Populations in rural areas grapple with poorer health outcomes due to challenges such as greater resource constraints and shortage of health care personnel and facilities, with vulnerable populations being the most affected. This is particularly true for rural populations in North Dakota (ND) (Molmen et al., 2013). Constituting a substantial portion of the overall state population, older adults (aged 65 and above) in rural areas are particularly affected by the worrying health care situation in the state, especially in terms of smoking, alcohol consumption, and obesity. Education provides a valuable tool through which the behavioural health of older adults in rural North Dakota can be addressed. This paper provides an educational plan for reducing the prevalence of smoking, alcohol consumption, and obesity in older adults in rural North Dakota. The plan describes demographic characteristics of the community, the health care needs of older adults in the community, the role of education in addressing the needs, and strategies for implementing the educational intervention.
Target Population, Demographic Characteristics, and Health Care Needs
Older adults in rural North Dakota are the target population for this plan. North Dakota as a whole has a population of approximately 673,000 people (51% males and 49% female; 90% white and 5% Native American) as of 2010 (Molmen et al., 2013). The state is one of the least densely populated states in the U.S. Approximately 52% of the state's population resides in rural areas (areas with less than 50,000 people). More specifically, 29% live in rural areas with less than 10,000 people (Molmen et al., 2013). Rural areas in North Dakota are characterised by a higher incidence of poverty and lower health care coverage compared to urban areas and much of the rest of the country. In 2009, poverty rate in rural areas stood at 14% (compared to 12% in urban areas), while the proportion of the uninsured population was 10.1% (compared to 8.9% in urban areas) (Molmen et al., 2013).
Rural North Dakota has historically experienced an acute shortage of primary health care providers as well as uneven distribution of health care facilities (Molmen et al., 2013). Majority of providers and facilities in the state are located in urban areas.
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This explains the poor health outcomes exhibited by North Dakotans compared to the rest of the country, especially with respect to obesity, smoking, and drinking. The population most affected is the rural population, which is largely characterised by older, poorer people with little or no insurance coverage. North Dakota is home to one of the highest proportions of senior citizens in the U.S. Statistics indicate that 11.8% of adults over 65 years in rural areas in North Dakota smoke (Molmen et al., 2013). Within the same population, prevalence rates of 42.8% and 67.9% are reported for alcohol consumption and obesity, respectively (Molmen et al., 2013).
Indeed, the prevalence of behavioural risk amongst older adults in rural North Dakota is quite disturbing. This is an important concern given the increasingly aging population of the state (Molmen et al., 2013). More fundamentally, smoking, alcohol consumption, and obesity are vital risk factors for chronic conditions such as diabetes, cancer, and heart disease in older adults (Kwon et al., 2016). As the prevalence of smoking, alcohol consumption, and obesity increase, the risk of chronic disease increases as well. Chronic disease can significantly reduce the quality of life and increase the risk of mortality (Kampmeijer et al., 2016). This underscores the significance of improving the behavioural health of older adults in rural North Dakota.
The Role of Education
The role of education in promoting behavioural health is silf-evident, especially in terms of smoking, alcohol consumption, and obesity. Evidence demonstrates that education can lead to the avoidance of tobacco and alcohol intake as well as unhealthy foods, thereby contributing to better quality of life, reduced risk for chronic disease, and increased life expectancy (Lange, 2012; Kampmeijer et al., 2016; Duplaga et al., 2016). Indeed, a considerable number of diseases experienced at old age are partially or totally preventable if individuals lead a healthy lifestyle. For instance, eating healthy and engaging in physical activity can prevent heart disease, hypertension, diabetes, and other common illnesses in old age, thereby reducing premature mortality (Kampmeijer et al., 2016). For these outcomes to be achieved, however, older adults must be equipped with the appropriate knowledge (Lange, 2012). They must be.....
Duplaga, M., Gryszstar, M., Rodzinka, M., & Kopec, A. (2016). Scoping review of health promotion and disease prevention interventions addressed to elderly people. BMC Health Services Research, 16(5), 278.
Kampmeijer, R., Pavlova, M., Tambor, M., Golinowska, S., & Groot, W. (2016). The use of e-health and m-health tools in health promotion and primary prevention among older adults: a systematic literature review. BMC Health Services Research, 16(5), 290.
Kwon, Y., Norby, F., Jensen, P., et al. (2016). Association of smoking, alcohol, and obesity with cardiovascular death and ischemic stroke in atrial fibrillation: The Atherosclerosis Risk in Communities (ARIC) study and Cardiovascular Health Study (CHS). PLoSONE, 11(1), e0147065.
Lange, J. (2012). The nurse's role in promoting optimal health of older adults: thriving in the wisdom years. U.S.: F.A. Davis Company.
Molmen, D., Wynne, J., Arnold, T., et al. (2013). Second Biennial Report: Health Issues for the State of North Dakota. UND School of Medicine and Health Sciences Advisory Council. Retrieved from: http://www.med.und.edu/community/files/docs/second-biennial-report.pdf
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