Case Study 1 “ Arab Americans 
In this case study S.M is a nurse practitioner caring for Arab Americans. She is participating in a health fair screening even at a local Islamic cultural center. She anticipates the attendees to be local Arab-American. S.M is aware that some of the common health issues that Arab Americans face include diabetes and cardiovascular disease. In todays fair she hopes to meet with the families to learn their behaviors and to educate them regarding healthy lifestyles while gaining their trust and planning follow up care that they may need.  
The occurrence of people with multiple comorbidities are currently on the rise worldwide. It is expected with age that multiple morbidities will be present, however, an increased number of working age individuals now live with multiple morbidities. Multiple morbidities are linked to increased healthcare costs, frequent hospitalizations, decreased quality of life, and an increased rate of mortality (Willadsen et al., 2016). As health care providers it is important to screen patients who are at risk for multiple morbidities and provide them education, early intervention, and treatment.   
There are many different kinds or risk factors that can be attributed to the increase of multiple morbidities. Some of the risk factors can be dependent on the environment a person lives in, while other factors can be dependent on the person themselves. Environmental risk factors include people living in food desserts. This means patients living in areas where there are more fast-food options and junk food options than there are any healthy options for food. Poor outdoor air quality and lack of clean drinking water are other examples of environmental risk factors. Examples of person dependent risk factors include smoking, sedentary lifestyle, and alcoholism. These are all examples of choices an individual makes that has a negative impact on their life 
Preventative screenings have long been an important health care strategy in early identification, diagnosis, treatment, improvement of quality of life, and prevention of premature deaths (Bell et al., 2017). As health care providers we should encourage patient screenings whenever possible because of its potential positive outcome. When S.M is caring for patients from a different culture she may encounter barriers that may affect her teaching. These barriers include both language barrier and poor health literacy. S.M will need to find someone that is both health literate and proficient in the Arabic language to help her provide education and answer any questions they may have.  
Economics and nutrition often go hand in hand. Research shows that with a 10% increase in income, malnutrition decreases by 5% (Alderman, Behrman, & Hoddinott, 2007). People with low income should be encouraged to apply for supplemental government assisted food programs available in their states. They should also be encouraged to shop at their local farmers market as they may pay less for more fresh products compared to shopping at big chain grocery stores. Lastly, they should also be encouraged to create a community garden within their community, where they can grow their own crops at a much cheaper price.  
References 
Alderman, H., Behrman, J. R., & Hoddinott, J. (2007). Economic and nutritional analyses offer substantial synergies for understanding human nutrition. The Journal of nutrition, 137(3), 537“544. https://doi.org/10.1093/jn/137.3.537 
Bell, N. R., Grad, R., Dickinson, J. A., Singh, H., Moore, A. E., Kasperavicius, D., & Kretschmer, K. L. (2017). Better decision making in preventive health screening: Balancing benefits and harms. Canadian family physician Medecin de famille canadien, 63(7), 521“524. 
Willadsen, T. G., Bebe, A., Køster-Rasmussen, R., Jarbøl, D. E., Guassora, A. D., Waldorff, F. B., Reventlow, S., & Olivarius, N. (2016). The role of diseases, risk factors and symptoms in the definition of multimorbidity – a systematic review. Scandinavian journal of primary health care, 34(2), 112“121. https://doi.org/10.3109/02813432.2016.1153242