Monmouth County, NJCOUNTY NEEDS ASSESSMENT

ADULT OVERWEIGHT/OBESITY: THE PROBLEMWhat is Obesity?

• Defined as weight higher and not proportionate to height and weight

BODY MASS INDEX:

• Underweight (<18.5)

• Normal (18.5-24.5)

• Overweight ( 25.0-29.9)

• Obese ( > 30)

As found in: http://www.cdc.gov/obesity/adult/index.html

ADULT OBESITY FACTS 5 facts

• Common serious and expensive

• Middle age 40-49

• African American have the highest rate of obesity

• Higher income women less likely to have obesity

• Relationship between education and obesity among womenAs found in: http://www.cdc.gov/obesity/adult/index.html

CAUSES & CONSEQUENCES OF OBESITY

Causes:

• Genetics

• Environment

• Lifestyle

• Disease

• Drugs/Medications

• Age

Consequences:

• Death

• Type-2 diabetes

• Coronary heart disease

• Stroke

• Low quality of life

• Mental health As found in: http://www.cdc.gov/obesity/adult/index.html

METHODS

As found in: http://www.countyhealthrankings.org/app/new-jersey/2016/overview

DESCRIPTION OF THE PROBLEM Monmouth County

• Adult Obesity: 23%

• Food Environment Index: 8.5

• Physical Inactivity: 20%

• Access to Exercise Opportunities: 96%

New Jersey

• Adult Obesity: 24%

• Food Environment Index: 8.1

• Physical Inactivity: 24%

• Access to Exercise Opportunities: 96%

As found in: http://www.countyhealthrankings.org/app/new-jersey/2016/downloads

DEMOGRAPHICS Demographics Monmouth County New JerseyPopulation 629,672 8,899,339% below age of 18 22.6% 22.7%% 65 and older 15.2% 14.4%% Non- Hispanic African American 7.0% 12.9%% American Indian and Alaskan Native 0.3% 0.6%% Asian 5.4% 9.2%% Native Hawaiian/ Pacific Islander 0.0% 0.1%% Hispanic 10.3% 18.9%%Non-White Hispanic 76.1% 57.6%% Not proficient in English 3.20% 6.4%% Females 51.3% 51.2%% Rural 3.7% 5.3%

2015 County Demographics

As found in: http://www.countyhealthrankings.org/app/new-jersey/2015/rankings/monmouth/county/outcomes/overall/snapshot

SOCIAL & ECONOMIC FACTORSSocio-Economic Factor Monmouth County New JerseyMedian Income Factor $83,424 $70,224

Children Eligible for Free Lunch 15% 29%

High School Graduation 93% 87%

Some College 71.7% 66.6%

Unemployment 7.5% 8.2%

Children in Poverty 10% 17%

Income Inequality 5.0 5.0

Children in Single-parent Households 22% 29%

2015 Social and Economic Factors

As found in: http://www.countyhealthrankings.org/app/new-jersey/2015/rankings/monmouth/county/outcomes/overall/snapshot

OBJECTIVESINCREASE THE PROPORTION OF ADULTS WHO

ARE AT A HEALTH WEIGHT

• Baseline: 30.8% of people 20 years and up were at a healthy weight in 2005-08• Target: 33.9%

Compared to Monmouth County: N/A

Compared to New Jersey: N/A

REDUCE THE PROPORTION OF ADULTS WHO ARE OBESE

• Baseline: 33.9% of people 20 years and up were obese in 2005-08

• Target: 30.5 %

Compared to Monmouth County: 23%

Compared to New Jersey: 24%

As found in: https://www.healthypeople.gov/2020/topics-objectives

COMMUNITY GUIDE INTERVENTIONS

Provider Education with a Client Intervention

• Educate healthcare providers in order to:

• Increase knowledge

• Improve attitudes

• Change how they help clients address overweight & obesity

• Implementation of a method to help their clients

lose weight

Results• Provider-level outcomes:• Trained practitioners were much more likely to:• Discuss weight• Record weight• Target weight• Dietary target

• Client-level outcomes:• Studies with a parallel comparison group reported median

weight loss of 1.15 kg• Studies using a before-after study design reported median

weight loss of 5.0 kg

Provider-Oriented

As found in: http://www.thecommunityguide.org/obesity/provider.html

COMMUNITY GUIDE INTERVENTIONS

Interventions in Community Settings Intervention to Reduce Recreational Screen-time Among Children• Target Ages: 13 years & younger• Goal: reduce screen in order to:• Increase physical activity• Improve diet• Improve/maintain healthy weight-related outcomes

Results:• Decrease in composite screen-time• Increase in physical activity• Decrease in BMI• Decrease in proportion of participants obese

As found in: http://www.thecommunityguide.org/obesity/ProviderEducation_client.html

WHAT WORKS FOR HEALTH INTERVENTIONS

Interventions for Diet and Exercise Plans Intervention that would help to improve the structure of physical exercise for middle school children • Targets: outline was a guide for teachers and a plan for what they could implement throughout the P.E

class. • Goals of the outline plan:• Increased physical activity level• Improved physical fitness• Improved weight status.

Results: The research study that is used for evidence to show that this worked including 2014 article titled “ School-based Physical Activity Program (KISS) on fitness and Adiposity in Children: A cluster- Randomized Controlled Trial.As found in: http://www.countyhealthrankings.org/policies/homework-or-extra-credit-pe-class

HEALTH DEPARTMENT INTERVIEW

Q: “I am doing a research project for my public health class specifically on the Monmouth County in New Jersey. How and

if is the county implementing overweight/obesity programs?”

A: “Yes, the higher focus is on the school health programs and outreach Education outreach services”

Q: “Could you identify county resources and barriers that exist to help or hinder the residents in maintaining weight”

A: “The community’s interest, and for more information look on our website.”

R: “To whom did I speak and what is your title/ position?”

I: “Nursing Supervisor Geryl, Krutle”

Phone number called (732-431-7456), called April 12 at 8:30 am and April 13, at 8: 45 a.m.

HEALTH DEPARTMENT INTERVIEW

Goal: To identify and reduce the barriers to healthcare services by increasing access to healthcare.

Strategies:• 1. Educate Community about alternative services• 2. Increase availability of alternative services• 3. Advocate importance of customer service, focusing on sensitivity and culture

Potential Barriers:• Funds• Resistance

As found in: https://co.monmouth.nj.us/page.aspx?ID=1932

POTENTIAL PARTNERSHIPS Meridian Fitness and Health Meridian Weightless:• Weight-loss surgery program that encompasses all the stages leading up to surgery:• Nutrition & Fitness• Understanding Obesity• Weight-loss Surgery

Contact: Joseph Barbalinardo, M.D., FACS • DrBarbalinardo@meridianweighless.com

As found in: http://meridianweightless.staywellsolutionsonline.com/NutritionFitness/ Nutrition and Weight Status. (n.d.).

POTENTIAL PARTNERSHIPS American Academy of Pediatrics• Goal: provide pediatric health care providers current practice based resources• Programs include:• Lead & Asthma Care• Medical Home• Obesity Prevention

Contact: Marcela Betzer, MPH - PEdiatric Partnership Initiative• mbetzer@aapnj.org

As found in: http://njaap.org/programs/

POTENTIAL PARTNERSHIPS Monmouth County Health Department• Health Education• Maternal & Child Health • Prevention and Control of Childhood Obesity• Facts About Lead Poisoning

• Adult Health• Cholesterol and You - “Which One Is The Good One Again?”• Eating For Health

Contact: MCHD at (732) 431-7456

As found in: https://co.monmouth.nj.us/page.aspx?ID=2182

BIBLIOGRAPHY Health Rankings. (n.d.). Retrieved April 13, 2016, from http://www.countyhealthrankings.org/app/new- jersey/2016/rankings/monmouth/

county/outcomes/overall/snapshot

Monmouth County. (n.d.). Retrieved April 13, 2016, from https://co.monmouth.nj.us/page.aspx?ID=1932

Monmouth County. (n.d.). Retrieved April 13, 2016, from https://co.monmouth.nj.us/page.aspx?ID=2182

Nutrition & Fitness. (n.d.). Retrieved April 13, 2016, from http://meridianweightless.staywellsolutionsonline.com/NutritionFitness/ Nutrition and Weight Status. (n.d.).

Nutrition and Weight Status. (n.d.). Retrieved April 13, 2016, from https://www.healthypeople.gov/2020/topics- objectives/topic/nutrition-and-weight-status/objectives

Obesity Prevention and Control: Provider Education with a Client Intervention. (n.d.). Retrieved April 13, 2016, from http://www.thecommunityguide.org/obesity/ProviderEducation_client.html

Obesity Prevention and Control: Provider-Oriented Interventions. (n.d.). Retrieved April 13, 2016, from http://www.thecommunityguide.org/obesity/provider.html

Obesity Prevention and Control: Behavioral Interventions that Aim to Reduce Recreational Sedentary Screen Time Among Children. (n.d.). Retrieved April 13, 2016, from http://www.thecommunityguide.org/obesity/behavioral.html

Programs. (2016). Retrieved April 13, 2016, from http://njaap.org/programs/