Compose a focused paper that explains and describes your healthcare issue/topic “Lack of Affordable Housing a Public Health” Would a preventable approach to Affordable Housing improve child development? from the scientific and mathematical/analytical perspectives of inquiry. (You will cover two perspectives in one paper.)

Address your general topic by forming and answering two levels of research questions for each inquiry.

· Choose a “Level 1 Research Question/Writing Prompt” from both of the lists below to answer in the paper.

· Compose a “Level 2 Research Question/Writing Prompt” for each kind of inquiry that provides detail, specificity, and focus to your inquiry, research, and writing.

· State your research questions “Would a preventable approach to Affordable Housing improve child development? in the introduction of your paper.

· Answer each research question and support your assertions with evidence (research) to form the body of your paper.

· In the conclusion of the paper, briefly review the issues, research questions, answers, and insights.

Your paper must be five pages in length and reference four to six scholarly, peer-reviewed resources. Be sure to follow current APA Style (e.g., spacing, font, headers, titles, abstracts, page numbering).

Refer to the rubric for evaluation details and to assist in preparing the paper.

This week you are going to be composing the first 1/2 of your paper, the Scientific and Mathematical Perspectives of Inquiry. In this paper you are trying support the argument that your chosen topic “Lack of Affordable Housing a Public Health” should be considered a public health issue with evidence, not personal opinion. You will need to establish that your social or environmental injustice impacts your population in a significant way. To do that you will discuss both healthcare issues as well as the economic burdens. The content that you include will need to be inline with your research question “Would a preventative approach to affordable housing improve child development? so make sure that

· Research question “Would a preventative approach to affordable housing improve child development?: Incudes specific population (Bay Area) and disparity within chosen public health issue

. Example for decline in honeybee populations:  Would approaching the decline in honeybee populations ensure the continued availability of produce to decrease rates of chronic illness in the American population?

Your paper should also follow this outline

· Scientific and economic perspectives of inquiry (6 page)

. Establish your topic is a problem (establish link between health issue and medical condition in your population)

. Which body systems are affected?

2. One

2. Two

2. Three

. What are the economic issues involved?

Scientific and Mathematical Perspectives of Inquiry Paper

Food environment as a Public Health Issue

Would Approaching the Decline in Bee Populations as a Public Health Issue Ensure Continued Access to Crops Associated with Preventing Chronic Disease for Americans?

August 25, 2020

Kathryn Ayres

West Coast University

Evidence of the connection: Decline in bee population and chronic illness

The decline in the honeybee population has raised concerns for many environmental, health, and economic experts. Pollinators are responsible for the production of approximately 35% of the world’s supply of crops (Klein et al., 2007). This contributes 15 billion dollars to the United States economy (The Economic Challenge Posed by Declining Pollinator Populations, 2014).The honeybee alone pollinates 80% of over 100 cultivated crops (Bees as Pollinators: Arkansas Pollinators, n.d.), providing 40% of the supply of essential micronutrients (Eilers, Kremen, Smith-Greenleaf, Garber, & Klein, 2011). The intake of these foods has shown to decrease chronic diseases because of their high concentration of vitamins, minerals, fiber and phytonutrients (Boeing, et al, 2012). The loss of the honeybee would result in the loss of food security, nutrient intake, biodiversity and profitability.

A study published in the Lancet investigated the consequences of the loss of pollinator populations at 50 percent, 75 percent and 100 percent. A database of 224 types of foods from 156 countries was used to quantify nutrient composition and pollinator dependence around the world. This compilation was used to estimate the reductions of micronutrient intake and the health burden that would result at each percentage of decline. The study estimated that a 100% decline in pollinator populations could result in a decrease the supply of fruit by 22.9%, vegetables by 16.3% and nuts and seeds by 22.1%. It was estimated that this reduction of food supply could cause 1.42 million deaths related to chronic disease and malnutrition. The findings also suggested that individuals living in poor countries would experience the decline of produce differently than those living in developed countries. Areas such as the Sub-Saharan region of Africa and South Asia would be more likely to experience an increase in diseases related to deficiencies of vitamin A and folic acid leading to more night blindness and neural tube defects respectively. While wealthier countries, such as North America and Europe, would see an increase in chronic diseases and a significant rise in healthcare costs (Smith et al, 2015)

The increase in chronic illness would be a consequence of a decreased intake of micronutrients found in plant foods such as fruits, vegetables, nuts and seeds. Nutrition and pollination experts have found that the majority of vitamin C, lycopene, β-cryptoxanthin and β-tocopherol, carotenoids, calcium, fluoride, and folic acid come from pollinated crops (Eilers et al, 2011). Micronutrients are essential in the diet because are actively involved in many biological pathways that maintain physiological function. Many trace minerals such as zinc and selenium act as essential cofactors in 100s of enzymatic reactions. Organic compounds, such as vitamins, aid in biological reactions by acting as coenzymes. Some vitamins, such as vitamin A and D, can enter the nuclear envelope and act as transcription control factors and regulate gene expression. Lastly, micronutrients that include vitamin C, lycopene, β-cryptoxanthin and β-tocopherol function as antioxidants to prevent the destructive activities of reactive oxygen species (Shenkin. 2006). These micronutrients found in foods that are dependent on pollination, have been linked with the prevention of chronic diseases such as cardiovascular disease, stroke and diabetes (Eilers et al, 2011; Smith et al, 2015).

Body system one: Cardiovascular Diseases

Cardiovascular disease (CDV) is an umbrella diagnosis for medical conditions related to the heart and vasculature, some of which include coronary artery disease, deep vein thrombosis, pulmonary embolism, cardiomyopathy and myocardial infarction. One in four deaths are caused

by cardiovascular disease making it the leading cause of death the Untitled States (Center for Disease Control [CDC], 2020). Two of the most common risk factors for cardiovascular diseases are elevated LDL levels and high blood pressure (CDC, 2020) because of their ability to destroy endothelial tissue in the vasculature tissue causing atherosclerosis (Talayero &, Sacks, 2011).

Fortunately, many micronutrients, found in crops that are dependent on pollination, are able to actively prevent and reverse pathways involved in the initiation of CDV at the molecular level. For example, the antioxidants β-carotene and lycopene are fat soluble which allows them to be transported by lipoproteins such as LDL (Goulinet & Chapman, 1997). This gives them access to lipids that have been oxidized and prevent free radical damage in the vasculature. Lycopene has also shown to have gene regulation ability. In an in vitro study lycopene was able to decrease the production of LDL molecules and upregulate LDL receptors, which remove LDL from the blood. When this was tested in vivo, subjects had a 14% reduction in plasma LDL. The researchers estimated that if individuals ate foods high in lycopene there could be a 30 – 40% reduction in myocardial infarction (Fuhrman, Elis & Aviram, 1997). The prevention oxidative stress and plaque formation is important because it can also play a role in other chronic illnesses such as diabetes and stroke.

Body System Two: Diabetes II

An estimated 34.2 million people in the United Stated are diagnosed with diabetes. Individuals with this medical condition are at a higher risk for heart disease, stroke, kidney failure, blindness, neuropathy and amputations. Approximately 90- 95 percent of cases of diabetes are type two. This type of diabetes is linked with poor diet and lifestyle (CDC, 2020). Type II diabetes is a complex metabolic disease that affects the body’s ability to regulate blood glucose resulting in hyperglycemia. Prolonged exposure to modified glucose molecules in the microvasculature increases oxidative stress, further contributing to insulin insensitivity (Vlassara, & Uribarri, 2014).

Many micronutrients form pollinated crops are antioxidants and can play a role in decreasing oxidative stress. A study published in the Diabetes Care Journal investigated the effects of vitamin E supplements on patients with diabetes found a 27% decrease of plasma peroxidases, a reactive oxygen species responsible for endothelial damage, after 3 months and by 29% at 6 months (Manning, et al, 2004). The improved blood glucose control was only observed temporally indicating that insulin sensitivity is highly complex and needs multiple interventions. Vitamin E was able to bind to the unpaired electrons in the plasma without becoming destabilized, preventing endothelial damage.

Body System three: Stroke

Strokes are the fifth leading cause of death in the United States and is the leading cause of disability (CDC, 2020). 87% of strokes are ischemic and are caused by the blocking of an artery that supplies brain cells with oxygen (CDC, 2020). This blockage can occur in two ways. Atherosclerotic plaques can block off the artery entirely or a plaque in the vasculature can break off and travel in the blood to the brain and become lodged. (CDC, 2020). A hemorrhagic stroke occurs when an artery in the brain bursts and creates pressure that damages brain cells. A major risk factor for this type of cerebrovascular accident (CVA) is hypertension.

Micronutrients found in pollinated crops can also help to decrease the risk for stroke through multiple mechanisms. For example, calcium is involved in blood pressure regulation through several interrelated pathways. Serum calcium levels are controlled by parathyroid hormone (PTH). When levels are low PTH released calcium form the bone into the blood. In this attempt to correct calcium levels, intracellular levels of calcium in the smooth muscle of the vasculature increase. This causes vasoconstriction by allowing contractile fibers to interact. Low levels of calcium also activate the rennin-angiotensin pathway which stimulates the reuptake of sodium and water into the blood (Martinez, 2004). The combination of vasoconstriction and increased blood volume increase blood pressure and which could result in hypertension. Diets with sufficient calcium have shown to lower the risk for stroke (Larsson, Orsini, & Wolk 2013).

Preventing damage to the vasculature and plaque formation is also important in stroke prevention. For example, folic acid found in dark leafy greens acts as a cofactor in the recycling of homocysteine to methionine. Homocysteine is a sulfur containing intermediate in amino acid metabolism responsible for making methionine and cystine. These amino acids are eventually used for gene regulation and protein synthesis. However, if homocysteine levels are elevated, the molecule has the ability to induce endothelial dysfunction, eventually resulting in plaque formation (Wang, Mao, Wang, & Zhang, 2004). Although many studies have failed to find lower homocysteine levels after folate supplement interventions (Marcus, Sarnak, & Menon, 2007), strong evidence does exist that diets high in folate rich foods decreases the risk for stroke. In fact, there is a more substantial decrease in risk when a combination of fruits and vegetables are consumed, allowing multiple micronutrients to regulate biological pathways simultaneously (Hariri et al, 2013). This indicates that a reductionist approach to treating and preventing chronic illness is not sufficient. If disease prevention is the goal, the availability of a diverse crop supply must be protected.

Economic Burden

Agricultural

However, the loss of crop diversity is only one consequence to the decline of pollinator populations. The economic burden of this issue is two tired. Initially the impact will fall on the agricultural sector. Honeybees are responsible for contributing $15 billion dollars to the economy (The Economic Challenge Posed by Declining Pollinator Populations, 2014). The honey crop alone has been valued at $300 million for the product itself as well as its usage in other foods and cosmetics a year. Honeybees are responsible for not only crops used for human consumption but also livestock as well. It is estimated that they contribute $20 billion a year to the agricultural sector (Honey Bees Are Pollinators, n.d). Wild species of the bees, such as the bumble bee and alfalfa cutters, also play a significant role in the pollination of citrus fruit, berries and alfalfa. Their contribution has been valued at $4 billion a year (Ramanujan, 2012).

Healthcare

The second economic burden will fall on the healthcare field and to some degree already has. The cost of diabetes in the United States in 2017 was estimated at $327 billion. $237 billion was spent on direct medical costs and $90 billion in reduced productivity. The estimated cost of cardiovascular diseases was $219 billion between 2014 and 2015. The CDC also estimated that the cost of strokes, including the cost of cost of care services, medicines to treat stroke, and missed days of work was $34 billion (CDC, 2020). That is a total of $580 billion dollars spent on the treatment of diseases that can be prevented through diet.

A study published in PLOS ONE analyzed the impact of 10 dietary factors, including fruits and vegetables, to estimate the summative total of a diets that do not include adequate intake of nutrients. Their study found that the cost of a poor diet was approximately $50 billion per year for cardiometabolic diseases (CM including as heart disease, stroke and type 2 diabetes. The researchers estimate that $9.552 billion and $10.055 billion dollars are spent on healthcare costs related to CMD due to suboptimal intake of fruits and vegetables respectively (Jardim et al, 2019)

The healthcare costs in the United States compared to other countries showcases a system that does not promote prevention. In 2016 Americans spent $9,892 per capita, about 25 percent higher than the next country. The reason for this difference is that medical care is more expensive in the United States. But despite the high cost, Americans have less access to healthcare providers compared to other developed countries. (Anderson, Reinhardt, Hussey, & Petrosyan, 2003). With extravagant costs and less access to healthcare, a decrease in the availability of disease preventative foods would only exacerbate an already existing healthcare crisis in America. A public health approach to addressing the decline in bee populations could help to ensure continued production of diverse crops and that a healthy food environment is even possible.

References

Anderson, G. F., Reinhardt, U. E., Hussey, P. S., & Petrosyan, V. (2003). It’s the prices, stupid: why the United States is so different from other countries. Health affairs (Project Hope), 22(3), 89–105. https://doi.org/10.1377/hlthaff.22.3.89

Bees as Pollinators: Arkansas Pollinators. (n.d.). Retrieved August 19, 2020, from https://www.uaex.edu/farm-ranch/special-programs/beekeeping/pollinators.aspx

Boeing, H., Bechthold, A., Bub, A., Ellinger, S., Haller, D., Kroke, A., Leschik-Bonnet, E., Müller, M. J., Oberritter, H., Schulze, M., Stehle, P., & Watzl, B. (2012). Critical review: vegetables and fruit in the prevention of chronic diseases. European journal of nutrition, 51(6), 637–663. https://doi.org/10.1007/s00394-012-0380-y

Eilers, E. J., Kremen, C., Smith Greenleaf, S., Garber, A. K., & Klein, A. M. (2011). Contribution of pollinator-mediated crops to nutrients in the human food supply. PloS one, 6(6), e21363. https://doi.org/10.1371/journal.pone.0021363

Fact Sheet: The Economic Challenge Posed by Declining Pollinator Populations. (n.d.). Retrieved August 24, 2020, from https://obamawhitehouse.archives.gov/the-press-office/2014/06/20/fact-sheet-economic-challenge-posed-declining-pollinator-populations

Fact Sheets. (2020, July 08). Retrieved August 25, 2020, from https://www.cdc.gov/diabetes/library/factsheets.html

Fuhrman B, Elis A, Aviram M. Hypocholesterolemic effect of lycopene and beta-carotene is related to suppression of cholesterol synthesis and augmentation of LDL receptor activity in macrophages. Biochem Biophys Res Commun 1997;233:658–62

Goulinet S, Chapman MJ. Plasma LDL and HDL subspecies are heterogenous in particle content of tocopherols and oxygenated and hydrocarbon carotenoids. Relevance to oxidative resistance and atherogenesis. Arterioscler Thromb Vasc Biol 1997;17:786–96.

Hariri, M., Darvishi, L., Maghsoudi, Z., Khorvash, F., Aghaei, M., Iraj, B., Ghiasvand, R., & Askari, G. (2013). Intakes of Vegetables and Fruits are Negatively Correlated with Risk of Stroke in Iran. International journal of preventive medicine, 4(Suppl 2), S300–S305.

Heart Disease Facts. (2020, June 22). Retrieved August 25, 2020, from https://www.cdc.gov/heartdisease/facts.htm

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Jardim, T. V., Mozaffarian, D., Abrahams-Gessel, S., Sy, S., Lee, Y., Liu, J., Huang, Y., Rehm, C., Wilde, P., Micha, R., & Gaziano, T. A. (2019). Cardiometabolic disease costs associated with suboptimal diet in the United States: A cost analysis based on a microsimulation model. PLoS medicine, 16(12), e1002981. https://doi.org/10.1371/journal.pmed.1002981

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Klein, A. M., Vaissière, B. E., Cane, J. H., Steffan-Dewenter, I., Cunningham, S. A., Kremen, C., & Tscharntke, T. (2007). Importance of pollinators in changing landscapes for world crops. Proceedings. Biological sciences, 274(1608), 303–313. https://doi.org/10.1098/rspb.2006.3721

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Intro

· Food environment

· Pollination

· Micronutrient

· Chronic disease

Culture

· Why this is happening to the bees

· Laws

Ethics – fix the problem

Conclusion

· myriad physiological function

· 32 countries, including the USA and many European nations, derive 5–10% of dietary calorific intake directly from the action of pollinators (Lancet) – should be more