As a result of increasingly sedentary lifestyles and poor nutritional choices, an increasing number of consumers are gaining weight and obesity has reached epidemic levels in many countries. Although the social and economic consequences of obesity are well documented, there remains a need to better understand the epidemiology of obesity in order to formulate effective population-based interventions. To this end, this paper provides an analysis of the obesity problem in the United States compared to Thailand where obesity is not as great a problem, but where the prevalence of obesity is still on the rise. A further comparison of obesity rates and obesity-related healthcare costs in New York compared to national rates and costs is followed by an assessment concerning how the political aspects of this issue hinder the ability of epidemiologists in addressing this problem. In addition, recommendations concerning four new policies or laws that the government can implement to address the obesity problem in the U.S. are followed by an analysis of the implications of those policies or laws on people, health insurance, healthcare providers, businesses, and the food industry. Finally, an examination of the causes that have made obesity rates increase for the past decade is followed by a summary of the research and important findings in the conclusion.
Review and Analysis
Analysis of the obesity problem in the U.S. compared to Thailand
The United States and Thailand are about as different as two countries can be, and yet they share many similarities in terms of their history (the U.S. was the first country to establish diplomatic relations with Thailand in the modern era), and Thailand stands out among its neighbors in Southeast Asia by virtue of never having been colonized by a Western power (the name "Thailand" literally means "Land of the Free"). Unfortunately, the United States and Thailand share the dubious distinction of experiencing rising rates of obesity in recent years, due in large part to many of the same reasons. In the U.S., Hickey (2002) reports that each year, obesity-related hospital costs have increased 300% during the 20-year period from 1979 to 2000; more importantly, for children between the ages of 6 and 7 years, the costs for obesity-related conditions increased from $35 million to $127 million (Hickey, 2002). Likewise, Daniels (2006) emphasizes that of all the economic issues related to obesity, the most important is the cost of the healthcare problems associated with the condition, and estimates indicate for people the medical expenses for obese adults are 36% higher in the U.S. younger than 65 years (Daniels, 2006). In addition, about 500,000 Americans die each year from obesity-related hearts diseases, especially coronary artery disease (Hersen & VanHasselt, 1998). Moreover, increased mortality due to cardiovascular disease has been identified in adult relatives of persistently obese children and the relationship between childhood obesity and family mortality appears to be particularly strong if the obese child also has elevated blood pressure (Hersen & VanHasselt, 1998). Based on self-reported measures of height and weight, the prevalence of overweight and obesity in the United States has experienced a steady increase; for instance, during the period between 1991 and 1998, the prevalence of obesity increased throughout the U.S. For males and females, as well as across all age groups, races and ethnicities and educational levels (Kantachuvessiri, 2005). According to one epidemiologists, the findings that emerged from the 1999 National Health and Nutrition Examination Survey (NHANES), based on measured heights and weights indicated that about 61% of all adults in the U.S. are overweight, including the 26% who were classified as obese (Kantachuvessiri, 2005). According to Kantachuvessiri (2005), "The incidence of obesity among adults has doubled since 1980 and overweight among adolescents [in the U.S.] has tripled in that time frame" (p. 555). Although far fewer studies have been completed to date concerning comparable obesity rates in Thailand, the studies to date do in fact indicate that the prevalence and incidence of obesity is also increasing across all relevant measures in affluent Thai urban populations. In this regard, Kantachuvessiri (2005, p. 555) cites the results of the studies of obesity in Thailand to date as follows:
1. Conducted in 1985 among 35-54-year-old Thai officials of the Electricity Generating Authority of Thailand (EGAT); this study found that 2.2% of the 2703 men, and 3.0% of the 792 women, had a BMI > 30, whereas BMI of 25-29.9 (grade I obesity) were higher (23.3% in men and 18.4% in women).
2. Conducted in 4,069 adults with dental diseases (ADDs), consisting of 1,247 men and 2,822 women, aged 19-87 years during September 1989- August 1990, the results of this study showed that 1.7% of men and 2.4% of women were in grade II obesity, whereas 14.2% of men and 15.9% of women were in grade I obesity.
3. Conducted in 1991, this study was smaller (66 men and 453 women), and had a broader age range (19-61 years), but also assessed nutritional factors in affluent urban Thais. The results of this study showed that 3.0% of men and 3.8% of women had a BMI > 30. Prevalence figures for BMI 25-29.9 were considerably higher (15.2% in men and 23.2% in women).
4. In 1991, the first report on National Health Examination Survey of Thailand was conducted in 13,300 adults, aged > 20 years. The results revealed that 12% of men and 19.5% of women (total 16.7%) had BMI 25-30, whereas 1.7% of men and 5.6% of women (total 4.0%) had BMI >30.
It is hypothesized that the hotter temperatures in Thailand dull the appetite, which may account for the highly spicy nature of the most popular foods which are designed to stimulate the palate, account for the historical lower obesity rates compared to the U.S. It is also hypothesized, though, that as Thailand has experienced economic development in recent years and has become an industrialized society, the country's growing middle class has acquired a taste for Western foods that are less nutritious and higher in caloric content.
Compare obesity rates and obesity-related health care costs in North Carolina to all of the U.S. And Recommend how North Carolina can treat obesity as a threat to public health
Although some regions of the state (see highlighted regions in Figure 1 below) have experienced higher obesity rates and healthcare costs compared to the national average, the majority of the state mirrors the national rates across the board.
Figure 1. Percentage of Overweight or Obese Adults in North Carolina
With respect to younger people in North Carolina, the 2009 North Carolina Youth Risk Behavior Survey indicates that among high school students, 13% were obese (students who were > 95th percentile for body mass index, by age and sex, based on reference data). Other salient findings of this most recent survey of North Carolina youth included the following:
1. 83% ate fruits and vegetables less than five times per day during the 7 days before the survey;
2. 72% ate fruit or drank 100% fruit juices less than two times per day during the 7 days before the survey.
3. 91% ate vegetables less than three times per day during the 7 days before the survey.
4. 33% drank a can, bottle, or glass of soda or pop at least one time per day during the 7 days before the survey.
5. 15% did not participate in at least 60 minutes of physical activity on any day during the 7 days before the survey.
6. 76% were physically active at least 60 minutes per day on less than 7 days during the 7 days before the survey.
7. 76% did not attend physical education (PE) classes in an average week when they were in school.
8. 76% did not attend PE classes daily when they were in school.
9. 36% watched television 3 or more hours per day on an average school day.
10. 23% used computers 3 or more hours per day on an average school day.
Source: NC Health Info (2012) at http://www.eatsmartmovemorenc.com/Data/Texts / Obesity_NCStudents_YRBS2009.pdf
How the politics of this issue will hinder the ability of an epidemiologist to help communities and/or states deal with the issue of obesity
There is a great deal of money at stake on maintaining existing levels of obesity among American consumers and the fast food industry in particular can exert political pressures on local, state and national politicians that can reasonably be expected to hinder epidemiological analyses of obesity in any given region of the country (Segelken, 2005).
Four new policies or laws that the government can implement to address the obesity problem in the U.S. And their implications
There are several general approaches to addressing obesity include universal prevention (this is based on a total population approach) while selective prevention and targeted prevention initiatives are focused on groups who are at high risk for becoming obese (Kantachuvessiri, 2005). As a result, selective and targeted prevention measures require the identification of individuals in appropriate settings such as schools to screen out…