D025 Social Determinant of Health Policy

The State of Florida possesses policies preempting local laws connected to nutrition, healthy food financing funding, implemented a comprehensive streets policy, and policy for elementary and high school learners to engage in physical education. Additionally, the state possesses laws dictating the licensed ECE projects to avail drinking water to children and eligible learning institutions to implement the provision of community eligibility. However, the state does not possess licensing laws connected to the CACFP or the Child and Adult Care Food Program standards that update automatically and policies or statutes on Safe Route to School and laws associated with the compulsory participation of schools in the National Lunch Program. As a result, the state has not overcome childhood obesity by increasing physical activities and nutritious diets for teenagers and children in schools as expected (State of Childhood Obesity, 2021).

Ethical Implications of Current Policy or Absence of Existing Policy

Safe Route to School includes regulations that promote wheeling, bicycling, and walking to school and from school by offering the communities the materials and resources to construct additional crosswalks, bike paths, sidewalks, enhance signage and lighting to ensure that the students enjoy safe and secure conditions. Walking, bicycling, and wheeling includes a physical activity that assists in minimizing weight resulting in reduced rates of obesity and overweight among the children and teenagers (Rodriguez, et al., 2019). Acknowledging the health advantages of physical activity and that most kids fail to access adequate levels of physical activities remain important. It is recommended by authoritative agencies and governments internationally that children should receive at least sixty minutes of physical activities daily. The sixty-minute physical activity daily must get spent participating in vigorous or moderate physical activity such as bicycling, brisk walking, and wheeling to school (Rodriguez, et al., 2019).

The absence of the policies or statutes of Safe Route to School in Florida, therefore, possesses ethical implications because it violates nonmaleficence. Failure to implement the SRTS policy fails to permit the children to have sixty minutes of physical exercise while walking, wheeling, and bicycling to and from school increasing the likelihood of overweight and obesity as well as increase health disparities because obesity and overweight impacts the minority from low-income households safely and with limited harm (Rodriguez, et al., 2019). Additionally, the absence of the policies or statutes of Safe Route to School violates the justice code of ethics(American Nurses Association, 2015). The children and teenagers from low-income populations remain the most impacted by obesity and overweight, hence creating disparities in healthcare. Therefore, failure to support the policies or statutes of Safe Route to School will increase the healthcare disparities, fail to protect human rights, and promote health diplomacy (Rodriguez, et al., 2019).

Demographics Table

Policy Proposal and Implementation Plan

Two Policy Alternatives to Address the SDOH

Since the state does not possess licensing laws connected to the CACFP or the Child and Adult Care Food Program standards that update automatically and policies or statutes on Safe Route to School, it remains significant for the state to consider developing the policies to overcome childhood obesity by increasing physical activities and nutritious diets for teenagers and children in schools as expected. CACFP offers states federal funding to reimburse providers offering nutritious snacks and meals to grownups and children in their care. Approximately 4.3 million kids and 130, 000 grownups participate in the program yearly. The 2017 CACFP nutrition standards require that the providers offer various vegetables and fruits, less saturated fats, whole grains, and limited sugars (State of Childhood Obesity, 2020). Children are supposed to increase their whole grain and vegetable intakes as well as minimize their consumption of grain desserts to enhance their health. Studies show that moderately engaging in CACFP enhances the consumption of vegetables and milk among kids and minimizes the overweight prevalence. However, CACFP must extend to permit the third meal service option and CACFP must continue funding the wellness and nutrition program efforts and education in addition to streamlining paperwork and operations of the program to permit quicker and simpler provider enrollments to act as the program sponsors (State of Childhood Obesity, 2020).

Moreover, SRTS or Safe Route to Schools aims at assisting the learners to cycle and walk to and from their learning institutions by offering societies with funds and materials to construct crosswalks, bike paths, and sidewalks as well as enhance signage and lighting to ensure that the students cycle and walk safely and securely. The Safe Route to Schools further assists in making walking and bicycling more attractive as an option for transportation, encouraging an active healthy lifestyle early in the life of a child. Moreover, it facilitates project implementation, development, and planning and activities that will enhance safety, minimize fuel consumption, air pollution, and traffic near learning institutions. The school district must ensure that they integrate physical activity opportunities for the children healthily and safely to ensure that the students participate in physical activities to overcome the obesity and overweight health issues among the teenagers and children (Rodriguez, et al., 2019). More so, the district must ensure that each school participates in the School Lunch Program to ensure that each child access healthy meals. Sometimes the students fail to access meals from the programs and eat other foods that may not be healthy. As a result, the efforts to eliminate obesity become a challenge. However, making it compulsory for each student to consume healthy meals and engage in physical activities will ensure that childhood obesity is reduced or eliminated (Izumi, et al., 2018)

Preferred Policy

The Safe Route to School policy remains important in Florida to ensure that the students get encouraged to participate in physical activity through bicycling and walking safely. The policy will demand the school district to involve physical activity in their local wellness regulations to school and from school. Active transportation including biking or rolling and walking to school and from school can assist in enhancing physical activities for the students and their families (Safe Route Partnership, 2020). The policy will require all the school district engaged in the National School Lunch Program to implement local wellness regulations to reflect the important role played by learning institutions to promote the health of the learners including overcoming childhood obesity, The local wellness regulations must entail the objectives for promoting nutrition, physical activity, and education among other school practices that promote the wellness of the learners. The local wellness policies will include the promotion of physical activities to address various opportunities for the learners to remain physically active in school (State of Childhood Obesity, 2021).

The district will offer storage facilities for active transportation equipment including scooters, and bicycles and offer safe routes to the schools as well as limit the low-costs and free automobile parking. They will further take into consideration the sufficient crossing guard provision. More so, the district will ensure equal distribution of the resources; assess resources and policies that support convenient and safe active transportation to school and out of school. Additionally, the district should pursue and determine the state and federal funding among other sources to support and encourage the Safe Route to School programs (Safe Route Partnership, 2020). Additionally, the district will develop remote drop-off areas where the learners will get dropped by the car or busses and walk safely the remaining distance to school. It shall find safer routes to the bus stop to permit learners dropped by vehicles and buses to integrate active transportation daily. The district will select places that support the entire needs of learners, the families, and the community while encouraging socioeconomic, ethnic, and racial diversity. The district will further get required to design the locations to ensure maximum convenience and safety for bicycling and walking to the school. Each learning institution will get required to conduct walk audits to evaluate the safety and traffic conditions near the school and determine the safety situations requiring mitigation and the district will mitigate the issues (State of Childhood Obesity, 2021).

The district must facilitate a yearly bicycle rodeo program to educate on bicycle safety and skills to the learners by developing at least 2 educational projects in the community to foster and teach appropriate pedestrian and bicycle safety habits. Students should get educated on bicycling etiquette and walking through after and in school pedestrian and bicycle safety education and build safety campaign to create awareness on students bicycling and walking to and out of learning institutions. A family-oriented education training project that concentrates on a school safety campaign remains critical as well as a parent workshop to offer support, resources, and tools required to motivate parents and the community to embrace bicycling and walking transportation (State of Childhood Obesity, 2021). Additionally, the District must examine strategies to promote bicycling and walking via the determination of safe routes, educating grownups, rewarding participation, and organizing events by updating the language of the policy to ensure it remains more encouraging. The district must encourage the schools to motivate students to bike or walk to their learning institutions and showing the associated health advantages. The district must reward learners to motivate positive reinforcement and participation in global Bike and Walk to School Days (Safe Route Partnership, 2020).

Moreover, to enforce the policy, the district must address the safety and traffic concerns by adopting and determining enforcement measures within the bike and walk zones by enhancing the prevalence of traffic police in strategic areas during the dismissal and the arrival of the learners or hiring a trained grownup. Additionally, the district must develop successful automated speed signs and their installation near the school and drop-off sites. In engineering, the district must enhance the current infrastructure in the community to support active transportation safely to ensure that the constructions comply with the conventional standards, develop crosswalks and sidewalks near learning institutions, close the drop off near the schools, restrict parking, install and rehabilitate new sidewalks and install speed limits near the schools (Safe Route Partnership, 2020). The district must evaluate the programs through monitoring the baseline data and improve depending on the results. They can administer parent questionnaires twice per year to monitor and analyze the behaviors of school travel and perception and assess the baseline health data to assess the health enhancement in time. The district must ensure equal and fair distribution of resources despite the socioeconomic, race, ethnicity, or family background (Safe Route Partnership, 2020).

Additionally, National School Lunch Program will ensure that all the students, despite their economic background access healthy food to ensure they remain healthy and reduce the risks of remaining overweight and obese. The program will get implemented through Farm to School initiative. The initiative will ensure that the learning institutions link the local farmers as well as other food manufacturers to ensure serving local foods to the students. The initiative will promote and increase vegetable and fruit intake among the students. The students will visit the farms to gain insight into the foods and learn which foods remain healthy for their consumption. The program remains significant because it will enhance community involvement and a sense of belonging (Izumi, et al., 2018). Additionally, school gardens will further enhance knowledge among the students on healthy foods by offering the students opportunities to plant and grow fruits, vegetables, harvest and prepare them. As a result, it will assist in developing the culture of students to consume vegetables and fruits to improve their health. However, the program may remain expensive and the farmers may not meet the needs of the students adequately (Story, et al., 2009).

How the Desired Results of the New Policy will Optimize Health in Community

Physical activity through the Safe Route to School will minimize the enhanced risks of obesity and overweight and the connected chronic illnesses. It further enhances academic performance, enhanced concentration, moods, attendance, and mental health of the students. Additionally, active transportation possesses community advantages, including minimizing traffic, air pollution, congestion near the schooling, developing safer streets, motivating cost savings, and establishing a powerful sense of community (State of Childhood Obesity, 2021). Biking and cycling remain major practices to enhance physical activity because they can decrease the likelihood of the students becoming overweight by improving the amount of daily physical activity. The research recommends that kids must access 60 minutes of physical exercise daily. However, nationally, fifty percent of the students in high school engaged in physical activity that enhanced their heart rate for sixty minutes on 5 or more days weekly. Therefore, fifteen minutes of cycling and walking to school and from school can assist the learners to meet the recommended sixty minutes of physical activity daily at an early age, cycling and walking instill the habit of participating in an active lifestyle which may go towards adulthood (Healthy People 2030, 2020).

The National School Lunch Program will assist in encouraging and promoting healthy eating habits. The program will ensure that the students take healthy foods, including vegetables and fruits while eliminating snacks and other foods rich in calories and cholesterol. As a result, the students will eliminate poor eating habits and the number of obese students will reduce (Story, et al., 2009). Nutrition education remains an important strategy to empower students and provide the knowledge to make healthy food and diet choices. Therefore, the National School Lunch Program initiatives will assist the students to gain more knowledge on healthy diets and consume more vegetables and fruits to enhance their health (Izumi, et al., 2018).

Financial Costs and Benefits of Proposed Policy Alternative

The state will obtain funding from federal and state transportation funding and is expected to access funding of one million US dollars per biennium to develop the Safe Route to School initiatives and one-time funding of 5 million US dollars. State funding is expected to amount to 3 million US dollars, making the total funding amount to 8 million US dollars (Pelletier, et al., 2019). The funding aims at supporting the Safe Route to School program implementation costs for project administration, construction, planning, and infrastructure. (DiMaggio, et al., 2016)

After the implementation of the SRTS program in approximately 90 district schools that serve the majority of the low-income students as well as the high and middle-income students, it's estimated that 20% of the students would adopt bicycling and walking active transportation. As a result, the state would save more money approximately 500,000 US dollars in the next ten years due to the reduced car and bus travel, air pollution, traffic, and congestion while the students would save approximately 100 US dollars in the next ten years (Pelletier, et al., 2019). Investing in the Safe Route to School policy in Florida would assist in attaining the recommended sixty minutes of physical activity by bicycling and walking to and from their learning institutions. More so, the children's well-being will improve and the state would experience a reduced number of obese and overweight cases which result in other chronic illnesses, hence minimizing health costs. The students will further experience muscular and aerobic fitness, enhanced bone health, enhanced moods, improves school attendance, and academic performance (DiMaggio, et al., 2016).

The National School Lunch Program will obtain its funds from the federal and state government as well as other donors. The program will require one million US dollars twice per year to fund the initiatives, including the Food to School and the School Garden initiative to support the program. The state will provide funding of 4 million US dollars totaling 6 million US dollars to support food supply from the farmers and farming in the school garden as well as pay the workers who prepare the meals at the school Cafeteria (Izumi, et al., 2018). After its implementation, all the students, including the low-income students will access healthy meals reducing obesity and health-related costs. The program will assist in ensuring that every student despite their socioeconomic background access a healthy diet and eats food low in calories to improve their health and reduce obesity and overweight. In the next ten years, the program will ensure that the number of obese students remains very low, increasing the students' academic performance, concentration, and productivity (Chaldoub, et al., 2018).

The policy remains more valid and effective compared to the CACFP because research indicates that healthy eating and physical exercise reduce obesity and overweight (Appelhans, et al., 2014). The policy includes physical activity encouraged by Safe Route to School and healthy eating by the National School Lunch Program to reverse the rates of childhood obesity. The school food setting will ensure that the teenagers and children take a large amount of healthy food because they consume nineteen to fifty percent of their calories at learning institutions (Parliament, et al., 2016). More so, the SRTS program will ensure that the students attain the sixty minutes of physical exercise as recommended. The policy will, therefore, ensure that the students remain healthy and reduce the rate of childhood obesity (DeNisco, 2021).

Two Ethical Implications of Proposed Policy Alternative

The policy will assist the nurses in practicing justice by ensuring that all the children access the program despite their race, ethnicity, socioeconomic status, gender, or family background (American Nurses Association, 2015). The policy considers the needs of the low-income minority students as well as other students and enhances their health through physical exercise to minimize obesity and overweight and other connected chronic illnesses (DiMaggio, et al., 2016). More so, the policy will assist the healthcare professionals in employing the non-maleficence principle which entails not harming the patients and individuals by choosing interventions that will result in limited harm to attain advantageous outcomes ((Nickitas, et al., 2020). Through the SRTS program, the children will get an opportunity to access physical activity and a healthy diet safely and with limited harm to enhance their health and well-being (CDC, 2018).

Barriers to Implementation of Proposed Policy Alternative

Obtaining federal funding may remain a challenge and the project may have to rely on state funding as well as other sources of funding which may be challenging. More so, community awareness may act as a barrier because they may not understand the importance of the SRTS projects. Therefore, the state and district must educate their communities to create awareness on the benefits of the projects and the importance of encouraging the students to participate in active transportation, including bicycling and walking as well as eat a healthy diet at school (Cradock, et al., 2017).

Communication Methods used to Introduce the Proposed Policy

Face-to-face communication remains the most effective communication to introduce the SRTS policy proposal. The face-to-face communication strategy will ensure that the concerned legislators remain aware of the proposal and its importance. Face to face communication assist in obtaining feedback, improving trust and credibility, show the importance of the proposal and address the sensitive issues connected to the policy. More so, the email communication strategy remains important because the proposal will get emailed to individual legislators informing them about the proposal and provides feedback. The method remains faster and straightforward (National League for Nursing, 2020).

Potential Results of Inaction

Failure to engage the student in physical activity through the SRTS program will result in increased childhood obesity and overweight, which could increase the likelihood of adult obesity. More so, the state may experience increased rates of chronic diseases such as some type of cancers, heart diseases, asthma, and high blood pressure increasing health costs (Smith, Fu, & Kobayashi, 2020).

Reflection

Change Agent Description

A change agent entails advocates actively engaged in the design and adaptation of change such as a process or policy (DeNisco, 2021). As a nurse, it remains significant to serve as a change agent through advocating for new policies or processes to ensure enhanced health care. Advocating for the implementation of the SRTS policy in Florida will ensure that childhood obesity, especially among the low-income population gets minimized and that the health care costs related to the connected health issues associated with obesity get eliminated or reduced. The proposal will ensure equal access to the SRTS programs in the district school in urban and rural areas serving the low-income and minority populations to reduce health disparities. More so, the National School Lunch Program will ensure that all students eat a healthy diet (Parliament, et al., 2016).

As an advocate, I have recognized that there remains a need to consider the underrepresented in the community. I feel very satisfied with the policy because it will integrate physical activity and a healthy diet to ensure that the minority and low-income students also access the services. Reducing disparity and ensuring justice for all as a nurse advocate make me happy and motivated to advocate for more policies that fail to consider the underrepresented. I had a chance to apply nursing ethical codes including justice and non-maleficent while advocating for the policy, increasing my knowledge in the subject. Meeting the legislators was an outstanding experience because I had to consider the most appropriate communication strategy to ensure that the policy and its intentions are met and considered.

Knowledge and Skills to Develop

As a change agent, it remains important to develop communication skills because they will assist in introducing and proposing the policy as well as communicate the change effectively. More so, flexibility silks remain significant because they will help in engaging with various and diverse individuals to ensure the success of the change (DeNisco, 2021). Listening skills remain appropriate because they will help in listening to other people's opinions and ideas to explore various perspectives and obtain the most appropriate solution. It remains critical to extending the cognitive skills and knowledge of the topic to ensure that one understands the issues and the changes that remain necessary to solve the issues (Nickitas, et al., 2020).

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