The United States is home to many great advantages, but it is also home to multiple disadvantages and disparities. Billions of dollars each year are spent on one preventable aspect of healthcare, issues and disease that are the direct result of the obesity epidemic (Millan, 2012). Children are developing diseases once thought to only plague adults, such as fatty liver and type two diabetes (Gibson, et al. 2017). Added onto these newly appearing childhood illnesses, children now may live shorter lives than those of their parents (Olshansky, Passaro, et al., 2005). Childhood obesity, an epidemic, and a major cause for concern for parents, nurses and the 21st century.
A health disparity is simply defined as when one population is plagued by an illness or disease at a higher rate than another population, race or ethnic group (Andrews & Boyle, 2016). Obesity is one of the leading health disparities and has absorbed the United States, costing an estimated 190.2 billion per year due to obesity related illnesses (Millan, 2012). Not only is obesity costly, its shortening lives. According to the New England Journal of Medicine children now who suffer with being overweight and obese, may have a shorter life expectancy than their parents and older generations (Olshansky, Passaro, et al., 2005). Statistics like these make childhood obesity one of the leading and most concerning health disparities facing the modern world.
According to the Center for Disease Control (CDC) since the 1970’s childhood obesity in the United States has tripled (CDC, 2018). Data and studies between 2015 and 2016 recently found that astoundingly one in five children in the United States is obese (CDC, 2018). Although the epidemic of childhood obesity effects almost every race in the United states, it is most prevalent among Latin Americans.
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Latin Americans are one of the fastest growing minorities in the United States (Delva, O’Malley & Johnston, 2007). Being the fastest growing minority in America comes with its own risks when discussing the prevalence of obesity, especially given that Hispanics and people of Latin decent have a 21 percent higher obesity rate than their non-Hispanic white counter-part (Millan, 2012). Overall Latin American youth are more at risk than non-Hispanic white, and African American youth for becoming overweight or obese (Dela et al., 2007).
With childhood obesity on the rise and the financial and societal consequences burdened upon multiple communities, where do parents stand on the issue of obesity in their children?
Myers and Vargas found that 35% of parents of obese children did not believe that their child was overweight, but 78% were concerned about heart disease as a possible consequence of childhood obesity….perceptions of obesity are also culturally influenced. Myers and Varags’ study was based on an Hispanic population, whereas in Young-Hyman et al’s study based on African-American population, substantially fewer parents (44%) perceived their child’s weight as a possible health problem (Covic, Roufiel & Dziurawiec, 2007, p.124).
Some common factors were found that parents from multiple groups felt contributed to childhood obesity. These included emotional eating, having a sedentary lifestyle, emotional or environmental disturbances and the cost of having healthier options at home (Covic, Roufiel & Dziurawiec, 2007).
Poverty is a contributor to childhood obesity and leads those struggling in circumstances of poverty at a major disadvantage to many of the ways to create a healthier lifestyle. When schools in rural North Carolina were studied they found that if most of the population lived above the poverty line there were less incidents of childhood obesity (Piontak, Schulman, 2016).
Also discovered in these studies when the schools mostly consisted of minority groups and were in rural areas they had much higher rates of obesity than areas where the school was more racially diverse (Piontak, Schulman, 2016). Most studies show that children exposed to poverty overall are more likely to develop high BMI ratios and have multiple unhealthy eating habits and live sedentary lifestyles (Min, Xue & Wang, 2018). Another shocking statistic; a child who either grew up in poverty or currently revisit a status of poverty throughout their life is at the second highest risk of childhood obesity, not because of initial influxes but because of their steady BMI rise throughout their life (Min, et al, 2018).
Although poverty may only be a portion of the problem it is certainly one of the largest disadvantages facing children suffering with obesity and being overweight. Especially being that children who are constantly struggling with poverty have a 1.5 times higher risk of being overweight then children whom have never been burdened with poverty (Min, et al, 2018).
With poverty being one of the contributing factors influencing childhood obesity, the emotional burden of being obese and overweight as a child can contribute to why children remain overweight and obese throughout their lives (Gibson, et al. 2017). Not only are these children at risk for type 2 diabetes, sleep apnea and fatty liver disease they are also at risk for body dissatisfaction, low self-esteem, depression and social isolation (Gibson, et al. 2017). Children who have a higher body mass index have been shown to have increase signs and symptoms of depression, eating disorders and body dissatisfaction and are frequently bullied which causes a major drop in an already low and struggling self-esteem (Gibson, et al. 2017).
These psychological symptoms have lead researchers to believe it causes a trend of obesity in children throughout their life (Gibson, et al. 2017). It’s been studied that young adults at the age of 18 who were either overweight or obese 91% of those young adults were either overweight or obese at the age of 12 and 90% of those were also overweight at the age of nine (Gibson, et al. 2017). These obesity rates throughout the lifespan according to research seem to affect girls and young women more from a psychological perspective more then it affects young men and boys (Gibson, et al. 2017).
With all the risks, all the statistics and 36 percent of African American, 38 percent of Hispanic children between the ages of two and eighteen being affected by obesity what is society doing to prevent the growth of the epidemic and restore a healthy youth? (Saxe, 2011). Established Government programs such as Supplemental Nutrition Assistance Program (SNAP) and Women, Infants and Children (WIC) have been put in place for many years to help those in lower socioeconomic status gain access to healthier food options (Armstrong et al. 2011).
Although these programs often have specific federal guidelines, citizens are also limited in their community and state standards for meeting the economic requirements for gaining access to these programs (Armstrong et al. 2011). Nutritionists and Government programs have also attempted to tackle school lunches and children who come from lower income households access to free or reduced cost lunch and breakfasts (Armstrong, et al. 2011).
In order for students to apply for programs such as the National school lunch program or the school breakfast program parents need to first contact the school to see if they qualify for these programs (Armstrong, et al. 2011). Although the United States Government has set up numerous programs to help combat childhood obesity the rates are still too high and have yet to reduce (Armstrong, et al. 2011). This means that healthcare providers including nurses and parents are pivotal and key factors in the fight against childhood obesity.
As previously stated Hispanics and those of Latin decent have a 21 % higher risk of developing obesity and becoming overweight (Delta et al. 2017). The National Association of Hispanic Nursing (NAHN) is fighting back against this epidemic plaguing their community (Millan, 2012). The NAHN created a program targeted towards minorities and specifically those within the Hispanic communities on education with both the children and the parents on healthy and balanced nutrition (Millan, 2012). A nurse’s impact can be of vital importance right from the beginning of a child’s life.
Nurse midwifes or obstetric nurses can influence generations by encouraging new mothers to breast feed and provide proper nutrition and exercise throughout their child’s life (Andrews & Boyle, 2016). One of the most important nursing roles in affecting change in childhood obesity seems to be ignored the most, the role of the school nurse. School nurses are well aware of the prevalence of childhood obesity. Although a staggering amount; 35% in a New Jersey study felt that they weren’t fully competent in recommending and providing weight loss programs to children (Nauta, Byrne & Wesley, 2009).
An even more shocking discovery in this study showed that nearly 65% of school nurses in New Jersey reported rarely ever using age specific BMI calculators to determine obesity in children (Nauta et al. 2009). Nurses are well educated and informed and know and are concerned in many communities and countries on the pandemic of childhood obesity and yet in some areas they are not be utilized as one would suspect, an unfortunate finding which needs to be addressed and changed.
One group that has lead the fight against health disparities including childhood obesity is Healthy People 2020. Healthy People 2020 has set four main goals that they would like to achieve these include: Attain high-quality, longer lives free of preventable disease, disability, injury and premature death. Achieve health equity, eliminate disparities, and improve the health of all groups. Create social and physical environments that promote good health for all. Promote quality of life, healthy development, and healthy behaviors across all life stages (CDC, 2015).
Eliminating childhood obesity would achieve all of these goals presented by Healthy People 2020. If children were encouraged and taught by community programs how to eat healthier foods it could reduce these new found illnesses, that are shortening and costing the lives of young people (Gibson, et al. 2017). The programs such as providing free or reduced cost lunches and breakfast is helping to eliminate the socioeconomic burden and achieve health equality by making sure all students regardless of income receive a healthy nutritious breakfast and lunch (Armstrong, et al., 2011). If all nurses who have a direct influence on new mothers, such as those stated above influence and teach their clients about the importance of proper nutrition from the beginning, nurses can directly promote quality of life and develop healthy behaviors across a child’s life (Andrews & Boyle, 2016).
Childhood Obesity; highly preventable and yet, one, if not the largest health disparity facing the modern world. Since the 1970’s childhood obesity has tripled, and one in five children today are either overweight or obese (CDC, 2018). Since often children who are overweight or obese start out their early lives struggle with not only health problems such as type 2 diabetes and fatty liver but also depression and body dissatisfaction it has led to a large quantity of adults being overweight or obese (Gibson, et al. 2017).
This epidemic has cost the United States an estimated 190.2 billion dollars from obesity related illnesses (Millan, 2012). If this trend continues and effective programs and policies are not put into place obesity could potentially cost the united states financially, but also socially with children today expected to die at a younger age than their parents (Olshansky, Passaro, et al., 2005). Childhood obesity should be the most concerning health disparity facing the twenty first century, because it’s not slowing down, and its doing irreversible damage.
References
- Allen, K., Zubrick, S., Byrne, S., Gibson, L., Blair, E., Davis, E., … Byrne, S. M. (2017). The psychosocial burden of childhood overweight and obesity: evidence for persisting difficulties in boys and girls. European Journal of Pediatrics, 176(7), 925–933. https://doi-org.ursus-proxy-7.ursus.maine.edu/10.1007/s00431-017-2931-y
- Andrews, M. M., & Boyle, J. S. (2016). Transcultural concepts in nursing care. Philadelphia: Wolters Kluwer.
- Armstrong, S. C., Wacker, J., Best, D., & Mcpherson, M. E. (2011). Fighting childhood obesity: resources to help the community pediatrician curb this epidemic. Contemporary Pediatrics, 28(2), 40–51. Retrieved from https://library.umaine.edu/auth/EZProxy/test/authej.asp?url=https://search-ebscohost-com.ursus-proxy-7.ursus.maine.edu/login.aspx?direct=true&db=rzh&AN=104827778&site=ehost-live
- Covic T, Roufeil L, & Dziurawiec S. (2007). Community beliefs about childhood obesity: its causes, consequences and potential solutions. Journal of Public Health, 29(2), 123–131. Retrieved from https://library.umaine.edu/auth/EZProxy/test/authej.asp?url=https://search-ebscohost-com.ursus-proxy-7.ursus.maine.edu/login.aspx?direct=true&db=rzh&AN=106164618&site=ehost-live
- CDC. (2015, July 08). Healthy People 2020: Oral Health Objectives. Retrieved from https://www.cdc.gov/oralhealth/healthy_people/index.htm
- CDC. (2018, January 29). Healthy Schools. Retrieved from https://www.cdc.gov/healthyschools/obesity/facts.htm
- Delva J, O’Malley PM, & Johnston LD. (2007). Health-related behaviors and overweight: a study of Latino adolescents in the United States of America. Revista Panamericana de Salud Publica, 21(1), 11–20. Retrieved from https://library.umaine.edu/auth/EZProxy/test/authej.asp?url=https://search-ebscohost-com.ursus-proxy-7.ursus.maine.edu/login.aspx?direct=true&db=rzh&AN=106151773&site=ehost-live
- Gibson, L. Y., Allen, K. A., Davis, E., Blair, E., Zubrick, S. R., & Bryne, S. M. (2017, May 24). The psychosocial burden of childhood overweight and obesity: Evidence for persisting difficulties in boys and girls. Retrieved from https://onlinelibrary-wiley-com.ursus-proxy-7.ursus.maine.edu/doi/pdf/10.1111/ijpo.12292
- Millan, A. (2012). What Is the National Association of Hispanic Nursing Doing About Obesity in Children? The Muevete USA[TM] Project. Hispanic Health Care International, 10(3), 106–108. Retrieved from https://library.umaine.edu/auth/EZProxy/test/authej.asp?url=https://search-ebscohost-com.ursus-proxy-7.ursus.maine.edu/login.aspx?direct=true&db=rzh&AN=108151973&site=ehost-live
- Min, J., Xue, H., & Wang, Y. (2018, August 15). Association between household poverty dynamics and childhood overweight risk and health behaviours in the United States: A 8‐year nationally representative longitudinal study of 16 800 children. Retrieved from https://onlinelibrary-wiley-com.ursus-proxy-7.ursus.maine.edu/doi/pdf/10.1111/ijpo.12292
- Nauta C, Byrne C, & Wesley Y. (2009). School nurses and childhood obesity: an investigation of knowledge and practice among school nurses as they relate to childhood obesity. Issues in Comprehensive Pediatric Nursing, 32(1), 16–30. https://doi-org.ursus-proxy-7.ursus.maine.edu/10.1080/01460860802610186
- Olshansky, S. J. et al. (2005, March 17). A Potential Decline in Life Expectancy in the United States in the 21st Century | NEJM. Retrieved from https://www.nejm.org/doi/full/10.1056/NEJMsr043743
- Piontak, J. R., & Schulman, M. D. (2016). School Context Matters: The Impacts of Concentrated Poverty and Racial Segregation on Childhood Obesity. Journal of School Health, 86(12), 864–872. https://doi-org.ursus-proxy-7.ursus.maine.edu/10.1111/josh.12458
- Saxe JS. (2011). Promoting healthy lifestyles and decreasing childhood obesity: increasing physician effectiveness through advocacy. Annals of Family Medicine, 9(6), 546–548. Retrieved from https://library.umaine.edu/auth/EZProxy/test/authej.asp?url=https://search-ebscohost-com.ursus-proxy-7.ursus.maine.edu/login.aspx?direct=true&db=rzh&AN=104598146&site=ehost-live
