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Article

Laurens Holmes, Sequoia Jackson, Alexandra LaHurd, Pat Oceanic, Kelli Grant and Kirk Dabney

The purpose of this paper is to examine the prevalence of obesity/overweight using higher body mass index (BMI), assess racial/ethnic variance in overweight/obese…

Abstract

Purpose

The purpose of this paper is to examine the prevalence of obesity/overweight using higher body mass index (BMI), assess racial/ethnic variance in overweight/obese prevalence, and to determine whether or not insurance status explains the variance.

Design/methodology/approach

A cross-sectional design was used to assess medical records of children in Nemours Healthcare System during 2011. The authors reviewed the records and extracted information on normal BMI, BMI percent, higher BMI, prevalence of overweight/obese and other variables as well as race and ethnicity. χ2 statistic, Fischer's exact and logistic regression model were used to examine the data.

Findings

Overall, the prevalence of higher BMI as overweight/obese was comparable to that of the US pediatric population, 33.4 percent. Compared to Caucasian/white, Asians were less likely to have higher BMI, prevalence odd ratio (POR)=0.79, 95 percent CI=0.70-0.90, but Blacks/African Americans (POR=1.22, 95 percent CI=1.18-1.27) and Some other Race were more likely to have higher BMI, POR=1.61, 95 percent CI=1.92-1.71. After controlling for insurance status, the racial disparities in higher BMI persisted; p<0.0001.

Research limitations/implications

Racial/ethnic disparities exist in childhood higher BMI, which were not removed after controlling for insurance coverage as a surrogate for socioeconomic status. These findings are indicative of assessing sex, religious, dietary patterns, physical activities level, environmental resources, social media resources; and geographic locale as confounders in race/ethnicity and higher BMI association.

Originality/value

Understanding the predisposing factors to obesity/overweight among diverse populations is essential in developing and implementing intervention programs in addressing this epidemic in our nation.

Details

International Journal of Human Rights in Healthcare, vol. 8 no. 1
Type: Research Article
ISSN: 2056-4902

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Book part

Roel Pieterman

This paper investigates whether in the case of obesity medicalization implies transforming deviants into patients. First, a brief history is presented of the social…

Abstract

This paper investigates whether in the case of obesity medicalization implies transforming deviants into patients. First, a brief history is presented of the social construction of obesity as an epidemic. Since the turn of the millennium obesity experts claim that a continuously increasing proportion of the Western population is becoming overweight and that this trend is spreading across the globe. Other claims have been made as well, such as that fatter people die younger and add substantially to the cost of health care. Counterclaims have been made too, such as that in Western countries obesity no longer increases and that only extreme obesity increases the risk of dying young.

Furthermore, several explanations for the obesity epidemic are discussed. Public health experts all over the world prefer two explanations that suggest the obesity problem is amenable to intervention. Most basically, it is held that people become overweight because their intake of calories exceeds their expenditure. In addition it is proposed that modern societies are obesogenic, for example, offering food in abundance while removing the need for physical exertion. The first explanation leads to blaming overweight people for their own condition. The second offers opportunities for disciplining the food industry, which following the anti-tobacco movement is labeled “big food.” Especially with regard to individual citizens the conclusion seems warranted that medicalizing fatness adds opportunities for stigmatization and discrimination beyond those offered by conceptions of beauty and fitness. This causes a double bind for governments that want to fight both obesity and stigmatization.

Details

Contributions from European Symbolic Interactionists: Reflections on Methods
Type: Book
ISBN: 978-1-78441-854-0

Keywords

Content available
Article

Lyne M.G. Blanchette, Vivian M. van de Gaar, Hein Raat, Jeff French and Wilma Jansen

This paper aims to present a description of the development and implementation of a combined school- and community-based intervention for the prevention of overweight

Abstract

Purpose

This paper aims to present a description of the development and implementation of a combined school- and community-based intervention for the prevention of overweight among children, using the combined methods of social marketing (SMk) and intervention mapping (IM).

Design/methodology/approach

The SMk total process planning (TPP) framework was used, a simple but robust framework that consists of five stages: scoping, development, implementation, evaluation and follow-up. In addition, IM tools were embedded in the development stage to strengthen the development element of the campaign.

Findings

The use of the SMk TPP framework led to the selection of one specific target segment and behaviour. IM tools helped to select the most important and modifiable determinants and behaviours in the target segment, as well as to select and appropriately apply theoretical methods for influencing determinant and behaviour change. The resulting “Water Campaign” was aimed at Turkish and Moroccan mothers and their 6-12-year-old-children (target segment). This intervention addresses the consumption of sugar-sweetened beverages through the promotion of tap water drinking (target behaviour). The systematic involvement of key stakeholders resulted in capacity-building and co-creation.

Originality/value

A key finding of the present work is that the SMk TPP framework and IM tools can be successfully combined in intervention development, helping to develop enhanced interventions. Combining these methods led to a theory-based and client-oriented intervention, which was directed at multiple ecological levels and which systematically involved key stakeholders. With this detailed description of the intervention development, this paper aims to assist other researchers and practitioners in their quest to develop better interventions.

Details

Journal of Social Marketing, vol. 6 no. 4
Type: Research Article
ISSN: 2042-6763

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Article

Venka Simovska, Kevin Dadaczynski and Barbara Woynarowska

The purpose of this paper is to introduce the HEPS project (Healthy Eating and Physical Activity in Schools) and discuss initial steps of the project implementation within…

Abstract

Purpose

The purpose of this paper is to introduce the HEPS project (Healthy Eating and Physical Activity in Schools) and discuss initial steps of the project implementation within EU countries. On the basis of the Health Promoting School approach as a conceptual foundation for the project, HEPS aimed at developing and implementing an effective tool for supporting the development of national policies on healthy eating and physical activity in schools across Europe. For this purpose, a package of publications (HEPS Toolkit) was produced and disseminated within the Schools for Health in Europe (SHE) network.

Design/methodology/approach

An initial implementation survey was carried out with national coordinators of the SHE network (n=24).

Findings

Results indicate that more than half of the respondents were familiar with and disseminated the HEPS Toolkit to relevant stakeholders at national, regional and local levels. However a number of problems and barriers in the implementation were encountered, such as lack of support and resources, existence of competing programmes, and frequent education and health reforms.

Practical implications

The findings are discussed against two models of implementation and a few recommendations are suggested for optimizing the further implementation of this, and other similar projects.

Originality/value

THE HEPS toolkit is the first attempt to support all EU member states in the development and implementation of a national policy on healthy eating and physical activity in schools. The involvement of the national coordinators of a well established European network of school health can be seen as an innovative way to implement and disseminate the project outcomes.

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Article

Melanie Babooram, Barbara Ann Mullan and Louise Sharpe

The purpose of this paper is to investigate children's understandings of the intent and importance of current media initiatives designed to target childhood obesity…

Abstract

Purpose

The purpose of this paper is to investigate children's understandings of the intent and importance of current media initiatives designed to target childhood obesity. Semi‐structured interviews were analysed using qualitative content analysis, for the responses of overweight and normal weight children.

Design/methodology/approach

In total, 33 children were interviewed, 24 of normal weight and nine overweight. They were shown two print and four television advertisements from the New South Wales Health Department web site that were popularly broadcast between 2003 and 2007. Children were then asked if they had seen the advertisement prior to the interview, and their understanding of the intent and importance of the advertisements.

Findings

Most children in both weight groups recalled seeing five out of the six presented advertisements prior to interview. The main themes identified were “Health Maintenance” and “Illness Prevention” for five of the six advertisements. Overweight children were more numerous in their detection of a health message as opposed to normal weight children, who mostly commented on the safety aspect of advertisement six.

Practical implications

Future evaluations of mediated health campaigns should go beyond recording simple recall of campaign material and investigate instead the understandings of target groups. Mediated health campaigns should also specify messages to particular target groups, as they appear to be most likely to facilitate behaviour change.

Originality/value

Mediated health campaigns are mostly evaluated quantitatively rather than by qualitative means. In addition, no study has evaluated the views of overweight and normal weight children with regards to these health campaigns.

Details

Nutrition & Food Science, vol. 40 no. 3
Type: Research Article
ISSN: 0034-6659

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Article

Patricia V. Roehling, Mark V. Roehling, Jeffrey D. Vandlen, Justin Blazek and William C. Guy

The purpose of this paper is to investigate whether overweight and obese individuals are underrepresented among top female and male US executives and whether there is…

Abstract

Purpose

The purpose of this paper is to investigate whether overweight and obese individuals are underrepresented among top female and male US executives and whether there is evidence of greater discrimination against overweight and obese female executives than male executives.

Design/methodology/approach

Estimates of the frequencies of overweight and obese male Fortune 100 CEOs and female Fortune 1000 CEOs were obtained using publicly available photographs and raters with demonstrated expertise in evaluating body weight. These “experts” then estimated whether the pictured CEOs were normal weight, overweight or obese.

Findings

Based upon our expert raters’ judgments, it is estimated that between 5 and 22 per cent of US top female CEOs are overweight and approximately 5 per cent are obese. Compared to the general US population, overweight and obese women are significantly underrepresented in among top female CEOs. Among top male CEOs, it is estimated that between 45 and 61 per cent are overweight and approximately 5 per cent are obese. Compared to the general population overweight men are overrepresented among top CEOs, whereas obese men are underrepresented. This demonstrates that weight discrimination occurs at the highest levels of career advancement and that the threshold for weight discrimination is lower for women than for men.

Practical implications

Weight discrimination appears to add to the glass ceiling effect for women, and may serve as a glass ceiling for obese men.

Originality/value

This paper uses field data, as opposed to laboratory data, to demonstrate that discrimination against the overweight and obese extends to the highest levels of employment.

Details

Equal Opportunities International, vol. 28 no. 2
Type: Research Article
ISSN: 0261-0159

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Article

Sally Robinson and Kirsty Page

This paper aims to provide a summary of current policy and research related to pre‐school overweight and obesity, and to provide a rationale for why early years settings…

Abstract

Purpose

This paper aims to provide a summary of current policy and research related to pre‐school overweight and obesity, and to provide a rationale for why early years settings are being placed at the forefront of strategies to address the problem.

Design/methodology/approach

The paper is based on a narrative review of current research, policy and practice.

Findings

Today 22.9 per cent of four and five year olds are overweight or obese. The Healthy Weight, Healthy Lives strategy is a cross‐government initiative, which aims to make England the first major country to reverse the obesity epidemic. The pre‐school period represents a critical time for interventions, which could prevent excess weight gain and its associated physical and psychological damage to health.

Practical implications

Practitioners in early years settings have a significant contribution to make to promoting the healthy weight of children.

Originality/value

Concerns about overweight in childhood have received much attention. This paper seeks to raise awareness of the importance of the pre‐school period, and to provide a useful review of current research, policy and sources of support for those who are best placed to address the issue.

Details

Health Education, vol. 109 no. 6
Type: Research Article
ISSN: 0965-4283

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Article

Jennifer A. O'Dea

The purpose of this paper is to review current programmes and major issues surrounding preventive interventions for body image and obesity in schools.

Abstract

Purpose

The purpose of this paper is to review current programmes and major issues surrounding preventive interventions for body image and obesity in schools.

Design/methodology/approach

A literature review was carried out by analysing papers cited in major literature databases from the last 50 years. This review describes and summarises activities from body image programmes and eating disorder prevention programmes in schools and outlines self esteem and media literacy approaches that have produced positive results in some large, randomised and controlled interventions.

Findings

A total of 21 programmes met the inclusion criteria. Of these, four included males and 17 reported at least one improvement in knowledge, beliefs, attitudes or behaviours. The most effective programmes were interactive, involved parents, built self esteem and provided media literacy.

Practical implications

Body image concerns, eating problems and obesity among children and adolescents are becoming increasingly targeted for preventive health education and health promotion programmes. The role of health educators is complicated because of legitimate concerns that we must “do no harm” in our efforts to ameliorate both issues in schools. Health educators need to be careful to ensure that the implementation of programmes for the prevention of child obesity do not inadvertently create food concerns, body image issues, weight stigma, prejudice or eating disorders. Similarly, eating disorder prevention programmes must take care both not to condone obesity nor to glamorise or normalise dieting or disordered eating.

Originality/value

This paper provides health educators with an overview of important issues and suitable strategies to consider when implementing programmes for body image improvement and the prevention of eating problems and childhood obesity.

Details

Health Education, vol. 105 no. 1
Type: Research Article
ISSN: 0965-4283

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Article

Carlota Quintal and Joana Oliveira

The purpose of this paper is to assess the association between socioeconomic status and child overweight/obesity in Portugal and to evaluate income-related inequalities in…

Abstract

Purpose

The purpose of this paper is to assess the association between socioeconomic status and child overweight/obesity in Portugal and to evaluate income-related inequalities in its distribution.

Design/methodology/approach

Data come from the last Portuguese National Health Survey (2005/2006) – sample of 6,903 observations. To define child overweight/obesity, the International Obesity Task Force cut-offs for body mass index (BMI) were used; the logistic regression analysis was adopted to explain the risk of overweight/obesity and inequality was measured by means of concentration curve and index.

Findings

The evidence obtained points to income-related inequalities in child overweight/obesity favourable to the better-off. The probability of child overweight/obesity was lower for higher income households, but up to a certain point a positive association between income and caloric food intake was found. The concentration index obtained was −0.072 (p-value<0.001).

Research limitations/implications

Some data limitations, no information on: physical exercise; sleeping habits; parents’ education and BMI; age is coded in groups. Although the data are from 2005/2006, the current analysis is useful to future works aiming to discuss the impact of the economic and financial crisis which occurred after these data were collected.

Social implications

It is important to tailor policies targeting child obesity/overweight in order to tackle not only the prevalence of this disease but also its distribution.

Originality/value

Drawing attention on inequalities in child obesity/overweight in Portugal as the vast majority of studies have focussed on prevalence. The middle income effect is an issue raised in this work which deserves further investigation.

Details

International Journal of Social Economics, vol. 44 no. 10
Type: Research Article
ISSN: 0306-8293

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Article

Melanie Babooram, Barbara Ann Mullan and Louise Sharpe

The aim of this paper is to qualitatively examine the ways in which primary school children, aged between 7 and 12, perceive various facets of obesity as defined by the…

Abstract

Purpose

The aim of this paper is to qualitatively examine the ways in which primary school children, aged between 7 and 12, perceive various facets of obesity as defined by the common sense model of illness representation (CCM).

Design/methodology/approach

The study was qualitative in nature. Semi‐structured interviews were conducted with 33 children on all dimensions of the CSM. Twenty four children were normal weight and nine were overweight. A drawing task formed the methodology for the “identity” section of the interview.

Findings

Although children identified food intake as a main cause of obesity, almost half did not name sedentary behaviours as a cause of obesity. Duration (timeline) of obesity was regarded by most children as reliant on a person's undertaking of positive health behaviours. Normal weight children were found to list more severe consequences of obesity than the overweight group. It was found that experience contributed to the detailed knowledge of overweight children's perceptions of cures of obesity. Overweight children also spoke of personal incidents of barriers to cures.

Practical imlications

The findings suggest that the CSMs can be used to classify children's perceptions of obesity. Future childhood obesity interventions can utilise these findings to create campaigns and strategies that are more consistent with children's understandings of this condition.

Originality/value

To the authors' knowledge, no previous study has examined children's perceptions of obesity beyond perceived causes.

Details

British Food Journal, vol. 113 no. 2
Type: Research Article
ISSN: 0007-070X

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