Critical to improving the health of the US population is expanding the role of primary care in the prevention and treatment of childhood obesity. Providers can improve prevention and treatment through efforts in clinical and community setting, healthy lifestyle promotion, community health education, policy advocacy, weight status assessment and monitoring, clinic infrastructure development, and multi sector community initiatives. Coordinated and collective efforts in multiple sectors and settings are needed to address high prevalence of childhood obesity. There is a recognized need to expand the role of primary care to include advocacy in addition to traditional measurement of patients’ heights and weights to assess growth. It is important to identify successful models that integrate primary care, public health, and community-based efforts to accelerate progress in childhood obesity prevention. Vine, Hargreaves, Briefel & Orfield (2013) stated that based on 96 peer-reviewed articles published between 2005 to 2012, primary care providers (PCPs) are increasingly being included in childhood obesity interventions which is consistent with current recommendations from scientific and professional organizations. Being the critical stages of growth and healthy lifestyle development, prenatal and childhood periods need new strategies that encompass more than individual-level behavior change and post-assessment treatment. Well-child visits is the best timing to counsel parents about healthy lifestyle, mold healthy behaviors and refer families to community resources. It is necessary to stress the importance of PCPs to take on the role as educators, promoters of healthy lifestyle practices, and advocates in the broader community on treatment and intervention initiatives. Incorporating curative health services into broader population health is in essence within the scope of universal health coverage (UHC). Built on the 1978 Declaration of Alma Ata, Rodin (2013) stated that UHC movement reaffirmed that health is a human right and identified primary healthcare as the means for attaining “health for all” (p. 710). Transitioning towards UHC, it is necessary for government leaders and policy makers to take into consideration the unique health needs of women. It is important for policy makers to understand the biological and gender-based differences to successfully incorporate women’s needs into UHC schemes. The social protection schemes that cover women’s preventive services and curative services should seek to eliminate or at least reduce out-of-pocket spending on health and to remove the formidable financial barriers that prevent more women than men from accessing needed services (Rodin, 2013). The success or the efficient performance of UHC systems will be dependent upon the stakeholders’ focus on persistent differences between men and women’s health risks, health status, and access to service. Systematically including women’s health needs during the planning process of UHC will not only improve women’s empowerment, but also economic development.
Linguistic facility is a cultural health capital element that could be improved in order to understand, recognized and increase access to care for cultural and linguistic minorities utilizing ethnicity-specific subsystems of care. To create an organizational development model for ethnicity-specific health care organizations and infrastructures, it is useful to consider the historical experiences of the Chinese community in San Francisco. This model includes the development and recruitment of bicultural and bilingual healthcare workforce which will induce satisfying engagements between the target population and health professionals. The other stages in the development of this model are structuring health care resources for maximum accessibility, expanding health care organizations, and integrating ethnicity-specific health care resources into the mainstream health care system (Yang & Kagawa-Singer, 2007). This study further stated: “moving forward from the documentation of racial and ethnic disparities in health care toward long-term solutions that ameliorate disparities, ethnicity-specific health care organizations have untapped potential as a source for a strategy that addresses the structure of health systems that inhibit full access to quality health care for cultural and linguistic minorities” (p. 546). Ethnicity-specific health care systems can contribute to greater equity, comprehensive, and accessible quality care by greater expansion and integration of this health system into the mainstream. Delivering quality health care in culturally appropriate way, and opening the access which was impeded by cultural and linguistic characteristics could be efficiently implemented by matching of patients and providers. Integration of this system to the mainstream will need monitoring of discriminatory practices, and appropriate action to ensure fair competition among provider groups.
Baum, F. E., Legge, D. G., Freeman, T., Lawless, A., Labonté, R., & Jolley, G. M. (2013). The potential for multi-disciplinary primary health care services to take action on the social determinants of health: actions and constraints. BMC public health, 13(1), 460.
Rodin, J. (2013). Accelerating action towards universal health coverage by applying a gender lens. Bulletin of the World Health Organization, 91(9), 710-711.
Shim, J. K. (2010). Cultural Health Capital A Theoretical Approach to Understanding Health Care Interactions and the Dynamics of Unequal Treatment. Journal of Health and Social Behavior, 51(1), 1-15.
Vine, M., Hargreaves, M. B., Briefel, R. R., & Orfield, C. (2013). Expanding the Role of Primary Care in the Prevention and Treatment of Childhood Obesity: A Review of Clinic-and Community-Based Recommendations and Interventions. Journal of obesity, 2013.
Yang, J. S., & Kagawa-Singer, M. (2007). Increasing access to care for cultural and linguistic minorities: ethnicity-specific health care organizations and infrastructure. Journal of Health Care for the Poor and Underserved, 18(3), 532-549.