Physical Activity and Nutrition
The Physical Activity and Nutrition issue area focuses on building the community's capacity to deliver affordable, effective and culturally appropriate health and wellness programs for older adults, whether they are strong and healthy or frail and/or disabled. It addresses the need for a continuum of services, as well as the need to create a culture that supports healthy choices.
Desired Outcome
Older adults enjoy a range of support, choices and activities that ensure they remain healthy and active as long as possible.
Background
A vast majority of older Kent County residents (77%) describe their health as good, very good, or excellent, slightly better than the national average. This may be partially attributable to the level of physical activity among local elders - 71% engage in some leisure time physical activities. More moderate to high income elders in Kent County (78%) exercise than low income elders (61%). Nationally, only two-thirds of older adults take part in some leisure-time physical activities.
According to the National Centers for Disease Control and Prevention (CDC), physical activity is one of the most important steps older adults can take to maintain physical and mental health, quality of life, and the ability to live independently. Another important factor contributing to health is good nutrition. For almost all Kent County elders, a lack of money is not a barrier to getting enough food, but it is unclear how many are eating nutritious meals. According to the CDC, only one-third of older adults in America are eating the recommended five servings of fruits and vegetables a day and nearly one-third of older adults are obese, defined as at least 30 pounds above the recommended weight.
Most Kent County Elders Get Regular Exercise
The vast majority (71%) of Kent County elders engage in some form of regular physical exercise. That means, locally more than 18,000 older adults seldom or never exercise - about the same proportion (29%) found in national surveys of older Americans.
Exercise Levels Vary by Age, Gender, Health Status and Income
Although physical exercise generally decreased with age in Kent County, a majority of those 85+ (62%) engage in some form of exercise. More men (76%) tend to engage in regular exercise than women (68%), but an even larger disparity appears when we compare health status (Excellent/Good Health: 78% and Fair/Poor Health: 48%) and income levels (moderate/high income: 78%; low income: 61%).
Financial Limitations Not a Barrier to Having Enough to Eat
Two percent of Kent County elders - about 1,135 people - have had to reduce portions or skipped meals in the past year due to lack of money. In addition to financial limitations, elders face many barriers to maintaining a nutritious diet: life changes such as the loss of a spouse or a diminished sense of taste and smell can reduce appetite; and increased frailty and medical conditions may make it difficult for older adults to prepare meals, especially if they have dietary restrictions.
Recommendations
Capacity-Building and Accountability
Goal 1
Increase the community capacity to deliver affordable, effective, culturally appropriate health and wellness programs for older adults.
Objectives
- Provide oversight, coordination and planning through a Steering Committee that:
- Identifies existing health programs to determine service gaps across the age and health continuum and set priorities. Explores new opportunities - including funding.
- Supports or coordinates training opportunities such as "Stages of Change" and "Motivational Interviewing" to improve the skill and practices of care managers, case workers, and other professionals who interact with older adults.
- Develops and promotes community standards for health and wellness.
- Develops and implements state-of-the-art approaches to evaluation for individual programs and initiative effectiveness that includes a system for collecting standardized data across the community.
- Develop a structure to include programming, funding, outreach and evaluation subcommittees which report to the steering committee on their progress in implementing goals #2 - 5.
Goal 2
Increase funding for planning and effective prevention programs.
Objectives
- Increase the capacity of community and aging service providers to identify and solicit funds related to health and wellness from various funders including foundations, insurance companies, and private pay.
- Explore the development of one funding committee through Creating Community for a Lifetime to act as a resource and clearinghouse for funding support and information.
- Advocate for changes in Medicare and Medicaid that allow reimbursement for proven prevention activities.
- Educate funders and the community about the cost effectiveness of prevention activities.
Goal 3
Improve program effectiveness through appropriate evaluation, utilizing professionals with expertise in prevention, community intervention and evaluation.
Objectives
- Encourage the development of outcome measures and evaluation tools to assess effectiveness of health education, health activity, and health promotion interventions.
- Develop standardized data collection, outcome measures and evaluation tools for use among identified community programs to facilitate increased community data collection and analysis.
- Develop an evaluation plan for the health and wellness structure/initiative to assess function, effectiveness and efficiency.
- Identify opportunities to use outcome and demographic data for planning and targeting of resources.
Access
Goal 4
Preserve independence through increased access to effective, evidence-based health and wellness programs targeted to meet the needs of people across the continuum of strength and frailty.
Objective
- Initiate and support evidence-based health programs - using "peer" health coach models where appropriate - for maximum community impact on targeted populations and health issues by ensuring access to:
- A full continuum of programs such as PATH, Enhanced Fitness, Matter of Balance and nutrition education.
- Healthy foods and programs that encourage healthy selection, storage and preparation of food.
- Home-based programs, such as care management and home health care that incorporate evidence-based health prevention and promotion practices into their services.
Outreach
Goal 5
Create a culture and environment that supports healthy choices.
Objectives
- Plan and provide opportunities for:
- Persons impacted by disparities in health outcomes to learn about and make healthy lifestyle choices.
- Health professionals and service providers to support healthy lifestyle choices by older adults.
- Involve older adults in planning at every level.
- Mount effective campaigns to promote healthy practices and choices and establish a culture of wellness.
- Solicit a health champion(s) to increase community awareness - this could include public figures and/or health care professionals with a passion for prevention.
- Utilize tested materials developed nationally to reach targeted groups including those who have less income, persons who are frail, and persons of color.
- Increase community awareness of the negative impact of chronic disease and depression on quality of life and of the proven positive impact of current treatment options.
- Increase the number of physicians and health care providers who counsel, refer and recommend healthy aging practices to their patients.
- Increase health provider understanding of benefits of prevention for the frail elderly.
- Increase health provider awareness of the negative impact of chronic disease and depression on quality of life of older adults and of the proven positive impact of current treatment options.
Work Group
Co-Chairs
- Margaret Biersack - Spectrum Health Healthier Communities
- Tom Oosterbaan - Senior Neighbors
Members
- Eric Boss - Spectrum Health Rehabilitation & Sports Medicine
- Joe Chiaramonte - Spectrum Health Rehabilitation & Sports Medicine
- Beth Cieminis - YMCA
- Suzan Couzens - Grand Rapids Area Health Ministry Consortium
- Mike Faber - Older Learner Center at GRCC
- Shawn Fleet - Spectrum Health Nutrition Options & Wellness
- Nicole Hansen - YMCA
- Patricia Joyce - MSU Extension
- John Judich - Grand Rapids Parks and Recreation
- Ann Kikstra - Kent County Health Department
- Brenda Long - MSU Extension
- Syl Mosier - Gerontology Network
- Barb Hawkins Palmer - Kent County Health Department
- Jackie O'Connor - Area Agency on Aging of Western Michigan
- Kevin O'Hara - Gerontology Network
- Barb Nelson- Area Agency on Aging of Western Michigan
- Linda Quest - Senior Meals on Wheels
- Dimita Zweiback - Healthy Aging Initiative Michigan Dept. of Community Health