America's Preventable Epidemic

Contrary to most developing nations, America has public health problems of opulence; we can afford to eat richer foods, and more of them.  This not only affords us a comfortable lifestyle, but also the highest rate of childhood obesity.  For the past few decades, this rate has continued to increase at an alarming rate -- the number has tripled since the 1980s!  WHO has some interesting, and alarming, statistics.  The rate of obesity is increasing in both boys (up from 5% to 13%) and girls (up from 5% to 9%). 22 million in the world under 5 are overweight.  Of those, the majority are American.  

Obesity brings many related health problems, both physical and mental, including type II diabetes, high blood pressure and cholesterol, poor self esteem and even depression.  Public health can prevent obesity before these related medical issues need to be addressed.  In fact, public health initiatives will be the only effective form of intervention because obesity is a public health issue; it results from the unhealthy habits of a population as a whole.  But, the difficulty is figuring out the most effective solution to address the problem.  

A recent study, published in the New York Times, researched a solution to curtail this huge problem.  The idea was simple, yet ingenious: “school based health intervention” they call it.  The interventions teach kids healthy habits, increase their physical activity, and improve lunch options in the cafeteria.  This gives kids not only awareness, but also access, to healthy eating. 

To test the effectiveness of these interventions, a cohort study was used to follow over 4,500 students, split equally into two groups: one participating in a school health program, the other acting as a control.  The students were followed for the duration of middle school.  By eight grade, the rate of obesity declined significantly in the children participating in the health program -- by a full 24.6 percent.  But, surprisingly, the control group dropped by even more -- 26.6 percent.  So, what exactly does this suggest?  

The researches believe this indicates a much larger trend--a nationwide decrease in childhood obesity.  They see outside factors as contributing to the decrease in obesity rates of the control group as well as the experimental group.  However, I remain a little skeptical of this conclusion.  Unable to pinpoint exactly what these outside factors may be, the researchers seem uncertain.  Furthermore, the results do not seem to correlate.  Why would the control group have a higher decrease in obesity than the group with the health interventions?  If the same outside factors were influencing both groups, the experimental group should still have a larger percentage decrease because they also received further health interventions.  

The inconsistent results could also mean that the intervention was ineffective and obesity decreased due solely to other factors.  Or, it may indicate some selection bias within the study.  (i.e. could more children in the control group come from wealthier families, who can afford healthier, organic foods?)  Either way, potential biases of the study could possibly undermine its validity.  By controlling for these factors, the study could be strengthened.   

Despite these apparent weaknesses, I still find the school based health intervention approach to be innovative.  I think that, with further studies, this sort of approach will be confirmed as helpful.  If implemented in all public schools, I see it as having great potential to halt the nation’s most serious, yet preventable, epidemic: obesity.