Background of Miami Dade Florida
Miami Dade is a county in state of Florida. This populous county is located to the southeastern part of United States. According to US census report of 2010, Miami Dade Florida’s population is estimated to be over 2,496,435 people (Saint-Jean & Crandall, 2005). It occupies a total area of 1,946 square miles and has several urban cities such as Buena Vista, Carol City and Princeton among many others. Its principal cities are beautifully placed with half their population occupying metropolitan area of south Florida. Moreover, Miami city hosts a total human population of about 424,662 (Saint-Jean & Crandall, 2005). This essay explores health issues affecting elderly Cuban communities living in Miami Dade.
Besides Cubans, Jamaicans, Haitians and Colombians who live in Miami Dade County, census report indicates that 548,402 families and slightly over 776,774 households reside in this county. According to US census report of 2000, some of the dominant races occupying this county include Latinos or Hispanic races, Pacific islanders who, Asians, Native Americans, the blacks and African Americans, whites who are non-Hispanic as well as original whites who are majority and accounting for 69.7% of the entire population (Saint-Jean & Crandall, 2005). Additionally, the size of households is 2.84% with at least an elderly individual living alone in every 8.6% households of the total 23.3% (Anon., 1998). On the same note, 29.4% of the total household population is made up of small units of people who do not have families while women living alone stands at 17.2%, married couples at 47.7% and finally households with children at 33.8% (Skinner & Wennberg, 2003).
In terms of age distribution, Miami Dade Florida County, elderly people over the age of 65 years and above constitute 13% of the population, 45-64 years old make up 21.7%, 25-44 years old constituting 31% while those who are18 years and below constitute the remaining 24.8% (Skinner & Wennberg, 2003). The median income in the county among households is comparatively low since those above 65 years among other lower age groups have been found to be living within poverty line since they are unable to afford basic luxuries. According to the 2008 demographics census courtesy of US government, population of some ethnic groups such as blacks, whites, and non-Hispanic groups rose steadily to 19.5% down from 17.8% r compared to year 2000 census estimates (Anon., 1998).
Geographically, Miami Dade Florida’s physical environment is well endowed with diverse sceneries such as historical features, cultural landmarks and physical attractions. The latter is made up of swamps, beautiful summits, streams, ridges, lakes, islands, capes, beaches, bays and bars among others (Skinner & Wennberg, 2003). Cultural features include towers, reservoirs, parks, mines, levees, hospitals, harbors bridges and airports among others. Some of the historical features parks, islands, buildings and arches. The county’s health department (MDCHD) has been over the years working towards improving social and environmental status in order to curb and reduce health disparities within the populations through prevention initiatives, education and awareness creation (Fournier, 1998).
Community genogram/profile reflecting the health status of the community
Cubans in Miami Dade Florida County are known to be city dwellers. The elderly that dwell specifically in Miami are faced with certain health issues. Recent analysis and empirical studies indicate that elderly Cubans suffer from myriad of health complications and illnesses such as cancer, CAD, diabetes as well as long term depression. Some of the health issues affecting both rural and urban dweller in this county include chronic illnesses such as liver cirrhosis, diabetes mellitus, chronic obstructive pulmonary disease stroke and heart-related diseases. Among the elderly Cubans in Miami, the leading cause of death has been heart disease (Saint-Jean & Crandall, 2005). However, diabetes, CAD and depression incidents have risen in the recent past and as such; they have developed into sensitive healthcare conditions l a challenge to health care systems. Other illnesses worth considering in healthcare profile of this community include that are either infectious or may be termed as social in nature. Infectious diseases include HIV/AIDS, influenza and pneumonia among others. Social diseases in Miami Dade County include homicide, suicide, accidents from motor vehicles and unintentional injuries (Fournier, 1998).
The county’s health profile indicates that heart related complications are the leading cause death in Miami. It has been categorized as a lifestyle disease that is mainly depicted by the kind of lifestyles people live, specifically on eating habits. For instance, obesity, physical inactivity, smoking, high levels of cholesterol and high blood pressure are all possible triggers of cardiovascular complications although they can be prevented. It is important to note that elderly people above 65 years are more susceptible to this condition than those in lower age groups. Additionally, cancer ranks second in the county’s health profile (Anon., 1998). Some of the most common types of cancer affecting Miami Dade Florida County include stomach, prostate, esophageal, oral, endometrial, colorectal and breast cancers. It is believed that dietary habit adjustments and cessation in smoking habits are some of the ways in which cancer can be controlled.
Additionally, cerebro-vascular disease or stroke is another disease affecting the county’s community. In 1998, its rate per 100000 people was 43,382 in central Miami (Saint-Jean & Crandall, 2005). Reports indicated in the same year higher rates per 100,000 people in Miami Springs and Coral terrace of 67,368 and 61,012 respectively (Barrett & Turner, 2005). The elderly Cubans of both gender and who are above 65 years usually die of stroke and they account for 40% males and 60% females (Skinner & Wennberg, 2003). Besides, chronic obstructive pulmonary disease (COPD) is yet another health problem affecting the elderly in the county. Individuals suffering from COPD have difficulty in breathing. By fact, family history, air pollution and smoking are some of its risk factors. The rate of deaths due to COPD is higher in cities within the county of Miami Dade Florida with the males and females greatly affected being 75 years of age and above (Saint-Jean & Crandall, 2005). Other health concerns include chronic liver cirrhosis, HIV/AIDS, pneumonia and influenza, unintentional injuries, and diabetes mellitus (Miami-Dade HIV/AIDS Partnership, 2010).
Health concern studied in this fieldwork
During fieldwork, healthcare concerns that were studied among elderly Cuban community in Miami Dade Florida were depression, diabetes and CAD. The population of interest for this study was the elderly Cuban community incorporating both males and females above 60 years. To begin with, it is imperative to note that diabetes affects an individual whose body neither uses sufficiently nor produces enough insulin (Skinner & Wennberg, 2003). The hormone insulin is vital in the body in the production of energy due to its ability to convert some foods, starches and sugar. This chronic metabolic disease has been known to have serious effects on individuals. Some of the effects include impotence, stroke, heart diseases, amputations, nerve disease, kidney disease and blindness. According to Barrett and Turner (2005), improper and inappropriate response to insulin causes diabetes mellitus. Disabling complications are due to serious developments of metabolic abnormalities caused by elevated blood sugar levels. It is imperative to note that there are many types of diabetes mellitus. The most common types of diabetes mellitus include gestational diabetes, type 1diabetes and type 2diabetes (Skinner & Wennberg, 2003). Type 1 diabetes is as a result of failure of production of insulin by the body. It is also a subsequent cause of type 2 diabetes. Gestational diabetes affects pregnant women. Some among the complications cause by gestational includes perinatal difficulties and development of type 2 diabetes.
The elderly in Miami Dade Florida County are susceptible to development of type 2 diabetes. Being a minority group, they stand a higher chance of being affected. This can be supported by facts derived from Healthy People 2020 (2010) that points out that there are significant disparities of developing diabetes. This includes minority groups which constitute about 25% of adults alongside Cubans and other pacific islanders. According to reports released by CDC and HHANES, type 2 diabetes is prevalent among the elderly Cuban community between ages of 60-74 years (Barrett & Turner, 2005). Compared to the non-Hispanic whites, diabetes among Cuban Americans has been found to be 1.3 times higher. The elderly Cubans have impaired glucose tolerance. Findings indicate that the prevalence rate is higher among elderly people by 9.3% (Saint-Jean & Crandall, 2005). In central Miami Dade, the rate of mortality per 100000 people was 27,559 according to health care reports released in 2006. This figure is even higher today at 23.6 million.
During the field study, findings indicated that the rate of prevalence of diabetes among Cubans in Miami Dade Florida increases with age. It is important to underscore the fact that among all races in the United States, the elderly Cubans form a greater segment of the aged population estimated at 21% of the population (Barrett & Turner, 2005). This figure represents Cubans aged over 65 years. In addition, over 18% of this population lives under poverty line. Furthermore, Cuban elders between 65-74 years, forms the highest group among US ethnic groups suffering from type 2 diabetes. This disease is important since it is the leading cause of adult-onset blindness, a common feature among the elderly Cuban community. It also causes lower limb amputations and kidney failure. Besides, life expectancy of those suffering from diabetes is lowered by 15 years.
Reports from NIH and CDC website indicate that elderly Cuban community in Miami Dade Florida have increased major depressive symptoms. According to preliminary reports, the prevalence of this depression is higher among Cuban Americans by 10% compared to other US ethnic groups. Among the elderly community, depressive episodes were found to be occurring during their lifetime at a range of 3%-3.5%. This finding indicates that due to certain factors such as migration effect and acculturation cause depression among Cuban Americans in their lifetime. Some of the likely causes of CAD obesity, physical inactivity, smoking, high levels of cholesterol and high blood pressure are preventable (Barrett & Turner, 2005). It is vital to reiterate that it is a common health complication among elderly people age 65 years and above.
To recap it all, the state of Florida has set up plans and strategies through the Miami Dade County Health department (MDCHD) to improve social and environmental well being of the region. The concerned agencies which include, private sector practitioners, HHANES, non-governmental agencies and other key health sectors are indeed committed in offering healthcare information, educating as well as improving access to health services in order to reduce disparities.
References
Anon. (1998). Consensus development conference on the diagnosis of coronary heart disease in people with diabetes: Miami, Florida. Diabetes Care, 21(9),1551-1559.
Barrett, A. E. & Turner, R. J. (2005). Family Structure and Mental Health: The Mediating Effects of Socioeconomic Status, Family Process, and Social Stress*. Journal of Health and Social Behavior, 46(2), 156-69.
Fournier, A. M. (1998). Medical education in underserved communities: Experience from an urban area health education center. Journal of Health Care for the Poor and Underserved, 9(2), 109-16.
Miami-Dade HIV/AIDS Partnership (2010). Miami-Dade County EMA 2009-2011 Comprehensive Plan for HIV/AIDS. Web.
Saint-Jean, G. & Crandall, L. A. (2005). Utilization of Preventive Care by Haitian Immigrants in Miami, Florida. Journal of Immigrant Health, 7(4), 283-292.
Skinner, J. & Wennberg, J. E. (2003). Exceptionalism or extravagance? What’s Different About Health Care In South Florida. Health Affairs: Web Exclusives,W3- 372-5.