Childhood Obesity: Inequity and Interventions

This document discusses the reasons for inequity in childhood obesity between indigenous and non-indigenous Australians, including factors like income inequality and poor food intake. It also explores primary healthcare interventions that are addressing this health issue for indigenous Australians. Cultural knowledge and sensitivity in healthcare are also discussed in relation to access to primary healthcare services.

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Q1. Reasons for inequity between indigenous Australia and non-indigenous
Australia in relation to obesity
Historically the inequity between the indigenous Australia and non-indigenous Australia
started in the nineteenth century. The reasons for inequity in children with obesity between
aboriginals and Torres Strait Islander and the non-indigenous Australians factors like poverty,

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income inequality, poor food and nutrients intake, and inequity in physical activities among other
reasons(Browne, Adams & Atkinson, 2016). In this question income inequity and inequity in
food and nutrient intake is discussed in detail. Over the past decades, the minority groups across
the world have been recognized to suffer obesity more than majority groups (Black, Hughes &
Jones, 2018). This is because of the traditions held by these groups such like Aboriginal and
Torres Strait Islander, Pacific island nations, Papua New Guineans, Canadian Inuits, Alaska
Natives and American Indians. From the times of colonial history, Aboriginal and Torres Strait
Islanders people have not been able to enjoy similar receipt of money compared to the non-
indigenous population. It was until the beginning of equality era during the passage of the 1967
referendum and the racial discrimination act of 1975 that led to better salaries (Markwick,
Ansari, Sullivan and McNeil,2015).
According to new research conducted by the University of Auckland involving over
200,000 children in 36 countries, national income and income inequality have an impact on
children and adolescents’ body size(Dyer et al., 2017).. The study which was conducted in
Australia, the United Kingdom and New Zealand recognizes income levels with adolescence
girls in wealthier nations showing the highest rates of obesity (Smithers, Lynch, Hedges &
Jamieson, 2017). If a child is obese or overweight, they have a high risk of a range of health
problems like social problems, sleep disorders, respiratory and joint problems, some types of
cancers, type 2 diabetes, and coronary heart diseases.
Poor food and nutrient intake are common among Aboriginal and Torres Strait Islanders.
In a study conducted for children aged between 10-12 years living in relative socio-economic
disadvantaged areas of the north coast of New South Wales shown that a high number of
children had poor food and nutrient intake (Smithers, Lynch, Hedges & Jamieson, 2017). They

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had a far less fibre intake than the Australian Nutrient Reference Value which ranged between
74-84%. Calcium intake was less by between 54-86% Estimated Average Requirement, folate
and magnesium intake of 36% and 28% respectively less than Estimated Average Requirement
among girls.
The study also found that the majority of children exceeded sodium intake upper limit of
between 68-76%. White bread, salty snacks, high-fat processed meats, sugary drinks, and hot
chips were very common contribution per capita intake. Children for indigenous people were
found to consume less fruit and vegetables (Pandita et al., 2016). Intake of sodium,
macronutrients and energy were higher amongst indigenous boys than non-indigenous boys.
Indigenous people across the world face poor health status and suffer greater mortality than non-
indigenous peoples.
Australia leads with a greater gap as well as chronic diseases compared to other similar
countries. Indigenous people of Australia have a three times high rate of diabetes compared to
non-indigenous people and six times among indigenous youths compared to non-indigenous
youths (Hayes, Lung, Bauman and Howard,2017). Improving the diet of children is a strategy
that is associated with reducing the risks of chronic diseases for children and adults. Poor
nutrition and poor food intake during childhood have been linked to type 2 diabetes
development.
Q2. Primary healthcare intervention that is addressing this health issue for
indigenous Australians
Obesity has been recognized a global problem and children are among those highly
affected. According to Mihrshahi, Gow and Baur (2018), there are 124 million children across
the world suffering from obesity. This group comprised of children and adolescents aged

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between 5-19 years. Mihrshahi, Gow and Baur (2018) sate that out of the 34member countries in
the Organization for Economic Co-operation and Development, US leads with childhood obesity
and Australia ranks position eight positions 5 for boys. Overweight and obesity among school
children in 2015 rose to 22.9% where 7.1% suffered from obesity. In secondary school teenagers,
overweight was recorded at 21.7% overweight and 5.8% obesity(Mihrshahi, Gow and Baur,
2018).
Dealing with the issue of childhood obesity effectively requires the introduction of
system based policies. Policies that focus on food environment must be applied to prevent
obesity in children since they can provide long term changes for obesity and overweight among
children (Pandita et al., 2016). System based policy may focus on sugar-sweetened beverages
and fiscal policies to reduce consumption of harmful foods, restrictions on marketing unhealthy
food to children, initiatives to provide healthy foods in schools, and effective nutrition
labeling(Wang et al., 2015). A good example is in Mexico where a tax was introduced on sugar-
sweetened beverages in January 2014. This tax leads to a reduction in the purchase of sugar-
sweetened beverages by 6% in the latter year. This was significantly reduced in households with
low income(Smithers, Lynch, Hedges& Jamieson, 2017). The strategy was recommended by a
US study as the best intervention which would save the government of Mexico nearly $55 for
every $1 invested over ten years(Smithers, Lynch, Hedges & Jamieson, 2017). The intervention
aims at preventing the purchase and consumption of sugar-sweetened beverages.
Another similar April 2018 case of increase in tax in the United Kingdom led to
manufacturers improving their products before the tax was implemented. Also, children should
be protected from the marketing of nutrient-poor foods and energy dense (Smithers, Lynch,

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Hedges & Jamieson, 2017). This policy is highly cost-effective and can reduce $38 for every $1
invested in every ten years.
Studies in Australia have proven this to be effective in changing public attitude with
growth in supporting government intervention in regulating advertisement and implementation of
other regulatory policies targeting children (Bainbridge et al., 2015). Other up-stream macro-
environment includes lack of playfields among children, availability of shops, and proximity to
parks. Australia existing intervention strategies mostly focus on influencing behavioral change to
prevent obesity and overweight. The impact of System based policy in reducing inequity is only
serves to enhance consumption while doing too little to the in addressing underlying structural
causes of poverty and inequalities (Bainbridge et al., 2015). Research has indicated a significant
reduction of absolute poverty among indigenous Australians living in urban centers as opposed
to people in rural areas (Black, Hughes & Jones, 2018). This is a clear indication that
policymakers and civil society actors are supposed to pay more attention to systematic national
and global shift (Bainbridge et al., 2015). This is so without worrying about the effects it has on
the economy to achieve equitable and inclusive food systems.
3. How cultural knowledge and sensitivity in healthcare may affect access to
primary healthcare services
Cultural awareness in health promotion is very important in ensuring that health care
providers effectively provide cultural friendly care. Indigenous people have a history of
experiencing difficulty in accessing mainstream primary healthcare services due to barriers like
racism and discrimination. Issues that relate to social and cultural determination including poor
education and lack of jobs determine whether indigenous patients, their communities or families
can access healthcare services (Dyer et al., 2017).. Health services and professional Regulatory

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bodies have been prompted by service provision, inequalities in healthcare access and health
outcomes for the global indigenous population (Chaput et al., 2018). They have been made to
examine ways in which they can improve the healthcare needs of indigenous people.
Evidence shows that aboriginals and Torres Strait Islanders have poor health status and
poor healthcare as opposed to non-indigenous people. These inequalities have been greatly
linked to social factors that are outside the healthcare system (Bainbridge et al., 2015). Increased
knowledge has shown that inequalities are predominantly oblivious in infant health, mental
health, and life expectancy, communicable and chronic diseases. Ethnocentric health service
provision has been associated with negative impacts on the health status of Indigenous
populations (Dyer et al., 2017). Researchers and others recommend the availability of indigenous
health workers in health care systems to avoid indigenous people delaying going to service
(Chaput et al., 2018). Health disparities between the indigenous and the non-indigenous
Australians have been linked accessibility which is associated with geographical and economic
factors as well as several sociocultural factors (Black, Hughes& Jones, 2018). Therefore cultural
knowledge and sensitivity in healthcare provision are important in increasing the effort of
improving the systems' ability, services and practitioners to work with culturally diverse patients.
World’s indigenous people health situation can be improved through a fundamental shift in the
concept of health (Hayes et al., 2017). This is for the reason of incorporating the cultures and
world view of the indigenous people to design and manage the state of health systems (Dyer et
al., 2017).
Even though obesity has risen in all racial and ethnic groups non-white populations are
more affected. Issues that relate to the environment, interactions, socioeconomic status, culture,
physiology, and genetic make-up and others not fully recognized are linked to the reasons for the

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differences in childhood obesity (Salvy, de la Haye, Galama& Goran, 2017). When there is a
good understanding of these variables influence on the physical activity and patterns of eating
that leads to children's' obesity there will be critical development of public policies and useful
clinical interventions that not only treat but prevent childhood obesity.
In driving new directions for indigenous healthcare delivery in Australia, the aboriginal
community has been mandated to run and control health services movement to enable a shift in
the design of leadership. The civil right movements across western countries prompted the need
for cultural competence leading to the establishment of a movement controlled by community
members. The movement was responsible for alerting the administrators to the dissimilar
identities and long periods of authoritarianism inflicted to indigenous people, people with
disabilities, gays and lesbians, women, ethnic groups, and others (Brown, Halvorson, Cohen,
Lazorick & Skelton, 2015). Aboriginal Australians populations' experiences of racism and
discrimination in the health care system, cultural, financial and social barriers to healthcare
access led to the establishment of community controlled health services. Cultural knowledge of
peoples' view of obesity and overweight may help healthcare providers to choose the most
suitable primary healthcare intervention (Gortmaker et al., 2015). This knowledge will help to be
very sensitive on which intervention works best for which cultural setting.

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References
Bainbridge, R., McCalman, J., Clifford, A. and Tsey, K., 2015. Closing the gap.
Black, N., Hughes, R., & Jones, A. M. (2018). The health care costs of childhood obesity in
Australia: An instrumental variables approach. Economics & Human Biology, 31, 1-13.
Brown, C. L., Halvorson, E. E., Cohen, G. M., Lazorick, S., & Skelton, J. A. (2015). Addressing
childhood obesity: opportunities for prevention. Pediatric Clinics, 62(5), 1241-1261.
Browne, J., Adams, K., & Atkinson, P. (2016). title Food and nutrition programs for Aboriginal
and Torres Strait Islander Australians: what works to keep people healthy and strong?.
Chaput, J.P., Barnes, J.D., Tremblay, M.S., Fogelholm, M., Hu, G., Lambert, E.V., Maher, C.,
Maia, J., Olds, T., Onywera, V. and Sarmiento, O.L., 2018. Inequality in physical activity,
sedentary behaviour, sleep duration and risk of obesity in children: a 12‐country study: obesity
science & practice, 4(3), pp.229-237.
Dyer, S. M., Gomersall, J. S., Smithers, L. G., Davy, C., Coleman, D. T., & Street, J. M. (2017).
Prevalence and characteristics of overweight and obesity in indigenous Australian children: a
systematic review. Critical reviews in food science and nutrition, 57(7), 1365-1376.
Gortmaker, S.L., Long, M.W., Resch, S.C., Ward, Z.J., Cradock, A.L., Barrett, J.L., Wright,
D.R., Sonneville, K.R., Giles, C.M., Carter, R.C. and Moodie, M.L., 2015. Cost effectiveness of
childhood obesity interventions: evidence and methods for CHOICES. American journal of
preventive medicine, 49(1), pp.102-111.
Gwynn, J.D., Flood, V.M., D'Este, C.A., Attia, J.R., Turner, N., Cochrane, J., Louie, J.C.Y. and
Mihrshahi, S., Gow, M.L. and Baur, L.A., 2018. Contemporary approaches to the prevention and
management of paediatric obesity: an Australian focus. Medical Journal of Australia, 209(6),
pp.267-274.

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Hayes, A.J., Lung, T.W.C., Bauman, A. and Howard, K., 2017. Modelling obesity trends in
Australia: unravelling the past and predicting the future. International journal of obesity, 41(1),
p.178.
Markwick, A., Ansari, Z., Sullivan, M. and McNeil, J., 2015. Social determinants and
psychological distress among Aboriginal and Torres Strait islander adults in the Australian state
of Victoria: A cross-sectional population based study. Social Science & Medicine, 128, pp.178-
187.
Pandita, A., Sharma, D., Pandita, D., Pawar, S., Tariq, M., & Kaul, A. (2016). Childhood
obesity: prevention is better than cure. Diabetes, metabolic syndrome and obesity: targets and
therapy, 9, 83.Salvy, S. J., de la Haye, K., Galama, T., & Goran, M. I. (2017). Home visitation
programs: an untapped opportunity for the delivery of early childhood obesity
prevention. Obesity reviews, 18(2), 149-163.
Smithers, L. G., Lynch, J., Hedges, J., & Jamieson, L. M. (2017). Diet and anthropometry at 2
years of age following an oral health promotion programme for Australian Aboriginal children
and their carers: a randomised controlled trial. British Journal of Nutrition, 118(12), 1061-1069.
Wang, Y., Cai, L., Wu, Y., Wilson, R. F., Weston, C., Fawole, O., ... & Chiu, D. T. (2015). What
childhood obesity prevention programmes work? A systematic review and meta‐
analysis. Obesity reviews, 16(7), 547-565.