Epidemiology replies week 6

AnaidaSimonyantsEpidemiologyreply.docx

Anaida Simonyants

10 hours ago, at 10:04 AM

NEW

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Risk behaviors among adolescents in Miami Dade County. Historical and social bases

High-risk behaviors are defined as acts that increase the risk of disease or injury, which can subsequently lead to disability, death, or social problems. The most common high-risk behaviors include violence, alcoholism, tobacco use disorder, risky sexual behaviors, and eating disorders (Tariq & Gupta, 2024). The cause-and-effect relationship between these risk behaviors and structural racism has been studied. Structural racism, defined as the totality of ways in which societies foster discrimination through mutually reinforcing systems, includes both historical events, such as slavery, the black code, and Jim Crow laws, and more recent events, such as racist laws sanctioned by the State in the form of residential segregation (Egede et al., 2023). For example in cities throughout the South, including the City of Miami, black residents were relegated to exceedingly inferior housing (Spring, 2020).

The term redlining refers to the practice of systematically denying various services to residents of specific neighborhoods, often based on race or ethnicity and primarily within urban communities (Egede et al., 2023). Federal policy hindered the development of sustainable black communities in American cities. The creation of the Homeowners Loan Corporation (HOLC) during the New Deal helped enshrine pre-existing segregation (Swope et al., 2022). Through the HOLC, local planning agencies as well as bankers appraised neighborhoods based on lending risk involved. Racist appraisal practices meant areas of Dade county in which African Americans resided received the lowest HOLC ratings. Thus, federal policy initiated the practice of redlining. Blacks in Miami then had few options for housing and were at the mercy of white landlords, who often charged exorbitant rents for substandard housing. This situation guaranteed black neighborhoods a future of physical decay and intensified racial segregation (Spring, 2020). Having this historical knowledge we can analyze what risk behaviors among adolescents in Miami may be influenced by structural racism. Additionally, we will identify the lifelong health impacts of these risk behaviors and provide updated statistical data that enriches epidemiological knowledge.

Risk Behaviors Among Adolescents in Miami Dade County

Florida is one of 50 states conducting the Behavioral Risk Factor Surveillance System (BRFSS) with financial and technical assistance from the Centers for Disease Control and Prevention (CDC) (Behavioral risk factor surveillance system (BRFSS), n.d.). The BRFSS report that includes the data obtained during the 2017-2019 period reports alcohol consumption, physical inactivity and nutrition, and the use of and exposure to tobacco as relevant risk behaviors (De Santis & Ladapo, n.d.).

The 2020 Florida Youth Substance Abuse Survey (FYSAS) provides critical insights into the substance use behaviors among adolescents in Miami-Dade County. The most used substance was alcohol at 17% (n.d.). Meanwhile, America's Health Ranking reports 9.1% of alcohol consumption among adolescents in the last 30 days in Florida (Explore alcohol use - youth in Florida, n.d.). Although alcohol consumption was predominant, the use of other addictive substances is recognized, which represents a concern due to its impact on health in general (Toney-Butler & Siela, 2024).

Physical inactivity is another common risk behavior among adolescents in Miami-Dade County. Historical redlining has contributed to the development of neighborhoods with limited access to safe recreational spaces and facilities (Egede et al., 2023). Additionally, economic constraints may prevent families from affording extracurricular activities that promote physical fitness. Less than one-quarter (24%) of children 6 to 17 years of age participate in 60 minutes of physical activity every day. In 2017, only 26.1% of high school students participate in at least 60 minutes per day of physical activity on all 7 days of the previous week. In 2017, 51.1% of high school students participated in muscle strengthening exercises on 3 or more days during the previous week. In 2017, 51.7% of high school students attended physical education classes in an average week, and only 29.9% of high school students attended physical education classes daily (Physical activity facts, 2022). Added to this are the consumption of fast food and inadequate nutrition. These risk behaviors in children and adolescents lead to alarming figures of sedentary lifestyle in adulthood and obesity.

The CDC statistics on tobacco use among adolescents speak for themselves about the worrying problem. Tobacco product use is started and established primarily during adolescence. Nearly 9 out of 10 adults who smoke cigarettes daily first try smoking by age 18. Flavorings in tobacco products can make them more appealing to youth. In 2021, 80.2% of high school students and 74.6% of middle school students who used tobacco products in the past 30 days reported using a flavored tobacco product during that time. In 2023, 90.3% of high school students and 87.1% of middle school students who used e-cigarettes in the past 30 days reported using a flavored e-cigarette during that time(CDCTobaccoFree, 2024b).

Impact of risk behaviors on adult health

The impact of these risk behaviors during childhood and adolescence have an impact on health throughout adult life, often determining the onset of chronic diseases. Substance consumption leads to addictions and has an impact on the development of the nervous system, determining cognitive deficits and mental health problems (Substance use and co-occurring mental disorders, n.d.). It also increases the risk of suicide (Lynch et al., 2020). Miami-Dade County, Florida, is tackling obesity throughout the community, which is home to nearly 2.5 million residents. The rate of obesity and overweight adults in the county is 67.4% (CDC - community profile - Miami-Dade county, FL - communities putting prevention to work, 2019). Physical inactivity and poor hygiene and dietary habits lead to obesity and this leads to metabolic, cardiovascular and oncoproliferative diseases (Health risks of overweight & obesity, 2024). For its part, smoking is a well-documented carcinogenic factor (Weber et al., 2021). It's still true today, when nearly 9 out of 10 lung cancer deaths are caused by smoking cigarettes or secondhand smoke exposure. In the United States, more than 7,300 nonsmokers die each year from lung cancer caused by secondhand smoke (CDCTobaccoFree, 2024a).

Sources of information used

We rely on data from sources such as the CDC (Centers for Disease Control and Prevention), which is the main public health organization in the United States, whose objective is to work on the protection of public health, disease control, and the prevention of injuries and disabilities (CDC, 2024). We used data obtained through the Behavioral Risk Factor Surveillance System (BRFSS), which uses telephone health surveys that collect state-level data on health-related risk factors in the United States (Cdc - brfss, 2024). We also used Florida Youth Substance Abuse Survey (FYSAS). This is a statewide survey that assesses risk and protective factors related to substance abuse among youth (Florida youth substance abuse survey (FYSAS), n.d.). For the discussion and analysis of the content we used scholarly sources, especially from PUBMED.

In conclusion, every action has an effect. Causal relationships must be established to understand the phenomena of nature, society, and health. Structural racism, segregation, and social inequalities determine risk behaviors that persist over time and in turn generate short- and long-term problems that impact health. Segregation and its effects on risk behaviors in Miami Dade County and its impact on health are an example of this. The epidemiological approach expands the frontiers of scientific research, covering social historical background and its impact on the health and well-being of populations. The study and analysis of a health problem must delve into its roots and historical-social context, and not merely remain in the appreciation of its effects. Solutions must be aimed not only at treating the effects but also at eradicating their causes.

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PatriciaMartinGiraldinoEpidemiologyreply.docx

Patricia Martin Giraldino

Florida National University

7/302024

Adverse Childhood Experiences: An Ounce of Prevention

Adverse Childhood Experiences (ACEs) include different types of abuse, disregard, and household dysfunction that have a strong, long-term effect on health and well-being. Having explored ACEs about redlining laws and a summary of community-specific risk-related behaviors, the three most prevalent adolescent risky behaviors come into focus: substance abuse, truancy, and early sexual activity. These behaviors are aggravated by certain historical and systemic inequities, such as redlining, which permits minimal access to decent housing, education, and job opportunities, thereby fostering circles of inadequacy.

Risk-Related Behaviors Among Adolescents In The Community And Antecedent Factors Manifested In Adulthood

Substance Abuse

Substance abuse is one of the major risk behaviors among adolescents in our community. It is often used as a coping behavior to deal with their level of stress and trauma. According to research, youth with high ACEs are significantly more likely to have substance abuse (Carolina Villamil Grest, Cederbaum, Jungeun Olivia Lee, & Unger, 2021). This behavior in adolescence can lead to addiction, mental health disorders, and chronic diseases in adulthood. It may further diminish social and economic potential, eventually leading to socioeconomic instability and perpetuating ACEs through generational cycles.

Truancy

Truancy, or being chronically absent from school, is another risk-related behavior common among adolescents in marginalized communities. Instability and lack of support in the family and children not feeling safe at school are two key contributing factors to this behavior. In fact, according to research by the U.S. Department of Education, truant students can likely face issues of dropping out, which in turn causes them unemployment, poverty, and jail in their future lives (Mireles-Rios, Rios, & Reyes, 2020). Truancy has antecedent factors that extend to school failure, social and emotional development problems, and even increased involvement in criminal activities later in adulthood.

Early Sexual Activity

Early initiation of sex is common in adolescents who experience ACEs and who live in disadvantaged communities. This has been attributed to a mix of factors, which help explain the limited ability to access comprehensive sexual education and healthcare services, coupled with the normalization of this behavior that occurs as the result of high ACEs within environments. The National Campaign to Prevent Teen and Unplanned Pregnancy recognizes that too often, for many teens, early sexual activity brings about unintended pregnancies and STIs, as well as emotional distress (Song & Qian, 2020). These consequences will limit future possibilities in schools and labor markets. These conditions will also foster an increased dependence on social services and drive health inequity throughout a lifetime.

Effects of Redlining Laws and Policies

Redlining has historically segregated communities, concentrating poverty and limiting access to essential services such as healthcare, quality education, and safe recreational spaces. In turn, these conditions increase the risk of engaging in risk-related behaviors. In this regard, ACEs become systemically embedded through the redlining policies, making it quite hard to move beyond cycles of disadvantage.

The root causes of substance abuse, truancy, and early sexuality in adolescents need to be fully addressed through reforming policy, community-based intervention strategies, and increasing access to supportive services. This includes mental health preventive strategies at the level of resources, structures of educational opportunity, and safe community environments. Such an approach allows for understanding and mitigating antecedent factors associated with these behaviors to promote healthier and more stable futures for people and communities.

AnaidaSimonyantsEpidemiologyreply.docx

Anaida Simonyants

10 hours ago, at 10:04 AM

NEW

Top of Form

Risk behaviors among adolescents in Miami Dade County. Historical and social bases

High-risk behaviors are defined as acts that increase the risk of disease or injury, which can subsequently lead to disability, death, or social problems. The most common high-risk behaviors include violence, alcoholism, tobacco use disorder, risky sexual behaviors, and eating disorders (Tariq & Gupta, 2024). The cause-and-effect relationship between these risk behaviors and structural racism has been studied. Structural racism, defined as the totality of ways in which societies foster discrimination through mutually reinforcing systems, includes both historical events, such as slavery, the black code, and Jim Crow laws, and more recent events, such as racist laws sanctioned by the State in the form of residential segregation (Egede et al., 2023). For example in cities throughout the South, including the City of Miami, black residents were relegated to exceedingly inferior housing (Spring, 2020).

The term redlining refers to the practice of systematically denying various services to residents of specific neighborhoods, often based on race or ethnicity and primarily within urban communities (Egede et al., 2023). Federal policy hindered the development of sustainable black communities in American cities. The creation of the Homeowners Loan Corporation (HOLC) during the New Deal helped enshrine pre-existing segregation (Swope et al., 2022). Through the HOLC, local planning agencies as well as bankers appraised neighborhoods based on lending risk involved. Racist appraisal practices meant areas of Dade county in which African Americans resided received the lowest HOLC ratings. Thus, federal policy initiated the practice of redlining. Blacks in Miami then had few options for housing and were at the mercy of white landlords, who often charged exorbitant rents for substandard housing. This situation guaranteed black neighborhoods a future of physical decay and intensified racial segregation (Spring, 2020). Having this historical knowledge we can analyze what risk behaviors among adolescents in Miami may be influenced by structural racism. Additionally, we will identify the lifelong health impacts of these risk behaviors and provide updated statistical data that enriches epidemiological knowledge.

Risk Behaviors Among Adolescents in Miami Dade County

Florida is one of 50 states conducting the Behavioral Risk Factor Surveillance System (BRFSS) with financial and technical assistance from the Centers for Disease Control and Prevention (CDC) (Behavioral risk factor surveillance system (BRFSS), n.d.). The BRFSS report that includes the data obtained during the 2017-2019 period reports alcohol consumption, physical inactivity and nutrition, and the use of and exposure to tobacco as relevant risk behaviors (De Santis & Ladapo, n.d.).

The 2020 Florida Youth Substance Abuse Survey (FYSAS) provides critical insights into the substance use behaviors among adolescents in Miami-Dade County. The most used substance was alcohol at 17% (n.d.). Meanwhile, America's Health Ranking reports 9.1% of alcohol consumption among adolescents in the last 30 days in Florida (Explore alcohol use - youth in Florida, n.d.). Although alcohol consumption was predominant, the use of other addictive substances is recognized, which represents a concern due to its impact on health in general (Toney-Butler & Siela, 2024).

Physical inactivity is another common risk behavior among adolescents in Miami-Dade County. Historical redlining has contributed to the development of neighborhoods with limited access to safe recreational spaces and facilities (Egede et al., 2023). Additionally, economic constraints may prevent families from affording extracurricular activities that promote physical fitness. Less than one-quarter (24%) of children 6 to 17 years of age participate in 60 minutes of physical activity every day. In 2017, only 26.1% of high school students participate in at least 60 minutes per day of physical activity on all 7 days of the previous week. In 2017, 51.1% of high school students participated in muscle strengthening exercises on 3 or more days during the previous week. In 2017, 51.7% of high school students attended physical education classes in an average week, and only 29.9% of high school students attended physical education classes daily (Physical activity facts, 2022). Added to this are the consumption of fast food and inadequate nutrition. These risk behaviors in children and adolescents lead to alarming figures of sedentary lifestyle in adulthood and obesity.

The CDC statistics on tobacco use among adolescents speak for themselves about the worrying problem. Tobacco product use is started and established primarily during adolescence. Nearly 9 out of 10 adults who smoke cigarettes daily first try smoking by age 18. Flavorings in tobacco products can make them more appealing to youth. In 2021, 80.2% of high school students and 74.6% of middle school students who used tobacco products in the past 30 days reported using a flavored tobacco product during that time. In 2023, 90.3% of high school students and 87.1% of middle school students who used e-cigarettes in the past 30 days reported using a flavored e-cigarette during that time(CDCTobaccoFree, 2024b).

Impact of risk behaviors on adult health

The impact of these risk behaviors during childhood and adolescence have an impact on health throughout adult life, often determining the onset of chronic diseases. Substance consumption leads to addictions and has an impact on the development of the nervous system, determining cognitive deficits and mental health problems (Substance use and co-occurring mental disorders, n.d.). It also increases the risk of suicide (Lynch et al., 2020). Miami-Dade County, Florida, is tackling obesity throughout the community, which is home to nearly 2.5 million residents. The rate of obesity and overweight adults in the county is 67.4% (CDC - community profile - Miami-Dade county, FL - communities putting prevention to work, 2019). Physical inactivity and poor hygiene and dietary habits lead to obesity and this leads to metabolic, cardiovascular and oncoproliferative diseases (Health risks of overweight & obesity, 2024). For its part, smoking is a well-documented carcinogenic factor (Weber et al., 2021). It's still true today, when nearly 9 out of 10 lung cancer deaths are caused by smoking cigarettes or secondhand smoke exposure. In the United States, more than 7,300 nonsmokers die each year from lung cancer caused by secondhand smoke (CDCTobaccoFree, 2024a).

Sources of information used

We rely on data from sources such as the CDC (Centers for Disease Control and Prevention), which is the main public health organization in the United States, whose objective is to work on the protection of public health, disease control, and the prevention of injuries and disabilities (CDC, 2024). We used data obtained through the Behavioral Risk Factor Surveillance System (BRFSS), which uses telephone health surveys that collect state-level data on health-related risk factors in the United States (Cdc - brfss, 2024). We also used Florida Youth Substance Abuse Survey (FYSAS). This is a statewide survey that assesses risk and protective factors related to substance abuse among youth (Florida youth substance abuse survey (FYSAS), n.d.). For the discussion and analysis of the content we used scholarly sources, especially from PUBMED.

In conclusion, every action has an effect. Causal relationships must be established to understand the phenomena of nature, society, and health. Structural racism, segregation, and social inequalities determine risk behaviors that persist over time and in turn generate short- and long-term problems that impact health. Segregation and its effects on risk behaviors in Miami Dade County and its impact on health are an example of this. The epidemiological approach expands the frontiers of scientific research, covering social historical background and its impact on the health and well-being of populations. The study and analysis of a health problem must delve into its roots and historical-social context, and not merely remain in the appreciation of its effects. Solutions must be aimed not only at treating the effects but also at eradicating their causes.

Bottom of Form

PatriciaMartinGiraldinoEpidemiologyreply.docx

Patricia Martin Giraldino

Florida National University

7/302024

Adverse Childhood Experiences: An Ounce of Prevention

Adverse Childhood Experiences (ACEs) include different types of abuse, disregard, and household dysfunction that have a strong, long-term effect on health and well-being. Having explored ACEs about redlining laws and a summary of community-specific risk-related behaviors, the three most prevalent adolescent risky behaviors come into focus: substance abuse, truancy, and early sexual activity. These behaviors are aggravated by certain historical and systemic inequities, such as redlining, which permits minimal access to decent housing, education, and job opportunities, thereby fostering circles of inadequacy.

Risk-Related Behaviors Among Adolescents In The Community And Antecedent Factors Manifested In Adulthood

Substance Abuse

Substance abuse is one of the major risk behaviors among adolescents in our community. It is often used as a coping behavior to deal with their level of stress and trauma. According to research, youth with high ACEs are significantly more likely to have substance abuse (Carolina Villamil Grest, Cederbaum, Jungeun Olivia Lee, & Unger, 2021). This behavior in adolescence can lead to addiction, mental health disorders, and chronic diseases in adulthood. It may further diminish social and economic potential, eventually leading to socioeconomic instability and perpetuating ACEs through generational cycles.

Truancy

Truancy, or being chronically absent from school, is another risk-related behavior common among adolescents in marginalized communities. Instability and lack of support in the family and children not feeling safe at school are two key contributing factors to this behavior. In fact, according to research by the U.S. Department of Education, truant students can likely face issues of dropping out, which in turn causes them unemployment, poverty, and jail in their future lives (Mireles-Rios, Rios, & Reyes, 2020). Truancy has antecedent factors that extend to school failure, social and emotional development problems, and even increased involvement in criminal activities later in adulthood.

Early Sexual Activity

Early initiation of sex is common in adolescents who experience ACEs and who live in disadvantaged communities. This has been attributed to a mix of factors, which help explain the limited ability to access comprehensive sexual education and healthcare services, coupled with the normalization of this behavior that occurs as the result of high ACEs within environments. The National Campaign to Prevent Teen and Unplanned Pregnancy recognizes that too often, for many teens, early sexual activity brings about unintended pregnancies and STIs, as well as emotional distress (Song & Qian, 2020). These consequences will limit future possibilities in schools and labor markets. These conditions will also foster an increased dependence on social services and drive health inequity throughout a lifetime.

Effects of Redlining Laws and Policies

Redlining has historically segregated communities, concentrating poverty and limiting access to essential services such as healthcare, quality education, and safe recreational spaces. In turn, these conditions increase the risk of engaging in risk-related behaviors. In this regard, ACEs become systemically embedded through the redlining policies, making it quite hard to move beyond cycles of disadvantage.

The root causes of substance abuse, truancy, and early sexuality in adolescents need to be fully addressed through reforming policy, community-based intervention strategies, and increasing access to supportive services. This includes mental health preventive strategies at the level of resources, structures of educational opportunity, and safe community environments. Such an approach allows for understanding and mitigating antecedent factors associated with these behaviors to promote healthier and more stable futures for people and communities.

AnaidaSimonyantsEpidemiologyreply.docx

Anaida Simonyants

10 hours ago, at 10:04 AM

NEW

Top of Form

Risk behaviors among adolescents in Miami Dade County. Historical and social bases

High-risk behaviors are defined as acts that increase the risk of disease or injury, which can subsequently lead to disability, death, or social problems. The most common high-risk behaviors include violence, alcoholism, tobacco use disorder, risky sexual behaviors, and eating disorders (Tariq & Gupta, 2024). The cause-and-effect relationship between these risk behaviors and structural racism has been studied. Structural racism, defined as the totality of ways in which societies foster discrimination through mutually reinforcing systems, includes both historical events, such as slavery, the black code, and Jim Crow laws, and more recent events, such as racist laws sanctioned by the State in the form of residential segregation (Egede et al., 2023). For example in cities throughout the South, including the City of Miami, black residents were relegated to exceedingly inferior housing (Spring, 2020).

The term redlining refers to the practice of systematically denying various services to residents of specific neighborhoods, often based on race or ethnicity and primarily within urban communities (Egede et al., 2023). Federal policy hindered the development of sustainable black communities in American cities. The creation of the Homeowners Loan Corporation (HOLC) during the New Deal helped enshrine pre-existing segregation (Swope et al., 2022). Through the HOLC, local planning agencies as well as bankers appraised neighborhoods based on lending risk involved. Racist appraisal practices meant areas of Dade county in which African Americans resided received the lowest HOLC ratings. Thus, federal policy initiated the practice of redlining. Blacks in Miami then had few options for housing and were at the mercy of white landlords, who often charged exorbitant rents for substandard housing. This situation guaranteed black neighborhoods a future of physical decay and intensified racial segregation (Spring, 2020). Having this historical knowledge we can analyze what risk behaviors among adolescents in Miami may be influenced by structural racism. Additionally, we will identify the lifelong health impacts of these risk behaviors and provide updated statistical data that enriches epidemiological knowledge.

Risk Behaviors Among Adolescents in Miami Dade County

Florida is one of 50 states conducting the Behavioral Risk Factor Surveillance System (BRFSS) with financial and technical assistance from the Centers for Disease Control and Prevention (CDC) (Behavioral risk factor surveillance system (BRFSS), n.d.). The BRFSS report that includes the data obtained during the 2017-2019 period reports alcohol consumption, physical inactivity and nutrition, and the use of and exposure to tobacco as relevant risk behaviors (De Santis & Ladapo, n.d.).

The 2020 Florida Youth Substance Abuse Survey (FYSAS) provides critical insights into the substance use behaviors among adolescents in Miami-Dade County. The most used substance was alcohol at 17% (n.d.). Meanwhile, America's Health Ranking reports 9.1% of alcohol consumption among adolescents in the last 30 days in Florida (Explore alcohol use - youth in Florida, n.d.). Although alcohol consumption was predominant, the use of other addictive substances is recognized, which represents a concern due to its impact on health in general (Toney-Butler & Siela, 2024).

Physical inactivity is another common risk behavior among adolescents in Miami-Dade County. Historical redlining has contributed to the development of neighborhoods with limited access to safe recreational spaces and facilities (Egede et al., 2023). Additionally, economic constraints may prevent families from affording extracurricular activities that promote physical fitness. Less than one-quarter (24%) of children 6 to 17 years of age participate in 60 minutes of physical activity every day. In 2017, only 26.1% of high school students participate in at least 60 minutes per day of physical activity on all 7 days of the previous week. In 2017, 51.1% of high school students participated in muscle strengthening exercises on 3 or more days during the previous week. In 2017, 51.7% of high school students attended physical education classes in an average week, and only 29.9% of high school students attended physical education classes daily (Physical activity facts, 2022). Added to this are the consumption of fast food and inadequate nutrition. These risk behaviors in children and adolescents lead to alarming figures of sedentary lifestyle in adulthood and obesity.

The CDC statistics on tobacco use among adolescents speak for themselves about the worrying problem. Tobacco product use is started and established primarily during adolescence. Nearly 9 out of 10 adults who smoke cigarettes daily first try smoking by age 18. Flavorings in tobacco products can make them more appealing to youth. In 2021, 80.2% of high school students and 74.6% of middle school students who used tobacco products in the past 30 days reported using a flavored tobacco product during that time. In 2023, 90.3% of high school students and 87.1% of middle school students who used e-cigarettes in the past 30 days reported using a flavored e-cigarette during that time(CDCTobaccoFree, 2024b).

Impact of risk behaviors on adult health

The impact of these risk behaviors during childhood and adolescence have an impact on health throughout adult life, often determining the onset of chronic diseases. Substance consumption leads to addictions and has an impact on the development of the nervous system, determining cognitive deficits and mental health problems (Substance use and co-occurring mental disorders, n.d.). It also increases the risk of suicide (Lynch et al., 2020). Miami-Dade County, Florida, is tackling obesity throughout the community, which is home to nearly 2.5 million residents. The rate of obesity and overweight adults in the county is 67.4% (CDC - community profile - Miami-Dade county, FL - communities putting prevention to work, 2019). Physical inactivity and poor hygiene and dietary habits lead to obesity and this leads to metabolic, cardiovascular and oncoproliferative diseases (Health risks of overweight & obesity, 2024). For its part, smoking is a well-documented carcinogenic factor (Weber et al., 2021). It's still true today, when nearly 9 out of 10 lung cancer deaths are caused by smoking cigarettes or secondhand smoke exposure. In the United States, more than 7,300 nonsmokers die each year from lung cancer caused by secondhand smoke (CDCTobaccoFree, 2024a).

Sources of information used

We rely on data from sources such as the CDC (Centers for Disease Control and Prevention), which is the main public health organization in the United States, whose objective is to work on the protection of public health, disease control, and the prevention of injuries and disabilities (CDC, 2024). We used data obtained through the Behavioral Risk Factor Surveillance System (BRFSS), which uses telephone health surveys that collect state-level data on health-related risk factors in the United States (Cdc - brfss, 2024). We also used Florida Youth Substance Abuse Survey (FYSAS). This is a statewide survey that assesses risk and protective factors related to substance abuse among youth (Florida youth substance abuse survey (FYSAS), n.d.). For the discussion and analysis of the content we used scholarly sources, especially from PUBMED.

In conclusion, every action has an effect. Causal relationships must be established to understand the phenomena of nature, society, and health. Structural racism, segregation, and social inequalities determine risk behaviors that persist over time and in turn generate short- and long-term problems that impact health. Segregation and its effects on risk behaviors in Miami Dade County and its impact on health are an example of this. The epidemiological approach expands the frontiers of scientific research, covering social historical background and its impact on the health and well-being of populations. The study and analysis of a health problem must delve into its roots and historical-social context, and not merely remain in the appreciation of its effects. Solutions must be aimed not only at treating the effects but also at eradicating their causes.

Bottom of Form

PatriciaMartinGiraldinoEpidemiologyreply.docx

AnaidaSimonyantsEpidemiologyreply.docx

PatriciaMartinGiraldinoEpidemiologyreply.docx

AnaidaSimonyantsEpidemiologyreply.docx

PatriciaMartinGiraldinoEpidemiologyreply.docx