Population Statistics

Discuss about the Diabetes Self-Management Education Interventions.

A community is the residential association of a small or larger group of people living in a particular social unit behaving like a social unit. The heath of a community is dependent various different factors such as the population statistics of the community, economic status, social stratification, employment, available public services and the life style behaviour of the particular community, hence in order to understand the health status of a particular community it is crucial for the all the above mentioned contextual factors to be explored, analysed and addressed. The community health report serves this purpose excellently (Garber et al., 2016).

It has to be mentioned that ever community has particular health issues and health priorities and in order to be able to address the public health priorities with clarity and be able to address the particular health issues, it is imperative for the health promotional or prevention programs to focus on the different demographic and contextual factors. The community health reports are a potent tool that helps the health care sector or the related stakeholders to analyse and explore the health status and health outcomes of the community with respect to the demographic data and the contextual factors. This report will attempt to articulate a community health report for the city of Horizon and identify one potential health priority and promotion strategy by the registered nurses with respect to Ottawa charter and NMBA guidelines.

First and foremost, it has to be mentioned that the Horizon city is a quaint and small city located in the South eastern limestone coast region of the South Australia. The closest metropolitan city from Horizon is the Adelaide which is located 320 km away. Considering the population statistics of the city, it has roughly 29308 people inhabiting the area of 4284 hectares of the city. Hence as per the data shared by the Australian bureau of statistics, the population density for this city is 6.86 persons per hectare. Considering the gender and age related demographic data for the city, the city inhabits 13693 male residents (48.3%) and 14657 females in the city (51.7%). There are approximately 12273 residential households in this city and hence average household density is 2.3. In terms of diversity the city has a considerable ethnic mix in the society, close to 85.9% are true Australian born individuals residing in the region (Australian Bureau of Statistics). Along with that, 2.3% of the total population of the city is comprised of the aboriginal and Torres Strait islanders. Furthermore, more than 5% f the total population of the city speaks languages other than English. With respect to the age related data, the population of the city is rapidly aging with 44% of the population belonging to the age group of at or over 60 years. It has to be mentioned in this context that only 16.5% of the society belongs to the youngsters hence, it can be stated easily that the population of the society is aging fast and hence the needs for aged care is high for the community (University of South Australia, 2018).

Psychosocial Profile

With respect to the psychosocial structure of the community it has to be mentioned that the marital status of the lower in the community with only 16% being married and 25% having families. 1780 residents in the city had children and close to 4367 couples residing in the city did not have any offspring. The number of single parents in the city is 829 indicating that the divorce and separation rates are quite high in the community. The average house hold size was 2 people per family. The climate is perfect as the geographical position of the city made it one of the famous tourist spots in Australia (Australian Bureau of Statistics).

It is very important for a community health report to focus on the psychosocial profile of the community as it can have a significant impact on the ability of the community to lead a healthy and normal life. There are various contextual factors associated with the psychosocial profile of the community such as education level, employment level, household income, occupation type, communication network such as internet, transportation, social support service and community groups and organisations. Firstly, considering the educational profile of the community, it has to be mentioned that the level of literacy is critically low in the city of Horizon. Only 3296 people in the city are educated with comparison to more than 13400 people who do not have any education in their lifetime. Among the few literate people in the city, 8.5% of people had bachelor’s degree. Considering the employment rate of the city it has to be mentioned that close to 93% of the residents of the city were employed and 48% of them had a full time job (University of South Australia, 2018). Unfortunately the unemployment rate of the city is 6.7% which has increased significantly in between 2011 to 2016. According to the data shared by the organizations close to 10% of the staff had been associated with agriculture and fishing. The other famous employment sectors of the society include healthcare industry, retail trade and food service and accommodation service to tourists (Australian Bureau of Statistics).

Considering the income profile of the city, it has to be understood in this context that the economic state of the community is fair with close to $400 to $599 income of the majority on a weekly basis. It has to be mentioned that the city has a fair number of 7242 families being connected to the mobile internet in the city and 6379 families in the city had a broadband connection indicating that the connectivity statistics of the city is impressive. It has to be mentioned that road networks and transportation profile speaks a lot about the developmental status of a city. For the city of Horizon more than 64% of the communities use cars as their primary mode for transportation.  And it has to be mentioned that only 5.6% of the city utilized public transportation which indicates at the socio-economic stratification of the city. In terms of laws and legislations in place in the city, the most notable include the major Australian healthcare policy in the healthcare sector Australian criminal activity related policies (Australian Bureau of Statistics).

Community Infrastructure

Community infrastructure and the availability of goods and services are very important indicators of the prosperity in the lives of residents in the city and also indicate at the developmental status of the city. With respect to the City of Horizon it has to be mentioned that the city treats its residents with exceptional facilities and notable infrastructure, goods and service delivery. On a more elaborative note, it has to be mentioned that the lifestyle of the community is progressive and advanced. The city is equipped with several high end lifestyle facilities like Shopping malls, entertainment forums, ports, food outlets and restaurants, tourist spots, and recreational or leisure activity centres (University of South Australia, 2018). Few of the famous tourist attractions and architectural heritages of the city includes Horizon hotel, Horizon mall, and a few cafes and restaurants here and there. The city has recreational outlets such as fishing, sailing, hiking, trail bike riding, winery tours and lush green parks for the citizen to spend quality time. The social profile is progressive and facilitates community engagement with facilities such as community cultural centre, musical and book library and museum which attract the attention of various tourists across all year enriching the tourism industry of the city (Australian Bureau of Statistics).

One of the greatest resources which also experience a considerably higher demand in the city is the health care services and resources. In terms of the Horizon city, the residents are provided with quality health care services, the city has a fully equipped multispecialty tertiary hospital which provides the residents with services such as physiotherapy, podiatry, pathology, radiology, pharmacy, and different medical science services such as diet and nutrition related processes with adequate physicians or general physicians. It has to be mentioned in this context that close to 3500 people of the city is appointed in the health care industry of the city and with the innovative infrastructure and technological advancements in the city, the workforce ratio of the health care industry in the city has increased by an impressive 11% in the past couple of years. The social support or community support is another very important need of any community such as aged care facility, mental healthcare, specialist facilities, welfare service and social service which is also provided considerably higher for the city of Horizon. The health care sector of the city follows the Australian public healthcare act and it has to be mentioned that the effectiveness of the public health authorities, proper sanitation and disinfectant services are measured and ensured by the health sector authorities by the guidance of the act only. Hence, it has to be mentioned in this context that the health services and resources provided in the city of Horizon are extremely high end and in accordance to the needs of the residents (University of South Australia, 2018).

Health Care Services and Resources

There are various different issues represented by the community health report, there are a variety of different health issues represented by the community, such as poor diet and nutrition, unhealthy life style, mental health, obesity, domestic violence, delayed childhood development, community transport and suicidal tendency prevention. According to the national health survey of the national health survey, the health status of the city has been deemed to be fair to poor in the Limecoast area. Considering the burden of different diseases, the most important health concern for the area is the Rising prevalence of Diabetes. According to the national health report, both types of diabetes, type 1 and type 2 is represented with an alarming frequency in the city. However it has to be mentioned that close to 93% of the total burden is due to the type 2 diabetes (University of South Australia, 2018). It has to be mentioned in this context, there are various modifiable risk factors contributing to this scenario such as the weight, obesity and physical inactivity and lack of education or awareness to diabetes and its long term impact on the heath status of the city. Now it has to be mentioned that Diabetes is a deadly progressive disorder which paves way for other morbid co-occurring disorders such as the cardiac disorders, renal disorders and morbid obesity (Ley et al., 2014). With the 3.4% of the community being type two diabetic in the city of Horizon, it is easily the city with highest proportion of diabetes incidence. Hence, it has been chosen as the most impactful public health issue for the community health report.

furthermore, it has to be mentioned that, the cultural diverse o ethnic minorities, mainly the aboriginals have the higher proportion of incidence rate with respect to both types of diabetes and they have higher hospitalization and mortality rates when compared to the rest of the mainstream society as well. Hence, the lack of education and health literacy can be attributed as the most prevalent determinant. It has to be mentioned in this context that educational statistics and the health literacy is a very important aspect associated with the better health outcomes and health promotional behaviours. Close to 13400 residents of the city do not have any basic education to begin with, hence their lack of health literacy and basic education regarding the Diabetes, how to prevent it or how to manage it. It has to be acknowledged here in this context that 79% of the adults inhabiting this city are overweight and in the verge of being obese, the lack of health education and the health literacy is extremely low which restricts in the at risk population to diabetes from focussing on the health promotional activities (University of South Australia, 2018). The physical activity rates are also extremely low in the most of the community with 40% of the population leading a more or less sedentary lifestyle. Almost half of the population of this city is not meeting the nutritional requirements on a daily basis. According to the Powers et al. (2015), the successful diabetes management requires a particular diet and lifestyle to be maintained. Hence these contextual factors are also acting as key contributors to the present issue of diabetes in the community.

Identifying Health Priority: Rising Prevalence of Diabetes

According to the community health report, it can be stated that the lack of literacy and health education along with awareness regarding the impact of diabetes on lifestyle and life expectancy are contributors to the present situation in the target community. The community population statistics states a high percentage of obesity and lack of physical activity has contributed that directly leads to acquiring diabetes and better management of diabetes. Hence, enhancing their health literacy and education regarding health promotional behavior in healthy living is a very important (Lo et al., 2018). A registered nurse will play a fundamental role to educate the target population and convey the information in a manner that will be easily understandable to the target population. Considering the standard one of the NMBA registered nurse practice the nursing professionals are accountable to access, analyze and use the best available evidence to provide information and aware the target population with respect to different health issues and design key promotional strategies (Nursingmidwiferyboard.gov.au, 2018). For this particular assignment a registered nurse will have to use Strategies for enablement, advocacy, and mediation to promote diabetes prevention in the target population. According to the Chrvala, Sherr and Lipman (2016) enablement strategy can be defined as the tool to promote and implement intervention strategies by the health care professional in order to help the patient can better control of the health. Advocacy strategies are a tool for the registered nurses to advocate the healthcare needs of the target populations and highlight them to the policy makers and respective stakeholders so that these needs can be addressed across all sectors of the society. The mediation strategies can be defined as the opportunity for the registered nurses to serve as mediator between the target population and the healthcare industry in order to convey key information and Health Promotion behaviors that can get the target population overcome the burden of diabetes by means of adopting healthy lifestyle habits and better disease management (Stetson et al., 2015).

Considering the first area of the Ottawa charter, “building healthy public policy” is crucial for better disease management and health promotion. Here the registered nurse will have the opportunity to identify the key issues affecting the Diabetes statistics of the target community and advocate them to the policymakers and respective government. The second area is “creating supportive environments” which provides compassion and motivation to the target at risk population to fight the health issue. The third area is “strengthening community action” where the community engagement and participation helps in building a strong and optimistic health behavior in the community (Fan and Sidani 2018). Based on these two areas of the charter the registered nurse can make enablement strategies to provide different awareness and health education campaigns with culturally diverse, inclusive and participative workshops. The fourth area is “developing personal skills” which focuses on development of individual health promotion and prevention skills in the individual to fight a health issue. Here the registered nurse will have to serve as the mediation helping the individual build strategies to enhance their diabetes management skills like the mediation strategy. Here the registered nurse will have to help the diabetics or high risk or vulnerable groups on a one to one basis, counseling better lifestyle habits, weight management and diet habits to either manage or ward of diabetes (Thompson, Watson and Tilford 2018).

Health Promotion Strategy based on Ottawa Charter and NMBA Guidelines

Conclusion

On a concluding note, it has to be mentioned that this community health report had been successful in discovering all the critical diseases burdens affecting the health outcomes of the city. Although, the most impactful health burden had been discovered to be the diabetes, which is paving way for other more serious co-morbidities such as heart diseases, renal disorders and even mental health issues. It has to be mentioned that diabetes is a highly preventable condition and it can be very easily managed as well with a healthy lifestyle and health promotional behaviour. Although, lack of education, lack of health literacy, low socio-economic stability and low physical activities were discovered as key determinants. Hence, the health promotional strategy has been designed in the assignment with respect to NMBA guidelines and Ottawa charter to overcome the negative impact of modifiable and non-modifiable determinants of health and be able to improve the health status of the community.

Reference List

Australian Institute of Health and Welfare. (2018). Australia’s health 2016, Chapter 4 Determinants of health – Australian Institute of Health and Welfare. [online] Available at: https://www.aihw.gov.au/reports/australias-health/australias-health-2016/contents/determinants [Accessed 19 May 2018].

Australian Bureau of Statistics. 2018. 3222.0 – Population Projections, Australia, 2012 (base) to 2101. Retrieved from https://www.abs.gov.au/ausstats/[email protected]/Lookup/3222.0main+features42012%20(base)%20to%202101

Chrvala, C.A., Sherr, D. and Lipman, R.D., 2016. Diabetes self-management education for adults with type 2 diabetes mellitus: a systematic review of the effect on glycemic control. Patient education and counseling, 99(6), pp.926-943.

Fan, L. and Sidani, S., 2018. Factors Influencing Preferences of Adult with Type 2 Diabetes for Diabetes Self-Management Education Interventions. Canadian Journal of Diabetes.

Garber, A.J., Abrahamson, M.J., Barzilay, J.I., Blonde, L., Bloomgarden, Z.T., Bush, M.A., Dagogo-Jack, S., DeFronzo, R.A., Einhorn, D., Fonseca, V.A. and Garber, J.R., 2016.

Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm–2016 executive summary. Endocrine Practice, 22(1), pp.84-113.

Ley, S.H., Hamdy, O., Mohan, V. and Hu, F.B., 2014. Prevention and management of type 2 diabetes: dietary components and nutritional strategies. The Lancet, 383(9933), pp.1999-2007.

Lo, C., Zimbudzi, E., Teede, H., Cass, A., Fulcher, G., Gallagher, M., Kerr, P.G., Jan, S., Johnson, G., Mathew, T. and Polkinghorne, K., 2018. An Australian model of care for co?morbid diabetes and chronic kidney disease. Nephrology.

Nursingmidwiferyboard.gov.au. (2018). Nursing and Midwifery Board of Australia – Professional standards. [online] Available at: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx [Accessed 19 May 2018].

Powers, M.A., Bardsley, J., Cypress, M., Duker, P., Funnell, M.M., Fischl, A.H., Maryniuk, M.D., Siminerio, L. and Vivian, E., 2015. Diabetes self-management education and support in type 2 diabetes: a joint position statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics. Journal of the Academy of Nutrition and Dietetics, 115(8), pp.1323-1334.

Stetson, B.A.R.B.A.R.A., Boren, S.U.Z.A.N.N.E., Leventhal, H.O.W.A.R.D., Schlundt, D.A.V.I.D., Glasgow, R.U.S.S.E.L.L., Fisher, E., Iannotti, R., Randal, D., Kent, D., Lumber, T. and Nelson, J., 2015. EMBRACING THE EVIDENCE ON PROBLEM SOLVING IN DIABETES SELF-MANAGEMENT EDUCATION AND SUPPORT-Selfcare Journal. SelfCare Journal.

Thompson, S.R., Watson, M.C. and Tilford, S., 2018. The Ottawa Charter 30 years on: still an important standard for health promotion. International Journal of Health Promotion and Education, 56(2), pp.73-84.

University of South Australia, (2018). Welcome to the city of horizon. [online] Available from https://lo.unisa.edu.au/course/view.php?id=3552.[Accessed on 19th may 2018]

World Health Organization, 2016. Ottawa Charter for Health Promotion. Geneva: WHO, 1986.