Introduction
Epidemiology is an important part of public health. It is particularly imperative in the definition of the existence of a disease in a specific population. Epidemiology is defined as the science that studies disease distribution in a defined population, the causes, and patterns of the diseases, and the effects that the diseases have on the population (Szklo, & Nieto, 2006). This science has been central in the control and eradication of some diseases in the 20th century. The importance of epidemiological studies is to define the existence of a medical condition in a population in addition to the relevant prevention measures. It helps inform policies that are aimed at reducing the survival rate of the disease condition whilst monitoring their (policies) effectiveness.
Childhood obesity is a condition whose prevalence is reported to increase over the last few decades across the world, especially in developed nations (Ebbeling, Pawlak, & Ludwig, 2002). The observed trends in this condition are worrying upon considering the myriad of other health effects that are associated with it. One of the nations that have the challenge of increasing childhood obesity, which is defined here as a BMI that is equal to or greater than the 95th percentile for the particular sex and age, is the United States (Ebbeling et al., 2002). This essay looks at the epidemiology of childhood obesity in the United States. It uses this segment to explore some of the epidemiological concepts.
Childhood Obesity Epidemiology
As previously stated, the prevalence of childhood obesity is rising not only in the United States but also in most of the developing and developed nations. According to Flegal, Carroll, Ogden, and Johnson (2002), the US has seen a double rise in the obesity rate for children between the age of 2 and 5 years since 1980 when it stood at 5%. These researchers also state that the obesity rate for children aged 6 to 11 years has tripled. It has changed from 6.5% to 17 %, between 1980 and 2002 (Flegal et al., 2002). The same change is seen in the rate of obesity for adolescents (12-19). It increased from 55 to 17.6% over the same period (Flegal et al., 2002).
Most of the studies on childhood obesity demonstrate a similar trend for this condition, although the incidence is not well-documented (Ebbeling et al., 2002). The most commonly available data on childhood obesity is that of adolescents. This group closely resembles the adult population. According to Gordon-Larsen, Adair, Nelson, and Popkin (2004), the National Longitudinal Study of Adolescent Health showed an increase in the cumulative incidence of childhood obesity in the US. In this study and according to Cunningham, Kramer, and Narayan (2014), “the 5-year cumulative incidence of obesity among persons who were 13 to 20 years of age in 1996 and 19 to 26 years of age in 2001 was 12.7%, ranging from 6.5% among Asian girls to 18.4% among non-Hispanic black girls” (p. 404).
Data that is available on the incidence of childhood obesity comes from surveys and research studies. Routine data is almost inaccessible. Dehghan, Akhtar-Danes, and Merchant (2005) confirm that a quarter of children in the United States are overweight. However, 11% of them are obese. This figure is a worrying statistic, especially upon considering the many health conditions that are associated with the condition in childhood and adulthood. Another research reveals that a major complication of obesity in childhood is that it continues in adulthood (Ebbeling et al., 2002). Routine data on childhood obesity shows that there has been a constant increase since 1973. A double increase occurred between 1988 and 1994. The rate of increase in this condition was constant for the last century.
One of the organizations that are involved in the monitoring of this condition is the World Health Organization Project Monitoring of Cardiovascular Diseases (MONICA), which reports an increase in the incidence of childhood obesity in the United States (Dehghan et al., 2005). The incidence of childhood obesity in the US is high in the different races. However, there is a difference among the different races where the minority groups record a double growth compared to the Whites (Ebbeling et al., 2002). The available medical records show an increase in cardiovascular diseases in the US. Medical officers report this finding to be associated with the increased childhood obesity incidence.
Epidemiological Triangle
The epidemiological triangle is a concept that is commonly used in epidemiology to define the occurrence of a disease using the interaction of the host, agent, and environment (Szklo, & Nieto, 2006). This concept may be used to explain the existence of childhood obesity, with the host being the obese children. Characteristics that determine the occurrence of childhood obesity include genetics, the age of the children, and their race.
The environment where these children are situated also influences the outcome of childhood obesity, especially in the United States, which is a developed nation that has numerous resources and an abundance of food compared to other nations in the world, particularly the developing nations. The environment enables children to live a sedentary lifestyle. In the presence of food, this setting leads to increased caloric retention and weight (Cole, Bellizzi, Flegal, & Dietz, 2000). The other environmental factor that relates to childhood obesity is the availability of easy resources. Most children in the United States rarely walk to school. Playtime is also limited compared to their previous years.
Unlike other epidemiological conditions, childhood obesity is a non-communicable illness. This claim means that the condition is not transmitted from one individual to another except where the genetic predisposition is passed between individuals. If childhood obesity had an agent that spreads it, it would complete the epidemiological pyramid. For conditions that do not have a complete epidemiological pyramid, another important concept that may be used is the web of causation.
The different causative factors in childhood obesity constitute the web of causation. These causes interact intricately. The population’s vulnerability to childhood obesity is dependent on the epidemiological triangle. Children in the United States have been described as genetically vulnerable depending on their race (Cole et al., 2000). The black population is more susceptible compared to the white residents. Apart from the racial predisposition of children to obesity, several other factors also determine the development of this condition. The factors include a physical activity where children who lead sedentary lifestyles are susceptible (Cole et al., 2000). Other factors include a high-calorie diet, psychosocial factors such as stress, and people’s lifestyles. Some medical conditions are known to increase the risk of obesity (Cole et al., 2000).
Apart from racial consideration as part of cultural influence, the other important cultural factor in the occurrence of childhood obesity is the availability of food for this population (Cole et al., 2000). In general, the US is a nation that has ample food supply. The food is cheap and easily available in many outlets. The availability of sufficient food supply ensures that children and adults have satisfactory food, as the nation has an excess of it. The US is reported to waste about $10 billion worth of food every year (Cole et al., 2000).
The ethical and legal considerations that must be made when working with this population include the right to have the best healthcare and nutrition. The US constitution and other laws in the country allow the availability of food for all children and other individuals in the nation, and hence the high availability of abundant food. It is unethical for children to be denied food for any reason even in the presence of childhood obesity.
Childhood obesity is a condition that is commonly associated with affluence. For the black and minority populations in the US, obese children are sometimes an indicator that the family is doing well. This notion is another cultural value that has accelerated the increase of childhood obesity in the country. The effects of childhood obesity are mostly felt in adolescence and adulthood. However, they may also be manifested even in childhood. The commonest effects include an increase in asthma occurrence, increased psychological issues, steatosis, sleep apnea, and orthopedic complications (Cole et al., 2000).
The most significant effect of childhood obesity is the increased rate of cardiovascular conditions in adolescence and adulthood. This increment is reportedly causing morbidity and mortality. The US is one of the nations that have higher mortality rates from cardiovascular conditions that relate to obesity (Wang, Gortmaker, Sobol, & Kuntz, 2006). According to Wang et al. (2006), many individuals in the US who have high cholesterol and blood pressure have obesity. They have also developed glucose intolerance. There is also an increased risk of developing type II diabetes, with the condition being accelerated by the existence of obesity in childhood (Wang et al., 2006). Childhood obesity is an important public health concern because of these associated conditions. The country also spends significant financial and health resources in the management of the conditions that result from childhood obesity, which further affects the economy in general and other parts of the country (Cole et al., 2000).
Preventive Measures
The prevention of health conditions in public health constitutes different levels, which include primary deterrence, secondary, and tertiary prevention. Different measures are applied at these levels (Szklo, & Nieto, 2006). Primary prevention in epidemiology is done when preventive measures are put before the onset of a disease or medical condition to prevent the actual commencement of the condition. In secondary prevention, the condition is already in place. The measures that are put in place allow the prevention of complications. There are many measures to prevent the development of childhood obesity. However, they have different levels of efficacy. Different methods of monitoring the intervention measures are also applied.
Feasibility of Prevention
Childhood obesity is a preventable condition where simple measures may be used. It is crucial to monitor the diet that is practiced in families to ensure that children get what they need in the right amount (Wang et al., 2006). Residential areas should have places where children can play. These facilities should also be provided for in public areas. The reason behind the provision of playfields is to allow caloric use, which is associated with a reduction of childhood obesity rates. Most researchers state that obesity is a condition that is associated with a sedentary lifestyle (Wang et al., 2006). Hence, a little exercise should work.
The other measure that should be taken to reduce the childhood obesity rate in the US is the formulation of rules and regulations to allow regular interventions. The national healthcare system should provide educational services for families to ensure that they maintain appropriate weights for their children. This plan will also be important in the reduction of complications.
Evaluation of Prevention
The evaluation of preventive measures may be done through the assessment of the rate of obesity in the nation. Different measures that can be used to monitor the changes in childhood obesity rate also include the prevalence of conditions such as type II diabetes in adults. This plan will evaluate whether the complications are reducing in these populations. Preventive measures may also be evaluated through the financial input into the treatment of childhood obesity. If the preventive measures work, financial resources that are used in the treatment should also decrease. These measures should be adequate to monitor the prevention of childhood obesity.
Conclusions
In conclusion, childhood obesity is a condition that has a multi-factorial origin and diverse occurrence. There is a reported increase in the rate of childhood obesity in the world. Developed nations record a significant increase in childhood obesity. This paper has evaluated the epidemiological aspects of the condition in the USA. The findings indicate a progressive increase in this condition in the US. Several measures that may be used in its prevention can be evaluated using the above methods.
Reference List
Cole, J., Bellizzi, C., Flegal, M., & Dietz, H. (2000). Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ, 320(1), 1240-1243.
Cunningham, A., Kramer, R., & Narayan, V. (2014). Incidence of Childhood Obesity in the United States. The New England Journal of Medicine, 370(5), 403-411.
Dehghan, M., Akhtar-Danesh, N., & Merchant, A. (2005). Childhood obesity, prevalence and prevention. Nutrition Journal, 4(24), 1-8.
Ebbeling, C., Pawlak, B., & Ludwig, S. (2002). Childhood obesity: public-health crisis, common sense cure. Lancet, 360(1), 473–82.
Flegal, M., Carroll, D., Ogden, C., & Johnson, C. (2002). Prevalence and trends in obesity among US adults, 1999-2000. JAMA, 288(1), 1723-1727.
Gordon-Larsen, P., Adair, S., Nelson, C., & Popkin, M. (2004). Five-year obesity incidence in the transition period between adolescence and adulthood: the National Longitudinal Study of Adolescent Health. Am J Clin Nutr, 1(80), 569-575.
Szklo, M., & Nieto, J. (2006). Epidemiology: beyond the basics. Sudbury, MA: Jones and Bartlett.
Wang, C., Gortmaker, L., Sobol, A., M., & Kuntz, M. (2006). Estimating the energy gap among U.S. children: A counterfactual approach. Pediatrics, 118(1), 1721-1733.