Global Climate Change and Health Essay

Global Climate Change and Health Essay

Assignment: Global Climate Change and Health

The environment (both home and physical) has a significant influence on health, as you saw in the readings and media presentations for this week. You also read about the ramifications of global climate change on health. For the purpose of this Assignment, consider the implications of global climate change on health now and in the future.Global Climate Change and Health Essay

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Write a 4 page paper that addresses the following:

Topics could include increased exposure to vectors that transmit Zika, West Nile virus, or malaria; respiratory problems; food distribution problems due to drought or lack of water; or heat-related illness.

1. Describe two health care concerns related to global climate change.
2. Compare concerns in the United States related to these topics with one developed and one developing country.
3. Describe health promotion/health protection strategies a nurse could implement.Global Climate Change and Health Essay

Support your ideas with references from the professional nursing literature.

Required Resources: HOLTZ HAS TO BE USED!!!!

Holtz, C. (2017). Global health care: Issues and policies (3rd ed.). Burlington, MA: Jones & Bartlett.

Chapter 14, “Global Perspectives on Nutrition” (pp. 381-414)

Chapter 15, “Global Perspectives on Environmental Health” (pp. 419-439)

Stanhope, M., & Lancaster, J. (2016). Public health nursing: Population-centered health care in the community (9th ed.). St. Louis, MO: Elsevier.

Chapter 10, “Environmental Health” (pp. 217–241)
Public Health Nursing: Population-Centered Health Care in the Community, 9th Ed. by Stanhope, M., & Lancaster, J. Copyright 2015 by Elsevier Health Science Books. Reprinted by permission of Elsevier Health Science Books via the Copyright Clearance Center.

Veenema, T. G., Griffin, A., Gable, A. R., MacIntyre, L., Simons, N., Couig, M. P., … Larson, E. (2016). Nurses as leaders in disaster preparedness and response—A call to action. Journal of Nursing Scholarship, 48(2), 187–200.

Required Media
Laureate Education. (Producer). (2010a). Public and global health: Global emergencies and disasters [Video file]. Baltimore, MD: Author. Global Climate Change and Health Essay

TED. (2015a). Why climate change is a threat to human rights. Retrieved from https://www.ted.com/talks/mary_robinson_why_climate_change_is_a_threat_to_human_rights

Former President of Ireland, Mary Robinson, talks about the effects of climate change on human rights in poorer populations where some islands or lowlands are beginning to submerge as sea waters rise.

TED. (2016b). The case for optimism on climate change. Retrieved from https://www.ted.com/talks/al_gore_the_case_for_optimism_on_climate_change
Former Vice President Al Gore speaks practically about global warming and offers some reasons we should feel optimistic about recent developments and changes in outcomes. His message is that people are changing their attitudes about global warming into action to stop the warming trend.Global Climate Change and Health Essay

GRADING RUBURIC
Required Content

Presented two concerns regarding global climate change in the United States. Included information about why this concern is important to the US and, if left unchecked, what the result will be. Described what the US is doing to combat these problems, if anything.--

Excellent 54 (18%) - 60 (20%)
Proficient 48 (16%) - 53 (17.67%)
Basic 42 (14%) - 47 (15.67%)
Needs Improvement 0 (0%) - 41 (13.67%)Global Climate Change and Health Essay
Required Content
Presented two concerns regarding global climate change in another selected developed country. Included information about why this concern is important to them and, if left unchecked, what the result will be. Described interventions about what this country is doing to combat these problems, if anything.--
Excellent 54 (18%) - 60 (20%)
Proficient 48 (16%) - 53 (17.67%)
Basic 42 (14%) - 47 (15.67%)
Needs Improvement 0 (0%) - 41 (13.67%)
Required Content Global Climate Change and Health Essay

 

Assignment: Global Climate Change and Health

Note: This Assignment is not due until Day 7 of Week 5.

 

The environment (both home and physical) has a significant influence on health, as you saw in the readings and media presentations for this week. You also read about the ramifications of global climate change on health. For the purpose of this Assignment, consider the implications of global climate change on health now and in the future.

 

For this Assignment, review the following Global Climate Change and Health Essay:

 

AWE Checklist (Level 4000)

Walden paper template (no abstract or running head required)

The Week 5 Assignment Rubric for additional instruction and guidance

By Day 7 of Week 5

Write a 4 page paper that addresses the following:

Topics could include increased exposure to vectors that transmit Zika, West Nile virus, or malaria; respiratory problems; food distribution problems due to drought or lack of water; or heat-related illness.

  1. Describe two health care concerns related to global climate change.
  2. Compare concerns in the United States related to these topics with one developed and one developing country.
  3. Describe health promotion/health protection strategies a nurse could implement.

Support your ideas with references from the professional nursing literature.Global Climate Change and Health Essay

Required Resources:

Holtz, C. (2017). Global health care: Issues and policies (3rd ed.). Burlington, MA: Jones & Bartlett.

Chapter 14, “Global Perspectives on Nutrition” (pp. 381-414)

Chapter 15, “Global Perspectives on Environmental Health” (pp. 419-439)

Stanhope, M., & Lancaster, J. (2016). Public health nursing: Population-centered health care in the community (9th ed.). St. Louis, MO: Elsevier.

 

Chapter 10, “Environmental Health” (pp. 217–241)

Public Health Nursing: Population-Centered Health Care in the Community, 9th Ed. by Stanhope, M., & Lancaster, J. Copyright 2015 by Elsevier Health Science Books. Reprinted by permission of Elsevier Health Science Books via the Copyright Clearance Center.

Veenema, T. G., Griffin, A., Gable, A. R., MacIntyre, L., Simons, N., Couig, M. P., … Larson, E. (2016). Nurses as leaders in disaster preparedness and response—A call to action. Journal of Nursing Scholarship, 48(2), 187–200.

Required Media

Laureate Education. (Producer). (2010a). Public and global health: Global emergencies and disasters [Video file]. Baltimore, MD: Author.

TED. (2015a). Why climate change is a threat to human rights. Retrieved from https://www.ted.com/talks/mary_robinson_why_climate_change_is_a_threat_to_human_rights

Former President of Ireland, Mary Robinson, talks about the effects of climate change on human rights in poorer populations where some islands or lowlands are beginning to submerge as sea waters rise.Global Climate Change and Health Essay

TED. (2016b). The case for optimism on climate change. Retrieved from https://www.ted.com/talks/al_gore_the_case_for_optimism_on_climate_change

Former Vice President Al Gore speaks practically about global warming and offers some reasons we should feel optimistic about recent developments and changes in outcomes. His message is that people are changing their attitudes about global warming into action to stop the warming trend.

GRADING RUBURIC

Required Content

Presented two concerns regarding global climate change in the United States. Included information about why this concern is important to the US and, if left unchecked, what the result will be. Described what the US is doing to combat these problems, if anything.--

BUY A PLAGIARISM-FREE PAPER HERE

Excellent 54 (18%) - 60 (20%)

Proficient 48 (16%) - 53 (17.67%)

Basic 42 (14%) - 47 (15.67%)

Needs Improvement 0 (0%) - 41 (13.67%)

Required Content

Presented two concerns regarding global climate change in another selected developed country. Included information about why this concern is important to them and, if left unchecked, what the result will be. Described interventions about what this country is doing to combat these problems, if anything.--

Excellent 54 (18%) - 60 (20%)

Proficient 48 (16%) - 53 (17.67%)

Basic 42 (14%) - 47 (15.67%)

Needs Improvement 0 (0%) - 41 (13.67%)

Required Content

Presented two concerns regarding global climate change in a selected undeveloped country. Included information about why this concern is important to them and, if left unchecked, what the result will be. Described interventions about what this country is doing to combat these problems, if anything. (60)--Global Climate Change and Health Essay

Excellent 54 (18%) - 60 (20%)

Proficient 48 (16%) - 53 (17.67%)

Basic 42 (14%) - 47 (15.67%)

Needs Improvement 0 (0%) - 41 (13.67%)

Required Content

Described 2–3 health promotion strategies public health nurses might implement to help mitigate concerns of global climate change?--

Excellent 54 (18%) - 60 (20%)

Proficient 48 (16%) - 53 (17.67%)

Basic 42 (14%) - 47 (15.67%)

Needs Improvement 0 (0%) - 41 (13.67%)

Academic Writing Expectations (AWE 3) 4000 Level--

Excellent 27 (9%) - 30 (10%)

Proficient 24 (8%) - 26 (8.67%)

Basic 21 (7%) - 23 (7.67%)

Needs Improvement 0 (0%) - 20 (6.67%)

APA

"APA Formatting: cover page, title of paper on second page, level headings, Times New Roman 12 font, 1"" margins, and page numbers. APA References: Uses in-text citations appropriately and format correctly. Paraphrases to avoid plagiarizing the source.Global Climate Change and Health Essay

Reference list is in alphabetical order, hanging indent, double spaced in format. Each specific entry contains all information required by APA format including author, year of publication, title of publication, pages, DOI, website, as appropriate."--

Excellent 27 (9%) - 30 (10%)

Proficient 24 (8%) - 26 (8.67%)

Basic 21 (7%) - 23 (7.67%)

Needs Improvement 0 (0%) - 20 (6.67%)

Total Points: 300

Name: NURS_4115_Week_5_Assignment_Rubric Global Climate Change and Health Essay

Here is chapter 14 14 Global Perspectives on Nutrition Carol Holtz Marvin A. Friedman Emily Peoples INTRODUCTION Good nutrition is the basis for health, for people of all developmental levels, and for infant and children’s growth and development. In addition, it is correlated to a more effective immune system and reduction of a number of diseases. In considering nutritional status, two classes of nutrients are distinguished: macronutrients and micronutrients. Macronutrients make up the bulk of the diet and consist of fats, starches, and protein (amino acids); they primarily provide energy. Micronutrients are frequently enzyme cofactors or catalyze other reactions;Global Climate Change and Health Essay they are required in much smaller amounts than macronutrients. Despite the incentives to overcome malnutrition, it continues to be a worldwide problem for all countries, affecting about one third of the world’s population. Some forms of malnutrition, such as stunting, are showing modest but uneven declines; other forms, such as anemia in women of reproductive age, are unchanged. Yet other problems, such as overweight and obesity, are increasing. Traditionally the World Health Organization (WHO) focused on the issue of deficiencies induced by disease, but more recently the agenda for both developing and developed countries is the improvement of global nutrition related to overnutrition, especially obesity. Worldwide, obesity and malnutrition are leading causes of such chronic diseases as cardiovascular disease, cancer, hypertension, and diabetes. Deficiency diseases include scurvy, a vitamin C deficiency; blindness that results from vitamin A deficiency; kwashiorkor, a protein deficiency; goiter, an iodine deficiency; pellagra, a niacin deficiency; anemia that results from an iron deficiency; vitamin B12, or folic acid, deficiency; and many more. Significant morbidity, mortality, and economic costs are associated with these kinds of nutritional imbalances (WHO, 2014). Despite the incentives to overcome malnutrition, it remains a problem of staggering size worldwide. Malnutrition affects all countries. Almost one in three people on the planet experience it. For every country it represents a substantial drag on sustainable development. Efforts to combat it are gathering momentum and are beginning to deliver results, but turning the tide of decades of neglect will not be easy. While some forms of malnutrition, such as stunting, are showing modest but uneven declines, other forms, such as anemia in women of reproductive age, are stagnant. And still others, such as overweight and obesity, are increasing. Malnutrition is considered to be the world’s leading threat to life and health today. The following is a common scenario: An infant has marginal macronutrient intake, usually as a result of maternal milk supply drawing to an end. The infant then develops diarrhea from an intestinal parasite or other infectious agent. This disease is promoted by low immune response from macronutrient deficiency. Unable to stop the consequent water–sodium imbalance, the infant dies of dehydration. Even if the infant survives, the long-term consequences of this bout with disease can be catastrophic. It is difficult to imagine living on less than $1 per day, yet 1.2 billion people in the world do so. With this limited amount of income, it is very difficult to maintain a healthy and adequate diet. Every day 24,000 people worldwide die from hunger and malnutrition, the majority of whom are young children as described in the preceding scenario. In addition to macronutrient deficiency, nearly 33% of the world suffers from micronutrient malnutrition, which results in the following problems: • Decreased mental and physical development • Poor pregnancy outcomes • Decreased work capacity for adults • Increased illness • Global Climate Change and Health EssayPremature death • Diseases • Deficiencies in zinc, leading to immune deficiency, growth retardation, and diarrhea • Bone loss • Blindness (WHO, 2014) OBTAINING A NUTRITIONAL ASSESSMENT Dietary habits, cooking methodology, and soil composition vary within the world’s geographic locations and tend to result in different nutritional deficiencies (Tsang, Sullivan, Ruth, Williams, & Suchdeov, 2014). The ability to produce an accurate nutritional assessment continues to be a challenge. Nutritional excesses are frequently appearing globally with different outcomes, and it is difficult to differentiate between the influence of overnutrition resulting in obesity, as well as the relationship of excess iron intake and decreased intelligence (Senior, Charleston, Lihoreau, Buhl, Raubenheimer, & Simpson, 2015). The primary concerns for nutritionists are the nutritional deficiencies resulting in chronic health issues, which include the impact on behavior, immunology, birthweight and neonatal survival, and obesity, which are the subjects of current research. These topics are often difficult to quantify. Many regulatory agencies publish what are called “market basket surveys,” which enable researchers to identify and quantitate what people eat (Callan, Hinwood, & Devine, 2014). Once the nutrient content is determined, these market baskets yield knowledge regarding nutrient uptake. Another way to accomplish surveys on population eating is by diet recall, asking people to recall what they have eaten within one day, seven days, or 28 days (Cremaschini et al., 2015). The short one-day questionnaire is more accurate as compared to extended days recall. People can more accurately remember what they ate yesterday as compared to a week or longer period of time. WHO indicates a need for improvement in the global nutrition of women and children and created the following goals: Global Nutrition Targets for 2025 (WHO, 2014) 1. Reduce stunting by 40% in children under five 2. Reduce anemia by 50% in women of reproductive age 3. Decrease low-birth-weight babies by 30% 4. No increase in overweight children 5. Increase the rate of exclusive breastfeeding in the first six months up to at least 50% 6. Global Climate Change and Health EssayReduce and maintain childhood wasting to less than 5% FREEDOM FROM HUNGER: A HUMAN RIGHT In the International Covenant on Economic, Social and Cultural Rights (ICESCR), freedom from hunger is described as a human right. More specifically it was agreed, “The right to food is a human right inherent in all people, to have regular permanent and unrestricted access, either directly or by means of financial purchases, to have quantitatively and qualitatively adequate and sufficient food corresponding to the cultural traditions of people to which the consumer belongs, is one that ensures a physical and mental, individual and collective fulfilling and dignified life free of fear” (UN Committee on Economic, Social and Cultural Rights [CESCR], 1999, p. 3). The signatory parties to this agreement concluded that the right to adequate food is linked to the inherent dignity of the human person. Furthermore, “the right to adequate food is realized with every man, woman and child, alone or in community with others, having physical access at all times to adequate food or means for its procurement” (CESCR, 1999, p. 3). In addition, a human rights framework was addressed by the Universal Declaration of Human Rights, which was adopted by the United Nations in 1948. According to this document, to fulfill the right to food is to not interfere with one’s ability to acquire food. To protect the right to food is to make sure that others do not interfere with the right to food. The right to food and the right to be free from hunger are outlined in article 25 of the Universal Declaration of Human Rights, which describes a minimum standard of living that includes the right to housing, clothing, health care, and social services. To fulfill the right to food, it is necessary to facilitate social and economic environments that foster human development and to provide food to people in an emergency or in circumstances when they are unable to provide for food by themselves (CESCR, 1999). Today, not only are there problems from lack of quantity and quality of food to satisfy the dietary needs of individuals, that is, food that is both free from adverse substances and acceptable—but there are also worldwide issues with overnutrition (obesity). Overweight or obesity are prevalent global problems, and increasing numbers from emerging or transition economy nations are now facing health challenges related to these issues similar to the problems encountered by the developed world. Overweight and obesity in both developed and developing nations are creating chronic health problems and costing these countries’ economies hundreds of millions of dollars (WHO, 2015a). This is an even more extreme problem among individuals migrating from global areas where food is not available, to developed countries where overeating is easy. WHO’s Nutrition for Health Development established major goals at the World Summit for Children in 1990 and the International Conference on Nutrition in 1992, which with some modification in 2003, were still relevant in 2015. They include the elimination of the following: • Famine and related deaths • Starvation and nutritional deficiency diseases caused by natural and human-made disasters • Iodine aGlobal Climate Change and Health Essaynd vitamin A deficiency In addition, these goals called for reduction of the following: • Starvation and widespread hunger • Undernutrition, especially in women, children, and the aged • Other micronutrient deficiencies, such as iron deficiency • Diet-related communicable and noncommunicable diseases • Barriers to breastfeeding • Poor sanitation, hygiene, and unclean drinking water Strategies for implementing these goals include the following measures: • Developing new nutritional health policies and programs • Improving household food security • Improving food quality and safety • Preventing and treating infectious diseases • Promoting breastfeeding • Promoting diets with micronutrient supplements • Assessing and monitoring nutritional programs Stunting and low-body-weight problems are due to persistent undernutrition. The combination of food distribution imbalance, rising fuel costs, and the global financial crisis beginning in 2007 has had negative impacts on global nutrition. The question is how long these crises will last and how they will affect food availability. Of particular interest is the U.S. Environmental Protection Agency’s (USEPA’s) and Brazilian government’s requirement that a percentage of corn production be allocated for ethanol production, which will likely result in a substantial increase in food and livestock costs (USEPA, 2010)Global Climate Change and Health Essay. TYPES OF NUTRITIONAL CHALLENGES Micronutrient Deficiencies Micronutrient deficiencies are widespread among 2 billion people worldwide. These are silent epidemics of vitamin and mineral deficiencies affecting people globally of all genders, races, and geographic locations. Not only do they cause specific diseases, but they also exacerbate infectious and chronic diseases, thereby affecting morbidity, mortality, and quality of life. Deficiencies related to chronic diseases include osteoporosis, osteomalacia, thyroid deficiency, colorectal cancer, and cardiovascular disease. Consumption of folic acid and fortified foods by pregnant women is well known to prevent many congenital malformations and cognitive impairments. Deficiencies in micronutrients increase the severity of illnesses such as HIV/AIDS and tuberculosis (Tulchinsky, 2010). Micronutrient deficiencies include deficiencies of iron, iodine, and vitamin A as well as zinc, folate, and other B vitamins. In many settings, more than one micronutrient deficiency exists, which necessitates interventions that address multiple micronutrient deficiencies. Areas of prevalence are especially extensive in Southeast Asia and Sub-Saharan Africa. These deficiencies are mainly caused by inadequate food intake, poor quality of foods, poor bioavailability because of inhibitors, types of preparation, and presence of infections, especially as a result of poor water quality (WHO, 2015b). Iodine Deficiency Disorders Iodine deficiency is the world’s most prevalent, yet easily preventable, cause of brain damage. Today we are on the verge of eliminating it—an achievement that will be hailed as a major public health triumph that ranks with getting rid of smallpox and poliomyelitis. Iodine deficiency disorders (IDD), which can start before birth, jeopardize children’s mental health and often their very survival. Serious iodine deficiency during pregnancy can result in stillbirth, spontaneous abortion, and congenital abnormalities such as cretinism, a grave, irreversible form of mental retardation that affects people living in iodine-deficient areas of Africa and Asia. However, of far greater significance is IDD’s less visible, yet pervasive, mental impairment that reduces intellectual capacity at home, in school, and at work. A simple solution is to add iodized salt to the diet (WHO, 2015b). Iodizing table salt is one of the best and least expensive methods of preventing IDD. The target is the elimination of IDD through universal salt iodization. Progress has been dramatic since the primary intervention strategy for IDD control with the universal salt iodization, adopted in 1993. Salt was chosen because it is widely available and consumed in regular amounts throughout the year, and because the cost of iodizing it is extremely low for about US$0.05 per person per year. This solution has been implemented in most countries where iodine deficiency is a public health problem. Globally, UNICEF estimates that 66% of households now have access to iodized salt (WHO, 2015b). Iron-Deficiency Anemia Iron deficiency is the most widespread nutrient deficiency in the world, affecting more than two billion people. It is best known for causing anemia, a condition in which the body manufactures an inadequate number of red blood cells. Although iron deficiency is the main cause of anemia, other causes may be related to nutrient deficiencies such as vitamin B12 and folic acid, as well as nonnutritional causes such as malaria, genetic abnormalities (thalassemia), and chronic disease. Iron deficiency, which is diagnosed based on low hemoglobin or hematocrit levels, develops over time. Populations especially vulnerable to iron-deficiency anemia are young children and women of childbearing age. When a person experiences decreased numbers of red blood cells, which normally carry oxygen throughout the body, the individual has a decreased oxygen level and develops symptoms of weakness and fatigue Global Climate Change and Health Essay. This problem has profound effects on infants and children by limiting learning capacity and impairing the immune system. Within the region of Southeast Asia, millions of people are affected by this problem, mainly adolescent girls and childbearing-age women (due to menstruation) and young children. Pregnant women with iron-deficiency anemia are more likely to die in childbirth as a result of postpartum hemorrhage, or to have their fetus or newborn die as a result of decreased oxygen levels in the tissues. Research indicates that children who have this problem have a five- to seven-point reduction in IQ score. The main contributing factors to iron-deficiency anemia include inadequate intake of iron, poor iron availability from cereal-based diets, and high intestinal worm infections. According to WHO, iron-deficiency anemia is second only to tuberculosis as the world’s most prevalent and costly health problem. In India and parts of Africa, more than 80% of the population has this condition (Healthline, 2015). Iron supplementation improves iron status during pregnancy and the postpartum period, and infants born to mothers who take iron during pregnancy benefit by being protected from iron-deficiency anemia. Iron-deficiency disorders in pregnant women cause fetal and infant thyroid function alterations. Countries such as China, Pakistan, India, Indonesia, and Ethiopia continue to have insufficient dietary iron intake (Boy et al., 2009). Signs and symptoms of iron-deficiency anemia include pallor, fatigue, and weakness. Adaptation occurs such that the disease may go unrecognized for a long period of time. In severe cases, patients may have difficulty in breathing. In addition, unusual obsessive cravings, known as pica, may be evident; dirt, white clay, or ice may be consumed. Also, patients may experience hair loss and lightheadedness. Other symptoms may include mouth ulcers, sleepiness, constipation, tinnitus (ringing in the ears), fainting, depression, missed menstrual cycle, heavy menstrual cycle, itching, or poor appetite (National Institutes of Health [NIH], 2012). Adding micronutrients to such products such as table salt has been practiced for many years to replenish deficient levels of iodine; a form of table salt with iron fortification has also been manufactured to help combat iron-related anemia may also sometimes have a rusty taste. Niacin Deficiency (Pellagra) Pellagra, also known as “black tongue,” is found among populations who consume corn as the main staple of their diet, a practice often seen in Mexico, northern Italy, and South America. Because corn is deficient in the amino acid tryptophan, and because tryptophan is required for biosynthesis of niacin, these populations are particularly sensitive to niacin deficiency. Signs of niacin deficiency include photosensitivity, red skin lesions, and dementia, and the condition can lead to mortality. Pellagra is easily treated with niacin supplements. Genetically engineered maize that has a high tryptophan content and does not cause pellagra is also available; a Nobel Prize was awarded for the development of this bioagricultural product (WHO, 2015b)Global Climate Change and Health Essay. Vitamin A Deficiency Vitamin A deficiency (VAD) occurs because of inadequate storage of vitamin A, caused either by inadequate intake of food rich in vitamin A or by severe and repeated illnesses. Approximately two billion people in the world are at risk for vitamin A deficiency, along with iodine or iron deficiencies. This problem is especially prevalent in Southeast Asia and Sub-Saharan Africa, and pregnant women and young children are at greatest risk. In many of these areas, more than one micronutrient deficiency exists, so that interventions must address multiple micronutrient deficiencies. Severe vitamin A deficiency is usually associated with signs of night blindness and decreased levels of vitamin A (less than 0.35/dL). Serum retinol is the biochemical indicator of vitamin A status. VAD is the leading cause of preventable blindness in children and increases the risk of disease and death from severe infections. In pregnant women, VAD causes night blindness and may increase the risk of maternal mortality. Vitamin A deficiency is a public health problem in more than 50% of all countries, especially in Africa and Southeast Asia, hitting hardest young children and pregnant women in low-income countries (WHO, 2015b). Crucial for maternal and child survival, supplying adequate vitamin A in high-risk areas can significantly reduce mortality. Conversely, its absence causes a needlessly high risk of disease and death. • For children, lack of vitamin A causes severe visual impairment and blindness, and significantly increases the risk of severe illness, and even death, from such common childhood infections as diarrheal disease and measles. • For pregnant women in high-risk areas, vitamin A deficiency occurs especially during the last trimester when demand by both the unborn child and the mother is highest. The mother’s deficiency is demonstrated by the high prevalence of night blindness during this period. The impact of VAD on mother-to-child HIV transmission needs further investigation. • WHO’s goal is the worldwide elimination of vitamin A deficiency and its tragic consequences, including blindness, disease, and premature death. To successfully combat VAD, short-term interventions and proper infant feeding must be backed up by long-term sustainable solutions. The arsenal of nutritional “well-being weapons” includes a combination of breastfeeding and vitamin A supplementation, coupled with enduring solutions, such as promotion of vitamin A-rich diets and food fortification. Food fortification takes over where supplementation leaves off. Food fortification, for example, sugar in Guatemala, maintains vitamin A status, especially for high-risk groups and needy families. For vulnerable rural families, for instance in Africa and Southeast Asia, growing fruits and vegetables in home gardens complements dietary diversification and fortification and contributes to better lifelong health. Vitamin A is available from raw, colored foods such as carrots or tomatoes (WHO, 2015b). Vitamin D Deficiency This nutritional deficiency is unique among vitamin deficiencies. Vitamin D is required for the absorption of calcium and translocation to bones and teeth. Deficiency of this micronutrient in children results in rickets, which is a failure of the long bones to mature. In adults, it causes osteoporosis (fragile bones) and osteomalacia (bone thinning). Chronic vitamin D deficiency eventually also causes dermal lesions. What makes this vitamin unique is that the body easily produces a large amount of vitamin D from the reaction of sunlight and sterol (a cholesterol derivative). In the absence of sunlight, the body cannot get enough vitamin D from diet alone. This disease was first seen among nuns in Europe who were always completely covered by their habits and generally worked inside. Now, vitamin D is added to milk, which is the major source of dietary calcium (Pettifor, Global Climate Change and Health Essay2008). Rickets is a disease widely recognized in many developing countries today. Its origin was identified only in the early part of the 20th century with the discovery of vitamin D, and the advent of ultraviolet light irradiation therapy meant that rickets could be eradicated. Today rickets is still found in some breastfed African American infants, and in Europe it is often found in children of recent immigrants from India, Pakistan and Bangladesh, North Africa, and the Middle East. In the Middle East, vitamin D deficiency and rickets continue to be problems despite abundant all-year sunshine. Infants, adolescent females, and pregnant women are particularly at risk, especially in areas where social and religious customs prevent adequate sunlight exposure of pregnant women and their adolescent daughters (Pettifor, 2008). Iodine-Deficiency Disorder Iodine deficiency is the leading cause of preventable brain damage in childhood. Iodine deficiency is found in populations with no access to saltwater fish (seawater is high in iodine) or as a result of consuming vegetables such as broccoli that bind with iodine and make iodine unavailable for absorption. During the last decade, worldwide improvement in the prevalence of this micronutrient deficiency has been realized through low-cost prevention measures such as the iodization of salt (WHO, 2015b). Under normal conditions the body has small amounts of iodine, housed mainly in the thyroid gland and used for the synthesis of thyroid hormones. Iodine deficiency causes hypothyroidism (goiter), which can lead to the syndrome called iodine-deficiency disorder (IDD). In developed countries, iodine intake correlates with obesity and basal metabolic rate because the hormone requiring iodine—thyroxin—regulates basal metabolism rate. Worldwide data on urinary iodine levels and goiter are monitored via the WHO’s Global Database on Iodine Deficiency Disorders. These disorders comprise deficiencies resulting from decreased intake of the element iodine, which is essential in minute amounts for normal growth and development. Thyroid failure causing irreversible brain damage can occur if the iodine deficiency occurs in the period ranging from fetal life to three months after birth. Iodine deficiency causes a decreased mean IQ loss of 13.5 points in children (WHO, 2015b).Global Climate Change and Health Essay During the past century, iodine fortification has been implemented into foods such as bread, milk, water, and salt. Salt has been the most commonly fortified product because it is widely used and available. WHO recommends the addition of 20 to 40 milligrams of iodine per kilogram of salt to meet daily iodine requirements, assuming that the average consumption is 10 grams per day. It is necessary that the iodine content of iodine-fortified foods be monitored during manufacturing to ensure that the prescribed levels are maintained. Iodine fortification is safe, but excessive intake may produce hyperthyroidism. Problems caused by iodine deficiency include goiter, psychomotor defects, impaired mental function, and slow cognitive development. The universal iodization of salt has been very successful in bringing the prevalence of these conditions down in many countries (WHO, 2015b). Nuclear events, such as the one that occurred in Chernobyl, in the former Soviet Union, cause the production of I131, the radioactive form of iodine. Consumption of this isotope results in thyroid cancer. Similarly, irradiation of the head and neck, as was common in acne therapy in the 1950s, also caused conversion of iodine to I131 and a consequent epidemic of thyroid cancer (WHO, 2015b). Zinc Deficiency Dietary zinc deficiency is unlikely in healthy persons. Secondary zinc deficiency can develop in the following individuals: • Patients with hepatic insufficiency (because the ability to retain zinc is lost) • Patients taking diuretics • Patients with diabetes mellitus, sickle cell disease, chronic renal failure, or malabsorption problems • Patients with stressful conditions (e.g., sepsis, burns, head injury) • Elderly institutionalized and homebound patients (common) Maternal zinc deficiency can cause fetal malformations and low birth weight. Zinc deficiency in children causes impaired growth and impaired taste (hypogeusia). Other symptoms and signs in children include delayed sexual maturation and hypogonadism. In children or adults, symptoms include alopecia, impaired immunity, anorexia, dermatitis, night blindness, anemia, lethargy, and impaired wound healing. Zinc deficiency should be suspected in undernourished people with typical symptoms or signs. However, because many of these symptoms and signs are non-specific, low albumin levels, which are also common in zinc deficiency, make serum zinc levels difficult to interpret. Diagnosis usually requires the combination of low levels of zinc in serum and increased urinary zinc excretion. If available, isotope studies can measure zinc status more accurately. Treatment consists of elemental zinc 15 to 120 mg/day, Global Climate Change and Health Essaygiven orally, until symptoms and signs resolve (Boy et al., 2009; Johnson, 2008). Hypozincemia is usually a nutritional deficiency but can also be associated with malabsorption, diarrhea, chronic liver disease, chronic renal disease, sickle cell disease, diabetes, and malignancies. Zinc deficiency, however, is typically the result of inadequate dietary intake of zinc. Decreased vision, smell, and memory are also connected with zinc deficiency. Moreover, a deficiency in zinc can cause malfunctions of organs and their related functions. One sign that may be caused by zinc deficiency is white spots, bands, or lines on the fingernails (Boy et al., 2009; Johnson, 2008). One third of the world population is at risk of zinc deficiency, with the percentage of the population at risk ranging from 4 to 73% depending on the country. Zinc deficiency is the fifth-leading risk factor for disease in the developing world. Providing micronutrients, including zinc, has been identified as one of the four quick positive solutions to major global problems. Zinc food fortification and supplementation to children in developing countries have been proven to decrease diarrhea, pneumonia, and childhood mortality (Boy et al., 2009; Johnson, 2008). Protein–Energy Malnutrition Protein–energy malnutrition (kwashiorkor) is a global health problem and is potentially fatal, often causing death in children, mainly in developing countries where the environment is characterized by unsafe water, reductions in macronutrients, and deficiencies in many micronutrients. Kwashiorkor is an example of various levels of inadequate protein or energy intake. Although it mainly occurs in infants and children, it can be found in persons of any age in the life cycle. In the United States, secondary protein–energy malnutrition is seen in elderly people who live in nursing homes and in children in poverty. Such malnutrition may result from AIDS, cancer, kidney failure, inflammatory bowel disease, and other disorders. It usually appears in people who have chronic disease or chronic semistarvation, and takes three forms: • Dry (thin, desiccated). Marasmus results from near-starvation with a deficiency of protein and calories. The marasmic child consumes little food, usually because the mother is unable to breastfeed, and appears very thin as a result of loss of body muscle and fat. This is the predominant form of protein–energy malnutrition in most developing countries. It occurs when energy intake is insufficient for the body’s requirements and the body uses up its own reserves. Marasmic infants have hunger, weight loss, growth retardation, and wasting of fat and muscle. The chronic phase of this disease is made acute when an incident of diarrhea takes place. This diarrhea usually takes on fatal consequences. • Wet (edematous, swollen). Kwashiorkor is an African word meaning “first child–second child”; it refers to the fact that a first child may develop protein–energy malnutrition when a second child is born and replaces the first child at the breast. In many poor areas of the world, the weaned child is then fed a thin gruel of poor nutritional quality and has organic failure to thrive. Edema results because the protein deficiency is greater than the energy deficiency. Global Climate Change and Health EssayIncreased carbohydrate intake is accompanied with decreased protein intake, and a decrease in albumin causes the edema. Those affected get thinning and discoloration of the hair and have an increased vulnerability to infections. The body weight increases due to edema. • Combined form (between the two extremes). In marasmic kwashiorkor, children have some edema and more body fat than marasmus. Treatment of these conditions includes the following measures: • Correcting fluid and electrolyte imbalances. • Treating infections (causing diarrhea) with antibiotics. • Supplying macronutrients (primarily milk-based formulas) by diet therapy and malnutrition ranges from 5 to 49% (WHO, 2015b). OBESITY Worldwide, at least 2.8 million people die each year as a result of being overweight or obese, and an estimated 35.8 million (2.3%) of global DALYs are caused by overweight or obesity. Overweight and obesity lead to adverse metabolic effects on blood pressure, cholesterol, triglycerides, and insulin resistance. Risks of coronary heart disease, ischemic stroke, and type 2 diabetes mellitus increase steadily with increasing body mass index (BMI), a measure of weight relative to height. Raised body mass index also increases the risk of cancer of the breast, colon, proGlobal Climate Change and Health Essaystate, endometrium, kidney, and gall bladder. Global Climate Change and Health EssayMortality rates increase with increasing degrees of overweight, as measured by BMI. To achieve optimum health, the median BMI for an adult population should be in the range of 21 to 23 kg/m2, while the goal for individuals should be to maintain BMI in the range 18.5 to 24.9 kg/m2. There is increased risk of comorbidities for BMI 25.0 to 29.9, and moderate to severe risk of comorbidities for BMI greater than 30. The BMI metric correlates the amount of body fat with height but does not directly measure body fat. Other modes of measuring body fat include skinfold thickness and waist circumference, calculation of waist-to-hip circumference ratios, and other diagnostic measurements such as ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI). For children and adolescents, the BMI ranges are defined by taking into account normal male and female variations of body fat for specific ages (WHO, 2015c). Global Climate Change and Health Essay

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Global Climate Change and Health Essay