Childhood obesity has been identified as the biggest health concern of the 21st century as most of the nations throughout the world is currently suffering from childhood obesity and overweight and majority of the affected children are from low or middle income countries (Ng et al., 2014). Therefore, it indicated towards the linkage of this occurrence to the socio-economic status of the society or to a larger context to the social determinants of health of the nation affected with the disorder primarily. According to the World Health Organization (2018), the global estimation of obese people in the year 2016 was 41 million and in which half was children belong to Asia and Africa. While discussing the background on this disorder, it should be mentioned that obesity is a lifestyle related or majorly acquired disorder in which individual’s diet, nutrition, environment, and acquired behaviors lead to overweight or obesity related issues (Stevens et al., 2012, p. 22). Further, the consequences of obesity in childhood or early adulthood creates more complicated disease condition in adulthood such as diabetes or cardiovascular disease at very younger age that affects the immune system of the patient (Ng et al., 2014, pp. 766-781). In this assignment, In light of childhood obesity in the United States of America will be discussed with its importance and it will be supported with several researches. Further, policies acquired by other countries to fight or combat the situation will be discussed. Finally a set of recommendations will be provided with objectives so that the policies related to childhood obesity can be controlled.
Why is the issue important?
In the United States of America, childhood obesity, overweight teen and kids are few of the major concerns of the federal government. Several organization such as WHO, CDC America, healthcare, the National Conference of State Legislatures, healthcare ministry of USA are the important organizations that are responsible for creating policies and legislations. The current policies that have been applied by the federal government to combat obesity and its associated disorders are Nutrition standards for food and beverages served in child care setting, physical activity standards for childcare settings, calorie information labelling and restricting several beverages so that a certain age group can by that (Shier, An & Sturm, 2012, pp. 723-730). Further, policies on portion size restriction, procurement, restriction on several fast food outlets within a certain distance of school or children’s reach, imposing high tax on food products that can increase obesity, children’s food and beverages advertisement initiative (CFBAI), promoting healthy food marketing, nutrition related education in school are few of the policies that the USA federal government has already implemented or about to implement to control the increasing rate of childhood obesity in the States (Ogden et al., 2014, pp. 189-190). Television is the primary source nowadays to enter a household and through these routes food and beverages industries are influencing people to consume their food product thereby making them affected with obesity. It is determined by the USA statistical resources that every year more than $10 billion are spent for food product advertisement and marketing. In this, the organization namely the Children’s Advertising Review Unit (CARU) plays an important role by creating and monitoring guidelines related to truth, adequacy, appropriateness and accuracy of the television ad directed for children (Boulos et al., 2012, pp. 146-153). As per the guidelines created by CARU promotes that the advertisement should promote sound use of the product and should also indicate towards the healthy development of good nutritional practices in children. Further, parental responsibility, promoting healthy food habits, and emphasized in the global regulation of the food products and maximum brands are serving in multiple countries (LeBlanc et al., 2012).
However, in these policies, the primary focus has been given in promotion or advertisement of food products which make children prone to obesity or making the food product more reliable by printing their detailed nutritional value as well as increasing their health literacy so that they can be aware of the negative implications of the obesity increasing food products (Prentice-Dunn & Prentice-Dunn, 2012, pp. 255-273).
Kristensen et al. (2016, pp. 604-612), studied the efficacies of three Federal policies in the United States, which aims to reduce childhood obesity. These policies were 1) programs on afterschool physical activities, 2) an excise tax of $0.01 per ounce of sugar sweetened beverages (SSB) and 3) Banning television commercials on fast food directed towards children. Their studies showed that afterschool physical activities can reduce obesity by 1.8% among children aged between 6 and 12 years, the advertising ban can reduce obesity by 0.9% among children and the imposing excise tax on SSB can reduce the obesity by 2.4% among adolescents between 13 and 18 years. The studies also showed that all the three policies can reduce obesity among ethnic groups such as the Black Americans and Hispanics, compared to the While population, while tax on SSB can reduce the obesity disparities the most. This shows that SSB tax is the most effective strategy among the three. However, afterschool physical activity is also considered as an important strategy my several authors. Study by Wikie et al. (2018, pp. 7-12) showed that vigorous intensity physical activity was negatively correlated with body mass index, showing that with physical activity, which children can reduce their Body Mass Index, and hence reduce obesity.
What does research tell us?
There is a huge number of research projects that have been carried out and some are in progress to determine the effectiveness of policies and legislative steps taken by the USA government to maintain or control the level of obesity in children of America (Cairns et al., 2013, pp. 209-215). The primary focus of the researchers were to understand the level of inactivity within children of USA, the effect of socio economic status in increasing obesity condition, the role of television advertisements in increasing obesity and the way the governmental policies can be implemented so that the risk of obesity from unhealthy food and beverages can be minimized. The primary focus of Keller et al. (2012, p. 1), was to determine the sedentary behavior and inactivity in the children of USA and for that purpose, researchers conducted cross sectional study among school children of a community to understand the level of their physical activity. They found that physical activity was minimal as they were always involved in studies or used to eat fast food from nearby fast food store. .Hence, the availability of fast food was one of the biggest reasons for sedentary and less active lifestyle among children in USA. Some researcher linked the extravagant farming and cropping and then trading of USA crops to the obesity. According to Clarke et al. (2012, pp. 53-64), these crops created and Obsogenic or obesity causing environment that enhances the incidences of obesity. They indicated to the point that due to excess amount of food crop generation, the government provided tax free trading of food crop that increases the supply to different food and Beverages Company and from them, through advertisements and marketing, the product reached to each household, increasing the risk of it. The third research which is included in this section was conducted to understand the policy of advertising unhealthy and inappropriate food. As per literature, such advertisements determined that controlling the food advertisement will help to limit its reach to children and their parents will also understand the type of food they should provide to their kids to secure them from healthcare issues (Gearhardt et al., 2012, pp. 657-663). Further to understand the level of sedentary life in high socio-economic status and obesity was determined through the research of Wang and Lim (2012 pp. 176-188). The research proved that high SES people have access to everything they need to spend a quality and relaxing lifestyle and therefore people with high SES is generally seen to be affected with obesity related condition.
What are the implications of the research?
From these above-mentioned researches indicated towards different aspects of childhood obesity, there are several implications, that indicated towards the regulatory reform and restructuring of the policies. According got this, healthcare regulations should be strictly implemented and reforms should be done in marketing, packaging and advertisement of food products so that starting from seller up to buyer can go through the nutritional value of the food product (Keller et al., 2012, pp. 379-386). Further reform should also be implemented in food production step so that companies cannot use food products that can make the buyer prone to obesity. Thirdly, the advertisements of unhealthy food products should be restricted and guidelines of advertisements policies should be reformed so that organizations cannot influence children to eat unhealthy and junk food (Wang & Lim, 2012, pp. 176-188). Further, in case of children, the research indicated towards the fact that in spite of creating new regulations, the USA government should focus on changing or reforming existing policies, so that it could become more comprehensive and the ambiguity present in the process can be removed. Hawkes, Jewell and Allen (2013, pp. 159-168), determined that people cannot achieve success through self-regulation, if the government do not change their policies and reform them to control the companies. Therefore, the US government should reform it existing policies related to advertisement and marketing, production and packaging of food products. Secondly, it is seen from the above discussion that besides influence of organizations, unhealthy, inactive lifestyle is primary factor that make children prone to obesity and increase their body weight. In such situation, the government should also reform the children’s curriculum in schools so that they can spend some active time playing their favorite sport as well as the parents should also be provided with health literacy related to childhood obesity and for that healthcare promotional plan against obesity should be implemented (Clarke et al., 2012, pp. 53-64).
What is the experience in other jurisdictions?
Obesity is one of the key determinants of health identified for 2020 Sustainable developmental goals determined by the UNESCO. Hence, all the countries are preparing themselves to fight the disorder with strict policies so that from each aspect such as social, political and economic prospect, combat against this disorder can be continued. In this section, the obesity rates after implementation of different evidence based strategies in countries such as Germany, France and United Kingdom will be described. The experiences of these countries will be highlighted in this section.
The government of France has developed policy and is protective against people affected with obesity. It protects the obese people against stigmatization and discrimination. The French government believes that the citizen are able to behave as the government want them to in case of using healthy food and diet to avoid obesity, only if they have right information (Vallgårda, 2015, pp. 317-323). French government policies focus on health literacy, increasing awareness and nutritional education. Public Health Act 2004 implemented “Second National Nutrition and Health Programme” and ensured display of heath warning during advertisements and on food label ((World Health Organisation 2013, p.13).
These policies have been successful in decreasing the health warning advisory labels on television advertisements. The policy can be used as framework to improve the advertisement policies in US. The outcomes of these initiatives include obese students inclining towards alternative food products instead of fast food and beverages. National nutritional health program has been successful in promoting parents awareness on benefits of consumption of fruits and vegetables, who are participating actively toward healthy diet of children (World Health Organisation 2013, p.13).
National Nutrition and Health Programme can also be implemented by USA as it has been ineffective in its policies related to health diet for children. USA has been ineffective due to defective system in evaluating the outcomes. USA does not focus on display of warning signs on food packets.
Germany’s government focuses on National Action plan to promote healthy diets and physical activity. Five steps to manage obesity is incorporated in this plan. The first step is appealing the citizen to stop eating unhealthy or obesity prone foods through providing health education (Vallgårda, 2015, pp. 317-323). Secondly, emphasizes responsibilities that let people and their families to foster this knowledge in their lifestyle. Thirdly, if these steps do not motivate people, then they foster the third step in which the government motivates people to take care of their own health by providing them with incentives or proving them with an influencer that motivates an entire society through his or some other examples (Schorb, 2013, pp. 3-16). In the fourth strategy, the government focuses on aspects such as daily structures, the social environment, income, education, environment and transport. The fifth strategy is the impetus for research for more evidence in this field. The plan provides a structure so that citizens can apply the step to improve their own health responsibly (Schorb, 2013, pp. 3-16).
These steps have been successful in reducing the percentage of overweight children in areas of implementation. It was also successful because of the government’s anti-obesity drive program. These steps was beneficial in preventing the selling of fast food in school premises and increasing the health literacy of children and their parents (Schorb, 2013, pp. 3-16).
These five steps can also be integrated in the US based campaigns for public awareness on childhood obesity. These steps in USA is however ineffective as the decrease in child obesity has been negligible. There is need of greater focus on the policy of banning advertisements on food and beverage and reduce child exposure in USA.
The government of UK is more focused on restriction on the advertisement of “High Fat, Salt and Sugar” (HFSS) food and reduce children exposure to these foods (Shannon, 2014). The government controls advertisers and the companies from promoting the consumption of fast food. Hence, they understand their responsibility by controlling the Deal Food Network to minimize the child exposure (Vallgårda, 2015, pp. 317-323).
UK government has been successful in reducing the advertisement of HSFF food on television (Advertising Standards Authority 2017). UK strategies have been successful as the government impose strict penalty on advertisers. The benefits of these strategies include decrease in child exposure to the fast food through commercial channels. It decreased parent’s perception of offering fast foods and snacks to their children.
USA has no specific regulations in this regard. There is a need of improvement in this area as despite advertisements of food and beverages, there is an increase in children’s commercial channels and revenue generated by advertisements. Therefore, there is a need of more monitoring and evaluation of the policy and if penalties are well imposed (Shannon, 2014, pp. 248-266). The government must seek alternative strategies in case the advertisers have developed alternate mode of advertising the food and beverages to children.
From these above-mentioned governmental policies, there are several recommendations that can be implemented in the policies of USA so that targeting and addressing childhood obesity especially becomes easier.
Firstly, the USA government should implement regular monitoring and evaluation of the existing policies and implement reforms so that the policies can achieve its intended goals. Regulatory reforms must be regularly monitored (Schorb, 2013; pp. 3-16). In effective policies like France can decrease the children’s chances to quit sedentary lifestyle. US can prevent childhood obesity, and decrease the selling of high calories and fat rich food by 'Mc Donald’s and KFC like industries. It will yield positive health outcome. The government can shape the public food choices by developing school based interventions that can instill in the school children to read the fast food packet labels before consumption (Taber et al., 2012; pp. 437-444). US must extend its regulations to ban fast food advertisement during child peak viewing periods. Extending regulations is cost effective in terms of heath costs. Secondly, the government should implement mandatory penalties for advertisement of the fast foods on television like France and UK. It will help decline the child exposure as well as reduction in childhood obesity (Vallgårda, 2015, pp. 317-323). Appropriate disincentive to advertisers must be given with regulations to help them stop advertisements. The government should impose strict penalties on companies for breach of regulation like cancelling license.
These recommendations will help develop healthier food environments and decrease the prevalence of the childhood obesity. It will reduce the children’s fast food eating preferences and promote healthier food products. These recommendations will decrease the television advertisements of unhealthy food and beverage. Altogether it will help parents and children to make healthy food choices.
In conclusion obesity is one of the major health issues in USA as it impacts people’s lifestyle, physical habits and activity level. USA has contributed a major section of obese people in global obesity percentage. In this assignment, using government’s data the state of childhood obesity in USA was determined. Further, the USA government’s policy was aligned and compared with France, Germany and UK government policies so that few loopholes can be identified and recommendation can be provided for the improvement of the policies. The government recommendations will help USA government to achieve their targets.
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