Context and importance of the problem
“Overweight and obesity” is one of the most important public health issues in the nation of Australia. Different health problems are related intricately with that of the excess body weight and this aspect impacts the healthcare system, communities, families as well as individuals (Newson et al., 2018). This disorder causes pressure on healthcare system and economic condition of the nation. Therefore policies are important to tackle the issue of obesity.
National statistics can always show the full extent of the issues. The report put forward by the Primary Health Networks (PHN) across the Australia showed some interesting findings. The percentage of the overweight or the obese adult individuals were seen to range from 53% in the Northern Sydney to 73% in Southern Australia. It was also seen that such individuals were also found to be higher in the regional PHN areas than the metropolitan PHN areas. Results of their studies reported by Australian Institute of Health and Welfare 2018 have shown that one quarter of the children accounting for about 26% were found to be overweight as well as obese in the years 2014 to 2015 (Healthy Communities: Overweight and obesity rates across Australia, 2014–15, 2016). About two third of the adults, accounting for about 63%, were found to be obese in the year 2014 to 2015. The proportion of the adults who are obese is also seen to be increasing over time. Approximately 11.2 million adults were seen to be obese or overweight with 1.2 million children and adolescents were obese and were deducted from the above mentioned percentages (A picture of overweight and obesity in Australia, 2017).
Researchers are of the opinion that obesity might lead to various types of harmful disorders and health concerns. This is the only important arenas which show how obesity is affecting the quality of health of the people of the nation (Newman et al., 2014). It is making people vulnerable to poor physical and mental health and causes series of other chronic disorders acting as their risk factors (Lee et al., 2016). Therefore, their disorder contributes to diseases burden of the nation with huge amount of money, resources and effort been spent every year in the healthcare industry. Suffering from this co morbid disorders affect the working capability of individuals and therefore not only affect the financial security of the individuals but affect the economic stability of the nation as a whole (Hearn et al., 2017).
Statistics
Obesity has the chance of increasing the likelihood of the development of many chronic conditions like those which include certain types of cancer as well as cardiovascular disorders. Asthma, back pain, dementia, chronic kidney disorders, diabetes and gout are also seen to be present in individuals who are obese and overweight (Mayne et al., 2015). Osteoarthritis and breathing problems during sleeping called sleep apnea are also seen to be quite common in the overweight and obese individuals. Individuals who are overweight or obese are seen to be presented with higher number of disorders than individuals who do not suffer from obesity. They are reported with more hospitalization with more expenditure of resources and finance besides creating mental and physical sufferings to the patients and family members (Brownell et al., 2017).
Children are also seen to suffer from obesity. They are also seen to be suffering from higher risks of breathing difficulties, fractures, insulin resistance, and hypertensions (Garnett et al., 2016). Researchers are of the opinion that with the increase of the BMI of more than 20.00 kg/m2, the severity of obesity and chances of occurring of other chronic conditions increase several folds (Hearn et al., 2017). This is seen to be associated with an increase in the complications of the chronic conditions of the heart resulting in suffering and huge outflow of resources. Therefore, this picture shows that it is one of the main reason that obesity should be considered of a national priority area and should be immediately be acted upon by concerned authorities to make the nation a fit and healthy one.
In order to address the issues of obesity in the nation, one needs to find the root causes that contribute to the occurrence of the disorder. Data suggests that about 10% of the total burden of the disorder in the nation was mainly due to the different risk factors with the diet low in fruits and vegetables accounting for about 2.0% and 1.4% of the total disease burden. Excessive energy intake is seen to be the main concern taken from foods and drinks high in calories (Huang et al., 2017). This results in energy intake more than requirement and this directly results in weight gain. It is seen that huge amount of processed foods that are calorie dense are circulated in markets that are low in cost and attracts the attention of low socioeconomic cohort. Thereby, it exposes them to high chance of developing obesity (Hearn et al., 2017)
Impact of obesity on health
Another cause of the development of obesity is sedentary lifestyle and lack of proper physical activities in daily live (Huang et al., 2017). In the year 2014 to 2015, nearly 1 in every 3 or 30% Australians of the age 18 to 64 were reported to be insufficiently active. They were seen to have 150 minutes of physical activity in the previous weeks while 15% were seen to have undertaken no exercises in the previous week. In the year 2014 to 2015, Australians were seen to spend 34 hours per week sitting at leisure which was up from 31 hour per week reported from 2011 to 2012 (Garnett et al., 2016).
Another cause is the “OBESOGENIC environment”. The environmental factors are often seen to promote obesity among individuals and the populations. Often people are seen to interact with different settings that are influenced by laws and policies of government, industry, economic imperatives and society as a whole. All these factors have the capacity to shape the environment of the people and can affect their energy balance either by inhibition or encouragement of the healthy dietary and physical activity patterns (Brownell et al., 2017). Excessive academic pressure of schools, work burden in offices, community environment forcing availability of cheap calorie-dense goods, less number of fields and parks, stress in lives and many other factors influence eating behaviors and sedentary lifestyles (Baker et al., 2017). All these factors need to be also taken in considerations and interventions should be laid accordingly.
It is extremely important for the government to introduce policies that would help the people of the nation to be aware of the facts about how obesity can result in poor quality lives. The community members should be educated about the health behaviors that they need to change to live healthy lives. The short term goal would be developing a collaborative approach where all concerned professionals should come together to develop strategies and help people overcome the issues (Clarke et al., 2016). The long term goal would be helping the citizens to identify the issues and change their own behaviors. This would help them to take self care and be aware about how their action might result in high weight gain and how they can take regular screening to understand their vulnerability (Buchmueller & Johar, 2015).
The concerns regarding obesity had been reported in many of the policies in a detailed manner. Starting from the policies introduced by the Australian Institute of Health and Welfare, Commonwealth Australia to many of the local guideline policies published by each state, most policies states a common approach where detailed information about the impacts of obesity, prevalence and many other aspects are discussed (Moore et al., 2018). This is indeed one of the most important positive factors as this help in the development of health literacy of the common people. It helps them to be aware of their behaviors and make them understand the necessity of them in changing their behaviors.
Causes of the occurrence of the disorder
Another important positive aspect that is also seen is that the policies like “A picture of overweight and obesity in Australia, 2017”, “NSW Healthy Eating and Active Living strategy”. : Public Health Association of Australia: Policy-at-a-glance – Promoting Healthy Weight Policy” and others give an overview of the actions that needs to be taken by the healthcare professionals, educators, local, federal and other part of the government, community leaders and many others. They are always seen to provide a generalized overview of actions that need to be taken at the community level, health promotion levels, laws and regulations as well as tax and price interventions that need to be undertaken (Hayes et al., 2017). These gave the stakeholders like the healthcare professionals, policy makers, government officials, nongovernmental sectors, NGO, local governments, schools and others an idea about their job function in the reduction of the prevalence of obesity and contribute their skills and knowledge for development of an effective nation.
However, one of the approaches that seem to be missing in the policies is explanation of the detailed roles of the stakeholders who are mentioned above. Each of the members of the healthcare teams need to be aware of their own roles, capabilities and strength. This aspect would be helping to make each of the strategies and health care programs for obesity prevention successful (Moore et al., 2018). The policies gives a broad overview of the actions to be taken by government, healthcare organizations, communities and many others, however, the role of each stakeholders in the collaborative approaches are never mentioned in policies (Baker et al., 2017). Often most of the policies are seen to take a community approach where they state that schools need to have education sessions of children, proper food menu in the canteens and many others however, very few policies are there that gives a detailed knowledge to a teacher or a food preparatory groups in the canteen about how to achieve the goals. A healthcare professional is said to educate patients but very few policies are there which helps the professionals or guides them in resource allocation, developing skills to educate and many others. It is stated that health promotion program is important but very few policies are there which gives details about model of health promotion like trans-theoretical model, health belief model or others. Therefore, it is high time to shift the focus from education based policies to intervention based polices helping each of the healthcare team members to understand their roles. This would help the members to contribute successfully to development of a collaborative approach with each other for meeting goals (Leslie et al., 2015).
Policy implications of the issue
It is seen that only making people educated about contributing factors and impact of obesity on their health is not enough to develop the present situation. Healthcare organisations have to take active parts and communities need to work closely with such organisations to develop compulsory screening sessions of each members of the society and identify the vulnerability (Huse et al., 2018). People with poor health literacy can then only identify themselves as vulnerable and take action.
An interesting approach was seen in the recent evidence based articles. Researchers have identified that many people have complained that it become very difficult for them to change their behaviours and they tend to leave such goals out of lethargy and de-motivation (Wesselink et al., 2014). In such scenario, health education can only bring success if it is compiled with cognitive behavioural therapy and motivational interviewing. Therefore, psychology based interventions should also be included in the policies.
Social determinants of health like low socioeconomic status, poor income, poor employment, poor education and many others are seen to be associated with obesity and policies need to separately address these issues in details in the nation to reduce the prevalence of the disorder (Reeve et al., 2015). For example, poor people are seen to buy cheap calorie dense foods and hence, this determinants of health needs to be addressed besides educating people.
From the above discussion, it becomes very clear that obesity is one of the most important disorders that are increasing the diseases burden of the nation. In the year 2011, 7% of the total burden of the disorder in the nation was due to overweight and obesity with 63% of this due to fatal burden. Men were seen to have higher burden about 7.3% from overweight and obesity than women about 6.6% reported by Australian Institute of Health and Welfare. About 53% of the burden of diabetes was due to overweight and obesity and 45% of the burden of osteoarthritis was due to overweight and obesity. It results in heart disorders, breathing problems, sleep apnea, bone and joint issues. Besides, high blood pressure, high level of LDL, gall bladder issues and many others are also seen to occur in obese patient. Therefore, it can be seen that obesity alone becomes the source and risk factor for huge number of disorders that result in suffering. Therefore, this disorder needs to be checked as it creates huge disease burden in the nation. Therefore, policies need to be developed to check these issues properly and help people live safe lives.
Direct financial costs about the diseases burden are associated with the healthcare system. This includes higher healthcare costs as well as higher demand on the healthcare services like that of the “general practitioners, specialists, allied health professionals, pharmaceuticals, administration, and other direct costs”. Indirect costs are also seen to be associated with losses in the productivity, costs of the caregivers, welfare payments, and forgone taxation revenues. It also associates with many other causes like that of the aids, equipment transport and accommodation, respite and other governmental programs. Huge flow of resources are also found to be intricately associated with the disorder that can be restricted if effective behavioral changes and development of health education occurs.
Sedentary lifestyles and poor quality diet are seen to be the primary causes of the disorder and these aspects need to be changed. Changes on health behaviors are important and professionals need to educate and make people aware of the impacts of their improper health behaviors. However, only developing health literacy in people are not enough. The “obesogenic” environment needs to be altered like availability of cheap calorie dense food in the communities, management of academic pressure on children so that they can engage in co-curricular activities, lessening of work burdens on individuals and many others. Schools, offices, governmental and non-governmental organization as well as policy makers and healthcare organizations need to work collaboratively. Developing broad goals in the policies are not sufficient, rather developing SMART goals, helping stakeholders understand their roles, allocation of resources and support from communities are essential for helping nation fight with the evil of obesity and develop quality lives in future.
References:
Aihw.gov.au (2017) A picture of overweight and obesity in Australia 2017, Australian Institute of Health and Welfare [online], retrieved from: https://www.aihw.gov.au/reports/overweight-obesity/a-picture-of-overweight-and-obesity-in-australia/contents/table-of-contents Accessed on 30th September, 2018
Aihw.gov.au (2018),,Overweight & obesity, Australian Institute of Health and Welfare, [online] retrieved from : https://www.aihw.gov.au/reports-statistics/behaviours-risk-factors/overweight-obesity/reports Accessed on 30th September, 2018
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