Hospitals And Global Health Perspectives

Introduction

A critical issue facing nursing practice in contemporary health care is the increased prevalence of obesity and the development of ischemic heart disease in paediatric and adult populations. Focusing on Queensland hospitals, this paper provides a description and analysis of obesity and its impact on population health and local nursing practices. However, the challenges associated with unhealthy weight gain has not been confined to Australia and is considered a global health problem. Therefore, to further assess the issue, the effects of obesity will also be examined on a national and global level. Moreover, to provide possible solutions that could aid in shaping health services, the consequences of obesity and provisions and the field of nursing in health services will also be discussed.

A contemporary issue

Obesity is a significant global, national, and local public health issue. Reports indicate that 1.2 million Australian’s are considered to be obese, whereas 1.3 million are deemed overweight [ref]. In Queensland, the obesity rate has been high for several years but has not risen since 2011 (Queensland Health, 2016[a or b?]). On the international stage, Australia ranks third amongst the 34 Organisation for Economic Co-operation and Development (OECD) countries, for obese male and female adults (Croyden et al., 2018). Furthermore, obesity prevalence in Australia is approximately 24% higher when compared to the OECD average for male and female adults (Hayes, Lung, Bauman, & Howard, 2017).

To determine these numbers and trends experts use the body mass index (BMI), a globally accepted tool that categorises individuals into underweight, obese, overweight, or a healthy weight [ref?]. BMI reports indicate that the prevalence of obesity in adults in Australia aged 45 to 54 is double that of individuals between the ages of 18 to 24, while the occurrence decreases amongst adults aged 75 and above (Vidgen et al., 2018). Additionally, females between 18 and 34 are closest to a healthy weight range, while male adults aged 45 to 74 are closer to the obese range (Vidgen et al., 2018). Moreover, adult males are 30% less likely to have a healthy weight, compared to adult females (Queensland Health, 2016[a or b?]).

Various factors can contribute to obesity prevalence and increase the risk associated with ischemic heart disease (Avsar, Ham, & Tannous, 2017). These factors include inactivity, unhealthy eating habits, medical problems, family lifestyle, and age [ref]. Furthermore, those who are obese have an 11% risk of developing an ischemic disease as compared to 2.6% in non-obese adults, which means that obese adults are four times more likely to have an ischemic disease (Queensland Health, 2016[a or b?]).

The impact on population health

The high prevalence of obesity has steadily increased in Australia over the past 30 years [ref]. In Queensland, 60% of adult patients are classified as obese, while 25% of children between the ages of 3-6 are also classified as obese (Queensland Health, 2016[a or b?]). Interestingly, obesity is also noted to be more prevalent amongst individuals living in rural areas (Baker, Gill, Friel, Carey, & Kay, 2017) - [why is this noteworthy? Why would this be the case? Are there any other interesting facts like this that could be added to increase your word count and make this paragraph more well-rounded?]. The continued increase in the prevalence of obesity over the next decade in Australia will affect approximately 70% of the entire population [ref].

Health expenditure on adult obesity in Australia between 2011 and 2012, and the forecast for 2031 to 2032, at constant prices.

The problems associated with obesity impose an economic and social burden on individuals, families, and communities – [expand on this statement further in this paragraph]. According to the AIHW (2016a), obesity and ischemic heart disease can reduce the life expectancy of men by approximately seven years and eight years for women. This reduction in life-expectancy may have long-term ramifications, especially for young adults and children (AIHW, 2016a) – [expand on this further – what are the ramifications? Apart from a shorter life span?]. Furthermore, health care costs may increase in the future – [expand on this further], and the rate of the conditions influencing obesity may also increase, driving life expectancy downward further (Mannan, Luz, Sainsbury, Touyz, & Hay, 2017).

Health expenditure attributable to elevated BMI in Australia

The main impact on the population is that obesity leads to a reduced quality of life for those affected. Evidence suggests that obesity contributes to shortness of breath, back pain, and a reduction in mobility [ref]. Furthermore, obesity can lead to an increase in risks associated with physical and cognitive disability, significant costs of health care, dependency, poor health outcomes, and mortality (AIHW, 2016b). Moreover, obesity accounts for about 8% of all deaths in Australia [ref]. An international study in 2016 indicated that 1 in 7 of these premature deaths could have been avoided if those affected had been within the range of healthy weight [ref].

Impact on health service provision

Since obesity poses a significant health issue in Australia, health services have attempted to ensure that there is sufficient health care provided to patients. The current estimation of the total cost incurred due to obesity in Australia is approximately $8.6BN (Kim, Lewis, Baur, Macaskill, & Craig, 2017). Almost half of this cost is imposed directly on the health care system for professional service provision, hospital care, interventions, and pharmaceuticals (Kim et al., 2017). According to Buchmueller and Johar (2015), a significant impact is in the provision of equipment used in the movement and management of these patients at every stage of their health care progress. Costs include the purchase and kitting out of ambulances, provision of stronger trolleys and beds, as well as the modification of buildings for patients to be accommodated safely. Additionally, these costs include the provision of specialist surgical equipment in operating theatres, so that patients can be safely operated on. Research indicates that if the growth rate of obesity is left unchecked, then there will be a total cost of $88.7BN in direct and indirect costs across Australia over the next ten years. However, these costs are considered to be an investment in health services (Buchmueller & Johar, 2015).

Queensland hospitals have three times more hospitalisation rates of obese Australians than average weight individuals [ref]. While health services have managed to identify potential strategic responses towards the rising prevalence of obesity, there has been a significant lack of action to aid in reversing this trend [ref]. It is evident that while there will be an increase in the rate of hospitalisations, there is also the need for sufficient interventions (Bolton et al., 2017). Nevertheless, health services have been working on changing their approach to the development of relevant products to tackle obesity (Hayes et al., 2016). Furthermore, health services are educating the community about the health consequences of obesity, to promote healthy eating habits and lifestyle changes (Adams et al., 2017).

Impact on nursing practice

Nurses in Queensland hospitals know that obesity is a significant health issue, and as such, its management makes up a substantial part of their role (Adams et al., 2017). Wherever they can, nurses in Queensland hospitals provide health information to patients regarding their weight by using comprehensive tools such as a national growth chart, the BMI calculator, and gender percentiles to improve nutrition and weight assessment for early detection and prevention of obesity (Australian Medical Association, 2016). Additionally, nurses play a significant role in practical matters, for example, providing counselling services on proper eating habits and consumption of healthy food [ref]. Furthermore, nurses in Australia lead an obesity education programme in schools to teach children about the health impacts of obesity (Laws et al., 2015). All nurses are in a prime position to promote healthy lifestyle practices, which can reduce the risks associated with obesity.

According to Queensland Health (2014), irrespective of a patient’s obesity aetiology, nurses in Queensland understand the needs of patients. In response to this need, they have formed a multi-disciplinary team to discuss various personalised issues related to holistic care. The team acts as a reliable resource when there is a need to consider the best nursing practices to suit patient needs. Furthermore, nurses provide family-based interventions, including behavioural modification as a strategic intervention that targets children and parents, to promote changes in family eating habits and improve weight-loss outcomes (Queensland Health, 2016[a or b?]). Additionally, nurses across Australia are involved in various innovative projects, designed to aid in assisting people to lose weight (Laws et al., 2015). Moreover, a recent study by Mannan et al. (2017) reported substantial and positive clinical activities related to clinical practice, attitude, and primary care beliefs regarding obesity management.

As demonstrated, there are multiple recommendations for nurses concerning the management of obesity in Australia. To begin with, they need to promote an increase in physical activity in adults. Likewise, they need to engage with families to encourage parenting styles that support an increase in physical activity and reduction of sedentary behaviour, in conjunction with adopting healthy dietary choices (Queensland Health, 2014). Prevention, appropriate treatment, as well as early detection of obesity are hugely significant in Queensland hospitals, and nurses should not undervalue them (Da Luz et al., 2017). And finally, nurses should also be obligated to participate in education and health promotion to prevent obesity.

Conclusion

This essay has provided an examination of the increased prevalence of obesity and ischemic heart disease in paediatric and adult populations in Queensland hospitals. Moreover, it has shown that the increased obesity rates are not confined to Queensland or even Australia, but are a global concern and regarded as a significant health issue for the contemporary public. The problems associated with obesity impose an economic burden on individuals, families, and communities. Additionally, there is a critical need for monetary investment in health services to provide for general health care and equipment. However, there is also evidence that Queensland hospitals have adopted effective nursing strategies in the management of health care to patients suffering from obesity, to aid in managing the obesity prevalence.

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