Body mass index (BMI) is a measure used to determine childhood overweight and obesity. It is calculated using a child's weight and height. BMI does not measure body fat directly, but it is a reasonable indicator of body fatness for most children and teens. A child's weight status is determined using an age- and sex-specific percentile for BMI rather than the BMI categories used for adults because children's body composition varies as they age and varies between boys and girls.Sources:Centers for Disease Control and PreventionBehavioral Risk Factor Surveillance System, CDC
•Foods on school campuses. About 55 million school-aged children are enrolled in schools across the United States, and many eat and drink meals and snacks there. Yet, more than half of U.S. middle and high schools still offer sugar drinks and less healthy foods for purchase. Students have access to sugar drinks and less healthy foods at school throughout the day from vending machines and school canteens and at fundraising events, school parties, and sporting events.•Advertising of less healthy foods/TV and Media. Nearly half of U.S. middle and high schools allow advertising of less healthy foods, which impacts students' ability to make healthy food choices. In addition, foods high in total calories, sugars, salt, and fat and low in nutrients are highly advertised and marketed through media targeted to children and adolescents, while advertising for healthier foods is almost nonexistent in comparison. Also, Children 8—18 years of age spend an average of 7.5 hours a day using entertainment media, including TV, computers, video games, cell phones, and movies. Of those 7.5 hours, about 4.5 hours is dedicated to viewing TV. Eighty-three percent of children from 6 months to less than 6 years of age view TV or videos about 1 hour and 57 minutes a day.TV viewing is a contributing factor to childhood obesity because it may take away from the time children spend in physical activities; lead to increased energy intake through snacking and eating meals in front of the TV; and, influence children to make unhealthy food choices through exposure to food advertisements.•Child care centers. More than 12 million children regularly spend time in child care arrangements outside the home. However, not all states use licensing regulations to ensure that child care facilities encourage more healthful eating and physical activity.•Quality physical activity. Most adolescents fall short of the 2008 Physical Activity Guidelines for Americans recommendation of at least 60 minutes of aerobic physical activity each day, as only 18% of students in grades 9—12 met this recommendation in 2007. Daily, quality physical education in school can help students meet the Guidelines. However, in 2009 only 33% attended daily physical education classes.•Safe outdoor play areas. Many communities are built in ways that make it difficult or unsafe to be physically active. For some families, getting to parks and recreation centers may be difficult, and public transportation may not be available. For many children, safe routes for walking or biking to school or play may not exist. Half of the children in the United States do not have a park, community center, and sidewalk in their neighborhood. Only 27 states have policies directing community-scale design.•Limited access to healthy affordable foods. Some people have less access to stores and supermarkets that sell healthy, affordable food such as fruits and vegetables, especially in rural, minority, and lower-income neighborhoods. Supermarket access is associated with a reduced risk for obesity. Choosing healthy foods is difficult for parents who live in areas with an overabundance of food retailers that tend to sell less healthy food, such as convenience stores and fast food restaurants.•Increasing portion sizes. Portion sizes of less healthy foods and beverages have increased over time in restaurants, grocery stores, and vending machines. Research shows that children eat more without realizing it if they are served larger portions. This can mean they are consuming a lot of extra calories, especially when eating high-calorie foods.Stress and depression. Research indicates that post traumatic stress and depression is directly linked to obesity and nutritional health concerns.Intimate Partner Violence. According to Archives of Pediatric and Adolescent Medicine Studyintimate partner violence may change the way mothers care for their children, including how they feed them. The stress of living with family violence also may disrupt hormones involved in the way children eat and store fat.Sources:Centers for Disease Control and PreventionBehavioral Risk Factor Surveillance System, CDC
Sources:Centers for Disease Control and Prevention: National Diabetes Surveillance System. Available online at: http://apps.nccd.cdc.gov/DDTSTRS/default.aspx. Retrieved 6/18/2012Behavioral Risk Factor Surveillance System, CDC
Physical Abuse includes hitting, pinching, slapping, pushing, punching, kicking, burning, stabbing or shooting. It may also include threats to cause harm. • Psychological Abuse (sometimes referred to as emotional or verbal abuse) includes put-downs, name calling, jealousy, isolation from family and friends, and threats to leave the relationship or to commit suicide if the victim does not co-operate. • Sexual Abuse includes unwanted touching or sexual activity. It may include control over birth control, forced pregnancies or abortions and transmission of Sexually Transmitted Diseases (STD). • Financial Abuse occurs when an individual uses finances to control another individual. This could include forcing a person to hand over all or part of their salary or by denying someone access to their own finances. • Spiritual Abuse occurs when an individual uses religious or spiritual matters to control another, such as forcing another to follow a particular faith or give up their religion.
Graph A shows the most common types of spousal assaults and their differential impact on men and women in 1999.Graph B shows that in a spousal relationship, women are the most likely to experience violence, especially severe, negative consequences such as kidnapping, stalking and murder.Source: www.toolkinb.ca (Canada)
Obesity: is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health.Anxiety: A feeling of unease, such as worry or fear, that can be mild or severe.Sexual maturation: The process of puberty. Spiraling rates of childhood obesity may play a large role in some girls’ earlier development because body fat is linked to the production of sex hormones. This may put girls at higher risk of breast cancer due to having a longer menstruation between onset and menopause. (Journal of Pediatrics)Deficit in immune activity: The nutrient intake and nutritional status influence the immuno-competence and the body’s response to illness or infection (Marti, et al. 2000, p. 132)Depression: There is a reciprocal link between depression and obesity. Obesity was found to increase the risk of depression and found to be predictive of developing obesity.Anger: Anger associated with exposure to family violence can be reduced by exercise. Aerobic exercise may be an effective strategy to help overweight kids reduce anger expression and aggressive behavior (http://abcnews.go.com/Health/Healthday/story?id=6386692&page=1).Limited or no physical Activity: Family Violence can alter a child's ability to be physical activity. Some studies have shown that an environment to family violence may cause a child to be secluded from their peers, staying in doors concealing family secrets, and not participating in extra curricular school activities. Bulimia: This is an eating disorder characterized by binge eating and purging, or consuming a large amount of food in a short amount of time, followed by an attempt to rid oneself of food consumed by vomiting or using a laxative or diuretic and/or excessive exercise. Family dysfunction and poor family relations are factors in the development of bulimia.Bipolar disorder: High expressed emotion in the family, which is a combination of over-involvement and criticism in the affairs of others, is a risk for developing bipolar disorder. 80-90 percent of patients with bipolar disorder have the illness in their families.IMPORTANT: We should also note that family violence, exclusive of other factors, isn’t the single factor associated with the cause of childhood obesity. However, the presence of intimate partner violence/domestic violence experienced by a parent increases the likelihood that a child will develop risk factors associated with obesity.These implications are all contributing factors to obesity among children. However, they are not exclusive of other factors like genetics, poor diet, family history of poor food choices, and socioeconomic factors.
What does this mean? According Dr. Renee Boynton-Jarrett of the Boston University School of Medicine “what it really means is broadening our focus to really consider psychosocial risk factors that may influence behavioral coping strategies that elevate the risk of early obesity. Nutrition and physical activity are extremely important but family violence might be one of the factors that predict nutritional content and the level of activity”.Resource:http://www.boston.com/news/health/blog/2010/06/_children_whose.html
What does this mean? According Dr. Renee Boynton-Jarrett of the Boston University School of Medicine “what it really means is broadening our focus to really consider psychosocial risk factors that may influence behavioral coping strategies that elevate the risk of early obesity. Nutrition and physical activity are extremely important but family violence might be one of the factors that predict nutritional content and the level of activity”.We should also note that family violence, exclusive of other factors, isn’t the single factor associated with the cause of childhood obesity. However, the presence of intimate partner violence/domestic violence experienced by a parent increases the likelihood that a child will develop risk factors associated with obesity.Resource:http://www.boston.com/news/health/blog/2010/06/_children_whose.html
1. Help to decrease coercive and inconsistent parenting practices2. Universal screening at birth helps health professionals to identify risk factors associated with child abuse would be effective in identifying children who required future services from child protection agencies.3.Research suggest that population health strategies aimed at decreasing child maltreatment are crucial to improving long term health outcomes. Strategies can include a continuum of supports for families such as improving early childhood learning, home visiting, and parenting programs.4. New systems also may be developed to monitor directly domestic violence against pregnant women and mothers. Health services for these groups may incorporate screening and treatment for domestic violence to mitigate its effects on maternal risk behaviors, mental impairments, and nutritional conditions predicting poor pregnancy outcomes.5. Better understanding of the psychosocial processes that contributes to poor physical health in adulthood as it relates to family violence is critical for informing programs and policies aimed at reducing disparities in health across the life course6. Regardless of whether individuals show current symptoms of disordered eating, emotion regulation strategies should be enhanced among individuals who have witnessed or who have been directly victimized by violence in the home.
Health Implications Of Family Violence
Family and Consumer Sciences By Danielle Y. Hairston Green
• Texas 12th as the Most OBESE state in the nation• In 2007 32% of Texas high school students were overweight or obese• In 2001, the healthcare costs for obesity were estimated to be $10.5 Billion.• Annie E. Casey Foundation reports that TEXAS has the highest rate of children living in concentrated poverty• In 2006 nearly 5, 000 deaths were directly attributed to diabetes, which is the 6th leading cause of death in TEXAS• One in three children born on 2000 will develop diabetes at some point in his or her lifetime. Among African American and Latino children, that number is one-in-two
Consequences of Childhood Obesity• Overweight- BMI above the 85th percentile• Obesity- BMI at or above the 95th percentile• Increased risk of impaired glucose tolerance, insulin resistance and type 2 diabetes• Breathing problems, such as sleep apnea, and asthma• Joint problems and musculoskeletal discomfort• Fatty liver disease, gallstones, and gastro-esophageal reflux (i.e. heartburn)• Social and psychological problems, such as discrimination and poor self esteem, which can continue into adulthood• If children are overweight, obesity in adulthood is likely to be more severe.
What causes Childhood Obesity?• Less healthy foods on school campuses• Advertising and television• Variation in licensure regulations among child care centers• Lack of physical activity• No safe playgrounds in community• Limited access to healthy affordable foods• Increasing portion sizes• Stress and Depression• Intimate partner violence suffered by the mother
• Between 3.3 and 10 million children are at risk of witnessing domestic violence each year in the U.S. ~4children.org• Childhood Abuse is the third most common public health concern for children (following asthma and allergies)~Palusci (2003)• “relationships between childhood traumatic stress and adult weight problems are due in part to … PTSD and depression”. ~Dedert et. al. (2010)• “experiences of violence in childhood- as a significant type of stress that is likely to elicit emotion focused coping strategies…using food in response to stress”. ~Greenfield & Marks (2009)• In families where domestic violence is present, child abuse and neglect is 15 times more likely than in other families. ~4children.org
Issues contributing to Obesity• Anxiety• Sexual maturation• Deficits in immune activity• Depression• Anger• Limited or no physical activity• Bulimia• Bipolar disorder
• Children whose mothers experienced chronic abuse at the hands of their partners were more likely to be obese at age 5 years. ~ Boynton- Jarrett (2010)• The Fragile Families and Child Well Being study revealed that girls had a higher prevalence of obesity then boys. However, boys risk of obesity was increased if mother perceived neighborhood as unsafe ~ Boynton- Jarrett (2010)• Research revealed that 30% of adolescent weight loss participants indicated that they had experienced an abusive family relationship. ~ Porter, et. al. (2010)
• The greater amount of exposure to violence (both direct and indirect) the more likely adolescents are to experience precocious behaviors. ~ Haynie, et. al. (2009)• Children who witness domestic violence experience low self esteem, depression, anger, fear, guilt and shame~(4children.org)• Pregnancy and infancy are critical periods for the development of physical and mental health and are likely periods of children exposure to domestic violence because they involve heavy dependence on maternal care ~ Yount, et al. (2011)• Adults who reported having experienced multiple types of abuse, especially of high levels of frequency, were most at risk for adult obesity ~ Greenfield & Marks (2009)
• Improve childhood learning, home visiting, and parenting programs.- Chartier, et. al. (2009)• Universal screening at birth.- Brownell , et. al. (2008)• Population health strategies aimed at decreasing child maltreatment. Chartier, et. al. (2009)• Monitor domestic violence against pregnant women and mothers ~ Yount, et. al. (2011)• Better understanding is critical in informing programs and policies aimed at reducing disparities. ~Greenfield & Marks (2009)• Emotion regulation strategies should be enhanced. ~Brady (2008)
Family and Consumer Sciences Tiffany Colbert Collin County Office 972-548-4233