Health factors & Disesase

Health can be affected by a multitude of environmental, occupational, and nutritional factors. Environmental risk factors such as air, water, climate change, and ultraviolet radiation have a significant impact on health; these factors contribute to nearly 100 diseases and injuries worldwide (World Health Organization [WHO], 2016). The workplace can also have an effect on health. Many people spend a significant amount of time at work; therefore, employee health can be affected by what they are exposed to at work-- this includes chemical exposures and physical labor. It is also widely known that nutrition has a direct relationship with health. Adequate nutrition is necessary for child development and proper health maintenance in adulthood (Skolnik, 2016).

Environmental risk factors

Air pollution is an environmental risk factor that has significant effects on the health of those living in the Philippines. In Manila, Philippines, the annual average air quality index exceeds the recommended safe level by 70% (WHO, 2017). As a result, air pollution has been ranked as the seventh risk factor driving the most deaths and DALYs (Disability-Adjusted Life Year) in the country (“Philippines,” 2017). According to Kim, Chen, Zhou, & Huang (2018), air pollution increases the risk of attaining respiratory diseases, such as respiratory infections and COPD (p. 89). Air pollution is also “positively associated with ischemic stroke and stroke severity” (Rajagopalan, Al-Kindi, & Brook, 2018, p. 259). In conjunction, ischemic heart disease and stroke are the top two leading causes of death in the Philippines while lower respiratory infections and COPD are the third and ninth leading causes of death, respectively (“Philippines,” 2017).

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Occupational risk factors

The Philippines is a lower-middle-income country. According to Skolnik (2019), occupational risks are the ninth most common cause of DALYs in low- and middle-income countries (p. 40). The most popular mode of transportation in the Philippines is the Jeepney bus, which has become an icon in Philippine culture. According to Santos and Lu (2016), Jeepney drivers average 16 hours of driving a day and have been found to engage in risky driving behaviors, such as speeding and road racing in order to reach their daily quota. 95% of drivers reported experiencing work-related accidents with an average of three accidents per driver. The most common accident was crashing into other vehicles. Health symptoms due to long hours of driving included fatigue and back pain as well as coughs and colds due to excessive vehicle emissions (Santos & Lu, 2016). According to Puhkala et al. (2016), their busy schedules and nature of the job make them susceptible to unhealthy lifestyles. Shift work is associated with unhealthy eating and weight gain and prolonged sitting is a risk factor for atherosclerosis and diabetes. Their long and irregular work hours predispose drivers to obesity and other cardiometabolic risk factors (Puhkala et al., 2016).

CNN Philippines. (2017). Local gov't units working to improve air quality in their areas [YouTube Channel]. Retrieved from https://www.youtube.com/watch?v=2kVz5rmdpkE

Nutritional risk factors

Dietary risks, high fasting plasma glucose, and malnutrition are the top three risk factors driving death and disability in the Philippines (“Philippines,” 2017). Rice is a staple to the Filipino diet; however, its high glycemic index and daily consumption by Filipino, increases their risk of acquiring diabetes (Shekhar, Howlader, & Kabir, 2017). Diabetes is the sixth leading cause of death in the country (“Philippines,” 2017). Fried foods are also very prevalent; this includes goods such as fried lumpia, fried fish, fried rice, and pancit (fried noodles and vegetables). According to Provido, Abris, Hong, Yu, Lee, & Lee (2020), “high fried food intake was associated with a high prevalence of prehypertension and hypertension combined” (p. 76). High blood pressure is the fifth leading risk factor driving the most death and disability (“Philippines,” 2017). The country also experiences a malnutrition burden which has impacted children under five years of age. Due to malnutrition, there is 33.4% prevalence of stunting, or short stature, among children under five; the average among developing countries in only 25%. There is also a wasting prevalence of 7.1%. Malnutrition has also resulted in 15.7% of women having anemia (“Philippines Nutrition Profile,” n.d.).

Boodle fight foods {Photograph} (n.d.). Retrieved from https://images.app.goo.gl/7FWf46cP29ENNNjP9

Health Promotion

Environmental: Local government units are attempting to clean air pollution by implementing more green spaces in their communities (CNN Philippines, 2017). A study by Su, Solomon, & Ragragio (2018) concluded that the “planting of various tree species along major roadsides can contribute to the greening of the metropolis [and] provide fresh air and ecosystem services in mitigating air pollution in the metropolis” (p. 1009). Implementing green spaces is one intervention that can effectively aid in cleaning air pollution.

Occupational: To reduce risk factors for Jeepney drivers, Puhkala et al. (2016), found that lifestyle counseling was an effective intervention for helping bus drivers live healthier lives. The study found that implementing lifestyle counseling had led to a significant reduction in body weight, waist circumference, body fat percentage, blood glucose concentration, and blood pressure amongst bus drivers (Puhkala et al., 2016). Jeepney bus drivers are at risk for obesity, diabetes, and cardiometabolic diseases, so lifestyle counseling may be a potential health promotion intervention.

Nutritional: The Nutrition Foundation of the Philippines was created to promote good nutrition in Filipino communities, and one of its objectives is to increase human resources for nutrition work within a community. A study by Reyes (2018), found that culturally tailored community health workers had positive effects on the population. The implementation of a community health worker resulted in “positive, significant changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), weight, body mass index (BMI), knowledge related to cardiovascular disease, nutrition, and self-efficacy related to diet and exercise” (Reyes, 2018, p. 8). This intervention was feasible and effective in this population, and can potentially be implemented within Filipino communities that are hotspots for malnutrition and diabetes.

Nutrtion education in classroom {Photograph} (n.d.). Retrieved from https://images.app.goo.gl/tDo9nqnBdCD8ZbFk8

References

CNN Philippines. (2017). Local gov't units working to improve air quality in their areas [YouTube Channel]. Retrieved from https://www.youtube.com/watch?v=2kVz5rmdpkE

Kim, D., Chen, Z., Zhou, L. F., & Huang, S. X. (2018). Air pollutants and early origins of respiratory diseases. Chronic Diseases and Translational Medicine, 4(2), 75–94. https://doi.org/10.1016/j.cdtm.2018.03.003

Philippines. (2017). Retrieved from http://www.healthdata.org/philippines

“Philippines Nutrition Profile” (n.d.). Retrieved from https://globalnutritionreport.org/media/profiles/v2.1/pdfs/philippines.pdf

Provido, S. M. P., Abris, G. P., Hong, S., Yu, S. H., Lee, C. B., & Lee, J. E. (2020). Association of fried food intake with prehypertension and hypertension: The Filipino women's diet and health study. Nutrition Research and Practice, 14(1), 76-84.

Puhkala, J., Kukkonen-Harjula, K., Aittasalo, M., Mansikkamäki, K., Partinen, M., Hublin, C., ... & Ojala, A. (2016). Lifestyle counseling in overweight truck and bus drivers-Effects on dietary patterns and physical activity. Preventive Medicine Reports, 4, 435-440.

Rajagopalan, S., Al-Kindi, S. G., & Brook, R. D. (2018). Air pollution and cardiovascular disease: JACC state-of-the-art review. Journal of the American College of Cardiology, 72(17), 2054-2070.

Reyes, R. M. (2018). A culturally-based intervention to decrease blood pressure in Filipino clients aged 40-69 years.

Santos, J. A., & Lu, J. L. (2016). Occupational safety conditions of bus drivers in Metro Manila, the Philippines. International Journal of Occupational Safety and Ergonomics, 22(4), 508-513.

Su, G. L. S., Solomon, N. F. R., & Ragragio, E. M. (2018). Air pollution tolerance index of selected trees in major roadsides of Metro Manila, Philippines. Nature Environment and Pollution Technology, 17(3), 1005-1009.

World Health Organization (WHO). (2016). Tackling environmental health challenges in the Philippines. Retrieved from http://www.wpro.who.int/philippines/mediacentre/features/tackling_environmental_healt h_challenges_Philippines/en/