Download - Research Assignment-Obesity in McAllen
Wei LinWR13300-04Kurt Milberger15 April 2013Final Draft
Fighting Obesity with Community-Based Initiatives
Obesity is one of the most serious health issues and will continue to rise if we do not
correct the problem. It is a concern especially with children, who risk carrying obesity into their
adult lives where it becomes a catalyst for more serious health issues, ranging from back pains to
cancer. By 2005, obesity cost more than tobacco-use in health care expenditures. According to
Campaign to End Obesity’s researchers, Michael J. O’Grady, and James C. Capretta, the United
States health care system spends about $146.6 billion on obesity-related illnesses (O’Grady and
Capretta 12). The economy of a community is important since obesity and poverty are linked
through the poverty-obesity paradox. The city of McAllen, Texas, the fattest city in America,
feels the full repercussions of both a failed economy and fragile health conditions. McAllen, with
its high prevalence of obesity and massive health care expenditures, may represent America’s
future. To be able to combat obesity in McAllen can set an example for the rest of the American
population struggling with obesity. In order to ensure the financial security and longevity of
McAllen’s future generations, we need to promote new community-based initiatives, such as
improving community safety, eliminating food deserts, and improving health curriculum in
school, to reduce the prevalence of obesity-related illnesses and improve the financial crisis in
McAllen.
There are a variety of approaches that can be used to define the financial impact of
obesity. For this paper, the financial impact of obesity will be defined by the decrease in
productivity from work and the cost of treatment for obesity-related diseases. The figure we are
calculating is not representative of the amount spent solely by the national health care, but,
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instead, a more holistic way of calculating the total impact in many aspects that arise due to
obesity. By calculating the holistic financial impact of obesity-related issues, we will have a
better understanding of the adverse effects obesity has on our nation, particularly McAllen. The
poverty-obesity paradox pertains to the fact that the most obese are also the most impoverished.
It’s a never-ending loop and by studying the financial impact of obesity, we can recognize how
to break that loop.
The decrease in productivity observed by employees who were obese or over-weight is
very apparent. In a study done by Jordana K. Schmier, Mechelle L. Jones, and Michael T.
Halpern, they found that the “obese [were] significantly more likely to have moderate and high
absenteeism (absent [up to] 6 [days for obese women] and 7 days [for obese men] in past 6
months) than the non-obese,” which is about 8 per year (Schmier, Jones, and Halpern 6).
Absenteeism does not also cost employees their salaries, but it also costs employers up to $12.7
billion per year; including health insurance, life and disability insurance, and paid sick leave for
employees between 25 and 64 years of age (Schmier, Jones, and Halpern 8). Another decrease in
productivity due to obesity is workplace injuries, such as lower back injuries and accidents. The
loss of productivity is only part of the enormous financial costs incurred because of obesity.
So much of the financial impact is rooted in the direct and apparent costs of dealing with
the medical expenses of obesity. In a study led by Dr. Christina C. Wee, the “adjusted
expenditure was $2127 for a typical normal-weight (BMI of 20 to 25) [Caucasian] woman aged
35 to 44 years and $3506 for women with BMIs of 40 or higher,” showing a substantial increase
in medical costs in women with higher BMIs. In the article “Obesity Now Costs Americans
More In HealthCare Spending Than Smoking,” Rick Ungar states that we spend about 190
billion dollars a year due to obesity-related health issues, which has surpassed the cost of the
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adverse effects of smoking (Ungar). Direct costs of health services provided include surgery,
laboratory and radiological tests, and drug therapy. These costs produce a strain on the health
care system, but there are costs that are not medical related and still threaten the financial
stability of individuals who are suffering from obesity.
In 2012, McAllen, Texas was named the fattest city in America. The prevalence of
obesity is 38 percent, which is way above the national average of 26.1 percent. Poverty has also
stricken this city with 34.8 percent of the people living below the poverty line. Due to the
increasingly high number of obesity-related health issues, such as cardiovascular diseases
(CVD), surgeries are performed very frequently and the average individual’s Medicare
expenditures is about fifteen thousand dollars, which is about twice than the national average
(Gawande, “The Cost Conundrum”). McAllen is a poverty and obesity-stricken area, and it
represents the future that much of the American population will suffer if nothing is done about
the issue of obesity. However, if you can overcome the most extreme case of obesity, then you
should also be able to implement the same things across the country where it’s not as
exasperated. So by extension, a solution to McAllen’s health troubles may be the solution to
most of America’s obesity concern.
The prevention of obesity is the key to lowering the prevalence of obesity. The onset of
obesity in adults is largely affected by habits developed during their childhood. About 17 percent
of children are considered obese, that means, their BMI’s are among the top 95 in their age and
gender group. Obese children usually continue to practice bad habits and will result in adverse
health effects as they grow up. In fact, obese children are twice as likely to die before the age of
55 than their non-obese counterparts due to possible health complications. Obesity is a
preventable condition, yet about 112,000 people die each year due to obesity-related causes,
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making it the second leading cause of preventable deaths in the United States. To clarify,
smoking is still the leading cause of preventable death, but obesity has cost more in health care
spending. To combat rising obesity rates in McAllen, we need to promote new community-based
initiatives. I suggest community-based initiatives because they influence a larger population, and
while individual results may not be as great or noticeable, the population as a whole may notice a
more gradual progress. Many factors that lead to increase occurrences of obesity are rooted in the
community and the characteristics of the individual’s neighborhood. These factors include
neighborhood safety, accessibility to healthy food sources, and school nutrition. The initiatives I
am proposing should combat these problems and a gradual improvement in health should be
noticeable after a couple of years. Combatting obesity at a young age is the best way to escape
the downward spiral to an unhealthy and life-threatening lifestyle. We need to focus these
initiatives to assist the children first.
Children get most of their physical activity from playing outside, but parents may be
concerned about the neighborhood safety and be more reluctant to let kids out. A report written
by Laure DeMattia and Shannon Lee Denney states that parents are concerned about
neighborhood safety more frequently on behalf of girls than for boys and are reported more
frequently by Hispanic parents than by non-Hispanic white and black parents (DeMattia and
Denney 88). Children living in the least safe neighborhood conditions are reported to have spent
more time watching television than other children (DeMattia and Denney 88). A study done for
Ohio State University states that poverty, not race, is tied to higher crime rates (Grabmeier).
With 34.8 percent of the population of McAllen falling below the poverty line, the neighborhood
may seem less safe and further worry parents. Reducing these uncertainties and reassuring
parents of their neighborhood’s safety may allow children more time to play outside. We can
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reduce these hesitations by introducing neighborhood patrols or encouraging parents to
accompany their children when they want to head out. Neighborhood safety also dictates the
mode of transportation to school for many kids. Top reasons for the decrease in active transport,
bicycling or walking, to school are concerns about distance and safety. Government officials of
McAllen should consider programs that will reduce the hesitations of these worried parents.
Safe Routes to School (SR2S) is a national program started in 2005 that is attempting to
make progress in addressing those concerns. SR2S funds communities and encourages the
development of programs and projects related to bicycle and pedestrian safety in an attempt to
encourage more students to walk to school. These projects include building more schools to in
different areas to make it more accessible to more families and easier for parents to walk their
kids to school. This initiative has been taken by the city of Milwaukee and should be
implemented in McAllen. DeMattia and Denney believe that “this small increase in physical
activity has the potential to [decrease and curb] weight gain we have seen in our community,”
and it may just be a very effective method of combatting childhood weight gain. McAllen should
try its best to bring SR2S to its communities (DeMattia and Denney, 89). Officials should
consider providing tax incentives for schools that choose to endorse SR2S and its programs. This
is one potential method of fighting obesity, but another option would be to improve the
availability of healthy and cheap foods.
The lack of accessible sources of healthy food is also a leading cause of childhood
obesity. In a study done by Morland, Diez Roux, and Wing, they made the correlation that
survey respondents in communities with access to a supermarket observed a lower incidence of
obesity, whereas areas with access to convenience stores observed just the opposite (Morland,
Diez Roux, and Wing). These areas with an abundance of fast food restaurants and poor access
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to healthy food choices are coined “food deserts.” Governor Ed Rendell of Pennsylvania
launched a program to form public-private partnerships attempts to improve the access to more
healthy food in food deserts. To rid areas of food deserts, the program encourages business
development in low-income areas by offering over $2 billion in incentives to encourage
businesses to start supermarkets, corner markets, or healthy food shop in these food deserts
(Flournoy, "Healthy Foods, Strong Communities").
New York City is laden with food deserts, especially in the borough of Bronx, Northern
Manhattan, and Brooklyn, with an estimate of 750,000 residents living in food deserts (“Fresh
Food for Urban Deserts”). Supermarkets all over the city are shutting down due to the increasing
rents and shrinking profits. The increase of food deserts in New York City has had the most
serious impact on low-income communities. To combat this issue, the city started the Green
Carts program and the Greenmarket program which brings affordable fresh fruits and vegetables
to underserved areas while providing jobs for vendors and farmers. Hundreds of Green Carts are
already on the streets in food deserts, and that number is rapidly increasing as prospective
vendors obtain training, licenses, and permits from the city. Greenmarket in Union Square
provides local farmers from upstate New York a way to increase profits by selling directly to
consumers while providing cheaper and healthier alternatives to New Yorkers who would
otherwise be unable to find such cheaper alternatives to fast food. These are all great and viable
solutions for parents who are struggling to find affordable and healthy foods to provide their
kids. The communities of McAllen should start urging government official to support these
programs by providing tax incentives to farmers and local produce vendors. They are
economically sound for both producers and consumers and provide a better source of nutrition
for both parents and children. By introducing healthy eating habits to their children, parents are
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setting up an example that the children will follow as they mature. Not only do these initiatives
boast healthier lifestyles, but also these initiatives will allow McAllen to secure its future
economy by benefitting both the farmers and families that engage in this business. As a result,
the residents can afford healthier lifestyles and prevent obesity. We can also target the problem
of obesity through another channel, the school system.
Since most children are required to attend school, schools are ideal environments for
providing community-wide health interventions while seamlessly incorporating it into regular
school activities such as physical education requirements, cafeteria nutrition, and health classes.
Experiments have been done by initiating classes that aimed to reduce the amount of time spent
watching television, using videotapes, and playing video games and then comparing the average
BMI to a school that did not implement such classes. Results showed that the school that
implemented these classes had lowered their average BMI by .45, which is an overall significant
success (DeMattia and Denney, 93). The Head Start Program is an example of a successful
educational initiative.
The Head Start Program is a pre-school program operated by United States Department
of Health and Human Services. It works to not only educate children of low-income households,
but it also teaches them to eat healthy. Based on farm-to-school food programs that were being
piloted around the country, it brought not only healthier foods into the Head Start food service
program, but it would also educate children about fresh fruits and vegetables by engaging the
children in activities centered around a featured food. One study examined the impact of
increasing exposure on children's acceptance of given foods. It was found that, while 2 to 3 year
olds were more reluctance to taste new or unfamiliar foods than 5 to 6 year olds, preference
increased with at least 8 to 10 exposure across both age groups (Swadener 294). These Head
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Start programs are confirmation of the success that curriculum-based initiatives and changes can
make a difference in a child’s life.
McAllen is in dire need of a solution. This Texan city is the prime example of a failed
health system and economy. With community-geared initiatives aimed at decreasing the
prevalence of obesity in children, we could have a profound influence on them and prepare them
with healthier habits for the future. This can potentially reduce the financial strain that it places
on these future adults and the future livelihood of McAllen. The people of McAllen need to start
asking public officials to provide tax incentives to encourage the implementation of programs
such as SR2S and Greenmarkets. The schools, too, need to recognize what is at stake and alter
their curriculum to combat obesity and set their students of a healthier path. Any one or mix of
these solutions will provide a long-term decrease in obesity and poverty rates. These plans have
been tested in other communities and they have reaped the benefits. It is time for McAllen to do
the same and escape this situation it is in. Obesity is preventable and by taking and implementing
precautionary measures with the younger generations, a brighter future lies ahead of McAllen.
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Works Cited
DeMattia, Laure, and Shannon Lee Denney. "Childhood Obesity Prevention: Successful Community-
Based Efforts." Annals of the American Academy of Political and Social Science 615 (2008): 83-
99. JSTOR. Web. 22 Mar. 2013.
Flournoy, Rebecca. "Healthy Foods, Strong Communities." Shelterforce 147 (2006): n. pag. National
Housing Institute. Web. 15 Apr. 2013.
"Fresh Food for Urban Deserts." Editorial. The New York Times. N.p., 20 Mar. 2009. Web.
Gawande, Atul. "THE COST CONUNDRUM." New Yorker 85.16 (2009): 36-44. Academic Search
Premier. Web. 15 Apr. 2013.
Grabmeier, Jeff. "POVERTY, NOT RACE, TIED TO HIGH CRIME RATES IN URBAN
COMMUNITIES." Research and Innovation Communications. The Ohio State University, n.d.
Web. 01 May 2013.
Morland, Kimberly, Ana V. Diez Roux, and Steve Wing. "Supermarkets, Other Food Stores, and
Obesity: The Atherosclerosis Risk in Communities Study." American Journal of Preventative
Medicine 30.4 (2006): 333-39. ScienceDirect. Web. 15 Apr. 2013.
O'Grady, Michael J., and James C. Capretta. "Assessing the Economics of Obesity and Obesity
Interventions." Campaign to End Obesity (2012): 12. Web.
Schmier, Jordana K., Mechelle L. Jones, and Michael T. Halpern. "Cost of Obesity in the Workplace."
Scandinavian Journal of Work, Environment, & Health 32 (2006): 5-11. JSTOR. Web. 15 Apr.
2013.
Swadener, Susan S. "Nutrition Education for Preschool Children." Journal of Nutrition Education 27.6
(1995): 291-97. USDA. Web. 1 May 2013.