Primary Health Care and childhood obesity - Essay Example

?Primary Health Care and Childhood Obesity Introduction Child health issues are at the core of public health concerns in all communities around the world. In Australia the more prevalent child health issues impacting on children are preventable and include obesity, dental disease, emotional and behavioural problems, bullying and learning delays. In the first decade of the new millennium the prevalence of obesity has doubled over the preceding years. Overweight and obesity prevalence among children and adolescents in Australia is to the tune of 23%, of which over 6% are obese. These figures arise from conservative estimates. The more worrying factor however, is that this trend of alarming growth rate in child obesity will only rise if efficient means to face the challenge are not put in place. The need for this becomes more significant, when there is realization that longitudinal studies show that once children or adolescents become obese it is not easy to backtrack and so they carry it through to adulthood along with the current consequences and negative implications for their well-being as adults (Waters & Baur, 2003). This paper attempts to identify the major social factors that contribute to obesity in children in Australia and the effects of obesity on the health and well-being of the affected children. The paper will also evaluate the issue of interaction of the contributory social factors and the impact of this interaction on the complexity of the child obesity problem. Finally, the paper will attempt to discuss how each of the five primary healthcare principles could provide guidance to nursing practice to bring about the desired positive change in health outcomes for children in Australia towards reducing the challenge of childhood obesity for society. Social Factors that Contribute to Obesity in Children Over the past several decades the cost of food relative to the income levels has dropped, thus making food easier to afford. This should be a good thing, but the issue is that the changing food intake styles have resulted in the diets being energy rich and poor in nutrition. Nourishment in present times for many individuals and families has become more of a source of pleasure and an indicator of social status than as a means of providing the body with the necessary and required nutrients. Another social factor that has contributed to childhood obesity is the general trend in society for reduced physical activity. Parents no longer encourage children to go out and play during free times and the children are quite happy to sit at home and watch television or play computer games. In communities there is less on making available physical activity avenues and influencing the members of the community to spend a little time on physical activities for health and well-being (Dehgan, Akhtar-Danesh & Merchant, 2005). Ethnic, cultural and racial practices contribute to the social practices of the frequency and type of feasts, meal frequencies and timings, the role and meaning attached to food and types of food consumed and the body image. In Australia there is a wide variance in these social practices between the Anglo/Caucasian children and other ethnic types, with particular emphasis on the Middle Eastern and Pacific Islanders. For example, among this ethnic grouping bigness in size makes for better masculinity in boys and reflects social class mores in girls. The consequence of this is seen in the much higher prevalence of childhood obesity among this ethnic grouping at 20%, when compared to the 5-7% prevalence among Anglo/Caucasian children (Odea, 2008). The final social factor is the inequality in the provision of healthcare services, wherein the communities that are more prone for obesity in children do not receive adequate healthcare support and remain oblivious to the dangers of childhood obesity and the ways of preventing it (Goroll & Mulley, 2009). Interaction of Social Factors and Complexity of Childhood Obesity The social factor of nutritional intake patterns lead to higher intake of energy rich foods. Removal of this excess energy intake requires high levels of regular physical activity. This runs against the current trend of the social factor of declining physical activity among children. Thus on one side the intake of energy is high and on the other side there is limited or no physical activity among children to burn up this excess energy. The consequence of this combination is severe energy intake and utility imbalance that results in the high growth rate in the prevalence of obesity among children (Dehgan, Akhtar-Danesh & Merchant, 2005). This is further compounded when the social eating practices tend towards eating more food than is required as a sign of social class. Children are thus encouraged to eat what they like and when they want with no caution or awareness provided on the consequences this overeating can have. On their own children would have tempered their eating styles if the body image requirements of society were to lean towards a slim image, as they would attempt to jeep a slim body to look good. This is not the case in societies in which bigness in image is considered the way to maintain ones body. Thus children in these societies get encouraged to eat more and continue eating more for there are no tempering influences (Odea, 2008). It is these very same societies that face a deficiency in the availability of healthcare services and therefore remain blissfully ignorant to the consequences of these unhealthy practices. These factors in combination result in a higher growth rate in childhood obesity and prevalence of childhood obesity in these societies, like the Middle Eastern and Pacific Islanders in Australia (Goroll & Mulley, 2009). Role of the Primary Healthcare Principles as a Guide to Nursing Practice McMurray 2003, p. 36-37, gives the most commonly accepted interpretation of the Declaration of Alma Ata as incorporating five primary healthcare principles of “accessibility, appropriate technology, increased emphasis on health promotion, intersectoral collaboration and public participation”. The accessibility principle means equitable distribution of healthcare services, so that all communities irrespective of their socio-economic standings and place of residence have access to the required healthcare services and healthcare information. This provides the guideline for nursing practice to identify segments of society that are at high risk for childhood obesity, because of their social practices and ensure that healthcare services and healthcare information in preventing childhood obesity can be accessed by them. The appropriate technology principle guides nursing to use the newly emerged technologies in the most suitable manner to the benefit of the communities that they work in. Creating awareness of the threat of childhood obesity and the means to prevent it through healthy eating habits and physical exercise in the communities is a role for nursing. Audio-visual communication will be more effective in the communication of these messages than printed matter on verbal communication. Audio-visual aid technology to this end is freely available for nursing practice to employ towards the objective of creating awareness on childhood obesity in the communities in Australia. The increased awareness on health promotion places the onus on nursing practice to identify health threats to the communities they work in and place the emphasis on prevention rather than cure. In the case of childhood obesity this means that nursing practice must lay the emphasis on prevention of childhood obesity rather than on meeting the challenge of the clinical co-morbidities that accompany childhood obesity. Intersectoral collaboration calls for cooperation among all the healthcare workers towards the goals of primary health. In the case of childhood obesity, the greater risk is found in the minority communities with low socio-economic standings. The nursing community made up mostly from the majority community may find it difficult to identify and communicate with the community leaders towards changing eating and living styles towards the prevention of childhood Obesity. However, social workers will have such access and nursing practice will need to seek collaboration with the social workers towards the goal of reducing the prevalence of childhood obesity in these communities. Public participation means seeking and getting the involvement of the communities in meeting primary health objectives. As a consequence of this guideline nursing practice will have to look at reducing the prevalence of childhood obesity as a joint venture of equal partnership between the members of the community in which they practice and themselves. Involving the members of the community will be essential to the success of reducing the prevalence of childhood obesity in the communities in Australia. Conclusion Childhood obesity is a growing threat to the well-being of children and adolescents in Australia, which they carry forward when they become adults. Four major social factors of unhealthy diet styles of consumption of energy rich and poor nutritional value foods; reduced physical activity; ethnic, cultural and social practices that encourage excess eating in children and inequality in the access to healthcare services contribute to this growing threat individually and in combination with each other. Nursing practice by employing the guidelines provided by the primary healthcare principles can contribute towards reducing the prevalence and threat of childhood obesity. Literary References Dehgan, M., Akhtar-Danesh, N., & Merchant, A. T. 2005, ‘Childhood obesity, prevalence and prevention’, Nutrition Journal, vol.4, no.24 [Online] Available at: http://www.nutritionj.com/content/4/1/24 (Accessed March 11, 2011). Goroll, A. H. & Mulley, A. G. 2009, Primary Care Medicine, Sixth Edition, Lippincott, Williams & Wilkins, Philadelphia, PA. McMurray, A. 2003, Community Health and Wellness: A Socioecological Approach, Second Edition, Elsevier (Australia) Pty Ltd., New South Wales. Odea, J. A. 2008, ‘Gender, ethnicity, culture and social class influences on childhood obesity among Australian school children: implications for treatment, prevention and community education’, Health and Social Care in the Community, vol.16, no.3, pp.282-290. Waters, E. B. & Baur, L. A. 2003, ‘Childhood Obesity: Modernity’s Scourge’, The Medical Journal of Australia, vol.178, no.9, pp.422-423. Read More