Epidemiology Paper
Allison Brown
Nur 408
May 14, 2012
Prof. Pamela Orr

Epidemiology Paper

People have many health concerns and diagnosis that presents to the current public health as daunting. The first step in any medical situation regarding a person’s health is prevention that is talked among the professionals in the health community. This will be the only way to help the cycle to break that will further prevent other diseases from occurring. Using epidemiology and the epidemiology triangle diabetes in African Americans will be observed. This health concern in many communities in the United States can be prevented and helped, but information is the key to success.
In this paper we will be examining the definition and description of epidemiology, the steps and methods of epidemiology, reviewing the data of the selected population. We will also be looking at the epidemiological triangle as well as various levels of prevention. Epidemiology is the study of the distribution and determinants of health-related states or events (including disease), and the application of this study to the control of diseases and other health problems. Various methods can be used to carry out epidemiological investigations: surveillance and descriptive studies can be used to study distribution; analytical studies are used to study determinants (WHO, 2012). Epidemiology is a type of science that guides our understanding of the strong points of how exposure and the relation to how it effects our health. Epidemiology can be used for many things such as the use of occupationally associated illnesses (Stanhope & Lancaster, p. 222, 2012). According to the Center of Disease and Control, epidemiology is the study of the distribution and determinants of health-related states or events in specified populations and the application of this study to control health problems (CDC, 2006). Epidemiology is able to put a measurable scale for the type of level of health. The scale would range from very good conditions that have energy varying down to the people that are decently well, down to the people that are fairly ill and not as well to the most people that are ill. This made the connection that health can be quantitatively measured and studied for the advances of diseases. This placed more of an acknowledgement in regards to the environment. Studies of epidemiology basis help to bring an understanding to the learning disabilities to many disease processes like exercise and heart disease. Environmental surveillances are able to provide data in regards to certain topics that allows tracking and better analyses for target populations. (Scuthfield & Keck, p. 27, 2009). Steps and methods for epidemiological studies are to confirm the occurrence of the disease causing a legitimate concern in the community. Gather information and statistical finds regarding the events. These include hospital records, censuses, and further studies help gather information for the incidence and prevalence of the events that occurred.
Diabetes is a bunch of diseases that are marked by high levels of blood glucose resulting of defects of the pancreas in insulin production, insulin action, or both. Complications can arise from this disease, but there are steps that can control the progression of this disease. There are two different types of diabetes. Type 1 (used to be called juvenile diabetes) happens when the body’s immune system attacks and damages the beta cells from pancreas. Patients with this type need to have insulin delivered by injection or a pump. Symptoms for these patients are increased thirst, urination, hunger, weight loss, blurry vision, and increased fatigue. If this is undiagnosed or treated, patients could drop down into coma that could be life-threatening. Type 2 (also known as adult diabetes) is when the body doesn’t make enough insulin are the body cannot use it properly. This type of diabetes could occur at the ages of 20 years or more. The symptoms are a sensation of feeling ill or tired, thirst, urination, weight loss blurry vision, recurrent infections, and wounds that heal slowly. Of these populations that require better analysis in regard to their population and health situations are African Americans and their relation to diabetes.
The data on this population according to American Diabetes association 3.7 million or 14.7 percent of African Americans 20 years or older has diabetes. More than 23.6 million people have diabetes in the United Sates, and pre-diabetes is common that previously thought. On average, African Americans are two times as likely to have the disease then Caucasians. African Americans are 1.8 times more likely to have diabetes than non Hispanic whites. Also 25 percent of African Americans between the ages of 65 and 74 have diabetes and 1 in 4 African American Women over 55 years of age has diabetes. Diabetes has been associated with many serious, life-threatening complications. Although many people are unaware they have developed this disease until they have one of the many complications. Of the complications diabetics can develop are blindness, kidney disease, amputations, heart disease, stroke, and nerve damage. Blindness in African Americans is likely to develop 50 percent to develop retinopathy as non-Hispanic whites. Kidney disease affects this population 2.6 to 5.6 times more than the 4,000 new cases that are diagnosed for End Stage Renal Disease a year. Amputations occur 2.7 times to get lower limb amputations and the rates between men and women are 1.4 to 2.7 higher for men. Heart disease and stroke happen about 65 percent of deaths for African Americans that have diabetes. The death rates for men for heart disease have decreased by only 13 percent compared to 36 percent of men that do not have diabetes. African American women have a death rate of 23 percent from the last 30 years as opposed to women without diabetes. Nerve damage (also known as diabetic neuropathy) can cause stinging and burning sensations, tingling, numbness in the hands and feet which gives patients an increased risk of injury and amputation to the extremities (American Diabetes Association, 2012). Steps to prevent complications of this disease are keeping blood glucose levels, blood pressure, and cholesterol levels. They could do this by diet, exercise and healthy living. To reduce the occurrence of diabetes and complications in minorities are to have early screenings and early treatments. Patients and providers need to improve care for the control and treatments of complications of diabetes. Also, for research for this disease clinical trials are conducted to prevent the onset of diabetes due to minorities are more likely to be affected by diabetes. Around 3.2 million deaths occur from diabetes every year that is related to the complications of diabetes, calculating to six deaths every minute. The health care cost range from 2.5% to 15% of the annual health care budgets, this depends on the local diabetes prevalence and difficulty of treatment that is accessible. It is estimated that there will be 336 million people to have diabetes by 2030 (Death to Diabetes, 2012).
The epidemiological triangle defines the relationship between agents (which could be chemical mixtures). This is “what” part of the triangle. Host is the community with people of different age, gender, ethnicities, cultures, and disease and states. This is the “who” part of the triangle. Then, there is the environment, which includes factors such as air, water, earth, food, temperature, humidity, and wind. This is the “where” of the triangle. This is a tool that scientists have come up with to study health problems and understand infectious diseases and how they spread. The other tool to use for research is called graphic information system. This system is a method that involves obtaining data that relates to the orientation to the Earth. (Stanhope & Lancaster, p. 222, 2012). The difference between descriptive and analytical epidemiology is that descriptive epidemiology work with the questions of : who, what when and where. Whereas analytical epidemiology figures out the rest of the questions of: why and how. Descriptive epidemiology gives a systematic method of characterizing health problems. This allows for understanding of the basic aspects of a health problem. This also helps with showing populations that are more of a high risk for a certain health issue. This does not allow for comparison of health groups or populations. Analytical data is utilized to identify the cause of the disease. This involves a study to be able to test the hypotheses that is developed from using the descriptive epidemiology. In the case of Diabetes and the prevalence of it in African Americans, it would relate to a descriptive epidemiology. This type of epidemiology uses who, what, when, and where of this disease. Who of this disease are African Americans, what is diabetes. Diabetes occurs when the islet cells of the pancreas do not function properly in production and absorption of insulin. The where of the descriptive epidemiology occurs for anyone with the predisposing factors of diabetes. Prevention is best for any disease to happen. Prevention for diabetics includes various activities. This includes, checking cholesterol levels, being overweight, smoking, physical activity, blood pressure, eating habits, age, race, gender, and family history are all involved in prevention. Cholesterol is a form of fat that floats in the blood stream in two forms of bundles or lipoproteins. Low-density lipoproteins (LDL), bad cholesterol can cause a backup of cholesterol in the arteries. The lower the LDL, the better off the heart will be. High-density lipoproteins (HDL), good cholesterol assists in taking out the bad cholesterol from the body. The higher the levels are the better. Triglycerides are another form of fat in the blood stream that can cause an increase chance of stroke, if the levels are high. Blood pressure is the force of blood that flows within the blood vessels in the body. The numbers to obtain are 120/80. Top number pushes the blood through to the body. Second number is pressure relaxes between beats. The higher number the more a person is at risk for stroke, heart disease, and others. Smoking lowers the oxygen that is trying to get to the organs by attaching a different component to the blood, which inhibits the oxygen to hook onto the blood cells. Physical activity keeps glucose levels, blood pressure, cholesterol and triglyceride levels within normal limits. Eating a healthy and balanced diet to regulate a healthy weight can help with the body. These are the things that can be done to prevent diabetes from happening. Things that can not be changed to prevent diabetes are age, race, gender, or family history. Being aware of these factors can make healthy choices in the right direction (American Diabetes Association, 2012). Epidemiology assists the health care field in many ways, which will continuously grow over time, education, and research to further the field of health.

References
Scuthfield, F. D., & Keck, C. W. (2009). Principles of Public Health Practice (3rd ed.). Retrieved from The University of Pheonix eBook Collection.
Stanhope, M., & Lancaster, J. (2012). Public Health Nursing (8th ed.). Retrieved from The University of Pheonix eBook Collection. http://www.diabetes.org/living-with-diabetes/complications/african-americans-and-complications.html http://www.who.int/topics/epidemiology/en/ http://www.cdc.gov/mmwr/preview/mmwrhtml/su5502a2.htm http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=3&lvlid=62 http://www.deathtodiabetes.com/Diabetes_-_Epidemiology.html http://www.diabetes.org/diabetes-basics/prevention/checkup-america/