A REPORT ON OBESITY IN AMERICA: THE GROWING EPIDEMIC
THE RESEARCH QUESTIONS
STATE AND COUNTY INFORMATION
ALABAMA:
What are the current medical definitions of your medical entity?
The medical entity, obesity, is defined as any adult with a BMI above 30. The BMI is calculated by dividing a person’s weight in kilograms by his/her height in m^2. It is thought to provide an indication of one’s health concerning excess body fat ().
What is the prevalence of the medical entity in the states and counties represented by the members of your study group?
In 2003, the Alabama Center for Health published a report using statistics from the Behavior Risk Factor Surveillance System, which estimated Alabama to have an obesity percentage of 24.5, ranking them in the top 7 states in the nation in obesity. Furthermore, 37.2 percent were found to be overweight. This study also included individual county studies of obesity, which demonstrated that counties in the lower third of the state had the highest numbers of obese people. An estimated 26.6 to 31.8 percent of people in these counties were found to be obese. Most of northern Alabama, as well as Baldwin and Geneva counties in south Alabama, had a percentage of obesity from 21.8 to 23.0 percent ().
According to a 2005 Behavior Risk Factor Surveillance System, 29 percent of adults in Alabama are obese. The percentage of overweight people is 36 percent (Alabama Department of Public Health).
In a more recent report published in 2006 and distributed by “Trust for America’s Health” in Washington D.C., Alabama was ranked 1st in the nation in obesity with an estimate 28.4% of the adult population being obese ().
Has the prevalence of your medical entity in those states and counties changed over the last 50 yrs?
The prevalence of obesity over the past 50 years has changed dramatically. Data collected from an article entitled “Obesity in America,” a 20 year obesity statistical recording listed that from 1985 to 2005, Alabama’s percentage of obese adults increased by almost 20 percent. In 1986, the percentage of obese people in Alabama was less than 10 percent. By 1998, the percentage increased to about 20 percent. From 2001 to 2005, the percentage fluctuated at around 25 percent and in 2006; Alabama became the most obese state in the nation, with about 28.4 percent of the adult population being obese ().
Income levels have a correlation with obesity, and can possibly be one of the main factors that one should use when considering the source of Alabama’s obesity. In Alabama, the prevalence of obesity in groups with less than or equal to ,000 was 30.9 percent. People with incomes around ,000 were 20.8 percent obese. Education also had an impact, showing 26.3 percent obesity for adults with only a high school education. This contrasted the 18.5 percent of college graduates in Alabama that were obese ().
What age groups (infants, children, teens, young adults, middle aged or elderly) have shown the greatest increase in the medical entity in the last 10 years?
The numbers of overweight youth in Alabama are rising fast as well. Data from the 2005 Youth Risk Behavior Survey shows that among high school students, 15 percent are overweight and 18 percent are at risk for overweight ().
CALIFORNIA (SAN DIEGO COUNTY):
What are the current medical definitions of your medical entity?
For adults, obesity is defined as having a very high amount of body fat in relation to lean body mass, or Body Mass Index of 30 or higher. BMI is a measure of an adult’s weight in relation to his or her height i.e. the adult’s weight in kilograms divided by the square of the individual’s height in meters. For children and teens, BMI ranges above a normal weight have different labels (at risk of overweight and overweight). The BMI ranges for children and teens are defined so that they take into account normal differences in body fat between boys and girls and differences in body fat at different ages (Wood County Health Department 13).
What is the prevalence of the medical entity in the states and counties represented by the members of your study group?
The rate of obesity is climbing in the state of California and is consistent with national trends. (2001) reported that there were more than 4.7 million obese adult Californians in 2001 with Marin County having the lowest proportion of obese adults. San Diego had lower percentage of obese adults compared to the general California percentage (2). According to the 2003 (CHIS), the prevalence of obesity among adults, age 18 and older, in California was 21 percent while the prevalence of obesity among adults in San Diego County was 18 percent (). Furthermore, in 2005, 33 percent of children in California are overweight and thus, are likely to become obese when not assisted (). In 2006, a third of California children and one in every four teenagers are either overweight or obese (). Approximately 28 percent of obese California children are in fifth, seventh and ninth grades .
Has the prevalence of your medical entity in those states and counties changed over the last 50 yrs?
In the last 50 years, the overall prevalence of obesity has increased in California, even doubling for both men and women from 1990 until 2003 (). According to the CDC’s Behavioral Risk Factor Surveillance System (BRFSS), in 1985 the prevalence of obesity among adults was less than 10 percent in California. In 1988, obesity increased to 10-14 percent. In 1989, obesity dropped back to less than 10 percent. In 1991, it increased again to 10-14 percent and stayed within this range until 1997 when it increased to 15-19 percent. In 2001, the prevalence increased to the 20-24 percent range. It dropped back to the 15-19 percent range in 2002. In 2003, the obesity prevalence increased to the 20-24 percent range and has remained in this range ( ). In addition, the obesity rate for men in 2003 increased by 23 percent while the rate for women recorded a 22 percent increase ().
The (NHANES) data show that the prevalence of overweight among children from 6-11 years old increased nearly four-fold between 1963 and 2000. Among adolescents from 12–19 years old, the prevalence of overweight increased more than three-fold between 1966 and 2000 ( ). In 2006, 14 percent of children in California who are between six and seventeen years old were obese, 15 percent of the same age group were overweight and 72 percent of fifth, seventh and ninth graders failed in the state standards of general physical fitness (Childhood Obesity). San Diego, which was once America’s Fittest City dropped to the 14th slot in the 2004 ranking as obesity continuous to heighten in the last 15 years – 50 percent in adults and 100 percent among children and adolescents (Obesity is Bad). Because overweight children are likely to become overweight adults, these children are more liable to suffer from cardiovascular disease, cancer, and diabetes in adulthood—all chronic, but largely preventable diseases that already account for two-thirds of all deaths in California (). The high prevalence of overweight and physical inactivity is caused by many individual, social, and environmental factors. This epidemic is perpetuated by conditions including, but not limited to, the following: increasing portion sizes, increasing consumption of fast food and soft drinks, lack of funding for nutrition and physical activity programs, availability of soda and junk food on school campuses, poor physical activity infrastructures in schools and communities, limited compliance with physical education requirements in many schools, limited access to healthy foods in low-income neighborhoods, and advertising of junk food to children and their families (3).
What age groups (infants, children, teens, young adults, middle aged or elderly) have shown the greatest increase in the medical entity in the last 10 years?
In the past 10 years, according to the Behavioral Risk Factor Surveillance System, the years 1995, 2000, 2005 in the United States revealed that the age group that has shown the greatest increase in obesity is the 30-39 age group. This group showed an increase from an obesity prevalence of 14.3 percent in 1995 to 24.4 percent in 2005 (a 10.1% increase). Males aging between 55 to 64 years old recorded an increase of 27.2 percent in 1988-1994 and 35.5 percent in 1999-2002 while 65 to 74 year-old females had the greatest increase in obesity from 26.9 percent in 1988-1994 to 39.3 percent in 1999-2002 ().
California is facing a public health crisis in the form of obesity. Californians have gained 360 million pounds in the last 10 years. More than half of the state’s adults are overweight or obese and more than a quarter of California’s students are overweight, placing California’s rate of childhood obesity higher than the national average. Poor diet and lack of physical activity are the second leading causes of death and disability, resulting in nearly 30,000 deaths each year in California. California’s economic burden as a result of this crisis was billion in 2000, and is expected to rise to billion in 2005. Health officials predict that if these trends continue, this generation of children will be the first to have a shorter life expectancy than their parents (). According to the (2007) unhealthy eating habits established in childhood, adolescence and late teens carry over to adulthood. Sedentary lifestyle coupled with decreased metabolic rate. Lifestyle changes due to technology such as elevators, cars, dishwashers, televisions, power lawn mowers, etc. Decreased metabolic needs and energy expenditure coupled with the same or increased food intake.
MARYLAND:
What are the current medical definitions of your medical entity?
The (2006) overweight and obesity are both labels for ranges of weight that are greater than what is generally considered healthy for a given height. The terms also identify ranges of weight that have been shown to increase the likelihood of certain diseases and other health problems. For adults, overweight and obesity ranges are determined by using weight and height to calculate a number called the “body mass index” (BMI). BMI is used because, for most people, it correlates with their amount of body fat: an adult who has a BMI between 25 and 29.9 is considered overweight; and an adult who has a BMI of 30 or higher is considered obese.
What is the prevalence of the medical entity in the states and counties represented by the members of your study group?
Fifty nine percent of Maryland adults were overweight or obese in 2004. Twenty-two percent of non-Hispanic white adults, 31 percent of non-Hispanic black adults, and 19 percent of Hispanic adults in Maryland are obese. Furthermore, 29 percent of low-income children between 2 and 5 years of age in Maryland are overweight or at risk of becoming overweight ().
Has the prevalence of your medical entity in those states and counties changed over the last 50 yrs?
The prevalence of obesity has increased over the last 50 years. The following statistics shows the percentages from different years:
1987-88: 10-14% (highest percentage range)
1989-94: 10-14% (second highest range)
1995-96: 15-19% (highest percentage range)
1997-00: 15-19% (second highest percentage range)
2001-02: 15-19% (third highest percentage range)
2003-04: 20-24% (second highest percentage range)
2005: 20-24% (third highest percentage range)
Overall, the prevalence of obesity increased in Maryland; the numbers indicate that the prevalence tended to reach a plateau for a few years and then increased ().
What age groups (infants, children, teens, young adults, middle aged or elderly) have shown the greatest increase in the medical entity in the last 10 years?
There has been an increase of 62 percent in the number of obese adults from 1990-2002 (No Children).
NEW JERSEY:
What are the current medical definitions of your medical entity?
The (2006) states that obesity is “the excess accumulation of body fat and a growing health problem. Obesity is a known risk factor of numerous chronic diseases, including diabetes, heart disease, high blood pressure, gall bladder disease, arthritis, breathing problems, and some form of cancer.”
What is the prevalence of the medical entity in the states and counties represented by the members of your study group?
In 2004, obesity affected 21.9 percent of adults in the state of New Jersey. The United States national average was 23.2 percent. In 2005, New Jersey was still under the national average ().
Has the prevalence of your medical entity in those states and counties changed over the last 50 yrs?
What age groups (infants, children, teens, young adults, middle aged, or elderly) have shown the greatest increase in the medical entity in the last 10 years?”
The following chart shows that in the state of New Jersey, 55 to 64-year-old individuals had the highest percentage of obesity. Almost one-third of this age group was obese ().
Moreover, the 2005 Health Survey found out that 12 percent of ninth to twelfth graders were overweight and another fifteen percent were at risk for becoming over weight. A study conducted in 2003 by the New Jersey Departments of Health and Senior Services and Education found that 20 percent of sixth graders evaluated were obese and another 18 percent were overweight. Higher obesity levels were observed among the sixth grade boys as compared to girls ().
The following reports and figures are from the (2005):
The above figures say that most students in New Jersey are “TV couch potatoes”. The figures reveal that 36 percent of New Jersey high school students spend three hours a day in front of the TV. It can also be deduced that male high school students are more likely to have obesity in New Jersey.
Another interesting chart showed ethnic groups and percentages and how prevalent obesity was in each group follows:
Source: (2000).
From the statistics in the figure below, it can be sorted out that there are about 385,000 New Jersey residents who are at the age of 60. From the figure above it can be said that 29 percent of this age group were obese ().
PENNSYLVANIA
TEXAS:
Total State Population: 22,859,968 (2005 estimate)
Dallas County Population: 2,305,454 (2005 estimate)
What are the current medical definitions of your medical entity?
According to the (2006) overweight refers to increased body weight in relation to height, when compared to some standard of acceptable or desirable weight. Overweight may or may not be due to increases in body fat. It may also be due to an increase in lean muscle. For example, professional athletes may be very lean and muscular, with very little body fat, yet they may weigh more than others of the same height. While they may qualify as “overweight” due to their large muscle mass, they are not necessarily “over fat,” regardless of BMI. The BMU of overweight people exceeds 25.
Desirable weight standards are derived in a number of ways: (1) by using a mathematical formula known as Body Mass Index (BMI), which represents weight levels associated with the lowest overall risk to health. Desirable BMI levels may vary with age; and (2) by using actual heights and weights measured and collected on people who are representative of the U.S. population by the National Center for Health Statistics. Other desirable weight tables have been created by the Metropolitan Life Insurance Company, based on their client populations (). These sources are consistent with the U.S. Dietary Guidelines and with the National Heart, Lung, and Blood Institute’s Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Obesity is defined as an excessively high amount of body fat or adipose tissue in relation to lean body mass. The amount of body fat (or adiposity) includes concern for both the distribution of fat throughout the body and the size of the adipose tissue deposits. Body fat distribution can be estimated by skin fold measures, waist-to-hip circumference ratios, or techniques such as ultrasound, computed tomography, or magnetic resonance imaging. BMI for overweight or obese is 25 or more ().
According to the (2005) obesity is a complex, multi-factorial chronic disease involving environmental (social and cultural), genetic, physiologic, metabolic, behavioral and psychological components. It is the second leading cause of preventable death in the U.S. Overweight and obesity are part of the U.S. Department of Health and Human Services’ health agenda that have steadily moved away from their established targets for improvement. Today, public health leaders recognize obesity as a “neglected public health problem.” This fact sheet will demonstrate the impact of overweight and obesity on millions of Americans of all ages and both genders.
What is the prevalence of the medical entity in the states and countries represented by the members of your study group?
Apparently that old saying that “everything is bigger in Texas” holds true for its residents as well. According to the (2006) in 2005, an estimated 10.4 million or 64 percent of Texas adults were overweight or obese. Also, a report released in 2005 found that Texas reported it had the 6th highest prevalence in adult obesity in the United States.
Has the prevalence of the medical entity in those states and counties changed over the last 50 years?
According to the (2006) Texas dropped its state ranking from 6th to 10th. Unfortunately, Texas dropped in the ranking because the prevalence of obesity increased in other states, not because the state of obesity had improved in Texas. If the current trends continue, 20 million or 75 percent of Texas adults might be overweight or obese by the year 2040, and Texas costs could quadruple from .5 billion today to as much as billion by 2040.
The (2005) cites that:
- There are no reports or statistics on American obesity prior to 1976. The earliest data on American obesity was recorded between 1976 and 1980. It was reported then that 46% of American adults were considered overweight and 14.4% were considered obese. Since that time the percentage of overweight and obese Americans has increased dramatically. The AOA last reported between 1999 and 2000. At that time 64.5% were considered overweight and 30.5 were considered obese.
- Early reported studies from the AOA do not give data for individual states and cities.
- In 1991 the AOA reported that 12.7% of Texas adults were obese. In 1998 that number climbed to 19.9%. In 2000 that number again increased to 22.7%. The last reported statistic was in 2001 at 23.8%.
- In 2000 Dallas, Texas was reported as the 15th most overweight city in the United States. In 2005 Dallas, Texas was reported as the 6th most overweight city in the United States.
What groups (infants, children, teens, young adults, middle aged, or elderly) have shown the greatest increase in the medical entity in the last 10 years?
The (2006) reports the following facts:
· Overweight and obesity are more pronounced among men, minorities and middle-aged adults.
· The prevalence of childhood overweight was greater in Texas in 2004-2005 than the U.S. rates reported for the 2003-2004 National Health and Nutrition Examination Survey (NHANES). The overall prevalence of overweight and at-risk for overweight in Texas schoolchildren was 42% for fourth graders, 39% for eight graders and 36% for eleventh graders in 2004-2005.
· In 2000-2001, the percentage of overweight students in Texas was much higher among minorities, with the highest prevalence of overweight in Hispanic boys in all grade levels, Hispanic girls in fourth grade and African American girls in the fourth and eleventh grades.
· 30% of Texas high-school students are overweight or at risk of becoming overweight.
· From 2000-2002 to 2004-2005, the prevalence of overweight increased among both eighth and eleventh graders, but slightly dropped among fourth graders in Texas from 25.6% to 23%.
On the other hand, the American Obesity Association (2005) claims that about 15.5 percent of adolescents (ages 12 to 19) and 15.3 percent of children (ages 6 to 11) are obese as of 1999-2000. The increase in obesity among American youth over the past two decades is dramatic.
WEST VIRGINIA (KANAWHA COUNTY):
What are the current medical definitions of your medical entity?
Obesity is defined as an excessively high amount of body fat or adipose tissue in relation to lean body mass: BMI = [(wt in pounds)/(ht in inches)2] x 703. Obesity ranges are determined using weight and height to calculate the “body mass index” (BMI), usually a number between 18.5 and 30. An adult BMI of 30 or higher is considered obese.
Height
Weight Range
BMI
Considered
5’ 9”
124 lbs or less
Below 18.5
Underweight
125 lbs to 168 lbs
18.5 to 24.9
Healthy weight
169 lbs to 202 lbs
25.0 to 29.9
Overweight
203 lbs or more
30 or higher
Obese
Calculated BMI is age- and sex-specific and is often referred to as BMI-for-age (Overweight and Obesity: West Virginia).
According to West Virginia Health Statistic Center (2005) “a single measurement that needs only two factors, weight and height, makes it possible to conduct surveillance on a worldwide basis. There are limitations to BMI, of course. It can be overestimated among persons who are very athletic and have large muscle mass, on the one hand, and underestimated among persons who have lost muscle mass, such as the ill and the elderly. It has been recommended that different BMI cutoff points be used to determine overweight and obesity in certain racial groups (25). In general, however, BMI is considered to be a reliable indication of total body fat content for most adults, regardless of sex.” Furthermore, obesity is multi-factorial, based on both genetics and behavioral factors. Obesity also can contribute to the following diseases: Type 2 diabetes, hypertension, stroke, myocardial infarction, congestive heart failure, cancer, gall stones and gall bladder disease, gout, Osteoarthritis, Sleep Apnea, and Pickwickian Syndrome (Definition of Obesity).
What is the prevalence of the medical entity in the states and countries represented by the members of your study group?
In 2000, the obesity rate in West Virginia was 23.3 percent, an 8.2 percent increase from 1999. From 1990-94 the prevalence of obesity in Kanawha County was 16.9 percent, ranking the county at 19 out of 55 counties. From 1995-99 Kanawha County had a 22.5 percent prevalence of obesity moving up to the 15th obese county in the state. Mineral County has also shown prevalence of obesity with an average of 37 percent compared to the US average of 33 percent. Obesity is increasing in all counties of West Virginia, but mostly a rise is being seen in the southern and western counties (which are the poorest counties), as well as the Eastern Panhandle (Obesity in West Virginia).
“In 2002, West Virginia ranked first in the nation in the prevalence of obesity (27.6%) and 42nd highest in the prevalence of overweight (36.1%). More than 63 percent of West Virginians are considered overweight or obese.” (A Need for a Healthier West Virginia)
Has the prevalence of the medical entity in those states and counties changed over the last 50 years?
The prevalence of obesity has changed in Mineral County, West Virginia over the past 50 years. In 1985 10 to 14 percent of West Virginians were obese with a BMI equal or greater than 30 (). According to reporter in 2005 West Virginia was considered one of the worst states in the country with obesity problems. West Virginia is consistently among the top three states in the nation for obesity, according to the Centers for Disease Control and Prevention and the State Bureau of Public Health. The most current data, 2002, 28% of West Virginians were considered obese. West Virginia also leads the nation in hypertension and is fourth in the nation for diabetes ().
What groups (infants, children, teens, young adults, middle aged, or elderly) have shown the greatest increase in the medical entity in the last 10 years?
Children, teens, and young adults have seen the most increase in obesity over the past 10 years (). For ages 18 years and above, the average weight for males and females in West Virginia has increased steadily from 1984 to 2000; the males rising from 177.2 pounds up to 194.0, and the women’s weight rising from 142.0 pounds up to 154.9 pounds (Obesity in West Virginia).
The 1999 Youth Risk Behavior Study, conducted by the CDC over the telephone, shows the latest available data for the youth of WV and this age group’s obesity issues. Using a BMI-for-age calculation formulated especially for children, whose BMI will differ according to sex and age during their developmental stages, the study showed that in 1999, 12.2% of West Virginia high school students in grades 9-12 were overweight, 15.8% being male and 8.3% being female, and that 15.9% of students were currently at risk of being overweight (Obesity in West Virginia).
Sixty-four percent of West Virginia adults are obese or overweight while 29 percent of high-school students are overweight or at risk of becoming overweight. Moreover, 28 percent of low-income children between 2 and 5 years of age in West Virginia are overweight or at risk of becoming overweight (Overweight and Obesity: West Virginia).
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