Vulnerable Population and Self-Awareness

Vulnerable Population and Self-Awareness

Identify a vulnerable population: Gil Martin, a Hispanic-American male

In the identified neighborhood, the Martin family shows a number of potential problems in its configuration. Most notably, the patriarch of the family Gil Martin is dealing with the sorrows of his mother, who has been recently widowed. Gil suffers from chronic back pain, and takes an analgesic called Percocet which is potentially addictive for the pain. He also suffers from high cholesterol and takes Lipitor to keep his cholesterol in check. He lives in a 'blended' or reconstituted family with his wife Helen and their children, along with children from previous marriages.

As a Hispanic-American, Gil Martin defies many stereotypes. He is a hard-working man and a good father. His job offers him health insurance and he is doing his best to manage his adolescent children's difficulties and conflicts. He is a part of the growing ranks of Hispanics in the U.S. "The Hispanic population in the United States grew by 43% in the last decade, surpassing 50 million and accounting for about 1 out of 6 Americans" (Cesar 2011). However, his health problems could escalate in a problematic fashion, given the potential risks of addiction. "The U.S. Drug Enforcement Agency, or DEA, classifies Percocet as a schedule II narcotic, which means it carries a high potential for abuse. As such, the DEA does not allow refills on Percocet prescriptions - the individual must visit a doctor to get a new prescription" (Percocet addition, 2012, Eopiates). Any person who takes Percocet on a regular or even a semi-regular basis runs the risk of becoming addicted.

An estimated 1.9 million persons in the U.S. meet diagnostic criteria for Percocet addiction (Percocet abuse in America, 2012, Percocet abuse help). Even though Gil was prescribed the painkiller for medical reasons and appears to use it judiciously (he does not use it when he is working), the drug still has a high potential for abuse, because of its effects on the reward center of the brain. "A dramatic increase in the nonmedical use of prescription opioids (also known as analgesics, narcotics, and painkillers) has occurred over the past 10 years. In 2002, an estimated 29.6 million Americans reported having used prescription opioids for nonmedical purposes in their lifetime (National Institute on Drug Abuse [NIDA], 2004)" (Daniel et al. 2007). "Opioid drugs (which include opium, heroin, morphine, codeine, hydrocodone, and oxycodone) are produced from the opium poppy. Opiate agonists, such as OxyContin, provide pain relief by acting on opioid receptors in the brain and the spinal cord and directly on tissue" (Tunnell 2005).

For Gil, the risks of addiction are especially acute because his job requires him to sit for long periods of time, which can place a great deal of strain upon the lower back, alternated with long periods of lifting heavy materials. He also has a sense of responsibility and a strong need to work. He is supporting children and a wife, and must also ensure that he keeps his health insurance because of his other problem of high cholesterol, for which he also takes Lipitor. "According to the American Heart Association (AHA), 49.9% of Mexican-American men…have high or borderline high total cholesterol levels," which is a higher rate than their Caucasian counterparts (Lee-Frye 2010). For genetic or other undetermined reasons, high cholesterol is also more likely to be deadly for Hispanic-American males (Lee-Frye 2010). "The disparity between Mexican-Americans and Caucasian-Americans widens when it comes to LDL (low-density cholesterol, the 'bad' cholesterol) levels. According to the AHA, 39% of Mexican-American men have high LDL levels, compared to 31.7% of white men" (Lee-Frye 2010).

As well as taking Lipitor, reducing the levels of saturated fat in the diet is suggested as an important preventative step to take for individuals with high cholesterol. However, eating 'on the road' makes it very easy for Gil to make unhealthy rather than healthy food choices. Having additional stressors in his life, such as caring for an aging parent further makes him vulnerable to engage in stress eating. Gil also has teenagers at home who might not want to eat a healthy diet. Including family members in a shift to healthy eating is an important component of reinforcing healthy behaviors at home. Gil may also be accustomed, because of his upbringing to eating a diet high in fat and sugar. One study found that "Mexican-Americans had higher total fat, saturated fat, and monounsaturated fat intakes than did Puerto Ricans and older Cuban Americans" (Loria et al. 1995).

Gil's job puts him at high risk for other health problems and exacerbates his high cholesterol because of the general lack of exercise inherent in being a truck driver (combined with days of eccentric heavy lifting that strains his back), the lack of sleep truck drivers have to deal with while driving, and also the risk of injury on the road. At least 30 minutes of exercise a day is suggested for all Americans, particularly those with high cholesterol (Lee-Frye 2010). Truck driving, according to the Centers of Disease Control, is an extremely unhealthy profession. "studies suggest that the risks of cancer, heart attacks, and other disorders may be associated with aspects of long-haul driving such as loading and unloading cargo, irregular schedules, long hours of driving, a sedentary lifestyle, and the nature of drivers' food choices on the road" (Truck driver safety and health, 2007, NIOSH science blog). Truck drivers face a risk of injury or illness 11 times greater than that of the rest of the population (Truck driver safety and health, 2007, NIOSH science blog).

Gil does not have a great deal of time to include exercise into his daily routine because he must care for his mother, as well as for his family. Gil is part of what is often called the 'sandwich generation.' "An AARP report found that 44% of 45- to 55-year-olds had both at least one living parent and one child under age 21" (Pierret 2006:3). He is still responsible for taking care of his children, but he also has aging parents to further burden him and prevent him from taking proactive steps for self-care. Gil does not particularly want to take his mother in, but when offered the choice, she jumps at the chance.

Beginning a regular exercise program could be extremely beneficial for Gil. It would reduce his need to take painkillers for his back. It would help him lower his cholesterol and reduce his risk for other health problems, including heart disease and diabetes, which also disproportionately afflict members of his ethnic group. It would also provide a potential source of stress relief from the current tensions he is navigating at home.