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Obesity is one of the main challenges facing the United States healthcare system. Obesity affects people of all ages resulting in negative health complications. Obesity is an increase in weight that is higher than the average body weight of the person corresponding to their weight and age. This is a medical concern in the United States and a risk factor for chronic diseases , especially asthma, hypertension and cardiovascular disease. These disorders are the leading causes of death in the world due to damage to the kidney that causes renal failure. Obesity in the United States has been rising at a steady rate for the last three decades. Nutrition is the main cause of obesity which is associated with increased deposition of adipose tissue in the body when an individual consumes high amounts of carbohydrates and fats. Poor nutrition choices are influenced by a lack of healthy food and money to buy organic food are linked to the increasing obesity rates. The healthy people 2020 have included obesity as one of the public health issues that must be addressed to enhance population health in the United States (CDC, 2019).
Obesity is a condition in which excess body fat and weight are observed. The determination of obesity in individuals involves assessing the body mass index ( BMI) of an individual to verify if an individual has the appropriate weight for their age , sex, and height. Determination is conducted by dividing the body weight of an individual into kilograms by their height in meters. A BMI of 25-29-9 indicates that an individual is overweight and is at risk of developing obesity, which requires weight reduction management. A BMI of over 30 shows obesity, which requires an immediate response in order to properly reduce weight. For the individual age, a BMI for the age percentile is calculated using the formulas of weight and height compared to the expected age of a person. A BMI percentile of 50 shows the individual’s average. The 85th BMI percentile
shows obesity.The calculations can be performed using online applications such as the calculation of BMI in the Center for Disease Control and Prevention (Nuttall, 2015).
Obesity affects individuals of all ages, but adults account for a higher percentage of obesity in the population. Middle-aged adults account for 39.5 percent of the total population with obesity, compared to young adults at 30.3 percent and older adults over 60 years with 35.5 percent, according to recent reports by the Centers for Disease Control and Prevention. There is a per-race difference in obesity rates. Compared to Caucasians, Hispanic communities and African Americans have high rates of obesity. The prevalence of obesity per race includes Hispanics 47%, blacks 46.8% and non-Hispanic whites 37.9%. The rate of obesity in both men and women follow a similar trend per age where middle-age adults have higher rates of obesity. There is no difference in obesity prevalence between men and women (CDC, 2019).
Obesity prevalence varies based on education level. In the United States, men and women with a college education have lower rates of obesity as compared to those with lower education levels below college. Income levels affect obesity where individuals with high income have lower rates of obesity as compared to those with low income (CDC, 2019).
There is a significantly high rate of obesity in individuals living in rural counties (34.2%) in the United States as compared to those living in urban areas (28.7%). The highest differences were observed in South and Northeast regions influenced by a lack of awareness of preventive measures. The findings are true for individuals in both areas in terms of demographic data including age, sex, education and race (CDC, 2019).
There is a differentiation per state in obesity rates. The state of New York has obesity levels of 27.6 percent, which rose from 17 percent in 2000. This state is ranked nationally in 9th place
and obesity rates have been ranked in different local regions to highlight the burden of the condition. The county of Washington has a 30 percent obesity rate, which is higher than the average state rate and among the highest in the state. These rates are higher than the global obesity prevalence in the world which currently stands at 13% on average (Robert Wood Johnston Foundation, 2019).
There has been a change in obesity rates over time. Obesity has been increasing at a constant rate with rates increasing from 30% in 2000 to 39.6% in 2016. This has been monitored to increase each year at a rate of 0.6% in one year. The rate of obesity increased from 35.7% in adults to 39.6% in five years between 2010 and 2016. These rates are expected to increase further in the next 10 years to hit over 45% in the adult population in the United States (CDC, 2019).
The prevalence of obesity is influenced by a number of factors including individual behaviors which is the main risk factor for obesity. The individual eating and physical activity engagement influence the development of obesity. High intake of fats and high carbohydrate food increases the risk of developing obesity due to excess calories in the body which is converted into fat for storage in adipose tissues. Physical inactivity where an individual does not engage in physical exercise increases the risk of obesity as energy demand is low with increased energy sources in the body (Hruby et al., 2016).
The second factor is policies that regulate access to healthy food. The requirement by food control policies to indicate nutrient content in food is not enough to solve the issue as individuals cannot read and understand the contents. The unhealthy foods such as processed carbohydrates are not labeled appropriately like cigarettes with warning labels. The third factor is the biological
factors involving inherited genes. Research has identified obesity causing genes that can be passed from parents to siblings called melanocortin-4 receptor genes that influence the development of obesity (Hruby et al., 2016).
The fourth factor is the environment which involves an interaction of the individual with their surroundings. Short distances to services such as supermarkets and food stores increase the risk of obesity due to physical inactivity. The availability of healthy food influenced by food stores in the neighborhood reduces the risk of obesity. Poor neighborhoods inhabited by the low income individuals lack appropriate food stores to supply safe foods which forces them to take what is available. This increases the risk of obesity. Lack of proper physical fitness centers increases the risk of obesity as the population cannot access physical activities. The place of work also influences obesity. Working in organizations with elevators increases the risk of obesity as compared. Stairs require energy to climb which helps in preventing fat accumulation (Hruby et al., 2016).
The fifth factor is education. High levels of education are associated with healthy living due to food and activity choices. Individuals with a high level of educational attainment are more likely to choose healthy food such as a low carbohydrate diet and engage in regular physical activities than those without education as they are not aware of the negative health effects. High levels of education increase health literacy which is associated with healthy living. Scheduling for regular physical activities with the aim of staying fit and controlling weight is observed in the highly educated group in the community due to their health awareness. Individuals who did not finish high school have high rates of obesity as compared to those with a college education (Hruby et al., 2016).
Another factor is income, high-income individuals are able to procure healthy foods such as organic food which are priced higher than the inorganic food and balanced diet. Those with low income cannot access safe food or make choices to balance their diet due to lack of enough money. This has been observed in minority groups such as Hispanics with low income on average as compared to the majority Caucasian groups (Hruby et al., 2016).
The best interventions to address obesity in communities include creating a healthy environment with food stores that supply healthy food to the community and opening community facilities such as schools for the communities to carry out physical activities such as regular walking. This has been associated with better outcomes in the community as they can easily get food to choose from and perform physical exercises without restrictions caused by the lack of spaces to practice. The development of biking and walking paths in urban areas has been reported to be effective in encouraging physical activities to prevent obesity (CDC, 2019).
The second strategy is primary care response where physicians are involved in early screening for risk of obesity and identification of individuals with obesity. The prevention and management of obesity require regular BMI measurement to assist individuals in working towards reducing weight appropriately. Diet change to reduce high calorie intake and regular physical activities has been identified as the most effective interventions for obesity in all age groups (Sebiany, 2013).
To conclude, in the United States, obesity is a public health challenge that raises the risk of chronic diseases such as diabetes. Obesity rates vary based on age, race, income and education among individuals. Obesity influenced by eating habits, lack of healthy food, physical inactivity, and limited availability of healthcare education are highly impacted by Hispanics and African
American adults. In order to prevent further increases, programs targeting obesity in communities need to be developed.
CDC. (2019, April 11). CDC: More obesity in U.S. rural counties than in urban counties. Retrieved from https://www.cdc.gov/media/releases/2018/s0614-obesity-rates.html
CDC. (2019, January 31). Adult Obesity Facts. Retrieved from https://www.cdc.gov/obesity/data/adult.html
Hruby, A., Manson, J. E., Qi, L., Malik, V. S., Rimm, E. B., Sun, Q., … Hu, F. B. (2016). Determinants and Consequences of Obesity. American Journal of Public Health, 106(9), 1656-1662. doi:10.2105/ajph.2016.303326
Nuttall, F. Q. (2015). Body Mass Index. Nutrition Today, 50(3), 117-128. doi:10.1097/nt.0000000000000092
Robert Wood Johnston Foundation. (2019). Rankings. Retrieved from https://www.countyhealthrankings.org/app/new-york/2019/measure/factors/11/data
Sebiany, A. (2013). Primary care physicians′ knowledge and perceived barriers in the management of overweight and obesity. Journal of Family and Community Medicine, 20(3), 147. doi:10.4103/2230-8229.121972
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