The document discusses obesity among African Americans. It notes that African Americans have disproportionately high rates of obesity compared to other ethnic groups in the US, with about 58% of African Americans being obese or overweight. It explores several factors that contribute to this disparity, such as poverty, lack of access to healthy foods, neighborhood environment, and lifestyle. The document then discusses some potential nursing interventions to address obesity in the African American community, including school-based programs and implementing healthy diet plans and physical exercise.

1. "You are retained by Columbia Corporation to audit its financial
statements for the fiscal year ended June 30. Your consideration
of internal control indicates a fairly satisfactory condition,
although there are not enough employees to permit an
extensive separation of duties. The company is one of the
smaller units in its industry, but it has realized net
income of about $500,000 in each of the last three years. Near
the end of your fieldwork, you overhear a telephone call
received by the president of the company while you are
discussing the audit with him. The telephone conversation
indicates that on May 15 of the current year, the Columbia
Corporation made an accommodation endorsement of a 60-day
$430,000 note issued by a major customer, Brill Corporation, to
its bank. The purpose of the telephone call from Brill was to
inform your client that the note had been paid at the maturity
date. You had not been aware of the existence of the note
before overhearing the telephone call.
a. From an ethical standpoint, do you think the auditors would
be justified in acting on information acquired in this manner?
b. Should the balance sheet as of June 30 disclose the
contingent liability? Give reasons for your answer.
c. Prepare a list of auditing procedures that might have
brought the contingency to light. Explain fully the likelihood
of detection of the accommodation endorsement by each
procedure listed."
there is a bit of research that can be done (for example, what is
an accommodation endorsement? :
Please use 2 APA citation
Running head: OBESITY AMONG AFRICAN AMERICANS 1

2. OBESITY AMONG AFRICAN AMERICANS 8
Obesity among African Americans
Yanet Galan
West Coast University
2/1/2021
Obesity among African Americans
The emergence of obesity as a major healthcare problem in the
United States has earned it the label of a national epidemic.
Data from the Centers for Disease Control and Prevention
(CDC) indicate that more than one third of the people in the
United States are overweight or obese. This number translates
to about 35% of the population. Although the number of the
affected is high across all ethnic groups in the country, African
Americans are the most affected by chronic disease and obesity.
White et al. (2017) state that African American women are
disproportionately affected by obesity. Data from NHANES
indicate an increase in the prevalence of obesity among African
American women in the last two decades. Currently, almost
47.8% of all African American women are considered obese
(White et al., 2017). Although obesity is a serious problem
among the African American community, there are limited

3. studies that seek to explore the issue and find possible
solutions. It is, therefore, important to analyze some of the
factors that have led to the emergence of obesity as a national
epidemic and the strategies that can be used to address it.
Assari, Wisseh, and Bazargan (2019) state that increasing rates
of obesity among African American communities and the rest of
the country has ignited a national conversation on how to best
deal with the crisis. The amount of money and other resources
that are being directed towards addressing obesity has forced
policy makers and citizens to look for solutions to the health
crisis. For example, increasing obesity rates in the United States
forced the National Health Institute to spend approximately
$857 million in 2014 in obesity research (Assari et al., 2019).
The amount of money and resources that have been pumped into
obesity research has been o na steady increase over the years.
Despite the huge investments in obesity research, the rates of
obesity research remain high among African Americans. The
analysis of data from CDC shows that the rate of obesity among
African Americans is staggering. Therefore, the country,
through the relevant agencies should give substantial attention
to obesity in African American communities and the rest of the
country.
Obesity Prevalence among African Americans
In their investigation of obesity prevalence in 2015, Knox-
Kazimierczuk and Shockly-Smith (2017) established that the
prevalence of obesity and overweight has dramatically increased
since the 70s. The CDC estimates that the rate of obesity among
adults in the United States has more than doubled to 33.9% from
1980 to 2008. Data from the National Health and Nutrition
Examination Survey (NHANES) also show that the rates of
obesity have remained high with more than 36% of the
population in the country considered to be obese or overweight
(Knox-Kazimierczuk & Shockly-Smith, 2017). The NHANES
used data from the studies it conducted from 2009 to 2010. The
data also indicated similar trends in obesity among racial
minorities like African Americans and Latinos. An analysis of

4. the data during the same period indicates that obesity rates
among African Americans increased. Currently more than 58%
of African Americans are more likely to be obese or overweight
than any other racial group.
Sims et al. (2020) observe that ethnic minorities from lower
socioeconomic groups are disproportionately affected by
obesity. African Americans, for example, are among the groups
that have been disproportionately affected by obesity,
cardiovascular diseases, diabetes, among other health issues.
Although there is limited research on why African Americans
are the most affected by various health challenges, it is possible
that a host of factors come together to contribute to these wide
health disparities. The prevalence of obesity among African
Americans is 66% which is 1.4 times more than that in
Caucasian women whose prevalence stands at 47% (Sims et al.,
2020). African Americans are also at the greatest risk of
developing diabetes and diseases like hypertension at an early
age. Sims et al. (2020) further state that African American
women have more abdominal fight than Caucasian women.
Approximately 48% of all adult African Americans are obese or
overweight. It is estimated that 56.6% African American women
and 37.1% men are clinically obese. The health risks that are
associated with obesity makes such statistics alarming. It is,
therefore, important that awareness of such risks must be spread
widely so as to motivate people to change their lifestyles.
Factors leading to high obesity rates among African Americans
Several factors can be used to explain why obesity prevalence is
high among African Americans than in other ethnic groups in
the United States. One of the major factors that contribute to
high obesity rates among African Americans is poverty of the
lack of financial resources. Although 2019 saw poverty rates in
the United States fall to 10.5%, the lowest since 1959, most
African Americans are still affected (Avery et al., 2016). The
poverty rate for African Americans was 18.8%, which is higher
compared to other ethnic groups. The high poverty rates among
African Americans directly and indirectly contribute to

5. increasing obesity rates. High poverty rates among African
Americans make it hard for them to access quality healthcare.
The United States’ healthcare system is among the costliest in
the world. As a result, individuals who are uninsured and poor
find it hard to access healthcare service that may help them
address the issue of obesity.
The lack of options for healthy foods is a also a contributing
factor towards increasing obesity rates among African
Americans. Moreno et al. (2017) state that a significant number
of African Americans live in poor neighborhoods where it is
hard to get healthy foods like fresh vegetables and fruits. In the
last 10 years, there has been an increase in the number of food
deserts throughout the country. Food deserts have been created
by an increase in fast food restaurants which give people access
to cheap and unhealthy foods (Schroeder et al., 2019).
Individuals who live in food deserts only survive on processed
foods because they cannot afford or access healthy and fresh
produce. The United States Department of Agriculture estimate
that more than 23 million people live in food deserts. Such
people live more than one mile from a supermarket in a
suburban or urban area or more than 10 miles in rural areas
(Schroeder et al., 2019). Since many African Americans live in
food deserts, it is hard for them to adopt a healthy diet hence
increased obesity rates.
Another factor that has contributed to increased obesity rates
among African Americans is the neighborhoods where most of
them reside. Since a significant proportion of African
Americans live in poverty, then can only afford to live in poor
neighborhoods. Such neighborhoods are usually abandoned with
limited infrastructure development of maintenance (Assari et
al., 2019). Most of the black neighborhoods lack essential
amenities such as playing fields, modern gyms and other
amenities. High crime rates in these neighborhoods further
discourage other people from participating in physical activities
that may improve their health and maintain their body weight.
Finally, lifestyle is also another factor that contributes to the

6. high obesity rates among African Americans. A significant
number of African Americans do not live healthy lifestyles. The
number of people in the African American community holding
more than one job is high due to the desire to uplift themselves
from poverty. As a result, most of them lack the time to focus
on things that may benefit their health in the long run. For
example, instead of cooking a proper meal, some would prefer
buying processed food, which are not healthy. The busy
lifestyles of most of the people in African American
communities mean that they do not have the time to exercise or
engage in other activities that may benefit them in the long run.
Possible Nursing Interventions
After understanding the obesity prevalence in African American
communities and some of the factors that contribute to the high
obesity rate, it is important to investigate some of the possible
and effective interventions. One of the strategies or
interventions that can be used to combat obesity in African
American schools is school based programs. Moreno et al.
(2017) state that school based programs have been used for
many years impact child health and set a firm foundation and
example foe the rest of the community. Preventive efforts are
the key to combating obesity among African American
communities. Therefore, schools offer an important setting
where nurses and other health care professionals can fight
obesity. School based programs are effective in the fight against
obesity because they promote physical activity, supportive
environments, and nutrition education (Schroeder et al., 2019).
The lessons gained by students can then be transferred to the
community. The use of school based programs is an effective
tool against obesity because it makes it possible top imprint
physical activity and proper dietary habits in children. The
move further allows schools to create lifelong eating habits. An
analysis of existing literature reveals mixed results when it
comes to the use of school based programs to combat obesity.
Interventions among African American communities that were

7. done between 1966 and 2001 showed minimal positive weight
related outcomes (Avery et al., 2016). The changes were
however small and the measures that were used varied from one
study to another. A study carried out by Avery et al. (2016)
established that school based programs are only successful when
the right parameters or measures are applied.
Another effective intervention is the implementation of healthy
diet plan and physical exercises. The adoption of a healthy diet
plan is currently the most effective and cost friendly
intervention. Nurses working with nutritionists identify the
right healthy diet plan depending on the patient and their
weight. Most of the studies that have investigated the
effectiveness of healthy diet plans and physical activities have
reported positive results with regards to weight loss. A study
cited by Schroeder et al. (2019) subjected 50 people to a two
year pilot study aimed at investigating the effectiveness of
healthy eating and physical exercise. Out of the fifty, 35 of the
participants experienced significant weight loss within the first
two years of the study. It was, therefore, evident that the
implementation of healthy diet plan and physical exercise is the
most effective intervention.
This study will, therefore, apply healthy diet plan and physical
exercise as the main intervention in the fight against obesity in
African American communities. The results will be collected
and analyzed to establish if the strategy is effective or not.

8. References
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