Childhood Obesity Focused on 6 to 11-Year-Olds in Tyler, Texas
Obesity is associated with a condition of calorific imbalance in which the ratio of consumption of calories consumed and the ones expended is skewed such that the amount of the ones spent is much lower than the amount consumed. The condition is influenced by a range of factors that include genetics, behavioral patterns, and environmental influences. In data availed by the Centre for Disease Control, children between the age of 6 to 11 with obesity condition stood at 7% in 1980 and increased to almost 18% in 2012. In 2014, figures from the Obesity Prevalence Map from the CDC showed that all states had obesity prevalence rates of 20% and above. Three of the states reflected an alarming 35% prevalence in their populations. The state of Texas was rated as having 30 to 35% people with obesity. Two states among the three that had a prevalence of above 35% were from around the state of Texas (in the neighborhood). The aggregate population targeted in this study is all the obese children and overweight children in the eastern part of Texas. Another study, from the Children’s Hospital Association of Texas shows that one in every three children of Texas is either obese of overweight. It also points that almost half of Hispanic Children are obese. The aggregate population targeted here consists of 50% non-Hispanic White people, 23% non-Hispanic Blacks, 22.8% Hispanic and 2.1% non-Hispanic Asians. Generally, the study aims at establishing the overweight and obese cases among children of 6 to 11 years from all races in the Tyler area of Texas. It seeks to establish a partnership based on collaboration between community members and the inter-professional networks so as to address the needs and work to initiate change for the people of the targeted study area.
In short, there is need to address obesity from a two pronged attack points, i.e. nutrition and encouraging people to take part in physical activity.
1. Introduction and Description of aggregate
Obesity is a result of calorific imbalance or very low usage of such calories. It is influenced by genetic, behavioral and environmental aspects (CDC, 2015). Children who develop obesity and/or overweight are likely to carry the problem to adulthood and are more vulnerable to stroke, heart disease, diabetes, some types of cancer and even osteoarthritis. Obesity and overweight are associated with a heightened risk of developing a range of cancers including breast cancer, endometrium, colon, kidney, esophagus gall bladder, pancreases, cervix, ovary, prostate, Hodgkin’s lymphoma and Myeloma (CDC, 2015). As mentioned, this study aims at the aggregate population of children between the ages of 6 to 11 years, in Tyler, Texas area.
Figures from CDC show that the percentage figures for children with obesity and overweight complications increased from 7% in 1980 to 18% in 2012 (CDC, 2015). Overweight means having a Body Mass Index above the 85th percentile and lower than 95%. Obesity, on the other hand is defined as having body weight above the 95th percentile for children of similar age and sex when it is shown on graphic growth charts (Stanhope & Lancaster, 2012). In my research, I discovered that there is no safe or immune state to this condition; yet it is only growing worse with the passage of time. CDC statistics in 2014 reveal that no state showed less than 20% prevalence in obesity or overweight. Three of the states studied showed a prevalence rate of over 35%. Texas was within the 30 to 35 range but two of those above the 35% mark were from the nearby areas. The study focuses on obese and overweight children of the eastern part of Texas. The children’s Hospital Association of Texas shows in a study that one in every three children from Texas are already obese or overweight. The figure highlights that nearly half of Hispanic children are also obese (Arons, 2011). Another alarm bell, in the whole scenario, points to the fact that these children stand over 2/3 risk of maintaining their obese situation beyond 35 years. Obesity treatment cost Texas in excess of $3.3 billion each year. The obese children today are set to multiply the adult obese cases in Texas threefold by 2040. There is also a direct correlation between such expansion and expenditure (Arons, 2011; Stanhope & Lancaster, 2012).
Obesity during childhood enhances the possibility of developing other health complications in childhood and in later years as an adult. The common diseases that affect such children and adults include but not limited to diabetes type II, hypertension, sleep apnea, cardiovascular disease, asthma and osteoarthritis (Gungor, 2014). Glucose intolerance is a common indicator of the onset of the development of type II diabetes and even cardiovascular disease is a common complex condition among children and adults that suffer from long-term obesity. In Diabetes type II, is the cause is insulin resistance. This affects the uptake of glucose. It also comes with glucose intolerance (Reinehr, 2013). Glucose intolerance is common among overweight and obese children.
The constitution of the aggregate population selected is 22.8% non-Hispanics, non-Hispanic Asians: 2.1%, 50% non-Hispanic whites, 23.5% non-Hispanic Blacks (city-data.com, n.d). The city ranked higher than the state in the number of college graduates at 2, 4 and professional levels at doctoral heights. The town of Tyler Texas was only slightly below Texas in the number of people pursuing Masters Programs. The families in the lower income bracket were split into couple and married couple families (27.3%), wifeless males at 19.7%, and females with absent husbands at 53%.
The Median household income in the year 2013 stood at $44,467 and was significantly higher that the states ($51,704) Poverty was notably higher in Tyler standing at 16.8% as compared to the Texas figure that stands at 15.4%(city-data.com, n.d). The adult obesity rate in Texas was slightly higher at 26.7% than the rest of the state.
One out of three children and half of Hispanic children in Texas suffer from obesity or overweight issues (Arons, 2011). Over two thirds of these children are likely to carry their obesity problems into adulthood. This eventuality will place a burden on Texas in terms of resources. Statistical data point at the burden (on healthcare) soaring to 3.3 billion dollars every year. The allocation to Tyler; based on demographics is 50% for non-Hispanic White people, 23.5%, for the non-Hispanic Blacks, 22.8% Hispanic while for non-Hispanic Asians stood at 2.1% (city-data.com, n.d). Tyler was rated higher on the poverty scale. It ranked higher than the rest of the state for obese college graduates. All these figures have a co-relationship with the trends of obesity. Tyler was ranked above average in health matters for cities that were comparable in terms of size but remained behind in some specializations such as pediatric Endocrinology that manages overweight or obese children with a medically related history. The town has a public transport system that operates all routes. However, it is more focused on key thorough-fares in the city. Going off the routes means that one has to seek alternative means (city-data.com, n.d).
Luckily, the school systems and health units in the area have accepted that there is a problem, and have already acted in some way to forestall the epidemic that only seems to grow worse. With a concerted effort from all stakeholders, children in future stand a chance of leading normal lives, as it should be (city-data.com, n.d). Indeed, many schools and colleges have incorporated physical activity programs in their routine and increased the time for these programs. Yet, such adjustment is still considered piecemeal. Tyler ISD has developed a 5-2-1-0 program that points at five fruits a day, 2 or less hours of TV, an hour of physical exercise and total avoidance of sugary foods. Texas developed strategies to prevent excessive expenditures on healthcare programs by enhancing healthcare outcomes. The state developed policies to arrest the runway childhood obesity complication. Three senate bills in the concern were passed over a six-year period. The bill 19 of 2001 showed a minimum physical activity in elementary schools, coordinated school health programs. The state even stated school health advisory councils for physical activity and nutrition. The senate Bill no.42 of the year 2005 increased the minimum physical exercise requirement to incorporate children in mid-school. The bill no 530 of 2007 promoted physical activity programs for children in grade K- 8. It even mandated annual testing for the physical fitness of these children (aerobic capacity, strength, flexibility, body mass index), also referred to as the fitness gram for children of grades 3 to 12. (The mandating of the Texas Department of Agriculture initiated guidelines for nutrition and vending machines for use in schools) (Nyberg, Burns & Parker, 2009).
Description of The Problem and The Rationale
After the 70s, the number of children with obesity and overweight issues increased dramatically across the, racial, age ranges, income and ethnicity. The national obesity rates doubled for children between 2 to 5 and 12 to 19 in the periods 1971 and 1974 and 1999 to 2000 respectively. It tripled for the children between the ages of 6 to 11. There are some indications that childhood obesity has stabilized within the past decade as from 1998, the rate remains extremely high (Nyberg et al., 2009; Green, 2015). Hispanic children have been noted to manifest the highest obesity and overweight rates. Considering the 2007 CDC data, 47% of Hispanic children in Texas suffered from overweight and obesity; as compared to 26% of children of black non-Hispanic background and 23% of white children of Hispanic background. SPAN studies show the same trends. Hispanic boys have the highest rates of obesity among boys of the same age range from other racial and ethnic backgrounds nationally. Black non-Hispanic girls elicited the highest incidence of obesity among girls of the same age. It is worrisome since the number of Hispanic children is rising fast (Skinner & Skelton, 2014).
1.1. Causes of obesity and overweight among 6 to 11-year-olds
There have been many great advances in technologies and conveniences in the past decade in the U.S. These developments have played a part in the increases of obesity. There have been convenience foods and convenient machines. The two have made the fight against obesity a nightmare. People eat foods with lots of calories in the name of convenience and hardly exercise (Skinner & Skelton, 2014). Studies show that reducing physical activity and increasing the calorie consumption is a real cause of obesity and overweight. Statistical data shows that one third of adolescents do not exercise sufficiently; 10% of this lot is very inactive. They tend to reduce physical activity as they grow older (Arons, 2011). The situation may even be worse than what is reported here. Experts have cited the contribution of the physical environment in the incidence of obesity (Skinner & Skelton, 2014). Several factors including busy streets, poor lighting on streets, lack of space and unattended dogs play a role in variedly preventing children and adults from exercising (Green, 2015). Parents influence the binge habits of their children to a great extent. The foods made available, the time they are left on their own and the social situations during eating (Taylor et al., 2012; Wolfenden et al., 2013) all play a role in the incidence of obesity. There are claims that exposing toddlers to complex sugars and fats in feeding bottles affect absogenic factors in babies and consequently make them vulnerable to weight gain later in their life. There is lots of evidence that points to genetic factors as a contributor to obesity. Biological components show a remarkable similarity in body weight trends. It is reported that heredity is responsible for between 5 to 40% of obesity incidence (Green, 2015; Wolfenden et al., 2013).
Excessive intake of calories causes a condition of weight gain, which easily leads to obesity. The interrelationship can be summarized as the intake of calories (the diet) versus the expenditure of the same (physical activity and the rate of metabolism). Nutrition and physical engagements of children within the U.S.A. have been changing over the past 40 years. Research indicates a correlation between such change and the incidence of obesity. The environment, advertising, genetics, socio-economic status, race/ethnicity, family structure may be some of the factors that come into play (Green, 2015; Fleischhacker, Evenson, Rodriguez & Ammerman, 2011. It is not possible to pick out one independent cause since it has been shown that the causes overlap. Owing to the knowledge vacuum, we still cannot pinpoint a single cause of obesity and prescribe the most appropriate way to deal with it in childhood.
Influence, Analysis and Implications
Healthy lifestyle including engaging in physical exercise can enhance one’s health and lower the risk of obesity (Fleischhacker et al., 2011). Tyler has followed in the footsteps resorted to by many other districts in developing programs to bolster wellness and health for all pupils. The program urges all stakeholders to promote the wellness of all students via nutrition education physical activities and activities around the school (City-data.com, n.d). There is already a coordinated wellness and physical activity program for grades across the board. They wish to boost the health of children and cut down on obesity in the district. Texas has also made sure that the nutritional value of foods available to children has been improved. It has also increased the physical activity programs that need exposure for all ages. Obesity does not occur in children quickly at the individual level and cannot, therefore, be reversed quickly. It will take time and concerted efforts before all school programs align to the push everyone to become fit through physical activity an eating healthy foods (Nyberg et al., 2009).
More and more Americans are spending time in their cars running errands that could have easily been executed by walking to some of the destinations. TV sets are a norm for the U.S. home. Indeed, children also have TV in their bedrooms. The Kaiser family foundation reported an exponential increase in the media content usage that stood at 6 hours each day in 1999 but has grown to 7 hours each day in 2009. There were, however, notable differences between the majority and minority youths. The Hispanic and Black youth average about 8 hours’ usage of media. There are many studies that link sedentary lifestyle and a poor activity and physical health. If children’s time with sedentary activities is managed assiduously, there will be a conformance to better health and will lead to a lower body mass index (Tremblay et al., 2011).
Preventing childhood obesity involves exercise and healthy eating habits among children aged between 2 and 19 years. There is need for a holistic approach in arresting the problem of child obesity. This would require community efforts to deal promoting. There is a need of multifaceted approach in solving the crisis to initiate social change. It is recommended, therefore, that obesity prevention efforts should incorporate a range of programs split between the ones based on nutrition and those that touch on physical activity. Traditionally, organizations that work to see that children are physically up to speed, do not work on their nutrition. The converse is true too. Many organizations are also merging their physical activity and nutritional agenda (Nyberg et al., 2009; Arons, 2011).
The organizations that are preoccupied with physical activity and even nutrition pursue three major approaches separately; access, advocacy and direct service educational efforts. Advocacy points to the efforts to influence changes in policy so as to promote such programs as physical exercise and even how foods are produced and supplied to various market segments. It also involves influencing policies that affect land and infrastructural programs. They pursue such initiatives as getting healthy food into the cafeterias of schools. It also involves availing properly constituted food to places where such food is inaccessible. Individual risk factors are addressed through Direct Service programs by enhancing good habits and picking out some socio-cultural norms that relate to physical activity and nutrition. The programs include sports, counseling in primary health care, community gardens or school farming, nutrition and cooking programs (Arons, 2011; Stanhope & Lancaster, 2012). Holistic initiatives as started by organizations that aim at access, advocacy, direct service educational programs to bring about significant change. All the approaches are important. Direct service programs will help to enhance individual longevity, lead to clear gains in their health and show the need for change in policy and the general environment.
In the population of the 6 to 11 years old in Tyler, the population blend is non-Hispanic constituting 50% White, 23.5% non-Hispanic Black, non-Hispanic Asian 2.1%, and Hispanics: 22.8%. A third of the children in Tyler are obese or overweight including half of the children of Hispanic origin. More than two thirds of the children are likely to carry the problems of obesity to adulthood. Such an eventuality places pressure on the financial resources in increased cost of health care now estimated to stand at 3.3 billion dollars every year. A decrease in energy expenditure juxtaposed with constant consumptions of calories is the major cause of obesity in children. Watching TV, playing videos games, using the computer occupy lots of children’s time hence influencing the amount of physical activity they pursue. Lack of physical activity has been cited by experts as a leading cause of obesity in children and adults. Parenting influences affect the feeding habits of their children. It includes what foods parents choose to feed their children. The quantity of time children have to themselves, and their interactions as they eat in social context, all have an effect on the way they eat later in their development.
There is considerable evidence that supports genetic influence as a key contributor to obesity in children. Preventing obesity on children involves encouraging them to eat healthy, and exercise regularly for children of ages 2 to 19. Holistic initiatives by the community will help address the crisis. There is need for policy change and environmental adjustments. Programs to inform people of the need for physical activity and healthy eating and behavior are equally important. Obesity prevention entails a range of programs that are split between nutrition and physical activity
Arons, A. (2011). Childhood Obesity in Texas, The Costs, The Policies, and a Framework for the Future. Retrieved from http://www.childhealthtx.org/pdfs/Childhood%20Obesity%20in%20Texas%20Report.pdf on 28 February 2016.
Center for Disease Control, (CDC). (last updated: June 19, 2015). Childhood Obesity Facts. Retrieved from http://www.cdc.gov/obesity/data/childhood.html on 28 February 2016
City-data.com, (n.d). Tyler, Texas. Retrieved from http://www.city-data.com/city/Tyler-Texas.html on 28 February 2016
Fleischhacker, S.E., Evenson, K.R., Rodriguez, D.A. & Ammerman, A.S. (2011). A systematic review of fast food access studies. Obesity Reviews, 12, 460-71. doi: 10.1111/j.1467-789X.2010.00715.x.
Green, M.J. (2015). Overweight and Obese Children’s Social Interactions and Peer Responses. Master’s Thesis, University of Tennessee.
Gungor, N.K. (2014). Overweight and obesity in children and adolescents. Journal of Clinical Research in Pediatric Endocrinology, 6(3), 129-143. doi: 10.4274/jcrpe.1471
Nyberg, K., Burns, A.C. & Parker, L. (2009). Childhood Obesity Prevention in Texas Workshop Summary. The National Academies Press, Washington, D.C.
Ogden, C.L., Carroll, M.D., Kit, B.K. & Flegal, K.M. (2014). Prevalence of childhood and adult obesity in the United States, 2011-2012. Journal of the American Medical Association, 311(8): 806-814.
Reinehr, T. (2013). Type 2 diabetes mellitus in children and adolescents. World Journal of Diabetes, 4(6), 270-281. Doi:10.4239/wjd.v4.i6.270
Skinner, A.C. & Skelton, J.A. (2014). Prevalence and trends in obesity and severe obesity among children in the United States, 1999-2012. Journal of American Medical Association of Pediatrics, 168(6), 561-566. doi:10.1001/jamapediatrics.2014.21
Stanhope, M., & Lancaster, J. (2012). Public Health Nursing: Population-Centered Health Care in the Community (8 edition). St. Louis, MO. Elsevier
Taylor, A., Wilson, C., Slater, A. & Mohr, P. (2012). Self-esteem and body dissatisfaction in young children: Associations with weight and perceived parenting style. Clinical Psychologist, 16, 25-35. doi:10.1111/j.1742-9552.2011.00038.x
Tremblay, M.S., LeBlanc, A.G., Kho, M.E., Saunders, T.J., Larouche, R., Colley, R.C., Goldfield, G., & Gorber, S.C. (2011). Systematic review of sedentary behavior and health indicators in school-aged children and youth. International Journal of Behavioral Nutrition and Physical Activity, 8 (PDF, 416KB), 98. doi:10.1186/1479-5868-8-98
Wolfenden, L., McKeough, A., Bowman, J., Paolini, S., Francis, L., Wye, & Puhl, R. (2013). Experimental investigation of parents and their children’s social interaction intentions towards obese children. Journal of Paediatrics and Child Health, 49(7), 604-607. doi:10.1111/jpc.12285
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