The term ‘Community Assessment' describes the process of establishing the assets, strengths, needs, as well as challenges of a given community. It entails evaluating the current situation in the community, reaching a decision on what the desired situation in the said community is, and comparing the existing and desired situation in a bid to prioritize concerns. Several principles govern community assessment, one of them being that members of a specified community are the ideal experts of the said community. Another guiding principle is that all the community members have abilities, talents, and skills that can be used to contribute to the community positively. The third principle is that a robust community has its basis in the resources and talents of its members. In the current project, the community assessment involves the Hispanic Americans, the primary purpose being to assess the health status of a member of this community.
Definition of the community
The Hispanic American community consists of any individual of Mexican, Cuban, South or Central American, Cuban and any other Spanish origin irrespective of race. Population estimates from the US Census Bureau indicate that as of 2015, there were around 56.5 million Hispanic Americans. The group accounts for 17.6% of the total population in the US. Within this community, the largest ranking groups are Mexicans at 63.4% followed by Puerto Ricans at 9.5%. Central Americans come in at a close third at 9.2% followed by South Americans at 6.0%, and finally Cubans at 3.7%. As of the 2015 population estimates, the state with the largest Hispanic population was California with 15.2 million Hispanic Americans (Department of Health and Human Services, 2019). Texas had the second largest Hispanic American population, followed by Florida, New York and then Illinois.
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Among the Hispanic American subgroups, there is a significant variation in language fluency, with population estimates showing that up to 73% of Hispanic Americans can communicate in a language other than English. In terms of education, the 2015 census estimates show that up to 66% of Hispanics have a high school diploma. This is relatively low compared to 97% among non-Hispanic whites (Department of Health and Human Services, 2019). The population of Hispanic Americans with a bachelor’s degree is also relatively low compared to that of non-Hispanic whites at 14.8%.
From the 2015 U.S. Census Bureau report, the median household income among Hispanic Americans was $44,782, a figure that is relatively lower compared to the $61,394 among non-Hispanic whites. A higher population of Hispanics, compared to non-Hispanic whites, were also found to be living in poverty (Department of Health and Human Services, 2019). As of 2015, 22.6% of Hispanics were living in poverty. Concerning insurance coverage, Hispanic Americans stand out as the group with the highest uninsured rates of any ethnic or racial community in the US. As of 2015, up to 19.5% of Hispanic Americans had no insurance coverage (Goodarzi, 2018).
Numerous factors impact the health of Hispanic Americans, key among them being cultural/language barriers, lack of health insurance, and limited access to preventive care. The CDC (2019) reports that the primary cause of illness and death among Hispanic Americans include cancer, heart disease, diabetes, accidents, and stroke. Compared to non-Hispanic whites, Hispanic Americans have significantly higher rates of obesity. The focus of the current assessment is on Hispanic Americans in Los Angeles, California. The purpose of the assessment is to examine the prevalence of obesity within the Hispanic American community living in the Downey area of Los Angeles.
Assessment
Obesity on the Rise among Hispanics of all Ages
When compared to other ethnic groups in California, both male and female Hispanic Americans have one of the highest rates of overweight, obesity, and type 2 diabetes. The California Department of Health Services (2019) reports that about seven in ten Hispanic American adults in California are obese or overweight. Among Latino adolescents in California aged between 12 years and 17 years, the risk of being obese or overweight is significantly higher compared to other racial groups. The significantly high prevalence of overweight and obesity among Hispanic Americans in California contributes to the relatively high prevalence of cancer, heart disease, stroke, and diabetes. All these medical conditions have obesity as a significant risk factor and are responsible for up to 60% of mortality among Hispanic Americans (Velasco-Mondragon et al., 2016). Childhood obesity among Hispanic Americans has also increased by a significant margin over the last few decades, and this has resulted in an increased for diabetes. Projections show that up to half of Hispanic American newborns are at very high risk of developing diabetes in their lifetime due to increased occurrence of childhood obesity.
Inactivity and Unhealthy Eating the main Cause of Obesity and Overweight
Obesity is linked to the consumption of foods that are poor in nutrients and are high in calories. These include fast foods, high sugar snack foods, and sweetened beverages. On the other hand, the uptake of diets characterized by whole grain products, fresh fruits, and vegetables as well as low-fat dairy and protein is linked to healthier weights (Woodward-Lopez et al., 2006). Despite many kids in the US not strictly adhering to healthy dietary guidelines, the Hispanic American children's diet places them at a higher risk of obesity. Their diets consist of foods that are relatively high in processed sugars and dietary fats and low in vegetables and fruits.
Another significant contributor to the high prevalence of obesity among Hispanic Americans in California is the lack of physical activity. The minimum recommendations from the CDC are half an hour of moderate physical activity at least five days every other week or at least 20 minutes of vigorous activity at least three days each week (CDC, 2019). However, very few Hispanic Americans do meet the recommended levels of physical activity. Male Hispanic Americans in Los Angeles County have been found to have the highest rate of sedentary lifestyle compared to any other ethnic group in the county ( Department of Health and Human Services, 2019). Other reports indicate that less than one in four Hispanic Americans take part in at least 20 minutes of physical activity three times in a single week. For Hispanic American children and youth in grades five, seven, and nine, only one in five meets all the fitness standards set out in the statewide fitness test. This is a clear indicator that the inadequate physical activity is negatively impacting the health of Hispanic American children and youth, and increasing their risk of obesity. It is reported that up to 10% of Hispanic American youth take part in very little to zero vigorous physical activity (CDC, 2019).
Barriers to Healthy Eating and Physical Activity
Socioeconomic inequities have resulted in the overrepresentation of Hispanic Americans in low-income neighborhoods which in turn tend to encourage sedentary lifestyles and unhealthy diets. The low-income neighborhoods in which the Hispanic Americans settle in are characterized by the limited availability of healthy and affordable food options. The neighborhoods instead have many liquor stores and mini-markets that primarily offer convenience foods and snacks that are rich calories but poor in nutrients ( Innella et al., 2016). An observation of these neighborhoods reveals that taco wagons, fast food joints, and street vendors are often clustered in areas where residents have limited options to access healthy foods. In a survey conducted among Hispanic Americans in California, 64% percent reported that it was quite challenging to get fresh fruits and vegetables at work and 54% reported that it was difficult to get the same in restaurants. 70% of those interviewed stated that getting fresh fruits and vegetables in fast food joints was difficult ( Innella et al., 2016). Low-income neighborhoods also tend to have fewer parks, properly equipped playgrounds, recreational facilities, and streets that are pedestrian and bike friendly. Taking the example of Los Angeles County, there is a disproportionate concentration of park space in wealthy neighborhoods. This implies that Hispanic Americans are less likely to have access to playgrounds and parks compared to their White non-Hispanic counterparts.
Schools in low-income neighborhoods in which Hispanic Americans are over-represented also tend to have relatively poor facilities for physical education. Additionally, the schools exhibit relatively high dependence on the sale of junk food to promote school programs and tend to allocate very little time to physical and health education compared to schools in affluent neighborhoods. Lack of adequate resources for recreation, unsafe neighborhoods as well as limited quality childcare have all contributed to increased dependence on TV among Hispanic American families in California. Viewing TV has immensely contributed to reduced physical activity time and resulted in increased children and youth exposure to junk food adverts. It is not surprising that there is increased demand for unhealthy foods which are frequently advertised on television among Hispanic American children and youth ( Innella et al., 2016).
Genetic, Cultural and Socio-economic Factors
According to Goodarzi (2018), genetics contributes to between 40 and 70% of obesity cases. However, genetics only influences the susceptibility to obesity as opposed to determining the actual weight that an individual will gain. Hispanic Americans stand out as one of the ethnic groups with a very high genetic-susceptibility to obesity. While this genetic susceptibility was useful in historical periods characterized by the limited availability of food, it has become a liability in modern times characterized by excessive availability of cheap calories and minimal physical activities among the people. The fact that Hispanic Americans live in communities where there is heightened environmental risk for obesity means that there is always a high likelihood for expression of the gene susceptibility.
Socio-economic factors also play an important role in obesity's etiology. In low-income societies, the environment does not favor healthy eating habits and does not encourage adequate physical activity. Low-income status also implies limited power to purchase healthy foods which tend to be pricey compared to unhealthy fast foods. Many Hispanic Americans in California agree that healthy foods such as vegetables and fruits are more expensive. Most Hispanic Americans also report that they have to work long hours, a fact that limits the time available for leisure-time physical activity and shopping for and preparing healthy foods ( Innella et al., 2016). Because many parents have to spend a lot of time at work, they get very little time to encourage their children to eat well and engage in multiple physical activities.
Other key factors relevant to Hispanic American obesity are immigration, acculturation, as well as the conditions in the home country. Off all the Hispanic Americans in California, the most significant proportion are of Mexican descent. Mexico, as a country has also been experiencing a rise in the prevalence of obesity, just like the US. In Mexico, the prevalence of obesity is reported to be highest in the states that border the US, an indicator of the influence of exposure to the culture in the US ( Isasi et al., 2015). Immigrants of Latino descent are impacted by protective influences as well as unique risks. Most of the times, traditional culture tends to be protective, with less acculturation being linked to more physical activity, healthier diets, and lower occurrence of obesity. Efforts aimed at preventing obesity among Hispanic immigrants thus need to focus on safeguarding healthy physical activity patterns and traditional dietary practices, and at the same time, reinforce cultural pride and identification (Goodarzi, 2018). Among those who have recently immigrated, an essential strategy to preventing obesity would be to make it easy for traditional foods to be accessed, and identifying ideal alternatives to traditional ingredients that cannot be found with ease in the US.
Prevention of Obesity
It should be noted that obesity is a significant public health concern among Hispanic Americans, hence the need for immediate reduction of the prevalence rates and the health and social impacts of the condition. A prevention approach is critical to Hispanic Americans whose perspectives and cultural values tend to align themselves to preventive strategies that empower communities and families and place emphasis on the greater concepts of physical and social health as opposed to depending on concepts that are narrowly defined such as Body Mass Index. Prevention of obesity in a manner that is sustainable and effective calls for enhanced daily access to high quality nutritious and healthy foods and limited access to unhealthy foods such as fries. Prevention of obesity among Hispanic Americans in California also calls for enough amount of physical activity in terms of biking, walking, and recreational sports. Several approaches, some of which have already been implemented, can be used to encourage healthy eating habits and engagement inadequate physical activities ( Innella et al., 2016). The approaches have focused on various aspects, including the food and beverage industry, youth leadership, school environments, and the media.
The food and beverage make a significant contribution to obesity, given its complexity and the fact that it is a vast industry. The industry has a significant say in what members of the community consume since they produce, price, and market a wide range of food items. As such, there is a wide range of potential entry points of interventions, including local efforts, national trade policies, and global agricultural and trade policy. To address the increased prevalence of obesity among Hispanic Americans in California, efforts have also been directed towards improving the physical activity environment in the communities. The efforts include the establishment of walking trails and bikeways, improvement of neighborhood parks, and establishment of community fitness centers. There have also been initiatives to involve youth leadership in community processes aimed at improving the food systems within the local Hispanic communities (Goodarzi, 2018). Within the school environments, efforts that have been undertaken include improving school meal programs, improving the quality of physical education and improving the quality of nutrition and health education
Conclusion
Obesity is a serious public health concern among Hispanic Americans in California, hence the need for immediate and collective action. The focus of this community assessment was on the prevalence of the condition among the Latino communities of California, factors contributing to the high prevalence and the prevention of future incidences of obesity. When compared to other ethnic groups in California, both male and female Hispanic Americans have one of the highest rates of overweight, obesity, and type 2 diabetes. Lack of physical activity and poor diets are the main factors that have contributed to the high prevalence of these conditions among California's Hispanic communities. Prevention of obesity in a manner that is sustainable and effective calls for enhanced daily access to high quality nutritious and healthy foods and limited access to unhealthy foods such as fries. Several approaches have so far been implemented to address the problem of obesity, the focus of these strategies being on the food and beverage industry, youth leadership, school environments, and the media
References
California Department of Health Services (2019). The State of Obesity in California . Retrieved from https://www.stateofobesity.org/states/ca/
CDC (Centers for Disease Control and Prevention) (2019). Physical Activity Recommendations & Guidelines . Retrieved from https://www.cdc.gov/physicalactivity/resources/recommendations.html
Department of Health and Human Services. (2019). Profile: Hispanic/Latino Americans . Retrieved from https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=64
Goodarzi, M. O. (2018). Genetics of obesity: what genetic association studies have taught us about the biology of obesity and its complications. The Lancet Diabetes & Endocrinology , 6 (3), 223-236.
Innella, N., Breitenstein, S., Hamilton, R., Reed, M., & McNaughton, D. B. (2016). Determinants of obesity in the Hispanic preschool population: An integrative review. Public Health Nursing , 33 (3), 189-199.
Isasi, C. R., Ayala, G. X., Sotres-Alvarez, D., Madanat, H., Penedo, F., Loria, C. M. ... & Van Horn, L. (2015). Is acculturation related to obesity in Hispanic/Latino adults? Results from the Hispanic community health study/study of Latinos. Journal of obesity , 2015 .
Velasco-Mondragon, E., Jimenez, A., Palladino-Davis, A. G., Davis, D., & Escamilla-Cejudo, J. A. (2016). Hispanic health in the USA: a scoping review of the literature. Public Health Reviews , 37 (1), 31.
Woodward-Lopez G, Ritchie L, Gerstin D, and Crawford P (2006). Obesity: Dietary and Developmental Influences . Boca Raton, FL: CRC Press.Yancey AK, Kuma
