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
For this week’s discussion, the selected practice problem is obesity among non-Hispanic Black African Americans residing in Prince George’s County, Maryland. This issue demands a multifaceted approach that integrates epidemiologic analysis, targeted health surveillance, and ethical data application. National and county-level statistics reveal the disproportionate burden of obesity within this group, shaped by socioeconomic, cultural, and environmental determinants.
Both descriptive and analytic epidemiology are essential in identifying high-risk populations, examining causal factors, and guiding interventions (CDC, 2022). Health surveillance systems help monitor trends, allocate resources, and support policies that promote equitable access to healthier food and physical activity. When ethical principles are embedded, these initiatives strengthen public trust and work toward reducing disparities in obesity outcomes (Maryland Department of Health and Mental Hygiene, 2022).
Explore the epidemiologic principles and measures used to address your selected practice problem at the national and specific geographic (city or county level) location for the population you have selected
Definition of Overweight and Obesity
According to the Maryland Department of Health & Mental Hygiene (2022):
- Adults with a BMI of 25.0–29.9 are considered overweight.
- Adults with a BMI ≥ 30.0 are considered obese.
- Children and adolescents are categorized as overweight when BMI ≥ 85th percentile, and obese at BMI ≥ 95th percentile for age and height.
Obesity is particularly concerning because it increases the risk of cardiovascular disease, diabetes, certain cancers, arthritis, and premature mortality (Miller et al., 2022).
Epidemiology of Obesity
National Level
At the national level, obesity is measured using prevalence, incidence, and mortality rates. According to the CDC (2022), the prevalence of obesity is higher among non-Hispanic Blacks (46.8%) compared with non-Hispanic Whites (37.9%) and non-Hispanic Asians (12.7%). These statistics highlight systemic racial disparities in obesity across the United States.
Local (Prince George’s County) Level
Prince George’s County, which has a predominantly African American population, mirrors or exceeds national averages. In 2015, 30.7% of adults and 15.1% of adolescents (ages 12–19) were obese, compared with 28.9% and 11.5% statewide, respectively (US Department of Health and Human Services Office of Minority Health, 2020).
By 2021, the prevalence of adult obesity among Black African Americans in the county rose to 43.8%, surpassing both Maryland’s rate of 34.1% and the U.S. rate of 33.9%.
Table 1: Obesity Prevalence Comparison
| 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 to address the practice problem and include data points (i.e., prevalence, incidence, mortality).
Descriptive Epidemiology
Descriptive epidemiology highlights the distribution of obesity by person, place, and time. In Prince George’s County:
- By Person: Black women are disproportionately impacted, with a prevalence of 75.5%, compared to 61.8% of White women.
- By Place: Low-income neighborhoods often lack access to grocery stores and safe recreational areas.
- By Time: Obesity trends show an upward trajectory in the last two decades (CDC, 2024).
Health disparities are further reflected in reduced life expectancy (77.7 years), and a 19% higher all-cause mortality rate among African Americans compared to Whites (Maryland Department of Health and Mental Hygiene, 2022).
Analytic Epidemiology
Analytic epidemiology focuses on determinants and causal relationships:
- Socioeconomic status influences dietary quality and opportunities for physical activity (Barrington et al., 2021).
- Environmental factors, such as the high density of fast-food outlets and limited supermarkets, contribute to unhealthy eating patterns (Bleich et al., 2021).
- Healthcare system barriers, including provider bias and limited culturally competent care, worsen outcomes for Black African Americans (Hui et al., 2020).
Propose how you might use surveillance to influence the determinants of health and improve the health outcomes of your population
Health surveillance systems can track obesity rates, identify risk clusters, and assess intervention effectiveness. In Prince George’s County, surveillance can:
- Monitor Trends – Evaluate progress in obesity reduction over time.
- Target Resources – Direct interventions to high-risk areas with limited access to healthy food or safe recreation.
- Support Policy – Provide data to advocate for urban planning reforms, nutrition assistance programs, and school-based wellness initiatives (Barrington et al., 2021).
- Improve Clinical Engagement – Incorporate digital health tools for real-time weight monitoring and personalized feedback.
Anticipate any ethical concerns that you might have related to the use of surveillance data in your population
Ethical considerations include:
- Confidentiality and Privacy: Safeguarding individual data when conducting surveillance.
- Bias and Stigmatization: Avoiding weight stigma and culturally insensitive messaging.
- Equity in Access: Ensuring that interventions are available across socioeconomic groups.
- Systemic Racism: Recognizing structural racism as a driver of obesity disparities (Longmire-Avital et al., 2019).
- Informed Consent: Obtaining patient consent when necessary for data collection.
Ethical obesity management requires cultural competence, addressing socioeconomic barriers, and ensuring that health promotion strategies do not perpetuate racial inequities (Payne-Sturges et al., 2021).
Conclusion
Addressing obesity in African American populations of Prince George’s County requires a comprehensive strategy that integrates epidemiologic analysis, health surveillance, and ethical practice. Descriptive and analytic epidemiology illuminate disparities, while surveillance systems support targeted interventions. By embedding cultural competence, equity, and community engagement, health systems can build trust, reduce disparities, and improve long-term health outcomes.
References
(Kept APA 7th edition; expanded with relevant citations you provided)
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 (CDC). (2022). Obesity prevalence in the U.S. https://www.cdc.gov
Centers for Disease Control and Prevention (CDC). (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
NR 717 Week 2 Discussion Epidemiology and Health Surveillance
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
US Department of Health and Human Services Office of Minority Health. (2020). Minority health framework for eliminating disparities. https://minorityhealth.hhs.gov