One of the most significant health problems seen in the United States is obesity. Within this dynamic there are particular issues of special concern for the health care industry and society in general, most notably the exponential increase in obesity found among children. (Strauss, Pollack, 2001, pgs. 2845-2848) and (Troiano, Flegel, 1998, pgs. 497-504) "Childhood obesity has more than doubled over the past 20 years, and it represents the most prevalent nutritional disease among youth in the United States." (Lowry, Wechsler, Galuska, Fulton, & Kann, 2002, pg. 1)
Though there are many other problems faced by the youth of America today the press on violence and relatively rare though increasing incidences of it far outweighs the press on the issue of childhood obesity, a much more widespread and deadly problem. Obesity is discussed through the overzealous and unrealistic body images of adults and young adults, as represented by the racially biased television and other media or through crazed and frenetic diet options offered as if doctrine to countless seekers of unrealistic goals. What children and adults alike learn from these views is decreased self-esteem and possibly after enough tries at unrealistic dieting, learned helplessness. (Davison & Birch, 2001, pg. 159)
Though historically defining obesity among children has been a challenge, using growth charts and mean body fat density ratios has been a tool. For this work the definition will be governed by a general percentage rule. "A weight that exceeds ideal body weight by 20% defines childhood obesity. More than one fourth of children in the United States are considered clinically obese." (Sothern, Hunter, Suskind, Brown, Udall, Blecker, 1999, pg. 577) Factors associated with risk for obesity are many, among them, dietary intake, level of sedentary behavior vs. high physical activity, self-esteem, socioeconomic status, gender, insurance status and last but certainly not least race and ethnicity.
This study will focus on the problems and solutions as they associate to issue of obesity in children with specific emphasis on the growing Hispanic ethnic minority population. With increased risk based solely on the isolated issue of ethnicity and the growth rate of this ethnic minority, (mostly Latinos of Mexican decent) especially in California race must be considered as one of the most important of all factors associated with risk for obesity and all its health consequences. One cultural aspect, being the overall acceptance or the perception by certain cultures of overweight as healthy. (Maynard, Galuska, Blanck, Serdula, 2003, pgs 1-17)
Though race can certainly not be altered, factors especially significant to racial minorities must be addressed carefully and solutions must include interventions that are navigable for those at greatest risk. Be it physical or environmental the challenges faced by Latino-American youth are many but obesity is clearly more prevalent, dangerous and deadly than gang violence. "Obesity is the most widespread and severe nutritional problem of children in the United States, with prevalence rates that vary greatly by ethnic group. Rates are generally highest for Hispanic...children." (Crawdford, Story, Wang, Ritchie, Sabry, 2001, pg. 855)
Special care must be taken to ground the society in changes that can assist all children at risk for obesity, yet the focus on alternatives, especially within schools on increased physical activity must have considerations for challenges of the growing ethnic minority population. Additionally, though the significance of the problem greatly impacts the individual and the family the outcome of widespread obesity among children and adults, in a population also at high risk for lower socioeconomic status and therefore greater need for publicly funded healthcare access demonstrates an extreme social and economic problem that can only be successfully combated through prevention.
Statement of Problem
One danger in our society is resting on the idea that this is something we can solve later with better adult offerings and behavior, or that children who are obese will likely grow out of the condition. Not, only is this not true, evidence suggests that the problem of obesity follows children into adulthood and significantly impacts their future health and even mortality rate. (MacKenzie, 2000, pgs. 527-530)
It is observed that many of the negative and even deadly health outcomes of obesity that are seen among obese and overweight adults (Reilly, Methven, McDowell, hacking, Alexander, Stewart, Kelnar, 2003, pgs. 748-752) are also seen in the very young. The seriousness of the problem just seems to be growing without any sign of slow down.
More than 60% of overweight children have at least one additional factor for cardiovascular disease, such as elevated blood pressure, hyperlipidemia, or hyperinsulinemia." (Lowry, Wechsler, Galuska, Fulton, & Kann, 2002, pg. 2) The challenges to society in general and specifically to individuals are complex but the health outcomes are directly associated with increases cost and decreased quality and length of life. (Pi-Sunyer, 1993, pgs. 655-660)
Challenges are many and complicated and the solutions to this particular growing health threat have been divided for the last twenty years but the impact of the number of hours children spend in school demonstrates an opportunity for intervention that has been largely ignored in the last twenty years. Most research has addressed factors such as environment, socioeconomic level, activity level and family history as important facets of the problem. Some would even lay blame upon the television as a serious factor for the development of obesity in children. (Lowry, Wechsler, Galuska, Fulton, & Kann, 2002, pgs. 1-23) Many blame nutritional changes that have taken place within the United States as a whole, regarding the amount of fast food we eat because of its easy availability and the reduction of fresh fruit and vegetables being replaced by the bulk high fat, high carbohydrate low nutrition foods available in the everyday marketplace.
As schools become more and are focused on the academic success of children and outcomes-based testing, and the disproportionate level of school funding in association with increases in cost of living there has been a reduction of extracurricular activities. One of the most foundational aspects of those cost cutting standards is the loss of physical education time and funding. "The National Children and Youth Fitness Study and other investigations indicate that at least half of today's; youth do not engage in physical activity appropriate to long-term health promotion and that less than 36% of elementary and secondary schools offer daily physical education classes. " (Sothern, Hunter, Suskind, Brown, Udall, Blecker, 1999, pg. 577)
Additionally, the growing trend has been to address physical education as an extracurricular activity that children must go out of their way to engage in and is not funded through schools. Making the real desire to involve oneself in physical education a competitive demonstration of far more than a desire to be involved in physical activity. Often those most in need of the opportunity to get up and move are barred from extracurricular activities by the competitive nature of the offerings and the time/resources needed to compete. Many would like to individualize the problem by addressing the children's behavior or lack of desire to engage in physical activity,
Recently the idea of learned helplessness has been suggested as a probable reason for lack of motivation... With learned helplessness, children justify the causes of bad events in their lives as stable in time, global in effect, and internal to themselves. Such children have a cluster of helplessness deficiencies, including (1) passivity/non-assertiveness, (2) cognitive flaws and inability to recognize existing opportunities to control outcomes, (e.g., being unable to see alternatives, (3) sadness, (4) lowered self-esteem, (5) lowered competitiveness / achievement-oriented behavior, and (6) lack of motivation, initiative and persistence. (Sothern, Hunter, Suskind, Brown, Udall, Blecker, 1999, pg. 577)
One problem with this view of the situation, though is that it does offer promising ways to combat the problem at a base level, rather than just attempting to remove negative environmental conditions, it also implies that the competitive offerings of our society are a viable and realistic availability for children regardless of their personal like or dislike of competitiveness and/or avoidance of popularity issues. It would seem that one possible intervention would be to increase offerings, both during the school day and outside it of non-competitive alternatives to organized sports as well as increasing physical education activity offerings and requirements in school.
One issue that is absolutely imperative to discuss is race as the problem is unquestionably more concentrated among racial minorities, than among white children. Challenges to the individual students are compounded by many factors but one factor of particular importance is associated with ethnicity. In a study attempting to isolate risk factors among both young students and adolescents a group of experts uses race, socioeconomic status, and health insurance status as points of study findings associated with race were most significant. " In the younger group, both Black and Latino children had a greater likelihood of being overweight compared with white children. Among the adolescent group, Latinos and Asian/Pacific Islanders were more likely to be overweight." (Haas, Lee, Kaplan, Sonneborn, Phillips, Liang, 2003, pg. 1)