Medical practitioners have been and should be in the forefront of catering for the health needs of society as a whole as seen in the codes and ethos outlined in the practice e.g. the Hippocratic Oath. Since nurses interact more with patients, they can have a huge impact in reducing the cases of health complications by undertaking preventive measures that promote and sustain healthy lifestyles through such means as health and fitness programs.
Nursing caters for the patients’ needs at all angles, even post-admission in hospital. Fitness programs coupled with dieting and healthy eating can be used to promote health behavior which is defined as “activity undertaken by an individual to promote good health and prevent health problems” (Quadagno, 2002).
Obesity and related complications such as diabetes have been major hurdles in the medical world. Obesity is fast becoming among the top killers worldwide and particularly in the US. It has further been exacerbated by the unhealthy lifestyle choices of today’s youth through physical inactivity. This is a lifestyle exemplified by a lot sitting (also referred to as sedentary lifestyles) and very little bodily movement (Ward, 2004).
“Obesity is defined as a body mass index (BMI) of 30 or greater. BMI is calculated from a person’s weight and height and provides a reasonable indicator of body fatness and weight categories that may lead to health problems” (Overweight and Obesity, n.d.).
Obesity is a principal dynamic in elevating or contributing to the risks for developing cardiovascular disease, certain types of cancer and type II diabetes. According to recent statistics posted by the CDC( Centers for Disease Control and Prevention), there has been a dramatic increase in obesity cases over the past two decades with some states like Alabama, Mississippi, Oklahoma, South Carolina, Tennessee, and West Virginia having prevalence rates of above 30 percent in the 2008 alone.
Some of the causes that have been postulated to increase the risk of being obese can be attributed to environment, behavior, drugs and genetics. As already mentioned above, physical inactivity is a major contributing factor. It has been linked to the caloric balance equation, which is defined as the balance between the calories consumed in food with the calories burned up in normal body functions, day-to-day activities and exercise activities (Overweight and Obesity, n.d.).
Environment is also an important aspect in obesity problems. Environments that are generally not conducive for promoting healthy lifestyles and health choices (such as healthy and balanced diets) contribute to obesity in general. For example, people who work in offices that do not encourage a lot of physical movement such as “cubicle jobs” increase the risk of employees becoming obese. Also, areas that do not have grocery stores with affordable prices can discourage people from opting to buy healthy vegetables and go for cheaper fast foods instead.
Disease and some drugs also contribute to obesity. These include Cushing’s disease and drugs such as steroids or anti-depressants.
Genes and heredity play a role in obesity but it is not the sole reason. Furthermore, it is not always a prognostication of complications in weight arising from genetic make-up. However, some disorders such as Bardet-Biedl syndrome and Prader-Willi syndrome are attributed to obesity.
According to Overweight and Obesity, n.d), the likely health risks that may be induced by obesity include:
- Coronary heart disease
- Type II diabetes
- Different forms of cancer (endometrial, breast, and colon)
- Hypertension or high blood pressure
- Dyslipidemia (which may include high total cholesterol or high levels of triglycerides)
- Stroke or CVAs
- Liver and Gallbladder disease
- Sleep apnea and respiratory problems
- Osteoarthritis
- Gynecological problems such as abnormal menses and infertility
With all this in mind, nurses are crucial to the provision of fitness and exercise programs both in analyzing those at risk before hand and providing treatment programs.
The following costs (expenses) are incurred in starting a simple gym and fitness club:
- Fixed Costs include those costs that are not dependant on production or sales volume (output). The sales volume refers to those signing up for membership. These costs will accrue regardless of the number of people who sign up.
- Variable costs are expenses that are directly proportional to output such that if traffic at the gym is low, the costs will decrease and vice-versa.
- Controllable expenses include the costs that the manager can influence or essentially control. The manager can make decisions on how to drive controllable costs down if they threaten to decrease profit margins.
- Unrecoverable expenses are past expenditures that cannot be recuperated and are a big contribution to bad debts.
The above sample budget is the analysis and estimates of undertaking a fitness and exercise program which enlists the components of a gym center. The total expenditure must be deduced from the averages of all gym and fitness club estimates and applied state by state.
Cost-Benefit Analysis
Obesity and its associated health problems have a colossal economic impact on the U.S. healthcare system (U.S. Department of Health and Human Services [USDHHS], 2001).The implementation of this program depends on a cost-benefit analysis. The benefits must outweigh the costs, it must be affordable to most of the potential beneficiaries and it should not put a big dent in the healthcare financial budget. The benefits of the program include: reduced costs in out-patient and in-patient services. According to Wolf and Colditz (1998), medical costs associated with overweight and obesity may involve direct and indirect costs. Direct medical costs involved in may include such services which seek to prevent, diagnose, and treat obesity and its related complications. Indirect costs are those that deal with morbidity and mortality costs of taking care of obese patients. Morbidity costs are defined as “the value of income lost from decreased productivity, restricted activity, absenteeism, and bed days” (Overweight and Obesity, n.d.).
The mortality costs are “the value of future income lost by premature death” (Overweight and Obesity, n.d.).
The costs associated with obesity averaged about 92.6 billion in 2002 (Finkelstein, Fiebelkorn, and Wang, 2003). The following is a table representing the national estimates and the cost it entailed for the insured and uninsured.
Table: Aggregate Medical Spending, in Billions of Dollars, Attributable to Overweight and Obesity by Insurance Status and Data Source, 1996–1998
Key: NHA (National Health Accounts), MEPS (Medical Expenditure Panel Survey)
According to the estimates in the sample budget, US $ 396 000 is used monthly in undertaking the venture. Annually the figure is set at US $ 4.776 million multiplied by the 2009 estimates of the number of fitness centers, the industry averages US $ 482.376 million.
The table shows that the expenditure in medical expenses is at US $ 47.5 billion (including institutionalized populations) as compared to a little less than half a billion.
4750000000 – 482376000 = 42 67624000 (US $ 42.67624 billion)
Is it worth implementing?
The estimates show that the costs of undertaking the fitness and exercise programs are far much more cost effective than the cost of dealing with medical expenses accruing from not maintaining a healthy diet.
Citing other studies, the Diet Blog website puts higher estimates of US $ 700 million. This is still an affordable number that shows how important this health promotion activity is in saving costs and saving lives (The Rise of the Gym through History, n.d.).
It is therefore a sound idea to invest in healthcare promotion activities with the help of nurses in order to curb the problem before it propagates into the phenomenal numbers that are being seen today, especially among the youth.
Reference List
Finkelstein, E.A., Fiebelkorn, I.C. & Wang, G. (2003). National medical spending attributable to overweight and obesity: How much, and who’s paying? Health Affairs, W3, 219–226.
Overweight and Obesity. (n.d.). CDC website. 2010. Web.
Quadagno, J. (2005). One Nation Uninsured: Why the U.S. Has no National Health Insurance. New York, NY: Oxford University Press.
The Rise of the Gym Through History. (n.d.). Diet Blog. 2010, Web.
USDHHS. (2001). The Surgeon General’s call to action to prevent and decrease overweight and obesity. [Rockville, MD]: U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General.
Ward, S. (2004). Preparing and Implementing a Training Workshop for Staff Members Initiating a Fitness Program for Persons with Developmental Disabilities Living in Group Homes. The Governor’s Summit on Healthy Virginians. Web.
Wolf A. M. & Colditz G.A. (1998). Current estimates of the economic cost of obesity in the United States. Obesity Research, 2, 97–106.