Heart Disease: An Epidemiological Problem In The U.S. Sample Assignment


It is apparent that heart diseases have been rampant and hence posing a challenge to the obese and overweight people in the United States of America (Franklin et al, 2001, p. 1245). However, epidemiological studies have already been employed to diminish health menace caused by cardiovascular diseases (CVD) in United States. According to Franklin et al (2001, p.1245), Framingham study examined factors and evolution of heart diseases over several decades.Generally, the study targeted to examine both men and women in order to obtain valuable insight on the prevalence of cardiovascular diseases. Moreover, the study has enhanced the scrutiny of predisposing factors as well as diagnosis of such ailments in both men and women. Empirically, it is evident that more than 65% of adult who are overweight are susceptible to heart diseases (Ford, Giles & Mokdad, 2004, p.1791). In this case, cardiovascular ailments have been ranked the highest among those maladies that contribute to high mortality rates in United States. This paper explores why CVD has become an epidemiological problem in United States. Besides, the impacts of Framingham study have also been prioritized in this essay.

Framingham Heart Study: Results

This study was carried out to investigate health status of men and women who aged from 30-60 years and did not have signs and symptoms of heart diseases (Franklin et al, 2001 p1248). Consecutively, they would be examined after two years and their medical details recorded. Moreover, their lifestyles and eating habits were observed and over several decades, a qualitative analysis was made in regard to the data recorded. Basing on the analyses made from the results, scientists were able to establish the concept of “risk factors” (Ford, Giles & Mokdad, 2004, p.1793). In this case, they aimed at elaborating various aspects in people’s health and lifestyles that accelerated their suffering from cardiovascular diseases. A report was released in 1961 that gave a conclusion on how to decimate limit factors which caused heart disorders (Linton & Fazio, 2003, p.10).

As part of the findings from the study, smoking was identified as one of the major predisposing factors of cardiovascular infirmities. Besides this, it was revealed that filters in cigarettes do not decimate the risks in anyway (Franklin et al., 2001, p.1249). Predictably, it was discovered that regardless of differences in age and pulse pressure, men were more prevalence to heart diseases due to smocking as opposed to women. However, women were more susceptible to diabetes mellitus than men (Franklin et al, 2001, p.1247). It is clear that, some of the notable heart complications are painless. However, they silently delimit the heart function and eventually cause deaths. Another predictable factor is on consumption of food that is highly rich in cholesterol. It is vivid that fatty foods have high levels of lipoproteins which have adverse effects on arteries and blood capillaries of the heart (Linton & Fazio, 2003, p.13). Gradual hardening of arteries due to fatty deposits in the arteries limits blood flow in the body. Eventually, the heart gets fatigued and fails to function. Certainly, it is clear from the research done that lack of exercise accelerates weight gain resulting into obesity.

From the statistical records obtained during the study, it is revealed that ailments which result to heart failure are triggered due to poor metabolism (Franklin et al., 2001 p1247). In this case, poor diet increases risks of ailing from diabetes, hypertension and obesity. It is estimated that 17% of children in United States are obese hence likely to succumb to cardiovascular infirmities (Ford, Giles & Mokdad, 2004, p.1791). In line with this, it is vivid that the poor minority are more prevalent to heart diseases due to malnourishment, stress and lack of recreational facilities for exercising. It is also a commonly observed experience in the United States that the population is highly prone to predisposing factors like smoking, alcoholism and poverty among the minor races (Linton & Fazio, 2003, p. 22). However, the study has also confirmed that cardiovascular epidemics can be decimated by weight control through physical exercises (Linton & Fazio, 2003, p. 25). In line with this, addiction to media programs accelerated inactivity among youths, children and older adults. Besides, people are different in the way they respond to metabolic syndrome. It is also factual that heart related problems invade people depending on their genes.

Framingham Heart Study: Impact

Qualitatively, the Framingham study has been appraised by health practitioners and clinicians in US in helping them understand features of CVDs (Ford, Giles & Mokdad, 2004, p.1799). In this context, this has enabled them to predict and monitor the predisposing factors that might occur in future. Models laid by this study are effective for lay people to desist from the baseline of CVD. Notably, Framingham study has highly resulted into decline in mortality rate in United States. It is evident from statistical records that, there has been a drop rate of 50% for people who die from cardiovascular illnesses (Burt et al, 1995, p. 307).

Moreover, empirical research studies indicate that the study has eventually diminished the number of smokers in U.S from 70% to 30% (Burt et al, 1995 p312). In this essence, smocking was perceived to be one of the predisposing factors that made people in US to become vulnerable to heart diseases (Franklin et al, 2001, p.1249). Decline in smocking rate has consequentially reduced risk of suffering from CVDs. In addition to this, and with the help of Framingham study, citizens in U.S have been enlightened that certain types of food contain cholesterol. This substance block the heart vessels like arteries causing heart attacks (Ford, Giles & Mokdad, 2004, p.1797). This has led to documentation of programs that help the state to reverse rate at which poor eating habit is actively increasing prevalence of CVDs.

It is evident that new drugs have been made available to control and decimate heart ailments like hypertension (Franklin et al., 2001, p.1247). Earlier on, heart specialists did not know that heart attacks caused no pain to patients. In this case, they diagnosed them for other infirmities. Contemporarily, they can now understand that painless attacks ruin heart functions. It is definite that there has been rise in survival rate of people with CVDs due to development of new form of therapies. These include thrombolysis and angioplasty to enhance the patients to recover from the illness (Burt et al., 1995, p. 309). Though the impacts remain unsatisfactory, it is predicted that the morbidity and mortality rate will decline with time. Frequently, several recommendations have been made through the study to impact changes in people’s lifestyles (Linton & Fazio, 2003, p. 27). Doctors have been equipped with knowledge from the study on how to advise patients on proper diet, exercise and treatment thus reversing the impacts of heart diseases. For instance, active exercise has helped old adults to reduce weight thus living healthy lifestyles. Consequentially, the data provided by Framingham study has fueled US specialists and the government to take stern measures on predisposing factors like smocking, drug abuse amid others (Franklin et al, 2001, p.1247). Coincidentally, this has improved the life span of citizens in US thus decimating mortality rates.


In summing up, it is imperative to note that cardiovascular diseases (CVDs) have been ranked highly among those illnesses that cause deaths in United States. Recently, it has been ranked as one of the most chronic ailments in developed countries. It is also apparent that one fifth of mortality cases are related to heart diseases. Nonetheless, there have been establishment of new tools to annihilate these risk factors associated with cardiovascular diseases. Better strategies have helped to underscore the risks thus making the public to improve their lifestyles. This has been accomplished by improving on diet, active physical activities and pre-diagnosis for early detection of CVDs. Through the Framingham study, clinicians and health specialists have documented on measures of freeing patients from CVDs. Subsequently, use of sophisticated methodologies to limit CVDs has enhanced a predictable trend.


Burt, L. et al. (1995). Prevalence of hypertension in the US adult population. Results from the Third National Health and Nutrition Examination Survey, 1988–1991. Hypertension. 25, 305–313.

Ford, E., Giles,H & Mokdad A. (2004).The distribution of 10-Year risk for coronary heart disease among US adults: findings from the National Health and Nutrition Examination Survey III. J Am Coll Cardiol. 43(10), 1791-1796.

Franklin, S. et al. (2001). Does the relation of blood pressure to coronary heart disease risk change with aging? The Framingham Heart Study. Circulation.103, 1245– 1249.

Linton, M. & Fazio, S. (2003). A practical approach to risk assessment to prevent coronary artery disease and its complications. Am J Cardiol. 92(1), 9-26.

Shirley Jackson’s “The Lottery”: Human Cruelty


Shirley Jackson’s story “The Lottery” was published in 1948 during the rebuilding of the world after World War II. Almost all the post-war period literature is, to one degree or another, devoted to understanding the consequences of what happened during 1939-1945. One of the cruelest and most inhumane episodes of the conflict was the mass genocide of the Jewish people called the Holocaust. In her story, the author reflects on the boundaries and potential of human cruelty, using a stylistic and semantic opposition of the beginning and end of the storyline.

Main body

The story’s main event is “The Lottery” held in a particular village every year as a tradition. The beginning of the story is full of factual information, and the opening lines convey the atmosphere of a sunny summer day when residents begin to gather in the square in the morning. Lexical units explicitly share the description of the carefree environment with a usually positive connotation: “clear and sunny”, “abundantly blooming”, “dense green” (Anderson & Kröger, 2016). The lottery appears to be an ordinary event that cannot distract the villagers from their daily worries.

The beginning of the story sets the reader up to perceive the narrative about a joint event in the villagers’ lives. A neutral description of the situation does not portend anything unusual or scary. However, as the plot develops, the expectation of danger becomes the dominant emotion. The dire psychological state of lottery participants is transmitted to each other gradually, with repeated repetition of the adjective “nervous”, the epithet “breathless pause”, and others. Therefore, in the plot development, the word “lottery” implies a win, but the positive emotions associated with it will acquire an utterly different semantic meaning

In the semantic structure of the story, the sign of danger and fear comes to the fore. As a result, the lottery winner is stoned to death by the villagers with stones prepared for this purpose. The end of the story preserves the sense of the ritual’s commonness for the lottery participants, which makes the bloody murder scene especially cruel (Eaton, 2019). A signal of the contrast between the ending and the opening is the carefree situation’s description at the beginning and the bloody murder scene at the end.

It should be noted that negatively colored vocabulary is present only when describing the horror of the dying victim. It is said that “she held her hands out desperado”, “Mrs. Hutchinson screamed” (Jackson, 1948, para. 9), while the murder scene itself is devoid of words denoting cruelty or violence. In this regard, attention is drawn to the correlation of the following lexical units describing the characters of the story: if in the beginning they are referred to simply as “people of the village”, in the end – “the crowd of villagers” (Philp, 2020).

The semantic volume of the word “crowd” contains in its meaning negative connotations rather than positive ones. In this context, the term “crowd” in combination with the word “villagers” acquires an exceptional semantic capacity and gives a negative connotation to the designation of actors’ faces, emphasizing the contrast between the calm mood of the characters at the beginning and their aggressiveness at the end of the story.

In terms of analyzing the details of the storyline, it is possible to highlight several vital phenomena linked to the Holocaust issue. The author connects patriarchal violence and anti-Semitism through massive consent to choosing one person against whom violence will be used by exploiting elements such as pitting neighbors against each other, and selecting of “suitable” and “unsuitable” people to continue life. This correlates with the brutality of the Nazi regime, in which the sophistication of the murder method served no purpose other than to satisfy the bloodlust. As with concentration camp violence, the sophisticated murder process in “The Lottery” masks a more brutal and aimless one.

The composure with which the villagers participate in the lottery demonstrates a complete detachment from any social obligations and connections. The critical point for them is the possibility of a collective act of violence while using the format of a long tradition: “Although the villagers had forgotten the ritual and lost the original black box, they still remembered to use stones” (Jackson, 1948, para. 1).

It should be noted that the residents are not personally responsible for the murder of the person. Having learned who the “winner” is, they massively throw stones at the person, which allows them not to single out the guilty one and continue their existence. In this, one can also see a correlation with the realities of wartime, especially the genocide of the Jewish people, in which inhuman cruelty was manifested in massacres. Even though individual commanders issued orders, many soldiers were involved at one moment, which allowed them to deny responsibility for their actions morally.


In conclusion, Shirley Jackson in her story “The Lottery” asks the reader about the limits and goals of human cruelty. In 1948, it directly referred to the most tragic and horrifying moments of the Second World War. The writer achieves the brutality of the moment through the lexical and semantic opposition of the beginning and end of the plot. Reflections on the horrors of the Holocaust are manifested through the random selection of the victim. The mass murder allows residents to relinquish personal responsibility for their actions, which will enable them to continue the bloody tradition from year to year.


Anderson, M. R., & Kröger, L. (Eds.). (2016). Shirley Jackson, influences and confluences. Routledge.

Eaton, T. (2019). The semantics of literature (vol. 1). Walter de Gruyter GmbH & Co KG.

Jackson, S. (1948). The lottery. The New Yorker

Philp, H. (2020). Reading and writing with Shirley Jackson’s “The Lottery”. Changing English, 27(3), 255-261. 

The Crisis Of Lethality: Suicide As Health Phenomenon

Suicide has been a troubling phenomenon worldwide. The latest statistics indicate that suicide is a killer in America (American Association of Suicidology, 2005). Statistics further show that the American population looses approximately 80 people per day in suicide related cases and about 750,000 people attempt suicide each year. This tear-jerking occurrence replicates the suffering caused by suicide. Having determined the weight of the situation, the need to develop further studies on the crisis of lethality would be significant. This paper develops a critical analysis of the crisis of lethality and provides a framework on the dynamics of suicide and its similarities with homicide. The paper further discusses on the moral dilemma caused by suicide, the characteristics of people who commit suicide, and the use of the triangle assessment form in addressing lethality.

Dynamics of Suicide

The forces surrounding suicidal attempts are not fully understood due to the complexity in suicidal behaviors. Nevertheless, different investigators have produced theories to account for the dynamics surrounding the high salary increase in suicide. Theories developed include biological, sociological and psychological dynamics.

Biological research emphasizes on the relationship between suicide and the operation of the human mind. Studies propose that body disorders may be induced by defects in genetics resulting from chromosomal abnormalities, and environmental strains that may cause abnormalities in the human head. This, in turn, may contribute to the growth of abnormal behaviors due to causes that are not within human control (Yousuf 2011).

The psychological dynamics of suicide correlate with the functioning of the human brain, including human thoughts, emotions and behaviors. The interpersonal-psychological theory proposes that individuals cannot commit suicide unless they acknowledge the capability and wish to do so (Joiner, 2005). The theory further asserts that, the wish to commit suicide can be induced by a person’s psychological state of apparent burdensome and isolation. In this case, people view themselves as existing burdens to the society and feel that death is worth that everyone around them (Joiner, 2005).

Surveys indicate that sociological dynamics of suicide correlate with social components that lead to ill health. Social factors include societal, ethnic and communal perceptions related to social functions and relationships. People’s inability to deal with societal stress factors leads to the development of maladaptive behaviors. The social causation theory proposes that people are prone to stress and maladaptive behaviors depending on the societal factors and prejudices existing in their societal constructions.

Suicide and the Moral Dilemma

The question surrounding the ethics of killing oneself has caused a moral quandary in the society. Most people who believe in the sacredness of life uphold that suicide is morally unacceptable, and a worthwhile life should not be shortened in any way. The desire to commit suicide questions the worthiness and the sanctity of life. Although not all people believe in the sanctity of life, it seems insightful that life is sacred. Moreover, as a rule, taking human life is completely wrong (Glover, 1977).

People who take their lives often see suicide as a solution, while observers view it as a problem. On the other hand, psychiatrists maintain that suicide is as a result of a disease. Even though suicide is not a crime, it is not legally acceptable in the society. The most troubling question that suicide poses to the society is whom the controller is, of when and how we die. This has evoked a lot of debates with participants using different references to support the ethics of suicide. Today, suicide has taken a new form, and it is no longer the concern of the church but the doctors and state.

Characteristics of People who Commit Suicide

Even though suicidal behaviors are complex, people may display a variety of characteristic behaviors prior to a suicide attempt. Characteristic behaviors that may be displayed include, and not confined to:

  1. Trouble with thinking and concentration
  2. Giving out their important personal belongings
  3. Displaying sudden change in behaviors, especially coolness after nervousness
  4. Living in isolation
  5. Adopting self-destruction behaviors like alcoholism
  6. Engaging in self destruction talks of on death and hurting oneself
  7. Depression

Similarities between Suicide and Homicide

Most people argue that suicide and homicide are contrasting behaviors, though their relationships may be complicated. The two behaviors are similar because either case presents taking life. What differs is the focal point of the impulse, but the outcomes are similar. In addition, both homicide and suicide have unhappy responses. This implies that the two can have the same similarities in the brain with the possibility of an individual being homicidal and suicidal concurrently. Studies suggest that all features of human behaviors transmit their opposite; thus, the wish to kill a person, is as well the wish to kill oneself (Jackmanv 2003).

Addressing Lethality Using the Triangle Assessment Form

The triangle model works on the basis that suicide cannot occur if one feature reduces adequately. The model comprises of three suicidal characteristics, namely: a longing to die, a suicidal strategy, and satisfactory concern for relief. Jointly, the characteristics offer a setting for self harm. The reduction or removal of one or more characteristics from the setting prevents self harm (Lester, 1967). However, the regulation of the wish to die cannot be done directly. The regularization of any self behavior offers an opportunity for the desire to die to re-correct itself. Most studies indicate that the wish to die does not completely vanish, but may return. Consequently, health professionals are notified to keep an eye on all states even if stability persists.


American Association of Suicidology. (2005). Suicide in the U.S.A. based on current statistics. Web.

Glover, J. (1977). Causing death and saving lives. London, England: Penguin Publishers

Jackmanv, N. (2003). The Brains of violent males: The homicidal & suicidal brain. Web.

Joiner, T. (2005). Why people die by suicide. Cambridge, MA: Harvard University Press

Lester, D. (1967). Suicide as an aggressive act. Journal of Psychology, 66:47-50.

Yousuf, S. (2011). Theories of suicide. Web.

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