Introduction
The goal of this study will be to assess the rationale for health promotion, planning and evaluation activities by focusing on the health issue of obesity in young children and teenagers from Saudi Arabia so as to develop a convincing argument for the development of a suitable intervention to decrease the rates of obesity.
Obesity is an important health issue given that the prevalence rate of young children, teenagers and youth around the world who suffer from the disorder has increased over the past 30 years (Bray, 2004). Obesity has been identified as the most common nutritional disorder for many teenagers and young adults around the world and it also contributes to the increased rates of mortality and morbidity amongst the 6 to 19 year age group (Johnson et al, 2002).
Haines & Neumark-Sztainer’s (2006) study on obesity related complications has shown that obesity especially in teenagers originates from both the genetic and environmental determinants such as energy imbalances, hereditary obesity within the family, discretionary physical activity to expend the energy imbalances and changes in the nutritional diet.
Such factors as well as other lifestyle changes have played a big role in the increased prevalence rate of obesity amongst children, teenagers and young adults over the past decade (Borodulin et al, 2008). According to data collected from the longitudinal Bogalusa Heart Study (Nicklas et al, 2003), the prevalence of cardiovascular diseases increased over time amongst children who were overweight thereby increasing their risk of associated co-morbidities such as hyperventilation, breathing problems, sleep disorders, cardiovascular disorders and reproductive health problems.
The results of the study which supported Haines and Neumark-Sztainer’s work (2006) also showed that the aetiology of obesity was mostly related to environmental factors such as the dietary patterns of most teenagers, their level of physical activity and the rate of their metabolism.
With regards to diet, the increased consumption of highly refined foods that have high levels of fatty acids, salt and sugar has been identified as a key contributing factor to the increasing rate of obesity in young children and adolescents. Studies conducted by Chopra, Galbraith and Darnton-Hill (2002, cited by Hills & King, 2007) have revealed that the energy intake of sugars and fat accounts for half of the energy intake for refined grains.
Other researchers, Gazzaniga and Burns in their 1993 study recorded a significant relationship between obesity in children and adolescents and the percentage of dietary intake that arises from fat consumption (Hills & King, 2007).
The target population for this study will be children, adolescents and young adults from Saudi Arabia between the ages of 6 to 19 years old. Obesity within this target group has been on the increase for the past three decades in the country. Based on a study conducted by Al-Nozha et al (2005), the prevalence rate of obesity amongst young people in the country is estimated to be 35.5 percent which has mostly been attributed to the economic growth and development enjoyed by the country for the last 30 years.
The quality and quantity of food intake is determined by the number of children and teenagers that have been exposed to a sedentary lifestyle. According to 1994 and 2000 statistics, the number of young boys estimated to be obese in Saudi Arabia accounted for 16 percent while the number of Saudi Arabian girls between the ages of 12 to 19 found to be obese was estimated to be 28 percent (Abalkhail, 2002).
Characteristics and Consequences of the Health Problem
According to the Centres for Disease Control and Prevention (CDC, 2011), the prevalence of obesity in children and adolescents has increased at a steady rate over the years where current statistics show that 15 percent of young children and teenagers aged between the ages of 6 to19 years are obese or overweight (Agras, 2001).
The characteristics that are used to explain obesity include the body mass index (BMI) measurement which compares the weight and height of individuals to ascertain if a person is obese. If a person’s body mass index is above the recommended measurement of 30kg/m2, then they are termed to be obese or overweight (Kushner, 2007).
The World Health Organization (WHO, 2000) developed the categories of people who are termed to be overweight to include; severe obesity denoted by individuals that have a body mass index of over 30kg/m2, morbid obesity where individuals have a BMI of between 30 to 49.9kg/m2 and super obesity where individuals have a body mass index of 45 to 50kg/m2.
The body composition of an individual is a characteristic of obesity where an individual’s waist circumference and skin-fold thickness is examined to determine whether they are overweight. The most commonly used technique for determining the body composition of an individual is the body mass index and the dual-energy x-ray absorptiometry (DEXA) which measures the energy levels of an individual (Sturm, 2007).
The body mass index of Saudi Arabian children based on a study conducted by Abalkhail (2002) was estimated to be between 29kg/m2 to 32kg/m2 which demonstrated that obesity was on the rise in the country. The anatomical distribution of fat refers to the deposits of adipose tissue that are present throughout the body and they are usually used as an indicator of the health status of an individual.
If a child has an excess amount of abdominal fat, then they are at risk of developing several health complications such as diabetes mellitus, heart complications and pulmonary disorders. One of the techniques used to measure the anatomical distribution of fat is the waist-to-hip ratio which calculates the circumference of a person’s waist and hips.
Computer tomography, ultra sounds and magnetic resonance imaging are also used to measure fat distribution within the body (Sturm, 2007). Other characteristics of obesity include energy intake levels which are measured by an individual’s dietary records and macronutrient composition, energy expenditure measured by the physical activity level and heart rate of an individual (WHO, 2000).
The consequences of obesity according to Bray (2004) fall into two broad categories with the first dealing with consequences that are related to the effects of increased body fat mass and those that are related to the increased number of fat cells within the human being’s body. The health consequences that are caused by increased fat mass in the first category include obstructive sleep apnea and osteoarthritis while the consequences in the second category include diabetes, cancer, cardiovascular diseases and liver disorders (Shoelson et al, 2007).
Obesity contributes to an estimated 300,000 premature deaths in children and adults every year with the main cause being heart related complications (heart failure, cardiac arrest or heart attacks) and other complications such as carpal tunnel syndrome, sleep apnea, asthma erectile dysfunction, chronic renal failure, pulmonary embolism, diabetes mellitus type 2, liver disease and cancer (Peeters et al, 2003).
According to large-scale studies conducted in both Europe and America (Cole et al, 2000), the mortality rates of obesity are termed to be lower at a body mass index of between 20 to 25kg/m2. Children and adolescents with a body mass index of above 32kg/m2 have a higher chance of dying when compared to a children with a BMI of 30kg/m2.
The studies revealed that a person with a BMI of 30 to 35 kg/m2 had a reduced life expectancy of between 2 to 4 years while a person with a body mass index that was above 40kg/m2 had a reduced life expectancy of ten years (Kushner, 2007).
Scope and Relative Cost of the Problem
The scope of obesity refers to the morbidity and mortality rates of the nutritional disorder in young children and teenagers. Morbidity refers to how obesity affects the productivity of a person where people that have obesity related illnesses are at an increased risk of developing physical and mental conditions such as high levels of cholesterol in their blood. Obesity has a significant impact on the economic costs that are needed to manage many healthcare systems around the world (Withrow & Alter, 2011).
These costs are usually in the form of direct and indirect costs where the direct costs refer to the amount of money used in preventive, diagnostic and treatment activities while the indirect costs of obesity are related to the mortality and morbidity costs that are incurred as a result of decreased productivity, restricted activity and loss of future income as a result of premature deaths.
According to Withrow and Alter (2011), the cost of obesity on a country’s total health care expenditure was estimated to be between 0.7 to 2.8 percent of the country’s health care costs. People who suffered from obesity had health care costs that were 30 percent more than those of their counterparts who had a normal body mass index. In the United States, which is one of the countries with the highest recorded number of obesity related cases, the economic cost of obesity accounted for 9.1 percent of the total US medical budget which totalled $78.5 billion dollars in the year 1998 (Sturm, 2007).
While there are no estimates or studies that have been conducted on the health care costs of obesity in Saudi Arabia, the small population in the country as well as the numerous medical facilities have made it easy to properly manage obesity and obesity related disorders amongst young children and adolescents within the country.
Based on 2009 statistics, the country spent 4.5 percent of its gross domestic product (GDP) in meeting health care costs for people suffering from diseases such as diabetes, cancer and cardiovascular diseases which are one way or another related to obesity. However the increasing prevalence of obesity in the country is bound to place some additional strain in the health care costs of the country in the future (Abalkhail, 2002).
Target Group
The target group that will be addressed by this study will be young children and adolescents between the ages of 6 to 19 years old from Saudi Arabia. The reasons that have been given for the increased prevalence rates of obesity within the country include the increasing sedentary lifestyle where more young people are consuming less nutritional food as well as participating in physical activities such as walking, running, playing games and participating in activities that require a lot of physical strength.
According to Abalkhail’s (2002) study of Saudi Arabian children in the eastern province, fewer children were engaging in physical activities and exercises which contributed in a significant way to the prevalence of obesity in the country. Abalkhail also noted that television watching and computer games contributed to the increasing rates of obesity especially in the case of children who were from big cities such as Jeddah.
Researchers have also attributed the increasing cases of obesity to television viewing where young children and adolescents who are frequently exposed to the television, Internet and other forms of media have a high risk of becoming obese or overweight (Brownson et al, 2005).
This argument is supported by a meta-analysis study conducted in 2008 where 86 percent of the respondents showed an increased rate of childhood obesity as a result of constant media exposure (Emanuel, 2008). According to Flegal et al (2001), obesity in children and adolescents has continued to increase over the years in both the developing and developed countries with most paediatricians citing it as a worldwide epidemic.
The prevalence of obesity is generally on the increase in Jeddah, Saudi Arabia where children exposed to urban lifestyles adopt unhealthy dietary patterns because of the sedentary lifestyle in the city. The lack of nutritional programmes for school going children to educate them on nutritional lifestyles has also contributed significantly to the growing cases of obesity amongst most young children and teenagers in the country.
A study conducted by Al-Nuaim et al (1996) showed that obesity was high amongst children from high income families when compared to children from the low income level families. Children from wealthy backgrounds have the ability to afford healthy lifestyles but because of the introduction of processed foods in Saudi Arabia, the prevalence of obesity has continued to increase.
Program Goals
Based on the research information gathered for the study, the program rationale for the project involves examining the key elements of obesity and ascertaining why obesity is a health issue that warrants health promotion planning and evaluation interventions. Health promotion involves providing people with the opportunity to increase control over their health status thereby improving their lifestyle.
The project goal will therefore be to develop health promotion interventions that involve cultural, social, political and economical factors that act as determinants for health. The goal of the project will also be to apply health promotion theories, processes and skills in the promotion of public health practices.
Conclusion
This essay has assessed the health issue of obesity by reviewing the characteristics and consequences of the nutritional disorder as well as the scope of obesity and also the relative economic cost that is posed by the disease on health care expenditure. The findings have revealed that obesity related costs accumulate the majority of national health care budgets around the world which points to the fact that obesity is a worldwide epidemic that needs to be dealt with.
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