Diabetes Risk in Plainsboro's Asian-Indian Community: A Windshield Survey
This paper presents a windshield survey of Plainsboro Township, New Jersey — home to the second-largest Asian-Indian population in the United States — to assess community characteristics and design a culturally appropriate public health intervention targeting diabetes. The paper reviews evidence that Asian-Indians face significantly elevated Type 2 diabetes risk due to genetic susceptibility, dietary patterns, and lower BMI thresholds recognized by the American Diabetes Association. Drawing on a hypothetical three-year, $300,000 grant, the paper outlines short- and long-term goals, culturally sensitive community programs, a cost-effective media campaign, and process and outcome evaluation techniques aimed at reducing diabetes prevalence among Asian-Indian residents of Plainsboro.
- Introduction: Plainsboro Township and Its Asian-Indian Community: Community history, demographics, and Asian-Indian population
- Diabetes Risk Among Asian-Indians: Rationale for Intervention: Elevated diabetes risk, BMI thresholds, and cultural barriers
- Short-Term and Long-Term Goals and Outcome Objectives: Awareness, testing, and prevalence reduction goals
- Three-Year Community-Based Intervention Plan: Programs, media campaign, incentives, and spokesperson
- Process and Outcome Evaluation Techniques: Benchmarking, self-reporting, and health policy supports
- Conclusion: Summary of findings and public health recommendations
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What makes this paper effective
- The paper grounds its public health intervention in specific epidemiological evidence, citing ADA guidelines, BMI cut-off research, and peer-reviewed studies to justify targeting Asian-Indians as a high-risk population.
- It integrates community context — the windshield survey of Plainsboro — with a practical intervention plan, demonstrating that public health proposals should be rooted in local demographic and environmental realities.
- The inclusion of culturally specific elements (the Diwali festival, authentic Indian cuisine as incentive, a Miss India USA spokesperson) shows how abstract cultural competence principles can be translated into concrete program design.
Key academic technique demonstrated
The paper exemplifies the windshield survey method — a systematic, observational community assessment technique used in public health nursing — by combining physical observation of the community with demographic data, resident perspectives, and health statistics. This technique is then directly linked to evidence-based program planning, showing students how to move from community diagnosis to intervention design.
Structure breakdown
The paper opens with community context (history, demographics, and infrastructure of Plainsboro), transitions to a health equity rationale (Asian-Indian diabetes risk and barriers to care), presents structured short- and long-term goals, details a three-year intervention plan with specific program components, outlines evaluation strategies and supporting health policies, and closes with a brief conclusion synthesizing findings. An appendix provides the BMI calculation methodology referenced in the body.
Introduction: Plainsboro Township and Its Asian-Indian Community
Established in 1919, the Township of Plainsboro, New Jersey (hereinafter alternatively "Plainsboro" or "the Township") has been transformed from a quiet, rural community into a vibrant, upscale suburb (Brooks, 2004). Originally called the "Borough of the Plains" or "The Plains," the local U.S. Post Office eventually changed the name to Plainsboro (Brooks, 2004). The Township's origins trace to 1897, when the site was selected as the home for an innovative certified dairy farm that produced some of the only high-quality infant formulas available at that time (Brooks, 2004). The community's transformation into its modern suburban form began when this company ceased operations in 1971 (Brooks, 2004). Although transformed, Plainsboro remains a highly desirable place to live, work, and recreate. As Brooks notes, "Today, with Princeton University as its largest property owner, Plainsboro is a quality suburban community that retains much of its agricultural and open-space heritage" (2004, p. 8).
A windshield survey of this community confirms these observations, and there is a general consensus among civic leaders and residents alike that the Township is a bucolic oasis amid surrounding urbanity. According to the township's website, "Plainsboro Township is a highly desirable community that has successfully balanced economic growth and open space preservation. Home to renowned corporations and award-winning schools, Plainsboro residents enjoy an exceptional quality of life" (About Plainsboro, 2015, para. 1). New Jersey Monthly magazine has designated Plainsboro as one of the top ten "Best Places to Live" among the state's premier suburban communities (About Plainsboro, 2015, para. 2).
Unlike many highly urbanized communities, Plainsboro enjoys an extensive public parks network, including the Plainsboro Preserve — a 1,000-acre facility featuring walking trails, healthy wetlands, a 50-acre lake, and large forest areas that serve as natural habitats for the region's flora and fauna (About Plainsboro, 2015). Other community resources include an expansive environmental education center operated by New Jersey Audubon, a world-class public library system, and a recreation and cultural center for senior residents (About Plainsboro, 2015). The community also boasts some of the best public schools in the state, ranking among the top five in New Jersey for SAT scores, with nearly all (96%) of high school graduates entering college (About Plainsboro, 2015). Plainsboro enjoys an average family income of $163,415 (Plainsboro Village Center, 2015), and the Township's careful planning has provided the community with a strong economic base, open spaces accounting for more than half of the Township's land, and a wide range of housing opportunities across budget levels (About Plainsboro, 2015). In 2011, a new $441 million hospital opened in Plainsboro on a 160-acre healthcare campus as part of the Bristol-Myers Squibb Community Health Center complex.
Given its numerous aesthetic qualities and mature infrastructure, it is not surprising that many immigrants have made their home in Plainsboro, including approximately 4,000 residents who identify themselves as having Indian ancestry (Sahney, 2010). Plainsboro is home to the second-largest community of people from India in the United States, topped only by Edison, another town in New Jersey (Sahney, 2010). According to Sahney, many Asian-Indians "prefer to live in Plainsboro because they point out that it has good schools" (2010, p. 40). The Indian-Asian population in Plainsboro has grown further over the past decade due to expatriate assignments to the United States from information technology firms in India (Sahney, 2010). Out of a total population of around 23,500, 16.97% of Plainsboro's residents — approximately 4,000 people — describe themselves as having Indian ancestry (Sahney, 2010).
The Asian-Indians living in Plainsboro are among more than 1.5 million individuals of Asian-Indian ancestry currently living in the United States, the majority of whom arrived within the last 50 years during the third wave of extensive immigration during the 1960s (Sheehan, 2001). Many of the Asian-Indians who have relocated to the United States have prospered more than other demographic groups; however, they have also encountered the same types of racially and ethnically based discrimination and prejudice that linger in the American consciousness (Sheehan, 2001). Moreover, despite their large numbers, Asian-Indians have frequently been ignored in public health care research (Sheehan, 2001). As Sheehan observes, "Two themes hold New Jersey's diverse Indian-American population together. As they strive for success, they struggle for acceptance. As they embrace America, they hold on to India. These thematic threads — individual economic achievement coupled with American racism, cultural transition alongside Indian tradition" (2001, p. 118).
Changes in Indian culture in New Jersey occur among people who frequently see themselves as atypical and who place the process of cultural assimilation within a larger context of personal and cultural transformation (Sheehan, 2001, p. 118). These dynamics suggest that powerful cross-cultural issues shape how Asian-Indians in Plainsboro view available healthcare services and their need for them. Although Plainsboro enjoys a high standard of living and state-of-the-art medical facilities, some Asian-Indian residents remain marginalized due to an inability to afford these services, and cross-cultural differences in views about healthcare may further exacerbate this lack of access.
These are important issues because Asian-Indians are among the highest-risk groups for contracting diabetes. A combination of cultural factors, limited knowledge about diabetes, and insufficient financial resources often causes Asian-Indians to avoid the healthcare system or fail to adhere to prescribed medication or lifestyle regimens (Chandras & Eddy, 1999). Assuming receipt of a three-year, $300,000 grant to address this problem, the following sections outline a feasible community collaborative intervention to address the gaps in care and services for this priority problem among the Asian-Indian population of Plainsboro.
References
About Plainsboro. (2015). Township of Plainsboro. Retrieved from
Anderson, E. N. (2014). Everyone eats: Understanding food and culture. New York: New York University Press.
Brooks, J. (2004, July 26). NLC membership offers many benefits to cities, towns. Nation's Cities Weekly, 27(30), 8.
Chandras, K. V. & Eddy, J. P. (1999, Winter). Counseling Asian-Americans: Implications for training. Education, 120(2), 239.
Edwards, K. (2014, Spring). Health disparities: What can we do? Journal of Cultural Diversity, 21(1), 3.
Fernandez, R. & Everett, B. (2015, Summer). Migratory implications for coronary heart disease risk prevention in Asian Indians: Evidence from the leading health indicators. Journal of Cultural Diversity, 22(1), 30–33.
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Misra, A. (2014, October 19). Go nuts this Diwali. Hindustan Times (New Delhi, India), 3.
Mohan, V. (2014, December 28). Indians with BMI of 23 should start worrying: Doctors. Hindustan Times (New Delhi, India), 7.
Pantalone, K. M. & Hobbs, T. M. (2015). Clinical characteristics, complications, comorbidities and treatment patterns among patients with type 2 diabetes mellitus in a large integrated health system. BMJ Open Diabetes Research and Care, 3(1), 888–893.
Perry, P. (2000, July). Checklist for diabetes. The Saturday Evening Post, 272(4), 48.
Plainsboro Township. (2015). U.S. Census Bureau. Retrieved from http://www.census.gov/quickfacts/table/PST045214/.
Plainsboro Village Center. (2015). Sharbell Development Corp. Retrieved from http://sharbell.com/commercial/plainsboro-village-center.
Sahney, P. (2010, Fall–Winter). Hindu domestic mandirs: Home temples in greater New York. The Journal of New York Folklore, 36(3–4), 39–43.
Sheehan, S. (2001, Spring). Coming from India: A radio documentary. The Oral History Review, 28(1), 118.
Appendix A: How to Calculate BMI for Asian-Indian Adults
[Source: Mohan, 2014, p. 7]
There are two methods for determining BMI — the metric and imperial systems:
Metric System
Divide the person's weight in kilograms by the square of their height in metres.
Example:
Weight: 90 kg
Height: 1.92 metres
1.92² = 3.69 m²
90 ÷ 3.69 = BMI of approximately 24.39
Imperial System
Multiply the person's weight in pounds by 703, then divide by the square of their height in inches.
Example:
Weight: 190 lbs
Height: 72 inches (6 feet)
72² = 5,184
190 × 703 ÷ 5,184 = BMI of approximately 25.76
BMI Cut-Offs per New Recommendations for Asian-Indians
A BMI of 23 kg/m² is now considered overweight (compared to the earlier threshold of 25 for the general population). A BMI of 25 kg/m² is now considered clinically obese (compared to the earlier threshold of 30). The waist circumference considered unhealthy for Indian men is 90 cm (35.4 inches), compared to 102 cm (40.1 inches) globally. For Indian women, the threshold is 80 cm (31.5 inches), compared to 88 cm (34.6 inches) globally.
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