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Cultural and socioeconomic factors of obesity in American Youth

Updated on September 6, 2013

Childhood obesity is an epidemic that affects many of the world’s children. In the United States, the problem is especially prevalent amongst many in the urban neighborhoods of the larger cities. Many cases of obesity in America’s urban youth is caused by a lack of physical activity, unhealthy eating, lack of access to healthier foods, and not enough education on healthier eating. The problems that surround childhood obesity have emotional impact upon children as well as a physical one. Childhood obesity is widespread amongst the youth in this country and if not stopped, future generations will face health problems such as diabetes, heart disease, asthma, high blood pressure, sleep disorders, early puberty, as well as lowered self-esteem, depression, behavior and learning problems, and eating disorders. This problem is growing and stems further than the current generation and will affect the future generations in the areas of health care, cultural tradition, connections amongst family members and peers, and socioeconomic. The problem seems to be widespread mostly in the urban neighborhoods of America. This could be due to a majority of factors; cultural and socioeconomic as well as education, nutrition, and genetics. Yet, no matter the factors, what is important is changing the lifestyles of these youths so they can lead healthier lives. These issues are not going to be solved anytime soon, unless plans and actions are put into place to save not only the children of today’s generations, but future generations as well.

Defining obesity

The Mayo Clinic defines childhood obesity as “a serious medical condition that affects children and adolescents.” (Mayo Clinic, 2012) The website goes on to list the following risk factors with regard to childhood obesity; diet, lack of exercise, family history, psychological factors, family factors, and socioeconomic factors. Some of these risk factors can be controlled, yet many others cannot be. For many children who live in urban neighborhoods family history or genetics, diet, psychological factors, and socioeconomic factors seem to play a larger role in contributing to their obesity. “Racial background is also a highly relevant factor in the US: the most recent figures for 1999–2000 show that black and Hispanic children are approximately twice as likely to be obese as white, non-Hispanic children, their prevalence rates having risen rapidly within the previous decade.” (Lobstein, Baur, & Uauy, R. 2004) This is in part due to their cultural diets of high starch foods consisting of rice, beans and potatoes, saturated fats, lard, and oils used to cook the foods. Traditional “Soul Food” in the African American communities and the Mexican American custom of the importance of food in their culture are large factors in how the dietary lifestyles of the children of these cultures.

Location and culture as a factor

The urban populations of the United States are at a higher risk for obesity than their suburban and rural counterparts. The ethnicity of the urban residents plays a factor in their obesity. “In the USA the prevalence of overweight among children aged 4–12 years rose twice as fast in Hispanic and African–American groups compared with white groups over the period 1986–1998.” (Lobstein, Baur, & Uauy, R. 2004) This is not to say that only non-white children are at risk for obesity, but the cultural traditions of these ethnic groups are an influence with regard to the obesity for non-white children. “Studies of Latinos have found that many mothers of obese children believe their child to be healthy and are unconcerned about their child's weight, although these same parents are likely to believe that obese children in general should be taken to a nutritionist or physician for help with weight reduction.” (Caprio, Daniels, Drewnowski, Kaufman, Palinkas, Rosenbloom, Schwimmer, & Kirkman, 2008) Through researching cultural traditions in urban residents, applied anthropologists will be better able to define what ethnic factors affect obese children “A study in Mexico noted that food ‘treats’ for children are a cultural index of parental caring, and that parents value child fatness as a sign of health. The study found that obese Mexican children have no greater social problems (peer rejection or stigma) or psychological problems (anxiety, depression or low self-esteem) than their non-obese peers.” (Lobstein, Baur, & Uauy, R. 2004) This tradition in itself, passed down through the Mexican-American communities in the urban neighborhoods of Los Angeles, is an element of the problem with obesity that impacts Hispanic children. “Culturally appropriate interventions may provide progress in educating minority children about ways to sustain a healthy lifestyle.” (Jackson, Mullis, & Hughes, 2010, pg. 89) By understanding this cultural tradition that follows many Mexican-American families, anthropologists will be better equipped to understand why Mexican-American parents do not choose to utilize solely American customs with regard to their children’s health.

According to the Campaign for Healthy Kids website “35.9 percent of African‐American children ages 2 to 19 are overweight or obese, compared with 31.7 percent of all children those ages.” (Overweight and Obesity Among African‐American Youths, n.d.) In many African American communities in the United States a tradition of eating Southern style “Soul Food’ is still prevalent even amongst Northern communities. The ideal body type imaging is also different in African American communities. “For instance, perceived ideal body size for African American women is significantly larger than it is for white women, and African American men are more likely than non-Hispanic white men to express a preference for larger body size in women.” (Caprio, et al 2008) Because of an ideal larger body mass, obesity is culturally overlooked as a health issue and is seen as being an idyllic size. “A study by Katz et al. found that both obese African American girls and their female caregivers were unaware of the potential health consequences associated with their current body size.” (Caprio, et al 2008) This larger size woman could be a traditional inheritance from their African roots, where a woman who had more body fat was preferable to women who were smaller, and seemed healthier and richer due to their size.


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Income as a factor

The socioeconomic aspect of the urban area neighborhoods is also a larger factor in the obesity of American urban youth. “As research consistently demonstrates that behaviors affecting health are rooted within individuals' social environments, it is critical to broaden the scope of inquiry such that health is understood not only as a function of individual traits, but also as related to the environments in which people live.” (Boardman, Saint Onge, Rogers, & Denney, 2005, pg. 229) With being from a neighborhood that is poorer, there is fewer access to fresher fruits and vegetable. There is more access to fast food restaurants and their ever popular “dollar” menus, where you can purchase processed and fried food for a cheaper price than you can fruit or vegetables. There are also more and more stores and restaurants that accept an EBT card or food stamps without regulations as to what can be purchased food wise from my observations and experience. Due to the lack of supermarkets in urban neighborhoods as well as the lack of physical activities available to urban youth, their genetic predisposition to health factors such as diabetes make being obese for many urban youth a ticking time bomb with regard to their health. Yet, there are programs funded by the government that promote healthier eating at an earlier age through providing fresh vegetables, whole grains, milk, and protein for those who are from lower income families. These programs also include one-on-one appointments with licensed nutritionists and lactation consultants to promote breastfeeding and make sure that the children enrolled in the program are meeting their weight goals through weighing and measuring the children. With programs like WIC in place, it is a stepping stone for urban youth, yet the program ends when the child is five years of age and the problems with obesity seem to begin in earnest.

The lack of income in many urban areas makes it harder for residents to establish healthier habits. “Residents of relatively disadvantaged communities will present more deleterious health profiles compared to residents of more affluent communities-regardless of their personal characteristics-because an important health-promoting infrastructure and health related services are inaccessible, ineffective, or unavailable in impoverished communities.” (Boardman, Saint Onge, Rogers, & Denney, 2005, pg.230) As stated above, the abundance of fast food restaurants and the lack of grocery stores add to this dilemma.

A young girl's struggle with obesity

Plans of action for a change

This is where an applied anthropologist would be a welcome asset to these communities to evaluate and develop various methods and models to combat the issue of obesity in the youth of America in urban areas. One of these models would be the institutional model. “The institutional model focuses on risks and resources that are external to the residents, social models focus on norms, values, and beliefs that are unique to the residents of the neighborhoods. These models hypothesize that neighborhoods provide a social context in which otherwise subcultural values regarding health-related behaviors become normative.” (Boardman, Saint Onge, Rogers, & Denney, 2005, pg.230) By working in the neighborhoods themselves, an anthropologist can better determine the needs of the residents. “Neighborhood context can influence behavior directly via imitation processes, or indirectly through the internalization of norms and attitudes present within the collective lifestyles of the neighborhood.” (Boardman, Saint Onge, Rogers, & Denney, 2005, pg.231) The methods that would best suit this issue would be compiling and creating a demographical and statistical database of the social, socioeconomic, and health indicators of the children at risk; forming community forums for parents, educators, and health care professionals to discuss the concerns of the children affected by obesity; and observations as well participant observations through community events that portray social issues.

With the utilization of the database that is complies, health care professionals can better determine what areas need to be addressed first and preform a triage of sorts for the individual issues that are part of the obesity problem. “Such prevention strategies will require a coordinated effort between the medical community, health administrators, teachers, parents, food producers and processors, retailers and caterers, advertisers and the media, recreation and sport planners, urban architects, city planners, politicians and legislators.” (Lobstein, Baur, & Uauy, R. 2004) By openly acknowledging the cultural and racial differences within these neighborhoods, health care professionals can better treat children who are obese. “Racial/ethnic differences in body fat distribution, insulin dynamics, fatty liver, dyslipidemia, and diabetes, and the influence of SES and culture on health, suggest that optimal treatments could well differ according to the race/ethnicity of the obese child.” (Caprio, et al 2008) With the open forums, parents can express their feelings about the socioeconomic issues that they face every day and help to educate the educators and health care professions as to what works best for their children.

Plans of action by corporations and the government to intercede on behalf of the children would also prove to be an effective method. “Examples of Action Plan priorities might be to: provide clear and consistent consumer information, e.g. on food labels; encourage food companies to provide lower energy, more nutritious foods marketed for children; develop criteria for advertising that promotes healthier eating; improve maternal nutrition and encourage breast-feeding of infants; design secure play facilities and safe local neighbourhoods; encourage schools to enact coherent food, nutrition and physical activity policies; encourage medical and health professionals to participate in the development of public health programmes.” (Lobstein, Baur, & Uauy, R. 2004) Another way to reach parents and children is by putting on theater productions that approach the children at their level and understanding, the message is sent further than just hearing about eating healthier from doctors, nutritionists, and teachers.

The First Lady's action plan for the childhood obesity epidemic

Better nutritional choices through education

The theater program is a these methods that is a designed to create awareness amongst urban neighborhood residents about the current social issues that affect them. “In an evaluation of Lil Red Ridin’ Thru ’Da Hood, a production that tested the use of nutrition theater with African American youth, researchers found improvements in food related knowledge after the intervention.” (Jackson, Mullis, & Hughes, 2010, pg. 90) By participant observation through different forms of mediums that appeal to them, the residents can connect with what is being presented to them better than by having someone directly tell them what to do with their lifestyles. “Results showed positive changes in participants’ food-related knowledge, attitudes, and behavior.” (Jackson, Mullis, & Hughes, 2010, pg.90) With applying different methods of reaching targeted groups, applied anthropologists can influence the nutritional choices of the obese children and their parents in spite of their socioeconomic standings. “The implications are that theater productions can be a productive way to deliver nutrition messages to children and can yield at least short-term effects on children’s food knowledge and behavior.” (Jackson, Mullis, & Hughes, 2010, pg.90) This indirect approach to nutritional needs in urban children provide not only entertainment, but also education for the children and parents without coming into their environment and proposing to know what is best for them and their children.

Through education, applied anthropologists can effectively change how many of the urban residents chose to live, in regard to diet, physical activity, and nutritional programs available to them. In the age of multimedia, many resources are available to parents to better educate themselves and their children. The blogs, Childhood Obesity, Spark, and My Obese Child provide a platform for parents to connect and discuss the dilemma of their child’s obesity problem in a safe anonymous atmosphere. There is also access to websites such as the Mayo clinic, Campaign for Health Kids, and the American Heart Association, as well as many others that offer resources for parents who have online access. This allows for those in urban neighborhoods to take control of their situation, no matter their socioeconomic position. “Access to resources and services may not be equivalent for a given level of education or income. Neighborhood of residence may influence access to healthy foods, opportunities for physical activity, the quality of local schools, time allocation, and commuting time.” (Caprio, et al 2008) Although the residents have restrictions that are not the same as those in non-urban settings, they can change their circumstances through education; theirs and the professionals involved.

Through education, the residents can better prepare for their circumstances and hope to change them through petitions for more grocery stores in their neighborhoods, change of menus in the local schools, creating safer parks for their children to play in, as well as changing their own lifestyle through daily habits with regard to nutrition and exercise. “A whole-family approach also appears vital, with several studies showing that outcomes are improved if the parents are engaged in the process, or even are the key instigators of the process, at least for younger children.” (Lobstein, Baur, & Uauy, R. 2004) This is just the tip of the iceberg where prevention methods and models are concerned. “Efforts to prevent obesity should include measures involving a wide range of social actions, such as: public funding of quality physical education and sports facilities; the protection of open urban spaces, provision of safer pavements, parks, playgrounds and pedestrian zones, creation of more cycling paths; taxes on unhealthy foods and subsidies for the promotion of healthy, nutritious foods; dietary standards for school lunch programmes; elimination or displacement of soft drinks and confectionery from vending machines in schools and offering healthier choices (i.e. low-fat dairy products, fruits and vegetables); clear food labelling and controls on inconsistent health messages; controls on the political contributions given by the food industry; restrictions or bans on the advertising of foods to children; limits on other forms of marketing of foods to children; assessment of food industry initiatives to improve formulations and marketing strategies.” (Lobstein, Baur, & Uauy, R. 2004) These needs are starting to be met on the national level as well as the local level in many urban areas. The government is stepping in through the First Lady’s Let’s Move campaign and the Child Nutrition Act that promotes awareness in communities as well as in the schools where kids spend most of their time. By bringing more resources and education to the urban areas, the residents will have more choices with regard to how they and their children live.

Obesity In America

Factors for change

Many factors need to be changed if American urban youths change the tide of obesity that is upon them and future generations. These factors include; more supermarkets in urban neighborhoods, the presence of more fruits and vegetables in urban schools, more opportunities for extracurricular activities that promote exercise in urban schools, better education for urban area parents with regard to their child’s nutrition and education about genetic factors with regard for diabetes and other health problems. “The prevention of childhood obesity requires: improving the family’s ability to support a child in making changes, which in turn needs support from the school and community, for example; ensuring the school has health-promoting policies on diet and physical activity, and that peer group beliefs are helping the child, which in turn requires that the cultural norms, skills and traditional practices transmitted by the school are conducive to health promotion, and that the community provides a supportive environment, such as neighbourhood policies for safe and secure streets and recreation facilities, and ensuring universal access to health-enhancing food supplies, which in turn requires that .authorities at municipal, and regional level are supporting such policies, e.g. for safe streets and improved food access through appropriate infrastructure, and that national and international bodies that set standards and provide services are encouraging better public health, and commercial practices consistently promote healthy choices, which in turn may require legislative and regulatory support to ensure that strategies for obesity reduction are fully resourced and implemented, and appropriate control measures are enforced, and that these are not contradicted by other government policies, and that government and inter-governmental activities in all departments, including education, agriculture, transport, trade, the environment and social welfare policies are assessed for their health impact, and Government food purchases, e.g. for departmental staff, for the military, police, prisons, hospitals and schools and other agencies involved in public sector supply contracts are consistent with health and nutrition policies.” (Lobstein, Baur, & Uauy, R. 2004) Through the educational methods that can be applied, parents, children, educators, and health care professional can all learn from each other what is best for the child and what cultural implications can be modified or applied to help the children to understand better about nutrition and their racial or ethnic background with regard to how they approach their nutritional needs.

Conclusion

Through understanding what the needs are and how best to approach them, the future generations may have a chance to live healthier lives and extend the cultural traditions of their ethnicity for many generations to come. By implementing these measures, future generations may be saved from the inheritance of childhood obesity that plagues the urban youth of the United States. Although their socioeconomic situation cannot be controlled, some of the other factors can be changed to help the children of the urban areas to defeat childhood obesity.

Sources

Boardman, J. D., Saint Onge, J. M., Rogers, R. G., & Denney, J. T. (2005). Race Differentials in Obesity: The Impact of Place. Journal of Health and Social Behavior, 46(3), 229-243. Retrieved from http://www.jstor.org/stable/4147669

Caprio, S., Daniels, S. R., Drewnowski, A., Kaufman, F. R., Palinkas, L. A., Rosenbloom, A. L., Schwimmer, J. B. and Kirkman, M. S. (2008), Influence of Race, Ethnicity, and Culture on Childhood Obesity: Implications for Prevention and Treatment. Obesity, 16: 2566–2577. Retrieved from doi: 10.1038/oby.2008.398

Childhood Obesity. (2012). Retrieved from Mayo Clinic website: http://www.mayoclinic.com/health/childhood-obesity/DS00698

Jackson, C. J. & Mullis, R. M. & Hughes, M. (2010). Development of a Theater-Based Nutrition and Physical Activity Intervention for Low-Income, Urban, African American Adolescents. Progress in Community Health Partnerships: Research, Education, and Action 4(2), 89-98. The Johns Hopkins University Press. Retrieved from Project MUSE database.

Lobstein, T., Baur, L. and Uauy, R. (2004), Obesity in children and young people: a crisis in public health. Obesity Reviews, 5: 4–85. Retrieved from doi: 10.1111/j.1467-789X.2004.00133.x

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