Describe how BIG GEMS contribute to the different disease patterns of José and Jorge.

NOTE: PLEASE READ THE ENTIRE DESCRIPTION AND I HAVE INCLUDED EXTRA INFO AT THE BOTTOM AND A RUBRIC WHICH MUST BE FOLLOWED TO THE LETTER!
Description: In public health, we are often faced with new situations and need to apply our critical thinking skills to assess available options and respond appropriately. For this assignment, you will prepare a 3-4 page double spaced (12 pt, Times New Roman) , analysis of a public health scenario requiring synthesis of information and application of critical thinking skills.
Details: Please read and critically assess the case study titled, José and Jorge-Identical Twins without Identical Lives from the textbook Public Health 101 Healthy People-Healthy Populations and respond to the questions below. (For your convenience, the case study is also provided below.)
QUESTIONS TO ADDRESS
Describe how BIG GEMS contribute to the different disease patterns of José and Jorge. Be specific and incorporate applicable course material, as appropriate.
Select one non-communicable disease AND one communicable disease experienced by José and/or Jorge and respond to the questions below:
a. Which diseases did you select? Clearly identify which is the non-communicable disease and which is the communicable disease.
b. What factors did you take into consideration when deciding to focus on these diseases? Think like a public health professional faced with having to decide where to focus limited resources. Factors such as disease impact, feasibility, cultural or environmental constraints, funding, etc. should be discussed in detail, adequate support provided, and resulting rationale should be sound.
Select at least one strategy to address the non-communicable disease and at least one strategy to address the communicable disease. Provide rationale for selecting these strategies and describe how you would apply them on a population-level to address the circumstances contributing to their development, such as those experienced by José and Jorge. Be specific and incorporate applicable course material, as appropriate. Use no more than 3 outside sources.
José and Jorge: Identical Twins Without Identical Lives
José and Jorge were identical twins separated at birth. José grew up in a large family in an impoverished slum in the middle of a crime-ridden and polluted district of a major city. Jorge grew up in an upper-middle-class professional family with one other brother in a suburban community in the same city. Despite the fact that José and Jorge were identical twins, their lives and health could not have been more different.
José had few opportunities for medical care or public health services as a child. His nutrition was always marginal and he developed several severe cases of diarrhea before he was one year of age. He received a polio vaccine as part of a community vaccination program, but never received vaccinations for measles, mumps, rubella, or other childhood illnesses. At age four, he developed measles and was so sick his mother was sure he would not make it.
As a child, José developed asthma which seemed to worsen when he played outdoors on hot smoggy days. Dropping out of school at age 14, José went to work in a factory, but quit when he found himself panting for breath at the end of the day. As a teenager José was repeatedly exposed to crime and drugs. Once, he was caught in the crossfire of gangs fighting for control of drugs in his community. Experimenting with drugs with his teenage friends, José contracted HIV from use of contaminated needles. José did not know he had HIV until he was nearly 30 years old and developed tuberculosis (TB). He did receive treatment for the TB free-of-charge from the health department, but once he felt better, he didn’t follow-up with treatment.
By the time the TB returned, José had lost 30 pounds and could barely make it into the emergency room of the public hospital because of his shortness of breath. He was hospitalized for the last two months of his life, mostly to prevent others from being exposed to what was now drug-resistant tuberculosis. No one ever knew how many people José exposed to HIV or TB.
Jorge’s life as a child was far less eventful. He received well child-care from an early age. He rarely developed diarrhea and had few sick days from diseases of childhood. He did well in school, but like José, he developed asthma. With good treatment, Jorge was able to play on sports teams at least until he began to smoke cigarettes at age 14.
Jorge soon began to gain weight and by the time he graduated from college was rapidly becoming obese. In his twenties, he developed high blood pressure, and in his 30s he had early signs of diabetes. Jorge had a heart attack in his mid 40s and underwent bypass surgery a few years later. The treatments for diabetes, hypertension, and high cholesterol worked well and Jorge was able to lead a productive professional life into his 40s.
By the time that Jorge turned 50, his diabetes began to worsen and he developed progressive kidney disease. Jorge soon needed twice-a-week dialysis, which kept him alive as he awaited a kidney transplant.
From: Public Health 101 Healthy People-Healthy Populations by Richard Riegelman

EXTRA INFO:
Do not use outside sources for question 1 about BIG GEMS. You should use course material as applicable. The outside sources are needed in question 2 and 3.
For question 1 (BIG GEMS), please write about both Jose and Jorge.
For questions 2 and 3, pick one non-communicable and one communicable disease. It doesn’t matter who it is. It can be the same person (for example, both diseases focus on Jose) or different people (one diseases is Jorge’s- one is Jose’s).
Please don’t write more than four pages.
For Question 2b:
Think of yourself as working in the health department at Jose’s or Jorge neighborhood. Each neighborhood has multiple public health issues. Which will you choose to address and why? In answering “why”, think about things like impact of the disease, feasibility of addressing the issue, cultural or environmental constraints or opportunities, funding/cost issues, and other reasons. Your answer should be specific to the issues in those neighborhoods but the factors of why you chose them can be based in research that you do. As per the rubric, I’m expecting at least 4 factors that are well supported and explained.
I’m hoping you will not need more than 3 outside sources to answer all of the questions in this assignment, since the entire assignment is only 4 pages. I will be flexible with one more outside source, for a total of 4 sources. Please don’t use more than that.
Be sure to double-space your document, using Times New Roman 12 point font. The 4 pages do not include a title page or a references page.
If you have more questions, PM me

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