Sandra Nwugo

Stevenson University

07/22/16

Childhood Obesity In Baltimore City a Global Health problem

This paper was prepared for NURS 424 Community Health Nursing, taught in Summer 2016, 8W.

Abstract

Due to the grave public health consequences of being overweight, obesity is considered to be one of the most serious public health challenges of the 21st century. Over the past five decades, the global prevalence of obesity has increased substantially, with an estimated 200 million children projected to be overweight (World Health Organization [WHO], 2012). Using Baltimore city as a yardstick, this paper will define what obesity is, its statistical prevalence, contributory factors, and health consequences of being overweight. Additionally, this paper will discuss the roles public health nurses can play in countering and preventing obesity among children in Baltimore City, Maryland, USA. Furthermore, this paper will shed light on the ethical considerations and that she (a public health nurse) can come across in the event of employing these strategic options in the management of obesity among children. In conclusion, this paper will propose nursing-centered solutions to the problem of childhood obesity in the context of Baltimore city.

So, what exactly is obesity? According to the National Association of School Nurses (NASN) (2013), obesity is a condition where an individual has excess body fat to a point that it might have negative effects on their health. Obesity is a disease that is defined by environmental (external) and internal factors that make it hard for someone to control when dieting. You might be wondering how obesity is measured. Well, according to the American Nursing Association (ANA) (2009), there are very many ways of measuring obesity but the most common approach is Body Mass Index. BMI is a ratio of whether someone is a healthy weight for his or her height, and is calculated by dividing an individual’s weight in kilograms by his or her height in meters squared. An individual with a BMI of 30 or more is thought to be too “heavy “for his or her height and is therefore considered obese. The weight is renowned to be amplified by excessive body fat (ANA, 2009). With the current public health challenges attributed to the growing occurrence of childhood obesity in Baltimore, health professionals, governments, and communities are investing much of their time and resources in trying to coin solutions to the epidemic. All these healthcare stakeholders are enthusiastically engaged in the management of childhood obesity in Baltimore. Notwithstanding the efforts wielded by all the different stakeholders, a public health nurse is the major player because she has the aptitude to assess the health needs of overweight kids, develop interventional policies, and provide assurance that everything will be okay.

Childhood Obesity Prevalence in Baltimore City

In this section, this paper will closely look at the prevalence of obesity. A report released by World Health Organization (WHO) (2010), showed that in Baltimore city, one in four children aged 6-12 is either overweight or obese. One in three of Baltimore’s children live below the federal poverty line, with more than 32% of Baltimore households earning less than 30,000 dollars a year. In the same report, the obesity rate among children aged 6 to 12 was reported to have increased to 15.1% from 11.5% in the previous year which had increased from 2008. It becomes apparent that the incidences of obesity are intensifying in Baltimore City. These figures are an indication of the fact that the overweight trend is going up in this city. Unlike other lifestyle ailments, obesity cuts across all ethnic backgrounds, races and ages. Unlike other lifestyle ailments, obesity cuts across all ethnics, races and ages. However, there is a slight disparity in prevalence regardless of its manifestation across all races. In Mexican American male children aged 6-12 years, the prevalence of obesity increased from 12.1% to 17.9% between 1985 and 2000, unlike in African American male children in the same age that experienced an increase to 17.5% from 13.3% in the same period (WHO, 2010). As indicated by the Obesity Action Coalition (OAC) (2016), the 2012 Baltimore City obesity prevalence in non-Hispanic whites was 28.2%, compared to 42.1% in non-Hispanic black children. Generally, blacks see more cases of children obesity, followed closely by Mexicans, and finally Americans. Even if obesity is a disease that cuts across all races, ethnics, and ages, it does radiate some slight disparity in occurrence.

Contributory factors

Obesity is a disease that has both internal and external causal factors. An example of an internal contributory factor is genetics. Some individuals develop obesity as a result of digestive disorders or hormonal discrepancies that are passed down to subsequent generations. Above and beyond internal factors, Gayle (2010) argues that external factors are the major contributory components to the development of obesity. Gayle continues to clarify that studies showed that 82% of the daily food consumed by preschoolers in low income families comes from fast food stores, and not healthy food stores and restaurants. These impoverished families are used to ingesting canned foods that are unhealthy for daily consumption. For this reason, these children frequently consume unhealthy foods that potentially increase their susceptibility to the development of life threatening diseases like obesity. According to Flegal, Carroll, and Ogden (2010), poverty often comes in three dimensions: Inadequate food supply, reduced quality of food, and potential for hunger. The combination of these dimensions of poverty is what pushes the impoverished families into irregular feeding habits that predispose their children to the development of obesity. Unhealthy eating is certainly not limited to impoverished families. For those that are privileged enough, indulgence in the consumption of foods rich in sugar and saturated fat greatly contribute to the development of obesity (Flegal et al., 2010). Therefore, the sedentary lifestyle of privileged families also plays a crucial role in the progression of being overweight. Obesity has a many causative factors, categorized into internal and external aspects.

Health Consequences of Obesity in the Body

The deposition of excess body fat raises health concerns in the body. According Stanhope &amp Lancaster (2016), an overweight individual is exposed to the risk of developing more complex health conditions. Some studies have indicated that an overweight child stands greater odds of developing cardiovascular system disorders. As a result of the excessive body fat, the thickness of the blood vessels supplying the body with blood and oxygen is reduced. In addition to this, as Gayle (2010) observes, the elasticity of blood vessels is impaired, making it tougher and harder for the heart to pump blood through them. What results is heart a complication, since the heart is pumping harder to get blood circulated through the body of an obese individual. This leads to a condition known as hypertension, which is one of the most common health consequences among overweight individuals.

Over and above cardiovascular diseases, there are other body organs that are affected by the deposition of excessive body fat. The kidney and lungs are examples of body organs whose normal functions are affected because the normal flow of oxygen and blood is significantly “cut.” Furthermore, the irregular and centralized distribution of fat to the upper body is associated with the onset of type II diabetes mellitus. This has been attributed to the interference of the hormones that break down sugar in the human body. According to Enggist et al. (2014), obesity interferes with the normal functioning of hormones far beyond those regulating sugar. The metabolism of lipids and proteins is also inhibited, causing hyperlipidemia and lipodystrophy for instance. Thus, obesity also affects the normal functioning of the digestive system. As a chain reaction, the interference of the metabolism and distribution of lipids, proteins, and other nutritional constituents potentially increase the odds of an overweight child to developing bone and muscle problems (WHO, 2010). Also, overweight children are at greater risks of developing peripheral artery disease, stroke, obstructive sleep apnea, pulmonary disease, coronary artery disease, dysmenorrhea, depression, and eating disorder among many more ailments (The Health People, 2013). The deposition of excessive body fat has many negative health consequences on the body, ranging from cardiovascular ailments to the interference of the normal functioning of other body organs like the kidney and lungs.

Role of a Baltimore City Community Health Nurse in Countering Obesity

In this section, this paper will discuss the roles of a community health nurse in countering obesity. The WHO (2010) recognizes the need to combine the key concepts of public and personal health, owed to an increase in the number of obesity related ailments among children. And so, it is the role of a nurse within a proactive public system to act in her professional capacity to counter obesity. Stanhope &amp Lancaster (2016) point out three core functions of a public health nurse: Assessment, policy development, and assurance. From this point of perspective, it is the role of a community health nurse to assess the health needs of her patients, develop customized policies for the management of their health needs, and provide assurance to them that the policies will be effective and beneficial in the long-run.

With the help of nutritionists and medical specialists, a public health nurse can assess the health needs of an obese kid by calculating its daily caloric requirements. Since obesity is a disease caused by the imbalance between calories-in and calories-out, a public health nurse will devise interventional strategies envisioned to induce a “balance” between ingested and spent calories. In collaboration with the kid’s family, school community, local leaders, nutritionists, medical specialists, and the government, a public nurse can develop and implement the dietary, physical, or behavioral therapy interventional policies intended to increase the consumption of calories. After successfully employing an interventional strategy, she can collaborate with nutritionists, the kid’s family, and school community to provide assurance to the affected kid that the health interventional strategy will be beneficial in the long run. Thus, the role of a public health nurse in Baltimore city in countering the effects of excessive body fat among children is to assess the health needs of the overweight kids, develop interventional policies, and provide assurance that everything will be okay.

Ethical Considerations of a Baltimore City Community Health Nurse

This section will address the ethical considerations of a nurse while performing her nursing responsibilities. For a public health nurse to effectively execute her contractual obligations, she must be in constant communication with her patients. Recognizing that altering a dieting culture to improve the health of a community is an uphill task, she needs to assess the categories and levels of mediations appropriate for the patient, the family, cultural settings, environment, language, economic status, among many other factors. The relevance and appropriateness of any interventional approach is thus highly dependent on the cultural settings, social class, economic status, among many other family values and standards (NASN, 2013). Hence, she has to make prior ethical considerations of individualized family settings, standards, and values of each overweight patient’s kinfolk so as to avoid unethical instances that may appear as stigmatization or prejudice against certain races, ethnics, or tribes. In a Baltimore city setting, the most prevalent ethical consideration issues a public health nurse would have to consider are cultural settings, family values, and economic status of the overweight children’s kinfolk.

Strategies for a Baltimore City Public Health Nurse to Address Obesity

There are different strategies a community health nurse can employ to address obesity. As pointed out earlier, a fruitful community based intervention for Baltimore city’s overweight children entails the integration of public and public health needs. For that reason, a public health nurse can employ a variety of strategies to bring about the desired changes in dieting behaviors. First, she can counsel families on how to reduce the consumption of foods high in saturated fat, sugar, and salt. Additionally, she can advise families to reduce the consumption of beverages high in sugar, and enlighten them on the advantages of replacing them with fresh vegetables and fruits. She can also canvass for a decreased television viewing time in children and encourage them to take part in physically involving pastime activities instead. Overweight children can engage in healthier activities like non-competitive and competitive sporting events. To further increase physical activity in children, a public health nurse can also advocate for a walk to school over taking a bus. Per se, the potentially overweight children in Baltimore will stand a better chance of burning the excess body fat through daily strolls to school (OAC, 2016). However, as a nurse, she cannot achieve these societal dieting changes single handedly she has to involve the government, parents, teachers, business leaders, students, local leaders, and a broad range of other stakeholders. Distinctly, a public health nurse in the city of Baltimore can use a combination of two or more of these approaches to address obesity in children.

Proposed Solutions

In this context, a Baltimore city nurse can partner with the media to sensitize individuals and create awareness of the manifestation and dangers of childhood obesity in the city through newsletters, advisements, programs, and posters especially in public places. Additionally, she can work closely with school heads to provide guidance on the nutritional needs of school going children. School heads can also be sensitized on the benefits of physical education in the curriculum and health of school going children (WHO, 2012). She can also partner with the WHO and the FDA to institute policies that will significantly reduce the rations of sugar, salt, and saturated fats in foods and drinks accessible to children.

Conclusion

Obesity is a health condition characterized by the accumulation of excessive body fats. Sadly, the global occurrence of obesity is on an upward trend, progressively increasing with each decade. Obesity has many negative effects on the heart, bones, kidney, liver, and other vital body organs. To deter the gradual increase in childhood obesity and its associated health consequences, a community health nurse has pivotal roles to play. With the help of nutritionists and other medical professionals, she can tactically assess the health needs of overweight kids by calculating their daily caloric requirements. In collaboration with a kid’s family, school community, local leaders, nutritionists, medical specialists, and the government, she can develop dietary, physical, or behavioral health interventional policies. Working with families, nutritionists, and school communities, she can provide assurance to overweight children that everything will be okay once the interventional strategies are in play. Hence, a public health nurse is the major player because she has the aptitude to assess the health needs of overweight kids, develop interventional policies, and provide assurance that everything will be okay. A public health nurse is the greatest player in this theatre because she can work with families, health professionals, local leaders, the media, international organizations, and the government to curb the prevalence of childhood obesity in Baltimore city.

References

American Nursing Association. (2009, January 09). Advocating for the Prevention of Childhood Obesity: A Call to Action for Nursing. Retrieved July 19, 2016, from http://nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol142009/No1Jan09/Prevention-of-Childhood-Obesity.html

Enggist, Stefa, Mellers, Lars, Galea Gauden &amp Udesen, Caroline (2014). Prisons and Health. United Nations Office on dug and Crime. 1-207.

Flegal, KM, Carroll MD &amp Ogden, CL. (2010). Prevalence and trends in obesity among US adults. JAMA. 20 (303): 235-41.

Gayle. (2010). Childhood obesity: Treatment or prevention? Childhood Obesity Prevention, 196-202. doi:10.1093/acprof:oso/9780199572915.003.0017

Healthy People. (2013). Nutrition and Weight Status. Retrieved July 19, 2016, from https://www.healthypeople.gov/2020/topics-objectives/topic/nutrition-and-weight-status

National Association of School Nurses. (2013). Overweight Children and Adolescents. Retrieved July 19, 2016, from https://www.nasn.org/PolicyAdvocacy/PositionPapersandReports/NASNPositionStatementsFullView/tabid/462/smid/824/ArticleID/39/Default.aspx

Obesity Action Coalition. (2016). What is Obesity? Retrieved July 19, 2016, from http://www.obesityaction.org/understanding-obesity/obesity

Stanhope, M., &amp Lancaster, J. (2016). Community &ampamp public health nursing. New York: Prentice-Hall.

World Health Organization. (2012). Obesity and overweight. Retrieved July 19, 2016, from http://www.who.int/mediacentre/factsheets/fs311/en/

World Health Organization. (2010). Physical activity and young people. Retrieved July 19, 2016, from http://www.who.int/dietphysicalactivity/factsheet_young_people/en/

ABBREVIATIONS

ANA- American Nursing Association

BMI- Body Mass Index

FDA- Food and Drug Authority

NASN-National Association of School Nurses

OAC- Obesity Action Coalition

WHO- World Health Organization