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Health Impact Framework/Research Paper

Malnutrition

Delaware Technical and Community College

NUR 310 Global Health

Alyssa Shoemaker

December 3, 2017
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ABSTRACT

Malnutrition is a key factor in the global burden of disease. Malnutrition includes people of

society who are underweight and overweight. Nutritional status is a fundamental part of the growth of

young children, their proper mental and physical development, and their health as adults (Skolnik,

2016). In some underdeveloped countries, undernourished and inadequate nutrition can lead to early

deaths for mothers, infants, and young children, and impaired physical and brain development in young

children (Challenges, 2017). In developing countries, obesity is a growing problem. Obesity can lead

to many diseases such as cancer, cardiovascular disease, and diabetes (Challenges, 2017). There are

multiple socioeconomic factors that impact malnutrition. There are many clinical interventions and

ways to change the culture to help aid with malnutrition. There are also many different professional

opportunities in the global health field.

INTRODUCTION

Nutritional status is a fundamental part of the growth of young children, their proper mental and

physical development, and their health as adults (Skolnik, 2016). Malnutrition is a key factor in the

global burden of disease. Malnutrition includes people of society who are underweight and

overweight. In some underdeveloped countries, undernourished and inadequate nutrition can lead to

early deaths for mothers, infants, and young children, and impaired physical and brain development in

young children (Challenges, 2017). In developing countries, obesity is a growing problem. Obesity

can lead to many diseases such as cancer, cardiovascular disease, and diabetes (Challenges, 2017).

Under-nutrition contributes to about one third of all child deaths and thirteen million children are born

with low birth weight or prematurely due to maternal malnutrition and a lack of essential vitamins and

minerals in the diet affects immunity and healthy development. Maternal malnutrition, which accounts

for more than ten percent of the global burden of disease, also leads to poor fetal development and

higher risk of pregnancy complications (Challenges, 2017). On the other hand, about 1.5 billion people
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are overweight worldwide and about 43 million children under age five were considered obese

(Challenges, 2017). Growing rates of maternal obesity are leading to higher risks of pregnancy

complications and heavier birth weight and obesity in children. All over the world, at least 2.6 million

people die each year as a result of being overweight or obese (Challenges, 2017). There are many

socioeconomic factors that relate to malnutrition, as well as interventions we can take to help fight this

global health problem. One must also consider long term and long-lasting interventions to plan and

teach a society healthy alternatives with their resources and career opportunities.

SOCIOECONOMIC FACTORS

There are multiple socioeconomic factors that impact malnutrition. Socioeconomic refers to a

person's economic, social, and work status. People with higher education have more control over their

lives and their socioeconomic status. Once their status improves, their health does as well (Skolnik,

2016). If you can't afford food to eat, or eat the right amount of proteins, carbs, fats, etc., the chance of

dying or having health problems obviously increases. In order for the body to survive and maintain

itself, it needs the proper nutrients. Some underdeveloped and poor countries would still have this

problem. Communicable diseases and nutritional causes still account for half of premature deaths in

Africa (Global Burden, 2017). Although Dr. Majid Ezzati, Chair in Global Environmental Health at

Imperial College London stated in his article from the Institute for Health and Metrics Evaluation, We

have gone from a world 20 years ago where people werent getting enough to eat to a world now where

too much food and unhealthy food even in developing countries is making us sick (Global Burden,

para 14).

Education plays a major role in being healthy and eating the proper foods. Studies have shown

that the single best predictor of the birth weight of a baby is the level of education of the mother

(Skolnik, 2016). Consuming enough calories with the appropriate nutrients is very important for your

body's health. Iodine is an important regulator of your thyroid. Salt made with Iodine is seen in more
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high income countries than in low income. Iron and folic acid are also important parts of your diet

especially while pregnant. Many women in low-income countries do not get supplements of iron or

folic acid or able to eat many foods with iron and folic acid (Skolnik, 2016). In some countries, the

amount of food a person receives depends upon social position. In some cases, the women and girls do

not get as much food or as much nutritious foods as the boys and men get (Skolnik, 2016). Some

cultures may not believe in breast feeding or may not have the education to understand the benefits of

breast feeding. This will effect whether the baby gets the appropriate nutrients it needs to survive in the

first few months especially if the appropriate food is not available.

Cultural factors that increase obesity in Egypt and Saudi Arabia is that women are discouraged

from participating in physical activity (Skolnik, 2016). In some cultures like Arab and African

countries, being obese is a sign of prosperity (Skolnik, 2016). All over the world, our own health

practices and beliefs lead to being malnourished. The way we live everyday depends upon our health.

Anorexia or Bulimia to avoid weight gain can lead to major health problems and eventually cause

death.

INTERVENTIONS

There are many clinical interventions and ways to change the context to help aid with malnutrition.

The healthcare team needs to focus on entire family, don't just focus on the individual obese child,

spend more time on treatment, target changes in physical activity and sedentary behavior, not just

changes in diet, aim for weight maintenance instead of weight loss in most cases (Reilly, J J, 2006). A

child, rather than adult, is learning and accepting the parents lifestyle. It is important to look at the

whole family rather than just the obese child to help modify lifestyle changes. Nurses need to promote

physical activity and abandon a sedentary lifestyle. So many children these days are caught up in

playing with electronics rather than going outside to play.

Some other short term interventions the community can take is having water readily available,
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designing communities to promote physical activity, bicycling instead of driving, taxing alcohol and

soda, reducing sodium, and promote breast feeding (Frieden, T.R., 2010). Heath care workers can

assess for nutritional deficiency. Nurses need to look for physical signs and symptoms of malnutrition

such as delayed growth and development determined by growth charts, pallor of skin, mucous

membranes, nail beds, changes in hair color or physical appearance, and edema (Nutritional

Assessment, 1973). The sooner this can be diagnosed, the sooner the treatment plan can be made

available. Nurses can facilitate interactions with dietitians or local nutritional support groups. This can

help individuals plan a diet which best suits them with their available resources. Health care staff can

also recommend to some individuals surgical possibilities, such as gastric bypass or the gastric sleeve.

Health coverage can be limited in some countries and is a greater problem in the United States

and other countries without universal healthcare coverage (Freiden, T.R., 2010). Nonadherence,

rigorous accountability, incentives for meaningful outcomes, and systems to enable improved

performance are all essential to improve health care system performance (Freiden T.R., 2010).

Electronic health records have the potential to facilitate greatly improved preventive and chronic care

across the country. This goal is more likely to be reached if electronic record keeping is implemented

along with changes in both financial incentives and physician practices to proactively support

preventive care and control of chronic diseases (Reilly, J J, 2006).

Long term interventions would include improving government policy and action on nutrition. It

will require a good understanding of the nature of the nutrition problem in different situations like

group, gender, and ethnicity, and each of these will need tailored to their local circumstances (Skolnik,

2016). People of society need to create partnerships of civil society, government, and the private sector

that can work together to ensure nutritional needs are being met and how they can collaborate with

each other to implement solutions (Skolnik, 2016).

The Diffusion of Innovations Model can be related to Malnutrition. Its origins were that it
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focuses on promoting agricultural change in the U.S. Communication is needed to promote social

change and that by the diffusion process by which innovations are communicated over time among

people from different groups and societies (Skolnik, 2016). If the health care team discusses the

importance of proper nutrients in foods and create diet plans it will help with nutrition across society.

Nurses can also educate on how to grow gardens so we are able to grow our own healthy foods and

vegetables or innovate different ways to grow certain vegetables in certain environmental conditions.

Nurses can also involve physical therapy who can incorporate a new exercise program to help people

lose weight or just build muscle.

CAREER OPPORTUNITIES

There are many different professional opportunities in the global health field. Nurses could

work for the Centers for Disease Control and Prevention. The Centers for Disease Control and

Prevention has many links to opportunities. One example, from the CDC website, is collecting data

through surveys. Violence Against Children Surveys (VACS) has collected data on violence for

approximately ten percent of the world's youth population. The results showed that almost one in four

girls describe their first sexual experience as being forced or coerced. This has led to pregnancy and

HIV transmission. It is by this data collected that we can effectively come up with a plan to help slow

and/or stop the transmission of sexual diseases. Nurses can also educate about vaccines and how they

can fight diseases and save lives.

There is a Rwands Biomedical Center that held a training for their noncommunicable disease

program managers. Being part of a program like that would be an interesting career choice. The CDC

has worked with Thailand Ministry of Public Health and has produced new disease prevention and

intervention strategies that have had pertinent global impacts. There are also volunteer opportunities

like taking a job in the Peace Corps. Working for the World Health Organization would also be a career
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opportunity in global health. The CDC works along with the WHO, for example, creating regional

stockpiles of personal protective equipment and medicines for emergency outbreak response.
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REFERENCES

Challenges. (n. d.). 2017. World Health Organization. Retrieved from:

http://www.who.int/nutrition/challenges/en/

Clinical Assessment of Nutritional Status. (n. d.) (1973). American Journal of Public Health.
Retrieved from: http://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.63.11_Suppl.18

Frieden, T.R. (2010). A framework for public health action: The health pyramid. American Journal of
Public Health, 100(4), 590-595. (doi:10.2105/AJPH.2009.185652)

Global Burden of Disease: Massive shifts reshape the health landscape worldwide 2012. 2017.
Institute for Health Metrics and Evaluation. Retrieved from: http://www.healthdata.org/news-
release/global-burden-disease-massive-shifts-reshape-health-landscape-worldwide

Reilly, J J. (2006). Tackling the obesity epidemic: new approaches. US National Library of Medicine
National Institutes of Health. Retrieved from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2082930/

Skolnik, R. (2016). Global health 101 (Third ed.). Burlington, MA: Jones & Bartlett Learning.