Prevalence of Overweight and Obesity in the USA - Research Paper Example

Prevalence of Overweight and Obesity in the USA Background Obesity is defined simply as body mass index of 30 or more. Body mass index is a measure of height to weight of an individual. Overweight refers to body mass index between 25 and 30 (Tsai, Williamson and Glick, 2011). Over the years, American living culture has in many ways promoted the advancement of poor health lifestyles that lead to overweight and obesity among the population. Some of the lifestyle habits that have significantly worsened the epidemic include use of junk foods and drinks available from the ever proliferating fast food outlets and the heavy universal reliance on automobiles as a means of transportation as opposed to walking that promotes physical activity and body exercise. Many agencies and organizations that offer advice to governments embrace policy proposals that have over the years been met with unbending resistance from the lawmakers and the (food) industry disprove the thought that obesity is principally the outcome of a lack of restraint on the part of the populace arguing that numerous strategies will be required to bring the epidemic to manageable levels (Arterburn et al, 2010). The CDC1 in 2010 reported that 35.7% of American adult population was obese with children population at 17%. About 65 percent of the American population is overweight or obese with the low-income groups carrying the highest overweight levels and obesity. A study conducted by the TFAH2 in 2010, to establish the level of action by the federal government and states to address the crisis, estimates the average direct costs associated with the crisis so far at about USD 190 billion per year which is about twenty per cent of healthcare spending. Indirect costs could be estimated in terms of insurance premiums, lost productivity and absenteeism from work. It is factual that there is an escalating development in the levels of obesity and related illnesses in America. For example, obesity levels in about 41 states are in excess of 20 percent. A recent study funded by CDC projects an 8 per cent increase in adult obesity in the USA by 2030 from the current 34 percent. Thus, adult obesity by 2030 is estimated at 42 per cent. Of these, 11 per cent will be severely obese compared to the current 6 per cent. A third of American children population aged from 2 to19 is currently obese. A multifaceted approach in dealing with the epidemic is inevitable and should include public health policy together with considerable funding as well as national leadership to ensure the participation of health officials, educators and legislators among others in creating a public health drive (Arterburn et al., 2010). This paper will explore the issue of the obesity crisis in terms of implementation and evaluation of the federal government policies, the current policy impact and the role of the local, state and federal government. It will also provide some proposals in terms of legislation or policy reform and recommendations for improvement if any. The Policy Environment The national government had set a clear policy on obesity, which aimed to reduce the proportion of adults who were obese to 15 per cent or lower by the year 2010 but state and local governments did not seem to support the achievement of this goal based on the way they handled programs aimed at realizing the policy objective. The TFAH report showed that America’s strategies of addressing the obesity crisis are not strong enough. The strategies are not adequately aggressive and lack the much needed coordination at national and state government levels, which are some of the factors that have continued to threaten the worsening of the epidemic. Although it has been observed that state policies and actions on obesity reduction are insufficient and disintegrated, some effort is evident among states such as California, Hawaii, Texas and Virginia that have set nutritional standards for schools other than those sponsored by the federal government in terms of the lunch program. About eighteen states have limited range of competitive foods to those required by the federal government (Tsai, Williamson and Glick, 2011). Although many states have put in place some form of guidelines on physical education in elementary and secondary schools, these are not usually enforced, and the majority are inadequate to meet the desired objective of effectively dealing with the health problem. About eleven states including Colorado have passed legislation to limit law-suits that are associated with obesity. A number of states have improved their physical infrastructure to embrace physical activity by building side-walks improvement of social security and development of parks, which have been effective in enhancing outdoor physical activities. It has earlier been stated that obesity is more dominant in low income communities compared to medium and high incomes groups and even so, there is low effort to access low cost nutritious foods types by the low income groups that could be termed as saddening and ironic. This is a case of opposition on the part of the victim population because government policies in place support the utilization of low-cost foods, which usually are healthier as opposed to expensive junk that are the root causes and centre of this crisis. Obesity does not only affect individuals, but it also affects the entire humanity. It is a significant risk factor that may augment the frequency and severity of related diseases such as heart disease and diabetes. Obese individuals, for instance, are twice more likely to suffer hypertension and thrice more likely to contact type II diabetes mellitus than non-obese ones. This point to declining health for the society and additional costs connected with augmented medical care for those suffering from diabetes itself and associated diseases. Personal behavior has been advocated as a key to maintaining a healthy lifestyle by observing proper diet and exercise, but there are huge expectations from the masses about the role of the government in addressing the obesity crisis. These expectations seem far from being met, either because of the kind of policy environment around this issue or/and problems at the implementation level of the various programs that emanate from the policy directions (Liu et al., 2010). It has been observed that the federal government has failed in terms of organization of programs aimed at reducing obesity levels. This has included the lack of proper leadership among the implementation agencies with open bureaucratic management styles taking the centre stage. Some effort has, however, been noted where the local, federal, and state governments are working jointly to develop the health environment in neighborhood schools by requiring food merchants to schools to supply only snacks that meet certain specified requirements and providing guidelines for schools to uphold a school health plan. Such intensive efforts could act as a recipe for fighting obesity at all levels and providing an alternative and lasting solution to a health problem that has disturbed the minds of many Americans for many years. This would be one of the sure ways to promote a healthier atmosphere for upcoming generations. Proposals and Recommendations for Improvement The government levels including the local, federal, and state should embrace proper leadership of programs aimed at dealing with the scourge and must learn to balance the competing interests of the health industry and the priorities of public health. In order to effectively fight the crisis with determination and zeal, one of the campaigns should be to embrace proper diet and physical activity culture with programs on these life aspects in schools and other social places receiving stronger support from both the private and public segments than is the case currently (WTO, 2010). This way, dealing with the problem will become a collective affair with the outcome of a new culture which future generations will find and keep. The implementation of existing policy programs primarily on nutritional and physical activities must be seen to be taking place. Enforcement of set ground rules and guidelines should be adhered to the latter to ensure better health levels in both the young and adult population. The federal government should centralize existing health policies on obesity and seek to enhance the adequacy of those policies to effectively meet the objectives of reducing the crisis as well meet the expectations of its people. The implementation of the firmed up policies could be designated to a single agency such as the Centre for Disease Control, which will be empowered by sourcing technical expertise from both internal and external health sectors and increasing its funding to enable it effectively deliver its mandate as a command centre guiding a multiagency approach to fight the epidemic. The CDC would also be responsible for coming up with the requisite nutritional guidelines to be observed by the country as well as organize educational campaigns for the masses. To empower the CDC, perhaps a special legislation might need to be passed if one is not in place already, or strict amendments and/or rules be included in the existing legislation on healthcare. Where state or local governments fail to effectively implement the provisions of the ’obesity law’ including compliance with information provision and reporting requirements, the CDC should be empowered by the federal government to withdraw funding with immediate effect. Within the fiscal legislation, tax policies could be enhanced to provide incentives for employers to enable them put in place effective programs for wellness and physical fitness at the work places. Tax incentives should also extent to real estate sector to enable builders to provide for physical infrastructure that promotes exercise and physical activity at every homestead or/and workplace (Vitolins et al., 2012). Also, zoning changes to call for pedestrian entrance and guidelines to encourage bike commuting could be useful. Flexible financing and streamlined permitting or tax credits could be used as encouragement. Existing research on obesity in terms of cure and treatment as well as community programs should be interrogated to provide solutions to contain obesity. There should be a rapid response initiative on obesity to gather information on implementation of programs and track disease trends to counter emerging forms early enough. Commercial activities such as advertising and marketing have been associated with the level of the epidemic in one way or the other. Certain food and drink products are known to be inappropriate when it comes to a healthy diet, and some have been associated with the obesity crisis in America and across the globe. These products apparently receive high public acceptance because of the level of advertising and marketing on the various media. The federal government should take deliberate action through the CDC to investigate the truth about these allegations and when confirmed, perhaps take necessary legal actions to forestall the selling and distribution of those products by the concerned companies and/or force improvement of those products to meet the set health standards. When these cannot be satisfactorily enforced, withdrawal from the market could be a last option. On body fitness, the CDC should be in a position to report the status of the school going population in terms of physical fitness and its association to performance in class. This could be achieved by conducting regular national surveys to establish the level of achievement of desired results of national programs on fitness particularly among the youth. Obesity prevention campaign could be funded from small taxes on selected products that significantly add calories to the body and have high fat content such as junk foods; hamburgers and doughnuts and soft drinks or those that reduce bodily physical activity such as automobiles. Another recommendation is to have healthy food and drinks easily obtainable everywhere citizens eat (from shopping centers to sports amenities and chain eateries). The inspiration is that more populace will eat healthier if little active alternative is needed. When businesses offer consumers a full range of choices particularly when the healthy preference is the default, many buyers will go for salads over food that is deep-fried. Employers and insurers could do more to combat obesity by offering health insurance plans that favor persons who are not obese and are non smokers. Some companies offer discounts on premiums for carrying out weight-loss courses. On childhood obesity control, screening and brief counseling could be used as part of national policy to deal with the problem. These measures have, however, been questioned by stakeholders particularly scholars arguing that more resources could better be targeted on prevention and improvement of treatment because there is little evidence that interventions through screening and counseling are indeed effective. References Arterburn et al., (2010). Body Mass Index Measurement and Obesity Prevalence in Ten U.S. Health Plans. Clinical Medicine & Research, Vol. 8 Issue 3/4, p126-130 Liu et al., (2010). Prevalence of Overweight and Obesity in Youth with Diabetes in USA: the SEARCH for Diabetes in Youth Study. Pediatric Diabetes, Vol. 11 Issue 1, p4-11 Tsai, A. G., Williamson, D.F., Glick, H.A., (2011). Direct Medical Cost of Overweight and Obesity in the USA: a Quantitative Systematic Review. Obesity Reviews, Vol. 12 Issue 1, p50-61 Vitolins et al., (2012). Obesity Educational Interventions in U.S. Medical Schools: A Systematic Review and Identified Gaps. Teaching & Learning in Medicine, Vol. 24 Issue 3, p267-272 WHO, (2010). Obesity: Preventing and Managing the Global Epidemic. USA: World Health Organization Read More