Tag Archives: social inequalities

Parental Obesity and New Mentality: Raising the Risk of Child Obesity

Our nation’s most urgent health problem is the disparities in health care. There are stark disparities in health by gender and socioeconomic status. According to Davis et al. (2005), “the social and community environments affect health directly as well as indirectly by influencing behavior”(p. 2168). Which group do we put parents who have a distorted perception of their child’s body size? This phenomenon is most prevalent among low-income women and Hispanic mothers. But regardless of race or socioeconomic background, the obesity epidemic is eroding the general impression of what healthy looks like. What if obese is the new normal? If obese is the new normal, then it will be our failure as Public Health professionals to emphasize the importance of the role of parents and family to combat child obesity. Parents should play a crucial role in influencing children’s food habits and physical activity. Parental obesity may increase the risk of a child becoming obese. Wrotniak et al. (2004) is the first study to examine the incremental effects of parental weight change on child weight change while controlling for variables that influence child weight loss. The study stated that youth benefit the most from parents who lose the most weight in family-based behavioral treatments (Wrotniak et al., 2004, p. 342).

The prevalence of obesity is increasing in all pediatric age groups according to the Health and Nutrition Examination Survey (NHANES). Genetics, environment, metabolism, lifestyle, and eating habits are among the factors believed to play a role in the development of obesity. More than 90% of cases are idiopathic; less than 10% are associated with hormonal or genetic causes. Hirschler et al. (2008) found an association between mothers’ distorted perception of their children’s shape and eating habits and mothers’ obesity and their children’s overweight. The study provides clues for obesity prevention programs. There is a multitude of health problems that are associated with obesity. Without dealing with the new trend of maternally distorted perception of their child’s body size, health problems faced by family care physicians will continue to rise. There will be continued prevalence of obesity associated diseases such as type 2 diabetes and heart disease to hyperlipidemia, asthma, and obstructive sleep apnea. According to Friedman & Schwartz (2008), “A key concept in developing obesity-related policies is creating ‘optimal defaults’17. When there is an optimal default, the health promoting behaviors are those that come most easily, require the least effort or thought, and offer a more healthful option” (p.718).

References

JAMA Network | JAMA Pediatrics | Parent Weight Change as a … (n.d.). Retrieved from http://archpedi.jamanetwork.com/article.aspx?articleid=485676

Hirschler, V., Calcagno M., Clemente A., Aranda C., Gonzalez, C. (2008, July 21). Association between school children’s overweight and maternal obesity and perception of      their children’s weight status. Journal Pediatric Endocrinololgy & Metabolism. 7:641-9.

Cohen, L., Chavez, V., Chehimi, S. (2010). Achieving Health Equity and Social Justice. L. Liburd & W. Giles, Prevention is Primary (pp. 33-53). San Francisco: Jossey-            Bass.

Friedman, R., & Schwartz, M. (2008). Public Policy to Prevent Childhood Obesity, and the Role of Pediatric Endocrinologists.Journal of Pediatric Endocrinology &                    Metabolism, 21, 717-725.

A Health Strategy on the Reduction of Inequalities: Not a Utopian Fantasy

          As social inequalities in health in the U.S. and international evidence continue to increase, disparities in income and wealth widened the gap making social class as a key determinant of population health. The gap is widening between upper-middle-class Americans and middle class Americans. Health and longevity are determined by the access of advances in medicine and disease prevention. These benefits are disproportionately delivered to individuals who have more education, connections, money, and good jobs. They are the ones in the best position to learn new information early, modify their behavior, take advantage of the latest treatments and have the cost covered by insurance. Since 1911, mortality statistics in Britain have consistently shown an inverse relation between measures of socio-economic status and mortality. While social class has been a less popular topic in the United States, this has been a trend in Europe since George III. Socio-economic disparities in mortality statistics have been increasing both in the U.S. and Britain, despite an overall decline in death rates. It is almost universally the case that the social class, the combination of income, education, occupation and wealth, plays a pivotal role in defining an individual’s ability to change their lives and shaped the odds of getting better. In Europe, people in lower economic class have more morbidity and disability and have shorter lives. Like the U.S., European countries’ immigrant workers and long term unemployed are increasingly isolated from the rest of society.  It is not a Utopian fantasy to develop a health strategy that include reduction in inequalities. Health inequalities vary between countries, thereby it is not a fixed magnitude. Marmot et al. study (1997) stated “material deprivation plays an important role in generating inequalities in health. At a threshold above absolute deprivation, other factors may be more important in generating relative differences in health. If we are to appeal to the concept of relative deprivation, this implies the operation of psycho-social factors related to the position in the hierarchy.”

         There are four major models used to describe social class in health. Life-course, psycho-social, and materialist model are the models that could best explain the relationship of social class and the health outcome of early medical care. Life-course model explains social class inequalities rooted from what happened to a child in-utero and early childhood. Poor home condition overtime is the predominant causation of occupational disadvantage. Psycho-social model explains the effect of social inequality to body chemistry. Stressful social circumstances produce emotional responses which bring about biological changes, thereby increasing the risk of heart disease. Plethora of socio-economic challenges tends to discourage individual to seek early medical intervention.  Materialist model pertains to economic factors in relation to the individual’s environment, such as air-pollution and substandard housing conditions. Studies show a higher rate of childhood respiratory disease in damp housing. Bartley & Blane (2008) noted the fourth model-behavioral model in reference to the Whitehall 1967 study.  The Whitehall study found that differences in health behavior explain only one-third of social class differences in mortality. Evaluations of interventions that seek to change health behaviors have rarely found clear-cut improvements in health.

References

Poverty, Ill Health and Health Care Expenditure – Scribd. (n.d.). Retrieved from http://www.scribd.com/doc/42351361/Poverty-Ill-Health-and-Health-Care-Expenditure

Inequalities in the distribution of health and health care … (n.d.). Retrieved from http://healthknowledge.org.uk/public-health-textbook/medical-sociology-policy-ec

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