Introduction
This essay will include a comprehensive analysis of the issue of childhood obesity. Since a child's early development, circumstances and experiences influence and define their long-term health and prospective health disparities. Thus, establishing a good start in life is a vital public health concern. It makes social and economic sense to establish programs focused on enhancing early childhood development outcomes. Over the decades, has struggled to improve its children's development prospects, particularly during their early childhood years and the transition to schooling. Weight issues and childhood obesity are linked to low-income households and ethnic minorities (Davies et al., 2019). Most overweight children stay obese throughout adulthood, affecting their life quality and shortening their mortality. Creation of obesity prevention programs at schools and extracurricular time will help children live long healthy lives while saving money for the Public Health Service and our economy (Rudolf et al., 2019). Obesity affected approximately 64% of the U.K. adult populace by 2019 (Holmes, 2021), costing the National Health Service £4.2 billion a year (Butland et al., 2007). Obesity is much more difficult to reverse in adults than it is in children. Thus, we need to address obesity prevention in children's development so that they can continue a healthy and active lifestyle throughout their life course. Obesity prevention in children has become a top priority for the WHO and governments worldwide (Rudolf et al., 2019).
Obese children struggle with a variety of psychological, behavioral, and emotional issues. Due to harassment, bullying, and stigma by their peers in school and at home, many children suffer from low self-esteem. Children also have a higher risk of developing health problems, including cancer, cardiovascular illnesses, respiratory problems, high blood pressure, and diabetes which significantly affect their quality of life. Childhood obesity also has a negative impact on the emotional development of children, who often experience discrimination, social isolation, and bullying. This leaves children with low self-esteem and anxiety (Sagar and Gupta, 2017).
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High numbers of children are not reaching the recommended levels of physical activity (PHE, 2020), in particular children from lower socioeconomic groups and ethnic communities. Ofsted's thematic review of obesity and physical activity (2018), recognizes that whilst it is one of the biggest public health concerns in our century, schools play a crucial role in supporting healthy lives. Only 47% of young people and children met the Physical Activity Guidelines by the Chief Medical Officer, and engaged in 60 minutes or more on average physical exercise each day, according to the Sport Active Lives research from 2018 to 2019.
Promoting the health and well-being of students through increasing extracurricular time at schools has the potential to improve health and well-being outcomes and minimize unhealthy behaviors and poor health throughout adolescence and adulthood. For instance, implementing active environments such as swimming, martial arts, and physical sports will all allow students to appreciate hard work, and determination and become successful adults that make healthy habits and thrive under pressure, instead of turning to detrimental lifestyle choices to cope. Ofsted's thematic review (2018), shared that parents often struggle with the cost of such school clubs, so schools must take into account the offer of reducing costs, in order to beat health inequalities. This is an example of primary preventive measure schools across the country should take to reduce the barriers to health.
Secondary preventions are another key factor based on detecting ill symptoms early and preventing them from escalating (Kisling and Das, 2021). Implementing a range of activity programs in's boroughs would address weight loss within families and communities with the greatest need which can potentially identify any health risks early on and invite a range of individuals to join. The NICE guidance (2014) highlights weight loss programs within communities are both cost-effective and evidence-based interventions that reduce the risks of diseases associated with obesity. However, GPs' reluctance to raise this issue and a lack of confidence in the effectiveness of the program have resulted in low referral rates (Ahern, 2017).
Discussion
The RE-AIM framework assesses effectiveness based on five factors: reach, efficacy, adaptability, implementation, and maintenance (Glasgow et al, 1999). The framework may be used to assess whether community-based and public health interventions are worth investing in in real-world environments, providing decision-makers with information on the adaption or discontinuation. Reach represents the participation of individuals as well as their characteristics and is compared to the target population. Efficacy relates to how effective the impact of the intervention is on behavioral outcomes and participant satisfaction. Adoption means the number and proportion of settings such as communities that adopt a given policy or program. Implementation describes the extent to which the intervention is delivered as intended. Lastly, maintenance ensures that the intervention stays stable and sustained over time (Shaw et al, 2019). The RE-AIM framework has been proven to be effective in addressing contextual elements such as policies and analyzing the consequences of an intervention on participants' quality of life. The intervention may be implemented in a GP or school context (King et al, 2010). However, implementing the five RE-AIM factors can be challenging and bring difficulties to the implementation of interventions. For instance, economic constraints on communities, changes in local demographics, and upkeep are all variables that impact whether or not public areas remain used indefinitely. As a result, the RE-AIM framework must be expanded to cover a broader range of indicators, such as those impacting maintenance costs.
Health care is an important aspect of the economic growth of a country. Therefore, the government needs to increase its spending on public health promotion and the well-being of its citizens. An ailing population means most public resources will be spent on healthcare instead of developing infrastructure for economic growth. By 2050, it is estimated that the NHS will spend close to £9.7 billion on obesity and overweight-related illnesses (Public Health, 2017). We can achieve health promotion by integrating strategies, policies, values, and concepts into the public health system (The King's Fund, 2010).
Certain socio-economic variables lead to childhood obesity. The surroundings where a child grows up can influence whether or not the child becomes overweight. Obesity is common amongst individuals from low-income homes and those from high-income households have been observed to be healthier and in standard weight. Between 2006 and 2012, childhood obesity rates in Liverpool, one of the's poorest cities, rose by upwards of 3% (Noonan, 2018). Throughout the six-year research, children from impoverished areas become overweight at a higher frequency than children from less disadvantaged groups (Noonan, 2018). According to Government research, a child born today in the most deprived area in will have nineteen years less to live in good health and die nine years earlier than a child born in the least deprived area (PHE, 2018). Due to this, to address the causes of poor health rather than merely the symptoms, health and social care services across the country must undergo substantial changes toward preventative care. Prevention on all levels improves not only health but reduces the demand for public services and supports economic growth. Nevertheless, we spend 60% of public healthcare funding on cure and rehabilitation, and only 5% is spent on prevention. This implies we spend £97 billion a year on disease treatment and barely £8 billion on disease prevention (ONS, health accounts, 2018).
Currently, children are consuming an excessive amount of sugar intake. According to PHE (2018), a ten-year-old is consuming as much as an eighteen-year-old should. Given the rising burden of obesity-related health conditions, sugar intake has become a key public health target used to lobby decision-makers. To help overcome this and beat health inequalities, the government introduced a soft drinks levy which was designed to encourage businesses to reformulate their products' sugar content and produced excellent results. Over 45 million kg of sugar annually was removed from soft drinks following the reform, allowing families healthier options to choose from and tackling childhood obesity (HM Treasury, 2018).
The goal of economic evaluation is to determine the value gained from resources spent to perform a certain intervention or program. This assists in identifying how efficiently resources are used, whether there are better methods to use them, and the benefits that might have resulted from pursuing a different approach (PHE, 2018). This allows clear decision-making about where resources are allocated, considering the implications and advantages before any decisions are made, and enables the distribution of resources that are beneficially maximized to society as a whole.
Economic evaluation contributes to evidence-based decision-making by providing insight into the value of public health investments to the broader public health system. Evidence demonstrates that increased investment in preventative efforts, as well as advances in public health practice and decision-making, appears to provide measurable and long-term health benefits (Rabarison et al, 2015). Through considering epidemiological evidence of health issues, public health professionals are able to identify disease risk factors and targets for preventive healthcare and treatments, thus allowing information on policy choices and evidence-based practice. This is beneficial for public health as the data from interventions enables decision-makers to choose which interventions are effective, efficient, equitable, and sustainable (Rabarison et al, 2015) thus indicating how economic evaluation demonstrates the scalability and long-term viability of interventions.
For instance, decision-makers may allocate resources for an intervention that would align with a health policy or a local priority such as reducing health inequalities or obese children. If the health policy was aimed to reduce obesity, a running group for school-aged children may be funded instead of an acting class, if it meant supporting obese children to live healthily. In this approach, decision-making is influenced by economic evaluation rather than adopting it. Through assessing whether spending is in alignment with policies and choosing priorities, an explicit assessment of helping a priority group is established.
According to PHE, (2018) guidance, challenges to effective evaluability assessment include a shortage of required economic expertise and knowledge, inadequate time, and difficulty measuring costs, especially when merged with various sectors such as education as it will be difficult to collect data. As well as this, spending resources in one sector may lead to another being left with limited funds.
Overall, it is critical to consider economic evaluability as adding value to decision-making and supporting disadvantaged groups. It has become a common approach for guiding health policies and influencing therapeutic decisions. It assesses the relative costs and impacts of health treatments, with the overall goal of maximizing population health for the resources available.
Conclusion
With the rising prevalence of obesity and chronic illnesses, the government should establish measures to assist children in making healthier consumption choices and put a stop to the epidemic which will be expected to skyrocket in the next ten years if appropriate policies are not implemented. It is critical to find new and inventive approaches to combat obesity. Policymakers have a unique potential to address the obesity epidemic in our country. The findings of this research are important in supporting the future's longevity and health.
As a nurse, I have developed a new way of thinking about obesity since understanding the root causes and preventative measures to combat it. It has influenced my future practice by broadening my knowledge of wider determinants of health, enabling me to empower patients through education on healthy meals and lifestyle choices.
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