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Maintaining the Health of Sarasota County

Kristine Martin
University of South Florida



As the obesity epidemic rises in America, it is important for nurses to rise to their
potential to prevent obesity and the detrimental health effects caused by it. Named the Happiest
city in the U.S. by Pawlowski from NBC Today (2015), Sarasota County Floridas percentage
of the population that is obese is only is 21%, 5.4% less than that of the state of Florida (County
& State, 2015). While the county has one of the states lowest obese populations, it is important
to implement policies to keep this number low. North Port, the southernmost and largest city in
Sarasota County, is rural and offers little opportunity for community members to exercise
affordably. By implementing a policy to provide residents of North Port with accessible and
affordable exercise opportunities, Sarasota County can continue to keep their percentage of the
population with obesity below that of the states.
Created in 1921, the south Florida county of Sarasota borders the Gulf of Mexico and is
home to 390,429 residents as of 2013 (County & State, 2015). This 725 square mile area is a
mix of both urban and rural, with two of its three cities being urban and the third and largest city
being rural. Three of the countys major employers include the School Board of Sarasota County,
Sarasota Memorial Health Care System and PGT industries (Economic Development, 2013).
The major health care facilities include Sarasota Memorial Hospital, Venice Regional Medical
Center, and an emergency center branch of Sarasota Memorial Hospital located in the city of
North Port. In Sarasota County, 9.4% of those over the age of 25 have received their high school
diploma, 5.3% less than the state (County & State, 2015). Sarasota Countys percent of total
population below poverty level is at 10.5%, 3.3% less than the state (County & State,
2015).11.8% of Floridas population over the age of five can speak English well, whereas in
Sarasota County the percentage is only 5% (County & State, 2015).



According to County Health Profiles, Sarasota County demonstrates several strengths

related to the health of the countys population. Sarasota Countys rate of HIV, STDs, and adult
obesity is less than that of the state of Florida. Per 100,000 people, 10.7 people in Sarasota
County are diagnosed with HIV, whereas per 100,000 people across the state, 27.8 people are
diagnosed with HIV (County & State, 2015). The rate of STDs, including Gonorrhea,
Chlamydia and infectious Syphilis, for the county is just 325.2 people per 100,000 whereas the
state of Florida has a rate of 522.3 people per 100,000 (County & State, 2015). Another
strength of Sarasota County, as mentioned above, is the percentage of those who are obese.
Overall, the percent of Sarasota Countys population that is obese is 21% while the percent for
the state of Florida is 26.4% (County & State, 2015). These strengths are of particular
importance because they are all preventable with the right resources and knowledge. Although
the county has great strengths, there are great weaknesses as well. The percentage of adults
making less than $25,000 per year who could not see a doctor at least once over the past year due
to cost in Sarasota county is 43.9%, significantly higher than the states percentage of 35.2%
(County & State, 2015). The inability to see a doctor can make a simple health concern
become detrimental if treatment is not received, thus putting a large percent of the population at
risk of premature death. One objective of Healthy People 2020 is to eliminate premature death.
Another weakness in Sarasota County is the prevalence of adults who smoke. 36.6 percent of the
population are smokers, slightly higher than the percent statewide (36.4%) (County & State,
2015). Smoking contributes to several different forms of cancer and is a major risk factor for
Coronary Artery Disease, thus putting this particular population at risk for premature death as
well. Though the countys percentage of the population that is obese is less than that of the state,
their percent of the population who is overweight is equal to that of the states at 36.4% (County



& State, 2015). Being overweight can lead to obesity which puts this population at a greater risk
for developing chronic health problems such as hypertension and diabetes. This is a priority
health issue for Sarasota County and is important to address because in preventing people from
becoming obese, the health risks that come with it, many of which leading to premature death,
are avoided as well.
The Determinants of Health Model describes how a persons social, economic and
physical environment along with the persons individual characteristics and behaviors influences
their health (The Determinants, 2015). This model assists the community health nurse to
develop interventions that address a population based health issue by allowing the nurse to
distinguish what factors are most greatly affecting the populations health and if these factors are
modifiable. Some factors that contribute to the population in Sarasota County, specifically the
city of North Port, being overweight includes financial status of the population as well as the
physical environment. According to Hill and Melanson (1999), the most likely environmental
factor contributing to the current obesity epidemic is a continued decline in daily energy
expenditure and increasing physical activity may be the strategy of choice for public health
efforts to prevent obesity. For the residents of North Port, the lack of public transportation and
availability of affordable gym memberships prevents them from becoming physically active.
Because North Port is a rural, wooded area, there are few streets with sidewalks or sufficient
lighting which deters residents from exercising in their neighborhood, forcing them to seek a
gym. However, the rural community lacks bus stops and residents must walk long distances to
reach a public bus stop. For those without a car, the lack of public transportation can hinder their
ability to reach a gym and prevent them from being physically active. According to Boehmer,
Brownson, Hoehner, Deshpande, & Ramirez (2007), reduced access to public transit was



reported more often among the obese population. According to Lindsay Mclaren (2007), those
falling below the poverty line were significantly more likely to be obese. For residents of North
Port, with their lack of sidewalks and parks in the heavily wooded residential area, those who fall
below the poverty line are likely not able to afford a gym membership and therefore are unable to
engage in a significant amount of physical activity due to their inability to exercise in their
neighborhood. The residents of North Port are at risk for becoming obese due to their lack of
affordable gym memberships and lack of public transportation as evidenced by the percent of the
population who is overweight.
The primary level of prevention of obesity would take place at the individual level. The
intervention would include health promotion such as informing individuals of the importance of
maintaining a healthy weight by being physically active as well as risk factor modification such
as changing dietary habits. The stakeholders in this intervention include the community members
as well as health care providers, as they would take part in sharing this information with the
community. As shown in the Intervention Wheel Model, the community health nurses role
would be health teaching. The community health nurse would teach clients about ways to
maintain a healthy weight by being mindful of their energy intake versus output. A secondary
intervention would also take place at an individual level, as everyones lifestyle is different
therefore the method in which they lose weight will be different. The community health nurse
would screen for individuals who are overweight by calculating clients body mass index. After
identifying those who are overweight, the nurse would discuss the eating habits of the client and
determine what modifications they could make to reduce their caloric intake and increase their
energy output in an effort to lose weight. This intervention would also be affecting the
community members as well as health care providers. The tertiary level of prevention would be



at the individual level and aimed at preventing further negative impacts on health by reducing the
risks associated with obesity such as diabetes and hypertension. The community health nurse
would act as a case manager and refer their clients to their primary physician to monitor their
blood pressure and glucose levels as well as to community resources such as obesity support
groups and nearby gyms. In order for this intervention to be successful in the City of North Port,
a policy must be implemented to provide community members transportation to gym facilities as
well as ensure the gym membership is affordable. This intervention would affect community
members such as support group member and gym owners as well as health care providers who
are monitoring the clients health risks related to obesity.
In an effort to reduce the percent of the population who is overweight in Sarasota County,
and more specifically North Port, a new health policy must be introduced that best meets the
communities needs. The purpose of the policy will be to first bring public transportation into the
rural and more residential areas of the City of North Port in an effort to provide those who lack
private transportation an opportunity to reach exercise facilities. Due to the fact the City of North
port has few sidewalks and streetlights in its more rural and residential areas, residents are less
likely to feel safe exercising in their neighborhood and will feel deterred from so. Being that they
are unlikely to exercise in their neighborhood, residents would need to find a local gym.
However, if these residents lacked private transportation, they would be forced to walk several
miles to the nearest bus stop to make it into town where the facilities are located. By bringing
public transportation into these areas and making transportation more accessible, these
community members have the ability go to the gym and reduce their risk of being obese. The
policy will also address the fact that for many residents, an affordable gym membership is not
available. By introducing a sliding-scale payment method to the community gym, more



residents will be able to afford to use this facility and avoid becoming obese. By implementing
this policy, residents will have accessible and affordable exercise opportunities. The stakeholders
affected by the implementation of this policy would include community members, health care
providers, public officials and the funders of the community gym. Community members would
be most affected, as they would now have access to public transportation and the opportunity to
become a gym member. Health care providers would be affected in that their patients would
hopefully be using these resources and becoming healthier, therefore needing fewer trips to the
doctor and less medication for their obesity related illnesses. Public officials would be involved
in the implementation of the policy as well as planning the placement of the bus stops. Those
who are funding the community gym would be affected because they would have to agree to the
sliding scale payment model. These funders may either support the policy because it could
potentially bring in more business, or disagree with it because it would mean more people using
the gym for less money. Community members would be in support of this policy because they
are receiving more accessible public transportation and the opportunity to have an affordable
gym. There may be a few outlying members of the community who would be opposed to
bringing public transportation into the community because it would cause more traffic in the area
and more noise along with that. Being that North Port is a rural community; members may want
their town to stay small and secluded. Health care providers should be in support of the policy
because it would be better the lives of their patients, however; health care providers might be
opposed because they would lose money if patients no longer sought treatment from their
provider as often.
The first step toward implementing this policy would be to contact the Sarasota County
Area Transit who provides public transportation to North Port. If they agreed to have more bus



stops placed throughout the community, the next step is to contact the local government officials
to determine the costs associated with bringing more public transportation to the area and if there
is the budget to do so. If the budget was approved, the county officials would decide the best
location for the bus stops in order to reach the most number of people. To get the community
gym involved, the owners would be contacted and presented with the idea of the sliding scale
along with the benefits of doing so. The implementation of this health policy will impact the
county of Sarasota by preventing those who are overweight from become obese and in turn
preventing the health risks associated with obesity. The policy addresses the needs of the
underserved population by providing community members with public transportation and an
affordable gym membership.
Community health nurses have the ability to greatly impact the community they serve.
With the continuous rise of the obese population, community health nurses have the potential to
reduce this population by implementing policies that best meet their communities needs.
Although Sarasota County has a lower percentage of obese population when compared to the
state, the percent of those who are overweight is equal to that of the state. In an effort to keep this
population from becoming obese, the rural City of North Port must address their lack of public
transportation and affordable gyms. Sarasota County can continue to keep their percentage of
obese population below that of the states by implementing a policy to provide residents of North
Port with accessible and affordable exercise opportunities by introducing more public
transportation in residential areas and a sliding scale payment method at the local gym.



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McLaren, L. (2007). Socioeconomic Status and Obesity. Epidemiologic reviews, 29(1), 29-48.
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