Childhood Diabesity: International Applications for Health Education and Health Policy

Article excerpt


The twin epidemics of diabetes and obesity have been identified as a growing public health concern worldwide (1-5) to the point that the terms Obesity-Dependent Diabetes Mellitus (ODDM) and diabesity have been coined to express the relationship between the obesity epidemic and increasing rates of Type 2 diabetes. (6-8) Diabesity is an important public health problem due to its high treatment costs, its many co-morbidity factors; decreased productivity among those affected and shortened life expectancy, but perhaps most importantly due to its increasing rates. (1), (9,10) In the United States alone, the prevalence of overweight and obesity is increasing with an estimated 129 million Americans classified as either overweight or obese. (11) The prevalence of diabetes among Americans has been estimated at 7.3% for population 20 years or younger. (12) Diabesity, however, is a worldwide problem; it is estimated that by the year 2025, the worldwide number of patients with diabetes will be approximately 300 million.

The literature suggests that while diabesity in the adult population leads to negative health outcomes, ODDM (Overweight and Diabetes) in children can be worse. Children with ODDM suffer from biological and psychological effects as well as decreased quality of life. (13-16) Worldwide, the WHO global database on child growth and malnutrition indicates that the highest prevalence rate of overweight is found in Latin American and the Caribbean.

Purpose of Study

The purpose of this paper is to explore policy implications for the development, implementation, and evaluation of health education programs designed to decrease diabesity among children.

Threats to childhood health

Decreasing childhood obesity has been identified as a public health priority by the World Health Organization.5 The incidence of childhood obesity and overweight has increased not only in industrialized nations, but also in developing countries. The 2002 World Health Report revealed that high rates of overweight in children is becoming a marker for countries at risk for development of a future diabesity problem in nations with developing economies. (9,17)

Findings from a literature review on obesity, suggested that the World Health Organization has documented disparities in obesity levels around the world. Rates, as low as 5%, have been found in countries such as China and Japan. In Samoa,estimates indicated that 75% of the non rural population is obese or overweight. Obesity rates in China were 20% or higher in cities as compared to rural areas. (9) In Brazil, obesity rates increased by 92% in men and 63% in women between 1975 and 1989 (18). Barcelo reported that according to the National Health and Nutrition Examination Survey (NHANES) in the United States, 31% of children and adolescents between 6 and 19-years-old were at risk for overweight and 16% had been classified as overweight.19 In Mexico, the prevalence of overweight in children and adolescents was estimated to be 27%, while in Brazil it was 13%, in Chile it was 14%, and in Peru it was 12%. (19)

The literature suggests that health policy makers need to be more proactive and engage in a process of analysis at the economic level of the major morbidity and mortality issues affecting a population, within the context of an evaluation of the cost-effectiveness of the various proposed interventions. This analysis should also include what governments can do, with the full range of interventions that are available, including improving public relations, exploring taxation and regulation and developing new strategies in response to the epidemic of chronic disease. These new strategies need to focus less on the direct provision of health services and more on ensuring that the process of economic development encourages healthy behaviors and life style changes. (20)

Health Policies and Diabesity Prevention

The World Health Organization created the Global Data Base on Child Growth and Malnutrition in order to collect systematic data to orient the development of international health policies for childhood diabesity prevention. …


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