NR553 Week 2 Discussion, Epidemiologic Transition

Epidemiologic Transition NAME Chamberlain College of Nursing NR 553: Global Health Policy DATE Correlate one leading risk factor causing the greatest burden of disease in developed regions with Omran’s theory of epidemiologic transition. Week 2: Epidemiologic Transition Agyei-Mensah and Aikins (2010) state that Omran’s theory of epidemiological transition model explains the complex changes in patterns of health and disease as well as the interaction of the trends with socioeconomic, demographic determinants, and consequences. The model asserts that there are three stages, the first referred to as “Age of Pestilence and Famine” which was characterized by cyclical birth and death rates due to widespread epidemics of famine and infection. The second stage referred to as “Age of Receding Pandemics” was characterized by a reduction in infection. The third stage referred to as “Age of Degenerative and Man-Made Disease” was largely influenced by social factors such as income, occupation, lifestyle, and diet. According to Forouzanfar et al. (2015), behavioral, occupational, environmental and metabolic risks account for half of the global mortality rates and more than one-third of the global disability-adjusted life year. Further, high body mass index (BMI) is the leading risk factor for disease burden in barely all developed countries. Also, dietary risks, high systolic blood pressure, and tobacco were noted to be the leading disease burden contributing factors in nearly all high-income countries. Thus, the developed nations are in the third stage of Omran’s theory where social factors significantly increase the health burden. The high BMI and high systolic blood pressure are attributable to dietary choices and physical inactivity are predisposing factors too numerous conditions affecting the people in developed nations including obesity, diabetes, cardiovascular diseases among others. References Agyei-Mensah, S., & Aikins, A. D. G. (2010). Epidemiological transition and the double burden of disease in Accra, Ghana. Journal of urban health, 87(5), 879-897. Forouzanfar, M. H., Alexander, L., Anderson, H. R., Bachman, V. F., Biryukov, S., Brauer, M., & Delwiche, K. (2015). Global, Regional, and National Comparative Risk Assessment of 79 Behavioural, Environmental and Occupational, And Metabolic Risks or Clusters of Risks In 188 Countries, 1990–2013: A Systematic Analysis for the Global Burden of Disease Study 2013. The Lancet, 386(10010), . PROFESSOR RESPONSE TO A PEER: What countries have done a good job in primary, secondary and tertiary prevention of obesity? How did they do it? RESPONSE TO PROFESSOR: Dr. Fildes and Leslie, Due to a combination of poor nutrition, such as overconsumption of sugary soft drinks and fast food, and insufficient exercise, diseases such as diabetes have become much more common among younger age groups. Throughout Europe the problem of obesity is prevalent. According to the Regional Office for Europe World Health Organization (WHO/Europe), in Finland, more than half of all adults are reported to be overweight, and 1 in 5 are obese. In adults between the ages of 25-64, 66% are overweight and 20% obese, compared to 46% of women being overweight and 19% obese (National Institute for Health and Welfare, 2018). In children and young people, 10% of boys and 15% of girls in pre-school age are reported to be overweight in Finland (National Institute for Health and Welfare, 2018). Food promotion influences children’s nutritional knowledge, food preferences, purchasing and purchase-related behavior, consumption, and diet and health status. In May 2004, WHO called on governments, private industry, and consumer groups to take action against marketing messages that promote unhealthy dietary practices. To successfully reduce the prevalence of obesity in European countries WHO called for national action to protect children from marketing by substantially reducing the volume and impact of the commercial promotion of junk foods in 2006 (WHO, 2006). In Finland, the National Consumer Ombudsman published guidelines on the marketing of food to children in 2004. These guidelines are intended to tighten regulation of advertising through TV, radio, and other means of technology is utilized to reduce children to the exposure of unhealthy food advertisement. The National Board of Education and the National Public Health Institute recommended that schools should not provide vending machines selling sweets and beverages on their premises in 2007 (WHO/Europe, 2013). The National Institute of Health and Welfare (THL) works to promote health and wellbeing throughout Finland. The main goal of THL is to ensure that people in Finland live good and healthy lives. In order to reduce the incidence of obesity throughout Finland, the THL coordinated the National Obesity Programme . The goal of the National Obesity Programme is to encourage different stakeholders from the various sectors of society to take part in the collaboration, guidance, and communication of information promoting a healthy lifestyle to reduce obesity (National Institute for Health and Welfare, 2018). The goal is to create systematic collaboration to promote population health, thus achieving a downward trend in obesity. Health in All Policies (HiAP), the main health theme of the Finnish European Union Presidency in 2006, is a natural continuation of Finland’s longterm horizontal health policy (Ministry of Social Affairs and Health, 2013). The HiAP emphasizes the consequences of public policies on health determinants, and aims to improve the accountability of policy-makers for health impacts at all levels of policy-making. Health in All Policies addresses the effects on health across all policies such as agriculture, education, the environment, fiscal policies, housing, and transport (Ministry of Social Affairs and Health, 2013). HiAP is not confined to the health sector and to the public health community but is a strategy with a potential towards improving a population’s health, with health determinants as the bridge between policies and health outcomes. References Ministry of Social Affairs and Health. (2013). Health in all policies. Seizing opportunities, implementing policies. Retrieved from National Institute for Health and Welfare. (2018). Support for implementation. Retrieved from World Health Organization/Europe. (2013). Nutrition, Physical Activity and Obesity Finland. Retrieved from World Health Organization (2006). Marketing of Food and Non-Alcoholic Beverages to Children: Report of a WHO Forum and Technical Meeting. Retrieved from RESPONSE TO PEER: Leslie, Dr. Fildes, and classmates, After engaging in this weeks’ discussion thread I’ve learned there are comprehensive volumes of literature and regarding overweight and obesity and the relation to comorbidities. In developed countries, it is seen that greater social inequality is associated with an increase chance of obesity in comparison to developing countries. Once obesity is established, it is very difficult to reverse through interventions. In this situation, the role of primary prevention is of importance besides incorporating strategies of behavioral changes, diet control, and physical activity. Lack of accessibility to healthy food choices and the commercial driven food market environment can be considered one of many probable causes of obesity not only in the U.S. but many other countries. I believe the U.S. government could use the example set by WHO/Europe and the Finnish government on the stiffened regulation of advertising through TV, radio, and other means of technology is utilized to reduce children to the exposure of unhealthy food advertisement. No matter the solution, a public health approach to developing population-based strategies for the prevention of overweight should target all factors contributing to obesity, should be comprehensive, and actively involve different levels of stakeholders and other major parties. Thank you for an enlightening discussion on obesity and excess weight gain. Carole B.