Academic journal article Health and Social Work

Understanding and Acting on the Growing Childhood and Adolescent Weight Crisis: A Role for Social Work

Academic journal article Health and Social Work

Understanding and Acting on the Growing Childhood and Adolescent Weight Crisis: A Role for Social Work

Article excerpt

The focus of national public health efforts has begun to shift away from the treatment of adulthood obesity to the prevention of childhood and adolescent overweight and obesity (Dehghan, Akhtar-Danesh, & Merchant, 2005). In 2000, the U.S. Department of Health and Human Services (HHS) Healthy People 2010 initiative placed national emphasis on child and adolescent weight status, identifying overweight and obesity as one of 10 leading indicators of public health (Centers for Disease Control and Prevention [CDC], 2010). Further national efforts were undertaken in 2002 when the Institute of Medicine (IOM) was charged by Congress with the development of prevention action steps (IOM, 2004). These efforts represent national attempts to achieve gains in childhood and adolescent overweight and obesity outcomes. Although there is evidence that national obesity rates are stabilizing in some segments of the populations (Flegler, Carroll, Ogden, & Curtin, 2010), it is important for social work professionals to recognize that there is still much ground to be gained in the battle to reduce childhood and adolescent overweight and obesity.

The increase of overweight and obesity among school-age children, and subsequently adults, is influenced by a myriad of factors (CDC, 2008). Described in different terminology, as a multisystem disease in the medical field (Ebbeling, Pawlak, & Ludwig, 2002) and a multisystemic social problem within the social sciences (Eliadis, 2006), what is clear is that the etiology of childhood and adolescent overweight and obesity rests at both the public health and the individual levels. This article seeks to place the causes, impacts, and ameliorations of childhood and adolescent overweight and obesity within the context of ecological systems and current prevention efforts.

BACKGROUND

Overweight and obesity are characterized as chronic physical illnesses with associated chronic health complications and psychosocial implications (Bosch, Stradmeijer & Seidell, 2004). The prevalence of overweight and obesity in children and adolescents, as defined by the presence of a body mass index for age ranging from the 85th to greater than the 95th percentile (CDC, 2009a), is currently three times higher than it was in the 1980s (CDC, 2009b). During this same time period, overweight adults doubled (CDC, 2009b). Prior to 1980, the percentage of overweight and obese children was small; 6.5 percent of children ages six to 11 were overweight or obese, and 5 percent of children ages 12 to 19 were overweight or obese (Eliadis, 2006). By 2004, this percentage significantly increased to 18.8 percent of children ages six to 11 and 17.4 percent of children ages 12 to 19 (CDC, 2008). An additional 31 percent of children under the age of 18 are at risk of being overweight (Hedley et al., 2004).

DETERMINANTS WITHIN MULTIPLE SYSTEMS

There is no single determinate of child and adolescent overweight and obesity; influences occur at multiple levels. The biopsychosocial determinates of obesity and overweight exist at biological, behavioral, psychological, family, and societal levels. Although susceptibility to overweight and obesity can be increased by genetic characteristics, the activation of biological influence more often occurs within the context of environmental influences (Dehghan et al., 2005). Children who have two parents who are obese or overweight may have a genetic susceptibility to being overweight; a slight increase in food consumption may result in a larger weight gain for a child with overweight parents compared with a child with nonoverweight parents (Francis, Ventura, Marini, & Birch, 2007). Support for the existence of a combination of factors is seen in the tripled rate of obesity among school-age children in the past three decades, whereas the genetic characteristics of humans have remained the same (CDC, 2009a).

Behaviors associated with food consumption and physical activity (Arluk, Branch, Swain, & Dowling, 2003; CDC, 2010; Gidding et al. …

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