Obesogenic Environment and Race, Ethnicity and Health Flashcards
(30 cards)
What is the consensus with obesity and general harm in the form of diseases (co-morbidities)?
Obesity harms health as multiple morbidities associated with obesity of which may be very wide-ranging
What is the epidemiological trend of obesity e.g. USA? Is this ubiquitous?
Obesity increasing ≈ greater proportion of patients obese ≈ multi-morbidities
Is obesity a growing problem and why?
Worldwide prevalence ≈ ubiquity of fast-food revolution, reduced agricultural quality (growing global population) + portion sizes increasing as well as availability and normality of calorie-dense foods
- Growing prevalence
- Fast-food revolution
- Reduced agricultural quality
- Portion sizes
- Availability + normality of calorie-dense foods
What is the obesogenic environment?
sum of complex interactions of surroundings, opportunities, condition of life ≈ physical environment; food environments; society; media; infrastructure; psychological; developmental ≈ increase obesity in individuals
List the main components of the obesogenic environment.
- Built environment
- Food environments
- Society
- Media - Infrastructure
- Psychological
- Developmental
What is the relationship with media and obesity?
Media: Education, media consumption, media availability, peer pressure, importance of body-size image
What are some influencers of physical activity?
Activity: domestic activity, occupational activity, recreational activity, functional fitness, social depreciation of labour and Infrastructure: safety of unmotorised transport, dominance of motorised transport, walkability of living environment, ambient temperature
What are some environmental factors?
- Walkability = access to shops and services; high residential density; pavements; public transport associated with residents meeting physical activity
- Density of fast food outlets associated with overweight and obesity in children and young people
- Interplay with other factors - one Australian study showed high stress levels found in socially disadvantaged neighbourhoods were associate with poor weight management, less physical activity in leisure time and frequent fast food consumption in women
What is public health?
‘the science and art of preventing disease, prolonging life and promoting health through the organised efforts and informed choices of society, organisations, public and private communities and individuals’ - CEA Winslow
What is the public health approach?
Identifying the problem and endeavouring to reach the response through: surveillance, risk factor ID, intervention, evaluation and implementation
Problem: Defined and identified issue
Risk factor: increasing likelihood of disease
Intervention: aetiology ≈ intervention (vice versa)
Measurability: measures to bring about ∆
What is the distribution of obesity in adults in Scotland amongst the most and least deprived?
Data shows a disparity and inequity in wealth/deprivation and obesity incidences (percentage of population obese). The gap between level of obesity in the 20% most ad least deprived areas in Scotland is bigger for women than men but the size of the gap has not changed much since 1995 thus inequality still plays a part in obesity
What is the distribution of obesity in adults in Scotland for children in the most and least deprived 20%?
Obesity risk has increased for children aged 2-15 and in the most deprive areas sine 1998
Is life expectancy strongly associated with deprivation?
Yes, life expectancy is strongly associated with deprivation as shown by SIMD1 (most deprived) having a life expectancy of 76.7 and 71.3 (females and males) to SIMD5 (least deprived) 84.5 and 81.9 (females and males)
How can you promote healthy behaviour in public health at a macroscopic level?
- Commission services providing support for struggling families to access fresh food
- Qualitative research into what motivates people in specific communities to take up exercise
- Support for national and local campaigns - Targeting resources for maximum health benefit - proportionate universalism - Lobbying government for changes to laws and policy e.g. sugar tax
How can you monitor the health status of the population?
- Survey data on obesity rates in population, including variation by e.g. sex, age, deprivation, ethnicity and learning disability
- Data on risk factors for obesity e.g. physical activity levels, alcohol intake - Direct measurement
- National Child Measurement Programme in England and Wales
- Data on illnesses for which obesity is a risk factor e.g. diabetes, coronary heart diseases, some cancer
What is 4-P medicine in Public Health?
- Personalised: right for individual and tailored to their disease and circumstances
- Predictive: what will happen to this person, not the general %s
- Preventive: best way to avoid the fallout from many diseases but all too easily forgotten as we chase technological solutions
- Participatory: patients and healthy public involved in their own preventive and management strategies
What is race?
Division of species into groups based on frequency of hereditary traits ≈ phenotype
What is ethnicity?
Social division of people into groups based on their identification with shared origin
List 3 following ways by which people may be divided socially (ethnically).
- Language - Food - Religion - Clothing - Myths - Traditions - Music - Art
What is the relationship between race and ethnicity?
Race is a biological and genetics approach whereas ethnicity is socially produced
1) Biological: Biological division of species into groups based on frequency of hereditary traits
2) Social: Social division of people into groups based on their identification with shared origin
What is naive biology?
A historical assumption that physical differences between people of different ancestry are a stable grouping.
What is a cline?
Measurable gradient in a single character or biological trait of a species which are gradual gradients across space. Spaces of rapid change are geographic boundaries but even these are clines rather than distinct groups
What is naive biology?
A. Measurable gradient in a single character or biological trait of a species which are gradual gradients across space.
B. Historical assumption that physical differences between people of different ancestry are a stable grouping
C. Re-racialisation of medicine
D. Biological division of species into groups based on frequency of hereditary traits
B. Historical assumption that physical differences between people of different ancestry are a stable grouping
What is an example of race in medicine?
What flaws may exist in this?
Re-racialisation of medicine in discovery of BiDil which showed no significant improvement in treatment of white patients but benefited Black patients for heart failure
Flaws:
- Black (race)?
- Poverty
- Stress
- Genetic differences in the ACE gene due to selection
- Where do you draw the line of ‘black’ e.g. Ethiopians or South Indians?
