Saturday, November 9, 2019
How to Write Dialogue
How to Write Dialogue How to Write Dialogue How to Write Dialogue By Michael Dialogue refreshes. Seeing quotation marks on a page has been proven to increase readability, which means that readers find the page more interesting. And you want your readers to stay interested. Dialogue breaks up gray text and gives your eyes a break too. Dialogue uses basic rules for punctuating and formatting: When the speaker changes, hit Return and start a new line (which Maeve Maddox demonstrates in Formatting Dialogue.) Put punctuation, such as the closing comma, inside the quotation marks. A colon can be used in a script, but in other forms of writing, you dont routinely punctuate dialogue with a colon. TOM POLHAUS: Heavy. What is it? SAM SPADE: The, uh, stuff that dreams are made of. Here are some suggestions for more effective dialogue: Do something, dont just talk. Conflict creates action out of dialogue. If everything is dialogue, its a play. In real life, people do things while they talk, and they dont talk all the time. Dont be yourself. New writers need to find their voice, but when you write dialogue, its not your voice now, but anothers. If they all sound like you, they all sound the same. Figure out what makes your characters different from you perhaps age, life experiences, or social status and how those differences affect their speech. Whos speaking, please? If its hard to tell the characters apart, your reader will be confused, bored or frustrated. Ali Hale gives several solutions in Dialogue Writing Tips. For example, you can have each character speak at his or her own rate, fast or slow, terse or wordy, big words or little words, long sentences or short, rude or polite. Vocabulary can also distinguish characters. They may express agreement in different ways: Aye, Yup, Ja, Okey dokey, Absolutely, For sure, dude! Indubitably. Limit extreme dialect. In the 1800s, authors would represent a regional or cultural group by phonetically spelling their pronunciations, leaving out dropped endings, and so forth: Och, dat wuz frightnin an no dout!. Unfortunately, deliberately adding misspellings and apostrophes makes your writing harder to read. Maeve Maddox and Kate Evans provide a better way in Showing Dialect in Dialogue and Writing Dialogue In Accents and Dialect. You dont have them with Hello. In fact, start your dialogue after the greeting. Leave out the fluff, pleasantries, and repetition. Real speech can be so repetitious that professional transcriptionists have special keys to avoid typing words such as Okay and Fine. Some people can have an entire conversation using only the word Fine. But dont put it in your novel. Skip past the boring details. Really, its not the details that are boring, but the vague parts. How are you doing? Fine? Glad to hear it. How is your family? Fine? If a dialogue doesnt advance the plot or expand the character, omit it. People all over the world say Looks like rain every day everyone can agree on the weather but you dont need to do it in your story unless the rain would ruin an important action or object. You dont have to use complete or grammatical sentences. Real-life dialogue isnt like that. People interrupt themselves, pause, change their minds, and so on. Show their motivation. Or at least, show they have motivation, even if what it is remains a mystery. They may not be telling the truth or telling everything, but they have reasons for saying what they do. Dont have the maid tell the butler what he already knows. Yes, dialogue is a great way to feed details to your reader, but it needs to reflect what your characters would have actually asked. Is Heathcliffe Manor dark and dismal? Yes, as you remember from working here for the past thirty years, the previous owner had most of the windows painted over. Try it out, out loud. Reading your writing audibly to yourself (or someone else) helps you decide whether your dialogue is natural. It may cause you to shorten parts of it by showing you that you need to breathe. Avoid the info-dump. Sometimes at the beginning and the end of a detective novel, someone says: First, tell me everything you know about the murder. Tell me, how in the world did you figure out that the butler did it? But an info-dump isnt as much fun as revealing information naturally. This gold mirror must be four feet wide! How will we get it downstairs? From this one piece of dialogue, we can surmise that strangers are moving rich people out of a multi-story house. Limit the cast. The more characters there are, the more confusing the conversation can be. If its hard to distinguish character voices spread through the story, its even harder to distinguish them when theyre all talking at once. About dialogue tags A dialogue tag tells you who is speaking. Writers and teachers disagree about what else it should do. Call a taxi, she said. Taxi! he shouted. Where you wanna go? the driver said gruffly. Some teachers want their students to choose from the hundreds of alternatives to said, telling them, Said is dead.: Stop the presses, he bellowed. Everything will be fine, Kate reassured them. Yall need to meet my grandson, she gushed. Only the Shadow knows, he whispered. J.K. Rowling is notorious for her adverbial dialogue tags, which she usually places in the middle of a dialogue. Three examples from a single page of Harry Potter and the Sorcerers Stone: Oh yes, everyones celebrating all right, she said impatiently. You cant blame them, said Dumbledore gently. I know that, said Professor McGonagall irritably. On the other hand, Stephen King advises writers to avoid adverbs and use nothing but said: ââ¬Å"While to write adverbs is human, to write ââ¬Ëhe saidââ¬â¢ or ââ¬Ëshe saidââ¬â¢ is divine.â⬠He also says, ââ¬Å"I believe the road to hell is paved with adverbs. Journalists are taught to use only two verbs in dialogue tags: said and asked. Adding adverbs or using more colorful verbs compromise their objectivity. I agree with Stephen King. The word said doesnt distract from the dialogue itself. It is unnoticed and unobtrusive. Dialogue is a character talking. A dialogue tag is you talking. The writers rule is show, dont tell, and when you add an adverb to a dialogue tag, you are telling. You are also drawing attention to yourself. When it comes to verbs, I distinguish between active verbs such as croaked or whispered and descriptive verbs such as threatened or urged. Saying he croaked shows your reader the sound of the speakers voice, something which they wouldnt otherwise know. Saying he threatened is a crutch the reader should be able to see the threat in the dialogue itself. I never say ââ¬ËShe says softly.ââ¬â¢ If its not already soft, you know, I have to leave a lot of space around it so that a reader can hear that its soft.â⬠Toni Morrison More suggestions for dialogue tags: Dont use impossible verbs. Several commonly used dialogue tags represent actions that cant really be performed while speaking. Thats not necessary, laughed Bob. If this could happen in real life, this would sound more like: Thats (ha ha) not (ha) necessary (ha ha), said Bob. Laughing and talking simultaneously is not possible. Avoid Tom Swifties. The authors of the Tom Swift adventures of a century ago didnt limit themselves to said because they believed in elegant variation. As a result, dialogue tags with obtrusive verbs and adverbs have been parodied in a class of puns called Tom Swifties. Someone has let the soup boil over! Tom said hotly. Its pouring rain outside, Tom stormed. Ill hold the flashlight for you, Tom beamed. I prefer pancakes, said Tom flatly. Dont be like Tom. Is this dialogue tag necessary? Sometimes you dont need one. In a conversation between two characters, the reader can assume that alternate lines are spoken by the same character. Heres an example from Leo Tolstoys War and Peace with some of the dialogue tags removed: Forgive me! Natasha said in a whisper. Forgive me! I love you, said Prince Andrei. Forgive Forgive what? Forgive me for what I didid. Can you use an action tag instead of a dialogue tag? You dont need a dialogue tag if you have just identified the speaker in a different way. The detective abruptly snuffed out his cigarette. How about you and me working together? In this case, he reader understands that the detective is speaking. Dialogue is not just for fiction. Try including dialogue in everything you write, even scholarly papers and business memos. Seeing quotation marks brightens the eyes of an academician as much as anyone else. Instead of formally summarizing what your employers said to you, why not quote them word-for-word? Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Fiction Writing category, check our popular posts, or choose a related post below:100 Words for Facial ExpressionsThe Parts of a WordEbook, eBook, ebook or e-book?
Wednesday, November 6, 2019
Thursday, September 15th, 2005 Birmingham, My flat â⬠Creative Writing
Thursday, September 15th, 2005 Birmingham, My flat ââ¬â Creative Writing Free Online Research Papers Thursday, September 15th, 2005 Birmingham, My flat Creative Writing Well! I finally have some time to write here again! At first, I have to confess that Im a very lazy man. Im not one of those persons who are working all day, and trying to be useful to our society. I just try to live my life calmly, doing exactly the things I must do (never more) and trying to sleep the biggest number of hours I can. I just keep maintaining a diary because when Ill be older, it will be funny to look at my stupid youth thoughts. Since when I got up this morning, I could see clearly that today was going to be a horrible day. I even could say that my brain has been stopped from yesterday night until now. To start the day, I arrived ten minutes late to school, and I had to endure my French teachers tactless questions like Why are you late today? You dont look very well! Whats the matter with you? Butwhat to answer to all this? I was torn between telling him the truth, so that my only problem today was that my brain didnt want to get up, or telling him an other truth which was that I couldnt stand him, that he was the most tiresome person Ive ever known, and that I thought his lessons were just rubbish so I let my sleepy brain decide, and I just said my problem is that I must listen to you every morning, sir, saying stupid things that doesnt really interest me. There was not the least reason to say this to my teacher, but Im not actually a good lyre, so I think it was the best option. The fact is that the man go t quite angry and I was punished: I had to write an essay about what my French teacher called a day of horror, (even though I assume he didnt know he was giving me that day). As you can see, this essay could be done quite easily. In this precise moment, when I finish writing these lines in my personal diary, I see that my essay is finished. Following my lazy way of living life, Ive done two things at the same time: I have written one page in my diary, and at the same time I wrote my essay. When my French teacher will read this, he might punish me again, but at least, now he knows that I hate the French literature. Research Papers on Thursday, September 15th, 2005 Birmingham, My flat - Creative WritingStandardized TestingPersonal Experience with Teen PregnancyQuebec and CanadaWhere Wild and West MeetComparison: Letter from Birmingham and CritoAnalysis Of A Cosmetics AdvertisementThe Effects of Illegal ImmigrationCapital PunishmentHip-Hop is ArtAssess the importance of Nationalism 1815-1850 Europe
Monday, November 4, 2019
See instructions Personal Statement Example | Topics and Well Written Essays - 500 words
See instructions - Personal Statement Example This mutiny has led to a permanent dissolution of civil wars at least in Angola and Sudan. The Democratic Republic of Congo is experiencing conflict in terms of distribution of wealth which directly goes to those who are more powerful. The unemployed local miners swear to join militias for a living. Bloodshed will continue if the economy of the countries is not sustained. The collapsing economy is the pivotal point in the course of history which leads to an uprising. What is most concerning and at the same time interesting to observe in the article is the analysis made by the author about how the uprising had stirred up a large number of protest movements where the sub-Saharan rulers might have felt threatened to be dethroned. Africa is experiencing a rare moment according to the author quite agreeably that the country is high on prices of food and less in terms of employability. All the benefits from the resources sold go to those in power and this is not at all justified. One considers asking the author as to why he believes that this uprising in North Africa will not allow the past larger-scale conflicts to never return? He does back this with the evidence that the civil wars are ending but it remains questionable. There is no doubt that the north is much more promising as the sub-Saharan Africa. No protest can alter this fact. For the foreign investors, places like Ghana and South Africa have more in store because they have remained comparatively stable in terms of politics and leadership. Overall, the article is a good read since it opens up to the recent and future possibilities of trade in Africa. Agriculturalists and economist must definitely read and criticize it for broader perspectives since this will not only help them gain insight but also allow journalists to pick from their point onward to build on their hypothesis. There is always a better way to look at the political situation. Oliver August has done
Saturday, November 2, 2019
Summaries Assignment Example | Topics and Well Written Essays - 750 words
Summaries - Assignment Example The author claims that science does not end with one discovery, because a new finding often leads to further questions which serve as a new challenge for scientists. The article outlines the four-step process undertaken by scientists to come up with new theories. The scientific process always starts with a fruitful question. A fruitful question is a question which in spite of taking into consideration everything known about the object or event, still crops up and remain a mystery about such object or event (The scientific state of mind 399). After identifying a fruitful question, the scientist comes up with several hypotheses that are possible answers to the questions. These hypotheses are then tested, either through laboratory experiments or through scientific observations. If a hypothesis is proven to be true, then it will be considered as a theory. The fourth stage follows which is known as the ââ¬Å"question chainâ⬠because after coming up with a scientific theory, new ques tions come up that will again go through the scientific process. One can therefore say that the scientific process is a cycle because it goes on and on. ... The arguments enumerated by the author are clearly presented in the essay. First, he asserts that prostitution provides job opportunities for women. It pays more than the other lowly jobs such as servants and factory workers (Enough already, it's time we decriminalize prostitution 437). Furthermore, based on his interviews with prostitutes, some of these women freely chose to become prostitutes and are happy with their jobs. The author also argues that the decriminalizing prostitution offers safeguards to both the prostitutes and their clients. Problems such as sexually-transmitted diseases and low rates are better addressed. Prostitutes get police protection. Clients obtain a sense of security because prostitutes are required to register with the authorities and they undergo medical testing. The author professes that criminalization of prostitution is worse. He cites Swedenââ¬â¢s experience after it criminalized commercial sex in 1998. He says that the rates became lower, clients were fewer and there were more incidences of violence. The author concludes by stating that people should not make hasty generalizations by saying that ââ¬Å"sex workers are victims and all clients are demonsâ⬠(Enough already, it's time we decriminalize prostitution 437). He goes on further to say that people should not be moral judges and instead be more honest on the issue of prostitution (Enough already, it's time we decriminalize prostitution 437). Improvements Made and Principles Discovered Through these exercises one has learned that in summarizing articles, it is important first to state the title and author. One must also identify the main thesis of the article and state
Thursday, October 31, 2019
Give your reaction to the story, your impression of the story, how it Essay - 1
Give your reaction to the story, your impression of the story, how it relates to your life, compare it to another story, or anything--as long as it involves an assigned story you read - Essay Example ââ¬Å"The Rimeâ⬠and ââ¬Å"Odeâ⬠use vibrant imagery, where for ââ¬Å"The Rime,â⬠it contributes to the effectiveness of the plot in depicting scintillating events and characters, while for ââ¬Å"Ode,â⬠it underscores the ââ¬Å"naturalâ⬠essence of insight. When Coleridge says: ââ¬Å"As idle as a painted ship/Upon a painted ocean,â⬠this image is quite fitting to the situation of the sailors, not just as an effective ââ¬Å"pictureâ⬠of what is occurring, but as a representation of their hopelessness. ââ¬Å"Odeâ⬠employs numerous elemental imagery, such as sun, moon, mountains, and flowers. They are natural and seem simple at first, but they are also viewed as ââ¬Å"grandâ⬠examples of nature that implicate the religious theme of ââ¬Å"rememberingâ⬠the natural nature of ââ¬Å"rememberingâ⬠and they are connected to the raw and natural dispositions of children, whom Wordsworth attests as the bosom of meaning and a sourc e of true insight. Irony is one of the most interesting figures of speech in literature and Coleridge and Wordsworths apt use of it has made their works more intellectually stimulating. These lines demonstrate the irony of being surrounded by water and yet suffering from thirst in ââ¬Å"The Rimeâ⬠: ââ¬Å"Water, water, every where,/ Nor any drop to drinkâ⬠(Coleridge). It is similar to being surrounded by food, but not being able to eat them because they are poisoned. Situational irony is also present in how the mariner lives on, when he is the main reason that his co-crew members died. Nevertheless, ââ¬Å"The Rimeâ⬠shows that life is not better than death if it is cursed to be filled with guilt. ââ¬Å"Odeâ⬠applies irony when it says that celestial knowledge is only held during childhood, instead of being learned throughout adulthood. ââ¬Å"Heavensâ⬠(Wordsworth 67) knowledge submerges into a process of ââ¬Å"forgettingâ⬠(Wordsworth 59) and it is only through â⠬Å"rememberingâ⬠(Wordsworth 59) that people can regain true insight about life. These poem share religious
Tuesday, October 29, 2019
African Americans health disparities Essay Example for Free
African Americans health disparities Essay In 2010, the death rate for blacks was higher (25. 0 per 100,000) compared with any other racial ethnicity group (3. 0 whites). Blacks represented 49% of all deaths with HIV in 2010. A recent study showed that blacks diagnosed with HIV are less likely than other groups to be linked to care, retained in care, receive antiretroviral treatment and achieve adequate viral suppression. African American Males African American men accounted for 42% of HIV cases diagnosed among men in 2011. A majority (72%) of African American men with HIV contracted the disease by male to male contact while 19% contracted HIV through heterosexual exposure. African American Females Among African American women, high risk heterosexual contact was the most frequently cited mode of transmission, accounting for 89% of cases diagnosed in 2011. More Information: ?HIV/AIDS TOPIC SITE ?HIV/AIDS AND AFRICAN AMERICANS ?HIV/AIDS STATISTICS AND SURVEILLANCE Sexually Transmitted Diseases (STD) Gonorrhea In 2010, 69% of all reported cases of gonorrhea occurred among blacks. The rate of gonorrhea among blacks in 2010 was 432. 5 cases per 100,000 population, which was 18. 7 times the rate among whites (23. 1). This disparity has changed little in recent years. This disparity was larger for black men (22.2 times) than for black women (16. 2 times). Chlamydia In 2010, the overall rate among blacks in the United States was 1,167. 5 cases per 100,000, a 4. 0% increase from the 2009 rate of 1,122. 2 cases per 100,000. The rate of chlamydia among black women was over seven times the rate among white women (1,536. 5 and 205. 1 per 100,000 women, respectively). The chlamydia rate among black men was almost 11 times the rate among white men (761. 8 and 69. 9 cases per 100,000 men, respectively). Syphilis During 2009ââ¬â2010, the rate of primary and secondary (PS) syphilis among blacks decreased 8. 7% (from 18. 4 to 16. 8 cases per 100,000 population). In 2010, 47. 4% of all cases reported to CDC were among blacks and 31. 0% of all cases were among whites. The overall 2010 rate for blacks was eight times the rate for whites, while the 2009 rate was 9. 2 times the rate for whites. In 2010, the rate of PS syphilis among black men was 7. 1 times the rate among white men; the rate among black women was 21 times the rate among white women. In 2010, the rate of congenital syphilis was 33. 1 cases per 100,000 live births among blacks. Race/ethnicity for cases of congenital syphilis is based on the motherââ¬â¢s race/ethnicity. This rates was 12. 3 times the rate among whites (2. 7 cases per 100,000.live births). More Information: ?STD TOPIC SITE ?STDS AND HEALTH DISPARITIES ?STD SURVEILLANCE REPORT ?STDS IN RACIAL AND ETHNIC MINORITIES Viral Hepatitis Acute Hepatitis A During the past 10 years, there has been little difference between the rates of acute hepatitis A among white non-Hispanics and black non-Hispanics. The 2011 rates for these groups were 0. 29 and 0. 27 cases per 100,000 population, respectively. Acute Hepatitis B In 2011, the rate of acute hepatitis B was highest for Black non-Hispanics (1. 4 cases per 100,000 population). Acute Hepatitis C During 2002ââ¬â2010, the incidence rate of acute hepatitis C remained below 0. 5 cases per 100,000. The rate of hepatitis C among Black non-Hispanics increased 27. 3% (to 0. 14 case per 100,000 population in 2011). More Information: ?VIRAL HEPATITIS TOPIC SITE ?SURVEILLANCE REPORT FOR VIRAL HEPATITIS Tuberculosis (TB) In 2010, 84% of all reported TB cases occurred in racial and ethnic minorities. Non- Hispanic blacks or African Americans accounted for 24% of TB cases in 2010. African Americans make up approximately 14% of the U. S. population, but accounted for 40% of TB cases in U. S. -born persons. Overall, 11,182 TB cases were reported to CDC from the 50 states and the District of Columbia in 2010.
Sunday, October 27, 2019
Health Indicators for Diverse Groups in New Zealand
Health Indicators for Diverse Groups in New Zealand Introduction Public health is the science and art of promoting and protecting the life and well being of the population as a whole, by preventing the ill health and prolonging the life through the organized efforts of the state and the society. This assessment aims to discuss and present the health status indicators for diverse groups in the National and International perspectives. It also includes the causative factors in health. Current Health Status indicators for Three Diverse Groups from National and international perspectives. New Zealand New Zealand is located in the South Pacific. It is a multi-cultural country and a very supportive on health of the society and its program. There are several diverse groups that living in New Zealand namely: the Maori, The Pacific people, the Pakeha or Europians and the Asian migrants. a. The Maori Maoris are the most important ethnic groups in New Zealand. They are the original settlers of the country. One indicator that compromises the health of the Maori is smoking. Smoking was identified as the most prevalent health status indicator and it is significantly observed in areas inhabited by the Maori. Broughton (1996) stated that traditionally the Maori society was tupeka kore (tobacco free). Maorisââ¬â¢ first encounter with tobacco was through the British, it was used as a tool of colonization by gifting or trading it in return for land and other resources. Currently, 32.7 per one hundred of Maori identified as being regular smoker, more than twice the smoking rates of European and Asian ethnic groups. Among Maori males the regular smoking rate is 30.5 percent and among females it is 34.7 percent. For Maori women of childbearing age (20-44 years), 40.5 percent smoke regularly. (Statistics New Zealand, 2014) Moreover, the Maori youth aged 15 ââ¬â 19 years has higher smoking rate than non-Maori. In this age group, 38.8 percent (CI 29.3ââ¬â48.3%) of Maori were current smokers compared with 13.7 percent (CI 10.4ââ¬â17.1%) of non-Maori. There were some findings that there were notable difference in the average of the Maori and non-Maoriââ¬â¢s initial taste of cigarette. On average Maori youth, their first cigarette was as early as 11.5 years compared to non-Maori youth at 12.7 years. As a result, tobacco smoking is the primary cause of the preventable death for Maori in New Zealand. Approximately, three times as many Maori died from Lung cancer and other smoking related diseases as Non-Maori each year. Maorisââ¬â¢ current smokers are more likely to prefer on smoking a roll-your-own-cigarette than non- Maoris smokers. The frequency of roll-your-own-cigarette was 70.3 percent for Maori and 57.4 percent compared to non-Maori. The most common reason of Maori and non-Maori for using the roll-yourââ¬âown-cigarette was that, it has less expense than the manufactured cigarettes. The other reason for Maori and non-Maori they gave was, it last longer and taste better. Another health indicator among Maori is the Life Expectancy. The life expectancy of Maori men is 73 years while the Maori women is 77.1 compared to the non-Maori men which is 80.3 years and 83.9 years for the non-Maori women. The life expectancy at birth has narrowed the gap to 7.1 years between Maori and non-Maori people. In comparison with 8.2 years in 2005-07, 8.5 years in 2000-02, and 9.1 years in 1995-97 based on death rates of New Zealand in 2012-2014 (Statistics New Zealand, 2014). The differences in the life expectancy rate of Maori people compared to non-Maori are due to the number of factors including rates of smoking and socioeconomic status. b. The Pacific people The Pacific community in New Zealand are consist of different ethnic groups like the Samoans who are the largest group with 50% of the population, the Cook Islanders, 20%, the Tongan, 18%, the Niuaen, 8% and the Fijans who have the smallest group of 4%. (Ministry of Public Island Affairs, 2013) Obesity is one of the biggest issue in health for the Pacific Islanders. Among the New Zealand diverse groups, the Pacific adults had the highest rate of obesity with 67 percent followed by 46 percent Maori adults. Contrasting to, only one in seven Asian adult is obese, with a rate of 14 percent. On the other hand, Pacific children aged 2-14 are 55 percent obese or overweight, compared to 29 percent of the total child population in New Zealand. Based on body mass index, it was found out that almost one out of three adults from age 15 years and above were obese with a rate of 31 percent while about 34 percent were overweight. In ages 2-14 years, one in nine children were obese or 11 percent. Furthermore, high rate of overweight children of the Pacific people were also found, which was 22 %. c. The Asian group The Asian adults are generally in good health. They have the positive focus on health and well-being. In fact, Asian adults have comparatively low rates of smoking, hazardous drinking, asthma, arthritis, chronic pain, diagnosed mood or anxiety disorders (Asian Health, 2006). However, Asian adults are about 1.8 times as likely to have been diagnosed of type 2 diabetes as non-Asians. Self noted diabetes rates are common among Indian people, more than three times than the normal average. Asian adults generally report lower use of primary health center because of the language and cultural barriers that affect the access to health services (source). It was noted that after migration, Asian people may have increased risk of diabetes and cardiovascular diseases due to the lifestyle changes, physical activity and change in diet. United States of America United States of America is among the worldââ¬â¢s good provider on health for its people. The total population of America as of 2013 is 320,051,000, with a gross national income per capita of 53,960. The allocations for health per capita is 8,895 international dollar in 2012 and the total expenditures for health as percentage of GDP as of 2012 is 17.9. (WHO, 2015) United States of America is a multicultural country and they have several diverse groups namely: the Whites Americans, the African Americans, the Asian Americans, the Native Americans/ American Indians and Alaska Natives, the Native Hawaiians and other Pacific Islanders and Hispanic and Latino Americans. a. American Indians and Alaska Natives Tobacco remains the largest preventable cause of disease and death in the United States. Every year 480,000 of Americans are killed through cigarette smoking, and 41,000 of these deaths were due to the second hand smoking. (U.S. Department of Health and Human Services, 2014). Cigarette Smoking is the most prevalent case for the American Indians and Alaska Natives in the United States of America with significantly the highest percentage rate among other racial groups, of 26.1 percent compared to 19.4 percent of the White Americans, the African Americans with 18.3 and the Hispanics has 12.1 percentage respectively. The Asian American has the lowest percentage of smoking with 9.6 percent. Men in the United States are the most frequent smokers with 20.5 percent compared to women who has 15.3 percent. Among the adults in America, ages 25 to 44 years are the most habitual smokers with a 20.1 percent, followed by the ages 45 to 64 years with 19.9 percent and 18.7 percent for ages 18 to 24. The least frequent smokers are at the age of 65 years and older with 8.8 percent. (Centers for Disease Control and Prevention, 2015). b. The African American Obesity is based on the body mass index(BMI) of a person of 30 or higher. The body mass index is measured of an adultââ¬â¢s weight in relation to his or her height, calculated by the adults weight in kilograms divided by the square root of his or her height in meters.(U.S. Center for Disease Control and Prevention,2014). In the United States more than one-third or 34.9% or 76.8 million of adults are obese. The African American have the highest rates of obesity with 47.8 percent, followed by the Hispanic with the rate of 42.5 percent, the White comes third with a percentage of 32.6 percent, and for the American Asian has the lowest rate of obesity with a rate of 10.8 percent. (Journal Of American Medicine, 2014) Obesity are more prevalent among middle age group from 40 tp 59 year old with a rate of 39.5% compared to the younger adults, the 20-39 years age group with a percentage rate of 30.3%, and the adults of over 60 years and above has a percentage rate of 35.4 percent. (Journal of American Medicine, 2014) Another indicator among African American is Diabetes. Diabetes is the sixth leading cause of death in the United States of America, killing 71.5 thousand people in 2012. (WHO, 2012) Diabetes is a chronic disease characterized by hyperglycemia or high glucose levels in the blood. In a healthy person the blood sugar level are kept in an acceptable range by insulin. Insulin is a hormone, that is produced in the pancreas, that will help the body absorb excess sugar from the blood stream. Among diabetic people, blood sugar levels are not adequately controlled by insulin. (Agency for Healthcare Research and Quality, 2010). Diabetes is most prevalent among African American adults, from ages 18 and over, with a percentage rate of 13.2 percent compared to the Hispanics with 12.2 percent, while, 7.3 percent for both White Americans and Native Hawaiians.(CDC, 2014) In 2012, 44.2 per 1000 population of African American adults were hospitalized for lower extrimity amputation in contrast with 12.5 per 1000 population of the White and 25.4 of the Hispanics. (National Healthcare Quality and Disparities, 2014) c. White Americans The Center for Disease Control and Prevention(CDC)2014, gathered the information about the mortality in the U.S., including the death by suicide. In 2013, there were 41,149 suicide cases reported. This makes the suicide, as the tenth primary cause of death in America. The CDC calculates the suicide rate each year by the number of the accounted suicide deaths that occur for every 100,000 people in the population. White americans got the highest rate of suicide death with 14. 2%, followed by the American Indians and Alaska natives with a rate of 11.7%. Much lower and nearly the same rates are common among Asians and Pacific Islanders with 5.8%, Hispanic with 5.7%, and African American with 5.4% respectively.(Centers for Disease Control and Prevention, 2014) In 2013, Men were most likely to commit suicide compared to women with a significant rate of 20.2, and women had a rate of 5.5, that is four times higher in men. It was noted in in 2013 that 77.9% of males died in suicide in comparison to much lower rate in female for only 22.1%. Among the age group, 45 to 64 years had the highest suicide rate of 19.1%, followed by 85 years and older with 18.6%. The younger groups aged 15 to 24 years had lower suicide rate of 10.9%.(CDC,2014). Causative Factors a. National Causative Factors The influence of the family members or growing up in the house or environment where people regularly smoke has a great impact for the prevalence of smoking among Maori people. The total lack of discouragement since some or all of the family members are smoking. In general, the peer pressure for the teen agers that caused them to start smoking at an early age and the feeling of relief from stress and fatigue. Lastly, the use of the roll-yourââ¬âown-cigarette which has cheaper cost. (The Buzzle, 2015) The factors that influence the obesity of the Pacific people are, there lifestyle, habits and food consumption. For age fifteen years and above, less than half or about 40.9% of the Pacific males and Pacific females (48.9%) met the recommended vegetable intake that was notably lower than non-Pacific group. In addition, Pacific males and females consumed more servings of soft drinks or energy drinks per week. In particular, Pacific female, were three times as likely to eat fast food and takeaways in comparison to non-Pacific people. Children aged 2-14 years were less likely to have eaten breakfast at home compared to non-Pacific. (The Pacific Peoples Health, 2014) One causative factor of Diabetes is obesity. Atleast 80% of Type 2 diabetes are overweight. Due to todayââ¬â¢s sedentary and westernised lifestyle, people will become overweight and eventually become obese. Obesity causes insulin resistance, meaning that the fats and muscle cells of obese people do not seem to react to the insulin, so there is an uncontrollable blood glucose level in the body, thus, leading to Type 2 diabetes. (Diabetes Info NZ, 2014) b. International Causative Factors The factor that triggers the prevalence of smoking among American Indians and Alaska Natives is that, it is included in a sacred tobacco ceremonial rights, religious practices and as medicinal roles for native culture. In addition, tobacco sold in tribal lands are exempted from state and national taxes, thus, it is cheaper and affordable. (U.S. Department of Health and Human Services, 2015) The causative factor of obesity of the African American is the limited access to safe places for outdoor physical activities. In order to carry out a a good and a balance healthy living, one must participate in a sufficient physical activity. In addition, lower incomes and poverty contributes to the increasing obesity, since less nutritious foods or calorie-loaded foods are often less expensive and affordable than healtier foods. (Racial and Ethnic Disparities in Obesity, 2014) The risk factor of diabetes which is prevalent among African Americans are due to lifestyle choices. The lesser chance of regular physical activity and consuming high-calorie foods in larger amount than necesarry will have the high risk of devloping type 2 diabetes. Another factor is heriditary, if someone in close family has diabetes, other members might also develop diabetes.(Endocrineweb, 2014). Based from the causative factors of the different health problems encountered from the national and international aspects, it is observed that they have almost the same common factors that triggers the prevalence of diseases. Lower incomes and living in more deprived areas are more prone to such diseases. Regular physical activities and proper nutrition is the key to have a healthy life. 3. Discussion Smoking is one of the major problem that the government of New Zealand is facing especially with the Maori group who is the leading cigarette or toabcco smoker than other ethnic groups. It is further noted, that there is a strong relationship between smoking and neighborhood deprivation. It means that there are more people who are engaged in smoking in most deprived areas than the least deprived areas. The government should continue to dessiminate information and awareness for the effects of smoking for the active and passive smokers most especially to the deprived areas where smoking is rampant. Conduct counselling for the addictive smoker and the family. Create programs or provide facilities that promotes physical activities to different groups. There should be a thorough emphasis and education for the tremendous effect of smoking like: smoking can harm every organ and systems in the body, cause 80% of lung cancer, and respiratory condition like emphysema and chronic bronchitis. Smoking is also a major cause of heart disease, stroke and other cancers. In addition, smoking around children increases the risk of lung infection like croup, bronchitis and peumonia. There are a lot of health problems that the United States of America is facing, one of them is obesity and it is quite alarming that more than one-third of the population in America are obese. Among the diverse groups, Afrian Americans has the highest percentage of obesity. One factor of obesity for Black Americans is that they have limited access to safe areas for outdoor activities. To carry out a balance and healthy living one must indulge in a regular physical activitivities. It is also observed that lower income and poverty contributes to the increasing obesity since they will opt to consume the cheaper, less nutritious and high calorie foods. Being obese increases the persons risk to developing heart diseases (cardiovascular heart disease, stroke), type 2 diabetes and and other forms of cancer. In order to prevent obesity and the risk of developing long term diseases the government should continue to support programs that involves physical activities. Provide facilities for indoor and outdoor sports and a safe playground for children. The government should also provide a team that will monitor the intake of nutritious foods especially in the deprived areas where obesity is common. A quarterly checks of the blood for blood sugar, lipid profile and blood pressure for the obese persons.
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