1. Community Health Promotion Project.
Community Health Promotion Project. Community health promotion projectPopulation of
interestThe population of interest has been identified as older adults who are 65 years of
age or older and residing in South Charlotte, in Charlotte City, Mecklenburg County, North
Carolina State. The project area has a population of 233,794 of which 122,399 are females
while 11,395 are males. The median age is 38.8 years with the median age of males being 38
years while median age of females is 40 years. Employment data reveals that 47.48% of the
population is unemployed while 52.52% are employed.Community Health Promotion
Project. Of the employed persons, 5.81% 46.71% hold white collar jobs while 5.81 hold blue
collar jobs. 5.85% of the population is self-employed, 39.01% work in the private industry,
3.6% work in the government, and 4.06% work in non-profit organizations. The life
expectancy of males is 76 years while the life expectancy of females is 82.5. The infant
mortality rate is reported at 7.5%. Approximately 50% of reported deaths are resultant of
chronic conditions such as cancer, heart diseases, and stroke(Point2 Homes, 2020).ORDER
A PLAGIARISM-FREE PAPER HEREThe South Carolina community has 91,987 households of
which 13.7% are family households while 25.65% are non-family households. Each
household has an average of 3 persons. The average annual income for each household is
$127,691.81 and median household income is $84,366.00. 7.5% of the population lives in
poverty while the remaining 92.5% lives above the poverty level. Age reviews by
incomeshows that persons less than 25 years of age have annual median earnings at
$38,529, persons between 25 and 44 years of age have annual median earnings at $86,650,
persons between 45 and 65 years of age have annual median earnings at $115,833, while
persons over 65 years of age have annual median earnings at $58,231(Point2 Homes,
2020). The age dependency ratio for the population is 51.3 with dependency ratio of 15.2
reported for older age (older than 64 years) and dependency ratio of 36.1 reported for
children (less than 15 years) (World Population Review, 2020). Older adults have been
considered of interest because of their unique risk factors for complications during the
post-operative recovery period. Of particular interest to the present project is the potential
benefits from optimizing body mass index, A1C management and smoking as risk factors for
complications in the post-operative recovery period.Mortality and morbidity risk
factorsOlder adults represent a public health burden for South Charlotte community. That is
because aging is a leading risk factor for major chronic medical conditions. Approximately
28% of this population are healthy while the remaining 72% have been diagnosed with one
or more chronic condition. In fact, 7% have more than three coexisting chronic conditions,
2. 11% have three coexisting chronic conditions, 21% have two coexisting chronic conditions,
and 33% have one chronic condition. The most common chronic conditions are myocardial
infarction, hypertension, diabetes, arthritis, cataracts, emphysema, chronic bronchitis,
cancer, stroke, and congestive heart failure. Other chronic conditions of concern in include
nephritis, pneumonia, influenza, cerebrovascular disease, chronic lower respiratory disease,
and heart diseases (Liu et al., 2018).Community Health Promotion Project.The increasingly
higher life expectancy of the general population has been partly driven by reduced
mortality among older adults. As is true among their younger counterparts, older adults
report heart disease as the most common cause of death, with cancer coming second. The
five leading causes of death among older adult populations are heart disease (30.4%),
cancer (22%), Alzheimer’s disease (3.7%), chronic lower respiratory tract disease (6%),
and cerebrovascular disease (7.4%). They account for 69.6% of all reported deaths. There is
an exponential increase in heart disease, Alzheimer’s disease, and cerebrovascular disease
incidences with Alzheimer’s disease presenting a sleeper increase. However, the mortality
rates for lower respiratory tract disease and cancer do not have a steep increase, perhaps
because they are mostly reported among smokers who die at younger ages. Also, diabetes
rates do not show steep increases because diabetics disproportionately die at younger ages.
Still, it is important to note that there have been remarkable declines in mortality rates
resultant from chronic diseases, perhaps a reflection of major advances made in treatment
and prevention approaches, as well secular trends. Unfortunately, the mortality rate for
cancer continues to rise (Pilotto& Martin, 2018).Community Health Promotion
Project.Among older adults, the most common medical condition is hypertension, followed
by stroke and coronary heart disease. Chronic joint symptoms and arthritis are also
reported among the older adult population, and they have an impact on their overall quality
of life and health although they do not appear in the list of most common conditions (Busby-
Whitehead et al., 2016). Another unique health feature of older adult populations is the high
comorbidity: co-occurrence of multiple chronic medical conditions. It is not uncommon for
older adults to report more than one chronic condition. In fact, 39% of older adults report
comorbidities. Heart disease remains the leading cause of hospitalization among the
population, with congestive heart failure being more common than other heart disease
manifestations. Other chronic diseases are also frequent causes of death and hospitalization,
but so are the diseases typically not associated with mortality among other populations to
include psychosis, chronic bronchitis, osteoarthritis, and fractures. That is because these
diseases cause volume depletion and septicemia that is particularly burdensome for older
adults experiencing physical declines as they are frail and at high risk of these diseases
(Pilotto& Martin, 2018).Community Health Promotion Project.Dementia is another
condition of aging that occurs among older adults and for which incidence and prevalence
rates are not readily available because of the complexities of diagnosis. Yet another concern
is disability, a consequence of severe medical conditions such as heart disease and stroke on
mental and physical functioning with effects on work ability and need for informal and
formal care. Limitations present for basic tasks such as grasping, reaching and standing.
Although not a measure of disability, these basic tasks represent the building blocks of
functioning. Disability remains a powerful marker for predicting adverse outcomes among
3. older adults as they can capture the presence and severity of impact for multiple
pathologies to include psychological, cognitive and physical conditions. In effect, disability is
a produce of disuse, sedentary lifestyle or the medical condition from which an older adult
suffers, and physiological declines resultant from aging. Overall, it is important to note that
disability status remains a relevant measure among older adults because it represents
overall health status with complex disease patterns, and it has direct implications for health
care needs (Kahn, Magauran Jr. &Olshaker, 2014).Community Health Promotion
Project.Although the leading causes of death among older adults are also some of the
leading causes of death among other age groups, many of these medical conditions are
treatable and preventable. It is important to understand these disease, how to delivery
treatment, and how the older adult population can live with them to prolong health and life
(Busby-Whitehead et al., 2016).Health risk factorsHealth risk factors refers to the set of
circumstances that determine health outcomes through increasing the probability of
disease occurrence. The first risk factor for older adults is increased age. As adults age, they
become more susceptible to disability and diseases. In fact, aging among older adults is
deleterious to their fitness. In addition, aging can evolve into a consequence of the declining
force of natural selection attributable to the extrinsic survival hazards whereby aging
presents as a side-effect of the accumulation of disease pressures that accumulate over
time.Community Health Promotion Project. It presents as an accumulation of multiple forms
of pathology and damage to different body systems resulting the integrity of the body
maintenance pathways being compromised. To be more precise, there are several
conserved mechanisms that are compromised by aging to include repair of damaged body
tissues, DNA repair, energy and metabolic homeostasis, mitochondria, and nutrient sensing
pathways. As such, as aging can be considered as the accrued effect of the finite number of
biological pathways in the body and causes the disease burden of older adults to increase
(Busby-Whitehead et al., 2016).The second risk factor is obesity (BMI > 30). Persons who
are obese, compared to their counterparts with health/normal weight, are at higher risk for
developing serious health conditions and diseases to include stroke, hypertension and
coronary heart disease. Unfortunately, obesity is now common among older adults with
incidence at 25%. 27% of females and 24% of males are obese. Although the causes of
obesity are multifactorial (to include social, environmental, psychological, physiological,
nutritional and genetic causes), the main cause is excessive calories intake matched with
limited energy expenditure. Obesity remains a serious risk factor among older adults due to
the high prevalence, causal relationships with many disorders and diseases, increased
mortality and morbidity, reduced quality of life, and accelerated aging. In fact, obesity has
approximately the same association with chronic diseases as does 20 years of aging, greatly
exceeding the associations reported for smoking. It increases the relative risk of premature
death to 2 among women and 2.58 among males. The implication is that obesity is a health
risk factor among older adults(Mattu, Grossman & Carpenter, 2016).Community Health
Promotion Project.The third health risk factor is diabetes. 25% of older adults suffer from
diabetes, and aging among them is a significant driver for the medical condition. Among
older adults diagnosed with diabetes, they either report the disease as an incident condition
that developed in old age or as a long-standing conditions that developed at a young age.
4. The disease has been linked to higher risk of institutionalization, reduced functional status
and higher mortality among older adult populations. Also, older adults suffering from
diabetes are at higher risk for chronic and acute cardiovascular and
microvascularcomplications. However, the heterogeneity of health status of older adults
shifts attention away from diabetes as a health risk factor and concern. Still, it is important
to note that diabetes increases the risk of other health concerns to include higher rates of
amputations of lower extremities, renal disease, visual impairment, and myocardial
infarction. Deaths and emergency room visits resultant from diabetes are also significantly
higher among older adult populations. Although type 1 diabetes occurs among older adults,
type 2 diabetes is more common owing to the combined effects of impaired pancreatic islet
functions, decline in islet proliferative capacity, and insulin resistance. These age related
concerns are associated with physical inactivity, sarcopenia, and adiposity that are more
common among older adults(Mattu, Grossman & Carpenter, 2016).Community Health
Promotion Project.The fourth risk factor is smoking. It increases the risk of developing
chronic conditions such as peripheral vascular disease, stroke, coronary heart disease, and
chronic obstructive pulmonary disease. These are medical conditions that target older
adults to negative affect their social, psychological and physical health. Smoking is also
associated with frailty, a condition linked to reduced physiological reserves and increased
vulnerability to adverse health outcomes such as institutionalization, hospitalization,
disability, fractures and falls. Given that smoking is a modifiable lifestyle factor that
increases the risk of chronic conditions, reduced smoking among older adults has a high
potential for interrupting the causal pathway (Pilotto& Martin, 2018).Community Health
Promotion Project.Health promotion activityThe health promotion activity for older adults
has been identified as targeting obesity, diabetes and smoking as risk factors for adverse
post-surgery outcomes among the population of interest. There is an acknowledgement that
although heart diseases and reduced functionality are the strongest predictors of adverse
outcomes during the post-operative period, obesity, diabetes and smoking are risk factors
for these predictors. The health promotion activity anticipates that targeting older adults in
South Carolina for health education on how to manage obesity, diabetes and smoking, will
improve their awareness and healthy behaviors while helping in improving surgery
recovery outcomes for this population. The promotion activity will seek to achieve three
main objectives: maintaining and increasing functional capacity; maintaining or improving
self-care; and stimulating education of health information that supports independence
(Stanhope, 2016).Community Health Promotion Project.The community under review has
been identified as South Charlotte, in Charlotte City, Mecklenburg County, North Carolina
State. The community is suffused by old-fashioned southern charm with a unique feel,
culinary sophistication and culture. There are numerous green spaces with parks, water
accesses, bike lanes transit tramand ample sidewalks. It has a population of 233,794
comprised of 122,399 females and 111,395 males. The median age of the residents is 38.8
years (Point2 Homes, 2020). South Charlotte is comprised of six distinct areas. The first
area is Arboretum, located at the intersection of NC Highway 51 and Providence Road
(Highway 16) with most buildings constructed in the 1980s and 1990s. The second area is
Ballantyne that covers an area of 2,000 acres and located in the southern tip of Mecklenburg
5. County. It was initially farmland and was recently converted into a residential area. The
third area is Blakeney located to the south of I-485 and located at Rea and Ardrey Kell Road.
It is a 300 acre development that includes upscale home, office parks, apartments, retail
shops, and restaurants. The fourth area is Matthews. It was founded in the 1800s as a
farming community that produced cotton. It is currently a residential area with 25,000
residents, schools, and enjoys lower taxes. The fifth area is Pineville, a shopping hub that
houses major retail outlets. It has 6,500 residents and is located between York County and
Charlotte. The sixth area is SouthPark, which occupies a 3,000-acre area. It was initially
owned by North Carolina Governor Cameron Morrison but was later transformed into a
live/work community (Reimax, 2020). Our community is supported with a broad spectrum
of health care services and facilities, including but not limited to two major hospital
systems, eight free or low-cost health clinics and a new community hospital and is still
expanding resources.Community Health Promotion Project.It has a population of 233,794
people comprised of 122,399females and 111,395 males. People are living longer, life
expectancy in females is 82.5 and Men at 76 years old. Also,Infant Mortality Rate (Deaths
per 1,000 live births) is at 7.5% with a steady live birthincrease at 7%. In 2016, there were
6,204 deaths reported in the county. Chronic conditions, such as Cancer, Heart Disease and
Stroke account for nearly 50% of all deaths. The median age of the residents is 38.8 years
with the median age for females being 40 years and median age for males being 38 years.
90.29% of the population are US citizens with the remaining 9.71% being non-citizens. With
regards to occupational employment in South Charlotte, 47.48% of the population is
unemployed while 52.52% is employed of which 5.81% hold blue collar jobs while 46.71%
hold white collar jobs. 5.85% of the population is self-employed, 39.01% are employed by
private companies, 3.6% are employed by the government, and 4.06% are employed by not
for profit organizations (Point2 Homes, 2020). With regards to the number of households in
the community, there are 91,987 households of which 25.65% are non-family households
while 13.7% are family households. The average number of persons per household is 3.
30,729 (13.14%) households have children while 61,258 (26.2%) households are without
children. A review of annual incomes reveals that the average household income is
$127,691.81 with the median household income being $84,366.00. 212,171 people live
above the poverty level while 17,499 live below the poverty level. A review of median
income by age reveals that persons under 25 years of age earn $38,529, persons between
25 and 44 years of age earn $86,650, persons between 45 and 65 years of age earn
$115,833, while persons over 65 years of age earn $58,231 (see figure 1; Point2 Homes,
2020).Community Health Promotion Project. Number of Live Births by Year, Figure 1.
Graph of Live Births by Year, Mecklenburg Residents(Source: NC DHHS, Vital Statistics
Data,2020) Figure 2. Graph of median income per age group in South Charlotte (Source:
Point2 Homes, 2020)A review of the housing in South Charlotte reveals that there are
91.987 occupied housing units, of which 33,587 (14.37%) are renter occupied while 58,400
(24.98%) are owner occupied. 44,430 (19%) housing units have mortgages and 13,970
(5.98%) are without mortgage. The median value of the housing units with mortgage is
$348,800.00 while the median value of housing units without mortgage is $295,900.00. The
median housing cost per month in South Charlotte is $1,326.00 (Point2 Homes, 2020).The
6. education statistics for South Charlotte reveal that 1.99% (4,646 persons) of the population
do not have high school education, 12.09% (28,261 people) have some high school
education, 15.67% (36,631 people) have some college education, 4.98% (11,646 people)
have associate degree education, and 28% (65,453 people) have bachelor’s degree
education (Point2 Homes, 2020). A review of the marital status in South Charlotte shows
that 54.489 (23.31%) of the population have never been married, 105,052 (44.93%) are
married, 3,404 (1.46%) are separated, 8,578 (3.67%) are widowed, and 17,017 (7.28%) are
divorced (Point2 Homes, 2020).The most popular means of transport in South Charlotte is
cars that are used by 102,886. 1,891 people use trolleys and buses, 474 people use the
railroad, 157 people use bicycles, 112 people use motorcycles, 181 people use taxicabs, and
1,317 people walk (Point2 Homes, 2020).Long known as “The City of Churches,” Charlotte is
increasingly also becoming a city of mosques and temples. And English is no longer the only
language you’ll hear at worship. Muslims in and around Charlotte pray in Arabic at about a
dozen mosques. We have Vietnamese, Chinese and Cambodian Buddhist temples. Also,
there is more than 700 churches and denominations.Community Health Promotion Project.
Religious statistics for the community reveal that it has historically been Christian
Protestant denomination. 52% of the population is religious affiliated. The population is
expected to grow because of foreign immigration and return immigration because of the
lower cost of living. The population density is approximately 1,100 people per squared
kilometer. Population demographics reveal that Whites account for 49.54% of the
population, African Americans account for 35.09%, Asians account for 6.54%, Native
Americans account for 0.37%, Pacific Islanders (Native Hawaiians) account for 0.06%, and
other races account for 8.4% (see Figure 2). Age dependency ratio revealed the ratio of
dependents against working population between 15 and 64 years of age. Age dependency
for the population is 51.3 dependency ratio for the whole population, 15.2 for old age
dependency ratio and 36.1 child dependency ratio. A review of the educational attainments
by race reveal that the Whites are most educated (see Figure 3). A review of earnings by
educational attainment reveals that males generally earn higher than females for the same
level of education (see Figure 4). A review of the language used by the community members
reveals that 78.48% speak only English and 12.04% speak Spanish, 4.4% speak Indo-
European languages, 3.6% speak Asian and Pacific Island languages, and 1.5% speak other
languages (see Figure 5; World Population Review, 2020). Community Health Promotion
Project.Figure 3. South Charlotte population proportions by raceFigure 4. Educational
attainment by race/ethnicityFigure 5. Earnings by educational attainment and genderFigure
6. Languages used by proportionThe aggregate of interest in the present survey is at risk
older patients who are over 65 years of age and who would benefit from optimization of
risk factors of increased body max, poor management of diabetic A1C,as well as smoking.
The adults age 65 and older (“older adults”) are the fastest growing segment of the United
States population, and their number is expected to double to 89 million people between
2010 and 2050. Based on these evolving demographics, it is expected that there will be a
concurrent rise in the demand for a variety of surgical services. In fact, its mortality, co-
morbidities and prevalence are higher among the elderly than among younger people.
Population statistics reveal that 55% of all diabetes cases are reported among this
7. population, with 80% of them reporting the condition at different stages. This is a concern
since the elderly only account for 15% of the whole national population. Another concern is
that approximately 69% of those with diabetes have been diagnosed and are receiving
treatment, while the remaining 31% are yet to be diagnosed not to talk of receiving
treatment.Community Health Promotion Project. Also, the factors raise another concern is
that unlike their younger counterparts , elderly persons with are likely to have other
comorbidities (such as kidney and heart insufficiencies) that limit the prescription options
for managing the condition (Huff, Kline & Peterson, 2015; United Health Foundation, 2020).
This makes it clear that this population has a high risk for surgical procedures, perhaps the
most alarming health concern among elderly populations with a need to not only ensure
that they are diagnosed early on but are also offered the appropriate treatment. In addition,
there is a need to offer health promotion and preventive services to preempt the diagnosis
and management concerns. In addition, the three criteria relate to diabetes, weight and
smoking interventions that can be applied to the population.As a nurse, I have always
considered it my responsibility and duty to provide the appropriate and required care. I
perceive the concept of caring as central to the nursing profession since it implies a true
concern for patients with a focus on improving population wellness and health as the
central goal. With regards to preoperative optimization among the elderly in South
Charlotte, my interest is in improving management for the best care outcomesof all surgery
patients. The strategies will be rationalized by tangible scientific evidence that can be
verified so that stakeholders are motivated to invest in projects applying the strategies to
targeted elderly populations in South Charlotte and other areas. The result will provide the
population with resources and tools to prepare for managing diabetes, weight loss and
smoking cessation.The needs as witnessed by patient interactions in the clinic support the
need for more education on preventive services and practical resources and tools for a
higher quality of life.Community Health Promotion Project.Working with a community-
based hospital, orthopedic surgeons and primary care health professionals. The goal of the
capstone project is to use evidence and practice-based questions to identify how modifiable
risk factors, when optimized improve out comes and decrease costs. The primary
preoperative risk factor for poor post-operative outcome in older people is not age, but co-
morbidity. Cardiac disease (especially heart failure and arrhythmia) and reduced functional
capacity are the strongest predictors of post-operative problems, although pulmonary and
neurological conditions are also significant (Dyrda, 2011). These risk factors are potentially
modifiable, implying that careful preoperative assessment is the key to preventing adverse
post-operative outcomes.Also, I hope to learn of service gaps, clinical needs, and potential
obstacles in elective orthopedic surgery for older adults in Charlotte, NC communities. The
processes will be to review, interview and supply data that shows the benefits of
optimization. tracking cancellations, emergency room visits, while measuring outcomes of
non-optimized patients. In, the community addressing, obesity (BMI >40),
diabetesmanagement(A1C >8.0), and smoking cessation within 30 days of surgery. The
strategies promotion strategies for the elderly generally have three basic aims: maintaining
and increasing functional capacity, maintaining or improving self-care, and stimulating
8. education of health information that supports independence (Stanhope, 2016).Community
Health Promotion Project.
