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Social Determinants of Health: Trend Analysis Essay

Excessive Weight and US Health Care

Obesity is regarded as one of the most dangerous pandemics of the modern world. The USA has been one of the leading countries regarding the rate of people with excessive weight. The problem is associated with such serious health issues as cardiovascular diseases, type 2 diabetes mellitus, and even cancer (Malik, Willett, & Hu, 2013). Malik et al. (2013) claim that obesity leads to considerable financial losses for the American economy, as “medical costs attributable to obesity” reached the US $147 billion in 2008 (p. 13). This is a heavy burden on the country’s economy as well as its healthcare system. Obesity among adolescents is of specific concern, as the lifestyles developed at early ages persist and define people’s behaviors in adulthood (Ahluwalia et al., 2015). Ahluwalia et al. (2015) note that adolescent obesity tends to have long-term effects irrespective of people’s weight in adulthood.

It has been acknowledged that the rate of overweight adolescents in the USA has stabilized, which is a positive trend. Researchers note that there is quite a small increase in the number of obese adolescents in the USA, which is a positive change given that the rate of overweight adolescents had been increasing in past decades at a significant pace (Ahluwalia et al., 2015). Vereecken et al. (2015) note that there is a certain growth in fruit and vegetable consumption among US adolescents (during the 2000s). It is noteworthy that the physical activity of US youth has also increased considerably. These findings show that there is a certain positive shift in health-related behaviors as American adolescents tend to have healthier diets and lifestyles as compared to older generations.

Nonetheless, these seemingly promising trends conceal one of the major issues persistent in US society. Social disparities contribute to a substantial difference between the lifestyles of minorities and economically disadvantaged groups and middle-class and rich adolescents (Frederick, Snellman, & Putnam, 2014). Frederick et al. (2014) emphasize that recent research shows that the obesity rate among high-socioeconomic status adolescents decreased while the same index for economically disadvantaged groups increased considerably.

It has been found that major factors contributing to the prevalence of obesity among teenagers coming from low-income families are population density, distance to parks, affordability of fruit and vegetables, and the availability of high-quality healthcare and educational services. Rossen and Talih (2014) note that demographic and geographical factors are major contributors to the prevalence of unhealthy behaviors among American adolescents. Young people coming from low-income and ethnic minority groups have few opportunities to be physically active and consume healthy food, which increases the rate of obesity.

It is noteworthy that the US government has tried to address this issue in many ways. Thomson and Foster (2013) note that educational establishments have become the primary platform for promoting healthy lifestyles. Young people are taught what to eat and that they must be physically active to be healthy. Moreover, both the government and non-governmental organizations have introduced various programs promoting healthy lifestyles. At the same time, research shows that these measures have proved to be ineffective as a considerable (and growing) part of American adolescents are still overweight and leading unhealthy lifestyles.

Potential Positive and Negative Impacts

It is possible to consider the impact of the trend in question on the healthcare system with the use of the complex adaptive systems theory. The focus of this paper is on overweight adolescents. Importantly, their socioeconomic status is disregarded as the number of teenagers with excessive weight is considerable in both groups, underprivileged and middle-class or rich people. It is difficult to identify any positive outcomes of the trend mentioned above, but it could potentially lead to major shifts in American society. Excessive weight is a noticeable feature, which will make people see the persistence of social disparity in society (Rossen & Talih, 2014). It is necessary to add that the obvious presence of the problem has made it more acceptable, and many people do not pay a lot of attention to it.

Nevertheless, the number of middle-class overweight adolescents is likely to reduce while the number of poor overweight people will increase, which can make all people see this shift in society. The excessive number of overweight youth will make it a norm for poor people. New stereotypes may appear. Just like people still think that a person of color is likely to be less well-off than a white person, an average person will regard an overweight person as a representative of lower classes. The concepts of emergence and self-organization can be applied when analyzing this positive outcome. There is a certain shift to more sustainable practices as people try to help those in need. Various non-profit organizations appear, and people become more active in their communities. New patterns of helping disadvantaged groups emerge, which can result in the development of various community-based programs encouraging and providing opportunities for disadvantaged groups to lead have healthier lifestyles. People will self-organize to create groups and communities of like-minded individuals who want to help or to seek needed help.

Apart from the potential positive effect on social justice, the trend in question can have a positive impact on the patient/client experience. Healthcare professionals start using inclusive strategies that imply engagement of the client/patient’s relatives, friends, community, and so on. Therefore, when treating disadvantaged groups, healthcare professionals might educate them and, more importantly, help them find opportunities to have healthier lifestyles. Instead of treating symptoms associated with obesity, healthcare practitioners will be able to address the root cause of the trend. Emerging patterns may involve the collaboration of diverse agents that will provide resources to disadvantaged families.

These resources may include training, facilities or areas for physical activity, food (affordable vegetables and fruit), jobs, and so on. Self-organization can also be a characteristic feature of this positive outcome. As has been mentioned above, the major stakeholders can form new systems. Healthcare professionals, low-socioeconomic status groups, high-socioeconomic status individuals focusing on the sustainable growth of the society, and officials can create platforms (non-profit organizations, governmental organizations, groups including digital communities) to contribute to a more proportionate distribution of resources. These agents will be united by such values as empathy, justice, sustainable growth. Americans develop numerous projects aimed at helping different groups of people including disadvantaged populations. Therefore, the chances of middle-class Americans’ involvement in addressing the issue are quite high.

One of the major and the most obvious negative outcomes of this trend is associated with financial issues. Excessive weight is likely to remain a heavy burden on the US healthcare system, as significant funds will be spent to address health issues associated with adolescent and adult obesity. Malik et al. (2013) note that over US$80 billion “in economic production” could be lost if the epidemic persists (p. 14). The concepts of non-linear interdependencies and diverse agents can help explain this outcome. The major agents involved in this situation are disadvantaged groups, middle-class and rich groups, the healthcare system, and the US government. The interaction of these agents will shape the development of their systems as well as the system as a whole (the American society). For instance, privileged and disadvantaged groups shape their lifestyles within the scope of the resources available. High-socioeconomic groups can afford a healthy diet and a lot of training (going to a gym, water pool, doing sports, and so on).

Disadvantaged groups have money to pay for their dwelling, food (often convenience food), some sort of education, but they do not have funds to invest in healthier lifestyles. The government has to address the needs of all groups within American society, which means that they should allocate certain resources needed to address the health issues of disadvantaged groups. Healthcare providers’ operations are shaped by the interactions of the three systems mentioned above as they follow the regulations developed. At the same time, the media can play a central role in the process. The rate of overweight adolescents is high in all socioeconomic groups, so the media will be able to focus on common values such as health and wellness, development, longer and better lives, and so on. Media should promote healthy lifestyles appealing to people’s desire to live better and to become successful. Many modern teenagers want to look like celebrities who are beautiful and successful. Media can continue revealing some secrets of the life of famous people.

The trend in question could also exacerbate social inequity as socioeconomically disadvantaged groups will still have limited access to health care and healthier lifestyles while high-socioeconomic status groups will be able to have healthy diets and lifestyles (Frederick et al., 2014). The concepts of co-evolution and diverse agents can be applied to better understand this effect. The major agents involved have been mentioned above. These agents will behave in a way to fit in their system as well as the larger system (US society). Ethnic minorities, low-income families, immigrants, and so on will try to survive and focus on meeting their families’ basic needs (accommodation, food, education, health care, and so on).

Limited resources will prevent them from having healthy lifestyles, and younger generations are likely to remain in their parents’ class, as they have fewer opportunities compared to privileged groups. The latter will try to improve their life by having healthier lifestyles and obtaining better educational and healthcare services. Privileged groups will see the negative health outcomes of obesity since the health condition will be well researched (minority groups will constitute the largest part of those affected). In other words, disadvantaged groups are prone to the development of this health issue, and their lifestyles have been analyzed and described. There are various educational incentives for teaching young people to have healthy lifestyles. Therefore, people will learn about numerous facts and scientific evidence, and they will see real-life examples in the streets of their cities that will show actual what obesity can be.

The healthcare system will also evolve in response to the development of the systems mentioned above. It is possible to come up with an example of nonlinear interdependence. Healthcare professionals will promote healthy lifestyles, but their strategies will be more successful with privileged groups. As for disadvantaged groups, healthcare practitioners will have to treat various symptoms associated with excessive weight and within the limits of the resources available to these groups. The government will continue investing in preventive measures, but when addressing the needs of disadvantaged groups, it is likely to allocate some funds to treat the symptoms rather than address the cause (social inequality) of the epidemic.


Healthcare managers can become the most active agents of change regarding the problem of excessive weight in American adolescents. The first recommendation to be given to these healthcare professionals involves the focus on the healthcare facility’s employees. The manager should launch a wide discussion of the major factors leading to obesity among adolescents as well as the strategies used by the employees to address the issue. It is crucial to discuss all the methods used with the focus on their benefits and shortcomings. This stage will help employees understand that a change is needed. The second stage will involve the implementation of research and discussions of numerous methods as well as particular procedures used in different states and different countries.

Healthcare professionals should understand that adolescents’ obesity and associated social disparity can and should be addressed at different levels (including the individual level). They should feel empowered to implement the change. It is noteworthy that modern healthcare professionals already pay a lot of attention to dietary habits and lifestyles. They provide information concerning possible outdoor activities, the benefits of healthy lifestyles, and so on. The discussion of excessive weight, its impact has become a part of many nurses’ daily routines (Thomson & Foster, 2013). Nevertheless, many healthcare professionals do not provide any training as they are reluctant to invest their time, which reveals an existing gap. Monetary awards have a positive impact as healthcare professionals enter a certain kind of competition.

The second recommendation to consider is associated with educating patients. Thomson and Foster (2013) argue that educational programs concerning healthy diets and lifestyles are quite ineffective. Healthcare professionals also educate patients/clients and their relatives concerning the most appropriate diets and lifestyles. However, this is not enough, as people having limited resources tend to ignore these recommendations. Moreover, they may feel depressed or even become angry, as they cannot afford the food and lifestyles recommended. It is essential to make this part of communication between the healthcare professional and client/patient more effective. Healthcare professionals should consult patients on the appropriate lifestyle and opportunities available for low-socioeconomic status groups when communicating with the corresponding individuals.

Healthcare professionals will have to implement quite extensive research on the matter, but the healthcare manager can inspire them to do so, stressing that they will become agents of the change that is needed for the development of the US society. The information provided can include data on local markets and groceries where prices are affordable, public parks or other public areas appropriate for physical activity, and so on. Since people often have quite different values, the changes can be hard to implement. The healthcare administration can be the necessary agents of change as they can motivate employees to train patients more effectively. Those who train patients effectively can receive monetary rewards, extra days off, more flexible hours, and so on. The administration should also pay the necessary attention to the development of proper culture involving the focus on such values as empathy, justice, growth, and so on,

The third recommendation to follow is related to the use of an inclusive approach. The healthcare manager should develop several strategies to get the community and different stakeholders involved in the process of addressing this trend. One of the easiest ways to do this is to address local churches and educational establishments as well as non-profit organizations. These agents can help low-socioeconomic status adolescents be more active through participation in various sports or different activities (dancing, manual labor, traveling with the focus on walking tours, and so on). More importantly, the healthcare manager can and should try to change the dietary habits of some groups making them healthier. The distribution of flyers including the information on affordable dietary options can be carried out with the help of educational establishments and local churches.

The healthcare manager can also address local business people (focusing on farmers and retailers) and high-socioeconomic status people who can create more opportunities for disadvantaged groups. The involvement of officials can be the most difficult and the most effective strategy. The healthcare manager can encourage local officials to launch programs involving tours to camps where healthy lifestyles are promoted. Officials can introduce some benefits for entrepreneurs providing more opportunities to disadvantaged groups. The educational sphere can be regarded as an example of the successful use of various projects aimed at changing children’s dietary habits (Malik et al., 2013). The use of certain menus has helped students understand that healthy food can be delicious and affordable. Again, it is necessary to stress that different agents’ values can differ significantly, and it is essential to focus on some values they can share. These may include sustainable development, collaboration, making a difference, and so on. The agents mentioned above have a common value associated with the development of society. Evolution and justice are values cherished in American society.


Ahluwalia, N., Dalmasso, P., Rasmussen, M., Lipsky, L., Currie, C., & Haug, E.,… Cavallo, F. (2015). Trends in overweight prevalence among 11-, 13- and 15-year-olds in 25 countries in Europe, Canada and USA from 2002 to 2010. The European Journal of Public Health, 25(suppl. 2), 28-32.

Frederick, C. B., Snellman, K., & Putnam, R. D. (2014). Increasing socioeconomic disparities in adolescent obesity. Proceedings of the National Academy of Sciences, 111(4), 1338-1342.

Malik, V. S., Willett, W. C., & Hu, F. B. (2013). Global obesity: Trends, risk factors and policy implications. Nature Reviews Endocrinology, 9(1), 13-27.

Rossen, L. M., & Talih, M. (2014). Social determinants of disparities in weight among US children and adolescents. Annals of Epidemiology, 24(10), 705-713.

Thomson, C. A., & Foster, G. D. (2013). Dietary behaviors: Promoting healthy eating. In K. A. Riekert, J. K. Ockene, & L. Pbert (Eds.), The handbook of health behavior change (pp. 139-155). New York, NY: Springer Publishing Company.

Vereecken, C., Pedersen, T., Ojala, K., Krolner, R., Dzielska, A., & Ahluwalia, N.,… Kelly, C. (2015). Fruit and vegetable consumption trends among adolescents from 2002 to 2010 in 33 countries. The European Journal of Public Health, 25(suppl. 2), 16-19.

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