AssessmentHumboldt County is a county in California, with a population of 134,623 and a geographical area of 4,052 square miles (census.gov, 2016). It has a fairly homogenous population with 82.7% white and 9.6% Hispanic or Latino (of any race), with the rest being divided mainly between American Indian (5.8%), Asian (2.3%) and mixed race individuals (4.7%) (census.gov, 2016). The physical environment is fairly warm with little extreme weather, and is well-placed on the coast. Socially, the area is affluent and has all the expected amenities, and has a median per capita income that is typical for the U.S. as a whole, although some areas are far below this (Cunningham et al., 2014).

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For this assessment, the health problem evaluated is that of adult obesity. This has been highlighted as a major issue by the Healthy People 2020 guidelines, particularly as the issue appears to be on the increase nationwide (NiH, 2014). Obesity is a significant problem in the United States, affecting 34.9% of U.S. adults and leading to a large number of obesity-related conditions such as heart disease, cancer, and type 2 diabetes (NiH, 2014). It has an estimated annual medical cost of $147 billion (Ogden et a., 2014).

As a result of its widespread nature, the target population is quite large. Both men and woman are affected by obesity. Despite this, obesity does affect some groups more than others. African Americans are most at risk (47.8% are obese) followed by the Hispanic population (42.5%). Those in middle age, between 40 and 59, are most at risk (Ogden et a., 2014). Additionally, socioeconomic status has a large effect, with those living below the poverty line and having a below average level of education being most affected by obesity (Flegal et a., 2012). California itself has one of the lowest rates of adult obesity in the United States, but it is still an issue that needs to be understood and targeted.

The health concern here is linked to a health disparity because it disproportionately affects minority groups and those in low socioeconomic groups, who are also less likely to have sufficient health insurance and access to care.

Outcomes Identification
The desired outcome for improvement is to target the fact that obesity disproportionately affects minority groups and those in lower socioeconomic groups. This has been chosen as an outcome because it will help to reduce the incidence of obesity-related disease in this population which reduces pressure on healthcare organizations from insurance issues.

Planning
The nursing action plan needs to have two population-focused specific objectives. The first is that nurses should focus on educating the population about healthy eating and exercise programs that can reduce weight and improve health (Flegal et a., 2012). The second is that nurses should engage with the community to create healthy living groups that engage African Americans and the Hispanic population in trying to tackle weight issues, as this has been successful in previous cases (Sturm & Hattori, 2013).

Evaluation
The easiest way of evaluating the effectiveness of the nursing plan is to take weight measurements from those who have been involved in the nursing action plan to assess whether it has led to an overall reduction in weight in this group (Sturm & Hattori, 2013).

Conclusions
Fieldwork has helped to highlight that there are several different factors that can influence a population’s susceptibility to obesity, and this is likely to affect their health in several other areas. Understanding the population of Humboldt County has allowed me to identify specific groups that need to be engaged with population-based health initiatives that lead to fulfillment of the Healthy People 2020 goals. It also highlights that more needs to be done to ensure that everyone has equal access to healthcare to improve the overall health of the population.

    References
  • Bureau, U. C. (n.d.). Census.gov. Retrieved April 30, 2016, from http://www.census.gov/en.html
  • Cunningham, S. A., Kramer, M. R., & Narayan, K. V. (2014). Incidence of childhood obesity in the United States. New England Journal of Medicine, 370(5), 403–411.
  • Flegal, K. M., Carroll, M. D., Kit, B. K., & Ogden, C. L. (2012). Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. Jama, 307(5), 491–497.
  • National Institute of Health. (2014). Health Risk Factors. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK209209/
  • Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2014). Prevalence of childhood and adult obesity in the United States, 2011-2012. Jama, 311(8), 806–814.