Childhood%20Obesity:%20What%20Nurses%20Can%20Do%20in%20the%20Fight%20Against%20a%20Growing%20Health%20Concern

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Childhood ObesityWhat Nurses Can Do in the
Fight Against a Growing Health Concern

• Presented By
• Linda Henry, RN, MS
• Linda Royer, RN, MPH, MSN
• George Mason University

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Objectives for the Viewer

• Define Obesity
• Identify Effective Measurement Standards
• Understand the Historical Significance
• Identify Societal Environmental Factors
• Identify Burden of Cost
• Identify Intervention Resources
• Learn Political Strategies for Advocacy

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Obesity Defined

• Presence of excess adipose (fat) tissue
• Significant increase in weight-for-height
  percentile for age (above 75ile)
• Obesity occurs when there is an imbalance of
  energy source intake and energy expenditure

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Standards of Measurement

• Hydrodensitometry
• (displacement measurement in water)
• Subscapular skinfold
• Body Mass Index (BMI)
• Height-Weight Chart

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Historical Analysis
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Historical Analysis
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Historical Analysis
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Historical Analysis
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Predictive Analysis
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The Burden of Obesity(Adapted from American
Obesity Association source, 2002)
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The Burden of Cost

• Taxes
• More than ½ of obesity-related medical costs are
  paid by taxpayers in 2003 a total of 75
  billion That comes to 39 billion/year, or
  about 175/ person.
• Covers treatment for type II diabetes,
  cardiovascular diseases, several types of cancer,
  and gallbladder disease.
• Patients of public sector health plans Medicaid,
  Medicare

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Measurement Screener
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The Following Slides Describe What Nurses Can Do
to Affect Policymaking on Several
Levels______________
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STRATEGIES FOR
Success
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Strategies for Success

• The Surgeon Generals Call To Action To Prevent
  and Decrease Overweight and Obesity, 2001.
• a. CARE- communication, action, research and
  evaluation
• b. 5 settings of action to include families
  and communities, schools, health care, media and
  communications and worksites.

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Strategies for Success

• 2. Support the Honorable Mr. Patrick J. Tiberis
  concurrent resolution -- H.Con.Res.76.
• Now in the Committee on Energy and Commerce
• Recognizes associated health risks of obesity
  (rising incidence of DMII, sleep apnea leading
  to learning problems, hi cholesterol, HTN,
  orthopedic problems, liver disease, and asthma)
• Increased hospital treatment costs
• Largely behaviorally based
• Encourages parents to promote healthy weight
  increased physical activity to their children

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More on H.Con.Res.76

• Introduced 3/27/03
• To express the sense of Congress
• Requires approval by both House and Senate, but
  is not sent to President for signature
  therefore does not have the force of law
• No appropriations

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Subcommittee Members
Democrats
Republicans
Brown OH Waxman CA Hall TX Towns NY Pallone
Jr NJ Eshoo CA Stupak MI Engel NY Green
TX Strickland OH Capps CA Gordon TN DeGette
CO John LA Dingell MI
Bilirakis FL Barton TX Upton MI Greenwood
PA Deal GA Burr NC Whitfield KY Norwood
GA Cubin WY Wilson NM Shadegg AZ Pickering
MS Buyer IN
Pitts PA Fletcher KY Ferguson NJ Rogers
MI Tauzin LA
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Strategies for Success

• In June 2003, U.S. Senate Majority Leader Bill
  Frist (R-TN), Senator Jeff Bingaman (D-NM), and
  Senator Christopher Dodd (D-CT) introduced a bill
  to reduce obesity, particularly among children
  and adolescents it passed in December 2003. It
  is called Improved Nutrition and Physical
  Activity Act or the IMPACT Act.
• It provides 60 million for a demonstration
  program to fund communities in developing proven
  interventions

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Strategies for Success
3. The third strategy would be to support
Department of Health and Human Services (DHHS)
Secretary, Tommy Thompson with a. Public
docket meetings b. Food and Drug
Administration 4. Fourth strategy support
state and local efforts such as the Marin County
-The Safe Routes to School Program
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Strategies for Success

5. Encourage your community visionaries to apply
for HHS announced 13.7 million to go towards 12
grants supporting community programs designed to
prevent diabetes, asthma and obesity. These
grants are part of the new program at HHS
entitled, Steps to a Healthier US.
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Strategies for Success

• Support
• proposed revisions in the nations dietary
  guidelines including a healthier proportioned
  daily food model than of the current pyramid
• school lunch programs
• the Womens, Infants and Childrens Food program
  (The Nations Health, 2003).
• -Michael Jacobson, the Executive Director for
  the Center for Science in the Public Interest

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Controversy Over Dietary Guidelines Policymaking

• Mary Story of APHA, Food Nutrition
  Cornerstone of Federal Nutrition Policy is an
  advocate her committee scrutinizes public
  policymaking
• CSPI (Center for Science in the Public Interest)
  opposes the inclusions of committee members on
  DHHS taskforces addressing obesity who serve dual
  loyalties (American Egg Bd., Sugar Assoc.,
  National Dairy Council).
• Peter Fitzgerald, R-Ill is critical of USDAs
  role.

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Strategies for Success

• 7. Remove barriers to physical activity.
• A recent study reported that children of
  Hispanic, Mexican- American and African-American
  ethnicity had decreased opportunities to
  participate in after school physical activity
  programs.
• (Duke, Huhman, Heitzler in JAMA 290(10)
  1308-1313.)

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Strategies for Success 7 continued

• National Coalition for Promoting Physical
  Activity.
• Four focus areas for physical activity to
  include
• After-school programs
• Community programs
• Community designs
• School programs.
• Three sections
• Rationale,
• Recommended policy options
• Policies in action

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Strategies for Success

8. Support Nutrition Educators To get
reimbursed for their services as they help to
incorporate health promotion strategies into
nutrition education interventions
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Strategies for Success

• Support and expand the medias efforts to make
  the general public aware of the epidemic
  proportion of childhood obesity.

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Strategies for Success

• CDC conducted a qualitative study to help
  researchers understand young peoples beliefs and
  issues related to healthy and unhealthy eating
  healthy and unhealthy weight, underweight,
  overweight and obesity physical activity/sport
  behaviors barriers to engaging in healthy eating
  and physical activities and potential campaign
  messages.
• The findings offer implications in
  communication strategies when targeting young
  people and healthy weight communication (CDC,
  2003).

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Dissemination of Knowledge
General Public
Public Officials Federal State Local
Special Interest Groups Media
Health Care Workers Pediatric Clinics Public
Health Dept School Based Clinics
Public and Private Schools
Nursing Organizations Specialty Groups Internet
viewers (nurses)
Tool Kit Letter - Poster Brochure -
Kids Risk Chart PowerPoint presentation
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Summary

• The nine strategies, as well as proposal and
  tools for dissemination of information, offer
  impetus to your effort of establishing
  community-based programs to combat the rising
  childhood obesity epidemic.
• The sad fact is that once children become obese
  the likelihood of returning to and maintaining a
  normal weight is small (Surgeon General, 2001).
• So, we must act now and work together to create a
  winning environment for the young people of our
  community.