Type I Diabetes in Children and Adolescents Essay Paper

The benchmark assesses the following competencies:
1.4 Participate in health care policy development to influence nursing practice and health care.
Research public health issues on the “Climate Change” or “Topics and Issues” pages of the American Public Health Association (APHA) website. Investigate a public health issue related to an environmental issue within the U.S. health care delivery system and examine its effect on a specific population.
Write a 750-1,000-word policy brief that summarizes the issue, explains the effect on the population, and proposes a solution to the issue.
Follow this outline when writing the policy brief:
1. Describe the policy health issue. Include the following information: (a) what population is affected, (b) at what level does it occur (local, state, or national), and (c) evidence about the issues supported by resources.
2. Create a problem statement.  Type I Diabetes in Children and Adolescents Essay Paper
3. Provide suggestions for addressing the health issue caused by the current policy. Describe what steps are required to initiate policy change. Include necessary stakeholders (government officials, administrator) and budget or funding considerations, if applicable.
4. Discuss the impact on the health care delivery system.
Include three peer-reviewed sources and two other sources to support the policy brief.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Rubric for excellent grade:
Excellent (100.00%)

A detailed description of the policy issue is presented. The origin of the policy is described and a strong correlation between the policy and the health issue for the population selected is established. The level at which this occurs is discussed. Strong rationale and evidence are offered for support. Insight into the policy health issue is demonstrated.

A problem statement is thoroughly developed with supporting details.

Suggestions for addressing the issue are thoroughly developed with supporting details. All assignment criteria are met and well-supported. The suggestions are well-supported and offer clear steps for initiating policy change.

A discussion on the impact on the health care delivery system is thoroughly developed with supporting details.
Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

Writer is clearly in command of standard, written, academic English.

All format elements are correct.

Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

Environmental Perfluoroalkyl Substances (PFASs) as a Public Health Issue Related to the Development of Dyslipidemia and Type I Diabetes in Children and Adolescents
Environmental health is an important component of public health in any jurisdiction around the world. This is because pollution of the environment by man-made chemicals predisposes humans to a variety of health complications. As an industrialized and developed country, the United States is one of the countries in the world that would be expected to have environmental health issues affecting its population. For instance, the US is known to be a large emitter of greenhouse gases responsible for climate change. This alone is a pointer to the fact that many other environmental pollutants are present in the US and that these are responsible for the development of health conditions that then cost the taxpayer billions of dollars to try and control. A case in point is the role that chlorofluorocarbons (CFCs) and hydrofluorocarbons (HFCs) play in the depletion of the protective ozone layer in the stratospheric layer of the upper atmosphere (Minnesota Pollution Control Agency, n.d.). These two chemicals are used in household appliances such as refrigerators that are present in practically every home in the US. Estimations show that 84% of CFCs and HFCs are man-made with only 16% from natural sources such as the oceans and volcanoes. Unfortunately, their destruction of the protective ozone layer results in the passage of dangerous ultraviolet cosmic radiation to the Earth’s surface. These cause skin cancers and compromise the immune systems of human victims. The purpose of this paper is to present another set of chemicals as environmental agents responsible for health conditions that present a public health problem to the population and health authorities. The chemicals in this case are referred to as perfluoroalkyl substances (PFASs) and they include perfluorooctanoic acid (PFOA), perfluorooctane sulfonate or sulfonic acid (PFOS), and perfluorononanoic acid (PFNA). They are ubiquitous in the environment and also form part of many consumer substances including food wrappers. The paper discusses their role in the development of dyslipidemia and also as biomarkers for type I diabetes in children and adolescents.
A Description of the Policy Health Issue Related to the Effect of Perfluoroalkyl Substances (PFASs) on the Health of Children and Adolescents Type I Diabetes in Children and Adolescents Essay Paper



PFASs are man-made substances that unlike CFCs and HFCs do not occur naturally at all in the environment. They are present in food packaging, polishes, lubricants, textiles, and fire-retarding foams just to mention but a few (Geiger et al., 2014). The main problem is that these chemicals are difficult to get rid of in the environment because they accumulate by biological magnification within food chains. Scholarly evidence shows that he PFASs are responsible for many adverse health conditions that include endocrine, cardiovascular, and developmental disorders. Studies in both humans and animals have shown that there is a positive correlation between PFOA, PFOS, and PFNA on the one hand and the development of dyslipidemia in children and adolescents (Louisse et al., 2020; Geiger et al., 2014). These PFASs have also been shown by yet other studies to be responsible as biomarkers for the development of type I diabetes mellitus in children (Predieri et al., 2015). These relationships have far-reaching health consequences for the population of concern that is children and adolescents.
Dyslipidemia is a biochemical state in which there is a high total cholesterol count, high quantities of low-density lipoprotein cholesterol (LDL-C), or low levels of high-density lipoprotein cholesterol (LDL-C) in the blood. In simple terms, LDL-C is bad cholesterol while HDL-C is good cholesterol. Dyslipidemia as a condition causes no symptoms but is responsible for the blocking of arteries through atherosclerosis, angina pectoris, myocardial infarction, and stroke (Hammer & McPhee, 2018). According to Geiger et al. (2014), dyslipidemia in children and adolescents has been associated with early and increased incidence of atherosclerosis and its attendant cardiovascular disease profile. According to the studies reviewed, the population adversely affected by the effects of these PFASs chemicals is that of children and adolescents. As much as adults are also affected by these chemicals, their effect on children and adolescents is more profound given the developmental aspect that is involved. This public health problem is a national issue since it occurs in the whole country. It is far from a localized county or state public health problem on a small scale.
The Evidence
The evidence as to the culpability of PFASs in the development of dyslipidemia and type I diabetes in children and adolescents has already been mentioned above. It is available in scholarly peer-reviewed scientific literature and is undisputed. To begin with, Geiger et al. (2014) carried out a cross-sectional study on a sample of n = 815 children and adolescents aged 18 years and below. The researchers acknowledged that PFOA and PFOS are already known to cause dyslipidemia in adults. However, they now sought to find out if this relationship also holds true among children and adolescents below the age of 18 years. Their outcome measure or dependent variable was dyslipidemia. They defined this as LDL-C of >110 mg/dL, HDL-C of <40 mg/dL, or a triglyceride count of >150 mg/dL. They found a positive association between the two PFASs and high total cholesterol and LDL-C. This was independent of amongst others the sex, age, BMI, ethnicity/ race, or socioeconomic status.

In the work by Louisse et al. (2020), they are in agreement with Geiger et al. (2014) and their findings in that PFOA and PFOS as two major PFASs that are indeed related to an increase in serum cholesterol and also triglycerides in some instances. The authors delved deeper into the molecular level of the pathophysiological pattern of these PFASs in human cells. Particularly, they studied the effects of PFOA, PFOS, and PFNA on intracellular cholesterol and triglyceride values in human liver cells. Lastly but not least on the evidence, Predieri et al. (2015) investigated the endocrinology effects of the PFASs in children and adolescents with regard to the onset of type I diabetes mellitus. The purpose of their study was to find out the concentrations of PFOA and PFOS in children and adolescents at the start or onset of type I diabetes. These concentrations were ten to be compared to those of healthy controls within the study framework. A sample of n = 44 children and adolescents participated in the study. The results showed categorically that PFOS concentrations were higher in children and adolescents with type I diabetes mellitus when compared to the controls.
Problem Statement
Frenetic industrial and commercial activities in the US have resulted in the accumulation of dangerous levels of the chemicals known as perfluoroalkyl substances or PFASs. These include perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), and perfluorononanoic acid (PFNA). Research studies into the effects of these chemicals on public health have shown that they are responsible for the development of dyslipidemia and type I diabetes in children and adolescents.
Suggestions for Addressing the Public Health Issue and a Discussion of the Impact on the Healthcare Delivery System
The suggestion for addressing this public health issue is to have policy change at the legislative level. The most effective way to do this would be to increase and add punitive taxes on all products that contain PFASs. The steps in doing this include lobbying elected representatives of Congress and having discussions at the health committee levels before amending legislation related to the taxation on the wide array of consumer products containing PFASs. Lastly, the impact on the healthcare delivery system of these public health adverse events is that the cost of containing the health conditions arising out of it will be astronomical. This is because cardiovascular disease (CVD) and diabetes are two of the leading causes of morbidity and mortality in the United States.

Geiger, S.D., Xiao, J., Ducatman, A., Frisbee, S., Innes, K., & Shankar, A. (2014). The association between PFOA, PFOS and serum lipid levels in adolescents. Chemosphere, 98, 78-83. http://dx.doi.org/10.1016/j.chemosphere.2013.10.005
Hammer, D.G., & McPhee, S.J. (Eds). (2018). Pathophysiology of disease: An introduction to clinical medicine, 8th ed. McGraw-Hill Education.
Louisse, J., Rijkers, D., Stoopen, G., Janssen, A., Staats, M., Hoogenboom, R., Kersten, S., Peijnenburg, A. (2020). Perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), and perfluorononanoic acid (PFNA) increase triglyceride levels and decrease cholesterogenic gene expression in human HepaRG liver cells. Archives of Toxicology, 94, 3137-3155. https://doi.org/10.1007/s00204-020-02808-0
Minnesota Pollution Control Agency (n.d.). Chlorofluorocarbons (CFCs) and hydrofluorocarbons (HFCs). https://www.pca.state.mn.us/air/chlorofluorocarbons-cfcs-and-hydrofluorocarbons-hfcs#:~:text=Chlorofluorocarbons%20(CFCs)%2C%20hydrochlorofluorocarbons%20(,the%20earth%2C%20changing%20global%20climate
Predieri, B., Iughetti, L., Guerranti, C., Bruzzi, P., Perra, G., & Focardi, S.E. (2015). High levels of perfluorooctane sulfonate in children at the onset of diabetes. International Journal of Endocrinology, 1-7. https://doi.org/10.1155/2015/234358    Type I Diabetes in Children and Adolescents Essay Paper

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