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Franklin's Grove is the county seat of Franklin County, a small rural county in the Southeast. On the basis of its demographic and economic profile, it was selected as a health improvement zone to receive Federal funds to implement programs to improve progress toward reaching the national health objectives. Communities receiving such funds are charged with identifying the most significant gaps between the current health status and national health objectives and with putting programs in place to narrow such gaps.
Using the PRECEDE framework, the county health department has conducted a social and health diagnosis. Some of the most severe quality-of-life problems were related to limb amputation and kidney failure. Prevalent health problems included diabetes, hypertension, and cardiovascular disease. Which of the following behavioral factors are most likely responsible for the above health and quality-of-life issues in Franklin 's Grove?
(A) Unprotected sex, early sexual initiation, use of drugs
(B) Sedentary lifestyle, high caloric consumption, low fiber intake
(C) Advanced age, low levels of education, history of racism
(D) Frequent tobacco, drug, and alcohol us