Health Policy Paper

Health Policy Paper
Nutritional Education Executive Summary The United States is experiencing the largest epidemic of obesity ever recorded. The rates of childhood obesity continue to rise steadily every year. With obesity comes the risk of many adverse health conditions and diseases, which can be preventable. The U.S. health care system faces a large economic impact because of these conditions. $190 billion in healthcare spending is due to obesity every year. This cost has passed smoking as health enemy number one. This enormous amount is reflected on insurance premiums, which continue to rise because of the high amount of claims due to obesity. Children who are obese are also more likely to be teased and be a victim to bullying. This causes low self-esteem and depression. This issue is affecting everyone in the United States one way or another. Something needs to be done in order to fight this problem and reduce the amount of obesity in our country. What I am proposing is to mandate that all schools be required to teach nutrition education classes to children grades K-12. The University of Crete did a study to discover the benefits of introducing a nutritional educational program in primary schools. This study also assessed whether this education lowered the risk of chronic disease risk factors. After six years they found that risk factors decreased significantly. Introducing children to healthy eating behaviors and the knowledge of how to eat healthy would be beneficial for them and all Americans. This nutrition education would not only focus on healthy eating behaviors but active lifestyles as well. The current health education curriculum is obviously not working. Children are in serious need of an intervention in order to prevent them from being unhealthy at an early age, which would continue throughout the rest of their lives. Some steps have already been taken in order to fight the rising rates of obesity. First Lady Michelle Obama created the Healthy, Hunger Free Kids Act, which was passed in 2010. This act was created to ensure that all kids receive a healthy lunch while at school. The USDA used a panel of experts to determine guidelines for healthy meals at school that have fewer calories in them. The other program, which was also created by the First Lady Michelle Obama, is the Let’s Move initiative. This program promotes the benefits of physical activity among children. I believe that the government would support nutritional education in all schools and that it would complement the other two newly created programs to fight childhood obesity.
The Problem The chief problem is that schools are not teaching nutrition education to the extent that they should be. While health education is required through U.S. schools there is not a large enough emphasis on nutritional education. The United States is experiencing the largest epidemic of obesity ever recorded. The rates of childhood obesity continue to rise steadily every year. One of the only ways this problem is going to be stopped is to integrate nutritional education into all schools to try and prevent this problem from increasing. Nutrition education should be taught and be required in all U.S. schools grades K – 12. With obesity comes the risk of many adverse health effects such as: “Coronary heart disease, type 2 diabetes, cancers (endometrial, breast, and colon), hypertension (high blood pressure), dyslipidemia (for example, high total cholesterol or high levels of triglycerides), stroke, liver and gallbladder disease, sleep apnea and respiratory problems, osteoarthritis (a degeneration of cartilage and its underlying bone within a joint), and gynecological problems (abnormal menses, infertility).” (1) The U.S. healthcare system faces a large economic impact because of these conditions. Everyone pays the price for obesity because insurance premiums rise. This is to make up for the expenditures of the obese. Another large problem that has come from childhood obesity due to poor nutrition is an increased risk of emotional problems. Children who are obese are more likely to be teased and be a victim to bullying. This in turn causes low self-esteem and depression. “According to new research presented at a meeting of the Royal College of Psychiatrists Child and Adolescent Faculty, teenagers who are overweight or obese are more likely to have considered suicide than those who are a normal weight.” (2) There is an obvious need for a solution to all of these problems. While nutrition education will not solve everything, it can promote prevention of this epidemic to decrease the amount of obesity in the United States.
Background Review Obesity is the result from a calorie imbalance. This means that more calories are being consumed than being burned every day. As time goes on weight continues to increase until you are considered either overweight or obese. This problem is not only occurring in adults but in the youth of our nation. “Childhood obesity has more than tripled in the past 30 years. The percentage of children aged 6-11 years in the United States who were obese increased from 7% in 1980 to nearly 20% in 2008. Similarly, the percentage of adolescents aged 12-19 years who were obese increased from 5% to 18% over the same period.” (3) Childhood obesity is a serious problem our nation is currently facing. Rates are continually increasing every year and there does not seem to be an end in sight. There are a few factors that cause obesity such as unhealthy eating habits, lack of physical activity, race, ethnicity, genetics, socioeconomic status, and the physical environment. Many of these factors are out of our control but eating habits and physical activity are within our control. A good start to preventing or reducing obesity is to eat healthy. The benefits of eating healthy are countless. Eating healthy reduces your risk of obtaining diseases, some of them which are life threatening. It promotes proper growth and development in children. It reduces your risk of being overweight or obese, which increases self-esteem. Eating healthy has also been associated with improved memory and mood. Schools play a critical role in providing a supportive environment for health behaviors. Providing children with an education of proper nutrition will be beneficial for them throughout their entire lives. Some students may only be exposed to healthy eating and nutritional information during their time at school. “Schools are in a unique position to promote healthy eating and help ensure appropriate food and nutrient intake among students. Schools provide students with opportunities to consume an array of foods and beverages throughout the school day and enable students to learn about and practice healthy eating behaviors.” (4) Most U.S. youth are not meeting the recommended guidelines for nutrition in their daily diets. They are particularly lacking in their intake of fruit, vegetables, and whole grains. They instead have increased intake of sodium, full-calorie sodas, and empty calories. Up to 40% of children and adolescents diets are empty calories, which are foods high in calories but low in nutritional value. Another factor adding to obesity is soft drinks. “Adolescents drink more full-calorie soda per day than milk. Males aged 12-19 years drink an average of 22 ounces of full-calorie soda per day, more than twice their intake of fluid milk (10 ounce), and females drink an average of 14 ounces of full-calorie soda and only 6 ounces of fluid milk.” (4) In order to change the eating habits of the youth in the U.S. there needs to be an increase of nutritional education in the school systems. Schools are one of the most influential factors of student’s lives. The University of Crete did a study to discover the benefits of introducing health and nutrition education in primary schools. This study also assessed whether this education lowered the risk of chronic disease risk factors. The study followed all of the first graders registered in two countries of Crete throughout a 6-year time frame. At the end of the study they found that the risk factors decreased significantly. “The findings of the present study underline the importance of such programs in health promotion and disease prevention. Although the long term effect of these programs can only be assessed by tracking this population through to adolescence and adulthood, these programs seem to have the potential to lead a healthier lifestyle and thus a reduction in risk factor levels.” (5) By introducing a nutritional educational program to all U.S. schools childhood eating habits would likely improve. This in turn would reduce the rate of obesity and the risk of chronic diseases. Obesity increases the risk for the following conditions: “coronary heart disease, type 2 diabetes, cancers, hypertension, dyslipidemia, stroke, liver and gallbladder disease, sleep apnea and respiratory problems, osteoarthritis, and gynecological problems.” (1) Overweight and obese children are starting out their lives with an increased risk of early onset of such diseases. There needs be something done about this increasing problem. A mandated nutritional education program in the United States would be a great start.
Policy Proposal What I am proposing is to increase the health education program in all schools throughout the United States to include Nutrition Education as a separate class. The current health education program is obviously not being effective enough because the obesity rate continues to rise each year. There has to be steps taken to decrease this amount. First lady Michelle Obama created the Healthy, Hunger Free Kids Act, which was signed into effect in 2010. This act was created to ensure that all students receive a healthy lunch while at school. The USDA used a panel of experts to determine guidelines for healthy meals at school that have fewer calories in them. “Elementary school students in grades kindergarten through fifth are allowed 650 calories per meal. Moving into middle school, lunches served to children in sixth through eight grades have a slightly increased calorie maximum at 700. By the time they are teenagers in high school, students are allowed 850 calories per meal – about one third of the total calories they require per day.” (6) The Healthy, Hunger Free Kids Act was the first step taken in trying to control this obesity epidemic that our country is currently facing. This act is helping children to eat healthy while they are at school. By educating students on healthy eating behaviors and proper nutrition they are more likely to eat healthy outside of school and throughout the rest of their lives. This would be a great preventative technique for childhood and adult obesity. Part of the nutrition education would be focused not only on healthy eating behaviors, but also practicing active lifestyles. The rise in obesity is not only due to eating habits but sedentary lifestyles as well. By encouraging and educating all youth to have healthy eating habits and active lifestyles they are much more likely to live healthy lives. “A recent examination of the Department of Education’s Early Childhood Longitudinal Survey (ECLS-K) found that a one-hour increase in physical education per week resulted in a .31 point drop (approximately 1.8%) in body mass index among overweight and at risk first grade girls. There was a smaller decrease for boys. The study concluded that expanding physical education in kindergarten to at least five hours per week could reduce the percentage of girls classified as overweight from 9.8 to 5.6 percent.” (7)
Macroeconomic Factors Overweight and Obese individuals are rising the costs of healthcare not only for themselves but for everyone else in the United States as well. $190 billion dollars in healthcare spending is due to obesity every year. This cost has passed smoking as health enemy number one in the U.S. “Obese men rack up an additional $1,152 a year in medical spending, especially for hospitalizations and prescription drugs, Cawley and Chad Meyerhoefer of Lehigh University reported in January in the Journal of Health Economics. Obese women account for an extra $3,613 a year. Using data from 9,852 men (average BMI: 28) and 13,837 women (average BMI: 27) ages 20-64, among whom 28 percent were obese, the researchers found even higher costs among the uninsured: annual medical spending for an obese person was $3,271 compared with $512 for the non-obese.” (8) This increased amount of healthcare expenditures continually raises healthcare insurance premiums for the American people. Obesity economically affects everyone in the United States. Another economic impact obesity has on America that most people have never thought of is the increase of energy usage. According to Sheldon Jacobson of the University of Illinois: “The extra weight carried by vehicles as a result of obese or overweight Americans is responsible for almost one billion additional gallons of gasoline being burned each year by our automobiles—nearly one percent of our total gasoline usage.” (8) Not only is this expensive but it is extremely harmful for the environment as well.
Political Process There are two programs that have been introduced by First Lady Michelle Obama that have the same goal in mind as nutritional education would. The first program, which has previously been discussed, is the Healthy, Hunger Free Kids Act. This act allows all children to eat healthier while at school, and provides low-income children with meals while at school. This is one of the first steps the government has taken against childhood obesity. Nancy Brown, Chief Executive Officer of the American Heart Association said: “The historic signing of the Healthy, Hunger Free Kids Act helps schools become part of the solution to the childhood obesity epidemic. It is a victory for American parents working to make sure their kids grow up healthy, and for schools wanting to provide students with more nutritious meals and a healthier environment. With the implementation of this law, our nations kids will be less likely to grow up with early risk factors for heart disease and stroke.” (9) The second program First Lady Michelle Obama advocated was the Let’s Move Initiative. This programs motto is that it is America’s move to raising a healthier generation of kids. This program promotes the benefits of physical activity among growing children. This program also encourages children to have healthy eating behaviors. The Let’s Move initiative believes: “Everyone has a role to play in reducing childhood obesity, including parents, elected officials from all levels of government, schools, health care professionals, faith-based, and community-based organizations, and private sector companies. Your involvement is key to ensuring a healthy future for our children.” (10) Nutritional Education in all schools would complement these other two programs very nicely. I do not believe you would have a difficult time passing this act through the Senate or the House. I believe that both the First Lady and the President would be nothing but supportive of the act.
Evaluation
I truly believe that the government would be supportive of this act to provide all students with nutritional education in order for them to lead healthier lives. They are fully aware that there is a serious problem the nation is currently facing due to obesity. This is apparent because there have already been a couple programs created by the government in order to control the rising epidemic of adult and childhood obesity in the United States. I believe that introducing a nutritional education program to all schools is a crucial step for children to make healthy choices throughout their youth and the rest of their lives. I would support this act to be mandated and implemented into the schools as quickly as possible. In order to track the effectiveness of this program and the other programs created to curtail childhood obesity I would monitor the obesity rates on a quarterly basis every year. If these programs were effective I believe you would see a dramatic decline in childhood and early adulthood obesity rates. Within 10 years I believe that the younger population would be practicing healthier behaviors and would in turn lead healthier lives. This would have a positive effect on healthcare because less insurance claims would be used towards complications related to obesity. American people would also be healthier and suffering less from preventable diseases. Sources
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5. Manios, Yannis, Joanna Moschandreas, Christos Hatzis, and Anthony Kafatos. "Health and Nutrition Education in Primary Schools in Crete." N.p., n.d.
6. "Michelle Obama's School Lunch Program Makes Kids Hungry." Parenting RSS. N.p., n.d. Web. http://www.sheknows.com/parenting/articles/974749/michelle-obamas-school-lunch-program-makes-kids-hungry
7. "Childhood Obesity." Childhood Obesity. N.p., n.d. Web. http://aspe.hhs.gov/health/reports/child_obesity/
8. Ungar, Rick. "Obesity Now Costs Americans More In HealthCare Spending Than Smoking." Forbes. Forbes Magazine, 30 Apr. 2012. Web. http://www.forbes.com/sites/rickungar/2012/04/30/obesity-now-costs-americans-more-in-healthcare-costs-than-smoking/
9. "President Obama Signs Healthy, Hunger-Free Kids Act of 2010 Into Law." The White House. N.p., n.d. Web. http://www.whitehouse.gov/the-press-office/2010/12/13/president-obama-signs-healthy-hunger-free-kids-act-2010-law
10. "Let's Move." Learn The Facts. N.p., n.d. Web. http://www.letsmove.gov/learn-facts/epidemic-childhood-obesity