Government Action Plan to Address the Problem of Obesity - Case Study Example

Case study: NSW Government Action Plan 2003-2007 to address the Problem of Obesity in Children and Young People Introduction Obesity is a condition which occurs when a person’s energy intake from food consumption exceeds the amount of energy used in physical activity, resulting in excess body weight (Medibank Health Solutions (MHS), 2010, p. 3; Burniat, 2002, p. 94). An obese individual has a higher risk of mortality from type 2 diabetes, cardiovascular disease, osteoarthritis, as well as particular forms of cancer (MHS, 2010, p. 3). According to the Australian Institute of Health and Welfare (AIHW) (2003) report, in Australia in 1999, approximately two thirds of males and half of females across all ages were overweight or obese, and there was a rapid increase in the rate of overweight and obesity among children and adolescents (AIHW, 2003, p. 229). Against this background, this paper evaluates the NSW Government’s effort to prevent overweight and obesity in children and young people through its report titled NSW Government Action Plan (GAP) 2003-2007. The report highlights the NSW Government’s realisation of the problem since the 1985-1995 decade and its strategies to control the situation by educating communities about obesity and how to address it. Background to the GAP Between 1985 and 1995, Australia saw a sharp rise in the number of overweight and obese children (NSW Department of Health (DoH), 2003, p. i; AIHW, 2004). By 2003, about 25 percent of children were overweight or obese, and conservative estimates indicated that the figure was increasing by at least 1 percent per year (NSW DoH, 2003, p. i; Lobstein, Baur & Uauy, 2004, p. 4). Figure 1 shows 2003 overweight and obesity data for young Australians. Source: AIHW (2003, p. 230). In recognition of the problems of obesity in young people in Australia, the NSW Government convened a Childhood Obesity Summit in September 2002. The gathering brought together representatives from government, communities, industry, parents and young people. Their intent of the summit was to suggest practical solutions to address overweight and obesity in children and young people. It is from the proposals made at the summit that the NSW Government developed the GAP to prevent obesity among children and young people. The GAP is a cross government response tackling overweight and obesity in children and young people. It recognises a wide range of initiatives required to deal the issues at hand. It also represents a commitment by the government to help build healthy environments and offer better opportunities for children and young people in Australia to become more active and make healthier food choices. It recognises that response to child obesity must emanate from the community as whole, not solely from governments; and reinforced through education. Aims and objectives of the GAP The GAP was developed to achieve three aims: Increase healthy nutrition, increase physical activity and lower sedentary lifestyles to avert child overweight and obesity (NSW DoH, 2003, p. 2). Along this line, it has been shown that critical aspects of children’s health include high rates of overweight and obesity, insufficient physical exercise and poor eating habits. Further, research has established that inadequate consumption of vegetables and fruits was more pronounced among older Australian children aged 12-17 years (Williams, 2011, p. 15). Offer quality programmes, services and infrastructure to raise the level of physical activity, reduce sedentary living and increase healthy nutrition. Such areas include walking and bicycling as means of transportation (NSW DoH, 2003, p. 2). Transportation investments can either support or impede bicycling and walking in neighbourhoods and near schools, depending on how they are developed and implemented (Robert Wood Johnson Foundation, 2009, p. 1). Attain social, health, economic and environmental benefits emanating from the prevention of childhood overweight and obesity (NSW DoH, 2003, p. 2). According to the WHO, once children (or adults) are obese, it is often difficult for them to lose weight through physical activity and healthy diet. Therefore, preventing weight gain from an early age is recognised as a strategy that will help realise health benefits in the long-term (WHO, 2009, p. 8). Strategies used to achieve the aims of the GAP The GAP adopted seven strategies that were referred to as key priority areas: Priority 1: Healthier Schools The GAP formulators were cognisant of the fact that children and young people spend a large proportion of their time at school. Thus, it was vital that young people be provided with a healthy environment at school, including taking nutritious food and opportunities for physical activity (NSW DoH, 2003, p. 3). This focus on schools is very important because according to WHO (2009, p. 8), experience in several countries has shown that successful obesity prevention and behaviour change during childhood can be achieved through a combination of population-centred measures, implemented both at national level and as part of the a component of local “settings-based” approaches, particularly school- and community-based initiatives. Notably, personal behaviour, lifestyle, knowledge and awareness can help to determine change in relation to diet and activity (Naidoo & Wills, 2009). The Healthier Schools priority area had two major objectives. First was to improve the nutritional value of food and drinks sold in school canteens. The Department of Education and Training and NWS health set out to develop a mandatory healthy school canteen to ensure that government schools (and encouraged other schools) provided a canteen service that offered healthy and nutritious food consistent with the national dietary guidelines (NSW DoH, 2003, p. 4). The second objective was to increase students’ opportunities to participate in activities that could develop fundamental movement skills, and this was achieved through the School Sport Foundation and the Department of Education and Training (DET). Through DET, the GAP also aimed to provide support for teachers to implement the Year 7-10 Personal Development, Health and Physical Education syllabus that would include articles focusing on physical activity (NSW DoH, 2003, p. 5). Priority 2: An Active Community According to the GAP, there is compelling evidence that an active lifestyle benefits individuals and can widen to social, environmental and economic advantages for the entire community. The stakeholders therefore chose to promote active transport (physical activity undertaken as a means of transport) (NSW DoH, 2003, p. 7). The GAP aimed to increase opportunities for children and young people to partake in physical activity in the community. Along this line, the Department of Sports and Recreation was given the responsibility to modify the active communities Grants Scheme to increase the focus on preventing childhood obesity. The GAP also focused on increasing community awareness of the benefits of active transport. The NSW Government thus took the responsibility to promote walking and cycling through strategies such as Bike Week and sponsorship of appropriate walking events such as Walk Safely to School Day (NSW DoH, 2003, p. 8). To increase opportunities for active transport, it was decided that the Traffic Authority would maintain its commitment to building off-road cycleways wherever applicable. The off-road cycle path could be used to link residential areas to schools, parks, shopping centres, sports grounds as well as other local facilities (NSW DoH, 2003, p. 8-9). Priority 3: Supporting Parents The GAP suggested practical ideas and strategies for parents to offer healthy meals, promote physical activity and reduce sedentary pursuits such as watching TV. It intended to improve parents’ access to information on how to prevent overweight and obesity in their children through the Department of Community Services. It also detailed how to improve access to support and treatment services for overweight and obese children and young people through an Expert Taskforce (NSW DoH, 2003, p. 8-9). Priority 4: Healthy Child and Out-of-School Care The GAP took note of the fact that children often spend a significant amount of their time in child and out-of-school care, and sought to come up with actions that would improve nutrition and physical activity in child care programmes. This would be achieved by increasing the provision of physical activity and good nutrition in child care throughout NSW and identifying the most effective approaches to delivering a positive, safe and fun physical activity experience for primary school-aged children attending out-of-school care (NSW DoH, 2003, p. 16). This was aimed at ensuring that children would be active and well fed even when outside the school environment. Priority 5: Community Understanding The stakeholders generally agreed that there was poor awareness in the society of the nature and full extent of childhood overweight and obesity. To counter this, the GAP included activities that could: Raise awareness of the seriousness of the problem among children Create an understanding that the whole community needs to take part in helping children increase healthy nutrition, increase physical activity, and reduce sedentary lifestyle Communicate practical steps that can be taken immediately for instance healthier food at home as well as at school, cycling and walking to replace the car for short distances, and limiting the duration of time devoted to computer games and television Offer advice regarding appropriate sources of assistance and information (NSW DoH, 2003, p. 16). Priority 6: Increasing our Knowledge According to the GAP there is still a lot to be learnt concerning issues of overweight and obesity. At the time of formulating the GAP, the prevalence of overweight in children in NSW was unknown, with latest figures dating from 1997. Thus, the stakeholders suggested that research into the causes of the problem was necessary, as this information could be critical in providing the evidence to underpin the design and implementation of programmes to address the issue. To achieve this, the stakeholders opted to increase the overweight and obesity research capability within NSW and increase the understanding of the problem in children and young people as well as fitness, physical activity, nutrition, and environmental factors (NSW DoH, 2003, p. 22). Priority 7: Governments, Industry and the Community Working Together The GAP noted that many factors that affect diet and physical activity patterns need a multifaceted response. Thus, creating and maintaining partnerships that can support effective action to promote healthy feeding and physical activity were fundamental to achieving change in childhood obesity rates. Partnerships were suggested between: Government agencies Local councils Government agencies and other institutions and community stakeholders. NSW and other states Learning from the GAP The strategies adopted in the GAP are very appropriate since they bring together all players’ efforts to reduce overweight and obesity in children and young people. Priority 1 is particularly notable since it appreciates the role that schools can play to educate learners about obesity and engage them in activities to avert the problem. A study conducted in the United States revealed that parents cited schools more frequently as having a lot of responsibility to reduce childhood obesity (Kropski, Keckley & Jensen, 2008). As O’Dea (2010, p. 4) notes, several aspects of prevention require attention when focusing on school-based health promotion, nutrition education and body image improvement, and this can be achieved through a whole-school approach, including school curricula, school policies, school ethos as well as school-community links. Further, schools can play an especially important role in preventing obesity because: many young people are enrolled in schools; well designed and well implemented school programmes can effectively promote physical activity; and there is evidence of connections between physical activity, excellent nutrition, physical education and nutrition programmes, and academic performance (Wechsler, 2004, p. 6). The second to fifth priority areas highlight the significance of the role that can be played by parents and the community at large to avert obesity in children and young people. The fact that regular exercise protects against heart disease and obesity (Wilkinson & Marmot, 2003, p. 28) cannot be gainsaid. Therefore, having an active community is perhaps one of the best strategies to counter the prevalence of obesity since it can be done at no significant costs. The good thing about the GAP is that it calls for community effort to ensure that children both in school and out of school have good nutrition and remain active. The role of parents is especially illuminated and this recognises the fact that parents are the role models of their children and can therefore determine the lifestyles that their children adopt. According to Lindsay et al (2006, p.170), parents are key to developing a home environment that fosters healthful eating and physical activity among children and adolescents. Parents also shape their children’s dietary practices, physical activity, sedentary behaviour and eventually their weight statues in many ways. They also play a fundamental role reinforcing and supporting the acquisition and maintenance of eating and exercise behaviours (Lindsay et al, 2006, p.170). Therefore, much as schools are important for shaping the behaviour of learners, parents seem to play the pivotal role. The sixth and seventh priority areas highlight the need to increase knowledge in the areas of obesity and the need to increase collaboration between various organisations and the community to address overweight and obesity in young people. Results of the GAP The GAP has a number of achievements as well as some drawbacks. The focus on healthy schools for instance is a good way of educating children to be creative in the choices they make regarding nutrition both in their early days and in their adulthood. According to Deakin University (2005, p. 5), consumption of particular foods during childhood is likely to establish food preferences that will last into adulthood. This means that schools and parents have a great role to play in determining the kinds of foods that children will get used to. The same applies to lifestyles such as watching TV, and adopting an active lifestyle through activities such as cycling, walking and regular exercise. Activities that bring together schools, parents and communities to fight the prevalence of obesity such as those mentioned in the GAP have also been adopted in areas such as Queensland with much success as outlined in the Queensland Government’s first Action Plan of 2005-2008 (Queensland, 2005). Nathan et al (2008) praise the NSW GAP by noting that NSW wanted to depict leadership in an area where there was possibly Federal Government inaction. Notable drawbacks of the Action include the fact that where funding is involved, benefits of the GAP may be realised only in those areas affected. For instance, the Active Communities initiative involved a range of activities such as Bike Week and sponsorships for Walk Safely to School Day – which is possible only if there are adequate funds and financiers. Additionally, development of infrastructure such as cycleways requires additional funding (Turnour, King & Wise, 2006, p. 23). Further, the effectiveness of collaboration between various organisations and communities (such as canteens in non-government schools) needs long term planning and this was not indicated in the GAP. Conclusion Through the NSW GAP 2003-2007, the NSW Government depicted that health interventions such as addressing overweight and obesity in young people require researchers and public health advocates to enhance their understanding of the policy process as well as the role that different types of evidence can play in influencing public debate and policy decision. A leadership role is particularly reflected since a great role of preventing the problem is bestowed upon schools and parents, who are deemed to best understand the environments in which children and young people. The Plan goes further than schools and parents as it urges communities, governments and other institutions to be involved in ensuring that children have appropriate nutrition and remain active as the best strategy of preventing overweight and obesity. Importantly, it calls for further research to understand the dynamics of the problem even though it failed to address issues such as financing and implementation of some key strategies. References AIHW (2003). “Australia’s Young People: Their Health and Wellbeing.” AIHW Canberra. 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Are there key health issues impacting differently on the learning of children from culturally and linguistically diverse (CALD) and Indigenous backgrounds?” The Smith Family. Retrieved 03 March, 2012, from http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=6&cts=1330774738763&sqi=2&ved=0CFsQFjAF&url=http%3A%2F%2Fwww.thesmithfamily.com.au%2Fwebdata%2Fresources%2Ffiles%2FHealth_Literacy_FINAL.pdf&ei=6AFST-b6LczZ4QT3n-24DA&usg=AFQjCNHANsCZzG5o9pmCqgDUHD5TiGMIrA&sig2=9FewZ8Y5O2M4ignXsIFNvA Read More