In this final course project, you are going to take everything you have learned in the course and apply it to a real-world scenario. As someone either already in the health field or intereste

Jasmine Fields

Columbia Southern University

Health Behavior PUH 5304

Dr. Williams

October 11, 2022

Prevalence of Diabetes in Columbus Georgia

At first glance, Columbus, Georgia, looks like one of the most beautiful cities in America. The city is blessed with amazing parks and trails, with the scenes made even more beautiful by the Chattahoochee River and its riverwalk. The city also has a lot of history, displayed in various sites such as the Columbus Museum. The region also has a diverse population, with an African American majority, followed closely by a Caucasian population. There are also other races living in the region, showing how diverse the community is.

However, under all this beauty lies a concerning statistic hurting many regional residents. There has been a rise in the number of cases of diabetes in the region, with some areas, such as Wynnton, having an estimated 24.6% of its residents diagnosed with diabetes (Huang et al., 2022). This rate places Wynnton at the 99th percentile for national prevalence. However, the most disturbing fact about this is that neighborhoods around Wynnton have significantly lower numbers of diabetes diagnoses, registering only 8% of reported diabetes cases. While this is still relatively high, it is nearly a third of the residents of Wynnton present.

Identifying the Target Population

To properly understand diabetes in Columbus, it is essential to understand the population breakdown in the area. Using Wyntonn as the sample, due to their large population afflicted by diabetes, the target population can be found by analyzing those affected by diabetes in Wynnton as a representation of Columbus. The population in Columbus is estimated to be 210 295 as of 2022, with 46.46% of the individuals in the region being African American, 42.47% being white, and other races closing the population (Huang et al., 2022). In Wynton, the population is generally black, with 64.1% of the residents in the region being African American, with Whites making up 27.4% of the population. Figure 1 presents the graphical representation of Wynnton residents in 2019 (City Data, 2022). The difference in racial makeup between Wynnton and the rest of Columbus and the high prevalence of diabetes shows that the target population for those affected by diabetes is primarily African American.

Figure 1: Racial Breakdown in Wynnton, Columbus.

The median household income in Wynnton is also significantly lower than in the rest of Columbus. While the median household income in Georgia is $61,980, the median household income in Wynnton is $39,628 (City Data, 2022). This shows that compared to other residents in Columbus, most of the population in Columbus is relatively poor. This presents another aspect of the target population. The population most affected by diabetes, using the residents of Wynnton as the sample, are likely to have a low median household income and to be African American (Data Commons, 2022).

There are more females than males in Wynnton. However, the difference between males and females is relatively small, and both genders are equally affected by the illness. Most of the residents in the region are between 10-36, showing that the population is relatively young. Figure 2 shows the age distribution of residents in Wynnton. The figure shows that the target population is between 15 and 50, as these are most of the population affected by diabetes (City Data, 2022).

Figure 2: Age distribution of residents in Wynnton

Wynnton also has one of the lowest education attainment rates in Columbus and Georgia. 28% of residents in Wynnton have less than a high school education, which is relatively high considering Georgia has less than 10% of its residents having less than a high school education (City Data, 2022). Figure 3 shows the educational attainment levels of residents in Wynnton and Georgia. It shows that the target population is also the ones who are less educated.

Relationship Between Diabetes and the Target Population

Education plays a significant impact in the prevalence of diabetes. Individuals who are more educated are more aware of the impacts of diabetes and are aware of the best ways to avoid it (Galicia-Garcia, 2020). This means that individuals who do not have a good education are more likely to have a higher chance of contracting the disease. Economic status also plays a role in the prevalence of diabetes. Those who are financially better off are more likely to purchase better-quality food, which is often healthier. Low-income families often rely on cheap food, which is often unhealthy and increases the likelihood of the person developing diabetes (Galicia-Garcia, 2020). Age is also a factor. As a person grows older, their metabolism slows down. This means that they cannot process food as they did, and if the person is not aware of this through education or cannot afford healthy food, they may develop diabetes if they continue to eat the same way.

Research shows that those with diabetes generally have relatively modest backgrounds, low education, and often range from 45 to above. In America, African Americans are often affected mainly by diabetes (Huang et al., 2022). This show that research corroborates what is happening in Wynnton and, by extension, in Columbus, Georgia. It shows a relationship between these factors and the prevalence of diabetes in the region.

References

Jasmine Fields

Columbia Southern University

Health Behavior PUH 5304

Dr. Williams

October 18. 2022

Health Behaviors that Promote Diabetes in Columbus Georgia

There are several contributing factors that can lead to the development of diabetes. These factors vary from region to region, with each region having its unique combination of factors contributing to a growing number of diabetes patients. Columbus has several risk factors that promote diabetes. Many of these factors are related to weight gain and obesity, one of the key contributors to obesity.

Weight gain leads to the creation of hormones, NEFA, glycerol, and other substances that lead to the development of insulin resistance (Georgia Department of Public Health, 2020). This then leads to the development of diabetes. Georgia has seen a steady increase in obesity. According to America’s Health Rankings (2022), the state had 10% of its population living with obesity in 1990. The number has increased steadily, and as of 2020, 35% of Georgians are obese. The high number of obese individuals means more people are at risk of contracting diabetes, which is a concern.

Figure 1: race and obesity Figure 2: obesity and education

Figure 3: Obesity and Age

Obesity levels in Georgia majorly affect the target population. It is mostly an issue for African Americans above 18 and those without good conditions. Figure 1, Figure 2, and Figure 3 show the graphical distribution of obesity based on race, education, and age. The trends in Wyntonn are reflective of this, as it shows that weight gain and obesity is a health behavior that influences diabetes. The following health behaviors help to promote diabetes through weight gain and obesity.

Poor Dietary Choices

Diet is a huge contributor to the development of diabetes. A diet high in cholesterol and saturated fats raises the levels of triglycerides, which increases the chances of diabetes (Georgia Department of Public Health, 2020). A poor diet also leads to an increase in weight gain, which increases the chances of diabetes. Diet is heavily influenced by financial status. Research shows that individuals from poor backgrounds are more likely to have poor dietary choices when compared to those that are not. This is because fatty foods are cheaper when compared to nutritious foods. This has led to an increase in diabetes rates among the poor. This case is especially true for Wynnton, which has one of the highest poverty rates in Georgia (City Data, 2022). This means that due to their financial strains, residents in Wyntonn and others facing a similar plight are forced to contend with poor dietary choices (Georgia Department of Public Health, 2020). The evidence of this is the small number of grocery stores in these areas.

Sedentary Lifestyle

Physical inactivity is the norm in Georgia. In 2020, 28.5% of Georgians reported that they were physically inactive. This means that one in four Georgians is likely to be physically inactive, which can be a high contributor to the rise of diabetes in the state. This is because most Georgians have sedentary jobs and long commutes, so they spend most of their time seated down. Many Georgians also do not prioritize physical activities or do not have the resources to get access to facilities such as the gym. This sedentary lifestyle is a reason for the increase in weight gain, which inevitably increases the chance of diabetes.

Tobacco Use

Smoking tobacco has been directly linked to an increased risk of diabetes. Individuals who smoke are 30-40% more likely to develop diabetes than non-smokers. As of 2020, 15.8% of Georgian adults smoked, which increased the chances of these adults developing diabetes (Truth Initiative, 2022). Smoking is also high among residents from low economic status, such as Wynton. Aside from promoting weight gain, tobacco helps to increase blood sugar levels in the blood, increasing the chances of diabetes. This makes why smoking is a health behavior that promotes diabetes.

Impacts of Sociological Model on These Health Behaviors

Human beings are a social species, and society significantly impacts their actions. Healthy behaviors are also affected by society. The sociological model provides a perspective upon which the effects of various aspects of society can be analyzed.

The social sphere of society has an immense impact on health behaviors that determine diabetes. One of the social sphere's negative impacts is the inheritance of poor health habits. For example, research shows that children from families who smoke are more likely to become smokers. This helps to propagate the spread of the behavior. This inheritance of bad habitsunhealthy habits is not tied to smoking alone, as other unhealthy habits can also be imparted to the younger generation. For example, societies that are more tolerant of obesity are more likely to encourage the consumption of unhealthy foods and weight gain, which can have immense impacts on society. This shows that there is a psychological connection between unhealthy behavior and society.

Culture also has a huge impactsignificant impact on health behavior. Culture aids in keeping negative behaviors for generations which helps to increase their occurrence over time. This is clearest regarding weight gain and obesity. An example of this application is the promotion of weight gain and obesity. Due to the change in culture and perspective toward obesity and weight gain, there has been a growth in obesity in Georgia over time. This is because the culture of promoting habits that increase obesity rates has slipped into Georgia, and the evidence of this is in the rise of cases of obesity, as demonstrated by figure 1. This has led to an increase in diabetes numbers.

However, it is essential to note that while society's cultural and societal features have had a negative impact on health behaviors, they can be used as credible tools in the battle against diabetes. A good example is developing policies impacting society and culture that aim to reverse the norms. Stakeholders can help change societal norms by promoting physical exercise, anti-smoking campaigns, and better diets. This can help reduce the rate of diabetes in society.

References

Jasmine Fields

Columbia Southern University

Health Behavior PUH 5304

Dr. Williams

October 25, 2022

Determinants of Health and Diabetes

Impact of Determinants of Health on Diabetes

Several elements influence community health. The CDC classifies five determinants of health, all of which have a significant impact on health and well-being (Hill-Briggs et al., 2021). All these determinants impact the prevalence of diabetes in Columbus, Georgia. However, not all of them have significant impacts, with some having a nearly negligible impact on the illness. According to the CDC, the five determinants of health impact diabetes in Columbus (O’Conner, 2017). These factors are genetics, behavior, environmental and physical influences, medical care, and social factors.

Genetics influences health by predisposing individuals to certain diseases. Some individuals are genetically predisposed to diabetes. For example, type 2 diabetes can be passed down genetically, and this increases the risk of those whose parents have diabetes (Hill-Briggs et al., 2021).

The environment can promote diabetes by encouraging poor dieting. The environment does this by blocking access to healthy foods by making them too expensive or placing them beyond reach for some residents (Hill-Briggs et al., 2021). The environment can also promote diabetes by encouraging habits that increase a person's risk of diabetes. For example, the environment can motivate smoking by promoting smoking through easing access and promoting its use. Physical influences also have an impact on diabetes. Obesity, which is one of the primary causes of diabetes, is exacerbated by a lack of physical exercise. This is why physical influence is so important in the development of diabetes (Hill-Briggs et al., 2021).

Medical care contributes to the rise in diabetes prevalence in two ways: prevention and healthcare delivery (Hill-Briggs et al., 2021). Modern healthcare plays a role in not speaking on measures to promote healthy living and offer diabetes-preventative measures. The prices of insulin also make the management of diabetes difficult, which is why diabetes claims so many lives per year in the region.

Social factors include economic and social conditions such as financial resources, power, and political factors (Hill-Briggs et al., 2021). The social factors that influence diabetes in the region are low education standards, poverty, and age. These factors influence diabetes by limiting access to treatment, information, and facilities that promote physical exercise. This leads to the development of diabetes by promoting traits such as poor diet, lack of physical activity, and smoking.

Determinants of Health and the Target Population

In Columbus, the main determinants of health are behavior, environmental and physical influences, medical care, and social factors. These four are responsible for the significant rise in the prevalence of diabetes in the region. In Wynnton, these health determinants have the most impact, which is a reason why the region has one of the highest rates of diabetes (O’Conner, 2017).

In Wynnton, behavior and physical influence play a role in demoting physical exercise (O’Conner, 2017). Many of Wynnton’s residents do not exercise and this behavior is rooted in their ideals and lack of physical influence. Despite the facilities in Georgia that promote physical activity such as the Chattahoochee Riverwalk, many of the state’s residents do not take part in any physical activity (O’Conner, 2017). Behavior also influences the prevalence of tobacco use in the region.

Environmental and social factors also affect diabetes in the target population. The environment in Wynnton does not encourage healthy eating. This is because the stores in the region do not sell wholesome foods, often selling foods that are saturated in fats and sugars (O’Conner, 2017). The healthy foods provided to residents in this region are expensive and this hinders the population’s access to them. Social factors such as poverty block the residents of Wynnton in the target population from access prevents these residents from accessing these foods. A lack of education also hinders a person's ability to choose their diet well.

Medical and social factors play a role in promoting diabetes by denying access to medical services to those in the target population (O’Conner, 2017). This includes pre-diabetes screening, preventative measures against diabetes, and care for people living with diabetes. This helps to increase the mortality rate of those living with diabetes in the region and promotes its prevalence.

PRECEED and PROCEED Model Implementation and Determinants of Health

Planning models are an essential part of interventions. They help to ensure that the intervention does what it is supposed to, which is to reduce the prevalence of an illness. The PRECEED and PROCEED planning model is highly used in the medical field to plan interventions for certain diseases (Gorina et al., 2019). For an educator planning to utilize the model to change the prevalence of diabetes in Columbus, Georgia, the determinants of health play a crucial role in planning.

The health determinants assist in preparing the epidemiological assessment (Saulle et al., 2020). This is the phase of planning that is responsible for identifying the problems and setting the goals as part of the PRECEED part of planning. The health determinants also impact the ecological assessment to determine how best to reach society and the best way to implement actions that can impact society (Saulle et al., 2020). Medical care contributes to the rise in diabetes prevalence in two ways: prevention and healthcare delivery (Hill-Briggs et al., 2021).

The health determinants also help to provide a base for the impact evaluation of the policies, regulations, and organizational constructs implemented as part of the ways to implement change (Gorina et al., 2019). These determinants present the current state of the situation, and when the policies have been implemented, they serve as a bar to assess their impacts. It also helps in outcome implementation and how the outcome benefits society.

References

Gorina, M., Limonero, J. T., & Álvarez, M. (2019). Educational diagnosis of self‐management behaviors in patients with diabetes mellitus, hypertension and hypercholesterolemia based on the PRECEDE model: Qualitative study.  Journal of clinical nursing,  28(9-10), 1745-1759.

Hill-Briggs, F., Adler, N. E., Berkowitz, S. A., Chin, M. H., Gary-Webb, T. L., Navas-Acien, A., & Haire-Joshu, D. (2021). Social determinants of health and diabetes: a scientific review.  Diabetes care,  44(1), 258-279.

O'Connor, J. (2017). Chronic disease prevention as an adaptive leadership problem.

Saulle, R., Sinopoli, A., Baer, A. D. P., Mannocci, A., Marino, M., De Belvis, A. G., & La Torre, G. (2020). The PRECEDE–PROCEED model as a tool in Public Health screening: a systematic review.  La Clinica Terapeutica,  171(2), e167-e177.

Jasmine Fields

Columbia Southern University

Health Behavior PUH 5304

Dr. Williams

November 1, 2022

Transtheoretical Model of Change and the Community

Author Mandy Hale once said, “change is painful, but nothing is as painful as staying stuck somewhere you do not belong (Notes, 2021)." This quote is especially true for diabetes and the residents of Columbus. Change is necessary to ensure that the scourge of the disease hurts Columbus's people. To institute change, society needs to determine where it currently is and whether it is ready to accept change. The transtheoretical model of change provides a model which allows people to assess where their thoughts are concerning change.

Many of the residents of Columbus are in the precontemplation stage. The people in this stage do not intend to act for the foreseeable future and are unaware that their actions are problematic and have negative consequences (Romain et al., 2018). The people in this stage misconstrue the pros of the change in behavior, emphasizing the cons (Romain et al., 2018).

One factor that shows that the residents of Columbus are not about to take action to reduce the prevalence of diabetes in the region is the lack of attention the issue has received in society and especially in the media. Many news sites often focus on the news and other topics, such as sports, rather than talk about a disease responsible for thousands of deaths each year. Another factor is the spread of the acceptance movement. Even beyond the borders of Columbus, society at large is beginning to embrace the fact that obesity is okay. Efforts by medical professionals to advocate for proper diets and loss of weight have often been met with scathing criticism, with many advocating for the acceptance of fatness and obesity (Eckert, 2020). Some in the medical field are even bowing to the pressure and have begun publishing articles that advocate for the acceptance of obesity (McPhail & Orsini, 2021).

These two factors hold the community back from acting on reducing diabetes, as they help to promote habits that lead to diabetes. Therefore, the disease has seen a steady increase in society, and without action being taken, this trend will likely continue for time to come.

Using TMC to Procced with Healthy Behavior Change

Self-awareness is a very important tool in implementing change. The TMC model allows the Columbus community and its stakeholders to know where they currently are, and this helps them identify the steps they need to take to make the changes that they require. The community can use the TMC to identify that they need to move toward the contemplation stage, where the illness is being spoken of in society. Until there is an increased awareness of the dangers of diabetes and its risk factors, there will be no change.

Once the next step has been determined, stakeholders can begin introducing the debate in society, allowing more conversations on the spread of diabetes and how to prevent it. While this is a sensitive topic in contemporary society, it is a debate that must be had and will help move society to the preparation stage. The TMC's main role in helping society proceed with healthy behavioral change is dictating the steps that lead the society towards action and eventual change.

Role of Health Educators in Behavioral Change

The health educator plays a very important role in guiding society toward change. One of the roles they play is the introduction of the debate concerning diabetes and its prevalence in society. The health educator is aware of how badly the disease has ravaged the residents of Columbus and can introduce the discourse on how to tackle the issue properly. The reason for the debate is to ensure that society has a say in how they would like to change the statistic and how they would like the change to happen. The discourse will allow members of society to realize where they are and the need to figure out ways to remove them from the dire situation, they are currently in.

The health educator can also help members of society in making policies that are aimed at changing the situation through advocacy. As professional experts, health educators can help improve the situation and institute change by advocating for policy changes and urging leaders to institute policies that address the current situation. They can also advise on the best strategies to help alleviate the suffering of those living with diabetes.

Health Educators and Stage Matching

Health educators can utilize stage matching to determine the type of intervention they could use to address the issue (Kim et al., 2004). This is especially true in the stage that society is currently in. Health educators need to encourage society to think about diabetes and ways to change its impacts on society. This can be done in various ways. The first way is to identify the reasons people are unwilling to let go of their sedentary lifestyle and embrace physical activity (Kim et al., 2004). This can help the health educator in finding ways to advocate for the benefits of physical exercise to reduce obesity levels in the region.

The health educator can also help society embrace change and physical exercise by promoting a discussion on the impacts of a sedentary lifestyle (Kim et al., 2004). Negative effects can also serve as a motivating factor for those affected by the illness to change their ways. When many in the community are aware of the damage their lifestyle is causing, they can begin to contemplate changing their ways (Kim et al., 2004). These interventions are drawn from the goal of getting people