The Concept and Measurement of the Obesogenic Environment - Case Study Example

The Concept and Measurement of the Obesogenic Environment and Why Some People May Be More Vulnerable Than Others March 29, Studies on obesogenic environments have increased for the past decade because of the social and health concerns on the role of the environment in rising obesity and obesity-related mortality and morbidity (Kirk, Penney, & McHugh, 2010). Obesity among adults and kids has grown three times for the past thirty years (Carroll-Scott et al., 2013, p.106). Several studies showed that the obesogenic environment was correlated with obesity-causing variables (Carroll-Scott et al., 2013; Gatrell & Elliott, 2015; Smoyer-Tomic et al., 2008). The concept of “obesogenic” was originally used in 1996 to pertain to environmental factors that result to weight gain (Weidenhofer, 1996 as cited in Gauthier & Krajicek, 2013, p. 203). The paper defines the obesogenic environment as one that has social, cultural, economic, and political micro and macro variables that promote obesity among individuals or populations (Gauthier & Krajicek, 2013; Kirk et al., 2010). The obesogenic environment is a sociological concern because it underlies the social factors that impact how people define their health-based identities and the social, economic, and political dynamics that promote and reinforce obesity. The paper discusses the issue of conceptualizing and measuring the obesogenic environment. It summarizes five academic articles and presents personal thoughts and recommendations in resolving the development of obesogenic environments. Summaries of Sources Carroll-Scott et al. (2013): “Disentangling Neighborhood Contextual Associations” Carroll-Scott et al. (2013) wanted to determine the features of a residential neighborhood that are associated with children’s body mass index (BMI) and obesity-related behaviors (e.g. amount of screen time). They focused on the characteristics of the built environment, socioeconomic environment, and the social environment. Their data came from the Community Interventions for Health chronic disease prevention study that the Yale School of Public Health’s Community Alliance for Research and Engagement conducted with New Haven Public School. The sampling was composed of dominantly ethnic subgroups. The researchers collected health surveys and physical measures, involving 1,048 fifth and sixth grade students, from 2009 to 2010. Their findings showed that built, socioeconomic, and social environments were related with BMI, diet, and physical activity. Carroll-Scott et al. (2013) learned that concentrated affluence had a protective effect on behavioral outcomes through more frequent healthy eating, while concentrated disadvantage had no significant effect on the latter. Concentrated affluence refers to percentages of residents aged 25 years and higher with a college education, high-income households, and residents with executive or professional jobs. Concentrated disadvantage pertains to percentages of residents living below the poverty line, unemployed, households accessing public assistance, and female-headed households. Findings also showed that children who lived more than half a mile from the nearest grocery store had higher BMI than those who lived within half a mile from the latter and that access to fast food and convenience stores selling unhealthy food contributed to higher childhood BMI. Moreover, Carroll-Scott et al. (2013) learned that children’s perceptions, and not actual physical measures, of neighborhood access to parks, playgrounds and gyms was linked with more recurrent physical activity. Park access was strongly related to healthy eating. Moreover, neighborhood social environments were connected with BMI and other related health behaviors. Neighborhoods with high crime rates had children with higher BMI. Finally, social ties influenced both unhealthy and healthy eating habits. Children with more cohesive social networks in their neighborhood exercised more often. Social ties had a more significant effect than perceived neighborhood safety on healthy behavioral outcomes (Carroll-Scott et al., 2013, p.112). Carroll-Scott et al. (2013) concluded that healthy behaviors were more related to built, social, and socioeconomic environment assets, while unhealthy behaviors were more connected to built environment obstacles. They stressed that neighborhood factors are more changeable than macro-level variables through policies and programs. They argued that neighborhood environments are crucial levels where concerned institutions can intervene to resolve and prevent childhood obesity and its long-run consequences. Smoyer-Tomic et al. (2008): “Socioeconomic Status and Exposure to Supermarkets” Smoyer-Tomic et al. (2008) studied the connection between supermarket and fast food outlet exposure and neighborhood socioeconomic status in Edmonton, Alberta. They examined differences between neighborhoods with and without an accessible supermarket (by accessible it means that it must be within 800 m.) and fast food outlet (accessible if within 500 m.) for the following variables: race/ethnicity, socioeconomic status, age and family status (e.g. two-parent household, lone parent or seniors), housing tenure (e.g. renter and average dwelling value), and urbanization (e.g. population density and public transport users). Findings showed that location of supermarkets and fast food outlets were related, in the sense that they were often present in one neighborhood, but their distribution was connected with neighborhood socioeconomic characteristics. Socioeconomic status was not a strong independent factor because supermarkets existed in low-income neighborhoods too. In addition, findings showed that higher access to fast food outlets was correlated with more “Aboriginals, renters, lone parents, low-income households, and public transportation commuters,” and access to fast food outlets was lower for neighborhoods with higher median income and dwelling value (Smoyer-Tomic et al., 2008, p. 751). They concluded that better access to supermarkets did not offset the relationship between mentioned social and demographic variables and higher access to fast food outlets. Smoyer-Tomic et al. (2008) discussed the social and political implications of these findings. They explained that well-off neighborhoods tend to be more organized in stopping fast food outlets from multiplying or even entering their areas, while low-income groups are not that organized or not seriously concerned of health and traffic issues that are associated with having more fast food outlets. They stressed that low-income households may not have sufficient political power and social capital that are needed to fight off unwanted fast food operators or to advocate for healthier environments. Smoyer-Tomic et al. (2008) concluded that vulnerable populations are at risk of being unhealthy because of high access to fast food outlets; thus, regulations are important in thwarting health consequences through zoning bylaws. These laws are important in protecting single-parent households from adverse health effects on parents and their kids due to unregulated fast food outlets. Gauthier and Krajicek (2013): “Obesogenic Environment” Gauthier and Krajicek (2013) conducted concept analysis to determine the attributes, features, and uses of the concept of obesogenic environment through a pediatric framework. They used the following databases, CINAHL, PsychINFO, Medline, and ERIC databases, and covered the years from 1995 to 2011 because they coincided with the rise in research on the said concept. They used the analytical model of Walker and Avant (2011) for their study. Their findings showed that the primary antecedents of the obesogenic environment were socioeconomic status, child developmental stage, social roles, cultural roles, geographic proximity to different kinds of food, and built environment. They noted that the main attributes of the obesogenic environment are places where children are exposed to situations or surroundings where atypical weight gain might happen, environmental characteristics (including home and neighborhood factors, and consistency of exposure of children to certain attributes that might result to atypical weight gain (Gauthier & Krajicek, 2013, p. 206). In addition, the concept of obesogenic environments has related physical/developmental and psychological consequences. The physical consequences are obesity and several kinds of chronic illnesses, while the psychological effects are lower self-esteem, higher depression, and experiences of discrimination and bullying (Gauthier & Krajicek, 2013, p. 206). Gauthier and Krajicek (2013) discussed the implications of their findings to the nursing practice, especially in terms of education, patient care, and policy efforts. Gatrell and Elliott (2015): Geographies of Health In the book, Geographies of Health, Gatrell and Elliott (2015) devoted chapters 5 and 6 to discuss health inequalities at global and regional levels and neighborhood levels, respectively. They learned that, as developed countries increase in income, obesity rates increase due to higher access to fast food outlets and lower time for physical activity. In addition, Gatrell and Elliott (2015) observed that socioeconomic status has a connection to obesity, wherein neighborhoods with low income tend to have residents who have higher BMI and lower levels of physical activity than those living in high-income neighborhoods (Gatrell & Elliott, 2015, p. 166). However, they asserted that low-income alone does not predict obesity because some high-income neighborhoods that have few physical activity facilities and more fast food outlets also have high obesity rates. Furthermore, Gatrell and Elliott (2015) reviewed literature that showed conflicting findings about the relationship between fast food and obesity, wherein some said that nearness to fast food lowered obesity, others countered that more fast food outlets meant more people with obesity problems and overweight issues, while several said that no significant connection existed between easy or more access to fast food and obesity (Gatrell & Elliott, 2015, p. 167). Gatrell and Elliott (2015) explained that these differences may be due to the lack of agreement on what defines “neighborhoods” as “obesogenic environments.” They concluded that certain populations are disadvantaged through living in obesogenic environments. Kirk et al. (2010): “Characterizing the Obesogenic Environment” Kirk et al. (2010) echoed the concern of Gatrell and Elliott (2015) because the former also noted that researchers do not have a consistent definition of the obesogenic environment. Kirk et al. (2010) conceptualized the meaning of the obesogenic environment using primary environmental studies and other reviews that examined weight, diet, and/or physical activity in connection to the obesogenic environment. They used a comprehensive framework through the Analysis Grid for Environments Linked to Obesity (ANGELO). Their study included 146 primary studies, published between January 1985 and January 2008, which fit the dimensions of the study, according to ANGELO. They learned that the concept of the obesogenic environment was hard to conceptualize and define. They noted that studies focused either too much on BMI or neglected it altogether, and not all considered the variables of the obesogenic environment’s outcomes and the role of physical activity in these environments. They concluded that researchers have yet to come up with valid measures of the obesogenic environment and plausible theories that can help interconnect and understand its diverse factors and mechanisms, as well as its social and health consequences. Personal Analysis and Reflections The concept of obesogenic environment deserves a widely-accepted definition to aid social research and analysis and public policymaking. Both Gatrell and Elliott (2015) and Kirk et al. (2010) already pointed out that researchers lack consensus on defining, conceptualizing, and measuring the obesogenic environment. They are concerned of how omitting or adding certain micro and macrolevels can impact research outcomes. I agree with them because without a widely-accepted definition and measurement of the obesogenic environment, sociologists cannot also study it in a way that can offer valid and accurate findings. It will also be hard for policymakers to generate evidence-based policies if researchers are divided on defining and measuring the obesogenic environment. Besides a clear and consensus-based definition, I also believe that sociologists have to actively participate in the conceptualization process of the definition and measurement methods of the obesogenic environment to expand its sociological perspective. Carroll-Scott et al. (2013) added the socioeconomic and social environments to their study, but others did not consider these environmental attributes. Sociologists can broaden and deepen the conceptualization of the obesogenic environment to ensure that policymakers do not only address immediate antecedents to the latter, but also the social, economic, political micro and macro levels that impact it in the long run. The importance of this contribution lies on its ability to address health gaps because these gaps can create or reinforce socioeconomic disparities (Carroll-Scott et al., 2013). Apart from influencing socioeconomic inequality, I understand that the issue of the obesogenic environment cannot be resolved overnight, but through interconnected individual and social changes, but in this case, government policies can help a great deal in decreasing the development and reduction of obesogenic environments. Several articles already stressed that local policies can help change obesogenic environments (Carroll-Scott et al., 2013; Kirk et al., 2010; Smoyer-Tomic et al., 2008). Carroll-Scott et al. (2013) talked about interventions that target pre-adolescent social networks to address obesogenic environment issues and zoning laws that limit the density of food outlets which sell unhealthy foods. Smoyer-Tomic et al. (2008) is more specific in recommending zoning laws, particularly for neighborhoods that are at risk for obesity, such as areas with low incomes, high numbers of single-parent households, and low access to healthy food outlets. Kirk et al. (2010) added that policies and programs should include marketing, food pricing, and agricultural programs and laws that address food disparities in low-income neighborhoods. They are advocating for laws that impact the media and access to healthy food, but I want to expand these suggestions to policies and programs that promote healthy attitudes and practices at neighborhood and school levels too. These include regular school and community programs and activities that encourage and even subsidize or completely fund community agriculture, consumption of healthy food, and increased physical fitness. Aside from applying these policies, I also underline that people need to change their mindsets about food from seeing it as something that has to be tasty, cheap, and convenient, to something that must be healthy, accessible, and low-cost through creating a health-centered cultural identity. Carroll-Scott et al. (2013) underlined that people should nurture a culture centered on healthy lifestyles, including physical activity and eating healthy food (p. 111). Kirk et al. (2010) stated that neighborhood crime and social support can impact healthy lifestyles too (p. 111). I believe they neglected to analyze that people cannot change their eating habits and physical fitness levels if their identities do not have a health-centered mindset. If mass media tell them to indulge themselves with fatty food and sweet treats, they may see happiness as related to accessible, tasty food. If their schools and families do not teach how to eat healthy and maintain a physically active life, the culture will remain in influencing them that their unhealthy life is not wrong. I think we have to start with our values and attitudes toward food. Do we see food as something that must be tasty, cheap, and convenient? If so, we are not placing priority on the nutritional value of our food. As for physical activity, do we care that we live in a neighborhood that promotes it? If not, we do not have the values and attitudes needed to advocate for such an environment. I believe that we cannot change the obesogenic environment if we remain tied to the thinking that sedentary living is acceptable, or even an essence of the American Dream of comfort and convenience. Instead, we must talk about these negative beliefs and change them, beginning with ourselves, our families, our schools, our churches, and our neighborhoods. Instead of being too indulgent, let us develop self-control (Tsukayama et al., 2010). I believe that it is time to have a culture where health is a moral calling that resonates with long-run wellness (LeBesco, 2011, p. 160). Only then can we accumulate the social capital needed to wield political power, so that we can influence public policies and programs and make them anti-obesogenic-environments. Until then, obesogenic environments will expand, and sadly, within low-income neighborhoods that will have continued poverty cycle because of obesity and obesity-related mortality and morbidity. References Carroll-Scott, A., Gilstad-Hayden, K., Rosenthal, L., Peters, S.M., McCaslin, C., Joyce, R., & Ickovics, J.R. (2013). Disentangling neighborhood contextual associations with child body mass index, diet, and physical activity: The role of built, socioeconomic, and social environments. Social Science & Medicine, 95, 106-114. Gatrell, A.C., & Elliott, S.J. (2015). Geographies of health: An introduction (3rd ed.). Massachusetts: John Wiley & Sons. Gauthier, K.I., & Krajicek, M.J. (2013). Obesogenic environment: A concept analysis and pediatric perspective. Journal for Specialists in Pediatric Nursing, 18(3), 202-210. Kirk, S.F., Penney, T.L., & McHugh, T.L. (2010). Characterizing the obesogenic environment: The state of the evidence with directions for future research. Obesity Reviews, 11(2), 109-117. LeBesco, K. (2011). Neoliberalism, public health, and the moral perils of fatness. Critical Public Health, 21(2), 153-164. Smoyer-Tomic, K.E., Spence, J.C., Raine, K.D., Amrhein, C., Cameron, N., Yasenovskiy, V., Cutumisu, N., Hemphill, E., & Healy, J. (2008). The association between neighborhood socioeconomic status and exposure to supermarkets and fast food outlets. Health & Place, 14(4), 740-754. Tsukayama, E., Toomey, S.L., Faith, M.S., & Duckworth, A.L. (2010). Self-control as a protective factor against overweight status in the transition from childhood to adolescence. Archives Of Pediatrics & Adolescent Medicine, 164(7), 631-635. Walker, L. O., & Avant, K. C. (2011). Strategies for theory construction in nursing (5th ed.). Upper Saddle River, NJ: Prentice Hall. Read More