Bryan, a ten-year old African American, came to our clinic with his mother for his annual physical exam and follow up immunization. Bryan is 4 feet 9 inches tall and weighs 210 pounds. During the examination, I noted that Bryan walked sluggishly as a result of his weight and he had asthma since the age of seven. Bryan wants to be a policeman or fireman, but right now he gets tired going up the stairs to his second floor class. His dietary intake is high in fat and carbohydrates and he consumes low nutrient snacks such as cookies, sweetened juice and soda. He rarely exercises and his mother believes that obesity is natural in their family and has no connection with her son’s lack of exercise or eating pattern.
Although Bryan is asthmatic, obesity increases his risk to other medical conditions such as diabetes, hypertension and arthritis and can affect his psychological and social wellbeing. His obesity is a problem to his family and our community. Bryan’s weight is a concern to me as a practitioner and my effort is needed to help him get to and maintain an appropriate body weight and thereby improve his quality of life.
According to a National Health and Nutrition Examination Survey report, 17.1 percent of United States children and adolescents aged 2-19 years old are overweight. This number has tripled since the early sixties. Obesity and its associated health problems pose a significant economic problem on our U.S health care system. In 2002, the national health costs related to childhood obesity was $92.6 million and Medicaid paid about half of these costs. State experts have noted that nearly $5 billion is spent annually in New York State for obesity related healthcare costs and 5 percent of all Medicaid costs in the state are due to obesity.
As a Nurse Practitioner practicing in impoverished communities, I have witnessed disparity in childhood obesity among African Americans and Hispanics. New York Department of Health statistics show that one in six African American and Hispanic children is overweight or obese. The statistics from Centers for Disease Control and Prevention (CDC) show that these same groups experience obesity at higher rates than other racial groups. The CDC Morbidity and Mortality report shows that African Americans have a 51 percent rate of obesity compared to Caucasians who have 21 percent prevalence. According to the report, the growth of childhood obesity among African Americans and Hispanics increased by about 120 percent between 1986 and 1998, while it increased by 50 percent among non- Hispanic whites in the same period. These statistics reported in Healthy People 2020 call for the prevention of childhood obesity as utmost importance to this nation.
The report from Racial Disparities in Childhood Obesity 2011 indicates that there are a number of reasons why minorities have a higher obesity rate:1) lack of adequate access to health information; 2) dietary patterns and accessibility to healthy food options; 3) limited access to recreational activities; 4) reduced access to primary care; 5) low levels of education and 6) cultural attitude about body weight. African Americans and Hispanics do not consider obesity as a negative trait which has led to cultural acceptance of the unhealthy condition. Our national goal should reduce disparities in childhood obesity that are influenced by racial, social, economic and environmental factors.
Childhood obesity, which is more prevalent among minority groups, must be addressed. This author supports a fat tax bill on currently untaxed snack foods, sweeteneddrinks and soda. The revenue should be allocated for nutrition and exercise programs for obese children, and also to educate families on the importance of exercise and diet. Opponents includes beverage, soda and snack industries and some congressional committees, who believes that a proposed sales tax will affect mainly low income families and force them to pay higher taxes. The critics of obesity intervention also say that the government should not be monitoring our cookie or snack intake because they are encroaching on the private lives and choices of their citizens. While this is true, I think that soda and snack taxes would have a modest effect on consumption but would generate billions of dollars that could be used to support childhood obesity campaigns especially among minority groups. The lawmakers should consider the effects of childhood obesity, which is more prevalent among African Americans, Hispanics and other minority groups, and implement a comprehensive approach to address the epidemic of childhood obesity. Doing nothing will virtually guarantee that the current obesity problem will continue to threaten the nation’s future and increase the financial burden on our health care system.
I encourage readers and parents of the obese children to support a government tax on soda and snacks, and be selective in their children’s foods choices at school. I also recommend that parents should advocate for schools to promote regular exercise and influence the government to build more recreational centers and primary care centers in their communities so that children like Bryan will grow up healthy and have a good quality of life.
Stella Ikwuazom is a board certified Family Nurse Practitioner who is a primary care provider in Queens, NY.