Strategies To Address Childhood Obesity: Socioeconomic Status And Diet Essay.

Discuss about the Childhood obesity in Australia for Lifestyle Factors.

Obesity is one of the most common nutrition diseases in both developed and developing countries. In the last two decades obesity has become prevalent among the children. Lifestyle factors such as lack of physical exercise, stress, bad nutritional behaviors are among the long list factors proven to cause obesity. For long, obesity has been considered a serious chronic diseases and one of the major factors behind diabetes, cardiovascular diseases, hypertension as well as low quality life of life.⁽¹⁾

The prevalence of obesity in children has caused many countries to pay extra attention to the epidemic. The World Health Organizations has also intervened to address the issue by setting some goals aimed at eradicating it in children by 2030. Despite the many effort and initiatives by different organization to deal with obesity especially among the children, the cases have been increasing every year. ⁽²⁾ It is only  few developed countries like Germany and united kingdom who  have recorded a decrease in the rate of obesity among both the children and adults. Some other countries especially in Asia have experienced significant increase in the obesity rate. 

Obesity is a global public health epidemic that must receive all the needed attention and resources. Obesity is a condition of excess or abnormal accumulation of body fat in adipose tissue. The collection of fat rises to interfere with the general health of the body. The excess weight can be determined using the Body Mass Index (BMI) formula. The BMI  is calculated through dividing the individuals (weight in kg) by (height in m)^2. The method is considered the most effective way of determining if an adult is overweight or obese. It is a little bit hard to determine whether children and the teenagers are either overweight or obese since the composition of the body keeps on changing and the height is also increasing. ⁽³⁾

In most part of the world childhood obesity has reached some very critical proportions.  Cases of childhood obesity are reported in all races, ethnic groups and social-economic classes. Some studies have revealed that the pandemic is prevalent in lower social economic families. The causes of disparities in obesity rates based on the socioeconomic status are due to some factors such as in availability of the healthy balanced diet and safe environments in schools and homes for the recommended daily physical activity. ⁽⁴⁾ In this paper, I am going to look at socioeconomic status and diet as some of the factors leading to childhood obesity and develop some strategies to address the two elements. The primary objective is to come up with  clear strategies that can adequately deal with diet and socioeconomic status as the determinants of childhood obesity in Australia. They will be focused  at reducing the number of obese children to less than 10%  of the children population by 2025. The two strategies are health education and health communication. The aim of the two is to educate all children the effect of obesity and how it can be avoided, teach all children the right choice of diet to ensure they remain health, the program will also implement some practical examples like ensuring all children across the country participate in physical exercise and get a balanced diet in schools. Health communication will aim to parents of all social classes are informed when making the choice of food  for their kids,  to make the parent get the need of allowing their kids to take part in physical exercise for their body health. 

Understanding Obesity

According to the WHO report of 2003 proper nutritional behaviors and physical body exercise are quite essential and should be encouraged and practiced early in life. Children should be able to choose the kind of healthy life they desire by considering the health behaviors, attitudes and preventable knowledge instilled in them at young age. The present-day rise in obesity especially among the children is as a result of the kind of food they consume. ⁽²⁰⁾ There is every need to develop a special health education program to address the pandemic of obesity in school children.

 Using the health education strategy to deal with the type of food they eat is one of the best method to reduce the cases of overweight and obesity in children.⁽⁵⁾ The strategy has proven very effective when utilized in implementing the disease prevention and health promotion programs. American Obesity Association  conducted a study to learn the attitudes of parent towards the weight of their children.  Many of the parent felt that recess should be improved and given attention rather than replacing them. Approximately  30%  were concerned about the weight of their children.  Around 35%  of the parent thought the schools did not teach enough on obesity and how to deal with it.  A significant number  number suggested more education on the disease be done in schools because to them  obese is the greatest health risk to children.

 Health education creates a good learning environment on major health topics. It offers room for the program to be developed in a way that focuses on different needs of the target population. It provides all the necessary information to the target group on different selected health topics.  Such information may include the recommended behavior in different environment. The health program will target the school children and will focus on helping them gain a lot of knowledge on the appropriate diet to maintain the required weight and remain healthy. ⁽¹⁸⁾ I chose the strategy because it does not only help the children learn but they will take part in every stage of their learning. The needs assessment of every community will be done to  identify the available resources and utilizes them depending on the needs and priorities of the people. The strategy is capable of planning the learning activities in a way that increases the skills and knowledge of the participants. ⁽⁶⁾ The health education program is flexible to be implemented in a well planned curriculum that is well integrated with the right materials at the convenience of the participants. The program will utilize Nola Pender’s health promotion model. The model acknowledges that every individual has some unique experiences and characteristics which affects the future actions and decision making. The model is among the most common models around the world and it has been broadly used to plan for the desired health behavior changes as well as support and promote health. It gives a lot of attention and focus on preventing the diseases and promoting health which makes the model unique and to stand out among all other models. The model is easily understood by many and it is applicable in public health. A number of studies have revealed that the model is effective and efficient in controlling and stopping unhealthy behaviors. It is based on social cognitive theory that influences the individual’s perceptions to self efficiency; health benefits among others determine the kind of interactions in health behavior. ⁽⁷⁾ The main aim is to modify and improve the factors which engage each other to affect the processes of cognitive perception. Pender's model is made up of different variables   with some parts considered to the intended intervention. The variables composition contains a very rich source different suitable strategies and content of interventions.

Factors Leading to Childhood Obesity

 All the  qualities above make the model to teach young school kids about diet and healthy living. The use of the model is facilitated by the fact that the main objective of this health program is to help as many kids as possible understand how the kind of foods they eat can influence their general body health especially if they become overweight or obese. The increased rate of obesity among the children is as a results lifestyle factors like poor diet. ⁽⁸⁾

Social economic factors play a big role in influencing  the rate of obesity among kids. ⁽¹⁹⁾ Some studies show that childhood obesity is a little bit high among the families of lower social groups. The kinds of choices the parent make in terms of their lifestyle have great influence in determining the weight of the children. There are a quite good range of factors that determine why people make bad choices. The availability or lack  of  financial resources  have a big impact in obesity. Kids brought up in families of lower socioeconomic class are said lack adequate and safe recreational places. ⁽⁹⁾

Lack of education or inadequate level of education among parent contributes to poor decision making on the types of food to take. According to some data on big body epidemiology, the quality of food is greatly influenced by social economic status of people.  A couple of studies reveal that children born by obese parent have a very high probability of becoming obese. This implies that the health of children is subject to the surrounding. Parents have a lot of influence to their children and they slowly and gradually instill their wrong diet choices to them. Studies have shown that many children carry their childhood behaviors to adulthood and therefore they are likely to continue with the  childhood feeding habits. ⁽¹⁰⁾

In order to address the impact of socioeconomic status among the parent, health communication strategy can used. Health communication is a method that is used to influence and inform individuals to make the right decisions which promote health. Health communication involves the use of verbal and written materials to empower and influence communities, populations or individuals to make some particular health choices. Often, health communication integrates different component of various models and theories to enhance the change in behavior and attitudes.  It is closely linked to the social marketing that requires some interventions and activities that are well developed and designed to change health behaviors positively.⁽¹¹⁾

Strategies to Address Childhood Obesity

 A school based physical activity and nutrition  education  intervention study  was conducted in Beijing for three  years.  It involved parent and their children and it achieved positive results. It involved different strategies  and two primary  schools in Beijing. The schools were provided with educational materials for the parent, lectures to parent on  lifestyle, effects of childhood obesity,  balanced diet  and classroom lessons on childhood obesity.  Every semester parent whose children were either overweight or obese had a special meeting with the research team and were given a list of light food items.  The study suggested that the prevalence of obesity was a bit  low  in the two schools compared to others. The results were 14.4%obese, 9.8%  overweight. Compared to 13.3% obese and 7.9% after three years. The  study was very successful and involving the parent and general public in dealing with childhood obesity can be quite influential.

Studies have shown that parents are very influential to their children. They are the agent of change to be targeted in order to completely deal with the avoidable health problems. The major focus will identify the most reliable and effective ways to reach the parent and communicate about healthy eating and physical exercise especially those who are affected by either overweight or obesity.  It is important to use a variety of methods to reach the parent because they depend on different sources of information each according to their level education, economic status or social class the society. The communication will major on the health of children and will therefore involve doctors and other health care workers to deliver the main message to the public in a way that  accommodates individuals with little or no education in the society. ⁽¹²⁾  The communication will be done using the social media, televisions, radios  written materials and verbally in public gatherings.  Some research established that friends are also influential source of information especially in social events. Encouraging people to share the knowledge of obesity and how it can be prevented will play a big role ensuring the information is available to more people. Churches, working places schools and mothers groups are very important in health communication especially among the parent. ⁽¹³⁾

In health communication strategy the health belief model will be the most appropriate and suitable. It looks at how people perceive and reacts to certain diseases threats and disadvantages of some behaviors and beliefs. According to the model the advantages of an action must be more than the barriers that people perceive. 

Health Education Strategy

In order to fully implement the health education and health communication as the appropriate strategies to deal with the childhood obesity in Australia, different parties and personnel have to take their responsibility very serious. The problem of diet is a significant cause of obesity among school children. There is every need for all the concerned parties to come together and develop a sound health education program to address the problem nationally. The department of education at the national level should invest and provide all the required resources and regulation to guide the program. Studies have established that children learn better through observing the practical, therefore teachers must ensure all the kids are physically active and provided the recommend diet in schools. The curriculum developers should come up with something that the kids can easily understand and teachers can easily incorporate it into the school program. ⁽¹⁴⁾

Health communication strategy will also require all the involved parties to effectively perform their duties. The primary health care workers and public health workforce should get active in enlightening the society on the right kind of diet and need for physical exercise. They should reach people of all social classes and communities without caring their level of education.  The department of health should take an initiative to invest and campaign against childhood obesity and tell people its health implications. The doctors and nurses working in public hospitals should be interested in speaking about the body weight and how it influences the individual’s health with the clients who visit them every day. ⁽¹⁵⁾  

The implementation of the proposed strategies will undergo some critical stages to make them useful. For instance the health education program will need some experts to sit and design what will be taught at different levels in schools. The education system planner should emphasize on  the need to ensure healthy living in schools.  On the other hand, health communication should be done regularly targeting the parent and other adults in the society. The public health workers should organize for one day every month to reach out to the people and educate them on the risks of obesity especially to the children. The adverts on disadvantages of obesity should frequently appear on the televisions and social media daily to ensure  majority of the people in the country  are aware of how to prevent obesity. ⁽¹⁶⁾

The strategies are developed and designed in a way to sustain them and ensure their effectiveness for a more extended period.  In order to ensure they are protected , the parliament will come in to form a constitutional commission that should always engage the community and assess the effectiveness of the to strategies. Every six months all the public hospitals  and public health care workforce  will be compelled by law to submit a report of what they did to reduce the cases of childhood obesity in the society. The responsibility of lowering obesity should be highly devolved from the national government to the states government and the lowest ranked office to reach all citizens. Health education must be included in the school syllabus and curriculum in order to be taught to generations over a period of time without it loosing the intended meaning.  The education officers at every level should ensure health education is offered in all learning institutions including private schools. A policy will be developed requiring all the hospital  to pin posters to create awareness that childhood obesity is dangerous and should be avoided by a means.⁽¹⁷⁾

The health promotion strategies to deal with the epidemic of obesity can be beneficial since it considered some of the most critical and fundamental issues in its development.  The plans are set in such a way as to ensure that the public is involved and participate in the implementation. The programs have also put in mind the principle of health equity and therefore focuses on the entire nation. Finally, the strategy must work sincethey emphasize on all the parties taking part in their responsibilities and ensuring nothing fails which target the health principle of action and action competence. 

Reference

1. Bleich SN, Segal J, Wu Y, Wilson R, Wang Y. The systematic review of community-based childhood obesity prevention studies. Pediatrics. 2013 Jul 1;132(1):e201-10.
2. Bradfield JP, Taal HR, Timpson NJ, Scherag A, Lecoeur C, Warrington NM, Hypponen E, Holst C, Valcarcel B, Thiering E, Salem RM. A genome-wide association meta-analysis identifies new childhood obesity loci. Nature genetics. 2012 May;44(5):526.
3. Borys JM, Le Bodo Y, Jebb SA, Seidell JC, Summerbell C, Richard D, De Henauw S, Moreno LA, Romon M, Visscher TL, Raffin S. EPODE approach for childhood obesity prevention: methods, progress, and international development. Obesity reviews. 2012 Apr;13(4):299-315.
4. Cairns JE, Rundle-Thiele SR. Eating for the better: A social marketing review (2000–2012). Public Health Nutrition. 2014 Jul;17(7):1628-39.
5. Dobbins M, DeCorby K, Robeson PH, H and Tirilis D. School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6-18. Cancer. 2017 Feb 3.
6. Eldredge LK, Markham CM, Ruiter RA, Kok G, Parcel GS. Planning health promotion programs: an intervention mapping approach. John Wiley & Sons; 2016.
7. Freeman E, Fletcher R, Collins CE, Morgan PJ, Burrows T, Callister R. Preventing and treating childhood obesity: time to target fathers. International Journal of Obesity. 2012 Jan;36(1):12.
8. Gupta N, Goel K, Shah P, Misra A. Childhood obesity in developing countries: epidemiology, determinants, and prevention. Endocrine reviews. 2012 Jan 12;33(1):48-70.
9. Heath GW, Parra DC, Sarmiento OL, Andersen LB, Owen N, Goenka S, Montes F, Brownson RC, Lancet Physical Activity Series Working Group. Evidence-based intervention in physical activity: lessons from around the world. The Lancet. 2012 Jul 21;380(9838):272-81.
10. Head KJ, Noar SM, Iannarino NT, Harrington NG. Efficacy of text messaging-based interventions for health promotion: a meta-analysis. Social Science & Medicine. 2013 Nov 1;97:41-8.
11. Hawkes C, Jewell J, Allen K. A food policy package for healthy diets and the prevention of obesity and diet?related non?communicable diseases: the NOURISHING framework. Obesity reviews. 2013 Nov 1;14(S2):159-68.
12. Lacy K, Kremer P, Silva?Sanigorski A, Allender S, Leslie E, Jones L, Fornaro S, Swinburn B. The appropriateness of opt?out consent for monitoring childhood obesity in Australia. Pediatric obesity. 2012 Oct 1;7(5).
13. Lupton D. Health promotion in the digital era: a critical commentary. Health promotion international. 2014 Oct 15;30(1):174-83.
14. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. Jama. 2012 Feb 1;307(5):483-90.
15. Park MH, Falconer C, Viner RA, Kinra S. The impact of childhood obesity on morbidity and mortality in adulthood: a systematic review. Obesity reviews. 2012 Nov 1;13(11):985-1000.
16. Puhl R, Peterson JL, Luedicke J. Fighting obesity or obese persons? Public perceptions of obesity-related health messages. International Journal of Obesity. 2013 Jun;37(6):774.
17. Roberto CA, Swinburn B, Hawkes C, Huang TT, Costa SA, Ashe M, Zwicker L, Cawley JH, Brownell KD. Patchy progress on obesity prevention: emerging examples, entrenched barriers, and new thinking. The Lancet. 2015 Jun 13;385(9985):2400-9.
18. Van Jaarsveld CH, Gulliford MC. Childhood obesity trends from primary care electronic health records in England between 1994 and 2013: the population-based cohort study. Archives of disease in childhood. 2015 Jan 7:archdischild-2014. 

19. Wang Y, Lim H. The global childhood obesity epidemic and the association between socio-economic status and childhood obesity.
20. World Health Organization, 2012. Population-based approaches to childhood obesity prevention.