Urban Diabetes, Research Paper Example

Introduction

Diabetes is a serious epidemic with disastrous consequences in today’s society. Millions of Americans suffer from diabetes and face serious health risks on a regular basis; therefore, these persons require ongoing care and treatment to alleviate symptoms and minimize long-term complications. Government agencies play a critical role in supporting the prevention and management of diabetes to prevent serious outcomes, as well as a means of establishing growth and change that will target and impact many population groups who do not have the resources and knowledge available to address the disease in their own lives. Diabetes affects all populations and has a significant impact on quality of life. Therefore, it is important to identify the resources that are available to support research, programmatic efforts, and other focus areas to support the disease and to maximize outcomes effectively. The American Diabetes Association provides a high level of support and education regarding the disease in order to accomplish the desired goals and objectives in a manner that is consistent with supporting viable outcomes for individuals. In particular, those from lower incomes require a higher level of support and education because they are unable to access necessary resources, such as healthy foods, due to neighborhood restrictions and other challenges that limit their access to and knowledge of healthy eating. The following discussion will address diabetes and its impact on lower income individuals and families without resources to achieve healthy eating, thereby necessitating policy-based changes and education to support the expansion of programs in this area. These factors support the growth and development of a new strategy to encompass new policy-based objectives and considerations to improve outcomes for lower income populations who face a high risk of developing diabetes at some point in their lives. The American Diabetes Association offers significant insight and education regarding the disease and how it manifests across many population groups, thereby contributing to new discoveries to prevent and manage the disease in an effective manner.  New policies and agendas regarding healthy eating must be in place in order to accomplish the chosen objectives, including improved access to food choices that are required to enable persons in low income families to increase healthy eating in local communities where this need is the greatest.

Analysis

With the development of policymaking agendas in communities with high levels of need, it is important to identify the resources and human capital that are desired to facilitate access to healthier eating alternatives and resources. Unfortunately, there is a level of social class inequality within American society that continues to increase, with a significant divide between the rich and the poor that is difficult to overcome. This problem continues to expand in scope and severely impacts health and wellbeing in many communities, accompanied by significant declines in housing, income, overcrowding in small spaces, and a general decline in quality of life that impacts both children and adults (Syme & Berkman). As a result, there is a lack of knowledge and limited access to healthcare services that impact general health and pose long-term risks to these communities (Syme & Berkman).

The issues related to socioeconomic status are perhaps the key determining factors in health throughout many communities, thereby creating disconnect between successful access to care and treatment and quality of life (Syme & Berkman). As a result, there are significant challenges to consider that have a negative impact on how children and adults prevent and manage disease, particularly in communities where access to healthcare services is severely limited (Syme & Berkman). For example, white males with lower levels of education have 64 percent higher mortality rates than males with higher levels of education, while white women with low education have 104 percent higher mortality rate (Syme & Berkman). It is generally known that “while improvements in the environment and in medical care clearly have been of value, other factors must be identified to account for this continuing differential in mortality rate and life expectancy” (Syme & Berkman, p. 31). Furthermore, there are significant gaps in disease rates and management within lower income groups, thereby increasing the burden on these communities as they struggle to obtain routine access to medical care and treatment, as well as preventative methods (Syme & Berkman). Based upon these conditions, it is necessary to establish policymaking agendas that will favorably impact those communities with the greatest level of need and where the gaps in access to medical care are of the greatest concern and focus (Syme & Berkman).

In a similar context, the health status of many people is largely influenced by the communities and cultures in which they reside (Schulz & Lempert, 2004). For example, it is believed that “race-based residential segregation may be a “fundamental factor” affecting health: that is, one that affects multiple health outcomes through multiple pathways, by influencing access to the resources that are necessary to maintain health” (Schulz & Lempert, 2004, p. 440). As a result, it is likely that many individuals face serious health risks, including diabetes, as a direct result of their communities and the food resources that are available (Schulz & Lempert, 2004). These factors contribute to an ever-increasing disparity between these groups and other resources that impact health outcomes in a negative manner and that require further evaluation (Schulz & Lempert, 2004). For those persons in low income communities with limited access to resources, it is very difficult to maintain a healthy lifestyle without these resources in place (Schulz & Lempert, 2004). It is necessary to address these challenges from a policymaking perspective in order to accomplish improved health through greater access to resources, including healthier foods (Schulz & Lempert, 2004).

Similarly, many communities face critical concerns regarding how to manage access to food resources, including healthier produce and ingredients (Raja et.al, 2008). Simply put, many communities are inadequately prepared to improve health through food because the food that is available is either process or of a fast food variety and is of very low quality (Raja et.al, 2008). These factors require a greater understanding of the needs of local residents and the level of support that is required to ensure that the appropriate resources are available that will have a positive impact on outcomes (Raja et.al, 2008). The nature of racial disparities often translate into poor health outcomes and low quality foods within communities; therefore, it is important to develop policies and to identify resources that will not only bridge some of these gaps, but also demonstrate a greater commitment to change and progress that will have a positive impact on these communities and all residents, both young and old (Raja et.al, 2008). Based upon prior research, it should be noted that “despite a greater number of grocery stores and convenience stores and competitive prices for many food items, the access to healthful food, namely fresh produce and whole grains, in neighborhoods of color may be rather limited in comparison to predominantly white neighborhoods” (Raja et.al, 2008, p. 479). In this context, it is observed that there are significant factors associated with the racial and cultural boundaries within a given community as key players in the types of food products that are available for purchase and consumption (Raja et.al, 2008). As a result, it is important to identify resources that will have a favorable impact on health outcomes within these neighborhoods and how they are influenced by the increased availability of resources to ensure that communities are able to access resources effectively to support improved access to healthier food products and freshly grown produce (Raja et.al, 2008).

A study by the UCLA Center for Health Policy Research (2008) indicates that “When grocery stores are not accessible—when residents do not have access to a private vehicle or reliable public transportation, or when grocery stores are not located within short walking distance—residents of these communities often resort to purchasing the generally higher-calorie, lower-nutrient foods sold at nearby convenience stores and fast-food restaurants” (p. 2). As a result, it is evident that many members of these communities do not obtain adequate nutrition on a consistent basis in order to meet their needs effectively, and therefore, face a serious risk of diabetes and other conditions as a result of poor nutrition (UCLA Center for Health Policy Research, 2008). These concerns are significant and require ongoing attention and consideration because they have a negative impact on communities where the need is greatest, and where access to nutritional food resources is limited (UCLA Center for Health Policy Research, 2008).

In many lower income communities, general habits regarding the purchase and preparation of food are of low quality, as these communities face difficult risks that require further evaluation and analysis. In particular access to quality food products, such as fresh fruits and vegetables, are often difficult to achieve, and this poses a serious threat to communities as they struggle for survival due to ever-increasing health concerns that impact their lives in a negative manner (Miewald & McCann, 2014). There is a serious disconnect in philosophy in many of the poorest communities, as the availability of fast food and processed food items runs rampant, while healthier alternatives are either unavailable within reach or are cost prohibitive for this population (Miewald & McCann, 2014). As a result, food is not a key priority within these communities, which increases the risks associated with weight gain and the risk of chronic disease (Miewald & McCann, 2014).

Many communities have begun to catch on to new perspectives regarding the availability of fresh food products and locally grown produce, not only as a means of improving overall health, but also in improving the environment: “At the present conjuncture in global North cities, food is squarely on the agenda of municipal attempts to reduce greenhouse gas emissions by replacing imported goods with local food from urban agriculture and farmers’ markets while food consumption itself is a fashionable cultural marker of class distinction and the basis for a restaurant industry that has long encouraged and benefited from advancing gentrification frontiers” (Miewald & McCann, 2014, p. 538). These factors support an improved understanding of the needs of local communities that will have a positive impact on health and wellbeing for children and adults (Miewald & McCann, 2014). Furthermore, these factors support an improved recognition of the needs of local residents through an expanded approach to creating gardens to produce food within the community that is safer and healthier for consumption for these populations (Miewald & McCann, 2014).

The survival of many lower income communities for the foreseeable future is contingent upon the expansion of knowledge, education, and policies that will positively impact local residents and how they view food within their lives (Miewald & McCann, 2014). Food is a key component of cultural identity and in sustaining life; therefore, it is important to identify resources that will positively impact quality of life through new perspectives to ensure that food products are a key to survival and improved health, rather than a deterrent in this process (Miewald & McCann, 2014). These issues are significant because they impact how organizations respond to the needs of lower income communities and how to improve health through the expansion of food knowledge and the choices that are made (Miewald & McCann, 2014). Under these circumstances, it is important to develop strategies within communities through the work of many high profile organizations, such as the American Diabetes Association and others, in order to accomplish the necessary objectives in improving access to healthier food choices and to minimize the disparities that currently exist.

The concept of a local foodscape is somewhat unknown in that lower income communities in many metropolitan areas are beginning to recognize the value of creating locally grown produce through individual and community gardens as a means of improving health and wellbeing for these residents (Miewald & McCann, 2014). These findings suggest that local and national organizations must recognize the benefits of these strategies and consider supporting them with the use of their own resources as a means of preventing disease through healthier eating (Miewald & McCann, 2014). In many ways, the disparities that exist between access to healthier food and improved nutrition is significant, yet few resources overall have been allocated towards alleviating these gaps (Miewald & McCann, 2014). This process requires a higher level of awareness and guidance in regards to the resources that are available to improve outcomes for residents and to alleviate gaps in access to healthier food that coincide with research and policymaking agendas for these organizations (Miewald & McCann, 2014).

There is a growing distinction between the work that is performed to improve access to community food resources and charitable food donations and meals, as the former is described as follows: “Community food security programs, including community gardens and kitchens, good food boxes and coupon programs at farmers’ markets have emerged. Unlike charitable meals, community programs engage participants in activities like food production or cooking and often have some skill- or community building aspect…They attempt to both improve the quality of food and, in some instances, address wider structural issues of income inequality” (Miewald & McCann, 2014, p. 549). Under these conditions, therefore, it is important to identify resources that will be used to accomplish the desired objectives, while also considering how to approach food resources within communities as a means of improving diets and in supporting the needs of local residents through locally grown products (Miewald & McCann, 2014). Furthermore, this perspective discourages the dependence on charitable meals that promote a mentality of need, rather than working towards a strategy of independence (Miewald & McCann, 2014).

In recent years, many organizations have sought to convey a message of locally grown produce to promote healthier eating and overall improved health. This strategy is essential to the discovery of new methods and techniques to ensure that communities are successful in their efforts to promote the sale and distribution of locally grown foods to support greater health. As a result, the concept of food hubs was born: “The USDA describes a food hub as the ‘drop off point for multiple farmers and a pick up point for distribution firms and customers that want to buy source-verified local and regional food.’ Some food hubs also provide transportation of farm products directly to consumers and retail, restaurant, and institutional customers. Food hubs take much of the burden of marketing and transportation from local farmers by finding viable consumers” (GRACE Communications Foundation, 2014). From this perspective, it is important to identify specific resources that will be effective in supporting the needs of local residents, as well as a means of promoting disease prevention for diabetes and other chronic health concerns for which healthy eating are a key priority. There are significant factors to consider in the development of new approaches to diabetes prevention that are directly associated with access to healthier foods, of which one feasible alternative is the expansion of gardens and farming within communities to increase the availability of locally grown produce.

Many local and national organizations have taken the initiative to improve local economies and overall health through the development of new programs to ensure that residents in low income areas receive the level of support and guidance that is required to achieve healthier eating and access to nutritious food choices. Therefore, one alternative for individuals is to use organically grown produce and other foods that are all natural and produced under safe conditions without the use of pesticides and other chemicals (Diabetes Self-Management). However, organic foods are not necessarily more nutritious than other alternatives, but they provide an opportunity to address initiatives to promote healthier eating within communities, particularly those in lower income neighborhoods where access to resources is severely limited (Diabetes Self-Management). These factors require a high level of support and understanding for the needs of local residents who require methods of improving their diets to alleviate some of the risks associated with diabetes. It is important to identify these resources and to recognize the importance of achieving new perspectives through the creation of foods that are safer to consume and that are generally healthier to eat than other alternatives (Diabetes Self-Management). These opportunities support the development of new perspectives to ensure that individuals within communities have greater access to nutritional foods, including organic foods, that are likely to reduce their risk of diabetes and also improve their overall health (Diabetes Self-Management).

As part of the current and future mission of the American Diabetes Association, it is necessary to develop strategies that will address improved access to higher quality food and ingredients that will favorably impact communities. There are considerable factors associated with the development of new perspectives to ensure that this organization and others provide a high level of support towards the prevention of diabetes through improved food choices. This process is critical to the success of a given endeavor and in the support of resources that will positively impact outcomes for local communities. The American Diabetes Association largely focuses on prevention efforts that are designed to target those who are at a severe disadvantage due to health disparities through healthy eating and other related behaviors. However, the organization must adapt to the needs of the surrounding environment with its activities in order to accomplish the desired objectives in an effective manner to have a greater impact on lower income communities.

This organization must continue to expand its efforts to be successful in supporting new initiatives that would have a positive impact on outcomes and in the development of new strategies to improve access to higher quality and nutritious foods that will improve their health over time.

The American Diabetes Association serves as a positive advocate for healthy eating because these behaviors will reduce the risk of developing diabetes in many individuals. At the same time, the organization requires significant support and attention in order to achieve these results, including greater attention to communities where health disparities are of significant concern. The process of policymaking is essential to improving health within these communities and this is achieved through greater access to resources and the development of new strategies that will enhance outcomes and support a long-term approach to improving the lives of many people. These opportunities convey the importance of developing policies that will support improvements in local communities, including the expansion of farms and/or gardens within communities to ensure that access to locally grown produce with many health benefits is achieved. It is essential for the American Diabetes Association to support programmatic efforts and policies to ensure that communities are successful in their efforts to provide access to healthier foods and resources that will improve health and also alleviate the risk of diabetes in local residents.

The American Diabetes Association must serve as a key facilitator of change within communities to recognize disparities, address their causes, and to determine how to best move forward with new strategies to improve the health and wellbeing of low income residents. Access to healthy food choices is often difficult in these communities; therefore, it is important to identify how to achieve these objectives through an organized effort to facilitate outcomes and to be successful in addressing the needs of residents through open discussion and collaboration. The resources of the American Diabetes Association are substantial; therefore, it is necessary to identify how these resources might be put to good use in order to support the needs of local low income residents as best as possible. The organization must put its knowledge and experience to good use in order to address how specific communities struggle as a result of their limited access to healthier foods and their subsequent reliance on fast food and processed foods as part of the daily diet. Although these behaviors are common, they should not be accepted as the norm because they pose serious threats to the health and wellbeing of many people within these communities. It is evident that additional support and guidance is required so that members of these communities are able to access foods that will contribute to a greater sense of health and wellbeing, as well as the prevention of diabetes.

Conclusion

Diabetes as a health epidemic ha-s posed significant challenges and has widely contributed to the health disparities that exist in many low income communities. Interestingly, these communities also possess limited access to many healthy foods because they are not in proximity to these residents, or they are cost prohibitive within many fixed budgets. As a result, there is a greater reliance on processed foods with higher sodium and fat content, as well as fast foods. However, there has been a significant push towards the development of strategies to improve access to healthier foods directly within these communities through the expansion of food hubs, as well as individual and community gardens to enable residents to access fresh produce without difficulty or at a high cost. These resources are of critical importance in enabling residents from low income communities to gain greater access to healthier foods that will alleviate some of the risks associated with diabetes and other chronic illnesses.

Organizations with significant resources, such as the American Diabetes Association, must be highly instrumental in shaping the direction of future policies regarding healthy eating that will have a positive impact on outcomes for low income communities. These efforts must include an expansion of resources to support local farming and the development of gardens to grow produce that will enable residents to obtain locally grown produce in order to prepare and consume healthier foods. This process is ongoing and requires a high level of support and an understanding of the challenges and needs of lower income communities, and to use this process as part of a much larger effort to alleviate some of the disparities that exist between the rich and the poor. Improving access to healthier foods to alleviate chronic illness and reduce the spread of diseases such as diabetes is one area that requires critical attention and focus. This problem is a severe epidemic that requires ongoing consideration and analysis because of its scope, purpose, and threat to the general health of modern society.  Programmatic and policymaking efforts through collaborations between different organizations, including the American Diabetes Association, may make a significant difference in these methods and support the development of new perspectives to ensure that local residents achieve greater benefits, including their ability to eat healthier and reduce their overall risk of a potential diagnosis of diabetes, both now and in the future.

References

Diabetes Self-Management. Is going organic the way to go? Retrieved from http://www.diabetesselfmanagement.com/articles/nutrition-and-meal-planning/is_going_organic_the_way_to_go/print/

GRACE Communications Foundation (2014). Local & Regional Food Systems. Retrieved from            http://www.sustainabletable.org/254/local-regional-food-systems

Miewald, C., & McCann, E. (2014). Foodscapes and the geographies of poverty: sustenance, strategy, and politics in an urban neighborhood. Antipode, 46(2), 537-556.

Raja, S., Ma, C., & Yadav, P. (2008). Beyond food deserts: measuring and mapping racial disparities in neighborhood food environments. Journal of Planning Education and Research, 27, 469-482.

Schulz, A.J., & Lempert, L.B. (2004). Being part of the world: Detroit women’s perceptions of  health and the social environment. Journal of Contemporary Ethnography, 33(4), 437-465.

Syme, S.L., & Berkman, L.F. Social Class, Susceptibility, and sickness. Pp. 29-33.

UCLA Center for Health Policy Research (2008). Designed for disease: the link between local food environments and obesity and diabetes. Retrieved from http://www.policylink.org/atf/cf/%7B97c6d565-bb43-406d-a6d5-eca3bbf35af0%7D/DESIGNEDFORDISEASE_FINAL.PDF