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

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Newaygo Michigan Healthy People 2020

Leading Causes of Death 2013

(DHD #10, 2013)Cancer CVD Diabetes Diabetes Related0

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100

150

200

250

300

Newaygo Michigan Healthy People 2020

2012 & 2013 Comparable

(DHD #10, 2013)

Cancer CVD Diabetes Diabetes Related0

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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