August 28, 2007 |
Obesity in the U.S. has evolved into an epidemic. Mississippi (1) has trended beyond 30% of adults considered to be obese. This definition obesity includes adults with a body-mass index [BMI] of 30 or more. Alabama, West Virginia and Tennessee are also reporting trends approaching 25% for adults.
“Healthy People 2010 provides a framework for prevention for the Nation. It is a statement of national health objectives designed to identify the most significant preventable threats to health and to establish national goals to reduce these threats. (2)” The notable goal of this federal initiative is two fold: A). Assist people of all life expectancies improve their life B). Eliminate health disparties. Both goals are truly notable. For the purpose of this article, there will be additional focus on health disparities and the link to obesity.
Several independent and federal organizations have launched studies and initiatives which have taken place within the past ten years, due to alarming trends in sevaral dietary factors and the correlation to obesity and overweight. According to the Healthy People 2010 Progress Review (3), these dietary factors comprise coronary artery disease (CAD), high blood pressure, cancer, stroke and type-2 diabetes. The costs associated with these particular dietary factors were $100 billion in 2004. Furthermore, the focus on fruit, vegetable and grain consumption has yielded no sign of progress. This observation in particular leads to a much larger dialogue. A dialogue that must embrace cultural and ethnic sensitivity, behavorial science and education. Hence, how does Healthy People 2010 with the national objective of eliminating health disparities and the Progress Report measure up thus far?
Among racial and ethnic groups for whom data are available, the trend toward increasing obesity is most pronounced for adult black females (50 percent of whom were obese in 1999–2000, up from 38 percent in 1988–1994) and for adult Mexican American females (40 percent of whom were obese in 1999–2000, compared with 35 percent in 1988–1994). What served as the catalyst(s) for the notable increase in 1988 from 40% to 50% in 1999?
The proportion of children and adolescents aged 6 to 19 years who are overweight increased from 11 percent in 1988–1994 to 15 percent in 1999–2000. The proportion of overweight females rose from 10 to 15 percent, and of overweight males, from 12 to 16 percent. For Mexican American children and adolescents, the proportion overweight in 1999–2000 was 24 percent; for black children and adolescents, 22 percent. Less than 5 percent of children and adolescents, male or female, were overweight in 1966–1970. The target is 5 percent (Obj.19-3).
Several scenarios have been enteratained including; a food dominated environment, consumers besieged by aggressive marketing and human physiology. But how does these challenges translate into the vulnerable cohorts affected. It is my opinion, there may be a significant correlation to poverty and or low-income with food choice and related behaviors. Particularly among women with low incomes or on the threshold of poverty (4).
According to the Health People 2010 Progress Report (3), several approaches have been introduced to address baseline data collected thus far. Among the approaches offered, none of them seem to addres the issue of poverty. For example, the promotion of health literacy is notable. But if the intended target population does not meet standard litarcy standards, this approach is ineffective for this cohort. Another approach is behavioral therapy for post-pubertal children. Will this service be offered at no charge? What institution(s) will offer these services. Will outreach efforts reach affected cohorts? What are the implications for insurance providers in terms of costs? Will Child Health Insurance Programs (CHIP) cover the costs?
If attention was increased on the correlation to poverty and obesity in the U.S., and articulated nationally. Then perhaps, notable action plans can truly reveal a positive yield.
1. Freaking, K.Obesity rates show no decline in US. (August 27, 2008). Associated Press. Retrieved from http://news.yahoo.com/s/ap/obesity_rankings;_ylt=ArXeXRe0VAfyQW9GFMkQmUDq188F on August 28, 2008.
2. Department of Health and Human Services. Healthy People 2010. Retrieved from http://www.healthypeople.gov/About/ on August 28, 2007.
3. Department of Health and Human Services. Progress Review: Nutrition and Overweight. (2004). Healthy People 2010. U.S. Department of Health and Human Services. Public Health Service.
4. Social Issues Research Center. Poverty and Obesity. Retrieved from http://www.sirc.org/articles/poverty_and_obesity.shtml on August 28, 2007.