Table of Contents
Lack of exercise is a major problem globally today. Although participation in exercise and sports related activities have rose by 3.6% from 2003 to 2015, there is still a need for education regarding the importance of physical activity (Woods, 2008). Medical professionals are starting to realize the detrimental effects of lack of exercise today. By providing regular physical activity to the general population we can see benefits such as increased cardiovascular, respiratory, musculoskeletal, and metabolic functions.
There are many more diagnoses and hospital visits today due to creating a sedentary lifestyle. There are also many different populations that are affected by lack of exercise including; racial and ethnic minorities, those of low socioeconomic status, and people with disabilities. In order to determine the factors that cause lack of exercise, we must look at the social and structural aspects of each community. By obtaining this information, we can begin to educate and implement new ways to get the community active. This can reduce the number of adults who do not meet public health recommendations for regular, moderate physical activity.
According to the CDC, only about one third of adults meet the current recommendations for physical activity (CDC, 2017). This paper will go over economic variables, vulnerable populations, barriers, and levels of prevention. The nursing process will be used to support the solution to this problem. Lastly, Healthy People 2020, National Patient Safety Goals, and the Health Belief Model will be consulted to discover new solutions to this ever-growing issue.
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Keywords: Exercise, Vulnerable Populations, Sedentary, Lacking
Objectives
- Describe the importance of regular, physical activity and its impact on public health.
- Discuss primary, secondary, and tertiary prevention techniques that we can implement as nurses to get people moving.
- Attempt to discover disparities between lack of exercise and community aspects.
- Discuss Healthy People 2020, National Patient Safety Goals, and World Health Organization models and how their impact can help us solve this community health problem.
- Look at the Health Belief Model and how it relates to the problem of lack of exercise
Introduction
Exercise is meant to be beneficial as it provides our bodies with the strength, power, and resilience it needs to fight off disease. There is substantial evidence claiming that there is a reduced risk of coronary heart disease, stroke, type II diabetes, colon cancer, and hip fractures (Hardman, 2001). While lack of exercise is still a major issue, it has been reduced due to efforts of researchers from the CDC. According to the CDC, more than 1.4 billion adults are putting themselves at greater risks of incurable diseases. With over 7 billion people living on earth currently, this is a problem that needs to be worked towards.
The CDC and state level exercise programs work together to solve this problem and decrease the number of sedentary people. In order to think about the number of people who do not exercise and are riddled with deathly diseases, we must reach out to community members to discuss impact. By doing so, the population will experience increased health and wellness and a longer, happier lifestyle. This paper will go over the education and services that are needed to jumpstart this need as well as important nursing interventions. Finally, the role of the community health nurse will also be emphasized as well as her role in the resolution of this issue.
Needs Assessment
The community health nurse plays an important role in assessing and analyzing the community health needs. The purpose of this needs assessment is to identify gaps in knowledge of the importance of exercise and economic variables regarding this. By identifying these gaps, the community health nurse can begin to create a plan which can be assessed once it has been implemented. The nurse can begin by discovering what the public’s perception of exercise is. From there, she can create an educational plan with a healthcare team to teach to community members; this is considered primary prevention (Henry et al., 2016, p. 10).
She can also perform a windshield survey by driving through the community and seeing if there are any recreational centers or gyms within a reasonable distance to the community. By doing this, she can also discover if the area is safe enough to walk around in because sometimes this is the reason people do not go outside. The nurse can use this information to decide whether or not it would be beneficial to create programs inside of the community or somewhere safer. This would be considered secondary prevention. Finally, tertiary prevention involves minimizing negative outcomes regarding a health problem (Henry et al., 2016, p. 10).
Here, the nurse can provide resources around the community for prevention of chronic illness as well as recommendations to centers to begin their exercise regime. By doing this, clients will be able to prevent chronic illnesses from forming and learn about available resources in the community. Each of these levels of prevention are essential to the health of the community. The nurse assumes responsibility to collect and assess these needs and implement them by using appropriate measures.
Vulnerable Populations and Cultural Diversity
There are many different populations that are at risk for medical problems related to lack of exercise. To start off, the social determinants of health must be discussed. These are the factors that affect individual health and conditions that a person is born into. These determinants include stress, socioeconomic status, access to healthcare, education, healthcare beliefs, support systems, finance, and the overall environment (Henry, 2016).
First, those who have low socioeconomic status are placed at increased risk for lack of exercise. According to Larsen (2016), “…55.4% and 62.6% of individuals living in low vs. high SES areas engaged in recommended levels of MVPA, representing a 26% lower likelihood of sufficient activity among low SES individuals” (p. 5). They also reported that low SES also places people at risk for lifestyle-related illnesses which can be prevented.
They also have an increased risk of mortality. There have been identified reasons as to why they are at a higher risk for lack of exercise. These reasons include, less access to facilities, lower levels of education, and higher levels of stress (Larsen, p. 6). There have also been reports made of this population being concerned about lack of safety in their neighborhood which has negatively impacted their activity levels.
Also, people with disabilities have been included as a vulnerable population as they are less active and likely to not exercise. By not exercising, they are placing themselves at risk for other comorbidities such as pressure ulcers, obesity, bowel and bladder issues, and depression (Larsen, pg 5). Depending on the disability, this population is placed at a higher risk for unemployment and low salaries which are included in the social determinants of health.
Another vulnerable population included here are individuals from minority racial backgrounds such as “…Hispanics, African Americans, American Indians, Alaska Natives, Asian Americans, and Pacific Islanders” (Larsen, p. 4). According to the NIH, these populations have been underrepresented in research and research has now since been readjusted to include them.
Researchers have used strategies such as partnering with local health centers, addressing safety concerns, and using social media campaigns to promote health promotion interventions such as exercising. Most research that exists pertains to Hispanic and African American women as they have low levels of physical activity and high levels of chronic illness. There were many studies done to intervene and promote physical activity where there was a marked increase in exercise promotion among minority women (Larsen, p.7). They also did some cultural tailoring for African American women where they created a 24-week program where they held meetings on diet and exercise led by African American staff.
There was an increase in exercise minutes from their baseline by the end of the 24 weeks. (Larsen, p. 7). This idea supports the efficiency of a community-based approach to this problem. As nurses, we must be aware of different cultural beliefs and find new ways to include these populations in health promotion practices.
