Childhood Obesity

Background:

Obesity has now become a global epidemic affecting every sector of society. Social economic factor (SES) is a risk factor for children being overweight or obese especially in rural areas. It seems as more people are living in urban areas, fewer selections of health food are available. Some people have fewer accesses to stores and supermarkets that sell healthy affordable food such as fruits and vegetables, especially in rural, minority, and lower-income neighborhoods. Supermarket accessibility is associated with an increased risk for obesity. Choosing healthy foods is difficult for parents who live in areas with an overabundance of food retailers that tend to sell less healthy food, such as convenience stores and fast food restaurants. (CDC 2012). Compare to urban areas, obesity rates are highest and rising fastest in lower-income and certain ethnic and racial populations in rural areas. Even though other factors also play a role in obesity, obesity rates are higher among rural areas because of their social-economic status, because at lower level people cannot afford healthy foods.

The obesity crisis is a growing national and international health concern. The obesity issues of rural communities have been relatively understudied, despite a large body of research on obesity. Studies in adults find obesity and socioeconomic factors (SES) factors are linked, but results are inconsistent for children. Research shows that people with lower incomes often have a problem with obesity (Gearhart, Gruber & Vanata 2008). At lower income levels, people are not capable to afford healthier foods, which typically cost more, and are hesitant to pay access to exercise facilities. The actual seclusion of rural areas often limits families' access to healthier foods.

Medical care expenses associated with obesity are actually estimated to be over $100 billion year and are estimated to be increasing for the following years (CDC 2012). Being overweight increases the danger of significant illness for instance diabetes, heart problems, and some cancer. Overweight and obesity are associated with high cholesterol, pregnancy complications, and other damaging health consequences. The higher rate of rural obesity may be a driving force behind the higher rural rates of chronic diseases that have been found in some studies. Rural residents need to be aware of these alarming statistics. Obesity is the second cause of death in the United States. It is only second to tobacco related death and is rising to be number one. Obesity increases the risk of death by one and a half time and doubles the risk of coronary heart disease. Obesity is also related to Type 2 diabetes mellitus, hypertension, stroke and some cancers, along with countless health problems (CDC 2012). Research has also documented the significant emotional toll that is felt by the obese in terms of stigmatization and discrimination. In addition to exacting a toll on health, obesity has a significant economic impact. "The economic impact of obesity for rural individuals is also becoming more evident. A study in Kentucky found that in 59 rural counties out-of-pocket expenditures for individuals with obesity added up to $38 million" (Hammond & Levine, 2010).

Methods

Data from the National Survey of Children's Heath and CDC were collected on obesity and social economic status. Data from the census bureau was collected on age, race, sex and socio-economic status. The study measured the prevalence of overweight and/or obese rural children and compared it with that of children in urban areas. A multivariate analysis was performed on the data to detect if differences varied by socio-economic status (SES) factors. The study focused on Children and adolescents aged from six to 18 years. The National Survey of Children Health includes physical and mental health status, access to quality healthcare, as well as information on the child's family and context.

Three urban and three rural counties in Florida were randomly selected. The Urban counties included were Hillsborough County, Miami-Dade County and Palm Beach. The rural counties were Citrus, Desoto and Okeechobee. Economic and health data were pulled for each of the six urban and rural counties, for children of both gender aged from six to -18 years. The prevalence of children being overweight or underweight in each county was examined by age group, sex, urban/rural residence and SES. Using logistics regression models SES and obesity association was analyzed.

Results:

Obesity appears to be more widespread in the low SES sections of American society regardless of the type of community. SES has been shown to be inversely related to sedentary behavior and incidences of overweight in children over six years of age. A childhood spent in poor social and economic conditions has been shown to lead to a less healthy adulthood. In both adolescent boys and girls, low SES and parental education levels were related to an unfavorable risk factor profile indicating a need for early intervention in low SES communities. The accessibility of community supermarkets is associated with lower rates of obesity. (Sobal, Troiana, & Frongillo1996). Many lower SES communities have fewer neighborhood supermarkets, which make certain food options more or less available

Other than physical activity levels, diet, and genetics, emerging data suggests that social economic status is a factor influencing obesity. People of low socioeconomic status (SES) and in racial/ethnic minority groups are extremely affected. Nationwide for the past few decades obesity has been on the rise particularly those groups who are considered to be on a lower socioeconomic status. It has been found that boys and girls in low-SES categories are at highest risk and are disproportionately affected for becoming obese. Being in a low SES group can be a factor for obesity, because those who struggle financially often have a hard time supplying adequate, healthy