Running head: CANCER PREVALENCE LAKE COUNTY

Cancer Prevalence in Lake County, Florida

Amber Morin
University of South Florida

CANCER PREVALENCE LAKE COUNTY

Cancer Prevalence in Lake County, Florida

Lake County, Florida is formed by many small towns and located northeast of Orlando.
The county is profoundly one of southern culture, which includes southern food staples. The
county has higher rates of obesity than the state average and higher rates of cancer deaths. Since
obesity is known to increase risk of cancer, health modification should take place in Lake County
to decrease deaths by cancer.
Local, State, and National Data
Lake County, Florida had a population of 297,047 people in 2010 (Office of Economic
and Demographic Research [EDR], 2015). The county is a mix or rural and urban, but rural area
predominates. Lake County covers a land mass of 938.38 square miles (U.S. Census Bureau,
2015). The three major employers, all with over one thousand employees, are Florida Hospital
Waterman, Leesburg Regional Medical Center, and South Lake Hospital (Community Profile,
2014). As of 2013, the poverty percentage was 14.5%, compared to the overall state percentage
of 17.1% (EDR, 2015). The county is comprised of an 82% white population, 9.8% black, and
12.1% Hispanic or Latino population. The percentage of individuals over age 25 with a high
school diploma was higher, at 86.4%, than the state average at 86.1% (EDR, 2015).
Analyze, interpret and prioritize data
Three Health Indicators of Strength
According to the Lake County Health Profile, the county has a lower rate of heart disease
related deaths per 1,000 people, compared to the state average; the rate of deaths caused by heart
disease, for all races, in Lake County is 146.8, compared to the states deaths of 154.5 (Florida
Charts, 2014). A second health indicator of strength in Lake County is lower rates of STD and
AIDS cases than the state. The annual average, per 100,000 people, between 2012 to 2014 of

CANCER PREVALENCE LAKE COUNTY

gonorrhea, chlamydia, and syphilis cases was 372.9 compared to the states average of 531.5.
Finally, a third health indicator of strength is a lower crime rate than the state average. All crimes
listed on the county health profile were significantly lower than the states. For example, Lake
Countys larceny rate was 1,552.4, compared to the states average of 2,244.4; the robbery rate in
Lake County was 38.5, compared to the states rate of 118.5 (Florida Charts, 2014). The overall
crime rate, per 100,000, is 2,568.3, compared to the states average of 3,450.7 (EDR, 2015).
Healthy People 2020 is concerned about all three of these topics, therefore it is promising the
countys rates are better than the states rates. Lake County needs to continue to lower their rates
in order to meet Healthy People 2020s goals.
Three Health Indicators of Weakness
One of Lake Countys major causes of death that is higher than the state average is
diabetes. From 2012 to 2014, Lake Countys death from diabetes rate was 22.2, compared to the
states rate of 19.6 (Florida Charts, 2014). Another cause of death that is higher in Lake County
than the overall state is cancer. Lake Countys death by cancer rate was 164, compared to
Floridas rate of 158.1 (Florida Charts, 2014). Finally, Lake Countys percentage of overweight
individuals and obesity is higher than the states average. In 2013, 65.5% of Lake Countys
adults were overweight or obese, while 62.8% of Floridas adults were overweight or obese
(Florida Charts, 2014).
Priority Health Issue
A health issue in Lake County that needs to be addressed is cancer. Cancer is the countys
leading cause of death (Florida Charts, 2014). It is important to address because by decreasing
rates of cancer, or by detecting cancer early, residents of Lake County can have the opportunity
to live longer, healthier lives. Healthy People 2020s goals for cancer are reduce the number of

CANCER PREVALENCE LAKE COUNTY

new cancer cases, as well as the illness, disability, and death caused by cancer (Office of
Disease Prevention and Health Promotion, 2015). Setting forth interventions to combat cancer
will help meet Healthy People 2020s goals.
Discussion of Community Health Models
Determinants-of-Health Model
The determinants-of-health model provides a layout to easily identify the many different
factors or determinants that can affect an individuals health. It is easy to be unaware of what
really caused someones illness, and therefore not be able to effectively treat their illness. For
example, if we do not realize that an individual does not own a car (living condition), we may
not understand their poor eating habits that contributed to their obesity. Their obesity puts them
at risk for some cancers. A nurse may try to educate the individual to make healthier food
choices, but if the individual has limited access to these foods, our education has not really
helped them or their disease.
Human biology, health system, environment, and lifestyle all can contribute to a
diagnosis of cancer. According to Hiatt and Breen (2008), only a small percentage of cancers are
directly caused by inherited genetics, however our genetics can interact with our social
environment to increase our cancer risk (p. 147). Moreover, behaviors long recognized as
important contributors to cancer include tobacco and alcohol use, poor diet, physical inactivity,
high-risk reproductive behavior, and occupational hazards (Hiatt & Breen, 2008, p. 146).
To show that Hiatt and Breens research is still valid, Jemal et al. (2011) stated
maintaining a heathy weight, increasing physical activity, and minimizing alcohol are the most
significant ways to prevent breast cancer (p. 74). These same modifiable risk factors, as well as
eating red and processed meat, also increase the risk of colon cancer (Jemal et al., 2011, p. 75).

CANCER PREVALENCE LAKE COUNTY

Risky reproductive behaviors can lead to human papillomavirus (HPV), which can lead to
cervical cancer (Jemal et al., 2011, p. 80). In terms of environmental causes of cancer, asbestos,
arsenic, and radon increase the risk for lung cancer (Jemal et al., 2011, p. 76). Finally, the health
system can affect the progression of cancer if early screening is not performed due to a lack of
access to healthcare (Hiatt & Breen, 2008, p. 143).
Population Diagnosis
Lake County residents risk for cancer is related to human biology, healthcare system,
environment, and lifestyle as evidenced by cancer being the leading cause of death in Lake
County.
Community Based Intervention
Primary Level of Prevention
While there are many primary interventions to combat cancer, one that seems most
appropriate for Lake Countys population is modification of diet, weight, and physical activity.
Excess of adipose, or fat, causes individuals to be at an increased risk for breast, endometrium,
colon/rectum, esophagus, and kidney cancers (Thun, DeLancey, Center, Jemal, & Ward, 2009, p.
104). Therefore, by maintaining a healthy weight through diet and exercise, there will be a
reduction of cancer risk.
The intervention would include reducing number of calories consumed per day to a
healthy amount of 1500 to 2000, depending on their current weight, and moderate exercise for 45
minutes, five times a week. However, not all people are going to be able to start at this level of
activity. Individuals should be educated to work their way up to that level of activity if they are
able. Otherwise, they need to do what they are physically able to do. The stakeholders for this
intervention would be community members, health care providers, and funding sources.

CANCER PREVALENCE LAKE COUNTY

Community members need to implement the intervention to prevent cancer. Health care
providers should be educating their patients on healthy lifestyle. Funding sources may be needed
to make pamphlets from information obtained from organizations like the CDC. The role of the
nurse would be to educate the community on diet and exercise at community events and the
nurses workplace. Education would constitute as outreach and health teaching on the
Intervention Wheel Model.
Secondary Level of Prevention
Secondary prevention for cancer in Lake County would be encouragement of
recommended cancer screenings and treatment if needed. Screening for breast cancer should start
in women no later than age 45 and a mammogram should be performed ever year (American
Cancer Society, 2015). One screening for colon and rectal cancer is to be screened every 10 years
with a colonoscopy and a fecal occult blood test every year. Pap smears for cervical cancer
should begin at age 21. At age 50, men should talk to their providers about PSA blood tests and
digital rectal exam to screen for prostate cancer (American Cancer Society, 2015). Nurses can
educate individuals on when to get their screenings completed. Screening and health teaching are
components that would be utilized from the Intervention Wheel Model.
Healthcare providers should pay attention to when their patient should be getting
screened and should encourage patient to get screened. Healthcare providers also should guide
their patients through treatment if needed. Legislators may need to be contacted for individuals
that have a higher cancer risk and need to be screened earlier. Funding sources such as insurance
companies need to comply with current screening recommendations and may be told to cover
more expenses due to new laws for earlier or new screenings. Also, insurance companies are

CANCER PREVALENCE LAKE COUNTY

involved in covering much of the expense for cancer treatment further making them a
stakeholder in this intervention.
Tertiary Level of Prevention
The intervention would be focused on the individual and would involve monitoring
treatment and treating and preventing side effects of treatment. Treatment may include surgery,
chemotherapy, radiation, and/or targeted therapy (American Cancer Society, 2015). Side effects
of treatment can include pain, nausea, vomiting, fatigue, anemia, infection, and lymphedema
(American Cancer Society, 2015). At this level, prevention of complete disability or death and
cure would be the objectives. The stakeholders would be healthcare providers and insurance
companies. Healthcare providers need to follow and implement treatment of cancer. The
insurance company is needed to cover much of the individuals medical expenses. Nurses in this
stage would advocate for their patient to ensure the best treatment. Collaboration between the
healthcare team would occur, and case management would be involved in care. Other
interventions from the Intervention Wheel Model would be heath teaching, referrals, and followups.
Health Policy Proposal
Implementing the primary level of prevention of reducing modifiable risk factors for
cancer would be a goal of the health policy. By encouraging Lake County residents to achieve
and maintain a healthy weight and exercise regimen, their cancer risk decreases. This will move
towards the goal of reducing cancer and cancer related deaths. Community members will be
involved by being encouraged to maintain healthy weights. Public officials and legislators may
be involved when planning events to promote the health policy to the community; they will also
be involved when getting permission and funding when distributing educational materials.

CANCER PREVALENCE LAKE COUNTY

Communication with public officials will allow the proposed health policy and its importance to
be discussed and distributed to the community. Health care providers should be reminded to
educate their patients on the importance of healthy diet and exercise. Funding sources will need
to be contacted if events are planned to promote the proposed health policy.
Supporters of the policy will be those with cancer, those that have known someone with
cancer, those in favor of a healthy lifestyle, and those with other coexisting medical problems
that can benefit from the policy. Opponents of the policy may be those who would prefer funding
sources to fund other issues, such as other health problems or county programs.
The health policy proposal would begin by finding a group to help take action for the
policy. The group could go speak to county officials about including education at community
events. The group could also contact the American Cancer Society and the Centers for Disease
Control and Prevention in order to access educational materials. The group could then get
permission from officials and businesses to put these materials in county offices and different
businesses.
The proposed health policy will not only help those wanting to prevent cancer, but many
other health problems. With proper education, residents of Lake County can make a positive
change for their health which will reduce their cancer risk. Those with unmodifiable risk factors
for cancer can and should eliminate their modifiable risk factors to reduce cancer.
Cancer is Lake Countys number one cause of death. Cancer can be caused by a multitude
of factors. In order to reduce the countys risk of cancer and cancer related deaths, modifiable
risk factors must be the focus. Major modifiable risk factors for cancer are being overweight,
eating a poor diet, and being physically inactive. These risk factors can be mitigated through
primary and secondary prevention, which include education and screening. Cancer related deaths

CANCER PREVALENCE LAKE COUNTY

can be prevented through secondary and tertiary prevention, which includes treatment and
management of treatment. A heath policy proposal would encourage education to Lake County
residents to reduce their risk factors for cancer, in hopes of reducing cancer rates and deaths.

References

CANCER PREVALENCE LAKE COUNTY

10

American Cancer Society. (2015). American cancer society guidelines for the early detection of
cancer. Retrieved from
http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/americancancer-society-guidelines-for-the-early-detection-of-cancer
American Cancer Society. (2015). Treatments and side effects. Retrieved from
http://www.cancer.org/treatment/treatmentsandsideeffects/index
Florida Charts. (2014). Lake County, Florida 2014 County Health Profile. Retrieved from
http://www.floridacharts.com/charts/CountyHealthProfile.aspx?
county=35&reportYear=2014&tn=31
Hiatt, R. A., & Breen, N. (2008). The social determinants of cancer. American Journal of
Preventive Medicine, 35(2), 141-150. doi:10.1016/j.amepre.2008.05.006
Jemal, A., Bray, F., Center, M. M., Ferlay, J., Ward, E., & Forman, D. (2011). Global cancer
statistics. CA: A Cancer Journal for Clinicians, 61(2), 69-90. doi:10.3322/caac.20107
Lake County Economic Development Department. (2014). Community profiles: major
employers. Retrieved from
http://www.businessinlakefl.com/CommunityProfile/Industry/MajorEmployers
Office of Economic and Demographic Research. (2015). Lake County. Retrieved from
http://edr.state.fl.us/Content/area-profiles/county/lake.pdf
Office of Disease Prevention and Health Promotion. (2015). Cancer. Retrieved from
http://www.healthypeople.gov/2020/topics-objectives/topic/cancer
Thun, M. J., DeLancey, J. O., Center, M. M., Jemal, A., & Ward, E. M. (2010). The global
burden of cancer: priorities for prevention. Carcinogenesis, 31(1), 100-110.
doi:10.1093/carcin/bgp263

CANCER PREVALENCE LAKE COUNTY

United States Census Bureau. (2015). Lake County, Florida. Retrieved from
http://quickfacts.census.gov/qfd/states/12/12069.html

11