NEWAYGO A COMMUNITY PLAN TO ADDRESS ADULT DIABETES PRESENTED BY: MOLINA ALLEN, CHERIE MCKAY-HORST, JESSICA RUTHIG, BRITTANY TOROK, SANDRA WERNSTROM
Jan 18, 2018
NEWAYGO
A COMMUNITY PLAN TO ADDRESS ADULT DIABETES
PRESENTED BY: MOLINA ALLEN, CHERIE MCKAY-HORST, JESSICA RUTHIG, BRITTANY TOROK, SANDRA WERNSTROM
Review current statistical data of Newaygo Analyze current health concerns that fall below Michigan’s benchmark
Identify a nursing diagnosis of one of the health concerns of Newaygo County
Develop a plan to reduce the occurrence of diabetes and provide improved outcomes for those diagnosed
Evaluate the effectiveness of the plan
OBJECTIVES
Statistical Analysis for Newaygo
Data obtained from District Health Department (DHD) #10, 2013
Education:1. High school grad 85.3%2. College grad 13.2%
• Persons below poverty 18.3%• Median Income $43,180
Education:1. High school grad 88.7%2. College grad 25.5%
• Persons below poverty 16.3%• Median Income $48,471
NEWAYGO MICHIGAN
Access to Health Care
NEWAYGO• No provider 11.4%
• No access due to cost 13.9%
• Uninsured 19.3%
(DHD #10, 2013)
MICHIGAN• No provider 13.2%
• No access due to cost 12.9%
• Uninsured 15.1%
Leading Causes of Death
NEWAYGO
• Diabetes 29.3
• Diabetes Related 80
(DHD #10, 2013)
MICHIGAN
• Diabetes 24.1
• Diabetes Related 76.9
Leading Cause of Death 2012
(DHD #10, 2013)Cancer CVD Diabetes Diabetes Related0
50
100
150
200
250
300
Newaygo Michigan Healthy People 2020
Leading Causes of Death 2013
(DHD #10, 2013)Cancer CVD Diabetes Diabetes Related0
50
100
150
200
250
300
Newaygo Michigan Healthy People 2020
2012 & 2013 Comparable
(DHD #10, 2013)
Cancer CVD Diabetes Diabetes Related0
50
100
150
200
250
300Chart Title
Newaygo 2012 Michigan 2012 Healthy People 2012Newaygo 2013 Michigan 2013 Healthy People2013
Problem Statement
The purpose of this community plan is to address the risk of adult diabetes among the citizens of Newaygo county related to knowledge deficit of proper nutrition, lack of access to healthcare, and higher percentage of poverty, which is demonstrated by a high percentage of diabetes in Newaygo County.
DIABETESOCCURRENCE OF DIABETES
Newaygo 12.2%Michigan 9.3%
MORTALITY FROM DIABETES RELATED ILLNESS 2013Newaygo 80 per 100,000Michigan 76.9 per 100,000Healthy People (HP) 2020 goal is 65.8 per 100,000
(DHD #10, 2013)
Cost of Diabetes Per Person in 2010
Diagnosed diabetes $9,963 Undiagnosed diabetes $2,864
Pre-diabetes $443 Gestational $3,305
• These values reflect data obtained in 2010 for Michigan. (Mi.gov, 2010)
“
”
“The cost to treat diabetes is expected to triple over the next 25 years…”(MICHIGAN DEPARTMENT OF PUBLIC HEALTH, 2010).
COST OF DIABETES
Social Ecological Model
• Consider change at the community level through educational programs.
• Approach community leader to develop policies that may provide healthcare access to more community members who have limited income or insurance.
Analysis of Assessment findings:What is causing an increase in Diabetes in Newaygo County?
• Health Care Access• Poor Nutrition• Increased Poverty Rate
(DHD #10, 2013)
Available Resources
Michigan State University is holding a Diabetes PATH (Personal Action Towards Health) Workshop October 3-November 7, 2014. “Which provides the skills and tools to manage chronic health conditions” (MSU, 2014, para. 1).
Metro Health Hospital in Cedar Springs, MI located within Newaygo County does a diabetes education class free of charge. They focus on diet and lifestyle changes. (Metro Health, 2014, para. 2).
Live Well • An organized movement to help the community maintain a
healthy weight a reduce risk factors associated with obesity (Live Well, 2014).
Available Resources
Diabetes Prevention Program• Participants receives support from a coach in a
group setting for weight reduction, healthy eating and healthy exercise.
• This is a one year program
Available Resources
Women, Infants and Children (WIC)• Helps people eat and stay healthy• Provides bridge cards to buy healthy foods• Provides nutritional information which includes web
based learning, individual learning, and group learning
• Provides healthcare referrals for immunizations and other resources in the community
Planning and Interventions
Health Care Access
Initiate volunteer program that assists Newaygo county residents in choosing a market under the Health Care Act and filing out accompanying paperwork.
Recruit five volunteers willing to assist needy Newaygo county residents with transportation to and from doctors appointments and lab work.
Initiate communication with three pharmacies that may be willing to form a prescription delivery to homes of Newaygo county residents that are unable to pick up their own prescriptions.
Wellness/Nutritional Counseling
Engage at least 20 Newaygo county residents in a healthy eating/wellness class Nutritional counseling is tailored to meet the needs of
the community. This counseling is tailored to the communities customs
and willingness to make change. Proper nutrition will be addressed. Nutritional counseling is important for people who are
diabetic, pre-diabetic, or anyone wanting information on healthier living.
Wellness/Weight Loss
Weight loss is recommended for people who are either diabetic or pre-diabetic.
Weight loss has been shown to improve insulin resistance (American Diabetes Association, 2008).
Because of the effects of obesity on insulin resistance, weight loss is an important therapeutic objective for individuals with pre-diabetes or diabetes” (American Diabetes Association, 2008).
Wellness/Healthy Lifestyle
“Lifestyle changes characterized by increased energy intake and decreased physical activity appear to have together promoted overweight and obesity, which are strong risk factors for diabetes” (American Diabetes Association, 2008).
Eating healthy can prevent or slow the development of diabetes. Low carbohydrates, low fat, and calorie restricted diets are
effective for controlling diabetes. “Exercise and physical activity are to be encouraged because
they improve insulin sensitivity independent of weight loss, acutely lower blood glucose, and are important in long-term maintenance of weight loss” (American Diabetes Association, 2008).
Diabetic Screening
Genetics can play a roll in the occurrence of type 2 diabetes. It is important to have your blood checked for diabetes during
your annual doctor’s visit. “The American Diabetes Association recommends testing to
detect pre-diabetes and type 2 diabetes be considered in adults without symptoms who are overweight or obese and have one or more additional risk factors for diabetes. In those without these risk factors, testing should begin at age 45” (American Diabetes Association, 2008).
Diabetic Teaching
Hold a class for newly diagnosed diabetic patients of Newaygo County with goal of at least 10 patients return demonstrating correct blood check and insulin administration techniques.
Reducing Poverty
Collaborate with five local food pantries to incorporate screening for government assistance/foods stamps during application process
Identify and collaborate with 20 local business to hold a job fair Assist at least 20 Newaygo county residents in updating
resume and filling out applications
Evaluation
Healthy Care Access
Newaygo projections for increased access to health care: No provider <3% No access due to cost <7% Uninsured <5%
Nutritional Counseling
Community focus: 20% increased number of eligible clients receiving Project Fresh,
WIC or SNAP funds. At least 80% of newly diagnosed diabetic clients participate in
diabetic education with goals of being able to return demonstrate proper diet choices and insulin administration.
For individuals with diagnosed diabetes: 5 appointments with nutritional counselor have been attended. Goals and projected benchmarks have been formed and
documented. Patient able to list 10 healthy foods to incorporate into diet and 10
foods to limit.
Wellness
Blood glucose, cholesterol, and blood pressure screenings initiated with at least 10 local events per year
Opportunities used to provide information on enrollment to Metro Health Diabetes Education, Live Well, and the Diabetes Prevention Program.
Reducing Poverty
Poverty rate reduced to Michigan average of 16.3% by 2016.
In 2015, 100% of those identified through screening as eligible for State benefits are assisted in the application process for monetary and food aid.
References
American Diabetes Association. (2008). Nutrition Recommendations and Interventions for Diabetes. Retrieved from: http://care.diabetesjournals.org/content/31/Supplement_1/S61.full
Diabetes Education. (2014). Metro Health. Retrieved from http://metrohealth.net/medical-services/diabetes-education/
District Health Department #10. (2013). Newaygo County Chart books. Retrieved from: http://dhd10.org/dhd10-community-statistics
Live Well. (2014). About the live well movement. Retrieved from: http://www.livewell4health.org/#!page2/cjg9
References
Michigan Department of Community Health. (2010). Cost of diabetes in Michigan. Michigan Department of Community Health. Retrieved from: http://michigan.gov/mdch/0,1607,7-132-2940_2955_2980_3168-237778--,00.html
Newaygo County. (2014). Michigan State University. Retrieved from http://msue.anr.msu.edu/events/diabetes_path_workshop
The National Diabetes Prevention Program. (2014). Diabetes Prevention Program. Retrieved from: http://www.dhd10.org/diabetes-prevention-program
WIC. (2013, January 1). Retrieved November 15, 2014, from http://dhd10.org/wic-landing