Cassidy Pont
A healthier America awaits...
Current Event
How young is too young to label some one ‘plus size? Many companies in the clothing industry are labeling little girls clothing ‘plus,’ for as little as three year olds; ‘plus-size’ entails the clothes being both longer and wider. They are doing this as a reaction to the growing population of bigger children: “a growing trend for America’s growing children.” The companies foresee making a large profit out of the plus-sized clothes. Many parents question how this will affect their child’s self esteem; will the labeling help or hinder it? Now, when children walk into stores, such as Sears and Old Navy, they see a section specifically for bigger children. For example, at Sears, they have adopted a new clothing line called, “Pretty Plus,” which is a plus-sized clothing line for little girls. Fashion expert, Jene Luciani, buys ‘plus-size’ labeled clothing for her daughter, who is taller than the average child. Although her daughter is taller, she does not fit the ‘plus-size’ mold; Jene’s daughter is tall, but skinny, therefore the clothes are too wide on her. Luciani appreciates that there is a section of clothes that offers longer clothing for her daughter, however Luciani says that putting a label on bigger clothes for girls, as ‘plus-size,’ forces the child to see how they are different in size than the general population, at such a young age. Morgan Joseph, a 5 foot 11 girl, who most stores would consider ‘plus-size,’ agrees with Luciani. Joseph says she does not appreciate being called ‘plus size.’ “I don’t really enjoy the word ‘plus,’ I’d rather they just put numbers like they do for other kids” (Eugenios 2012).
What makes a child “overweight” or “obese?” A child is “overweight” if his or her body mass index (BMI) is between the 85th-95th percentile, and a child is “obese” if his or her BMI exceeds the 95th percentile on the BMI-for-age-for-gender charts. To the left is the BMI chart for males between 2-20 years old; this chart is used to determine if a male, (between that age range), is overweight or obese (Center for Disease Control, 2011). Every year kids are falling more in the obese category. The prevalence of obesity has more than doubled form 1976-2008, and over the past thirty years, the number of obese preschool children and adolescent children has also doubled, and children aged 6-11 has tripled in the obesity category (Rahman et al., 2011, p. 29). This growing trend of our future, the children, has been spiraling out of control; as the years progress, child obesity becomes more of an issue. Based on data taken in 1976-1980 and 2003-2006 from the National Health and Nutrition Examination Survey, the amount of children overweight between ages 2-5 years old increased from 5.0% to 12.4%; for children ages 6-11 years old it increased from 6.5% to 17.0%; for ages 12-19 years old it increased from 5.0% to 17.6% (Li and O’Connel, 2012, p.391). “In 2007-2008 almost 17% of children and adolescents aged 2-19 years were obese”. This increase in obesity was across all levels of income (Ogden et al., 2010, p. 1). Obesity does not discriminate between any gender, race, level of income, or ethnicity. Among all races, the average percentage of child obesity is 14.4% for children aged 2-4 , and 16.6% for children who are overweight; this is found in the graph below (Dalenius et al., 2012, p. 8). How did childhood obesity become so prevalent in our society? What made these numbers become so large?
Obesity does not happen overnight, there are many possibilities to how it could have started. Some big causes, today, are that children are eating too much and have scarce physical activity. When people gain weight, they are in a state of “positive energy balance,” and the longer this state exists, the more weight people put on. “When more energy is taken into the body then is consumed by all energy-expending processes, the surplus is converted into matter…body fat.” Although this imbalance in the body is a cause of obesity, the ultimate cause of children gaining weight is our style of modern living. The convenience of “nutrient-dilute food items,” marketing unhealthy products to children, decreased recess time for kids at school, a lack of physical education, every piece of technology that has replaced human activity, and the loss of time for cooking healthy foods (Katz, 2011, p. 34); all these can be contributing factors to children/adolescents gaining weight, leading them to become overweight and obese.
Another factor that can contribute to childhood obesity is the environment in which the child lives in; an environment can determine how nutritious his or her diet is, as well as the amount of physical activity he or she is receiving. Areas where there is an abundance of high-caloric foods and convenient stores, there is an increase in the risk of having children being overweight; where as areas with supermarkets and farmers’ markets are “associated with lower childhood body mass index and overweight status” (Rahman et al., 2011, p. 51). Farmer’s markets and other places like such, offer more fresh produce to customers, than convenient stores, serving as a healthier place to shop. For example, an average farmers’ market sells a variety of fruits and vegetables they have grown; this is especially beneficial to costumers because these local farmers do not use any pesticide or chemicals that have the potential to damage their health. At a convenient store, the average customer buys a bag of chips or a box of cookies. Argo, if a child lives in a neighborhood surrounded by farmers’ markets, it is easier for him or her to receive fresh produce, due to the convenience of these stands. But, if convenient stores, like “Wawa” and “7/11” surround a child’s home, he or she will automatically be at a disadvantage with his or her eating habits. Because these convenient stores are in close proximity to the child’s home, it makes them too ‘convenient’ for him or her to obtain unhealthy food.
(Center for DIsease Control)
(Dalenius et al., 2012 p. 8)
Eating unhealthy foods and not getting enough physical activity can damage a child’s health. It is thought that the design of communities and neighborhoods can either promote or hinder physical activity for children (Rahman, 2011, p. 49). For example, if there is no park or recreation center for kids to play in close to their house, then their environment is hindering them from being physically active. It is very important for children to play outside, not only for their physical health, but for their emotional and social well-being, as well. It is a necessity that children have an area or center where they can fulfill their recreation needs, and be physically active.
To help figure out how to intervene with child obesity, the health promotion specialist could use the PRECEDE-PROCEDE Model. This model helps a health specialist plan a health program that will have the most influence on his or her targeted population; in this case, the targeted population is children and adolescents. This model will help the health specialist pinpoint the quality of life for children in a specific region, and then identify the specific health problems that are contributing to this health issue. After these steps are completed, the specialist will plan an intervention specific to the region he or she is trying to help promote child health. Implementation of the program will begin, and after, the health promoter will assess how well they followed the plan they originally intended to follow, and if it actually helped improve the children’s health. Finally, changes in the health status of the children will be evaluated. This model will help the health specialist determine what type of intervention or interventions needs to be done, and once that program is implemented, then he or she will see if it made a difference to the children’s health (Sharma, 2012, p. 43-48). With this model, the health specialist will work backwards by taking the issue presented to them, (overweight children/adolescents and childhood/adolescent obesity), and try to fix that issue.
One theory that could help change the unhealthy habits for the overweight/obese children is the “social cognitive theory.” This theory states that human behavior can be explained through a “triadic reciprocal causation;” the three factors that determine behavior are behavioral factors, environmental factors, and personal factors. There are nine constructs to this theory, which include: knowledge, outcome expectations, outcome expectancies, situational perception, environment, self-efficacy, self-efficacy in overcoming impediments, goal settings, and emotional coping. Since the first construct is knowledge/learning, which this theory stresses, it is effective on children (Sharma, 2012, p.174-195). Since the issue presented in this current event is child and adolescent obesity and children who are overweight, the targeted population is children/adolescents; it is logical to apply this theory, which caters to children. Children’s minds are open to learning new information; they are excited to learn and share the knowledge they have gained. This theory fulfills their excitement of learning. Not only will this theory help them learn health information, but also it will promote a healthier lifestyle to try and get the children to change their unhealthy behaviors.
In order to help this multifaceted problem, health specialists must do a multitude of interventions. The most important things that need to be addressed are increasing exercise and changing unhealthy eating habits of children and adolescents. “Physical activity is vital, condition work of the human machine, diet is its fuel” (Katz, 2011, p. 36); this idea can be applied to cars and gasoline, also. If one put bad gasoline in a car, it will act funny and possibly not operate. Humans are like cars; if you put unhealthy food in them as “fuel,” then they might not feel good and will not ‘run” efficiently, just like a car fueled with bad gas.
(Car-seupp Jokes, 2008)
Most children are not aware of the fact they that are not eating right and/or not having enough physical activity; they rely on their parents/caregiver to tell them what they are doing “wrong;” if their parent or caregiver allows unhealthy behaviors to occur, then nothing will change and the behavior will continue. Since children are still developing cognitively, parents and other caregivers play a major role in helping to improve this problem. (Burrus et al., 2012, p. 317). Children look up to their parent(s) and/or caregiver(s) as role models, therefore if the parent/caregiver has a poor diet and exercise routine, they will pass those unhealthy habits to the child. Person-to-person interventions seem to be one of the best ways to target this problem; this entails direct contact between the health specialist and the caregiver, improving parenting-skills, which will ultimately improve the health of the adolescent/child. Some examples of person-to-person interventions are in class training sessions or telephone conversations between the caregiver and health specialist to help guide them be better role models for the child they are caring for. Below is a diagram showing how changing the parent’s or caregiver’s behaviors will reflect the child’s behaviors (Burrus et al., 2012, p. 318).
(Burrhus et al., 2012, p. 318)
Not only do children need healthy role models to look up to, but also they need to be an environment to help promote this healthy life-style. “There is strong evidence to show that long-term solutions to the childhood obesity epidemic can be achieved by modifying the built environment to increase children’s physical activity and access to healthful foods, and reduce their access to unhealthy foods” (Rahman et al., 2011, p. 51). Health education specialists can help improve environments by using midstream interventions. An example could be a community program to encourage kids to be more physically active; a health specialist could implement an after school program where kids could come to a park, or area in the neighborhood, where they would be able to play and be physically active, under the supervision of an adult. The health promoter could appoint a community leader to implement these programs in the community every week or daily, to act as a supervisor to ensure the children’s safety. These appointed leaders could have a rotating schedule of certain physically challenging games, like “Sharks and Minnows,” that would get the kids moving, while having fun, of course. This rotating schedule would keep the kids wanting to come back the next day, and play another game; it keeps them entertained and holds their short attention span by playing different games.
If this community program was established it would help one of the most important things: increasing children’s healthy behaviors, but eating healthy is another aspect to improving their health. To help with eating better, a health specialist could plant a community garden. Even in areas of lower socioeconomic regions, building a garden is inexpensive, so a health promoter specialist could implement a garden be built in neighborhoods in need of a healthier food supply. Health specialists or community leaders could involve kids in helping upkeep the garden and planting, which would increase their physical activity (Rahman, 2011, p. 51-52). Not only would planting a community garden be beneficial for children’s health, but also all other residents of the community who would have access to the garden.
Since children spend the majority of their time at school, health promoters need to ensure that schools are doing their part in establishing a healthy environment; health specialists can implement acts, like “D.C. Healthy Schools Act.” This particular act does a number of things to promote a healthier lifestyle for children and adolescents. For example, all D.C. schools, (as of 2010), are required to serve free breakfast to all public charter school students. Not only is breakfast such an important meal to start off children’s days correctly, but lunch is the more prominent meal eaten at school. With the D.C. Healthy Schools Act, school meals have become nutritionally enhanced. All school meals must include more whole grains, a variety or fruits and vegetables, less fat, and less sodium than meals served prior to the act being implemented (DC Healthy Schools). Health specialists could mimic this act in other places to help improve the meals eaten at schools and the health of children, which would ultimately decrease the amount of overweight and obese children/adolescents.
The way children get to school can also improve their physical activity. Health promoters can also establish another act called, “the Surface Transportation Act.” This act encourages paved sidewalks between the neighborhoods where children reside in, to the schools they attend (Rahman et al., 2011, p. 55). This would encourage students to walk or ride their bikes to school, leading to an increase in their daily physical activity. To the right is a pie chart of how students got to school in 2009; the act would help increase the walk and bicycle section of the chart, augmenting the amount of time children and adolescents exercise. These acts, programs, and models are only some of the things health specialists can do to improve the health of children/adolescents, and decrease the number of child and adolescent obesity rates. There are many other things that can be done, but one has to remember the most important thing: children are our future. If people want to become a healthier nation/world, they need to target the children and adolescents first. Child obesity has become out of control, but with these tips and programs implemented, people can stop this growing epidemic.
(Rahmen et al., 2011, p. 55)
References
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