Childhood_Obesity

[pic] Alma Salley-Rumph Healthcare Economics HS544 Professor Walter Howell Keller Graduate School of Business December 07, 2010 Executive Summary Despite steady progress over most of the past century toward ensuring the health of our country’s children, childhood obesity is an epidemic that has taken over and is it growing like wild fire in the 21st century. This epidemic is occurring in boys and girls in all 50 states, in younger children as well as adolescents, across all socioeconomic strata, and among all ethnic groups though specific subgroups, including African Americans, Hispanics, and American Indians, are disproportionately affected. At a time when we have learned that excess weight has significant and troublesome health consequences, we nevertheless see our population, in general, and our children, in particular, gaining weight to a dangerous degree and at an alarming rate. Obese children can grow into adults that suffer from heart diseases, cancers, diabetes, high blood pressure, joint and muscle pains, psychological issues, and sleep apnea. The increasing prevalence of childhood obesity throughout the United States has led policy makers to rank it as a critical public health threat. Over the past three decades, its rate has more than doubled for preschool children aged 2 to 5 years and adolescents aged 12 to 19 years, and it has more than tripled for children aged 6 to 11 years. At present, approximately nine million children over 6 years of age are considered obese. These trends mirror a similar profound increase over the same approximate period in U.S. adults as well as a concurrent rise internationally, in developed and developing countries alike. Childhood obesity involves immediate and long-term risks to physical health. For children born in the United States in 2000, the lifetime risk of being diagnosed with diabetes at some point in their lives is estimated at 30 percent for boys and 40 percent for girls if obesity rates level off. Young people are also at risk of developing serious psychosocial burdens related to being obese in a society that stigmatizes this condition. There are also considerable economic costs. The national health care expenditures related to obesity and overweight in adults alone have been estimated to range from approximately $98 billion to $129 billion after adjusting for inflation and converting estimates to 2004 dollars. Understanding the causes of childhood obesity, determining what to do about them, and taking appropriate action require attention to what influences eating behaviors and physical activity levels because obesity prevention involves a focus on energy balance. Although seemingly straightforward, these behaviors result from complex interactions across a number of relevant social, environmental, and policy contexts. U.S. children live in a society that has changed dramatically in the three decades over which the obesity epidemic has developed. Changes such as both parents working outside the home, longer work hours by both parents, changes in the school food environment, and more meals eaten outside the home, together with changes in the physical design of communities often affect what children eat, where they eat, how much they eat, and the amount of energy they expend in school and leisure time activities. Other changes, such as the growing diversity of the population, influence cultural views and marketing patterns. Use of computers and video games, along with television viewing, often occupy a large percentage of children’s leisure time and potentially influence levels of physical activity for children as well as for adults. Many of the social and cultural characteristics that the U.S. population has accepted as a normal way of life may collectively contribute to the growing levels of childhood obesity. In this paper I hope that we as parents, teachers, business people, and those in the medical industry will gain an understanding of the problem that is robbing our children of living a healthy life. As a nation we must do whatever we have to do to help our children grow and mature to be healthy living adults that are free of diseases brought on by not eating the proper diets and getting the proper exercise. Together we can all do our part to develop a comprehensive obesity prevention strategy or program that is essential to reducing childhood obesity in the United States. Problem/Issue Statement Over the past 30 years childhood obesity rate has tripled in the United States. Today nearly one out of every three children is obese or overweight. Many of these children will grow up to be obese adults that will suffer from high blood pressure, cancer, asthma, and other health related problems. During the past ten years, obesity in the United States has doubled, and one in six children are obese or overweight. Due largely to this health crisis, we now have a generation of children with a projected life expectancy that is much shorter than that of their parents. Kids today live a very different life than we did twenty five years ago. Children that grew up in the seventies and eighties walked to school, they had more time in their gym classes, watched very little television, had more time for recesses, and children enjoyed riding their bikes after school, and played for hours after school. Meals were home cooked and children ate smaller reasonable portions. Many of the home cooked meals consisted of a meat, vegetable, rice, potatoes, bread, milk or water and maybe a desert. The thought of eating out was something that was done on very special occasions; or not at all. I remember as a young girl going to McDonalds for the first time; I was 10 years old. Nowadays children start going to McDonalds as early as 2 years old and many can pick the “golden arches” out while they are riding along. But in today’s the walks to school have been replaced by car rides to school or school buses, children spend more afternoons with their video games, or watching television. Many families do not eat dinner together and families eat out more today, texting is the new way of communicating amongst children and teenagers, no more telephones or actually talking with someone face to face, and many children nowadays spend a huge amount of their time on the internet and on social networking sites, such as Face book. Many of the households hare headed by single parents and many parents are too busy to prepare home cooked meals. Today children eat between three to five snacks a day, compared to kids from twenty five years ago, who only ate one snack a day and that was mainly after school. Another problem for children nowadays is the portion size has increased and this alone can add calories and more weight. The food portion sizes are five times bigger than they were 30 years ago and it is the norm for children to want and to eat the large portions. In this paper I will address the issues with childhood obesity define what is childhood obesity, signs and symptoms, medication interventions, and future directions of treatment and the many ways we get child back to eating healthier, exercising and living longer lives as adults and stopping childhood obesity in America. Literature Review Childhood and adolescent obesity is a problem that impacts members of all races and socioeconomic groups. It is not an issue that is only for one race, sex or nationality of people; it does not discriminate. But the high numbers of children that are obese are in certain nationality or race of people. In article titled, “The Crisis of Childhood Obesity: What You Can Do'”, written by Dr. Tiffany C. Rush-Wilson, she writes about this major issue and how it has taken a huge growth over the past two decades. In her findings she reports that over the last two decades the number of children and teens with obesity (ages two to eighteen) increased nearly 300%, with the number of overweight African-American and Hispanic/Latino children increasing dramatically and disproportionately. In this group there are nearly one-fourth of children that are overweight (www.cdc.gov). According to the Center of Disease Control childhood and adolescent obesity rates are higher in Georgia than in the United States (www.cdc.gov). The disparities in Georgia are very similar to those children that are across the United States. Children who are minorities and from rural areas are more like to be obese. And when taking a look at the statistics of obesity in children and adolescents in the United States, 18.8 percent of 6 - 11 year old children are obese, 17.4 percent of children ages 12-19 are obese (www.cdc.gov). Childhood obesity is associated with many different health related problems and issues. They may experience health risk and may be at risk for other health related problems as adults. Obesity in children and adolescents are psychosocial. Many obese children are discriminated against at an early age and can be targeted for bullying, low self-esteem, having a lack of social skills, and can hinder academics; these issues can persist into adulthood. Studies have shown that obese children and teens are at a high risk for heart diseases including high cholesterol levels, and high blood pressure. Obese children can also have other health issues that are associated with their obesity including asthma, some cancers, sleep apnea and Type 2 diabetes. According to a report on Childhood Obesity Statistics in Georgia in the cost and economics impacts of childhood obesity; overweight and obese children have significantly higher outpatient medical expenses than a child that is at a healthy weight. And here in Georgia, adult obesity attributable medical expenditures totaled $2.1 billion dollars per year from 1998-2000, with $405 million from Medicare and $385 million from Medicaid populations (www.georgia.gov). But what can parent, government, schools and the community these children grow up in do about helping them to live healthier lives' This is the question that has gotten the attention of first lady Michelle Obama and she is addressing the issue by getting on the trail of getting rid of childhood obesity in America. In an interview that she did earlier this year with Good Morning America hose Robin Roberts (www.abc news/GMA.com). The first lady told Robin, her goal is to eliminate the problem of childhood obesity in a generation. According to Michelle Obama, many Americans should want their kids to face a different and more optimistic future in terms of their lifespan. Problem Analysis There are many reasons why children in America are more obese than children that are in other countries. Some are inherited, poor eating habits, environmental causes and some children are just lazy and would rather watch television than ride their bikes, exercise, walk, or play outside. Children in America are obese because of many reasons (1) The average American child spends a significant percentage of leisure time watching TV, surfing the internet, or playing computer games. Few calories are burnt by just laying around on the couch watching television. Let the truth be told, American children and teenagers just do not get enough exercise to burn off the calories they intake. Not surprisingly, obesity rates are higher among children and teenagers who frequently watch television. Also, there is only a small minority of children who regularly participate in after school sports or extracurricular physical activity.  (2) Snacking is a probable cause of obesity in children and teenagers. Americans are estimated to spend over $1 billion dollars a day on snacks. The average American eats the equivalent of a fourth meal every day. And children are no exception. Most of the snacking takes place at school by high calorie snack vending machines dispensing sugary soft drinks; regular television watching exposes the child to a battery of high energy snack foods and drinks. Many children and teenagers do not eat the recommended daily intake of fresh fruit and vegetables, grains, lean meats, nuts and water. (3) Children consume too much of fast food is another probable cause of children and teen obesity. In 1992, children aged 6-14 years ate in fast food restaurants on average 157 million times a month. Children are targeted by too many fast food chains, who promote super size portions and all-you-can-eat offers. (4) It's difficult to separate genetic from family environmental factors as causes of childhood obesity. Although children of obese parents are estimated to have a likely chance of becoming obese themselves, part of this increased risk of obesity is probably due to eating habits and poor family nutrition, rather than heredity. Parental behavioral patterns concerning shopping, cooking, eating and exercise have an important influence on a child's energy balance. Obesity in a child or adolescent may also be encouraged by a distorted body image, due to peer pressure, parental influence; including attitude of parents to weight loss and dieting. And (5) Genes plays a huge part in obesity in children and teens and the number of weight related chemical processes in the body. Metabolic rate, blood glucose metabolism, fat-storage, hormones, are all influence genetic inheritance. Even though some genes do have an effect on the weight of a child, but they do not account for the sudden high rate of childhood obesity, or the rise in teen obesity. Solutions and Implementations Statistics have shown that over the past 25 to 30 years, childhood obesity has tripled. The Center for Disease Control reported, currently 12.5 million American kids ages 2 to 19 years old are obese. Also there are 16.5 percent more of American kids are at risk for becoming overweight if something is not done about their eating habits, physical activity, and making them aware of the many dangers childhood obesity can cause as they get older. But we have to come up with a solution to this big problem, which keeps getting bigger and bigger every day. This is the responsibility of the parents, kids, schools, state and federal governments. Many families can make three simple changes to help their kids maintain a healthy weight. First lady Michelle Obama is doing her part and is trying to get everyone in America involved. About ago Michelle Obama began a national conversation about the health of America’s children when she pitched the first shovel on the ground of the White House Kitchen Garden. Mrs. Obama has made it her goal to solve the challenge of childhood obesity within a generation so that children born today will reach adulthood at a healthy weight. With childhood obesity being a huge problem in America it puts the physical and emotional health of an entire generation and the economic health of an entire generation and the economic health and security of our country at stake. Michelle Obama has been on a nationwide campaign titled, Let’s Move, to bring more awareness of the obesity problem in Americas’ children. She is taking the campaign to the public and private sector, schools, families, and communities, letting everyone know that simple tools that can help kids be more active and eat better and get healthy. Mrs. Obama is being joined by members of Congress, governors, mayors from across the nation, students, leaders, sports industry, entertainment, and the business communities to help fight against childhood obesity. Even President Obama has joined the efforts by signing a memorandum that has created the first ever taskforce on Childhood Obesity. The government has taken big steps in making sure that other agencies are doing their part in making parents and children aware of what is in food. By the end of 2010 there will be a few changes that will help parents with better food choices for their families (Chappell, 2010). • At the end of 2010 the Food and Drug Administration, retailer and manufacturers to adopt nutritionally solid and consumer friendly labels on the front of packages. • The American Beverage Association and its members will place a clear, front of the package calorie label on all can and bottled drinks. • The American Academy of Pediatrics has joined the medical community in educating doctors and nurses across the country about obesity; and ensure that they monitored the BMI of all children when they have a doctors’ visit, and for the first time, they would write a prescription for parent informing them of simple things they can do to increase healthy eating and exercise or physical activity. • To help people with making healthier eating and physical activity choices, the U.S. Department of Agriculture have created the Next Generation Food Pyramid. • Children consume as much as half of their daily calories at school. Over the next 10 years the administration has planned to invest an additional 10 billion. Starting in 2011 this money will help to improve the quality of the National School Lunch and Breakfast Programs. This will put more fruits, vegetables, whole grains and low fat dairy products will be served in school cafeterias (Chappell, 2010). Justifications When First Lady Obama sat down with Ebony Senior Editor Kevin Chappell to discuss her war on obesity, what the Obama administration, and parents can do to help the children of America live healthier lives, eat a well balanced meal, and exercise she let us know she learned these lessons as a little girl growing up on the Southside of Chicago. In the interview, Mrs. Obama said, as a child she played many games outside, jumping rope, chase, handball, running, riding her bike and just simply having to walk to and from school (Chappell, 2010). And she did this every single week day and the weekends. According to Mrs. Obama, her family lived on the third floor of an apartment building and had to walk three flights everyday this was her one of her forms of exercise. In those days children walked where ever they had to go, they played outside until the street light came on. Even though she is aware that many of the neighborhoods where children grow up today are more dangerous than when she was growing up. She is aware that many parents today are afraid to allow their children to play in the park, ride their bikes, or to play outside without parental supervision. Schools around the country are not meeting the national recommendation of 60 minutes a day for children to exercise and many have cut out recess all together. But what many educators do not understand is, if children do not get the break and exercise that is much needed, they will be stressed, agitated, have short attention spans and could be labeled as being a problem child or a child that need medication, such as Ritalin to calm him/her down. Children that consume too much sugar and not enough fresh fruits and vegetables become tired early during the day and have the desire to sleep and will not be able to complete their class work. The solutions this problem that many parents are facing must become important to everyone from, government (state and federal), schools, doctors, nurses, parents and every business that has anything to do with food, beverages and the health of children. By the Obama administration taking the initiative in making everyone aware of obesity in children in America, those that are responsible will have to rethink their methods of catering to the child that watches cartoon every Saturday. By making it a priority, the Food and Drug Administration, retailer and manufacturers have adopt nutritionally solid and consumer friendly labels on the front of packages is a great step in helping parent make better choices when shopping for their families by placing clear nutrition labels on the front of soft drink and drinks sold in a vending machine. Many children consume as much as half of their daily calories at school. Over the next 10 years the Obama administration will invest an additional 10 billion. Starting in 2011 this money will help to improve the quality of the National School Lunch and Breakfast Programs, this will put more fruits, vegetables, whole grains and low fat dairy products will be served in school cafeterias. Conclusion In conclusion, childhood obesity is not just a problem that parents will have to be responsible for, but for the entire nation to help children live healthier lives. By developing a strategic plan to wipe out childhood obesity in America, we all must do our part by increasing the amount of exercise our children get, helping our children to eat healthier school lunches, dinners and snacks, placing labels on products so that parents will know the amount of calories their children are eating at one seating. Also the fast food industry must do their part by decreasing their super-size menu and expose the nutrition information on each French fry, hamburger, kid meal, desert and soft drink they sell. Until we all band together to tackle this problem children will grow into adults that have a weight and health issue well into their adulthood. References Chappell, K. (2010). Ebony Magazine. The First Lady’s Ware on Childhood Obesity, p. 82-83. Rush-Wilson, Tiffany C. (2010). The Crisis of Childhood Obesity: What You Can Do' http://www.georgia.gov. Childhood Obesity in Georgia. Retrieved November 20, 2010. https://www.cdc.gov. Childhood Obesity Statistics Retrieved November 15, 2010. http://abcnews.go.com/GMA/Health. Interview with First Lady Michelle Obama on Childhood Obesity. Retrieved November 17, 2010.