Crisis in Global Health and Social medicine the Problem of Obesity

Introduction

The healthcare understanding in an interdisciplinary and international context is known as global health. It incorporates research, study and medicine practice with a focus on health and healthcare equity improvement for global populations. Global health initiatives consider non- medical and medical areas such as sociology, epidemiology, public policy, economic disparities, cultural studies and environmental factors. In the past decades, the concept of crisis is an area of concern in the global health and social medicine context. Factors such as the dramatic consequences of climate change, the growing fear about the spread of deadly diseases, the terrorist attack of 11th Sep 2001 and the vulnerability of underfunded and rapidly increased privatized health care systems have contributed to a sense of a fragile world that is at the verge of collapsing. Global health and social medicine essential indicators have frequently pointed out a health crisis. This essay examines obesity as a non-communicable disease that triggers global health and social medicine crisis.

Childhood obesity

Powell, (2019) argues that obesity is a complex health disease characterized by an excessive amount of body fat. The author further explains that obesity is a medical issue that triggers risks to other diseases and health issues such as diabetes, high blood pressure, heart disease and certain cancers. Childhood obesity is a global crisis and its prevalence has increased over the last decade. An imbalance between calorie intake and calories utilized triggers childhood obesity. Psychological physical and social health problems are linked to childhood obesity. Childhood obesity is triggered by environmental, behavioral and genetic factors.

According to Samaras et al (2019) in 21st-century childhood obesity has become a serious public health issue area of concern. This issue is global and is steadily affecting many middle and low-income countries certainly in urban setups. Childhood obesity prevalence has escalated rapidly. Wolfenden, Ezzati, Larijani & Dietz (2019) argues that on a global scale the overweight children under 5years of age are about over 41 million. Additionally, about half of the total number of overweight children under 5 years lives in Asia while one quarter lives in Africa.

Wolfenden, Ezzati, Larijani & Dietz (2019) argues that there is a high probability of obese and overweight children to continue fighting obesity epidemic even at adulthood and prone to develop non-communicable diseases such as cardiovascular and diabetes at a younger age. Obesity and overweight, as well as diseases linked with it, are largely preventable; however, there is a need to prioritize childhood obesity.

Genetic influence on obesity

Over the past two decades, a growing number of genes have been described in which loss of function mutations are consistently linked with the severe obesity in early childhood development. Whilst individually these disorders are rare, cumulatively about 10% of children suffering from severe obesity have rare nonsense mutations, chromosomal abnormalities and missense mutations that strongly drive the carrier's risk of becoming obese. Farooqi (2019) argues that genetic obesity syndrome diagnosis provides valuable information to the patient and their family, thus helping them in dealing with social stigma linked with childhood severe obesity. In some instances, discovering genetic triggers for a patient’s obesity may lead to specific therapeutic interventions.

Farooqi (2019) argues that less than 1% minor allele frequency, highly penetrant genetic variants in multiple genes have been linked with childhood severe obesity. However, these disorders are rare, cumulatively at least 10% of children suffering from severe obesity have chromosomal abnormalities or other penetrant rare variants that drive their obesity. Severely obese children assessment should be directed at screening for neurological, endocrine and genetic disorders. Useful information is obtained from detailed family history as an approach of identifying probable consanguineous relationships, the presence of family members linked with severe obesity, the ethnic origin of family members and who have had bariatric surgery.

According to Farooqi (2019), some genetic obesity syndromes are linked with clinical disorders and learning difficulties that require children to seek medical attention at a young age. However, there is an increasing and large group of genetic disorders where severe obesity is the presenting feature. Additionally, childhood severe obesity can be triggered by a multiplicity of defects that involves the leptin-melanocortin pathway.

Genetic factors triggering childhood obesity are complex to alter. However, places and people play a vital role in helping children in achieving and maintaining a healthy weight (Farooqi, 2019).Environmental changes such as where children spend time in like schools, homes and community settings making it easier to access nutritious foods and be physically active. Schools can adopt practices and policies that aid children in to feeding on more vegetables and fruits, eat fewer foods and beverages that consists high volumes of solid fats, added sugars and increase daily minutes of physical activities. This type of school-based and after school policies and programs are cost-effective and save on costs.

Environmental influences on obesity

According to Ashi et al (2019), a global rise of childhood obesity is highly contributed by environmental factors such as high sweetened beverages, television watching, high food consumption, and less activity as opposed to biological ones. Today as a result of globalization, children are every day exposed to images and offers of high caloric/fat palatable and inexpensive foods. Additionally, the physical requirements have changed impacting on imbalanced expenditure and energy intake. Boswell, Byrne & Davies (2019) argues the modernized lifestyle subject individuals to an obesogenic environment encouraging people to exercise less while eating more. For instance, several studies discovered a close connection between obesity and time spent watching television in children. Ashi and colleagues further argue that several reviews on obesity point to the potential contribution of environmental factors that discourage physical activities and promote excessive food consumption.

Several factors explain the current childhood obesity epidemic. However, childhood obesity pathways are still complex and still unclear. Obesity reflects complex interactions among metabolic, genetic, cultural, behavioral and environmental factors. According to Katzmarzyk et al (2019), the majority of works relies on parent and child characteristics and fails to consider multilevel context or family system in which child risk factors emerge. It is therefore imperative to consider social and biological determinants of childhood obesity at family, individual and community levels and across early childhood.

Among diverse factors that underlie childhood obesity family and parental history of obesity are likely to have strong influences via genetic and environmental factors. Ashi et al (2019) argue that family factors play a significant role as family members are likely to have similar screen time, diets and physical activity behaviors as well as major influences by attitudes and perceptions concerning activity and diet that contributes to obesity. Behind these behaviors and factors, the family’s socioeconomic status plays a decisive role in childhood obesity aetiology.

Katzmarzyk et al (2019) link a socioeconomic gradient with childhood obesity. The author further argues that parental education is a socioeconomic position (SEP) indicator that has a consistent inverse association with childhood obesity. Other SEP indicators such as family income and parental occupation are normally inconsistent. Katzmarzyk and colleagues argue that low SEP is linked with a 41% higher risk of obesity in children between 0 age and 15years in high-income countries such as Europe, North America and Oceania.

According to Rouse et al (2019) childhood obesity is higher in people originating a low socioeconomic status in developed countries as opposed to developing economies. Socioeconomic factors are prone to be linked with child adiposity through diverse pathways such as attitudes, knowledge, constraints on physical activity patterns as well as constraints on nutrition patterns. Higher obesity risks in developed countries children with lower SEP is linked with less access to safe exercise and healthy food, discrimination against socioeconomic advancement, fewer interests in weight control and physical effectiveness. However, in developing countries and less economically developed areas where opulence coexist and malnutrition food availability is a daily threat in low SEP and obesity populations perceived a sign of wealth. Rouse and colleagues argue that parental educational levels are more consistently inversely linked with childhood obesity relative to other indicators. The author further argues that parental education level as socioeconomic indicator influences beliefs and knowledge and these are factored as essential for the development of obesity and healthy lifestyle. Additionally, higher education achievements facilitate better utilization of available nutrition information and understanding that assists individuals decisions on dietary practice and normally follows recommendations on health behaviors and actively responds to media messages that are health related as opposed to lower socioeconomic groups.

Katzmarzyk et al (2019) argue that children from more educated parents are prone to consume snacks and eat breakfast and are less likely to eat foods rich in energy contents such as sweetened beverages and instead they eat more fruit and vegetable intake. On the contrary, children from low SES tend to eat food that is rich in low-cost energy and dense food, low participation in physical activity sports and lower weight control awareness. The environment where families live also contributes to a less healthy eating diet. Rouse et al (2019) argue that children living in more deprived places tend to eat more sugar and sweets, fewer fruits and vegetables, salty snacks and soft drinks, fats processed meats relative to children living in higher-income households. Liao, et al (2019) argues that excessive intake of food is a significant contributing factor to obesity.

Families living in poverty differ in priorities to those with a stable SEP. Families facing poverty are prone to unintended disinvestments in health and health behaviors. The child hood obesity social gradient in some populations is partly due to physical activity and healthy eating is considered as a low priority in a deprived household. This challenge is still complex in the contextual world. Modernized food environments are encompassed with energy-dense and poor nutrients food. In essence, these foods are processed and highly palatable in a manner that makes it hard for the body to regulate weight and intake. Liao, et al (2019) argues that the biological vulnerability to ultra-processed foods is particularly a threat to children due to high preferences for sweeter foods as opposed to adults. Liao and colleagues argue that industries work to develop brand loyalty for Children food products. Therefore early exposure and marketing to ultra-processed foods at tender age shapes children’s preferences, taste and expectations for unhealthy products.

According to Cheng et al (2019) childhood obesity has contributed to rapidly increasing cases of obesity-related chronic illness in children. The author further outlines that being overweight increases a child risk for diverse conditions and diseases such as asthma, diabetes, heart disease, gallstones, liver problems, high blood pressure and trouble sleeping. According to Weihrauch-Blüher, Schwarz & Klusmann (2019) between 25 and 40 % of overweight children suffer a metabolic syndrome which sets the stage for heart problems and diabetes. These metabolic syndromes include insulin resistance, obesity, high blood pressure and abnormal lipids. Overweight children and adolescents are prone to become obese or overweight adults. Sedentary lifestyles and unhealthy diets are risk factors for cardiovascular disease, cancer and stroke the three leading causes of death in adults.

Stigma and self-esteem

van Vuuren et al (2019) argues that apart from suffering poor physical health, children who are obese and overweight are targets of early social discrimination. The social stigmatization and psychological stress trigger low self-esteem that interferes with social functioning and academic performance and persists into adulthood. Obese children may score lowly in school due to self-esteem issues relative to children who are not obese. Van Vuuren and colleagues argue that there are high suicidal cases linked with stigma and self-esteem issues due to obesity. Childhood obesity in most cases extends to teenage hood and finally adulthood. Obese teenagers struggle with self-esteem issues that sometimes lead to suicidal cases.

Conclusion

Childhood obesity is triggered by an imbalance between expenditure and energy intake. Genetics and lifestyle factors play a crucial role in obesity development. The hereditary studies outline the genetic component of obesity, however, currently only a small portion of that component is unravelled.On the other hand, western societies are linked to high rates of obesity due to sedentary behaviors and highly caloric diets. Though there is an increasing awareness on environmental factors The underlying triggers for obesity are more complex involving cultural and social aspects that a more biological context involving regulation of blood intake, epigenetics mechanism and gut microbiota contribution. Future studies focusing on gene lifestyle interactions, environmental and genetic factors will definitively help in the understanding complex architecture of childhood obesity onset and development. Educating both parents and children about healthy nutrition and encouraging them to be physically active reduces childhood obesity.

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References

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