This paper will center on the vulnerable population of Mexican-American immigrants with chronic type II adult-onset diabetes and how this affects this growing population. The definition, description, steps, and method of epidemiology will facilitate the discussion. Routine data such as demographics, census, birth, death, and surveillance records, and research data such as medical and health records, will bring pertinent information to the study. The Epidemiological Triangle and which type of epidemiology study that was used will be explored.
A description of the relationship of the disease levels of prevention will conclude the paper. Diabetes Type Two Adult According to “Healthy People. gov” (2012), “Diabetes occurs when the body cannot produce or respond appropriately to insulin. Insulin is a hormone that the body needs to absorb and use glucose (sugar) as fuel for the body’s cells. Without a properly functioning insulin signaling system, blood glucose levels become elevated and other metabolic abnormalities occur, leading to the development of serious, disabling complications.
People from minority populations are more frequently affected by type II diabetes. Minority groups constitute 25 percent of all adult patients with diabetes in the United States and represent the majority of children and adolescents with type II diabetes” (Overview). Many Mexican-Americans go undiagnosed for years, and it is only when the foot ulcers show up and get infected that they go to their health care professional and discover that they have diabetes. The Definition and Description of Epidemiology
Stanhope (2012) stated, “Epidemiology is the study of the distribution and determinants of health-related events in human populations and the application of this knowledge to improving the health of communities. Epidemiology is a multidisciplinary enterprise that recognizes the complex interrelationships of factors that influence disease and health at both the individual level and the community level; it provides the basic tools for the study of health and disease in communities” (p. 282). The rate of obesity among Mexican immigrants is rampant.
The impact of obesity has resulted in more healthcare-related illness such as heart disease, vascular disease and diabetes. Many of the factors that lead to diabetes are socioeconomic as well as cultural. In order to head off this potential epidemic, the factors related to both the individual and the community need to be recognized and explored. Dealing with the health-related events and applying the newfound knowledge to helping Mexican-Americans become healthier is a proactive measure that will impact the future healthcare system. The Steps and Methods of Epidemiology
The steps of epidemiology include surveillance of the event; in this case it is the collection and interpretation of data as it is related to diabetes in Mexican-Americans. Some of the routine data, such as census, birth, death, and surveillance records are not available to the public (California Health Interview Survey, 2012). . Therefore the data necessary for this step is limited to the recommended websites for the California Health Interview Survey (CHIS) and the National Health Interview Survey (NHIS), and the Behavior Risk Factor Surveillance System (BRFSS), which can be used to gather pertinent data.
The medical records and health records are also not available to the general public, so the review of research data will be assimilated through the aforementioned websites. According to Preventing Chronic Disease (2007), “Diabetes prevalence among Hispanics is approximately twice that among non-Hispanic whites (5-8). Consistent findings also relate type II diabetes in the Hispanic community with obesity (5-7,9), low income level (7-9), low educational level (7-9), and low level of health insurance (10), all of which are highly prevalent in the U. S. –Mexico border region.
In fact, a growing body of research suggests that diabetes is a far too common and rapidly growing problem among Mexican Americans living on the U. S. side of the U. S. –Mexico border (11). Recent health studies found that diabetes prevalence among Hispanics living near the border is more than twice the prevalence among non-Hispanics who live in the same region (12,13). These findings suggest to the public health community that diabetes is reaching epidemic proportions in the U. S. –Mexico border region (14)” (Diabetes Hospitalization at the U. S. -Mexico Border).
Stanhope (2012) stated, “Epidemiologic methods are used to describe health and disease phenomena and to investigate the factors that promote health or influence the risk or distribution of disease. This knowledge can be useful in planning and evaluating programs, policies, and services, as well as in clinical decision making” (p. 282). According to Preventing Chronic Disease (2007), “In 2000, a report from CDC’s National Center for Health Statistics showed that diabetes was the sixth leading cause of death in the United States: 25. 2 deaths per 100,000 standard population (1).
In addition, in 2004, CDC’s National Center for Chronic Disease Prevention and Health Promotion stated that more than 17 million Americans have diabetes and that 200,000 people die each year of complications associated with this condition (2) (Diabetes Hospitalization at the U. S. -Mexico Border). Epidemiology Triangle Stanhope (2012) stated, “Epidemiologic models explain the interrelationships between agent, host, and environment (the epidemiologic triangle) and the interactions of multilevel factors, exposures, and characteristics (causal web) affecting risk of disease” (p. 82). The host in this case would be the Mexican-American whose personal traits and behaviors lead to the development of obesity, the agent is physical inactivity and overeating and lack of exercise, and the environment would be their social and economic conditions that limit their exposure to proper health care facilities and knowledge of the disease process combined with social and cultural ramifications. The Type of Epidemiology
The type of epidemiology used for this topic is descriptive because, as Stanhope (2012) stated, “Epidemiologists investigate the distribution or patterns of health events in populations in order to characterize health outcomes in terms of what, who, where, when, how, and why: What is the outcome? Who is affected? Where are they? When do events occur? This focus is called descriptive epidemiology, because it seeks to describe the occurrence of a disease in terms of person, place, and time” (p. 282).
This type of epidemiology is used to determine the extent of diabetes and how the rapidly growing population of Mexican-Americans will impact the economy and the future of healthcare. The person includes the risk factors, education, occupation, ethnicity, diet and exercise. The place is where the population is, the density, economic development along with nutritional, and medical practices. Time is, since the event took place, age, and cycles or trends that might affect the disease process. Levels of Prevention
The levels of prevention for diabetes include understanding of how Mexican-Americans view diabetes as a health issue. Establishing a knowledgeable foundation from which to empower and provide unbiased information will enable a people to incorporate a healthier way of life. Understanding how Mexican American immigrants view obesity in their cultural will enable health care professionals to analyze certain beliefs and establish better programs to facilitate knowledge that already exist within in the community.
Education is a necessity in empowering Mexican Americans to improve their life style and incorporate better food choices and not let excuses get in the way of daily exercise. According to Lopez (2011), “Food availability is the second domain analyzed with regard to factors preventing proper health. Respondents had the knowledge of what a balanced diet includes; it was the cost of acquiring the ‘healthy’ products that prevented them from putting into practice their knowledge of proper health.
One example of not being able to practice one’s knowledge is embodied in an anecdote told to me by a non-profit group’s volunteer assisting in nutrition education workshops. A government spokesperson was explaining the 5-a-Day program at a health and nutrition workshop. At the end of his lecture a woman stood up and stated, “5 a day? There are eight in my house, which equals forty pieces of fruit! ” [referring to the price of forty fruits and vegetables]. This anecdote fully illustrates the current problem.
It is not that Mexican immigrants are ignorant of the biomedical ideals and standards of health; social forces play a larger role in the individual’s ability to implement this idea” (Food Affordability). Why is a piece of fruit so expensive? Why does an apple cost a dollar and a Happy Meal just as much? People know that fruit and veggies are better for them than fast food. Here in America where the availability of fast food is easier than healthy food or no food at all, I think that many immigrants don’t have a choice. It is easier to feed a family of eight with fried chicken from a fast food chain than it is to cook it at home.
Another level of prevention was promoted by the CDC and according to Preventing Chronic Disease (2007), “In 2000, to address the priority health problems of the population along the U. S. –Mexico border, the U. S. –Mexico Border Health Commission (USMBHC) initiated a disease prevention and health promotion program called Healthy Border 2010 (15). This program is similar to the U. S. program Healthy People 2010 (16), of which the main goals are to improve the quality of health and increase the years of healthy life for all people, and to eliminate health disparities among population subgroups.
To address health issues at the border, a panel of health experts sponsored by the USMBHC identified a set of health goals and established a 10-year program to eliminate or minimize the effects of selected diseases and conditions in the border region” (Diabetes Hospitalization at the U. S. -Mexico Border). Conclusion The growing number of Mexican-Americans in the United States is growing at six times the national average according to (El Nasser, 2004). Hispanics surpassed blacks as the largest minority group in 2002, when their numbers hit 38. 8 million” (Census Projects Growing Diversity By 2050: Population Burst, Societal Shifts). At the rate the population is growing, the impact that type 2 diabetes adult onsets will have on the national health care system is going to be a major problem. Poor access to healthcare facilities and education about the ramifications of obesity leading to major healthcare issues, such as diabetes, are rampant among the Mexican-American immigrant population.
Food choices are limited to the socioeconomic conditions in which they live; access to fast food is more readily available than fresh produce. The problem is not lack of knowledge about diabetes; it is the resources to change the lifestyle that are delinquent. Only when we start addressing safe neighborhoods in which people feel safe and have a sense of belonging and ownership can we start addressing exercise and diet. Change is difficult, but we need to address the problem now before diabetes becomes the number one leading cause of death in the United States.
Courtney from Study Moose
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