NR 717 Week 2 Discussion Epidemiology and Health Surveillance

NR 717 Week 2 Discussion Epidemiology and Health Surveillance

Student Name

Chamberlain University

NR-717: Concepts in Population Health Outcomes & Health Policy

Prof. Name

Date

NR 717 Week 2 Discussion: Epidemiology and Health Surveillance

Introduction

The selected practice problem for this discussion is obesity among non-Hispanic Black African Americans living in Prince George’s County, Maryland. This issue presents a significant public health challenge that requires an integrated approach, combining epidemiological principles, health surveillance, and ethical data practices. Data at both the national and county levels reveal that obesity disproportionately affects this population. Factors such as income, education, cultural practices, and access to healthcare resources play vital roles in shaping these disparities.

Epidemiology provides the framework to identify at-risk groups, investigate contributing causes, and develop evidence-based interventions (CDC, 2022). In parallel, health surveillance enables the continuous monitoring of obesity trends, informs resource allocation, and assists in formulating equitable health policies. Embedding ethical standards within these practices ensures transparency, builds trust within the community, and minimizes health inequities (Maryland Department of Health and Mental Hygiene, 2022).

Explore the Epidemiologic Principles and Measures Used to Address Your Selected Practice Problem

Definition of Overweight and Obesity

The Maryland Department of Health and Mental Hygiene (2022) defines overweight and obesity according to Body Mass Index (BMI) categories, as shown below:

Category	Definition
Overweight (Adults)	BMI 25.0–29.9
Obese (Adults)	BMI ≥ 30.0
Overweight (Children/Adolescents)	BMI ≥ 85th percentile for age/height
Obese (Children/Adolescents)	BMI ≥ 95th percentile for age/height

Obesity increases the risk of type 2 diabetes, hypertension, cardiovascular disease, arthritis, certain cancers, and early mortality (Miller et al., 2022).

Epidemiology of Obesity

National Level:
At the national level, obesity prevalence varies across racial and ethnic groups. According to the Centers for Disease Control and Prevention (CDC, 2022):

• Non-Hispanic Blacks have the highest prevalence (46.8%).

• Non-Hispanic Whites have a prevalence of 37.9%.

• Non-Hispanic Asians show the lowest prevalence at 12.7%.

These disparities highlight the persistent impact of systemic inequalities on obesity patterns nationwide.

Local Level – Prince George’s County (PGC):
Prince George’s County, which has a substantial African American population, exhibits particularly high obesity rates. In 2015, 30.7% of adults and 15.1% of adolescents were classified as obese. By 2021, obesity among Black African American adults had risen to 43.8%, surpassing both the Maryland average (34.1%) and the national average (33.9%).

Population Group	Obesity Prevalence (%)	Source
U.S. Adults (Overall)	33.9	HHS, 2020
Maryland Adults	34.1	HHS, 2020
Prince George’s County Adults	43.8	HHS, 2020
Black African Americans (PGC)	77.3	CDC, 2022
Black Women (PGC)	75.5	CDC, 2022
White Women (PGC)	61.8	CDC, 2022

Examine the Use of Descriptive and/or Analytic Epidemiology

Descriptive Epidemiology

Descriptive epidemiology examines who, where, and when obesity occurs.

• By Person: In PGC, Black women have a notably higher prevalence of obesity (75.5%) compared to White women (61.8%).

• By Place: Environmental conditions such as food deserts and unsafe neighborhoods limit healthy food access and opportunities for physical activity.

• By Time: Over the past 20 years, obesity rates have steadily increased across the region (CDC, 2024).

This trend correlates with higher mortality rates, as African Americans in Maryland experience a 19% higher all-cause mortality compared to Whites (Maryland Department of Health and Mental Hygiene, 2022).

Analytic Epidemiology

Analytic epidemiology explores causal relationships and determinants contributing to obesity in PGC:

Determinant	Description	Source
Socioeconomic Status (SES)	Limited financial resources reduce the ability to afford nutritious foods and engage in health-promoting activities.	Barrington et al., 2021
Environmental Influences	High fast-food density and lack of grocery stores foster unhealthy eating behaviors.	Bleich et al., 2021
Healthcare Barriers	Structural racism, lack of preventive services, and limited cultural competence in healthcare reduce obesity management effectiveness.	Hui et al., 2020

Propose How You Might Use Surveillance to Influence the Determinants of Health

Health surveillance serves as a crucial mechanism to address obesity determinants and promote health equity in PGC.

• Trend Monitoring: Continuous surveillance enables tracking of obesity patterns, helping assess the success of intervention programs.

• Resource Allocation: Data-driven insights can guide equitable distribution of health resources, such as nutrition initiatives and physical activity facilities.

• Policy Development: Evidence-based surveillance can inform policies supporting urban redesign, food subsidies, and school-based wellness programs.

• Technology Integration: Utilizing digital health tools allows for real-time monitoring and community engagement in obesity prevention efforts.

Anticipate Any Ethical Concerns Related to the Use of Surveillance Data

Ethical considerations are vital in using surveillance data responsibly. Key ethical concerns include:

Ethical Concern	Description
Confidentiality & Privacy	Safeguarding personal health data to prevent misuse or unauthorized disclosure.
Bias & Stigma	Avoiding weight-related stereotypes and culturally insensitive narratives.
Equity in Access	Ensuring fair and inclusive access to healthcare resources across all socioeconomic levels.
Systemic Racism	Identifying and addressing institutional barriers that perpetuate health disparities.
Informed Consent	Respecting patient autonomy in the collection and use of health data.

Implementing culturally competent care, inclusive health policies, and community participation is essential to maintaining ethical integrity and public trust (Payne-Sturges et al., 2021).

Conclusion

Tackling obesity among African Americans in Prince George’s County requires a comprehensive, evidence-based approach that integrates descriptive and analytic epidemiology, effective health surveillance, and ethical data management. These tools not only identify patterns and risk factors but also empower policymakers, healthcare professionals, and communities to create equitable, culturally sensitive interventions. Ensuring transparency, inclusivity, and community engagement is essential to reduce disparities, strengthen trust, and improve long-term public health outcomes.

References

Barrington, D. S., James, S. A., & Williams, D. R. (2021). Socioeconomic correlates of obesity in African American and Caribbean-Black men and women. Journal of Racial and Ethnic Health Disparities, 8(2), 422–432. https://doi.org/10.1007/s40615-020-00798-4

Bleich, S. N., & Ard, J. D. (2021). COVID-19, obesity, and structural racism: Understanding the past and identifying solutions for the future. Cell Metabolism, 33(2), 234–241. https://doi.org/10.1016/j.cmet.2021.01.010

Centers for Disease Control and Prevention. (2022). Obesity prevalence in the U.S. https://www.cdc.gov

Centers for Disease Control and Prevention. (2024). Trends in obesity-related health outcomes. https://www.cdc.gov

Fryar, C. D., Carroll, M. D., & Afful, J. (2021). Prevalence of overweight, obesity, and severe obesity among adults: United States, 1960–2018. National Center for Health Statistics. https://www.cdc.gov/nchs

Hui, B. Y., Roberts, A., & Thompson, K. J. (2020). Outcomes of bariatric surgery in African Americans: An analysis of MBSAQIP registry data. Obesity Surgery, 30(12), 4275–4285. https://doi.org/10.1007/s11695-020-04820-w

Lofton, H., Ard, J. D., Hunt, R. R., & Knight, M. G. (2023). Obesity among African Americans: A review. Obesity, 31(2), 306–315. https://doi.org/10.1002/oby.23640

Longmire-Avital, B., & McQueen, C. (2019). Exploring race-related stress and emotional eating among Black women. Women & Health, 59(3), 240–251. https://doi.org/10.1080/03630242.2018.1478361

Maryland Department of Health and Mental Hygiene. (2022). Obesity in Maryland and Prince George’s County. https://www.princegeorgescountymd.gov

Miller, H. N., Perrin, N., Thorpe, R. J., Evans, M. K., Zonderman, A. B., & Allen, J. (2022). Discrimination and BMI trajectories: A prospective study of African American adults. Family & Community Health, 45(3), 206–213. https://doi.org/10.1097/FCH.0000000000000326

Payne-Sturges, D. C., Gee, G. C., & Cory-Slechta, D. A. (2021). Confronting racism in environmental health sciences. Environmental Health Perspectives, 129(5), 055002. https://doi.org/10.1289/EHP8186

U.S. Department of Health and Human Services, Office of Minority Health. (2020). Minority health framework for eliminating disparities. https://minorityhealth.hhs.gov