Term Paper on "Diabetes: An Example of a Public Health"

Term Paper 5 pages (1686 words) Sources: 5

[EXCERPT] . . . .

Diabetes: An example of a public health action plan

Diabetes is a metabolic disease in which the body does not produce enough insulin or cannot properly use the insulin it does manufacture. "Insulin is a hormone that is needed to convert sugar, starches and other food into [the] energy needed for daily life" ("All about diabetes," ADA, 2007). Diabetes may be easy to define, but it a terrible and complex disease and one which the public and even modern medicine has trouble fully understanding. There are two different kinds of diabetes, Type I and Type II. Type I Diabetes is mainly genetic in its origins. The ailment is usually diagnosed in children and young adults. In this form of diabetes, the body stops producing insulin ("Type I Diabetes," ADA, 2007). Treatment usually requires the patient to use synthetic insulin for most of his or her adult life, and follow a special diet to control spikes or rapid drops in blood sugar.

However, in Type II Diabetes, the body does not produce enough insulin or the cells ignore the insulin produced by the body. Once, Type I Diabetes was called juvenile diabetes because Type II usually occurred in older, sedentary, and overweight adults. Sadly, because of the increased rates of obesity in America, younger and younger children are being diagnosed with what was once called adult-onset diabetes. "Children today may be the first generation in America that have shorter life expectancies than their parents" if current trends in childhood weight gain and physical inactivity continue, and one of the primary reasons for this shortened expected lifespan is the epidemic of Type II Diabetes (Livingston 2004: 2). The risks of diabetes include long-term damage to the sufferer's eyes, kidneys, nerves or heart ("Type II Diabetes," ADA, 2007).

The one 'bright' side to Type II Diabetes is that, unlike Type I Diabetes, it is preventable. It can even be contained if diagnosed early or ideally if at-risk populations who are overweight and sedentary change their lifestyles. It should be noted that there still is a genetic component to Type II Diabetes as it is more common in African-Americans, Latinos, Native Americans, and Asian-Americans and Pacific Islanders ("Type II Diabetes, ADA, 2007). But rates of Type II diabetes are increasing in all ethnic groups because of increased rates of obesity and decreased levels of physical activity in society.

Nationally, one in five children is overweight. These children are at the highest risk for having Type II Diabetes in their future. Solano County in California has a higher rate of overweight children and youth than in the state of California as a whole, and the state of California already as a higher rate of overweight children than the nation (Livingston 2004: 1). The statistics for Solano County are grim: over 31% of Solano children ages 2-5 are overweight or deemed significantly at risk because of their high BMI (Body Mass Index). Of children ages 5-20 years old, 38% at are overweight or significantly at risk for becoming overweight. Fifty percent of overweight children and teens will remain overweight as adults.

To take proactive community action against the health risks threatening future generations, Solano County developed an organization known as the Children and Weight Coalition of Solano County (CWCSC) of over 75 agencies and individuals to develop and implement effective solutions to the county's problems and at-risk populations. The organization encourages parents, educators, and community organizations to promote healthy, noncompetitive physical activities, reduce the consumption of junk food available to students, and promote a healthy lifestyle (Livingston 2004: 2). At present, 30% of Solano County youths do not engage in physical activity. A preventative strategy for diabetes treatment is best, and also these initiatives can help children who are already overweight, obese, or who even have diabetes, although exercise and healthy eating are not a replacement for medical attention, if necessary (Livingston 2004: 1).

The Children and Weight Coalition of Solano County (CWCSC) developed a strategic plan with action steps not simply on countywide basis but also step specific to the needs of each community within the county: Benicia, Dixon, Fairfield-Suisun, Rio Vista, Vacaville, and Vallejo. "Four strategic directions were identified as having the greatest impact on children and their environments: Home and Family Environment, School Environment, Community Environment, and Health Care Systems" (Livingston 2004: 3). An ecological model was adopted that addressed the obesity and Type II diabetes crisis from a legislative, media, government, food supply, health care, community, school, home, and child-centered approach.

One of the unique aspects of the action plan was the fact that each community tailored the plan to its own unique needs, although all communities had specific action plans for the school, community, health care systems, and families. For example, in Benicia, the highest priorities for that area in a section entitled "food choices" was to educate parents and kids on importance of eating healthy food, establish healthy food (snack) days, and to encourage families to provide more time to enjoy food at meal times while eating less. All of these specific steps worked to further the goal of weight reduction ("Children and Weight: Taking Action in the Benicia Community." May 29, 2003). However, in the Dixon community to achieve similar goals, the priority actions for Food Choices were to include more nutritious foods in vending machines, more nutrition education in schools, and only then to prioritize more nutrition education for parents and community members ("Children and Weight: Taking Action in the Dixon Community," 2004).

This order of priorities reflected the fact that in Dixon, many children depended upon the schools for their primary nutritional needs, because of economic reasons. Although this may not be an ideal situation, to address the problems of students in the short-term, changing the foods available in the vending machines and making students aware of the best ways to navigate the terrain of the school cafeteria would create more effective results than simply trying to change everything at once, and demand that students bring their own snacks, or that the area be targeted for economic improvement to reduce dependence on subsidized school lunches.

Other communities stressed creating healthy and fit days that were tailored to the ethnic composition and culture of the students. In primarily Hispanic Vallejo county, creating ethnic recipes that would be palatable to families and children but would help them meet their weight and budgetary goals were a priority of the action plan ("Children and Weight: Taking Action in the Vallejo Community," 2004). This reflects the idea that weight reduction is not merely an act of individual willpower -- rather to treat diabetes; one must treat it as a public health problem of a specific community. To instruct children to eat lower calorie foods that do not reflect their culture, and are perhaps not available or economically feasible for their parents to purchase is not a long-term solution. Becoming health and avoiding diabetes should not require children or their parents to give up their culture; rather aspects of the culture and cuisine that are healthy must be emphasized.

Physical activity is another critical component of diabetes prevention. However, quite often children in less affluent communities do not have access to after school sports activities, or streets and playgrounds where it is safe to play. Diabetes treatment as a public health issue, as both a preventative strategy and also for persons already afflicted with diabetes, requires some form of exercise to minimize weight gain and maximize weight loss for the already overweight. Dixon's action plan, for example, stressed the need for physical education within the schools, as students did not always have opportunities to exercise outside of school. It expanded non-competitive forms of enjoyable activity, as not all students had the ability, inclination, or finances to engage in formal, organized competitive sports ("Children… READ MORE

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