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Influenza A
Influenza A is a highly contagious communicable disease that severely affects the population of the US and the state of Florida in particular. An estimated 36,000 people die from the disease each year, and more than 100,000 are admitted to the hospitals. The Florida Flu Review shows a relatively stable incidence of approximately 2 to 5 percent of ED and UCC visits caused by influenza, and the preliminary estimated mortality resulting from pneumonia and influenza of 165 deaths (Florida Department of Health, 2016).
Aside from the high mortality rate, influenza A is dangerous for several reasons. First, several population groups, including children at a young age, old people, and people with chronic illnesses and weak health are at higher risk of getting a range of complications resulting from influenza A. Second, the virus is highly adaptable to countermeasures, which leads to the high (up to 40%) probability of developing it during the outbreak (Florida Department of Health, 2016). Third, influenza A has been conclusively associated with several negative maternal and neonatal outcomes, such as low birth weight, premature birth, and infant death (Doyle, Goodin, & Hamilton, 2013). These findings, combined with the fact that pregnant women are at higher risk of developing the disease because of the changes in the immune system and lung function associated with pregnancy, illustrate the possible impact influenza A has on the Miami population. Obesity has also been shown to increase the risk of developing the disease, which is a seriously aggravating factor considering the high obesity rates characteristic of the state of Florida (Doyle et al., 2013). Finally, the sporadic nature of the influenza outbreaks, coupled with the incapacitating symptoms, is responsible for the high rates of school absenteeism. This obviously compromises the integrity of educational activities and decreases overall social performance.
HIV/AIDS
HIV/AIDS is among the most widely recognized health issues of the Miami community, rivaled only by obesity. The state of Florida is constantly cited as one of the leading states in terms of HIV/AIDS incidence nationwide, with a steady increase in reported cases each year. The previous year saw an unusually sharp increase of 23 percent a contrast to the improvements observed prior to 2012 (Florida Department of Health, 2015). Miami-Dade County traditionally occupies the leading position among other Florida counties, with a current picture of one in 100 residents being HIV-positive. The city of Miami is currently a leader among the American cities in terms of AIDS diagnoses (Florida Department of Health, 2015). The number of reported pediatric cases is equally high both in the state and in the city of Miami. This fact is especially important since it both signifies a community threat and is grounded in a cultural layout.
HIV, and, by extension, AIDS, are largely social issues. Their incidence is strongly associated with the cultural and social background of the population. HIV incidence is dominant among the black segment of the population, presented by almost half the cases in Miami. The other half is distributed relatively equally between the Hispanic and white populations (HIV Incidence Rate, 2015). Another important factor is the gender distribution: more than 70% of cases are that of males (HIV Incidence Rate, 2015). Both results are best explained by the cultural background of the Miami population, which is highly diverse and traditionally includes a high number of immigrants. Such a setting is more prone to the disease for several reasons.
First, both the Latino and the black segment of Miami population are traditionally less educated and, in some cases, have insufficient knowledge of English, which nullifies the educational effort of community health establishments. Second, the cultural values of the Latino population usually codify the behavior of a male as a dominant machismo type, which is rarely compatible with safe sex practices, such as condom use or monogamy. Third, the illegal nature of some immigration practices restricts the use of official healthcare establishments. Finally, the diversity of cultural backgrounds complicates the implementation of standardized universal policies applicable to the majority of the population.
All of the issues combined illustrate the complexity of AIDS as a socially-rooted disease and suggest the need for the multi-faceted approach as the most likely solution for the problem.
Giardiasis
Giardiasis is a contagious illness caused by the microscopic parasite. Its symptoms include dehydration, diarrhea, vomiting, cramps, and greasy stools. It is durable and relatively easily avoidable but is complicated by several factors, most of which are characteristic of the city of Miami and Miami-Dade County. For this reason, the incidence of giardiasis is relatively high in the area: 1,219 positive cases were observed between 2011 and 2014. Besides, the distribution of incidents is similar to that of HIV: the Hispanic population represents the dominant part of the cases (62% of immigrants and 71% of residents), followed by the Non-Hispanic White (14% and 19%, respectively) and Non-Hispanic Black (4% and 6%, respectively) (Griffin, 2016). Such distribution suggests that the reasons behind the disease at least partially coincide with those of HIV, and thus reside within the social domain.
Giardiasis is mainly distributed by ingesting the parasite orally mostly with food or water, and, in some cases, via unprotected sexual contact. The official CDC recommendations on decreasing the risk of acquiring the disease centers around hand hygiene, avoidance of potentially contaminated food and water, and proper contraception (Griffin, 2016). Despite the easily applicable measures, the incidence is strong among the immigrants, who are traditionally numerous in the Miami-Dade County. This leads to the conclusion that the disease is grounded in a social environment and will persist unless specific measures are taken.
Intervention Plan
The Healthy People 2020 initiative offers a range of objectives consistent with the diseases in question. Some of the outlined objectives are applicable to all three illnesses while others address a specific disease.
A notable persistent issue which can be viewed as a cause of both HIV/AIDS and giardiasis prevalence is the poor literacy level and lack of health-oriented education, which, in turn, is a result of the social disparities between ethnic and cultural groups. Thus, the plan must include the encompassing educational and awareness events oriented at the diverse populations, or a number of specialized events each targeting a certain group. This will help reduce the giardiasis occurrences and improve the understanding of HIV causes. Food and water safety may be another relevant topic, but is unlikely to significantly change the picture, since it is not a primary cause of the giardiasis situation in Miami (Griffin, 2016). On the other hand, the LGBT-oriented policies which improve the relevant professional skills of the medical personnel and create the friendly and understanding environment will partially alleviate the burden of giardiasis and seriously improve the HIV situation. Besides, the plan should introduce antiretroviral therapies and health services covering health issues indirectly associated with the disease. The plan must also include appropriately scheduled nasal vaccinations, which will minimize influenza A incidence. The intranasal method is preferable since it is the least intrusive and best suitable for schoolchildren.
References
Doyle, T. J., Goodin, K., & Hamilton, J. J. (2013). Maternal and neonatal outcomes among pregnant women with 2009 pandemic influenza A (h1n1) illness in Florida, 2009-2010: A population-based cohort study. PloS one, 8(10), 1-12.
Florida Department of Health. (2015). EPI monthly report.
Florida Department of Health. (2016). Florida flu review. Web.
Griffin, I. (2016). Refugees and residents: the epidemiology of giardiasis in Miami-Dade County, Florida, 2011-2014.
HIV Incidence Rate. (2015).
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