as a greater absolute increase in the prevalence of diabetesamong elderly people than among young people. As cited in the article, diabetes is also associated with greater risks of disabilities related to mobility and daily tasks among elderly people. As such, the association of diabetes with physicaldisability is explained in part by and because of classic complications of diabetes. The authors ended their discussion with stating that as the number of older people with diabetes and other chronic diseases increases, outcomes such as cognitive and physicaldisability will become greater concerns because of their implicationsfor quality of life, loss of independence, and demands on caregivers.   Diabetes and Comorbidities               The role of diabetic complications and comorbidity in the association between diabetes and disability in the elderly is a common subject in diabetic research. (2004) made use of data from a nationally representative sample 5632 older Italians, aged 65 years and older. A physician conducted clinical diagnoses of diabetes and other major chronic conditions and disability was assessed by self-reported information on activities of daily living and physical performance tests. Disability on the basis of activities of daily living was associated with diabetes in women, but not in men and in contrast, the association between severe and/or total disability on the basis of physical performance tests and diabetes was strong in both sexes.                As  (2006) put it, important is to assess which of the broad range of determinants of health are most strongly associated with health-related qualityof life (HRQL) among people with diabetes. Studying the Canadian respondents, the researchers found out that comorbidities had the largest impact on HRQL including stroke and depression. Likewise, stress, physical activity, and sense of belongingalso were important determinants as well as social assistance and food insecurity.(2006) concluded their study with stating that ‘social and environmental factors are important,but comorbidities have the largest impact on HRQL among peoplewith diabetes’.               (2005) investigated the associations between diabetes and disability in three domains and to determine whether the associations are mediated by diabetes-related complications. Basic activities of daily living (ADLs), instrumental ADLs, and mobility are the three domains examined. Through studying of 2, 003 of older adults with diabetes, (2005) found out that older adults with diabetes are more likely to report difficulty in 12 of 15 ADLs than older adults without diabetes. Further, diabetic patients with diabetes are about twice as likely to report disability in higher functioning tasks only, as well as mobility and higher functioning tasks, and 3.5 times as likely to report disability in self-care tasks with or without any other mobility or higher functioning tasks as those without diabetes.  (2005) winded up their study with emphasizing that diabetes is strongly related to a wide range of disabilities in older Hong Kong adults and the underlying mechanisms might be different for different categories of disability.               Major depression, additionally, is a comorbidity of diabetes, leading to functional disability.  (2004) tried to determine the prevalenceand odds of functional disability in individuals with diabetesand comorbid major depression compared with individuals witheither diabetes or major depression alone. He found out that the odds of functional disability was higher for those with diabetes based on the data collected through 30, 022 adults with diabetes. The study concluded that diabetes and comorbid depressions have higher associations, contributing to the likelihood of functional disability.               Since cognitive decline is also apparent for older people with diabetes, another comorbidity by which functional disability is being associated upon is the common mental disorders. According to  (2007), there is the necessity to determine the associations between diabetes and common mental disorders as well as the associations between comorbid common mental disorders with the quality of life and diabetes and self-care indicators. The conducted study proved that people with diabetes were more likely to suffer from commonmental disorders and among people with diabetes, common mental disorders were significantlyassociated with impaired health-related quality of life, moredays off work, nonadherence, and difficulties with diabetesself-care.               Visual acuity is another comorbidity that is not usually considered. and his collaborators (2000) explored such issue, aiming to screen for impaired distancevisual acuity in older adults with and withoutdiabetes mellitus to determine whether diabetes increase the likelihood ofvisual impairment and to identify associatedfactors. With the comparison of the groups, the authors found out that diabetes was associated with an increased risk of visual impairment hence the significant association with impaired visual acuity and five domains of the SF-36 as physical and social functioning, mental health, vitality, and healthperceptions. As such, diabetes mellitus isassociated with significantly increased risk of visual loss and thisimpairment is associated with detriments in health-related quality of life. Particularly, SF-36 is the simplified short-form 36 questionnaire.(1993) tested the validity of the instrument and found that there is a high degree of internal consistency. As such, SF-36 is suitable for use with an elderly populationwhen used in an interview setting.   (2007) explored the nature of functional impairment in older people with diabetes. In a population-based case-control study conducted, the authors discovered that subjects with diabetes had more comorbidities than control subjects and were more likely to have severe functional impairment. The health status of the older adults in relation to physical function emphasize that diabetes remained significantly associated withmobility limitation. (2007) concluded that older people with diabetes have considerable functional impairment associated with reduced health status, recommending that older adults may benefit from comprehensive geriatric assessment and tailored diabetes management.              (2005) reiterated that diabetes mellitus is an important public health concern with impact that is increased by the high prevalence of co-existing chronic medical conditions. The authors evaluated how diabetes and other chronic medical conditions could affect the health-related quality of life. The chronic medical conditions considered are hypertension, heart disease and muscoskeletal illnesses. Generally, the co-existence of diabetes and chronic conditions reduced the health-related quality of life of elderly people with diabetes.    (2002) described the incidence of falls, risk factorsfor falls, and the frequency of fall-related fractures in acohort of individuals with diabetes and a prior foot ulcer in their study. With a total of 400 individuals with diabetes, the researchers were able to determine the association of diabetes with fall-related morbidity, emphasizing that he presence of one or more comorbid conditions,and insensate feet increased the risk including two or more falls ofany type were associated with a higher fracture risk.  (2002) concluded that falls are very common in individuals withdiabetes and prior foot ulcers, and were significantly higher in women than in men.   Diabetes and Older Men vs. Women               Another study which deals with older women with diabetes is that of (2002).  (2002) examined the relationship between diabetesand the incidence of functional disability and to determinethe predictors of functional disability among older women withdiabetes. Women aged ≥ 65 years were the subject of the analysis and were assessed by using questionnaire and physical examination over 12 years. The authors defined incident disability as onsetof inability to do one or more major functional tasks. Findings proved that the annual incidence of any functional disability which is associated with comorbidities was 9.8% among women with diabetes and 4.8% among women without diabetes. As such, diabetes remained associated with a 42% increased risk of anyincident disability and a 53–98% increased risk of disabilityfor specific tasks.  (2002) concluded that diabetes is associated with an increased incidenceof functional disability, which is likely to further erode healthstatus and quality of life.                          (2004) attempted to identify the patterns of disability related to diabetes in older women and distinguish the extent to which disability is mediated by selected diabetes complications. The results of the study include: women with diabeteswere significantly more likely to report difficulty in 14 of15 daily tasks. Some of these are walking 2–3 blocks, lifting10 pounds, using the telephone, and bathing. Further, women with diabetes were about twiceas likely to report difficulty in any one of four functioning groups consisting of mobility, upper extremity, higher functioning tasks,or self-care. These women are also and over three times as likely to report difficulty in a groupcombining higher functioning and self-care tasks. As such, diabetes is clearly associated with a wide range of disabilities in older women.                          (2002) inspected the role of diabetes-related impairments and comorbidities in the association between diabetes and physical disability by examining the association between diabetes and lower extremity function of older women with diabetes. The cross-sectional analysis of 1, 002 women resulted in particular findings that women with diabetes had a greater prevalence of mobility disability, activities of daily living disability and severe walking limitation. The main contributing factors are peripheral artery disease, peripheral nerve dysfunction, and depression. Even so, none of these conditions alone fully explained the association between diabetes and disability.  and his colleagues (2002) concluded that even among physically impaired older women, diabetes is associated with a major burden of disability. The researchers also contend that several impairments and comorbidities explain the diabetes-disability relationship, suggesting that the mechanism for such an association is multifactor.   (2000) estimated the prevalence of physical disability associated with diabetes among elderly adults in the US. The findings of the survey of 6,588 community-dwelling men and women > or =60 years of age suggest that 32% of women and 15% of men reported an inability to walkone-fourth of a mile, climb stairs, or do housework. (2000) claim that diabetes was associated with increased odds of not being able to do each task among both men andwomen. For women with diabetes, diabetes was also associated with slower walking speed,inferior lower-extremity function, decreased balance, and an increased riskof falling. The authors concluded that diabetes is associated with a major burden of physical disability in olderU.S. adults, and these disabilities are likely to substantially impairtheir quality of life.   Diabetes and Lower Extremity Disability    (2003) assert that older people with diabetes are more likely to have a higher prevalence of multiple risk factors for physical disability, resulting from the diabetes complications. Although the three-year longitudinal cohort study focuses on the case of women, the authors found out that impaired lower extremity function is a long-term diabetic complication in older patients. (2003) suggested that a comprehensive assessment of older diabetic patients must include a standardized evaluation of the performance of lower extremity.  (1995) recuperate that functional assessment is an important part of the evaluation of elderly persons. The researchers conducted a study to determine if objective measures of physical function could predict subsequent disability in older persons with emphasis given on functionality of lower extremity. The study pronounced that the increase in the frequency of disability in the activities of daily living and mobility-related disability is evident.     Lower body disability is said to be common among diabetic older people. A specific study such matter revealed that 48.7% of the of the 1, 835 of Mexican American older adults with ≥65 years old at baseline developed limitations in one or moremeasures of lower body function over a seven-year period of study. Aiming to examine the interplay between the two variables as diabetes and lower body disability, the study also found out that olderage and having one or more diabetic complications were significantlyassociated with increased risk of limitations in any lower bodyADL and mobility task. The authors suggested that awareness of disability as a potentially modifiable complicationand use of interventions to reduce disability should becomehealth priorities ( 2005).    (2007) supposed that diabetes in older adults is associated with a 2- to 3-times increased risk for falls and physical disability, and that muscle strength is reduced especially in the lower extremities. During a three-year period, the authors examined adults with diabetes aged 70 to 79 and then examined the rate loss of f upper and lower extremity skeletal muscle mass, strength, and quality.  (2007) found out that those with diabetes had greater body weight, body mass index, total fat mass, and total lean mass. Nonetheless, individuals with or without diabetes lost significant amounts of initial muscle strength. Findings also point out that older adults with type 2 diabetes lost their knee extensor strength more rapidly than those without diabetes and also lost greater amounts of lean leg muscle mass. However, changes in hand grip strength and arm muscle quality were not different between those with and without diabetes, although hand muscle mass declined more in patients with type 2 diabetes.   Particularly, gait characteristics differ among individualswith diabetes compared to those without diabetes. Nonetheless, there is limited explanation about the association of gait characteristic and diabetes.  (2008) studied the association betweendiabetes and gait characteristics in older adults and explored potential explanatory factors. The researchers have learned that diabetes was related to gait speed and is partially explained by factors as health status, visual impairment, lower-extremity strength,physical activity and body mass index. Evidently, diabetes was associated with gait alterations of the people suffering from the disorder.    Diabetes and Muscle Strength and Quality    (2006) also studied how muscle strength and quality in older adults with diabetes contribute to the chances of physical disability. The authors maintain that adequate skeletal muscle strength is essential for physical functioning and low muscle strength is a predictor of physical limitations, and the risk of physical disability is three times higher to older people with diabetes. According to their population study of 485 adults with diabetes, they found out that older adults with diabetes had greater arm and leg muscle mass than those without diabetes because they were bigger in body size. Despite such fact, muscle strength was lower in men with diabetes and not higher in women with diabetes than corresponding counterparts. Muscle strength per unit regional muscle mass or simply muscle quality was significantly lower in men and women with diabetes than those without diabetes in both upper and lower extremities. In sum, there is a clear association with diabetes, muscle strength and quality and physical limitations in older adults with diabetes.    (2005) also said that older adults with diabetes are more likely to have poor muscle quality and accelerated loss of strength over a three-year period. According to  epidemiologist, “these characteristics may contribute to the development of physical disability in older adults with diabetes.” A known fact, moreover, is that older adults with diabetes face a two- to threefold higher risk of physical disability. However, the increased risk with respect to changes in muscle characteristics is an area not yet explored. Park reported that older adults with diabetes had greater leg muscle mass but knee extensor strength was lower in diabetic men. Absolute strength at baseline did not differ by diabetes status, but muscle quality was significantly lower in women with diabetes.   Diabetes and the Role of Clinician and Treatment   (2006) stress that the increasing prevalence of diabetes is a major health concern. Reducing complications of diabetes has been a focus on treatment. However, the authors also highlight that less recognized complications of physical disability, cognitive impairment and depression which impact the quality of life of older adults are equally important in primary care considerations in older patients with diabetes. The researchers discovered that slower muscle contraction which is more common in diabetic older adults is a significant contributor to both balanceand gait impairment. As such, there is an interconnection between muscle power, contraction velocity and physical disability among diabetic patients. (2006) also claim that compliance to exercise activities and/or physical treatments was related to improved mobility.               In their study, (2007) inspected the dynamics of disease prevention andmanagement while also determining the prevalence ofphysical activity among adults with and at risk for diabetes. The findings of the study are summarized as: A total of 39% of adults with diabetes were physicallyactive versus 58% of adults without diabetes. The proportionof active adults without diabetes declined as the number ofrisk factors increased until dropping to similar rates as peoplewith diabetes. After adjustment for sociodemographic and clinicalfactors, the strongest correlates of being physically activewere income level, limitations in physical function, depression,and severe obesity. Several traditional predictorsof activity such as sex, education level, and having received pastadvice from a health professional to exercise more were not evident among respondents with diabetes. With these results,  (2007) suggested that there is the necessity to target interventions to increase the physical activity of patients with diabetes or at highest risk of developing Type 2 diabetes by reason of lack of engagement in regular physical activities.   According to  (2006), it is necessary for every clinician who manage older people with diabetes the special skills for the purpose of providing high quality care. The approach must be influenced by multitude of factors including the higherfrequency of medical comorbidities, frailty, and socioeconomicissues. The author also maintains that comprehensive geriatric assessment is a potentially important tool in ensuring that patients with diabetes receivea multi-professional assessment of their functional status andunmet needs. The target thereby is effective goal setting of providing additional means of conforming therapeutic approaches.                 (2006) assessed that diabetes self-management education (DSME) for older adults is a complicated endeavour. This is because of the high prevalence of medical comorbidities and declining functional status. In order for the diabetes health community to adequately meet the educational needs of older adults with diabetes, DSME should be individualized and also involve multiple disciplines, care partners for patients who cannot assume full responsibility of own self-care. There is also the necessity to weigh the potential effects of diabetes treatments on quality of life.  ended their discussion with suggesting that in providing appropriate carefor these patients is to ensure that an adequate initial assessmentis provided for them. The special needs of this population as well as the cognitive and physical issues must be also taken into account.                 Furthermore, achieving self-care goals would not be easy for older adults with diabetes especially when there is the inexistence of physical barriers. Physical barriers could pose challenges in sustaining the quality of life for older diabetic adults. The decision-making process for developing strategies to overcome physical barriers is thereby a must.  (2001) stresses that physical barriers may or may not be diabetes-related; there are various diabetes-related complications and manifestations and could arise from long term complications of diabetes, requiring the development of adaptive strategies. The types of physical barriers to functionality include: long term and short term barriers, cognitive and non-cognitive barriers.                                                   Credit:ivythesis.typepad.com

Diabetes is a notorious epidemic which affects mostly the elderly people

LITERATURE REVIEW – IMPACT OF DIABETES ON PHYSICAL FUNCTION IN OLDER PEOPLE Diabetes and Physical Disability (2005) s...

Obesity in America: The Growing Epidemic

A REPORT ON OBESITY IN AMERICA: THE GROWING EPIDEMIC       THE RESEARCH QUESTIONS   <li class="MsoNormal" style="line-height: 200%">What are the current medical definitions of your medical entity? </li> <li class="MsoNormal" style="line-height: 200%">What is the prevalence of the medical entity in the states and counties represented by the members of your study group?   </li> <li class="MsoNormal" style="line-height: 200%">Has the prevalence of the medical entity in those states and counties changed over the last 50 years? </li> <li class="MsoNormal" style="line-height: 200%">What age groups (infants, children, teens, young adults, middle aged, or elderly) have shown the greatest increase in the medical entity in the last 10 years?   </li>   STATE AND COUNTY INFORMATION ALABAMA:   What are the current medical definitions of your medical entity?   The medical entity, obesity, is defined as any adult with a BMI above 30.  The BMI is calculated by dividing a person’s weight in kilograms by his/her height in m^2.  It is thought to provide an indication of one’s health concerning excess body fat (). What is the prevalence of the medical entity in the states and counties represented by the members of your study group?  In 2003, the Alabama Center for Health published a report using statistics from the Behavior Risk Factor Surveillance System, which estimated Alabama to have an obesity percentage of 24.5, ranking them in the top 7 states in the nation in obesity.  Furthermore, 37.2 percent were found to be overweight. This study also included individual county studies of obesity, which demonstrated that counties in the lower third of the state had the highest numbers of obese people.  An estimated 26.6 to 31.8 percent of people in these counties were found to be obese.  Most of northern Alabama, as well as Baldwin and Geneva counties in south Alabama, had a percentage of obesity from 21.8 to 23.0 percent (). According to a 2005 Behavior Risk Factor Surveillance System, 29 percent of adults in Alabama are obese. The percentage of overweight people is 36 percent (Alabama Department of Public Health). In a more recent report published in 2006 and distributed by “Trust for America’s Health” in Washington D.C., Alabama was ranked 1st in the nation in obesity with an estimate 28.4% of the adult population being obese ().   Has the prevalence of your medical entity in those states and counties changed over the last 50 yrs? The prevalence of obesity over the past 50 years has changed dramatically.  Data collected from an article entitled “Obesity in America,” a 20 year obesity statistical recording listed that from 1985 to 2005, Alabama’s percentage of obese adults increased by almost 20 percent.  In 1986, the percentage of obese people in Alabama was less than 10 percent.  By 1998, the percentage increased to about 20 percent.  From 2001 to 2005, the percentage fluctuated at around 25 percent and in 2006; Alabama became the most obese state in the nation, with about 28.4 percent of the adult population being obese (). Income levels have a correlation with obesity, and can possibly be one of the main factors that one should use when considering the source of Alabama’s obesity. In Alabama, the prevalence of obesity in groups with less than or equal to ,000 was 30.9 percent. People with incomes around ,000 were 20.8 percent obese. Education also had an impact, showing 26.3 percent obesity for adults with only a high school education. This contrasted the 18.5 percent of college graduates in Alabama that were obese ().   What age groups (infants, children, teens, young adults, middle aged or elderly) have shown the greatest increase in the medical entity in the last 10 years?   The numbers of overweight youth in Alabama are rising fast as well. Data from the 2005 Youth Risk Behavior Survey shows that among high school students, 15 percent are overweight and 18 percent are at risk for overweight ().   CALIFORNIA (SAN DIEGO COUNTY):   What are the current medical definitions of your medical entity?   For adults, obesity is defined as having a very high amount of body fat in relation to lean body mass, or Body Mass Index of 30 or higher.  BMI is a measure of an adult’s weight in relation to his or her height i.e. the adult’s weight in kilograms divided by the square of the individual’s height in meters.  For children and teens, BMI ranges above a normal weight have different labels (at risk of overweight and overweight). The BMI ranges for children and teens are defined so that they take into account normal differences in body fat between boys and girls and differences in body fat at different ages (Wood County Health Department 13). What is the prevalence of the medical entity in the states and counties represented by the members of your study group?  The rate of obesity is climbing in the state of California and is consistent with national trends.  (2001) reported that there were more than 4.7 million obese adult Californians in 2001 with Marin County having the lowest proportion of obese adults. San Diego had lower percentage of obese adults compared to the general California percentage (2). According to the 2003  (CHIS), the prevalence of obesity among adults, age 18 and older, in California was 21 percent while the prevalence of obesity among adults in San Diego County was 18 percent (). Furthermore, in 2005, 33 percent of children in California are overweight and thus, are likely to become obese when not assisted (). In 2006, a third of California children and one in every four teenagers are either overweight or obese (). Approximately 28 percent of obese California children are in fifth, seventh and ninth grades .   Has the prevalence of your medical entity in those states and counties changed over the last 50 yrs? In the last 50 years, the overall prevalence of obesity has increased in California, even doubling for both men and women from 1990 until 2003 (). According to the CDC’s Behavioral Risk Factor Surveillance System (BRFSS), in 1985 the prevalence of obesity among adults was less than 10 percent in California.  In 1988, obesity increased to 10-14 percent. In 1989, obesity dropped back to less than 10 percent. In 1991, it increased again to 10-14 percent and stayed within this range until 1997 when it increased to 15-19 percent.  In 2001, the prevalence increased to the 20-24 percent range. It dropped back to the 15-19 percent range in 2002. In 2003, the obesity prevalence increased to the 20-24 percent range and has remained in this range ( ). In addition, the obesity rate for men in 2003 increased by 23 percent while the rate for women recorded a 22 percent increase (). The  (NHANES) data show that the prevalence of overweight among children from 6-11 years old increased nearly four-fold between 1963 and 2000. Among adolescents from 12–19 years old, the prevalence of overweight increased more than three-fold between 1966 and 2000 ( ). In 2006, 14 percent of children in California who are between six and seventeen years old were obese, 15 percent of the same age group were overweight and 72 percent of fifth, seventh and ninth graders failed in the state standards of general physical fitness (Childhood Obesity). San Diego, which was once America’s Fittest City dropped to the 14th slot in the 2004 ranking as obesity continuous to heighten in the last 15 years – 50 percent in adults and 100 percent among children and adolescents (Obesity is Bad). Because overweight children are likely to become overweight adults, these children are more liable to suffer from cardiovascular disease, cancer, and diabetes in adulthood—all chronic, but largely preventable diseases that already account for two-thirds of all deaths in California (). The high prevalence of overweight and physical inactivity is caused by many individual, social, and environmental factors. This epidemic is perpetuated by conditions including, but not limited to, the following: increasing portion sizes, increasing consumption of fast food and soft drinks, lack of funding for nutrition and physical activity programs, availability of soda and junk food on school campuses, poor physical activity infrastructures in schools and communities, limited compliance with physical education requirements in many schools, limited access to healthy foods in low-income neighborhoods, and advertising of junk food to children and their families (3).   What age groups (infants, children, teens, young adults, middle aged or elderly) have shown the greatest increase in the medical entity in the last 10 years?   In the past 10 years, according to the Behavioral Risk Factor Surveillance System, the years 1995, 2000, 2005 in the United States revealed that the age group that has shown the greatest increase in obesity is the 30-39 age group. This group showed an increase from an obesity prevalence of 14.3 percent in 1995 to 24.4 percent in 2005 (a 10.1% increase).  Males aging between 55 to 64 years old recorded an increase of 27.2 percent in 1988-1994 and 35.5 percent in 1999-2002 while 65 to 74 year-old females had the greatest increase in obesity from 26.9 percent in 1988-1994 to 39.3 percent in 1999-2002 (). California is facing a public health crisis in the form of obesity. Californians have gained 360 million pounds in the last 10 years. More than half of the state’s adults are overweight or obese and more than a quarter of California’s students are overweight, placing California’s rate of childhood obesity higher than the national average. Poor diet and lack of physical activity are the second leading causes of death and disability, resulting in nearly 30,000 deaths each year in California. California’s economic burden as a result of this crisis was billion in 2000, and is expected to rise to billion in 2005. Health officials predict that if these trends continue, this generation of children will be the first to have a shorter life expectancy than their parents (). According to the  (2007) unhealthy eating habits established in childhood, adolescence and late teens carry over to adulthood. Sedentary lifestyle coupled with decreased metabolic rate. Lifestyle changes due to technology such as elevators, cars, dishwashers, televisions, power lawn mowers, etc. Decreased metabolic needs and energy expenditure coupled with the same or increased food intake.   MARYLAND:   What are the current medical definitions of your medical entity?   The  (2006) overweight and obesity are both labels for ranges of weight that are greater than what is generally considered healthy for a given height. The terms also identify ranges of weight that have been shown to increase the likelihood of certain diseases and other health problems. For adults, overweight and obesity ranges are determined by using weight and height to calculate a number called the “body mass index” (BMI). BMI is used because, for most people, it correlates with their amount of body fat: an adult who has a BMI between 25 and 29.9 is considered overweight; and an adult who has a BMI of 30 or higher is considered obese.   What is the prevalence of the medical entity in the states and counties represented by the members of your study group?  Fifty nine percent of Maryland adults were overweight or obese in 2004. Twenty-two percent of non-Hispanic white adults, 31 percent of non-Hispanic black adults, and 19 percent of Hispanic adults in Maryland are obese. Furthermore, 29 percent of low-income children between 2 and 5 years of age in Maryland are overweight or at risk of becoming overweight ().   Has the prevalence of your medical entity in those states and counties changed over the last 50 yrs? The prevalence of obesity has increased over the last 50 years. The following statistics shows the percentages from different years:   <ul style="margin-top: 0in; margin-bottom: 0in" type="disc"> <li class="MsoNormal" style="text-autospace: none"> 1987-88: 10-14% (highest percentage range) </li> <li class="MsoNormal" style="text-autospace: none"> 1989-94: 10-14% (second highest range) </li> <li class="MsoNormal" style="text-autospace: none"> 1995-96: 15-19% (highest percentage range) </li> <li class="MsoNormal" style="text-autospace: none"> 1997-00: 15-19% (second highest percentage range) </li> <li class="MsoNormal" style="text-autospace: none"> 2001-02: 15-19% (third highest percentage range) </li> <li class="MsoNormal" style="text-autospace: none"> 2003-04: 20-24% (second highest percentage range) </li> <li class="MsoNormal" style="text-autospace: none"> 2005: 20-24% (third highest percentage range) </li> </ul>   Overall, the prevalence of obesity increased in Maryland; the numbers indicate that the prevalence tended to reach a plateau for a few years and then increased ().   What age groups (infants, children, teens, young adults, middle aged or elderly) have shown the greatest increase in the medical entity in the last 10 years?   There has been an increase of 62 percent in the number of obese adults from 1990-2002 (No Children).     NEW JERSEY:   What are the current medical definitions of your medical entity?   The  (2006) states that obesity is “the excess accumulation of body fat and a growing health problem. Obesity is a known risk factor of numerous chronic diseases, including diabetes, heart disease, high blood pressure, gall bladder disease, arthritis, breathing problems, and some form of cancer.”   What is the prevalence of the medical entity in the states and counties represented by the members of your study group?  In 2004, obesity affected 21.9 percent of adults in the state of New Jersey. The United States national average was 23.2 percent. In 2005, New Jersey was still under the national average ().   Has the prevalence of your medical entity in those states and counties changed over the last 50 yrs? What age groups (infants, children, teens, young adults, middle aged, or elderly) have shown the greatest increase in the medical entity in the last 10 years?”   The following chart shows that in the state of New Jersey, 55 to 64-year-old individuals had the highest percentage of obesity. Almost one-third of this age group was obese ().   Moreover, the 2005  Health Survey found out that 12 percent of ninth to twelfth graders were overweight and another fifteen percent were at risk for becoming over weight. A study conducted in 2003 by the New Jersey Departments of Health and Senior Services and Education found that 20 percent of sixth graders evaluated were obese and another 18 percent were overweight. Higher obesity levels were observed among the sixth grade boys as compared to girls (). The following reports and figures are from the  (2005):     The above figures say that most students in New Jersey are “TV couch potatoes”. The figures reveal that 36 percent of New Jersey high school students spend three hours a day in front of the TV. It can also be deduced that male high school students are more likely to have obesity in New Jersey. Another interesting chart showed ethnic groups and percentages and how prevalent obesity was in each group follows:              Source: (2000). From the statistics in the figure below, it can be sorted out that there are about 385,000 New Jersey residents who are at the age of 60. From the figure above it can be said that 29 percent of this age group were obese ().     PENNSYLVANIA     TEXAS:   Total State Population:  22,859,968 (2005 estimate) Dallas County Population:  2,305,454 (2005 estimate)   What are the current medical definitions of your medical entity? According to the  (2006) overweight refers to increased body weight in relation to height, when compared to some standard of acceptable or desirable weight. Overweight may or may not be due to increases in body fat. It may also be due to an increase in lean muscle. For example, professional athletes may be very lean and muscular, with very little body fat, yet they may weigh more than others of the same height. While they may qualify as “overweight” due to their large muscle mass, they are not necessarily “over fat,” regardless of BMI. The BMU of overweight people exceeds 25. Desirable weight standards are derived in a number of ways: (1) by using a mathematical formula known as Body Mass Index (BMI), which represents weight levels associated with the lowest overall risk to health. Desirable BMI levels may vary with age; and (2) by using actual heights and weights measured and collected on people who are representative of the U.S. population by the National Center for Health Statistics. Other desirable weight tables have been created by the Metropolitan Life Insurance Company, based on their client populations (). These sources are consistent with the U.S. Dietary Guidelines and with the National Heart, Lung, and Blood Institute’s Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Obesity is defined as an excessively high amount of body fat or adipose tissue in relation to lean body mass. The amount of body fat (or adiposity) includes concern for both the distribution of fat throughout the body and the size of the adipose tissue deposits. Body fat distribution can be estimated by skin fold measures, waist-to-hip circumference ratios, or techniques such as ultrasound, computed tomography, or magnetic resonance imaging. BMI for overweight or obese is 25 or more (). According to the  (2005) obesity is a complex, multi-factorial chronic disease involving environmental (social and cultural), genetic, physiologic, metabolic, behavioral and psychological components. It is the second leading cause of preventable death in the U.S. Overweight and obesity are part of the U.S. Department of Health and Human Services’ health agenda that have steadily moved away from their established targets for improvement. Today, public health leaders recognize obesity as a “neglected public health problem.” This fact sheet will demonstrate the impact of overweight and obesity on millions of Americans of all ages and both genders. What is the prevalence of the medical entity in the states and countries represented by the members of your study group?             Apparently that old saying that “everything is bigger in Texas” holds true for its residents as well.  According to the  (2006) in 2005, an estimated 10.4 million or 64 percent of Texas adults were overweight or obese. Also, a report released in 2005 found that Texas reported it had the 6th highest prevalence in adult obesity in the United States. Has the prevalence of the medical entity in those states and counties changed over the last 50 years? According to the  (2006) Texas dropped its state ranking from 6th to 10th.  Unfortunately, Texas dropped in the ranking because the prevalence of obesity increased in other states, not because the state of obesity had improved in Texas. If the current trends continue, 20 million or 75 percent of Texas adults might be overweight or obese by the year 2040, and Texas costs could quadruple from .5 billion today to as much as billion by 2040. The (2005) cites that: <ul style="margin-top: 0in; margin-bottom: 0in" type="disc"> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> There are no reports or statistics on American obesity prior to 1976.  The earliest data on American obesity was recorded between 1976 and 1980.  It was reported then that 46% of American adults were considered overweight and 14.4% were considered obese.  Since that time the percentage of overweight and obese Americans has increased dramatically.  The AOA last reported between 1999 and 2000.  At that time 64.5% were considered overweight and 30.5 were considered obese.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Early reported studies from the AOA do not give data for individual states and cities.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> In 1991 the AOA reported that 12.7% of Texas adults were obese.  In 1998 that number climbed to 19.9%.  In 2000 that number again increased to 22.7%.  The last reported statistic was in 2001 at 23.8%.</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> In 2000 Dallas, Texas was reported as the 15th most overweight city in the United States.  In 2005 Dallas, Texas was reported as the 6th most overweight city in the United States. </li> </ul> What groups (infants, children, teens, young adults, middle aged, or elderly) have shown the greatest increase in the medical entity in the last 10 years?             The  (2006) reports the following facts: ·         Overweight and obesity are more pronounced among men, minorities and middle-aged adults. ·         The prevalence of childhood overweight was greater in Texas in 2004-2005 than the U.S. rates reported for the 2003-2004 National Health and Nutrition Examination Survey (NHANES).  The overall prevalence of overweight and at-risk for overweight in Texas schoolchildren was 42% for fourth graders, 39% for eight graders and 36% for eleventh graders in 2004-2005. ·         In 2000-2001, the percentage of overweight students in Texas was much higher among minorities, with the highest prevalence of overweight in Hispanic boys in all grade levels, Hispanic girls in fourth grade and African American girls in the fourth and eleventh grades. ·         30% of Texas high-school students are overweight or at risk of becoming overweight. ·         From 2000-2002 to 2004-2005, the prevalence of overweight increased among both eighth and eleventh graders, but slightly dropped among fourth graders in Texas from 25.6% to 23%. On the other hand, the American Obesity Association (2005) claims that about 15.5 percent of adolescents (ages 12 to 19) and 15.3 percent of children (ages 6 to 11) are obese as of 1999-2000. The increase in obesity among American youth over the past two decades is dramatic.   WEST VIRGINIA (KANAWHA COUNTY):   What are the current medical definitions of your medical entity?   Obesity is defined as an excessively high amount of body fat or adipose tissue in relation to lean body mass: BMI = [(wt in pounds)/(ht in inches)2] x 703. Obesity ranges are determined using weight and height to calculate the “body mass index” (BMI), usually a number between 18.5 and 30.  An adult BMI of 30 or higher is considered obese.   Height Weight Range BMI Considered 5’ 9” 124 lbs or less Below 18.5 Underweight 125 lbs to 168 lbs 18.5 to 24.9 Healthy weight 169 lbs to 202 lbs 25.0 to 29.9 Overweight 203 lbs or more 30 or higher Obese   Calculated BMI is age- and sex-specific and is often referred to as BMI-for-age (Overweight and Obesity: West Virginia). According to West Virginia Health Statistic Center (2005) “a single measurement that needs only two factors, weight and height, makes it possible to conduct surveillance on a worldwide basis. There are limitations to BMI, of course. It can be overestimated among persons who are very athletic and have large muscle mass, on the one hand, and underestimated among persons who have lost muscle mass, such as the ill and the elderly. It has been recommended that different BMI cutoff points be used to determine overweight and obesity in certain racial groups (25). In general, however, BMI is considered to be a reliable indication of total body fat content for most adults, regardless of sex.” Furthermore, obesity is multi-factorial, based on both genetics and behavioral factors. Obesity also can contribute to the following diseases: Type 2 diabetes, hypertension, stroke, myocardial infarction, congestive heart failure, cancer, gall stones and gall bladder disease, gout, Osteoarthritis, Sleep Apnea, and Pickwickian Syndrome (Definition of Obesity). What is the prevalence of the medical entity in the states and countries represented by the members of your study group? In 2000, the obesity rate in West Virginia was 23.3 percent, an 8.2 percent increase from 1999.  From 1990-94 the prevalence of obesity in Kanawha County was 16.9 percent, ranking the county at 19 out of 55 counties. From 1995-99 Kanawha County had a 22.5 percent prevalence of obesity moving up to the 15th obese county in the state. Mineral County has also shown prevalence of obesity with an average of 37 percent compared to the US average of 33 percent. Obesity is increasing in all counties of West Virginia, but mostly a rise is being seen in the southern and western counties (which are the poorest counties), as well as the Eastern Panhandle (Obesity in West Virginia). “In 2002, West Virginia ranked first in the nation in the prevalence of obesity (27.6%) and 42nd highest in the prevalence of overweight (36.1%). More than 63 percent of West Virginians are considered overweight or obese.” (A Need for a Healthier West Virginia) Has the prevalence of the medical entity in those states and counties changed over the last 50 years? The prevalence of obesity has changed in Mineral County, West Virginia over the past 50 years. In 1985 10 to 14 percent of West Virginians were obese with a BMI equal or greater than 30 (). According to reporter in 2005 West Virginia was considered one of the worst states in the country with obesity problems. West Virginia is consistently among the top three states in the nation for obesity, according to the Centers for Disease Control and Prevention and the State Bureau of Public Health.  The most current data, 2002, 28% of West Virginians were considered obese. West Virginia also leads the nation in hypertension and is fourth in the nation for diabetes (). What groups (infants, children, teens, young adults, middle aged, or elderly) have shown the greatest increase in the medical entity in the last 10 years?   Children, teens, and young adults have seen the most increase in obesity over the past 10 years (). For ages 18 years and above, the average weight for males and females in West Virginia has increased steadily from 1984 to 2000; the males rising from 177.2 pounds up to 194.0, and the women’s weight rising from 142.0 pounds up to 154.9 pounds (Obesity in West Virginia). The 1999 Youth Risk Behavior Study, conducted by the CDC over the telephone, shows the latest available data for the youth of WV and this age group’s obesity issues.  Using a BMI-for-age calculation formulated especially for children, whose BMI will differ according to sex and age during their developmental stages, the study showed that in 1999, 12.2% of West Virginia high school students in grades 9-12 were overweight, 15.8% being male and 8.3% being female, and that 15.9% of students were currently at risk of being overweight (Obesity in West Virginia). Sixty-four percent of West Virginia adults are obese or overweight while 29 percent of high-school students are overweight or at risk of becoming overweight. Moreover, 28 percent of low-income children between 2 and 5 years of age in West Virginia are overweight or at risk of becoming overweight (Overweight and Obesity: West Virginia).           Credit:ivythesis.typepad.com

Obesity in America: The Growing Epidemic

A REPORT ON OBESITY IN AMERICA: THE GROWING EPIDEMIC THE RESEARCH QUESTIONS What are the current medical d...