Assignment #12

There are a range of key determinants in studying depression within the obese community in the United States. The determinants with the most importance fall into the biological, social, and environmental categories. Since this is a field that has been just recently looked into, researchers are still unsure if obesity causes the depression or if depression causes the obesity. Nevertheless, it is now becoming more and more evident how closely linked depression and obesity are, and because of these findings, some of the key determinants for depression in obese people have a strong overlap with those solely of the obese population.

One key environmental determinant is the distinction between rural and urban environments in America. There is a higher frequency of restaurants in urban areas. This means that just based on location there is more access and availability of food and a difference in eating lifestyles compared to those who live in rural areas. There is also more exposure to media in urban areas as opposed to rural, such as advertisements and merchandise in malls and the malls themselves. This lends to social and cultural pressures which will be discussed in further detail later. Also in today's society walking is not as prevalent an activity as it was in the past. There is a huge emphasis on speed and efficiency in American culture, therefore decreasing the appeal of physical exercise in order to travel from location to location.

Some of the most pressing and substantial key determinants are biological. Researchers have put forth that are a psychological reasons why depression can lead to obesity and obesity can lead to depression. Obese people can develop depression because of their negative perspective of their appearance giving them low self-esteem. Conversely, individuals suffering from depression are at risk of becoming obese because alterations they may experience physiologically in their immune and hormonal systems. Living in such a state, it is possible that those dealing with depression may lose the will to take care of themselves and therefore letting their bodies fall into an unhealthy state. Researchers have also found a hormonal link between obesity and depression – the HPA axis. This pathway in the brain links the hypothalamus and the pituitary and adrenal glands. “These three points of the body work together to maintain chemical equilibrium when the body is under stress. The HPA axis is responsible for releasing cortisol, the so-called 'stress hormone.' It plays a critical role in energy metabolism as well as other functions. The problem is, cortisol prompts the body to deposit fat around the abdomen, a pattern that is especially hazardous to health.”¹ Excess production of cortisol causes excess deposition of fat which could put an individual at risk of becoming obese.

The social and cultural factors hold the same importance as the biological factors. In the United States, there is a strong, relentless fixture on perfection. There is competition to be the best in terms of finances and education but one of the greatest focuses in our society today is on physical appearance. Magazines, television, and even the local clothing stores are full of images projecting the only ideal of beauty is stemmed from being slender. Our society does not appreciate or admire people that even just look overweight to the eye, not to mention obese. Living in a society such as this can only foster negative feelings of self-doubt and self depreciation those that are obese in our community. This social hostility that surrounds America's obese community definitely effects the biological facets of the disease. The stress that comes from being made fun of as an obese child or not being able to fit into an airplane seat, can build up and trigger the release of more cortisol adding additional fat deposits on the body. This is a basic skeleton of how the cycle starts and continues, the issue at present is how to make it cease.

Sources:

1. http://www.psychologytoday.com/articles/200305/the-obesity-depression-link

assignment #10

In recent searches it has been found that obesity and depression in children and adolescents in the United States are developing hand in hand. In 2007 it was estimated that the prevalence of depression in children up to age 12 is 2% and 4 – 8% in adolescents, ages 13 and above. And an estimated 17 – 13% of adolescents are obese. Doctors are discovering it difficult to pin point which issue definitely causes which. Obesity and depression have overlapping, underlying symptoms which include increased stress and inflammation, negative self image, unhealthy appetite and food intake, sedentary behavior and sleep apnea. Several studies have found that children and adolescents that are obese have a higher chance of experiencing depression and other psychological issues. Similar studies have proven that youth who are depressed have an increased chance of becoming obese.

The social environment of the United States plays a large role in this growing epidemic. We live in a society in which the economy thrives off of the over-consumption of the population, however there is a strong social stigma against those who participate in this excess consumption. Fast food corporations dominate the food industry in major cities all across America. They have specified kids meals that include toys – their sole purpose is to attract children. The cheap prices of these establishments make it an easy place for teenagers to spend their limited funds. While this is being advertised, popular culture promotes something else. The “media popularizes and promotes false ideals. Being glamorous, having a perfect body, being rich and famous, having perfect skin and hair, a great car, lots of girl/boyfriends - these are the kind of images teens are constantly bombarded with. Trying to be 'cool' and measure up to these unrealistic standards puts huge pressure on many teenagers which can lead to low self-esteem and depression.”

This leads to a vicious cycle fostered by our own society. It may not be intentional, but we our slowly killing our community with the negative encouragement offered by different food industries as well as the accepted image of beauty in the media. Doctors have previously been attempting to treat obesity and depression, especially in youths, as two separate issues. But now after observing the prevalence of one where ever the other exists, it is becoming more apparent that there needs to be a way to treat the two diseases together.

Sources:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2568994/

http://www.depression-recovery-life.com/teen-depression.html

Assignment #9

In my final paper I plan to address the issue of obesity and its supreme affect on this nation as well its growth throughout the world as a whole. I would like to focus mainly on childhood obesity because it is an issue that has worsened greatly over the past few decades. Because of childhood obesity, individuals are developing severe life-threatening diseases and afflictions that could be otherwise avoided had they not suffered from obesity at such young ages. This disease is lessing this generation's projected life expectancy by five years. Obesity is a problem that is annually impinging more and more lives within an extremely broad range of ages. One of the biggest dangers of obesity is developing diabetes. This is so dangerous because seventy-five percent of diabetic individuals ultimately die of cardiovascular disease – cardiovascular disease is the leading cause of death.

So many people, especially in the United States seem to be unaware or dismissive of the damage that obesity is inflicting among the population beyond the aesthetic stigma that society has placed upon it. In children in particular, obesity and even being overweight has a strong impact on their emotional health as well as their physical health. In many cases an overweight or obese child is not fully accepted in his or her community solely because of his or her appearance. This is also common among adults in social and working environments. Because of this exclusion, these individuals are left in isolation to wallow in thoughts of shame and self-disgust. These are the makings of emotional unhealthiness which can, in some cases, trigger additional eating to provide comfort – thus starts the cycle that fosters the increasing levels of obesity.

This topic is important to me because several members of my extended family struggle with problems with being overweight or obese. And though it has been proven that a major portion of obesity cases are caused by genetic means, I am aware that the habits and choices that some of my family members make on a daily basis do nothing but deteriorate any chances they have for good health. Obesity is a threat that is easily and swiftly capturing the lives of the American people, and I feel that it would be a terrible shame for it to spread its demolition to members of my family or any other individual because of his or her lack of knowledge of the dangerous nature of the issue.

Assignment #8

I think that many of the topics that we have gone over in the first half of the course have been very interesting. Interesting in the way that my mind was exposed to various terminology and themes and at the same time the professors and presenters gave me tools to learn the proper ways of approaching and developing theories about public health issues. I especially enjoyed learning about international health, epidemiology, and chronic and infectious diseases. I think these areas were intriguing to me because they seemed to overlap the most into the medical field out of all of the other topics we covered. I would really like to work in the international health field mostly because of the grand scheme of the global boundlessness of that field. It was also interesting to learn the facts behind obesity in America because it is a dire issue currently plaguing our nation. I know several people that suffer from obesity and learning about it makes me want to make the public more aware of how to protect and improve their health to prevent obesity from affecting them.

I did not expect to learn about injury prevention during this public health course. I had not previously considered injury prevention to be one the responsibilities of the public health field. Before this course when public health came to mind I thought about illness and not about general maintenance of a health lifestyle. Now after taking half of this course I understand that injury prevention is a large and important part of public health and that it is inevitably a part of everything in our lives. There would be much more harm ready to hurt many individuals in injury prevention was not an integral part of public health responsibilities.

I think that I have the same interests before, but now they have expanded. I now realize that issues such as obesity and smoking that are plaguing our nation are just as important as issues that need to be addressed globally. I understand that nearly every topic within public health can be translated into the medical world and that a good base and knowledge in this discipline would prepare me for a great future in the medical field. My interest level is seemingly the same, if not now a little more amplified. Now that I have been given a peep as to how the future of our nation and the world as a whole, relies almost solely on maintenance and advancements in public health, I truly understand public health's importance and would really love to be a part of it.

Assignment #7

The main goal of the health reform bill that was passed this week is to institute a plausible plan of ensuring health care for as many American citizens as possible. Though it may not be possible to guarantee that every single individual in the United States has adequate healthcare, this bill is an optimistic step in that direction. Every president before Barack Obama has made an attempt at passing a bill of this nature, the Obama administration, however, can claim being the first to succeed. Some of the main goals of this bill include, a “new competitive health insurance market,”¹ which means that every citizen, regardless of their socio-economic status can gain access to the same insurance policies. Another important goal is “greater accountability to healthcare.”¹ This essentially creates an increased responsibility for the provided healthcare administrators to lay out guidelines which would force premiums to remain low and cease occurrences of individuals being denied care. It also proposes to “end discrimination,”¹ against citizens who previously have suffered with conditions that inhibit proper access to health care. And furthermore the bill hopes to bring the “budget and economy on a more stable path.”¹ This will be quite a feat to accomplish, considering the significant amount of debt this country has sank into over the past decade.

Generally speaking, the Democrats are in higher favor of the bill as compared to the Republican party. The concentration on giving aid and support to America's poor population as well as America's youth and young adults falls under ideals that most Democrats believe in vehemently. Republicans do not share this same feeling towards the reform. “No Republican lawmakers voted for the 10-year, sweeping package that Obama signed Tuesday and will shape how almost every American will receive and pay for medical treatment.”2 It is highly possible that the owners of insurance companies are not in total agreement with the passing of this bill. Within a few years if the Obama administration's plans are fulfilled accurately, premiums should be lowered for Americans and because of this the insurance companies will have to settle for less money in their pockets. This reform is a positive move for small business that previously struggled to maintain health insurance and proper healthcare due to the comparative insignificance to larger businesses.

Personally, I am in favor of the bill. One part that is of great importance to me is that I will be covered under my parents insurance until I reach the age of twenty-six. This will be immeasurably helpful for me and all the other members of my generation, especially those of college age. It is also very comforting to know that when I am able to support myself that I will be able to do so to the fullest extent. I am put at ease to know that people are hard at work to make sure that every American citizen will have access to healthcare because even though I currently attend a prestigious university and plan to use this education for a prosperous future, one can never predict what the future may bring.

Sources:

1. www.healthreform.gov

2. http://voices.washingtonpost.com/44/2010/03/rundown---032610.html

Assignment #5

We were given an article to read, “The Challenge of Global Health,” written by Laurie Garret of Foreign Affairs. The article discusses the hardships generating and maintaining legitimate money sources to help with diseases and other areas of public health in developing countries.

The author suggests several reasons why global public health is worsening despite the constant increase in monetary resources. I found three that seemed to be extremely pertinent. One is that the “efforts this money is paying for are largely uncoordinated and directed mostly at specific high-profile diseases--rather than at public health in general....” With a lack of coordination and proper direction, one cannot expect positive results and improvements. Given the advanced nature of the developed nations in today's world, this is absolutely unacceptable. With all the work that public health administration does in an effort to keep our world safe and healthy, whichever branch that is authorized to collect allocate this money should realize that a majority should be spent on bettering the general public health of struggling populations. It is always beneficial to improve the situation of the whole.

Another reason the author suggested is that “According to the bank, money leaks out in the form of payments to ghost employees, padded prices for transport and warehousing, the siphoning off of drugs to the black market, and the sale of counterfeit--often dangerous--medications. In Ghana, for example, where such corruption is particularly rampant, an amazing 80 percent of donor funds get diverted from their intended purposes.” This is information that I was personally a slightly shocked to read. There needs to be a firmer system of regulation implemented when dealing with money for such a serious cause. Clearly this money needs to be watched by a trusted authority until it reaches its true and final destination, and until that happens, there can be no real hope for assisting developing countries, because all efforts will be squandered.

The two markers that are considered the most important indicators of the status of health care systems in developing countries are maternal mortality rate and life expectancy. Maternal mortality rate is large and important indicator because “pregnant women survive where safe, clean, round-the-clock surgical facilities are staffed with well-trained personnel and supplied with ample sterile equipment and antibiotics. If new mothers thrive, it means that the health-care system is working, and the opposite is also true.” Plainly stated, pregnant women can only survive in optimal conditions, so if there are fewer deaths among this specific population than it must mean that there are healthy and safe living conditions and vise versa. Life expectancy is an good indicator because it demonstrates “child survival and essential public health services.” If living conditions are healthy and safe, for example, ample and clean drinking water and access to medical care, than people will live for longer periods of time. And those who are susceptible to more diseases, like children, will be less likely to die at young ages.

Assignment #4

We were given an appeal to read of the Supreme Court of South Carolina. KIRK versus WYMAN et al., board of Health from August 19, 1909. The appeal dealt with isolation of an individual, Mary V. Kirk, who was isolated due to her found leprosy.

The CDC defines the difference between quarantine and isolation as follows. “quarantine applies to those who have been exposed to a contagious disease but who may or may not become ill.

isolation applies to persons who are known to be ill with a contagious disease.” ¹ Interpreting this definition of quarantine and isolation, from a public health standpoint I would define quarantine as a precautionary measure to protect the public from potential harm and isolation as a more of a secondary measure because the disease has definitely already set in.

I believe that is up to public health officials in the medical field to decide whether or not an individual needs to be quarantined. In that way they would have interest of the health of the surrounding population weighing heavily upon their decision and with medical knowledge they would have the capability to discern what diseases and afflictions warrant quarantine and to what extent. I do not believe that the judiciary system should play a major role in these decisions because the health matters concerning a population overrides what an infected or potentially infectious individual believes their rights should be in terms of avoiding quarantine.

Since democracy is the employed method of government I believe that the government should have the power to balance the right of the individual versus the community but those decisions should be influenced by proposal by officials and leaders and different areas, like the medical and public health branches for examples. As a population we elect government officials because we expect them to make the correct decisions for the benefit of our societies, because of this we should trust their judgement of how to balance individual rights with communal rights.

In my personal opinion it is definitely more important to make decisions to protect the rights and health of a community as opposed to solely protecting the rights and health of an individual. To state it in a simplistic manner, there are more individuals in a community than in one individual, therefore the precedence lays in the security of a population. In the case of Mary V. Kirk, if her individual wants were treated with more importance than the needs of her community then a potential outbreak could have erupted in the community. Though it is unfortunate to be forced to disregard the wants of an individual it is the government's first and foremost responsibility and obligation to protect the entire community.

Sources:

1. "Centers for Disease Control and Prevention - Controlling the Spread of Contagious Diseases ." Controlling the Spread of Contagious Diseases: Quarantine and Isolation. 02/23/2006. Centers for Disease Control and Prevention, Web. 26 Feb 2010. .