One of the Leading Health Indicators of Healthy People 2020 is nutrition, physical activity, and obesity. Throughout the progress of Healthy People 2020 from 2010 until now, the target for this indicator is 20.1% for Adults meeting physical activity and muscle-strengthening Federal guidelines, the rate in the most recent year is 20.6%. However, for obesity among adults, children, and adolescents’ rates have little to no detectable change. The target rate for adult obesity is 30.5%, the actual statistic is 35.3%. The target rate for children and adolescent obesity is 14.5%, the actual statistic is 16.9%. Moreover, the rate of daily intake of total vegetables is also showing little or no detectable change over the past couple of years. The target is 1.1% and the actual rate is 0.8%. For this health indicator, it can be viewed under 4 different categories which are physical activity, adult obesity, children and adolescent obesity, and daily vegetable intake to investigate and analyze the progress as well as overall outcomes.
The statistic of 2012 shows a significant trend that the higher education an individual has a higher rate of physical activity. Only 7.5% of adult who has less than high school education meets the exercise target rate, while the percentage for adult who graduated high school is 12.3%, some college is 18.5%, associate degree is 21.8%, 4-year college degree is 28.7%, and advanced degree is 30.9%. Shaw’s study on the association between education level, work status, and physical activity suggests that low education individuals’ reliance on employment as a major source of physical activity results in precipitous declines in physical activity as they move through early old age and transition out of the workforce (Shaw, 2008). In contrast, for individuals with higher levels of education, they have more leisure time to engage in physical activity (Shaw, 2008). The study also proposes the important intervention implications for adults with low levels of education; therefore, developing and promoting opportunities for physical activity among individuals with low levels of education should be a major public health priority.
Daily vegetable intake or nutrition has little to no detectable change over the past couple of years. While the nation is abuzz with healthy and fresh food, but for many people especially for those living in low-income communities and communities of color, healthy food is simply out of reach. Neighborhoods that offer access to high-quality foods are theorized to improve individual-level diet and weight outcomes of individuals residing in those neighborhoods (Gordon-Larsen, 2014). The relative costs of fresh fruit and vegetables have increased greatly compared with prices of processed food, making easier access for low-income consumers. Differences in availability and costs of healthier food items as well as other individual-level factors may substantially limit the opportunity for healthy eating among less-wealthy individuals (Gordon-Larsen, 2014). Another contributor to the vegetable intake is the density of fast food restaurant and convenience stores of the neighborhood. Eighteen studies have been conducted to investigate the relationship between income disparities and fast food outlet density, the result shows a significant difference in concentration of fast food restaurant and convenient stores in low, middle, and high-income neighborhood (Hilmers, 2012). Consequently, low-income individuals have easier access to fast food and processed food than fresh fruit and vegetables, more research and interventions are needed to address these issues.
Children's and adolescents’ obesity is another major public concern that needs to be addressed. The average weight of a child has risen by more than 5 kg within the decade, to the point where a third of children are overweight or obese (Lobstein, 2015). The recent statistic shows children aged from 2 to 5 is 13.3%, 6 to 11 is 18.4%, 12 to 19 is 20.6%, 20 and over is 39.6% (Craig, 2017). Children and adolescent’s obesity mostly caused by genetic factors, lack of physical activity, unhealthy eating habits, or a combination of these factors. Despite all the interventions and promotion in healthy eating habits and physical activity by public health, the rate of obesity in children and adolescents still shows no detectable change. One of the noticeable contributed factors is the rapid growth of technology. Studies have shown that children who have more than one hour of screen time such as computers, televisions, phone per day are more likely to be obese than those who watch less, and the average U.S. child has more than 4 hours of screen time for day (Mundi, 2010). This leads to children now have less time to participate in physical activities. Additionally, countless fast food advertisements have been shown on television, video games, and other social media which attract a large number of children that want to try their foods and gradually create unhealthy diet habits. Public health needs to implement more interventions targeting children and adolescents as childhood obesity is more likely will continue to obesity in adulthood.
Adult obesity would increase the risk of chronic diseases such as hypertension, type 2 diabetes, heart disease, stroke, osteoarthritis, sleep apnea and breath problems, cancers, and mental illness such as depression and anxiety (Bass, 2015). Physical activity, daily vegetable intake, and childhood obesity are highly correlated and contributed to adult obesity. The public health needs to conduct a further study to generate and implement a suitable intervention to address these health issues. Once these health issues are appropriately addressed, the rate of obesity in adulthood would be decreased to the desired target.
References
- Bass, R.E. (2015). Severe childhood obesity: an under-recognized and growing health problem. Postgrad Med Journal, 91(1081), 639-45. DOI: 10.1136/postgradmedj-2014-133033.
- Craig, M.H., Margaret, D.C, Cheryl, D.F, and Cynthia, L.O. (2017) Prevalence of Obesity Among Adults and Youth: United States, 2015-2016. NCHS Data Brief. Retrieved from https://www.cdc.gov/nchs/data/databriefs/db288.pdf
- Hilmers, A., Hilmers, D., and Dave, J. (2012). Neighborhood disparities in access to healthy food, and their effects on environmental justice. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3482049/
- Mundi, M. (2010). Childhood obesity’s rapid rise. Retrieved from https://www.empoweryourhealth.org/vol5_issue1/Childhood_Obesitys_Rapid_Rise
- Lobstein, T., Jackson-Leach, R., Moodie, M.L., et al. (2015). Child and adolescent obesity: part of a bigger picture. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25703114
- Shaw, B.A., Spokane, L.S. (2008). Examining the association between education level and physical activity changes during early old age. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2570711/
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Obesity as a Leading Health Indicator.
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