Obesity is regarded as one of the main preventable causes of death worldwide. Many studies have shown that obesity is becoming a major health issue in the United States, leading to life-threatening cardiac illnesses. While obesity is a worldwide issue, obesity rates in the United States are concerning. Obesity rates in the United States continue to rise, with two out of every three Americans classified as overweight or obese, according to the Institute of Medicine (2015). Furthermore, the Organization for Economic Cooperation and Development (2015) notes that "obesity has resulted in over 120,000 unnecessary deaths in the United States each year." It is documented that an obese individual incur an average of $1,429 annually on medical expenses, and about $147 billion is spent in the US annually on obesity. Kane and Frisco (2013) report that if the problem of obesity is not attended to, the rate of expenditure is likely to increase to about $1.24 billion every year until 2030.
Keywords: Obesity, Healthy people 2020, Prevention, Outcome, Healthcare
Obesity Health Concern
The problem of obesity is cited to contribute to around death cases of between 100,000 and 400,000 in the US annually along with increasing the healthcare expenditure. According to a report released by Institute of Medicine (2015) US directly spends $177 billion in obesity through diagnosis, treatment, and preventive measures and on indirect costs. The data shows that expenditure on healthcare accounts for around 6-12% of the national healthcare spending in the US. Data from OECD indicate that the US has the highest rate of obesity according to groupings of large trading nations (Organization for Economic Co-operation and Development, 2015). Estimates have steadily been rising since 1962. Only 13% of the American population age above 20 years in 1962 had obesity. In 1997, 19.4% individual had obesity, 24.5% in 2004 and 26.6% in 2007 and that of 2008 was 33.8% (Center for Disease Control and Prevention, 2014). Center for Disease Control and Prevention report also noted that children had a rate of 17%. The rate slightly reduced in 2013 where the rate was noted to be 27.6% by Organization for Economic Co-operation and Development (OECD). However, OECD indicates that by 2020, three-quarters of the US citizens are likely to have overweight and obesity issues. 2016 data showed that 78.6 million American (34.9%) were obese while children aged between 2-19 years from 17%. According to states, Mississippi has the highest cases of obesity which is 34.4 in adults, and West Virginia comes in second with 30. 6% cases of obesity. Alabama is the third state which denotes 30.1% cases. Colorado and Hawaii have the lowest obesity rates of 20.0% and 20.7% respectively.
Obesity in Adults and Health Inequality
According to health people 2020, the rate of obesity in adult people aged above 20 years with age-adjusted is 33.9%. The target for healthy people 2020 is 30.5% with a 10% improvement in the baseline. In 2011-2014 the rate increased to 36.2% raising the alarm to the nation (Aungst, 2015). Male who are aged over 20 years designated low levels rates of obesity compared to females. The rate of men was 34.2% while women had a rate of 38.2% between the years 2011-2014. Statistics among ethnic groups showed that the Asian non-Hispanic population registered the lowest rate of obesity which was 11.6% among the adults when age is adjusted. The Hispanic, black non-Hispanic and the non-Hispanic rates were 42.3%, 47.9%, and 34.4% (Aungst, 2015). According to the report, the population rate of black-on-Hispanic indicated to be four times more than that of the non-Hispanic population. The adult population aged 20 years and more and had no physical activity limitation recorded the lowest rate of obesity than the adults who had the limitation of activity. The rate was 34.4% and 43.7% considering activity limitation between 2011 and 2014. Adults who were 25 years and above considering education level indicated that college graduates registered the lowest obesity rate of 27.9% while adults who had an educational qualification less that high schools had a rate of 34.9% while high school graduates had the highest rate of 40.4%.
Adult Obesity and Socioeconomic Status
Adults who were aged above 20 years and lived with an income of 500% more than the poverty threshold depicted the lowest obesity rate among all the income groups with a rate of 27.1%. 42.7% was the rate of people with incomes of 100-199% above the threshold of poverty while 39.4% was the rate for the population with incomes under the threshold poverty level (Aungst, 2015). 38.4% was the rate for the population that earned between 200% and 399% above the poverty threshold while those who earned 400-499% registered 36.0%. Adults that were above 20 years and born outside the US had the lowest rate of 28.7% compared to those born in the US which was 37.9%. In adults with private insurance, the rate was 34.4% while public insurance adults showed a rate of 43.4%. Additionally, adults who were aged between 20-44 years had an obesity rate of 34.3%, 45-64 years was 40.3% and adults aged above 65 years had a rate of 34.7%. Besides, adults above 80 years had the lowest level of obesity which was 23.1%.
Obesity in Children and Adolescents
The rate of obesity in the population aged between 2-19 years between 2005 and 2008 was 16.1% while that of 2011-2014 was 17.0%. The target rate for healthy people 2020 among these population is 14.5%. Among ethnic and racial groups, the lowest rate was among the Asian non-Hispanic population which was 8.6%. Non-Hispanic populations, black non-Hispanic, and Hispanic, was 14.7%, 19.5%, and 21.9% respectively (Aungst, 2015). The population that had the lowest rate of obesity was recorded among children who had private insurance which was 14.2% and those with public insurance was 20.3% and uninsured with 19.3%. The obesity rate also varied according to the socioeconomic status of the family. The highest rate was noted among those who lived under 100-199% above the poverty threshold which was 20.3%, and those with income above 500% had the lowest rate of 12.0%.
Desired Outcomes
Obesity prevention measures have gained momentum due to the number of deaths that the epidemic claims in the US and globally. The desired outcome in adult, adolescent and even children focus on preventable measures involving identification of the specific behavioral targets of the population. Healthy people 2020 with more emphasis on eating healthy and maintaining physical activity. The overall outcome desire of obesity prevention is the creation of driven societal changes an environment behavioral synergy that will assist in fostering the achievement and maintenance of a healthy weight in the population. The objective denotes focused prevention measures of development of obesity through primary preventable measures. These main preventable measures drive more emphasis on strategies that increase the likelihood of shifting weight management strategies, eating and physical activity particularly in groups who are at high risk.
Desired outcomes in children and adolescent as outlined in healthy people 2020 and institute of medicine inform actions at the community and the national level. Maintenance of a healthy weight trajectory and prevention of excess weight gain when developing, growing and maturing are the primary goals to realize the outcomes. Objectives among these population involve prevention of adverse consequence arising from obesity in the early childhood stages along with long-term prevention of obesity in the adulthood. This is because children who become obese in their childhood are likely to remain with the obese epidemic in their lifetime. Therefore prevention of obesity in childhood could drive the desired results in adulthood. Appropriate concerns and dieting highlight the importance of maintaining a positive body image and concerns of avoiding excessive weight. Cognitive growth and development, reduction in cases of childhood and adolescent obesity and decreasing the prevalence of adolescent and childhood obesity are the desired goals. Also, improvement in the proportion of adolescent and children with dietary quality that meets the “Dietary Guidelines for Americans” and physical activity guidelines are among the goals of the healthy people 2020 (Kane & Frisco, 2013). Appropriate pregnancy weight gain and a healthy adult image is the desired outcome. Reduction of adult obesity, prevalence and attaining the desirable levels of BMI are emphasized by healthy people 2020.
Recommendation to Improve the Health Concern
The first means of improving obesity health concern is the creation of a community environment which will promote and support physical activity and a healthy eating choice. Healthy eating will ensure that there is the availability of affordable healthy food which meets the standard of the society and particularly people with limited nutrition access. This recommendation will also adopt policies and drive the implementation of practices that will work towards reducing the consumption of sugars and educate the public on the health risks that are associated with overweight and obesity. This will also be instrumental in enacting policies that will aid in the implementation of practices to increase the accessibility to affordable health care. Establishment of joint use of an open public facility for a safer physical activity is paramount. Additionally, adoption of strengthening measures and implementation of local policies and guidelines which facilitate an increase in the physical activity will positively work towards reinforcing the aims of the nursing program.
In addition, expansion of the role of heath care and service providers along with insurers in the prevention of obesity is another recommendation. This strategy will work towards ensuring that both the private and the public health insurance coverage comprehensively cover the accessibility of information and incentives for supportive measures. This will make the private and public insurer to direct more efforts to obesity prevention through screening, diagnosis, and treatment. There will also be an increase in the capacity of the primary care providers in the implementation of prevention, screening and treatment of obesity in adults and children by quality improvement methods and education training approaches. Furthermore, this comprehensive plan will direct the development of professional training programs in diagnosis, screening, prevention, and treatment of the obesity and overweight individuals. The training will reach a broad spectrum of medical and nursing practices and align heath programs like continued education. The linkage between the program and the health care based attempts with community prevention activities like a school-based comprehensive program on obesity prevention are vital in supporting the prevention of the epidemic.
Partnership
The private, public partnership that could be formed to aid in the implementation of the policy recommended involving the government and the non-government health sector. The non-governmental public health has to provide technical assistance to the community groups and the local government to aid in the creation and enhancement of playgrounds, parks and another area of physical activity and to include people with disabilities. The government public health practices should, on the other hand, give training, guidance, and support to people for them to have skills requires in the accessibility of nutrition and physical activity. The government has to promote the available opportunities for healthy foods and utilized the social media in the promotion of awareness of fundamental obesity prevention practices and strategies. This should also emphasize on the population that is affected by educational level, racial ethnicity, and economic disparities. Both the government and the nongovernment practices have to increase awareness of obesity and the risk factors of chronic diseases. The nongovernment has to share policies with the policy makers concerning the benefits of promoting the eating of healthy local foods. Schools and daycares have to be recognized and encourage the community to support the implementation and compliance regulations that affect children in the day care centers.
Evaluation
The nursing evaluation process is aimed at determining if the application of the nursing practice yielded the desired outcomes. The nurse has to compare the behavioral response of the target population with the predetermined goals and the criteria for the outcome. The purpose of this is to determine the response of the target population to the nursing interventions. The nurse has to assess the collaboration of the population and the team of nurses and point out any errors in the plan along with monitoring the quality of nursing care. A collection of evaluation data on the target subjects calls for the use of evaluative measures like skill and technique to make decisions on the status and progress of the client. Summarizing and interpretation of findings basing on the evidence will guide the nurse’s judgments on the effectiveness of the measures. The interpretation will help the nurse in developing clinical judgment which will match the results of the evaluation process. The effectiveness will be determined by comparing the established outcome and the set criteria of the outcome. Documentation of the findings is an important reporting factor of the evaluation process that will guide the nursing care plan. The nursing measurable assessment tools involve safety, teamwork and collaboration, quality of improvement and system thinking. Additionally, the patient-centered care and informatics are the other measurable outcomes of the evaluation process.
Conclusion
Healthy people, 2020 has considered practical policies that accelerate the prevention of obesity. Tremendous strides have been directed to address the epidemic of obesity owing to the attention that the epidemic causes. Due to scale and scope of the endemic, deliberate initiatives driven at addressing the obesity epidemic are on track according to healthy people 2020. Goals that are driven at refining the targets and approaches to accelerate relevant changes are aimed at reducing the prevalence of obesity. Notably, existing frameworks to realize successful prevention offer guidance on the way of tackling the epidemic of obesity. According to literature, human and societal consequences of obesity primarily result in the adult years. Adult obesity can be mitigated through stabilization of weight in the adult population. Avoiding incremental weight gain in adult and maintaining proper weight size in the adult years along with high-quality diet aim at reducing the calorie intake.
References
Aungst, R. (2015). Healthy People 2020. Perspectives On Audiology, 7(1), 29. http://dx.doi.org/10.1044/poa7.1.29
Center for Disease Control and Prevention. (2014). Overweight and obesity. Retrieved on June 14, 2017 from https://www.cdc.gov/obesity/
Kane, J., & Frisco, M. (2013). Obesity, school obesity prevalence, and adolescent childbearing among U.S. young women. Social Science & Medicine, 88, 108-115. http://dx.doi.org/10.1016/j.socscimed.2013.04.005
Institute of Medicine (2015). Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation. Washington, DC: The National Academies Press. Advances In Nutrition: An International Review Journal, 3(5), 708-709. http://dx.doi.org/10.3945/an.112.002733
Organization for Economic Co-operation and Development. (2015). Obesity update. Retrieved on June 14, 2017 from http://www.oecd.org/health/obesity-update.htm
