Running head: REDUCING CHILDHOOD OBESITY Obesity in School Age Children Residing in West Jordan, Utah Jamie Taylor Dixie State College 1 REDUCING CHILDHOOD OBESITY 2 Obesity in School Age Children Residing in West Jordan, UT Introduction Childhood obesity has more than tripled in the past thirty years, increasing from seven percent in 1980 to 20 percent in 2008 for children ages 6 through 11 (CDC, 2012). Experts argue that obesity will soon rival tobacco as one of the leading causes of preventable premature death (World Health Organization, 2005). There is an extensive list of physical and health consequences related to childhood obesity. Children with obesity are at a greater risk of developing serious, life threatening disease processes and disorders including: cardiovascular disease; metabolic syndrome; hyperlipidemia; insulin resistance; diabetes; asthma; sleep apnea; musculoskeletal disorders; fatty liver disease; and early sexual maturation. Psychosocial issues such as: discrimination; low self-esteem; depression; and poor body image can have a lasting impact that can continue into adulthood. Unfortunately, obese children have a greater likelihood of becoming obese adults and without intervention; these conditions will go on to become chronic health conditions. There have been several factors that have been identified as causes that can increase a child’s risk for becoming obese. These risk factors include: genetics; physiological influences; cultural influences; lack of physical activity; and nutritional intake. This paper will include an assessment of school-aged children between the ages of 6 and 11 who reside in the community of West Jordan, Utah. The focus will be on the lack of physical activity and the nutritional intake and how these two issues are contributing to the rising rate of obesity. REDUCING CHILDHOOD OBESITY 3 Community Assessment In 2010 the population for the community of West Jordan, Utah was 103,712, which is an increase of 51.8% in just a ten year time period. The percentage of children accounts for 45.4% of the total community (U.S. Census Bureau, 2010). In 2010 Vital Statistic Records indicated that 20.4% of Utah elementary school students were either overweight or obese. The obesity rate for West Jordan is 26.1%. Being overweight or obese as a child increases the risk of growing up to be obese as an adult. The Utah Department of Health indicates that over 60% of adults are overweight or obese. These statistics can be attributed to the fact that 47.8% of adults do not get enough physical activity. 67.9% do not get adequate fruit intake in their diet, and 76.5% do not get adequate intake of vegetables (health.utah.gov., 2009). Children are learning from young ages that a balanced diet, including fruits and vegetables, are not important to one’s health. Nutritional imbalances can be attributed to the families living below poverty level. In West Jordan the percentage of those living below the poverty level is 6.7% although lower than the state of Utah which is 10.8% (U.S. Census Bureau, 2010); it does contribute to families not having the money or resources to provide healthy, balanced diets to their children. Another way to interpret the lower poverty level would be that it allows families to spend money on junk food and eating out more frequently. The average family size in West Jordan is 3.87 compared to the state of Utah which is 3.04 (U.S. Census Bureau, 2010). Larger families require increased income to provide for all family members. Unhealthy food choices, and larger portion sizes all contribute to obesity. Eating meals away from home has become the habit of many in the community, with West Jordan offering over 107 restaurants and fast food establishments. REDUCING CHILDHOOD OBESITY 4 Cultural influences also attribute to the etiology of obesity. West Jordan’s racial makeup is comprised of 74.6% white, non Hispanic, Hispanic 17.7% African American 1.0% Asian 2.7%, and native Hawaiian and other Pacific Islanders 1.6% (U.S. Census Bureau, 2010). In 2008, obesity prevalence was highest among American Indian or Alaska Native (21.2 percent) and Hispanic (18.5 percent) children, and lowest among white (12.6 percent) (CDC, 2012). Cultural influences are a contributing factor to obesity, but I don’t think they are playing as big of an influence in the childhood obesity for West Jordan since the population predominantly white. According to the CDC, children should do 60 minutes or more of physical activity each day. Aerobic activity should make up the majority of the 60 minutes of activity. It is recommended that at least three days a week include vigorous intensity aerobic activity. Muscle strengthening should be done at least three days a week as well as bone strengthening activities (2012). Lack of physical activity is a major contributing factor to the increased rate of childhood obesity. 56% of children 8 to 16 years old have a television in their bedroom, and 36% of children six years old and younger have a television in their bedroom. (health.utah.gov, 2012). More shocking is the fact that children aged 8 to18 spend over 7.5 hours using entertainment media (CDC, 2012). The most current information on physical education showed that among adolescents, that the time spent on physical education had dropped 14 percentage points over 13 years; from 42% in 1991 to 28% in 2003 (CDC, 2008). The increase in social media and decreasing time spent on physical education is leaving physical activities to parental influences. Target Population There are approximately 13,763 students enrolled in the 16 elementary schools in the Jordan School district. An interview of random students in Ms. Stuart’s second grade class was REDUCING CHILDHOOD OBESITY 5 completed with a goal of establishing what factors determine their food choices, and what influences their participation in physical activities. All of the students interviewed participate in the school lunch program. They stated they liked the fruits, vegetables, and milk, but thought that the food tastes weird. One student even commented that he was not sure what they were feeding him, since he didn’t know what a pig in the blanket was. Navajo tacos were the least favorite food. At home they felt that they didn’t have an influence in what was prepared for dinner and the only time they got a choice was when they went out to eat. Seventy percent preferred hamburgers and french fries, pizza was the preference for 20%, and the last 10% preferred other foods. They all admitted to eating sugary snacks and drinking soda pop outside of school. Community Analysis For the first time in 15 years, the USDA issued new guidelines for all school lunch programs in an effort to fight childhood obesity. The Jordan School District has introduced a new program which allows students to make healthier choices; the hope is that these healthy habits will continue outside of school as well (2012b). Schools provide a great opportunity to teach children about nutrition and one program that is unique to the Jordan School District is the Farm to School Program. For eight weeks Jordan School District’s Nutrition Services Department arranges for a different produce item, all from local farms, to be included in the school lunch in the elementary schools. In addition to being able to try fresh, local products, children also receive a postcard that includes nutritional information and fun facts about the produce. Teachers are incorporating the information about the items into class curriculum so students learn about nutrition, the benefits of buying local and how farms help to supply food to the family dinner table. Introducing this curriculum into the schools teaches children healthy REDUCING CHILDHOOD OBESITY 6 habits that they need to learn since the information is not being taught at home as evidenced by the high obesity rate. Parents have the greatest influence on the decision to participate in physical activities or not. Children whose parents exercise also exercise, whereas children whose parents lifestyle is sedentary, so is their child’s. Watching television was the favorite activity when they got home from school, with the average of the students being 2 hours a day. There is a positive association between time spent using entertainment media and increased prevalence of childhood obesity. According the Jordan School District’s website, “elementary level is where kids get the love of physical activity. If you don’t’ start to implement it at the elementary level, it just doesn’t happen” (2012a). Like many school districts, Jordan's elementary schools don't have a physical education teacher for each school which again leaves it up to the parents to teach their children to love and participate in physical activities. Community Nursing Diagnoses The two community health nursing diagnoses that have been identified by analyzing the above data address the problems of childhood obesity in school-aged children age 6 to 11 who reside in the Jordan School District. Nursing Diagnosis 1 Increased risk of obesity among school-aged children related to unbalanced diet as demonstrated by the increase of obesity as evidenced by the obesity rate of 26.1%. Nursing Diagnosis 2 Increased risk of obesity among school-aged children related to inactivity as evidenced by the children spending an average of 7.5 hours per day using entertainment media. REDUCING CHILDHOOD OBESITY 7 Project Plan Goal The goal of the proposed community intervention plan is to reduce the percentage of childhood obesity in school-aged children age 6 to 11 who reside the Jordan School District. The results of a research article by Wang, Denniston, Lee, Gulaska, & Lowry (2010), noted that for a 1% point reduction in both overweight and obese child could reduce the number of obese adults by 52,821 in the future. As a result, lifetime medical care costs after age 40 years would decrease by $586 million. Healthy People 2020 states that diet and body weight are related to health status and good nutrition is important to the growth and development of children. A healthful diet also helps Americans reduce their risks for many health conditions. Healthy People 2020 list two objectives for decreasing obesity in school-aged children: NWS-2.2 Increase the proportion of school districts that require schools to make fruit or vegetables available whenever other food is offered or sold. And objective NWS-3.3 Increase the number of States that have State-level policies that incentivize food retail outlets to provide foods that are encouraged by the Dietary Guidelines. Obesity prevention in children goes beyond its immediate benefits; it can also reduce medical costs and increase quality of life substantially in later years. Offering nutritious foods through the school lunch program is one way of ensuring that children are receiving a balanced diet. Getting fruits and vegetables into the elementary schools in West Jordan year round is the focus of the nursing interventions which can achieve the goals of reducing childhood obesity. REDUCING CHILDHOOD OBESITY 8 Objectives Outcome Objective By November 3rd , 2013, as a result of petitioning local government and the Jordan School district to apply for federal funding grants to implement the Farm to School program year round, the percentage of obese children in the Jordan School district will decrease by 20% as measured by comparison of obese children currently enrolled in the Jordan School district. Impact Objective By November 3rd, 2013, 50% of school-aged children in the Jordan School district who participate in the Farm to School Program will report an increase in eating healthy foods. Resources The City of West Jordan is unique community in that it is a combination of both urban and rural areas. There are 6,500 acres of land in West Jordan that is zoned for agricultural usage. The agricultural land accounts for the 29.97% of land in the city (West Jordan City, 2012). Much of the farm land is not currently being used for agricultural; utilizing this land to grow fruits and vegetables for the Farm to School Program would supply the local schools with enough produce to implement the Farm to School Program year round. The USDA has funds available for Planning Grants which range from $20,00 - $45,000, and Implementation Grants that range from $65,000 - $100,000 (USDA, 2012). These funds could be instrumental in developing a long lasting partnership with the local farmers to supply nutritious foods year round to the local schools. With 13,763 school-aged children enrolled in the 16 elementary schools in West Jordan the student’s parents could be invaluable resource in petitioning the Jordan District School Board REDUCING CHILDHOOD OBESITY 9 and local politicians. Once involved these parents could attend city council meetings and get other parents involved. Involving parents in a nutrition education curriculum can enhance the eating behaviors of both the students and their parents. Constraints Maryland and Gonzales (2012) identified several areas that could affect the success of advocating the legislative arena. Although nurses understand healthcare issues and are trusted by patients and the public, nurses may not have the skills that enable them to participate in the public policy process. Nurses need to find a legislator or staff member who believes the idea or issue is worth addressing through the legislative process and who will work with legal counsel to develop a bill. The legislative process is a difficult, tortuous, and time-consuming process that can be influenced by a number of external forces. The process alone could make it difficult to succeed. The USDA offers federal grants for the Farm to School Program, however, Gerding (2008) reports that there are more than 1,000 federal grant programs totaling $400 billion annually. Federal grants often involve a very complicated application process and are very competitive. Developing a committee of individuals who are familiar with this process could prove to be a difficult task. West Jordan City is the third fastest growing city in Salt Lake County which could put the land that is currently used for agricultural at an increased risk for being rezoned for residential and commercial use. Plan of Action Improving the diets of school-aged children can only be accomplished by creating a partnership that promotes healthy food choices through the schools, media, families, and the REDUCING CHILDHOOD OBESITY 10 community. The CDC (1996) states that, “students are more likely to adopt healthy eating behaviors if they receive consistent messages through multiple channels (e.g., school, home, community and the media) and from multiple sources (e.g. parents, peers, teachers, health professionals, and the media)” (Guidelines for School Health Programs to Promote Lifelong Healthy Eating p. 225). Health promotion is one of the top goals of Healthy People 2020 and schools offer an ideal setting for delivering health promotion strategies (Wang, et al, 2010). “As of 2009, greater than 95% of children were enrolled in schools…schools have direct contact with students for approximately 6 hours each day…school environment also influences youth eating behaviors and provides them with opportunities to consume an array of foods throughout the school day” (School health guidelines, 2011). More than one-half of youths in the United States eat one of their three major meals in school, and 1 in 10 children eats two of three main meals in school. Schools can reinforce healthy eating habits and provide opportunities to practice healthy eating (CDC, 1996). Involving parents and other family members is one strategy to promoting healthy eating habits. To involve parents and other family member’s teachers could assign nutrition education homework that the students can do with their families. Working with the school nurse would be an effective way to offer nutrition education workshops and would also be a great resource to illicit support and build a team of parents who would be willing to get involved in lobbying the school board and local politicians to implement the Farm to School Program year round. Media connects people to people; media is a major and powerful source for distributing information (Carr, 2008). Using the media is an excellent opportunity to educate the residents in West Jordan about the Farm to School Program. Resources could include using posters in the REDUCING CHILDHOOD OBESITY 11 schools common areas, classrooms, lunchrooms, and hallways. Flyers could be distributed in daycares and doctor’s offices. Writing a letter to the editor of West Jordan’s community newspaper which is distributed monthly to all residents in the city as well posting information on the City’s website would be an excellent use of mass media and an effective option to distributing information to as many residents as possible. Spreading awareness of childhood obesity and the Farm to School Program could be accomplished by circulating a petition in the community in order to make local politicians and school board members aware of the number of parents and community members who care about this issue. Petitions could be left in high traffic areas such as the school offices, grocery stores, and other local areas. Reaching out to community leaders and other respected members of the community and asking them to write a letter of support to be presented to school board would further show the amount of support from the community. Getting children involved by having them write letters and collect signatures along with their parents would be a great learning opportunity for them. Using e-mails, telephone calls, and mail are effective tools in lobbying local politicians and members on the school board. Attending City Council Meetings which are held on the second and fourth Wednesday of each month would be an effective method of disseminating information on the Farm to School Program. Zoning and planning meetings are held on the third Tuesday of each month and attendance would communicate the importance of the agricultural land to the success of the Farm to School Program. REDUCING CHILDHOOD OBESITY 12 Conclusion Childhood obesity is a preventable medical condition which has the potential of increasing the risk of serious life threatening disease processes and disorders. The City of West Jordan has a significantly higher percentage of school age children who are either overweight or obese with 26.1% in comparison to other Utah elementary schools rate of 20.4%. If the city of West Jordan is going to combat the issue of childhood obesity it will take a commitment from schools, families, and the community. There are approximately 13,763 students enrolled in the Jordan School district. Schools provide an opportunity to teach children and families about obesity and the importance of eating a nutritional diet and physical exercise. The schools in West Jordan City have a unique opportunity of not only teaching children about nutrition but also to participate in the Farm to School Program. Making the community aware of the Farm to School Program through education, media, and lobbying local politicians and the school board will increase the awareness of the Farm to School Program and the value of participating in the program year round. Applying for the federal grants which are available can assist the community in implementing this program. West Jordan City’s 6.500 acres of agricultural land provide the resource to make this program successful. The revenue generated would stay in the community and could be utilized by the Jordan School district to implement nutritional education in the school curriculum. Diet is only one factor which can contribute to obesity; lack of physical activity also increases the risk of childhood obesity. The revenue generated could further be used to hire physical education teachers for the elementary schools to teach kids the importance of participating in physical REDUCING CHILDHOOD OBESITY 13 activities. For this plan to be successful, it will require active support from parents, schools, local government, and the community. REDUCING CHILDHOOD OBESITY 14 References Best Place to Live. (2012). Retrieved from http://www.bestplaces.net/climate/city/utah/west_jordan. Retrieved on September 7, 2012. Carr, E.R. (2008). Quality of Life for Our Patients: How Media Images and Messages: Influence Their Perceptions. Clinical Journal Of Oncology Nursing, 12(1), 43-51. doi:10.1188/08.CJON.43-51 CDC, Centers for Disease Control and Prevention. (2012). Retrieved from www.cdc.gov/healthyyouth/obesity. Retrieved on September 30, 2012. CDC, Centers for Disease Control and Prevention. (2012). Retrieved from http://www.cdc.gov/physicalactivity/everyone/guidelines/children.html Find Good Schools (2012). Retrieved from http://findgoodschool.com/schools-list-bycity/charter-elementary-schools-in-WEST-JORDAN-UT on September 8, 2012. Gerding, S. (2008). Tips and resources for finding grants. Online, 32(6), 16-21 HealthyPeople (2012). Retrieved from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicId=29 Homefacts (2012). Retrieved from http://www.homefacts.com/crime/Utah/Salt-LakeCounty/West-Jordan.html on September 9, 2012. REDUCING CHILDHOOD OBESITY 15 Maryland, M. A., & Gonzalez, R. (2012). Patient Advocacy in the Community and Legislative Arena. Online Journal Of Issues In Nursing, 17(1), 1. doi:10.3912/OJIN.Vol17No01Man02 School Health Guidelines to Promote Healthy Eating and Physical Activity. (2011). MMWR Recommendations & Reports, 60(RR-5), 1-78. South Valley Water. (2012). Retrieved from http://www.svwater.com. on September 4, 2012. U.S. Census Bureau. (2012). Retrieved from http://factfinder2.census.gov/faces/tableservices/jsf/pages/productiview.xhtml?src=blmk on September 8, 2012. U.S. Census Bureau. (2012). Retrieved from http://quickfacts.census.gov/qfd/states/49/4982950.html on September 4, 2012. Utah Department of Health. (2009). Retrieved from http://health.utah.gove/obestiy/families/obesity/the-facts.php on September 30, 2012. Utah Department of Health. (2012). Retrieved from http://health.utah.gov/vitalrecords/pub_vs/ia10/1/10bx_10122011.pdf. Retrieved on September 9, 2012. REDUCING CHILDHOOD OBESITY 16 Wang L., Denniston, M., Lee, S., Galuska, D., & Lowry, R. (2010). Long-term health and economic impact of preventing and reducing overweight and obesity in adolescence. Journal Of Adolescent Health, 46(5), 467-473. doi:10.1016/j.jadohealth.2009.11.204 West Jordan: Official Site of West Jordan. (2012). Retrieved from http://www.wjordan.com/Government.aspx?pgID=2.3 on September 4, 2012. West Jordan: Official Site of West Jordan. (2012). Retrieved from http://wjordan.com/Residents.aspx?pgID=4 on September 8, 2012. West Jordan: Official Site of West Jordan (2012). Retrieved from http://www.wjordan.com/search.aspx?q=disaster+plan+for+west+jordan&cx=015532021 538773750246%3agzcdp3rnoy4&cof=FORID%3a11 on September 8, 2012. West Jordan: Official Site of West Jordan (2012). Retrieved from http://www.wjordan.com/Files/Eng/Complete_Report.pdf on September 7, 2012. West Jordan District (2012). Retrieved from http://www.jordandistrict.org/schools/high/west Jordan/ on September 4, 2012. West Jordan District (2012). Retrieved from http://www.jordandistric.org/schools/westjordan/ on September 8, 2012. REDUCING CHILDHOOD OBESITY 17 West Jordan District. (2012a). Healthier Helpings Offered in School Lunch Rooms. Retrieved from http://www.jordandistrict.org/page2/ on September 30, 2012. West Jordan District (2012b). Farm to School Program - Back to the Basics. Retrieved from farmtoschool.org/state-programs.php? Retrieved on September 30, 2012. World Health Organization. (2005). Preventing chronic disease; A vital investment. Retrieved October 1, 2012, from http;//www.who.int/chp/chronic_disease_report_full.pdf REDUCING CHILDHOOD OBESITY 18 COMMUNITY ASSESSMENT TABLE Category Physical Environ ment: geography & Climate Physical Environ ment: Populatio n: size, demograph ic characteris tics, trends, migration, density Physical Environ ment: water, sewage & waste disposal, air quality, housing, Findings & Source of Data Geography: West Jordan is located at (40.606385, -111.976217). The city has a total area of 32.46 square miles, which is all land. The elevation is 4,330 feet above sea level. The city lies approximately 18 miles southwest of downtown Salt Lake City, Utah. West Jordan is bordered on the north by Taylorsville, and Kearns, on the south by South Jordan, on the east by Sandy, Murray, and Midvale, on the west by Copperton, and on the extreme northwestern corner by West Valley City. West Jordan is bordered on the west by the Oquirrh Mountains and on the east by the Jordan River. The western neighborhoods of Welby, Copper Hills, and Jordan Hills are rapidlygrowing regions located along the lower slopes of the eastern Oquirrh Mountains. Climate: July on average is the warmest month, with the highest recorded temperature of 111 degrees Fahrenheit in 1998. On average December is the coolest month, with the lowest recorded temperature of -17 degree Fahrenheit in 1990. April is the average wettest month. West Jordan gets 16 inches of rain per year. Snowfall is 34 inches. The number of days with any measurable precipitation is 79. On average, there are 230 sunny days per year in West Jordan. The July high is around 94 degrees. The January low is 23. The comfort index, which is based on humidity during the hot months, is 64 out of 100. Retrieved on 09/07/2012 from http://www.bestplaces.net/climate/city/utah/west_jordan Population: As of the census of 2010 the population of West Jordan was 103,712. The median age is 28.2, with 49.7% male and 50.3% female. Percent of children under 8 years of age is 35.2 percent, children under 5 years of age is 10.2%, and adults 65 years of age and older is 4.6% in 2010. The fastest development is currently taking place between 4800 west and Utah State Route 111, a highway that traverses the slopes of the Oquirrh Mountains. The racial makeup of the city is white, non Hispanic 74.6%, Hispanic 17.7%, African American 1.0%, Asian 2.7%, and Native Hawaiian and other Pacific Islanders 1.6%. 9.3% of the population of West Jordan is foreign born. Retrieved 09/04/2012 from http://quickfacts.census.gov/qfd/states/49/4982950.html Water Source: West Jordan's water supply comes from two sources, the Jordan Valley Water Conservancy District which currently provides approximately 75% of West Jordan's annual water needs. This water comes from the Upper Uinta Basin through Jordanelle Reservoir and Deer Creek Reservoir, spring water from the east bench of Salt Lake Valley, and groundwater wells. West Jordan operates four wells at various times of the year which provide approximately 25% of the City's annual water demand. The City annually samples and monitors the water quality from the City's REDUCING CHILDHOOD OBESITY 19 animal control wells. Sewage Disposal: West Jordan City wastewater is discharged into the South Valley Water Reclamation Facility, which is a regional wastewater treatment plant, located at 7600 South 1200 West, West Jordan. This encompasses a 200-square mile service area. The facility is an oxidation ditch design and was put into service in 1985. The 1998 capacity was 38 million gallons per day, at a total construction cost of $40,000,000. In the year 2010 the capacity was expanded to 50 million gallons per day. Retrieved on 09/04/2012 from http://www.svwater.com/ Waste Disposal: The City provides for the collection and disposal of residential solid waste, including recycling and composting programs. They contract with a private company to collect household trash and recycling, and participate with neighboring cities in a joint venture landfill. They also provide for Christmas tree recycling and neighborhood dumpster programs. Air Quality: The National Ambient Air Quality Standards have been established for Lead, Nitrogen Oxide, and Sulfur Dioxide. These pollutants are presently not a problem in West Jordan City. Motor vehicles are the primary contributors to lead pollution in the air. Nitrogen Oxide is generally a regional air pollution problem in which the Salt Lake Urban Area has never had a violation of the national standards. While motor vehicle emissions probably contribute as much as 50 percent of the Nitrogen Oxide emissions, there are no concerns with Nitrogen Oxide as a local air pollutant. Sulfur Dioxide is primarily an industrial pollutant. Ozone occurs in the summer months during periods of long days and hot weather. Emissions from motor vehicles can be as high as 50 percent of the precursor emissions that form ozone. Ozone exposure in West Jordan is expected to be similar to the entire county, with no major concentrations or localized ozone problems. Retrieved on /09/04/2012 http://www.wjordan.com/Government.aspx?pgID=2.3 Housing: There are 29,610 households in West Jordan, with 31,366 housing units. 15.7% are multi unit structures and 78.2% of the population in West Jordan own or are purchasing their homes. The median value of owner occupied housing is $225,900. The average household size is 3.60 and the average family size is 3.87. http://quickfacts.census.gov/qfd/states/49/4982950.html Economi cs: Income: The city of West Jordan has a total of 52,995 residents employed with a median income is $65,805, there is a 6% unemployment rate and 6.7% of the population lives below the poverty level. The top industries are health care, social assistance and retail trade. Retrieved on 09/08/2012 from http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview.xhtml ?src=bkmk. Education: 90.3 % of the population has a high school diploma or higher. 22.5% have a Bachelor’s degree or higher education. Retrieved on 09/04/2012 from http://quickfacts.census.gov/qfd/states/49/4982950.html Manufacturing: There are 7,746 different businesses in West Jordan. 2.4% are Asian owned businesses. 6.3% are Hispanic, and 26.4 are women owned. employme nt levels, manufactur ing, income levels REDUCING CHILDHOOD OBESITY 20 http://quickfacts.census.gov/qfd/states/49/4982950.html Educatio n: schools, types of education, special education, sex education, school lunch programs, afterschool programs, day care, access to higher education Recreatio n: parks & playground s, libraries, public & private Schools: The Jordan School district serves West Jordan. Jordan School district has the third highest graduation rate among the 50 largest school districts in the country (78.9%). There are approximately 13,763 students enrolled in 16 elementary schools (Copper Canyon, Falcon Ridge, Fox Hollow, Hayden Peak, Jordan Hills, Mountain Shadows, Oakcrest, Columbia, Heartland, Majestic, Oquirrh, Riverside, Terra Linda, West Jordan, Westland, and West Vale), with a combination of traditional and year round schools. Four junior high schools with an enrollment of approximately 4,406 students. (Joel P. Jensen, West Jordan, West Hills, and Sunset Ridge). Two high schools (Copper Hills, and West Jordan), with approximately 4,296 students. There are 9 private schools (West Ridge Academy, Copper Hills Youth Center, Challenger School, Children S Christian School, Learning Tree, Over the Rainbow, Tender Touch, West Jordan Christian School, and West Jordan KinderCare), with approximately 519 students. There are three Charter Schools (Hawthorn Academy, Itineris Early College High, and Navigator Point Academy), with an enrollment of approximately 1,517 student. West Jordan has two Universities, Hawthorne and Broadview. Salt Lake Community College also has a campus in West Jordan. Retrieved on 09/08/2012 from http://findgoodschool.com/schools-list-by-city/charter-elementary-schools-inWEST-JORDAN-UT http://www.jordandistric.org/schools/westjordan/ Special Education: South Valley School provides training for special education students in independent living skills, character education and vocational preparation in full-time and part-time programs. School Lunch Programs: Jordan School district offers before school breakfast and lunch programs with reduced rates for those who qualify. In the summer they also offer breakfast and lunch programs. Special Programs: Jordan School district does have early intervention pre-school for children aged 3-5. In junior high there is a full resource team, school psychologist, counselors, and teachers are on staff to serve students with special needs. In high school, students are offered different advanced placement programs, concurrent college courses, plus honors courses for college-bound students. Technical training is available and students may also participate in advanced vocational training at the Jordan Applied Technical Center. Retrieved on 09/04/2012 from http://www.jordandistrict.org/schools/high/westjordan/ Parks and Playgrounds: West Jordan has 30 neighborhood parks that are found within subdivisions, in most cases, they include an open grassy play area, a small play structure, and a picnic table. Occasionally, sand volleyball courts, basketball courts, tennis courts, or baseball diamonds are included. Six mini Parks that serve neighborhoods or subdivisions, and generally include REDUCING CHILDHOOD OBESITY 21 recreation, special facilities open lawn play areas and a small play structure. Occasionally, picnic and other facilities are also provided, and four community parks which are larger and often include specialty features like baseball complexes, rodeo grounds, soccer fields and large natural areas. They may also include open grassy play areas, play structures and picnic tables. West Jordan has the state’s first handicap-accessible ball field, which provides a smooth, flat surface for physically and mentally disabled athletes to participate in America’s favorite pastime. Blind athletes will also be able to play beeper ball. West Jordan holds an annual Easter egg hunt, and Western Stampede that has been a West Jordan tradition since 1954. Included in the celebration are a PRCA sanctioned Rodeo, Pro Bull Riding, Family Rodeo, and Demolition Derby. The event also includes a Carnival, Parade, Booths, Entertainment in the Park, Games & Activities for Children. Public and Private Recreation: West Jordan has a multiple activities, there is the Gene Fullmer Recreation Center, a public outdoor swimming pool, golf course, the Ron Wood Baseball Complex, West Jordan Youth Football, and a 20 field soccer complex. Special Facilities: There is a Senior Center in West Jordan that offers a diverse array of services, information, educational classes, fitness, socialization, volunteer opportunities, nutritious lunches, trips, and humanitarian projects. Retrieved 09/08/2012 from http://www.wjordan.com/Government.aspx?pgID=2.3 Religion: 0.67% of the population in West Jordan is religious. The predominant religion is the Church of Jesus Christ of Latter Day Saints with 53.25%. 6.54% are Catholic; 1.21% are another Christian faith; 0.43% are Jewish; 0.04% are an eastern faith; 0.39% affiliates with Islam. Retrieved 09/08/2012 from http://www.bestplaces.net/religion/city/utah/west_jordan denominati ons, communit y programs Commun ication: newspaper s, TV and radio channels Safety: fire protection, police protection, EMS, rape treatment centers, utilities, American Red Cross, disaster plans, potential Communication in the City of West Jordan is provided through local newspapers, a monthly newsletter, radio, television, an online e newsletter, and online city information through website. Retrieved 09/08/2012 from http://www.wjordan.com/Residents.aspx?pgID=4.0 The City of West Jordan has four fire stations with trained EMS, a police station that has taught the D.A.R.E program for more than fifteen years, with an average of 1,550 sixth grade students being made aware of the harmful effects of drugs, violence, and gang. There is also a free victim assistance program that is provided by the West Jordan Police Department and citizen volunteers. It provides victims of crime and other traumas emotional, logistic and sometimes financial support. Jordan Valley Medical Center provides emergency services. There is an IHC InstaCare in West Jordan. There are street lights, crossing guards, and an Animal Control Division. Retrieved 09/08/2012 from http://www.wjordan.com/Residents.aspx?pgID=4.0 Disaster Plan: On the City of West Jordan’s official site the Fire Department has information on what you can do to prepare yourself for a disaster such as REDUCING CHILDHOOD OBESITY sources of disaster Transpor tation: intercity & intracity, handicappe d, emergency transport Politics & Governm ent: Dominant party; how city/area is governed; how positions are filled 22 a fire, earthquake, or hazardous materials. West Jordan has an Emergency Operation Plan, the city also has a Local Emergency Planning Committee that works with local businesses, and there is also a Community Emergency Response Team. Potential Sources of Disaster: Earthquakes, fires, flooding, high winds, winter storms, thunderstorms and lightening, and hazardous materials are listed as potential sources of disasters in West Jordan. Retrieved on 09/08/12 from http://www.wjordan.com/search.aspx?q=diaster+plan+for+west+jordan&cx= 015532021538773750246%3agzcdp3rnoy4&cof=FORID%3a11 The average one-way commute in West Jordan, UT, takes 27 minutes. 79% of commuters drive their own car alone. 12% carpool with others. 2% take mass transit and 4% work from home. For local transportation there are paved roads and local highways. Interstate 15, a twelve-lane freeway, is located east of the city limits, providing access from the north and south, while Interstate 215, eight-lane beltway, is located northeast of the city. Bangerter Highway a six-lane expressway traverses the center of the city. State Route, 111, a twolane road, runs through the developing rural area along the foothills. UTA currently operates bus service in West Jordan along most of the arterials and major collectors. East-west routes run along 7000 South, 7800 South, and 9000 South. North-south routes connect to either TRAX stations that are farther north or into downtown Salt Lake City. Regular routes in the city typically operate at 30 to 60-minute headways on weekdays and Saturdays from early morning to early evening. Redwood Road is only street in West Jordan with Sunday bus service, which operates on 60-minute headways from the late morning and throughout the afternoon. Limited service in the city operates only on weekday mornings and afternoons. TRAX light rail also serves the area. This line begins at the Fashion Place West station in Murray and run southwest through West Jordan, with 6 stops in the city. The City of West Jordan is just recently adding bike lanes to their major roadways. Local ambulances and hospital emergency department is located at the Jordan Valley Medical Center. Retrieved 09/07/2012 from http://www.wjordan.com/Files/Eng/Complete_Report.pdf Dominant Party: 48.17% of the people in West Jordan, UT are registered as Democrats. 48.09 % Republican. The remaining are independent: 3.74%. Retrieved 09/08/2012 from http://www.bestplaces.net/politics/city/utah/west_jordan. How City if Governed: The City of West Jordan operates under the Council/Manager form of government. The mayor is elected at-large and serves a four-year term. The City Council is comprised of the mayor and six council members. Of the six council members, four are elected by district and two at-large. The council members serve four-year terms. As elected officials, the City Council is tasked with providing policy and direction upon which all city actions, programs and priorities are based. The City Council relies on the input of the city manager and city staff, as well as recommendations from REDUCING CHILDHOOD OBESITY 23 various boards, commissions and committees. The City Council also participates in local and regional organizations and seeks to influence State and Federal legislation to better address the concerns of our community. The City Manager is the executive/administrative head of the city organization and functions much like a chief executive officer in a private corporation. He is an at-will employee of the City Council and is responsible directly to that seven-member body. He directs the staff support of the City Council’s policymaking role, provides evaluation and analysis, negotiates with private and governmental entities, and responds to the needs and concerns of community groups and individual citizens. Citizens can address the City Council during a regularly scheduled meeting concerning any matter over which the Council has jurisdiction. On West Jordan City’s official website there is an electronic interactive agenda below allows comments to be made on the 'Citizen Comment' section, or on any 'Public Hearing' item. Retrieved 09/09/2012 from http://ci.west-jordan.ut.us/Government.aspx?pgID=2.0 Health Statistics : mortality, morbidity, leading causes of death, births Social Problems : mental health, alcoholism & drug abuse, suicide, crime rate, school dropout, unemploy ment, gangs Health Manpow er: number of physicians, dentists, and nurses In 2010 there were 2,120 residence births and 359 residence deaths in West Jordan. Cardiovascular disease accounted for 1,446 deaths in Salt Lake County Health District; followed by 273 deaths from chronic lower respiratory disease. Diabetes accounted for 176 deaths, 115 deaths from influenza/pneumonia, 306 unintentional deaths, and 75 from motor vehicle accidents. Currently an estimated 59.7% of Utah adults or 1.18 million adults are overweight or obese, 20.4% of Utah elementary school students are either overweight or obese. According to West Jordan’s official website 26.1% of the population is obese. Retrieved 09/09/2012 from http://health.utah.gov/vitalrecords/pub_vs/ia10/10bx_10122011.pdf In West Jordan there is a 6% unemployment rate and 6.7% of the population lives below the poverty level. Crime rates for West Jordan City for 2010 were reported per 100,000 people as: violent Crime 63.5%, murder 19.9%, forcible rape 128.4%, robbery 43.3%, aggravated assault 62.4%, property crime 89.4%, burglary 64.0%, larceny theft 114.8%, and vehicle theft 89.5%. In Salt Lake County there were 187 suicides. Retrieved 09/09/2012 from http://health.utah.gov/vitalrecords/pub_vs/ia10/10bx_10122011.pdf http://www.homefacts.com/crime/Utah/Salt-Lake-County/West-Jordan.html There are 326 physicians per 100,000 population in West Jordan, UT. The US average is 261. There are currently 1,169 dentists in West Jordan. I was unable to find information on the number of Registered Nurses in West Jordan. Retrieved 09/09/2012 from http://www.bestplaces.net/people/city/utah/west_jordan REDUCING CHILDHOOD OBESITY 24 per population Commun ity Services: senior citizen centers, hospitals, nursing homes, mental health care, ambulatory care, preventive health services, home health & hospice agencies, welfare services VIPS (Volunteers in Police Service) is a nationally recognized program committed to developing a spirit of cooperation and partnership with the community. VIPS is responsible to recruit, train, and retain volunteers who participate in community safety, security, and service programs, in addition to emergency response situations. Other Community Health Services: Immunizations Information, Cholesterol screening/Blood Pressure Clinics, Cancer Screening, Women’s Cancer Program, Well Child Clinics, Prenatal Care – Baby Your Baby Program, Infant Development, Child Health Evaluation and Care, Communicable Disease, Tuberculosis Program, Hepatitis, HIV-AIDS testing, Sexually Transmitted Diseases, School Nursing, Senior Clinics, Senior Housing Programs, Child and Family Health Programs, Family Planning. There is an Iasis hospital, IHC Insta Care Facility as well as local doctors and dentists available for the public. Retrieved 09/09/2012 from http://www.wjordan.com/cd.aspx?pgid=188.8.131.52 REDUCING CHILDHOOD OBESITY 25 WINDSHIELD SURVEY OF WEST JORDAN CITY, UTAH 1. Community vitality There are people are visible throughout the community. People are mowing their lawns, working in their yards, walking dogs, and playing with children in the parks. Some are jogging, riding bikes, shopping, and driving in their cars. The people living in the neighborhoods depend on the area. There are subdivisions that have starter homes, which have young families, preschoolers, and school aged children. There are 55+ subdivisions, and subdivisions that have more elderly people than younger adults. There are also subdivisions that have middle aged adults with teenage children. The most common race appears to be white. The general appearance is healthy. I did not observe any obvious disabilities or what would appear to be mental or emotional disabilities. The residence for the most part appears to be well dressed and clean. There are obese adults and children. There are no tourists or visitors that I notice. I did not observe any people who appeared to be under the influence of drugs or alcohol. In the neighborhoods that house younger families, I did notice pregnant women and women with young children and babies in the parks. 2. Indicators of social and economic conditions The overall conditions of the homes that I observed are well kept. There is a combination of both single and multifamily structures which were built from about the 1960’s to present. In the far north east end of West Jordan there is an area of older homes, and trailer park housing that appears to be dilapidated. This is also the area where there is subsidized housing; however this area which is across the street from the trailer park is being renovated and appears to be well kept. There is public transportation in the form of light rail and buses. On the major streets running west and east and Redwood Road running north and south there are bus stops, however, there are no benches or covered areas. The hospital is located on a major street that runs west and east and there are bus services on this road. In the south west part of West Jordan there is an industrial area. There are farms, a hospital, strip malls with small businesses and retail chains, and Jordan Landings which would provide employment opportunities to the residences. I did not see any unemployed or homeless people. I did not observe men congregating in groups on the street. The area is a combination of rural and urban development. There are farms located next to neighborhoods, and a large area on the western edge of West Jordan that is farm land. There are workers in the fields that could be migrant workers. There are children out of school during the daytime, but West Jordan does have year round schools. Since this is an election year there are signs in peoples yards and along major streets. There are no billboards, however, on television stations there are commercials for health education. I especially like the IHC commercial that focus on exercising. These do seem appropriate since I was surprised that there were not more people especially children REDUCING CHILDHOOD OBESITY 26 outdoors playing, so all I can assume is that they are watching television and hopefully these commercials will make an impact. There are 16 elementary schools, 4 junior high schools, 2 high schools, 9 private schools, 3 charter schools. There are 2 Universities, and Salt Lake Community College. There is a school that provides training for special education students. There are 14 child care centers. 3. Health Resources There is one hospital, Jordan Valley Hospital which is located on 9000 South and Bangeter. One IHC InstaCare located on 9000 South and 2700 West. First Med on 8800 South Redwood Road, There are dentist offices that are pediatric, orthodontist, and oral surgery. There are doctors’ offices that specialize in Family health, OB/GYN, orthopedics, gastroenterologist just to name a few. There are nursing homes, rehabilitation center, there is an adolescent drug treatment center, and pharmacies both free standing and in grocery stores. 4. Environmental conditions related to health The evidence that I have seen that makes me suspicious of ground, water, or air pollutants is the farms that are located by and within neighborhoods and the use of pesticides. West Jordan also uses well water which could be a concern. The large number of vehicles on the road contributing to the air pollutants. The majority of the homes seem to be in good repair. There is the north east area that seems to have housing that is in need of repair. The roads are in good repair. The potholes don’t appear until during the winter time and are repaired in the spring. Drainage systems are in place. There are traffic lights, sidewalks, and curbs. There are school zone lights and crossing guards. Railroad crossings have warning lights and barriers. There is one light rail crossing that still does not have a barrier which is a surprise since there has been a fatality at this crossing. The streets and parking lots are well lit. There is a combination of heavy traffic and areas of rural roads that make for hazardous conditions when the wildlife comes down to graze in the fields in the western areas of West Jordan. The curbs are ramped to allow for handicapped access as well as entrances to buildings. There are recreational facilities and playgrounds. I was surprised that there were not more people present. There are daycare and preschool facilities. There are some children playing in yards and in the neighborhood parks. There are restaurants and fast food restaurants. There are people eating in Jordan Landings where there are receptacles and places for people to sit. There are public restrooms located inside business and eating establishments. I did not notice any nuisances with insects or rodents, but I am sure that they are outside. 5. Social Functioning There are families in the neighborhoods; it appears that their parents are caring for them. I do not notice multi generations. The sense of neighborliness is evident by observing neighbors visiting with each other. There is community cohesiveness; I did notice many neighborhoods had neighborhood watch signs. REDUCING CHILDHOOD OBESITY 27 The most dominate religion is Mormon; there are 18 Mormon Churches in West Jordan, One Catholic Church, One Methodist Church, one Lutheran Church, one Seventh Day Adventist Church, and two Baptist Churches. There is evidence that makes me suspicious of gang activity, with gang sign markings on concrete fences mostly in the North West neighborhoods. 6. Attitude towards health and health care There are many herbal medicine stores in West Jordan. I do observe that clinics and the hospital parking lots do have cars that would lead me to believe that they are being utilized. I did not observe any health fairs, or advertisements for health-related events.