Issue Analysis
Issue Analysis
The incidences of childhood obesity in the United States have been on the rise for the past several decades, with no sign of stopping. American society as a whole needs to become more aware of the problems and risks associated with obesity in children. The results of the National Health and Nutrition Examination Survey (NHANES) show the percentages of overweight children in America spanning the past 20 years. Comparing the results from 1994 to 2004, the percentage increased from 7.2 to 13.9% among 2-5 year olds, from 11 to 19% among 6-11 year olds and from 11 to 17% among 12-19 year olds. In 2004, they estimated that approximately 17 percent of children (ages 2-19) are overweight (“Prevalence of Overweight” par. 1). Immediate action needs to be taken in order to reverse these statistics before it is too late.
Defining Childhood Obesity
The terms “overweight” and “obesity” are used to label weight ranges which are larger than what is considered to be healthy. They also identify which ranges increase the likelihood of weight-related health risks (“Defining Overweight”). To begin assessing the weight of a child, their Body Mass Index (BMI) is calculated using their height and weight. These ranges must then be charted so that the differences in body fat based upon gender and age can be taken into account. This method of measurement is referred to as BMI-for-age. Children falling between the 85th and 95th percentile are considered to be at risk of becoming overweight, and those falling in or above the 95th percentile are overweight (“About BMI”).
Problem Overview
There are numerous health risks involved with being overweight as a child, many of which continue on into adulthood. It is important to first discuss why childhood obesity has become an increasingly larger problem in the United States.
American society has changed dramatically in the past few decades. According to Christina Wilds, a doctorate student in the Behavioral and Community Health Sciences program at the University of Pittsburgh, “several of these changes, such as both parents working outside of the home and the availability of convenience foods often affect decisions about what children eat, how much they eat, and the amount of energy they expend in school and leisure-time activities” (3). As American lives become faster paced, fewer families take the time to prepare and sit down to a healthy, well-balanced, and home cooked meal. About one third of meals are eaten outside of the home (Strauss 12). These quick fixes, such as fast food and other take-out, do not suffice as alternatives to nutritious meals. In addition to unhealthy menu choices, restaurants also have poor portion control (if any at all), giving a much larger amount of food than a child should intake during one meal.
In addition to a poor diet, children today are experiencing a great lack of physical activity. Only about 10 percent of elementary schools provide a daily physical education program (Robert Wood Johnson 1). Statistics also show that only approximately half of high school students regularly participate in gym classes (Strauss 10). A major contributor to the lack of physical activity amongst children and adolescents is the advancement of technology, specifically electronic entertainment devices. Watching television, playing video games, and spending time on the computer all take time away from other physical activities. As children spend more and more time in front of television sets and computers, they are spending less and less time exercising their bodies. This low level of exerted energy, combined with a high fat and calorie intake is recipe for obesity.
Childhood obesity is an epidemic which needs to be addressed by the American nation as a whole. Our society is not currently providing children a healthy environment to grow up in. If the problem is not taken into serious consideration, the entire country’s future health and well-being is at risk.
Risks Involved
Overweight children are at risk for many health conditions. One consequence of being overweight as a child is cardiovascular disease. Obese adolescents and children often have elevated systolic or diastolic blood pressure, and account for 50% of the cases of juvenile hypertension (Strauss 15). Another main complication which arises in obese children is Type 2 diabetes, affecting the endocrine system. It was once almost never seen in adolescents. However, now as many as half of the new diabetes diagnoses made are in children. Pulmonary complications including sleep apnea, asthma, and exercise intolerance amongst children are also shown to directly correlate with obesity. These conditions can then affect the ability of a child to partake in physical activity, causing further weight gain (Ebbeling 473).
Other health risks for overweight children are psychological affects. Overweight children are often the targets of bullying amongst their peers. This can in turn cause them to have poor social functioning resulting from a low self-esteem (“Consequences”). Adolescent years are a critical period in the development of body image. Being overweight can have a significant negative affect on a child’s self image.
All of the health consequences (both physical and psychological) children face can directly effect their adulthood. In his article “Childhood Obesity”, Richard Strauss states that “fifty to 65 percent of adults with severe obesity were obese as children. This implies that childhood obesity predisposes to the most severe forms of adult obesity” (6). The health complications discussed above affect not just children, but adults as well. Therefore, being overweight as a child greatly increases an individual’s chances of struggling with poor health throughout their lives.
Stakeholders
American children are most affected by the high incidence rate of childhood obesity in the United States. Children of all age groups are in danger regarding the weight issues of our nation. This includes both children who are already struggling and categorized as overweight and children who are at risk of becoming overweight in the future. Although it is important to note that childhood obesity indirectly affects the American nation as a whole, the primary stakeholders are our country’s youth.
Risk Communication Audience
The most effective audience for risk communication regarding childhood obesity is not the children themselves. Rather, it is necessary for communication efforts to target the adult community; specifically parents, teachers, schools and healthcare providers. These are the people whom have the greatest influence and control over the environment which children are brought up in. If we want children to adapt a healthier lifestyle, their adult role models would be most effective in implementing this change.
This audience can effect change not only by altering their behaviors but also by providing children with necessary rules which will greatly benefit the child’s well-being. Both parents and schools are able to put these guidelines into place. In addition to having control over children’s physical activity level, adults also control their diet. If we want children in the United States to start eating healthier, it is necessary to get their guardians and schools to provide them with more nutritious meals.
Solutions
As risk communicators it is not our job to simply state ways in which parents and schools can help keep children healthy. Our most important function is to find out ways in which to educate these adults on the risks of childhood obesity, as well as the best means of prevention and treatment. For families and schools to start taking action, they must first be aware of the problem. This is where risk communication efforts come in; we must get the facts out there and tell people how to take the first steps towards a healthier life. Public health initiatives can be undertaken. Spreading information through health systems is a good way to reach our audience. Pediatrician and other doctor’s offices should provide parents with information on childhood obesity, including the health risks and methods of prevention. I believe that this is where we need to begin our efforts to educate the public of the major problems and risks involved with children being overweight.
According to Childhood Obesity: Public-Health Crisis, Common Sense Cure by Cara Ebbeling “prevention and treatment of obesity ultimately involves eating less and being more physically active” (476). In order for children to lose weight, they need to exert more energy than the amount they are putting into their body in the form of calories and fat (from food). It is important for children to be given restrictions regarding their diet. If unhealthy foods are made unavailable to them, they will not be able to consume them; simple as that. Richard Strauss stresses that “efforts should be made to change the overall fat content of the diet instead of focusing on the few low-calorie food alternatives” (21).
Exercise and physical activity is also important for all children. Inactive behavior, including time spent in front of the TV, video games, and computer, should be limited. If encouraged to decrease their amount of time spent doing sedentary activities, children will become more physically active naturally (Strauss 22). We must focus on how to improve the diet and increase the amount of exercise in children. Because children spend the majority of their time at home and in school, both families and education systems should be involved in this intervention.
Parents are primarily responsible for looking after and taking care of their children. Eating habits of the entire family must be changed in order for children to become healthier. This can be done very simply. Junk food should be removed from households (and replaced with healthy alternatives) so children are not exposed to these temptations. In addition, it is important for parents to find the time to prepare a sit-down meal for the family. By doing so they will be able to control not only what their children are eating, but also how much. Risk communication efforts can provide parents with the means to take action. Providing them with information about nutrition and recommended recipes (which are quick, easy, and healthy) will help guide parents in the right direction.
Parents can also organize activities, such as family bike rides or walks in the park to help children get a good amount of exercise. Constant family support and encouragement is needed for overweight children to change their unhealthy ways. Louise Baur explains that “parents should be involved by encouraging children to take part in physical activity, giving praise when children become more active, setting limits for TV viewing, providing alternatives to sedentary behavior and acting as role models by becoming more physically active themselves” (6). Community events can be organized by risk communicators to help get the general public actively involved.
School systems can help reduce the rates of childhood obesity by implementing changes in two areas: curriculum and the cafeteria. There needs to be healthier foods in school cafeterias for children to eat during lunch. Well balanced meals should be served, in appropriate portions. Minimizing the amount of fried food and sweets available to children will minimize the amount they consume. There are two areas in which curriculum changes can be made in schools: health and physical education. Regular gym class participation should be required of all students (of all ages). This would ensure that all children are getting at least some daily exercise. In addition, health education classes regarding nutrition and exercise should be put into schools. Many children, especially young ones, are not knowledgeable about how to have a healthy lifestyle. If they are taught how to do so, as well as the risks of being overweight, children are more likely to self monitor their behavior.
A great way to reach the target risk communication audience, parents, is to send them information directly. A method of risk communication which I propose is a newsletter on childhood obesity. To be most effective, the newsletter would include information on the topic of childhood obesity (including the causes and consequences) and ways in which to fix the problem. To reach the parents of many children, the newsletters could be mailed home through the public schools in numerous areas throughout the country.
Summary
The problem of childhood obesity in America today is quite evident. With the incidence rates rapidly on the rise, something must be done soon to change society’s unhealthy ways. Through our risk communication efforts, it is important to have realistic goals. A rapid and “large weight loss is not usually possible with a dietary or behavioral regimen. For the growing child, weight management is often an achievable, realistic goal” (Strauss 22). It is important to remember that changes are not going to be seen overnight. But by educating people about the seriousness of the problem and how to fix it, steps can be taken in the right direction.
Works Cited
About BMI for Children and Teens. 22 May 2007. Centers for Disease Control and Prevention: Department of Health and Human Services. 17 Feb. 2008. <http://www.cdc.gov/nccdphp/dnpa/bmi/childrens_BMI/about_childrens_BMI.htm>
Baur, Louise, et al. “Special Considerations in Childhood and Adolescent Obesity” Clinics in Dermatology 22.4 (July-Aug. 2004): 338-344.
Childhood Obesity. May 2007. Robert Wood Johnson Foundation. 18 Feb. 2008 <http://www.rwjf.org/programareas/ChildhoodObesityFramingDoc.pdf>
Consequences: Overweight and Obesity. 22 May 2007. Centers for Disease Control and Prevention: Department of Health and Human Services. 17 Feb. 2008. <http://www.cdc.gov/nccdphp/dnpa/obesity/childhood/consequences.htm>
Defining Overweight and Obesity. 22 May 2007. Centers for Disease Control and Prevention: Department of Health and Human Services. 17 Feb. 2008. <http://www.cdc.gov/nccdphp/dnpa/obesity/defining.htm>
Ebbeling, Cara, et al. “Childhood Obesity: Public-health Crisis, Common Sense Cure.” The Lancet 360.9331 (10 August 2002): 473-482.
Prevalence of Overweight Among Children and Adolescents: United States, 2003-2004. 30 Jan. 2007. National Center for Health Statistics. 18 Feb. 2008 <http://www.cdc.gov/nchs/products/pubs/pubd/hestats/overweight/overwght_child_03.htm>
Strauss, Richard. “Childhood Obesity.” Current Problems in Pediatrics 29.1 (1999): 5-29.
Wilds, Christina Louise. Assessment of Fun to be Fit: A School-based Approach to Childhood Obesity. University of Pittsburgh, 2006.
