The Rates Of Childhood Obesity

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The number of children experiencing childhood obesity continues to remain too high and poses health threats. Although childhood obesity is multifactorial, research has shown over and over again the impact physical activity has on decreasing this risk, as well as reducing many other health risks. After conducting a windshield survey in the Eliot neighborhood of Portland, OR, it was apparent access to physical activity for everyone, but specifically, children were lacking. Oregon’s obesity rate, or those with a BMI of over 30, is around 30% (OCSW, 2019). Although that value represents obesity overall, including adults and children it’s still a pertinent value, as childhood overweight/obesity often carries over to adulthood. To remedy this issue, the root causes or an upstream approach must be considered. One of those causes is access to areas with characteristics that either promote physical activity or where it can be easily facilitated. The authors of the study Association of neighborhood-built environments with childhood obesity: Evidence from a 9-year longitudinal, nationally representative survey in the US (2019), found living in neighborhoods with certain features reduced the risk of becoming overweight or obese. The article highlights many different built environment characteristics that make areas more or less walkable, including residential density, street intersection density, fitness facility density, and recreational facility density (Jia, Xue, Cheng, Wang, & Wang, 2019). The article concludes with evidence that the built environment is indeed an important contributor to childhood obesity and gives ideas for future studies to expand on this topic and verify the results.

Walking through the Eliot neighborhood or visiting schools in the Portland area can be an eye-opening experience in many ways. What became apparent during the windshield survey and clinical’s at the American Red Cross was that childhood obesity is still a prominent issue. The Centers for Disease Control and Prevention (CDC) reported in Multnomah County alone, 26% of eighth-graders and 23.4% of eleventh graders were either already overweight/obese or at risk of becoming so (CDC, 2013). Those are staggering numbers representing about a quarter of each age group. Childhood obesity may be a complex and multifactorial issue that’s difficult to fully understand, but that doesn’t mean we can’t study it and effect change. The authors of a pediatric obesity systematic review stated, “childhood and adolescence are particularly vulnerable life stages requiring protective social and public health policies” (Cauchi, Glonti, Petticrew, & Knai, 2016, p. 1117).

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Since this age group is vulnerable and in need of protective social and public health policies, as public health nurses we should ask ourselves how we can meet those needs. Messiah et al, (2017) gave an excellent example stating, “given the intersection of the health disparities and obesity crisis, it will be increasingly important to capitalize on existing resources” (p. 66). In that study and many others, our existing resources include environmental resources such as parks. Cauchi et al. (2016) conducted a systematic review of childhood obesity environmental prevention interventions. In all, 63 reviews were included and analyzed to show the effectiveness of childhood obesity interventions effective at the population level that had an environmental component (Cauchi et al., 2016). The review found strategies that targeted sedentary behavior consistently yielded the best results. Targeting sedentary behavior is important because to lose weight we must expend more calories than we consume. Sitting on a couch watching TV or playing video games doesn’t require as many calories as other activities such as going for a walk or riding a bike. If children don’t change their diet according to their activity level, they will inevitably have a calorie excess by the end of the day. Since the body doesn’t need the excess calories to function, they are stored as fat and the individual is at risk of becoming overweight or obese. The review also found the majority of the interventions implemented were school-based. Although schools are great places to target children as they spend a great deal of time in them, they shouldn’t be the only place childhood obesity interventions take place.

When considering neighborhoods, many existing resources and factors are contributing to either increased physical activity or sedentary behaviors. Jia et al. (2019) specifically pointed out environmental characteristics including population density, intersection connectivity, fitness facility density, and recreational facility density. These are all important characteristics because they affect both people’s ability and desire to go outside and be physically active. As mentioned earlier, Cauchi et al. (2016) systematic review found strategies that targeted sedentary behavior consistently yielded the best results. It’s thought by directly making a neighborhood more walkable and ensuring an adequate population, childhood sedentary behavior is targeted (Cauchi et al., 2016). This occurs because humans are social creatures and generally have an affinity to be near one another. When streets are walking-friendly and vibrant street life is present, children are therefore more likely to see other children playing outside and want to join them.

The windshield survey focusing on the Eliot neighborhood revealed many potential risk factors for decreased childhood physical activity. What makes this area interesting is that the neighborhood can be said to have two different sides/natures. While walking distinct residential and commercial areas can be seen. Based on the survey, both of the areas then posed their own separate risks for decreased physical activity in children. In the commercial areas, traffic, higher speed limits, limited crosswalks, and no green spaces were the main concerns for decreased childhood activity. In the residential areas, overgrown and ill-maintained sidewalks along with limited green areas were the potential activity decreasing factors. With this knowledge of the community and research conducted, the PICO question developed for this community assessment was, “How does a walkable neighborhood with environmental resources influence childhood obesity compared to neighborhoods that are lacking these qualities?” To research this question, the keywords used were “children, obesity, and the environment.” A Concordia University Library search led to the article “Association of neighborhood built environments with childhood obesity: Evidence from a 9-year longitudinal, nationally representative survey in the US” written by Jia et al.  

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