The first person that would be selected would be Dr. Lawrence Kring from Canton Primary Care from the Canton-Potsdam Hospital. His experience would be necessary in developing healthy weight loss initiatives for our target populations (children, adolescents, and parents) while taking into consideration individualized needs and incorporating those requirements into a successful treatment plan for the coalition. Specifically, Dr. Kring would serve as an expert. For example, Dr. Kring would help create healthy weight loss plans by reducing empty calorie intake and/or increasing the individual’s energy expenditure, or whatever he sees as most fit (combination of both, or one, etc.).
The second person that would be selected would be Dee Burlingame, a board member of the Canton Day Care Center, and the current president of Early Childhood Specialist with St. Lawrence Child Care Council. Ms. Burlingame would be a valuable member of our coalition as she would serve as a family and child advocate while also providing parents, families, schools, and daycare center staff with the necessary training and knowledge regarding nutrition and physical education. For example, by promoting mandatory active recess in schools, Dee would be encouraging increased physical activity amongst children in efforts to combat obesity. Dee also has familiarity working with the early childhood programs at SUNY Canton and BOCES and is a board member of the St. Lawrence County Community Development Program. Dee’s superior knowledge from working with children, poverty issues, and the community would prove her to be a treasured member as she would be able to be an expert on child care while offering counseling for select populations (such as those children who come from low-income families). She would also be a representative of the communities she is and has been a part of, where she can ensure diversity and varying perspectives/attitudes about childhood obesity prevention.
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The third person who would be selected to be a part of the Childhood Obesity Prevention coalition would be Marie E. Loson. As a board member of the Canton Day Care Center, she has helped to prepare the Center for its new capital growth campaign. Additionally, she worked at St. Lawrence University in fundraising for over 10 years, and her experience would be very helpful in acquiring funds to carry out the coalition. Considering her extensive fundraising background, Marie may be responsible for promoting physical activities in the community avenues through signage, worksite policies, social support, and joint-use agreements. Additionally, Marie is also responsible for being an expert in the field of fundraising to have sufficient materials and resources for our coalition.
The fourth person who would be selected to be a part of the coalition would be Kathryn L. Mullaney. Kathryn retired from St. Lawrence University as their Vice President for Finance and Treasurer, and she has been the Director and Treasurer of the Canton Day Care Center. Explicitly, Kathryn would be an expert and she would be responsible for managing finances as well as be responsible for funds available for investment and risk management related to the health improvement activities of the coalition. She could also be able to help increase the number of institutions with nutrition standards for healthy food and beverage purchases.
The fifth person who would be selected to be a part of the coalition would be Barbara Adams. Barbara is the director of Head Start while also a Board Director of the St. Lawrence Child Care Council, Inc. With Barbara’s expertise in providing wide-ranging preschool programs for children of low socioeconomic status, or children with disabilities, her services to the coalition would predominately focus on parental involvement. For example, Barbara may encourage early childcare programs to enroll in programs like the Child and Adult Care Food Program (CACFP) and the Eat Well Play Hard program (EWPH). Barbara would be a valuable member because she would be able to be both an expert and representative of child care, where she would have the opportunity to continue to advocate for a diverse population of children via education and resources to families. Additionally, Barbara would be useful in recruiting other organizations and businesses that would be of great assistance to our coalition considering her experience working for the SLCCC.
The sixth person who would be selected to be a part of the coalition would be Karen Durham, the head Social Welfare Examiner of SNAP (Supplemental Nutrition Assistance Program). Karen’s involvement with goals in reducing hunger and malnutrition of low socioeconomic status families would prove her to be a valuable member regarding business as she would be skilled in assessing and prioritizing individuals that require more urgent attention. Also, her experience with the Temporary Assistance Unit, at St. Lawrence County Department of Social Services, shows Karen to be effective at assisting families to meet basic needs. Also, Karen could help encourage districts to prohibit advertising and promotion of less nutritious foods and beverages. By being an expert and representative of her department, Karen’s responsibilities of identifying and evaluating the fundamental problems within a household would be valued because she would help the intervention effectively identify the social determinants of health within the family setting.
In New York State, St. Lawrence County is a relatively large and mostly rural region that is situated between the Adirondack Mountains and the St. Lawrence River. With a population of 110,007 in 2015, the median age in St. Lawrence County is 37.8 with 15% of residents being over 65. In 2014, the poverty rate was 19%, while the poverty rate for children was 26% which, in comparison to statewide and national rates, are high. Specifically, the estimate for the county’s poverty rate was 19.7% compared to 15.6% for New York State. St. Lawrence Country has a median household income of $43.5k, where it remains lower than the statewide median of $58.7k. Additionally, there is an association between educational level and poverty within the county where 33% of individuals without a high school diploma live in poverty compared to the 7% of those who have a four-year degree.
With elevated poverty rates and its correlation to education attainment, adult and childhood obesity is of high priority. Specifically, 33% of St. Lawrence County adults are obese, which exceeds most other counties in Upstate New York, and above the statewide rate of 25%. Compared to a previous survey (2008-2009) the incidence of adult obesity had increased. Shockingly, when overweight adults were incorporated, the rate rose to 71% (notably higher than the statewide rate of obese or overweight adults of 61%). Particularly, the rate of obesity among children and adolescents is 20%, which also exceeds the statewide (not including NYC) average of 17%. All in all, the county is classified within the top quartile of the state counties for childhood obesity. This suggests that childhood obesity is of significant concern especially considering how obesity is a risk factor for heart disease, stroke, many forms of cancer, kidney disease, and diabetes. If there are no public health measures taken to address this issue within the next 10 years, then the obesity epidemic could surpass smoking as the leading cause of preventable deaths and would have serious personal and economic repercussions. As for the economic repercussions, more money would be put into treatment and care for the chronic diseases associated with obesity. Over time, with a younger population of obese people on the rise, the money that will go into health care treatment may increase substantially. The percentage of obese adults in the county is increasing, which is important because cardiovascular disease is responsible for a near-majority of deaths (46%) of people age 80 or older. Furthermore, 29% of St. Lawrence County residents have been diagnosed with high blood pressure, which implies a heightened urgency to address this issue.
Some current interventions taking place focus on increased physical activities and improved awareness of nutritional requirements. Considering elevated poverty rates and the rural geographic isolation of the county, having access to physical activity is inconvenient or nearly impossible for many St. Lawrence County residents. Specifically, the Bridge to Wellness Coalition is currently working to create a community setting that promotes and supports healthy food and beverage choices as well as physical activity. Furthermore, they have created the objective to increase the number of adults with access to schools for physical activity with shared agreements that are advertised throughout the community. Therefore, providing increased access to, or awareness of, facilities offered within the community would be more cost-effective and feasible than constructing new resources/facilities. Furthermore, by increasing access to and awareness of physical health services and creating more spaces for physical exertion, community ties may become stronger and result in reduced health disparities. Also, promoting mandatory recess in schools and increasing the number of institutions with nutrition standards for healthy food and beverages, would help address the issue of childhood and adult obesity within St. Lawrence County.
According to the “Assess- Brainstorm Community Assets” document, one asset from the category of “Organizations” that would help facilitate my Childhood Obesity Prevention intervention would be the associations of businesses. Specifically, associations of businesses may be able to present recommendations to advise industries to support childhood obesity prevention and may be able to assist by developing and endorsing/sponsoring food products and opportunities that will inspire healthy eating choices and routine physical activity. Additionally, associations of businesses may also be helpful by regulating marketing and advertising strategies that would reduce the possibility of obesity in children and adolescents.
The second asset from the category “Private and Nonprofit Organizations” that would help facilitate my Childhood Obesity Prevention intervention would be hospitals (including doctors, health care facilities, and health insurance plans). The influence doctors and health plans can have on an individual’s health choices is very significant. Typically, doctors see their patients for a good portion of their lifespan, and they offer opportunities to advise their patients on healthy eating habits and activities tailored to their specific needs. They prove helpful in facilitating childhood obesity prevention by being role models for healthy lifestyles, and as members of the community, doctors can use their knowledge and position to advocate for beneficial changes that reach individuals outside the hospital. Additionally, healthcare facilities could be helpful in this intervention by making sure that there are not only healthy choices in cafeterias but also bans on fast food, sugary drinks, and similar unhealthy choices. Lastly, health insurance plans can be the most essential influence on the weight control practices of patients because they can cover the cost of obesity prevention and treatment, and they can use their position in the community to encourage and sponsor childhood obesity prevention efforts (like healthy meals in schools, physical exertion events, and the education of policymakers).
The third asset from the category “Public Institutions and Services” that would help facilitate my Childhood Obesity Prevention intervention would be public schools. Considering the area of St. Lawrence County, the majority of the education systems are public; therefore, public schools would prove valuable in this intervention because children spend a great deal of time at school and learn valuable lessons that carry with them later in life. Therefore, schools can incorporate nutrition and physical activity lessons into the curriculum. Specifically, physical education should prioritize getting students to engage in high-quality and routine activities. To improve nutrition, schools can incorporate healthier food options in the lunchroom and remove the promotion of unhealthy foods (like chips and candy in vending machines). To improve physical activity, schools can make safe walking and/or biking paths to school and should encourage active recess time. Lastly, most schools are central data sources on student health where information regarding students’ BMI can help educators and policy-makers decide if the current programs are effective or not and make decisions regarding changes to upcoming initiatives.
The fourth asset from the category “Physical Resources” that would help facilitate my Childhood Obesity Prevention intervention would be vacant lands. By renovating vacant lands within the community and turning them into an area of physical exertion, children within the community will have more opportunities to get active and be outside. For example, transforming a vacant lot into a basketball court would create access and stimulate kids to go and play, and as a result, would increase their physical activity and may strengthen community ties.
The fifth asset from the category “Informal Organizations and ‘Intangibles’” that would help facilitate my Childhood Obesity Prevention intervention would be community reputation. By improving the community's reputation, more people would be willing to relocate or move to St. Lawrence County. With the influx of more people and subsequent capital, the chances of new businesses starting up would increase, allowing residents more opportunities to get involved in their community. Furthermore, by improving the community's reputation the ability to attract qualified care providers and potential healthcare partners would increase, which would be beneficial in regards to ensuring adequate care provided at the hospital. Also, enabling reputation in your community allows members to be recognized and rewarded for participating, which may lead to more active community members. For example, considering the poverty levels in St. Lawrence County, providing members with financial incentives to improve their physical health and eating behaviors would prove to be multi-beneficial for the individual and the community.
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