Introduction
Obesity is a serious health problem that has negative social, physical and mental health consequences (Cervero & Duncan, 2003). Over the past decade, Krämer et al (2010) indicated that the rates of obesity have been rising rapidly among adults and children. Obesity results from an imbalance in energy that occurs when the consumption of energy exceeds the expenditure of energy. The paper will discuss how obesity is influenced by the urban (built/man-made) environment. CDC (2007) defined “built environment” as aspects of an individual’s surroundings that is modified or is manmade as compared with the environmental aspects that are naturally occurring. Furthermore, it will discuss two social factors that relate to or affect obesity: lifestyle and age. Finally, the essay will discuss the model/s of health and wellbeing (social model of health) that is most significant for the management or treatment of obesity, before concluding with a conclusion. VicHealth (2015) defined this model as a conceptual framework within which health and wellbeing improvements are achieved by directing effort towards addressing environmental, economic and social health determinants.
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How is your health issue influenced by the urban (built/man-made) environment?
Obesity among people results from a complex interaction between physical activity, diet and the environment. According to Papas et al (2007), the built environments comprises of a range of social and physical elements that make up a community structure and may influence obesity. The environment, in particular, the built environment plays a significant role in increasing consumption of energy and decreasing expenditure of energy hence influencing obesity (Hill, 1998).
According to Hill (2003), the built environment play a significant role in influencing obesity in adults and children by creating a climate promoting increased consumption of energy and reducing the expenditure of energy. The many ways in which the manmade environment influences health include not only factors in the broad social and physical environments that include urban development, housing, transportation, land use, agriculture and industry, but also direct pathological impacts of different biological, chemical and physical agents (CDC, 2007).
There is increasing evidence that the design of most urban areas contributes to the growing obesity prevalence and overweight among adults and children. Some features of the built environments like the presence of the streetlights, sidewalks, streets interconnectivity, use mix and population density seems to encourage physical activities hence reducing obesity risk. However, other factors such as lack of parks, and automobile focus transport and high-speed traffic may discourage physical activity and hence increases the risk of obesity (Berrigan & Troiano, 2002). According to Giles-Corti & Donovan (2002), people living close to parks have a higher likelihood of using them and be active physically compared to those who live far away from the parks. Similarly, Frank et al (2005) indicated that urban neighbourhood with a mixture of types of land use which includes residential, industrial, and commercial and office also appear to be promoting physical activity hence reducing the obesity risk. On the other hand, neighbourhoods that exclusively consist of housing appear to dampen physical activity and hence increase obesity risk (Cervero & Duncan, 2003).
According to Krämer et al (2010), economic growth and urbanization may contribute to increased obesity risk through multiple factors such as increased access to calorie, high fat dense food and beverages, promotion of consumption of large food portions, and promotion of increased processed foods that are prepared outside homes. Moreover, transportation and advancement in technology increase efficiency at work and homes, they may also contribute to increased engagement time in sedentary lifestyle behaviours and decreased expenditure of energy.
There is strong evidence according to the Australian Government (2015) that built environments affects choices of transport modes of both children and adults. Australian Government (2015) further indicated that neighbourhoods characterised by a poorly connected network of streets, low density, poor access to services and shops are associated with low walking levels. Furthermore, low walkability or urban sprawls appears to be linked with obesity. This may be because of long commuter trips for an individual to reach suburbs that are located on the fringe or urban.
What are one or two social factors that relate to or affect your health issue? E.g. Age, Education, lifestyle
Lifestyle
Lifestyle is an important social factor that influences the status of weight. Physical inactivity and unhealthy diets are major risk factors for obesity and overweight. England (2015) stated that physical activity includes activities such as cycling or walking, work-related activity, active play, active recreation, swimming, dancing, playing games or gardening as well as non-competitive and competitive sports. Physical activities are key determinants of expenditure of energy and form a fundamental part of weight control and energy balance. The lifestyle of an individual who engages in physical activity regularly can reduce obesity risk. Physical activity can be incorporated by an individual in his or her everyday lifestyle, for example through cycling or brisk walking and this is effective in losing weight.
On the other hand, sedentary lifestyle has been associated with obesity and overweight. Sedentary lifestyles among adults are impacted by gender, age, socio-economic conditions, weight status, occupation and some physical environments characteristics.
Nutrition is also part of the lifestyle of a person and is a major contributor to obesity in children and adults. Consumption of excess calories by people is as a result of consumption of high energy drinks and foods such as fast foods, processed and sweetened foods, large portion sizes and alcoholic drinks. Moreover, England (2015) asserted that eating habits are perpetuated trough cultures and families and are maintained often from childhood to adulthood
Age
According to Giles-Corti & Donovan (2002), obesity can occur to any person at any age. However, as a personage, less active lifestyles and hormonal changes increase the obesity risk. Additionally, the number of muscles in a human body tends to decrease with age (Frank et al, 2005). This lower mass of muscle leads to a metabolism decrease. These changes also reduce the calorie needs and make it harder for a person to keep off the excess weight.
Ageing is linked to considerable body composition changes. After the age of 20-30 years, Villareal et al (2005) indicated that fat-free mass decreases progressively, whereas the fat mass increases. The fat-free mass which is primarily made up of skeletal muscles decreases by up to 40% from the age of 20 to 70 years. Moreover, ageing is associated with fat-free mass and body fat redistribution. Villareal et al (2005) asserted that with ageing, there is an increase in intra-abdominal fat compared to the subcutaneous fat or the body total fat. Therefore, in older adults, body composition changes due to age and loss of height because of vertebral body’s compression alter the relation between body fat percentage and BMI.
Which model/s of health and wellbeing (i.e. biomedical or alternative holistic models) is the most significant for the management or treatment of your chosen health issue?
The social model of health
Health models are conceptual frameworks or different thinking ways about health (VicHealth, 2015). The essay adopted a social model of health as the most significant for the management and treatment of obesity. The model is based on the understanding that for the occurrence of health gains, environmental, economic and social determinants must be addressed
The social model of health approach addresses the broader health influences such as economic, environmental and cultural factors rather than injury and diseases. It is a community approach suitable for disease and illnesses prevention. The focus of the model is on health promotion, education and policies. According to VicHealth (2015). The social model of health that has been adopted goes beyond the focus of behaviour and lifestyles and accepts the need for social change to provide health prerequisites.
The social model of health model is grounded on five principles as discussed by VicHealth (2015)
Addresses the broader health determinants- This principle address all aspects of the health. VicHealth (2015) indicated that the broader health determinants such as ethnicity, gender, location, socio-economic state and physical environment influence determinants of behaviour and have a strong relationship with health, and are also becoming the major focus for promotion strategies of health. Therefore, applying this principle, obesity will be managed when health promotion strategies are focused on the broader health determinants
Reduce social inequities- The principle aims at promoting equity for everybody and therefore for this to be achieved, the social determinants that lead to inequality such as culture, gender, location, socio-economic status and physical environment are addressed. Therefore, for obesity to be managed or be treated effectively, this model will aim at promoting equity by addressing the social determinants in the society that has created inequality
Empower communities and individuals- Empowering communities and individuals with health knowledge means that they will be in a position of making positive decisions about their body health in addition to participating in healthy behaviours. Therefore, for obesity to be managed or treated, communities and people must be empowered with skills, confidence and knowledge to make good decisions to improve their health
Access to healthcare- Through this principle, the social model of health enables all people to access to healthcare. This is achieved by addressing the social factors that can impact healthcare access such as language and cultural barriers, education level, economic and geographical factors. This principle will enable obese people or the general population to access appropriate healthcare and health information
Inter-sectorial collaboration- This principle will involve all stakeholders and organizations who influence environmental and social health determinants of health hence addressing adequately the health issue of obesity and positively affecting health status. This can be achieved through a coordinated approach with government departments and health organizations
Conclusion
In conclusion, the essay addressed obesity as a health issue. Urban areas or built environments have been found to influence obesity among people. Some features of the built environments seem to encourage physical activities hence reducing obesity risk. On the other hand, other factors such as lack of parks, and automobile focus transport and high-speed traffic may discourage physical activity and hence increases the risk of obesity. Urban centres also have increased access to calorie, high fat dense food and beverages, promotion of consumption of large food portions, and promotion of increased processed foods. The social factors that relate to or affect obesity include lifestyle and age. Lifestyles such as lack of physical activity or being sedentary increases obesity risk while active lifestyles with good nutrition reduce the obesity risk. Finally, the social model of health is the most significant for the management and treatment of obesity because it is inclusive and incorporates every sector and addresses all social factors that contribute to obesity in people
References
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