California Policy against Childhood Obesity - Essay Example

CALIFORNIA FIGHT AGAINST CHILDHOOD OBESITY: A HEALTH AND HUMAN RIGHTS ASSESSMENT [First Name and Last Name] Table of Contents Introduction While the state of California continues to register modest gains in the fight against childhood obesity, the California Department of Public Health considers obesity a major health challenge, especially among underprivileged children. In the illustration, low-income children between 2-4 years of age report a 17.2% prevalence rate, while children between ages 5 to 19 reported a 23.3% obesity prevalence rate, exceeding the targets stipulated by the Healthy People targets for California residents (California Department of Public Health, 2014). While progress is visible, there exist disparities in obesity rates with respect to factors such as race, ethnicity, socio-economic factors, and geographical factors. Childhood obesity is of specific importance since it predicates adult obesity, with obesity being linked to an increased risk for health conditions and a preventable death. The conditions associated with obesity, include coronary disease, a variety of cancers including coronary cancer, and reproductive health issues. Obesity affects the population disproportionately, where low-income children between the ages of 2-19 of varying ethnicities, as well as youths aged 9-11 suffered more instances of obesity in comparison to higher income Californians (California Department of Public Health, 2014). The high prevalence rates of childhood obesity are not only limited to the American population but also affects other developed and developing countries globally. The statistics, however, differ, with first world countries showing a decreasing trend in obesity rates, while second and third world countries are reporting a drastic increase in obesity rates. According to statistics released by the World Health Organization, the period between 1990 and 2013 saw obese children in developing increase by 5 million, which was 30% higher than the increase rate in developed countries (World Health Organization, 2014). These statistics have prompted the development of an action plan targeting all countries, with the main aim of the strategic plan being the global control and prevention of non-communicable diseases. One of the major strategies in the action plan is the reduction of childhood obesity rates globally (World Health Organization, 2014). The other international organization that has introduced initiatives to deal with the high rates of obese children is the European Union. The EU policy aims at reducing childhood obesity rates in all European countries by introducing intergovernmental policies and investigating and addressing the root causes of the increase. The high rates of overweight children in the American and global population have prompted the need for community-based health policies that aim at reducing childhood obesity at a community level. This paper entails an assessment of human rights and health issues surrounding the childhood obesity pandemic, which will allow the identification of recommended interventions including development and amendment of policies, enhanced surveillance, and monitoring; therefore, inform on a policy intended to reduce childhood obesity -income rates among low-income children in California. Determining Unmet Needs of Obese Children The obese populations rank among the most underserved population in the global health landscape. The limited number of therapies and the increased risk of complications as a result of therapies aimed at treating obesity ranks as among the main reason why obese individuals remain globally underserved. Although there exist various conventional therapies including behavioral counseling, exercise, and diet, the only FDA approved therapy is bariatric surgery. According to Nguyen et al. (2012), bariatric surgery has the highest degree of long-term success in ensuring weight loss among obese individuals, as compared to other therapies which have been characterized by long-term failure. However, a very small fraction of obese patients seeks treatment using bariatric surgery due to complications likely t result after the surgery. Bariatric surgery is also limited to certain groups of the obese populations, with over-obese individuals and people with a low BMI being required to undergo other procedures before the surgery (Nguyen et al., 2012). Bariatric surgery is also quite expensive, which is another factor resulting in the reduced popularity of the procedure among middle and low-income families due to the inability to access the treatment. Kuo, Etzel, Chilton, Watson, and Gorski (2012) explained the lack of medical insurance to be the main cause of health disparities between non-poor and poor children in the American population. Programs intended to address obesity among children from low-income families should aim at being cost friendly; therefore, affordable to all individuals. Rather than relying on therapeutic treatments which are expensive, programs should aim at changing the diet and eating behaviors, as well as increased physical activities among obese children. Human Rights, Unmet Needs, and Social Epidemiological Profiles The Californian population ranks as one of the most racially diverse with the population comprising of Hispanics, African Americans, Asians, and white Americans. Of these populations, children from African American families report the highest cases of obesity with white children being the least affected by obesity. Obesity among individuals of African American descent is largely as a result of genetic and family factors. Instances of poverty are also to blame for the high rates of obese black children in California. Childhood obesity as a result of poverty and low-income is highest in the Hispanic, Alaskan and Native American populations. Children between 5-19 years account for the highest percentage of obese individuals among low-income Californian families, with Pacific Islander children having the highest obesity prevalence rates due to low-income (California Department of Public Health, 2014). This epidemiological profile reveals the main cause of obesity in California to be poverty. The diet in low-income families is limited to few cheap meals, which are mainly unhealthy; therefore, the main reason for the high obesity rates among children from low-income backgrounds. Low-income families also lack medical insurance; therefore, children from low-income families do not have equal access to medical care; therefore, illustrating a violation of children rights. Social Epidemiological Profile for Obese Children in California A social epidemiology profile highlights the social structural factors within a society in relation to their states of health. In California several variables are existent which predisposes sections of the target population to obesity. Obesity Indicators for Low-income Children in California Race/Ethnicity as an indicator for obesity Among adolescents aged 12 to 17, African American children report the highest rates of obesity at 28.6% with Hispanic children coming in second at 19.7%, irrespective of gender. The two groups exceed the aimed 16% obesity levels by the healthy people 2020 initiative. Low-income Obesity levels for low-income children in California for the year 2010 were higher than the Healthy People 2020 targets of 9.6 and 14.5 for age groups 2-4 years and 5-19 years respectively. Low-income obesity is highest among Indian-Americans, Hispanics, and Pacific Islanders. However, Asian children reported average obesity rates that were lower than the state target of 14.5% at 12.6% obesity rates (California Department of Public Health, 2014). State targets for obesity prevention Breastfeeding While breastfeeding is demonstrated as having a preventive effect against obesity, only about 27% of all California infants achieve the recommended six months of exclusive breastfeeding. It is imperative that infants suckle exclusively for six months, in addition to at least a year of breastfeeding and complementary foods. Dietary habits Adequate servings of fruits and vegetables increase nutrient intake as well as boosting immunity in addition to general wellbeing. Children between 2-5 years reported 60% consumption of five or more servings of fruits and vegetables, while the percentage falls to 48% for children aged 6-11 years of age (Geels, 2015). Promotion of the consumption of vegetables as well as fruits among children serves to reduce the obesity levels suffered by the target population. Sugar-sweetened beverages increase the risk of obesity, with available data showing a correlating increase in consumption of sweetened beverages to age. 2-5-year-olds consumed sweetened beverages at a rate of 4.4%, 7.5% for teenagers and adults reported a 29.5% rate of sweetened beverage consumption. Fast food is a major factor in California, where 63.6% of adults, 64.7 of young children as well as 69% of school going children concede to consuming fast food each week. Adolescents represent the largest consumers of fast food, with over ¾ of the adolescent population affirming to have consumed fast food each week. Physical activity Most Californians fall under the recommended physical activity guidelines, where 45% of children between 2-5 years meet the guidelines, 30.4% for children aged 6-11, while only 16.1% adolescents attained the recommended activity levels (California Department of Public Health, 2014). Adults report improved activity with a quarter achieving recommended activity levels. Assessment of International and National Laws and Policies The global childhood obesity crisis has been escalating over the past four decades, with non-commensurate actions taken in its prevention. Childhood obesity is among the non-communicable diseases identified as a principle area for global public health action. The World Health Organization (WHO) action plan earmarks policy interventions a central in mitigating risk factors for obesity. Intended policy interventions target changes in environments fostering the advancement of obesity. Additionally, WHO recognizes the potential of policy interventions in reaching various sectors of the community, such as the socio-economically disadvantaged who suffer inconsistently high level of obesity, especially in the middle and high income countries. In the field of obesity, the WHO Global Strategy on Diet Physical activity and Health remains a single most significant release. Crucially, the document was prepared through the input of member state, UN agencies as well as other stakeholders, and narrows down to diet and physical activity as the two major risk variables predicting obesity. Summation of the Global Strategy relates to the advancement and fortification of health through oversight of the creation of an empowering environment towards reduction of obesity. Recommendations range from national to regional principles of actions as well as responsibilities for every involved stakeholder. In Europe, the European Charter on Counteracting Obesity acts as the policy document guiding obesity reduction, where respective health ministers take commit to the prioritization of obesity in the political agenda within their respective countries. Similar to WHO recommendations, the European recommendations also focus on nutritional and physical activity interventions in the management of obesity (Dekker, 2011). Similarly, California employs related initiatives in activities aimed at reducing childhood obesity, such as encouraging uptake of physical activity, as well as offering guidelines on improved nutrition within the State. California obesity mitigation plan seeks state, local, and community establishment cooperation in the improvement of the health of all Californians. Additionally, the plan is guided by the CDCs identified target areas in mitigating this problem, including an increase in fruit and vegetable intake, physical activity, support for breastfeeding, reduced consumption of sugar sweetened soft drinks, junk foods as well as minimized screen time for children either in day care or at home. In addressing the obesogenic environment, the state intends modification and replication of its successful tobacco control initiative, which addresses environmental as well as social norm modification necessary in mitigation of obesity as well. Principally, the tobacco model relies on three key pillars being, modification of social and legal environment whereby obesogenic risk factors is de-popularized. Intended measures would include advertising against carbon saturated foods, sweetened beverages as well as a sedentary lifestyle. Government Duty in the Human right to health California’s social epidemiology reveals prevalence of risk factors for childhood obesity within the community. On consumption of fruits and vegetables, children aged 2-5 consumed the highest proportion of fruits and vegetables, with over 60% consuming the recommended five and above servings per day. The percentage fall further for children aged between 6-11 years old at 48%. Conversely, consumption of sweetened drinks was found to increase with an increase in the age group, with a 29.5% of adults reporting consumption of such drinks. Nonetheless, the major obesity predicting factor for Californians relates to their consumption of fast foods, with more than 60% of the aggregate population reporting consumption of fast foods within the week. On physical activity, a majority of California citizens fall under the recommended levels of activity, with 2-5-year-old children reporting the highest level of physical activity at 45%. While the state commits to improved understanding for the importance of physical activity and healthy eating, the epidemiological profile reveals deficiencies in state as well as federal government initiatives in mitigation of childhood obesity. While discrimination on the basis of health might not be immediately apparent, incidence of higher childhood obesity rates in the more impoverished areas points to an abundance of obesity predicting factors in such areas such as South Los Angeles in comparison to affluent areas such as West Los Angeles. Implementation of suggestions such as increased consumption of fruits and vegetables in documents such as the California Obesity Prevention Plan is yet to bear fruit in many of the disadvantaged neighborhoods (California Department of Public Health, 2010). Failure by a segment of the population to achieve healthy living points to a possible failure by the government in protecting the right to health for all its citizens equitably. Drafting a Local Policy for Obese Children History and Local Efforts Childhood obesity is highly prevalent among ethnic communities including Native Americans and African Americans as well as low-income groups in California. Californian children living in low-income families face increased risks of obesity due to lack of health food choices, as well as reduced opportunities for physical activities. The low prices of fast foods, as well as the availability of cheap soft drinks, and snacks coupled with reduced access to open areas and parks ranks as the main contributors to the high rates of childhood obesity in California. These high rates of childhood obesity in the Californian populations have resulted in the establishment of several local and community-based efforts aimed at reducing the number of overweight children in the state. Crawford et al. (2013) explained California to be among the leading states in fighting childhood obesity, due to the various interventions introduced by both private and public entities in California communities. One of the initiatives mentioned in Crawford et. al (2013) is the “Healthy Eating, Active Communities” program that aimed at improving children’s access to physical activity, and healthy foods. The program mainly targetted children from low-income communities. The initiative involved schools and the local community with schools implementing nutrition standards set by the state. Schools also increased class time meant for physical education and hired P.E specialist teachers. The program also barred grocery stored nears schools from displaying unhealthy snacks. Parents and the local community were also trained on the benefits of physical activities and a healthy diet (Crawford et al., 2013). Another locally-based initiative to reduce childhood obesity was introduced in Los Angeles County, with the main aim of the initiative being to reduce intake of soft drinks among children and their families. According to Karlamangla (2015), the initiative aimed at promoting the intake of water as a healthy alternative to soft drinks which are rich in unprocessed sugar. The program involved education sessions as well as posting of messages on the dangers of soft drinks in buses and other forms of public transport. Recommendations Current policies aimed at reducing childhood obesity in low-income communities have employed varied approaches with each reporting minimal though statistically significant changes among obese children. One positive aspect of these interventions is the involvement of community members in intervention strategies. Rather than just including school officials, current policies and programs incorporate parents and local businesses in activities for reducing obesity. The involvement of parents allows change from a home environment. Current policies also involve educating participants on the importance of physical activities. The education of physical activities also incorporates practical exercises aimed at weight reduction and prevention of obesity. However, some gaps may exist in current policies including lack of a cheap alternative to bariatric surgery for over obese children. These initiatives aim at preventing obesity as well as promoting weight loss, but little evidence is there to support the long-term success of such policies. Policies targeting low-income obese children should incorporate enhanced surveillance and monitoring f children’s weight and diet. Rather than just educating children on the need for physical activity and healthy eating, policies should conduct regular surveillance on the BMI of children. The lack of cost-friendly treatment is the most pressing unmet need affecting the population. Enhanced surveillance will allow comparisons; therefore, explain the level of effectiveness of the policies. Another unmet need is the lack of safe open areas, especially in low-income neighborhoods. Policies should aim at making parks and open spaces safer for children to play and exercise. Policies should make open areas the center-stage of activities including lessons on obesity. Making open areas the center of all activities will result in increased community involvement; therefore, even adults benefit from the program. Conclusion International Instruments International instruments are enforced through responsibility that each state has to the others in matters relating to the common welfare. The United Nations convention on the rights of the child addresses the universal concerns facing children in its preamble, as a family of human beings. In article 24 of the convention, the state parties commit to the right of every child to enjoy the highest standard of health, with state parties ensuring that all children are provided with their right to access health care. Children’s health care should be available, accessible, acceptable as well as of a high quality, where it the responsibility of the government to ensure sufficient and functional health facilities need should determine sufficiency, where attention focuses on the under reached and secluded populations. Accessibility, on the other hand, implies a range of features including universality of care, physical accessibility for all, economic accessibility, as well as information accessibility (White House Task Force on Childhood Obesity, 2010). Applicable National Policies and Local Ordinances The WHO framework on obesity mitigation targets the scourge from three dimensions, with the Socio-ecological approach aiming at policy actions shaping economic, social and physical environments. The behavioral approach seeks modification of behavior patterns majorly determining obesity prevalence. While the state of California has vowed its commitment to health food choices for its residents, food companies such as the soda industry continue providing obstacles in the fulfilment of such. The challenges faced by the City of Berkeley in implementation of tax against soda companies illustrates the challenges faced in creating an environment free of obesogenic influences. Nonetheless, the success enjoyed by the city is testament to the power that the community wields in influencing policy, with limited personal donations proving sufficient against ‘Big Soda’. International Instruments International instruments are enforced through responsibility that each state has to the others in matters relating to the common welfare. The United Nations convention on the rights of the child addresses the universal concerns facing children in its preamble, as a family of human beings. In article 24 of the convention, the state parties commit to the right of every child to enjoy the highest standard of health, with state parties ensuring that all children are provided with their right to access health care. Children’s health care should be available, accessible, acceptable as well as of a high quality, where it the responsibility of the government to ensure sufficient and functional health facilities need should determine sufficiency, where attention focuses on the under reached and secluded populations. Accessibility, on the other hand, implies a range of features including universality of care, physical accessibility for all, economic accessibility, as well as information accessibility (White House Task Force on Childhood Obesity, 2010). References California Department of Public Health. (2014). Obesity in California: The Weight of State, 2000-2012. California Department of Public Health. Crawford, P. B., Schneider, C., Martin, A. C., Spezzano, T., Algert, S., Ganthavorn, C., . . . Donohue, S. S. (2013). Communitywide strategies key to preventing childhood obesity. California Agriculture. Dekker, J. (2011  ). International Policy overview: Obesity prevention. EUphix, 1-19. Grynbaum, M. M. (2014, June 26). New York’s Ban on Big Sodas Is Rejected by the Final Court. The New York Times, pp. http://www.nytimes.com/2014/06/27/nyregion/city-loses-final-appeal-on-limiting-sales-of-large-sodas.html?_r=0. United Nations Human Rights (UNHR). (1990). Convention on the Rights of the Child: Adopted and opened for signature, ratification and accession by General Assembly resolution 44/25 of 20 November 1989 entry into force 2 September 1990, in accordance with article 49. Geneva: United Nations . White House Task Force on Childhood Obesity. (2010). Solving the Problem of Childhood Obesity Within a Generation. Washington DC: Executive Office of the President of the United States. Karlamangla, S. (2015, October 11). L.A. County launches campaign against childhood obesity. Retrieved from Los Angeles Times: http://www.latimes.com/local/california/la-me-adv-water-campaign-20151011-story.html Kuo, A. A., Etzel, R. A., Chilton, L. A., Watson, C., & Gorski, P. A. (2012). Primary Care Pediatrics and Public Health: Meeting the Needs of Today’s Children. American Journal of Public Health, e17-e23. Nguyen, N., Champion, J. K., Ponce, J., Quebbemann, B., Patterson, E., Pham, B., . . . Favretti, F. (2012). A Review of Unmet Needs in Obesity Management. Obesity Surgery, 956-966. World Health Organization. (2014, October 29). Facts and figures on childhood obesity. Retrieved from World Health Organization: http://www.who.int/end-childhood-obesity/facts/en/ Read More