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Write a 3- to 5-page paper that addresses the following: Describe two health care concerns related to global climate change. Topics could include increased exposure to vectors that transmit Zika, West Nile virus, or malaria; respiratory problems; food distribution problems due to drought or lack of water; or heat-related illness. Compare concerns in the United States related to these topics with one developed and one developingcountry. Describe health promotion/health protection strategies a nurse could implement. Support your ideas with references from the professional nursing literature.   6 Malaria and Malnutrition NURS 4115 Malaria and Malnutrition in Climate Change Climate change along with other natural and human-made health stressors influences human health and disease in numerous ways (CDC, 2018). Considerations include age, economic resources, and location. The United States will feel some strain from climate change, but under-developed countries will be affected even more. This paper will discuss the effects of malaria and malnutrition health care concerns in climate change in both developed and under-developed nations. It will also describe health promotion strategies that can be implemented to reduce these climate changes from occurring. Malaria and Malnutrition Climate changes can affect social and environmental determinates of health such as clean air, safe drinking water, adequate food and shelter (WHO, 2018). One concern that affects climate changes is the spread of malaria. Malaria is a life-threatening disease which is transmitted by the bites of the Anopheles mosquitoes and kills over 400,000 people every year (WHO, 2018). The population affected most by this disease is children under age 5 in developing countries such as Africa and some Philipines. Safe, effective, affordable vaccines could help in the spread of the disease. According to WHO, 2018, many more lives could be saved if more funds are secured. Countries with weak infrastructure like Africa are likely unable to cope or respond without assistance from other stronger nations who can offer support like the United Nations (UN) government agency. Partnerships with agencies like the UN help to establish awareness, scientific evidence and promote health interventions to reduce the spread of disease like malaria. In the United States, malaria was officially eradicated in the 1950s. The role of the CDC became one of surveillance within the U.S. and of assistance in the worldwide efforts to eliminate or control malaria in the economically underdeveloped areas of the world. The 1,500 or so cases of the disease seen in the U.S. are due to overseas travel (CDC, 2012). Quick treatment, personal protective measures (such as screening houses) and vector control quickly control any outbreaks. In countries like sub-Saharan Africa, malaria is the leading cause of death for children under five (WHO, 2018). Sub-Saharan Africa is a site of malaria transmission due to is the geographical location in the tropical zone. Tropical areas with large amounts of rainfall create vast breeding grounds for mosquitos carrying malaria. The focus must be put on prevention and providing the basic needs such as clean water, food, and shelter. Participation from all levels of the community and government, in Africa and non-local, will be needed for community programs that can benefit the communities’ infrastructure and the well-being of the people. In the Philippines, there is an 86% decrease in reported malaria cases since 2000 and procedures for evaluation and declaration of provincial malaria-free status were created (WHO, 2018). The Philippines is working to eliminate malaria in an additional 22 provinces by 2020, with a goal of national elimination in all 80 provinces by 2030. Malaria transmission occurs year-round but is typically higher during the rainy season. High-risk groups include forest workers, subsistence farmers, the poor and children. Another climate change concern is Malnutrition in public health. According to WHO, 2018, malnutrition, includes undernutrition (wasting, stunting, & underweight), inadequate vitamins or minerals, overweight, obesity, and resulting diet-related noncommunicable diseases. Malnutrition accounts for 3 million deaths each year in our most impoverished countries. Undernutrition can make children in particular much more vulnerable to illness and death. Poverty amplifies the risk of malnutrition. Even in the world’s greatest food-producing nation, children and adults face poverty and hunger in every county across America. In 2017, 40 million people struggled with hunger in the United States, including more than 12 million children. In the U.S. major federal food assistance programs are available to those in need including women and children. Advocating for policies that will ensure aid to hungry families is essential. In countries such as Africa nearly half of child and infant deaths on the continent are attributed to inadequate nutrition. Programs that include screening children and breastfeeding support are critical to Africa’s development to fight against malnutrition. The predominant cause of malnutrition in the Philippines is poverty. Because of poverty, people are not able to consume the appropriate amount of food or nutrients needed for good health. A program called “Operation Timbang” is conducted monthly where children are weighed, monitored and given supplementary feeding to help combat malnutrition. Continued rising temperatures and rainfall patterns are predicted to reduce crops and compromise food security even more (WHO, 2018). Flooding increases will create breeding grounds for disease-carrying insects such as the mosquitoes which carry malaria. WHO is striving for a world free of all forms of malnutrition, according to the 2016–2025 nutrition strategy, WHO works with the Member States and partners towards universal access to effective nutrition interventions and healthy diets from sustainable and resilient food systems. WHO uses its power to help set, align and advocate for priorities and policies that move nutrition forward globally; develops evidence-informed guidance based on robust scientific and ethical frameworks; supports the adoption of leadership and implementation of effective nutrition actions; and monitors and evaluates policy and programme implementation and nutrition outcomes (WHO, 2018). Malnutrition increases health care costs, reduces productivity and slows economic growth, which can perpetuate a cycle of poverty and ill health. Health Promotion/Protection Strategies Becoming a climate change advocate can help communities to recover and provide patient education to prevent further spread of disease (Holtz, 2017). Health care leaders and climate policymakers must stand together to confront climate change concerns. Health care systems in developed countries need to work with our underdeveloped countries to create sanitation services appropriate to function correctly during flood and drought conditions to prevent the spread of malaria and malnutrition. Surveillance systems are essential in monitoring outbreaks by providing early warning information of symptoms and rapid diagnostic tests so that patients can receive timely treatment with medicine and vaccines which help decrease the death rate of these diseases. Spraying insecticides and bed nets can help with vector control of malaria. Trained community health workers can provide prevention information and health access to those affected communities with limited healthcare opportunities. By boosting malaria prevention and control it will also reduce deaths of those suffering from malnutrition. References Centers for Disease Control and Prevention. (2018). Climate Effects on Health. Retrieved from https://www.cdc.gov/climateandhealth/effects/default.htm#factsheets Holtz, C. (2017). Infectious diseases from a global perspective. Global health care: Issues and policies (3rd ed.). Burlington, MA: Jones & Bartlett. World Health Organization. (2018).Global Climate Change. Retrieved from http://www.who.int/globalchange/en/ World Health Organization. (2018). Malnutrition. Retrieved from http://www.who.int/en/news-room/fact-sheets/detail/malnutrition Centers for Disease Control and Prevention. (2012). Malaria. Retrieved from https://www.cdc.gov/malaria/about/history/elimination_us.html Malaria and Malnutrition