Public Health: Obesity Problem In Children - Essay Example

PUBLIC HEALTH PROPOSAL (OBESITY IN CHILDREN) Public Health Proposal (Obesity in Children) Page1 Web Page to Public Disease Overview Obesity is a health condition characterized by excessive body weight and body fat that lead towards number of serious ailments such cardiac problems, blood pressure, diabetes, osteoarthritis, etc. and reduces life expectancy. In most western countries, individuals having BMI (body mass index) above 30 kg/m2 are considered as obese. There are different causes that may lead to obesity such as excessive food intake, reduced physical activity, sedentary lifestyle, slow metabolism and genetic tendency. Obesity is a serious health issue in all ages from childhood till old age. For each age group, obesity poses different health problems related to specific age, routine, dietary habits and genetic makeup of the individuals (Reilly 2005). Here, obesity in children (age 0-12) will be focused and discussed in detail. It is reported that the epidemics of childhood obesity appeared in the UK in the late 1980s. In different parts of the world, the problem of childhood obesity is getting worse. Lobstein, Baur and Uauy (2004) asserted that ten percent of the school going children in the world are estimated to contain excessive body fat. Among these overweight children 25 percent are declared as obese with a considerable prospect of developing cardiac diseases, type II diabetes and various other health problems in early adulthood. The prevalence of childhood obesity is considered much higher in economically developed and established countries like the UK (Lobstein, Baur and Uauy 2004). Social Impact The social impact of childhood obesity on children is also very dominant. A study conducted by Cornell University reported that obese children show lack of social skills than the normal weight children. The social exclusion of obese children provokes several personality issues like low self-esteem, isolation and lack of confidence. Researches also show that obese children are easily targeted for bullying by their peers. Due to several social issues faced by obese children their performance at school is also impacted. Low esteem, feeling of hopelessness and self-pity is usually accompanied by low performance at school and social exclusion that creates frustration and depression in children. Due to depression children become isolated, withdraw activities they used to like and lack interest in socialization and studies. The consequences of such symptoms could be disastrous in young and adult age on an individual’s personality. Parents and teachers should understand all these social impacts and must help obese children to fight their obesity and start living a healthy life (Saxe 2011). Statistics In Brighton, for controlling the childhood obesity prevalence, the National Child Measurement Programme (NCMP) is implemented. The program has showed significant reduction in prevalence rate. The Brighton government claims that the childhood obesity prevalence has been stable since few years that are with healthy weight children’s percentage of 78.1% as compare to England where the reported percentage is 76.9% ( Brighton and Hove City Council 2011). The Brighton and Hove City Council has recently reported that child obesity has significantly decreased in Brighton in last five years. Almost 13.3 percent of children aged less than 6 years and 7.3 percent of reception age have been measured to be obese (Brighton and Hove City Council 2011). The global trend of the prevalence of childhood obesity is also threatening. In 2013, the reported number of obese children under five years was 42 million in which 31 million were living in developing countries (WHO 2013). A research study on worldwide prevalence of childhood obesity conducted in 2010 has reported that the prevalence of childhood obesity has increased from 4.2% in 1990 to 6.7 % in 2010 and is expected to become 9.1% in 2020. The prevalence was very high in Africa that is 8.5% in 2010 that is expected to become 12.7% by 2020 whereas; in Asia it is 4.9% in 2010 (Onis, Blössner and Borghi. 2010). It is also found that the general trend of increase in childhood obesity is not related to inequalities due to religion, poverty or disabilities. The percentage is found much higher in children living in developing countries and belonging to upper society that indicates that the increase of childhood obesity is linked with certain other important factors that are mostly associated with lifestyle, environment and behaviour (Onis, Blössner and Borghi. 2010). Web Page to Manager Childhood obesity is itself not only dangerous but it also introduces multiple health problems like increased risk of type II diabetes, hyperinsulinaemia, hypertension, glucose intolerance, and sleep apnoea. Along with these health issues the children also face different social problems like depression, social exclusion, lack of confidence, compromised academic and extra-curricular performance and behavioural issues. It is important to consider that childhood obesity may result in increased cardiac disorders, gallbladder diseases, endocrine dysfunction, osteoarthritis and even some types of carcinomas in young individuals. The health picture of young adults is extremely at risk due to prevailing childhood obesity in different parts of the world. Due to increased risk of diseases the cost of health services also increases that ultimately impact the economic status of the country. Therefore, it is very important for the manager and the policy makers to look deeply in to the matter for developing the health policies that not only identify the risks of childhood obesity but also indicate the measures for preventing childhood obesity in specific population (Lobstein, Baur and Uauy 2004). For managers, it is important to note that the increasing trend of childhood obesity increases the burden on health service provision of the hospitals. For instance young individuals with diabetes II develop renal failure that required hospitalization and prolonged dialysis treatment. In developing countries the health budget may not be able to bear the additional expense that may lead to reduce life expectancy (Reilly 2005). While developing health policies this should also be considered that childhood obesity is prevailing in every social class from lower income families to westernized developed societies. The reasons and causes of childhood obesity although vary in each situation. For instance: in social structure with middle class and low income families children develop obesity due to lack of chances for physical activity and malnutrition and poor diet. In wealthy and rich societies the reasons for increasing childhood obesity are westernized dietary habits and reduced physical activity in children. Thus, to address the problem at local and global level it is integral to target the shift of dietary pattern of children, the mind-set of parents about the so-called instant and processed food items, lack of physical activity, excessive use of technology such as transportation, labour saving devices, automatic time saving machines, etc. (Saxe 2011). Research reveals that the environmental causes of childhood obesity appear to be very prominent and dominant. The manager should clearly understand that childhood obesity could not be controlled if the emphasis is only laid upon child’s health not the environment that is contributing in increasing the risk of developing obesity because it is clear and evident that in order to control childhood obesity focus should be given on its treatment as well as on its prevention. Therefore, it is significant to address all the related factors that are leading to increased risk of developing obesity in children (Atanda-lawal 2012). Hence, the manager should consider that the parents and teachers of the children are the major targets to increase the awareness about the problems associated with childhood obesity. The manager should also understand the importance of appropriate health policies and public health programs for controlling childhood obesity and the economic burden associated with it. It also important to consider that unlike any other health problem the treatment and prevention of childhood obesity need an expert dietician, psychologist, exercise physiologist and a physician (Sefer, Natan and Ehrenfeld 2009). Page 2 Web page to Public Childhood obesity is a health problem that has become epidemic in developing as well as developed countries. Tucker (2009) has emphasized on parents and parent-child dyads for bring change in behavioural practices for improving health in obese children. It is very important for the parents and teachers to consider the negative consequences of the factors leading to childhood obesity. In order to prevent and treat childhood obesity the identified life style changes include increase physical activity, take healthy diet and avoid junk food. Physical Activity Parents and teachers at school should encourage children to take part in physical exercises and games. They should motivate children to perform their jobs on their own, avoid using transportation (cars, cycles, etc.) for short distances, take stairs instead of escalator where possible and other similar activities to increase their mobility. Children must be instructed to perform exercise on daily basis, light to moderate exercises including rope jumping or running to fasten their metabolism and reduce fat accumulation. Healthy Diet Parents should ensure that their children take healthy and nutritious food including fruits, vegetables, fresh meat and proper amount of calories. In order to make sure that the children are taking healthy diet help should be taken from expert dietician. Avoid Junk Food It is very important that parents and teachers must be made aware of the hazards associated with taking junk food that has now become a common trait in the modern society. The food habits of children must be closely monitored at school and home and processed food items must be used to a minimum level (Saxe 2011). Health Promotion Nola Pender has presented a Health Promotion Model that is intended to improve the health outcomes of people globally. The model suggests that health promotion is not associated with any one person but it is linked with the interactive environment. The model is based on the assumptions that people seek to modify their behaviour and bear the ability of self-assessment. People can interact and change their environment including social, cultural and other factors. Thus, it can be said that improving health behaviour is not limited to physicians rather people in society can increase their health outcomes by handling socio-cultural, biological and psychological elements that provoke the prevalence of a disease. In the later section it is explained how HPM by Pender outlines the concepts that help individuals prevent and treat childhood obesity (Williams 2011). Web page to Manager In order to address the issue of childhood obesity the Health Promotion Model (HPM) by Pender will be discussed. It was presented in 1996. The HPM gives a detailed guideline for using different biopsychosocial processes to motivate individuals for adopting health improving behaviours (Pender, Murdaugh and Parsons 2004). The Pender’s HPM is based on establishing a life style and promote behaviours that improve health. It is not specific to any disease or injury rather it provides instructions to obtain better health outcomes. The model specifies that particular characteristics and behaviours can greatly influence health promotion behaviours of the individuals. Similarly, behaviour specific cognitions are influenced in the model that shows how environmental factors may impact the development and implementation of plan of action for treating and preventing obesity. In order to enhance the health promoting behaviours the HPM presents three motivational variables including activity related effect, immediate competing demand and preferences and commitment to plan of action (Pender, Murdaugh and Parsons 2004). Activity Related Affect shows the positive and negative feelings that appear due to behavioural changes based on the stimulus properties of the original behaviour of the patient. It influences self-efficacy that promotes the ability to plan and follow an action plan for achieving health goals. The particular motivational variable in HPM by Pender can be applied on childhood obesity by helping children improve their behaviour to achieve balanced health. Most importantly, activity related affect could help inducing lifestyle changes for children that can be followed by the children and their families in order to involve the kids in managing and preventing obesity. Immediate competing demands and preferences refer to environmental factors that are not fully controlled by the patient such as family or work demands. If a patient is unable to control these alternative behaviours and factors, his health behaviour can be influenced. Whereas, competing preferences are the behaviours that can be controlled by the patient thus the resisting competing preferences are based on the self-regulating behaviour of the patient. For instance: competing preference may lead the patient to prefer high calorie food on low calorie food due to taste or prefer to use transport for short distances rather than walking on feet. These competing preferences may influence the health plan followed by the obese patients as they appear as last minute urges. In order to achieve the desired health outcomes it is integral to restrict such competing preferences as indicated by HPM (Atanda-lawal 2012). The commitment to the plan of action is another important variable in HPM. It identifies the suggested plan or strategy for the patients to stick with the therapy and thus helps in enhancing the implementation of health behaviour. For childhood obesity this particular character is extremely important (Atanda-lawal 2012). Obesity in any age cannot be managed or treated overnight by taking pharmacological agents. Instead, medicinal agents are the last choice for obese patients. In children, the most common and effective remedy to treat and prevent obesity is to stay committed with the action plan and follow it till the results are achieved. It indicates that obese children have to follow their exercise and physical activity routine strictly as well as must stick to the recommended diet suggested by the physician and dietician in order to obtain health benefits. In order to manage the health and prevent obesity later on, physicians suggest continuing with exercises and particular diet that require strong commitment to the regime by the patient and support from family. HPM model suggests that patient’s commitment and motivation to follow the action plan is increased by formal agreements like nurse-patient contracts, scheduled health behaviour monitoring, purchasing low fat food items or accessories like exercising machines, joining gym or health club, etc. Figure: Pender’s Health Promotion Model (Pender, Murdaugh and Parsons 2004) Page 3 Following are the important references that can be helpful in obtaining detailed information and conducting analysis on childhood obesity particularly the policies and practices for controlling childhood obesity in Brighton, the United Kingdom and the world generally. Web page to Manager 1. Childhood obesity: current literature, policy and implications for practice (Sefer, Natan and Ehrenfeld 2009). The article gives valuable information on the risk factors associated with childhood obesity. The paper discusses specific cultural, social and national consequences linked with childhood obesity and also identify certain universal themes that are contributing in the prevalence of childhood obesity in the world such as advertising, social factors, exercise, public policy and importance of partnership in policy. In addition, the article can help in studying the role of public policies and community partnerships in the prevention of childhood obesity. 2. Prenatal Programming of Childhood Overweight and Obesity (Huang, Lee and Lu 2007). The article can contribute information on prenatal programming of childhood obesity by identifying the factors that can result in high risk of childhood obesity during prenatal stage. These factors include maternal diabetes, cigarette smoking and malnutrition. The information is valuable to suggest physicians a new approach of intervention to control childhood obesity by programing insulin, glucocorticoid and lepton in prenatal stage. The article can be used to develop health policies for incorporating prenatal programing for childhood obesity. 3. Unpacking vertical and horizontal integration: childhood overweight/obesity programs and planning, a Canadian perspective (MacLean, et al. 2010). The article can be helpful in providing information related to the vertical and horizontal integration of different intervention programs and health policies for controlling and preventing childhood obesity. The information can be used to understand the conceptual framework for structuring vertical and horizontal integration of obesity prevention practices and policies. In order to develop successful policies and intervention programming linked with environment to prevent obesity, the information presented in the article can be very useful. 4. Proposing a conceptual framework for integrated local public health policy, applied to childhood obesity - the behaviour change ball (Hendriks, et al. 2013). The article is very interesting and informative as it gives a detailed account of public health policies and the related issues for preventing childhood obesity. The article has proposed a ‘Behaviour Change Ball’ as a tool for studying and implementing integrated public health policies in local government. The article also helps in identifying different barriers and hindrances that occur during implementation of health policies. 5. Ethical and public policy aspects of childhood obesity: opinions of scientists working on an intervention study (Wickins-Drazilova and Williams 2010) (Wickins-Drazilova and Williams 2010). The article gives detailed information on ethical and public policy aspects related to childhood obesity. The article also suggests improvements in system for effective policy implementation such as improvement in health and nutrition education of adults and children, sensitive policy actions and awareness about appropriate obesity interventions instead of quick fixes and rapid remedies. The information is also important and relevant as it is an evaluation of the UK policies. 6. Childhood obesity and overweight prevalence trends in England: evidence for growing socioeconomic disparities (Stamatakis, Wardle and Cole 2010). The article can be helpful in updating information on the childhood obesity and prevalence rate in England. It will be useful in comparing the local childhood statistics with the country’s statistics. The results indicated that the rate of obesity is stabilized in England since last few years but the lower socio economic structure does not follow this trend. Thus, the data indicates the incorporation of programs and interventions in health policies to address the economic disparities in the British society for controlling childhood obesity. Web page to Public 7. Promoting Healthy Lifestyles and Decreasing Childhood Obesity: Increasing Physician Effectiveness Through Advocacy (Saxe 2011). The article is very useful as it explains the problems associated with childhood obesity in a very simple and understandable language for public. The most important and highlighted factors are lack of physical activity, poor diet, excessive television and games and their combinations. The article proposes environmental interventions as the most effective ones for reducing the rate of childhood obesity. Therefore, the role of physicians for counselling and advocating public has become more pronounced to address the health issue. 8. Parents as agents of change for childhood obesity prevention: a clinical nursing research programme (Tucker 2009). The article is important from public perspective because it emphasizes on educating parents and building parents and children relationship in understanding hazards associated with unhealthy life styles leading to childhood obesity. The researcher has studied the role of parents and parents-child dyad as agents of changing behavioural interventions and environmental practices for the prevention and control of childhood obesity. 9. Obesity in children and young people: a crisis in public health (Lobstein, Baur and Uauy 2004). The article again evaluates the British society, policies and practices implemented in the United Kingdom in order to study the increase in risk of childhood obesity in school going children. The article is useful in two ways first it increases public knowledge about the risks leading to childhood obesity secondly it also addresses policy makers to develop health policies that can help in controlling childhood obesity. 10. Early life risk factors for obesity in childhood: cohort study (Reilly 2005). The epidemics of childhood obesity in the United Kingdom has led the researchers to study different risk factors, causes and consequences of the health problem. The article has focused on early childhood obesity to study the risk factors involving children as well as parents. The article is helpful for increasing awareness in public (parents in particular) about the risk factors that should be considered to prevent childhood obesity. 11. Childhood Obesity: Whats Health Care Policy Got To Do With It? (Homer and Simpson 2007). The article addresses the health care industry to play its crucial role in controlling childhood obesity. Research reveals that certain behaviours in public can greatly influence the increasing trend of childhood obesity such as breastfeeding, decreased consumption of soft drinks, low intake of calories and sugar, more physical activity and implementation of counselling techniques and community-based strategies. The article also indicates the changes in health policies that can be made to incorporate these interventions. 12. Framing the Consequences of Childhood Obesity to Increase Public Support for Obesity Prevention Policy (Gollust, Niederdeppe and Barry 2013). The article analyses the perception of public on health messages related to childhood obesity in the US. It was found the public considers different consequences of childhood obesity as important justifications for obesity prevention policy. Therefore, the article can be used to understand the perception of public on the consequences of childhood obesity not only related to health but the economy and social structure also. Hence, the importance of effective public health policies for the control of childhood obesity becomes imperative. Bibliography Atanda-lawal, Bibiyemi. “Health Promotion for Overweight Children between the Ages of 7 to 12”. Novia, 2012. Brighton and Hove City Council. “City child health initiatives help reduce obesity.” Brighton and Hove City Council. December 11, 2011. http://www.brighton-hove.gov.uk/content/press-release/city-child-health-initiatives-help-reduce-obesity. Brighton and Hove City Council. “City celebrates another cut in child obesity”. Brighton and Hove City Council. December 4, 2014. http://www.brighton-hove.gov.uk/content/press-release/city-celebrates-another-cut-child-obesity Gollust, Sarah, Niederdeppe, Jeff and Barry, Colleen. "Framing the Consequences of Childhood Obesity to Increase Public Support for Obesity Prevention Policy." American Journal of Public Health 103, no. 11 (2013): 96-102. Hendriks, Marie, Jansen, Maria, Gubbels, Jessica, Vries, Nanne De, Paulussen, Theo and Kremers, Stef. "Proposing a conceptual framework for integrated local public health policy, applied to childhood obesity - the behavior change ball." Implementation Science 8, no. 1 (2013): 1-16. Homer, Charles, and Simpson, Lisa. "Childhood Obesity: Whats Health Care Policy Got To Do With It?" Health Affairs. 26, no. 2 (2007): 441-444. Huang, Jennifer, Tiffany, Lee, and Michael, Lu. "Prenatal Programming of Childhood Overweight and Obesity." Maternal & Child Health Journal 11, no. 5 (2007): 461-473. Lobstein, Tim, Baur, Louise and Uauy, Ricardo "Obesity in children and young people: a crisis in public health." Obesity Reviews 5, no. 1 (2004): 4-85. MacLean, Lynne, et al. "Unpacking vertical and horizontal integration: childhood overweight/obesity programs and planning, a Canadian perspective." Implementation Science. 5, no. 1 (2010): 36-46. Onis, Mercedes de, Blössner, Monika and Borghi, Elaine. "Global prevalence and trends of overweight and obesity among preschool children." American Journal of Clinical Nutrition 92, no. 1 (2010): 1257–1264. Pender, Nola, Murdaugh, Caroline and Parsons, Ann. Heath promotion in nursing practice (4th ed). New Jersy: Prentice Hall, 2004. Reilly, John, "Early life risk factors for obesity in childhood: cohort study." BMJ 330, no. 1357 (2005): 1-8. Saxe, Jessica Schorr. "Promoting Healthy Lifestyles and Decreasing Childhood Obesity: Increasing Physician Effectiveness Through Advocacy." Annals of family medicine 9, no. 6 (2011): 546-548. Ben-Sefer, Ellen Ben-Natan, Merav and Ehrenfeld, Jesse. "Childhood obesity: current literature, policy and implications for practice." International Nursing Review 56, no. 2 (2009): 166-173. Stamatakis, Alexandros, Wardle, Jon and Tim Cole. "Childhood obesity and overweight prevalence trends in England: evidence for growing socioeconomic disparities." International Journal of Obesity 34, no. 1 (2010): 41-47. Tucker, Sharon. "Parents as agents of change for childhood obesity prevention: a clinical nursing research programme." Paediatrics and child health 19, no. 2 (2009): 189-193. WHO. “Childhood overweight and obesity.” World Health Organization. 2013. (accessed March 9, 2015). http://www.who.int/dietphysicalactivity/childhood/en/ Wickins-Drazilova, Dita and Williams,George. "Ethical and public policy aspects of childhood obesity: opinions of scientists working on an intervention study." Obesity Reviews. 11, no. 8 (2010): 620-626. Williams, Nadine. “Critical Elements of Theory.” Weebly. 2011. http://nolapender.weebly.com/critical-elements.html Read More