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shaped by the distribution of money, power and resources at global, national and local levels…mostly responsible for health inequities”. The health of the individual begins in the environmentsin which they grow, learn and socialize and continues to be determined by the quality of available resources that is accessible in those environments. The support available in our homes and communities; the quality of schools and safety of workplaces; cleanliness of our water, food and air; and the nature of our social relationships explain in part why some individuals are healthier (HealthyPeople.gov, 2020). Healthy People 2020 identified five key areas of SDOH where each reflect important key issues including: (1) economic stability, (2) education, (3) 3
EPIDEMIOLOGY PAPERsocial and community context, (4) health and health care, (5) neighborhood and built environment (HealthyPeople.gov, 2020). In relation to measles cases and outbreaks reported throughout the U.S. each of these factors of SDOH play their part. Starting with economic stability those individuals with food insecurity and poverty is a cause for malnourishment in children, a major risk factor in developing the measles. This leads us into neighborhood and built environment where access to healthy foods and environmental conditions such as crowded communities combined with the social and community context and lack of social cohesion can contribute to the spread of measles. Additionally, a lack of education, health literacy and access to primary care can prevent individuals with young children to stick to the proper child immunization schedule or accessing proper medical care when necessary to prevent the virus.Epidemiologic TriadIn order to help us understand the course of a disease and how it is transmitted so that we may learn how to control and prevent the spread of those identified, the application of epidemiologic studies and its tools are necessary. Along with the chain of infection, the epidemiologic triangle or triad of agent, host, and environment is utilized to aid in the explanation and study of health occurrences (GCU, 2018). Included in the epidemiologic triangleare the host factors, agent factors, and environmental factors, all of which are identifiable in the measles virus. The agent component is the measles virus itself, a Morbillivirus of the Paramyxoviridae family. Humans are the only host of the triad, those who can acquire and spreadthe measles virus. While measles is a vaccine-preventable virus, children who are too young to receive the full course of immunizations, those who are immunocompromised and those who are susceptible are more likely to acquire measles. According to the CDC (2018), with measles being4
EPIDEMIOLOGY PAPER“one the most contagious of all infectious diseases; up to 9 out of 10 susceptible persons with close contact to a measles patient will develop measles”. Finally, the environmental factor of the triad signifies risk factors within the host’s environment that contributed to the exposure of measles. The CDC (2019) reported that “most outbreak-related cases occurred in persons who