PBHE427 Epidemiology

Question

Answer

Chosen topic and rationale

The health concern of obesity has been chosen for the preparing the epidemiological report for Alabama State because obesity has become an epidemic in United States since 20 years. Obesity is prevalent in almost all state with high rates in some of the states. Alabama is also one of those states. Consumption of fast food along with decrease in physical activity levels has significantly contributed to the obesity epidemic in United States. Due to severe adverse health consequence due to obesity, it has affected the direct medical cost, productivity cost and human capital cost of the region. This indicates that apart from health concern for affected person, the epidemic causes great economic loss for a country too (Hammond & Levine, 2010, pp. 285-95). Therefore, studying disease trend is important to take appropriate public health action. As Alabama is the state with 2^nd ranking in obesity rate in the 2015, it is necessary to study the trends of obesity in the region to determine the preventive actions needed to reduce the rate of obesity Adult (Obesity in the United States: The State of Obesity, 2017). This may also help to reduce some of the risk factor contributing to obesity and expand health initiatives to address the issue.

Problem statement

Due to the modern means of living, almost one in every three adults are now obese in United States. If the issue is not controlled, it can expose people to risk of negative health consequences such as heart disease, Type 2 diabetes, stroke, hypertension, high cholesterol, respiratory problems, arthritis and other health issues. Obesity in children and teens also exposes children to psychosocial problems like low self-esteem (Hurt et al., 2010, pp .780-92). Therefore, obesity has become a major epidemiological challenge for the health care system of United States. In relation to the state of Alabama, the problem is that the rate of child obesity is higher than other states. Due to this new health concerns have come to the forefront such as asthma and development disorders. The risk is even higher for children from poor families (Too many Alabama kids are unhealthy, 'food insecure,' say speakers at Birmingham conference, 2017). Hence, evaluation work is necessary to promote child health and reduce obesity in Alabama.

Current statistics in Alabama

Adult obesity rate has exceeded more than 35% in some states of U.S and for Alabama, the rate is 35.6% according to 2015 data (Adult Obesity in the United States: The State of Obesity, 2017). Hence, Alabama has second ranking in U.S according to current obesity rate. The rate was 11.2% n 1990, 22.6% in 2000 and 35.6% in 2015 (Alabama State Obesity Data, Rates and Trends: The State of Obesity, 2017).

Figure 1: Rate of growth child obesity rate in Alabama between 1990-2015. Source: (Alabama State Obesity Data, Rates and Trends: The State of Obesity, 2017).

Currently the obesity related health issue in the state includes diabetes, hypertension, arthritis and obesity related cancer. Alabama ranks third among 51 states of U.S. according to the adult diabetes and hypertension rate. According to 2015 statistics, the obesity is higher for Black compared to White and Latino. According to last update in 2014, Alabama ranked tenth in U.S with childhood obesity rate of 16.3% (Alabama State Obesity Data, Rates and Trends: The State of Obesity, 2017). The chart below presents the obesity rate by age in Alabama.

Obesity rate by age (2015):

Process used by Alabama health agency to collect obesity related data

The Alabama Center for Health Statistics collects and tabulates statistical data on health issue and manages vital records system for Alabama state. The data is obtained mainly from health related surveys in the region. Other source for gathering data may include hospitals, outpatient department inpatient setting. The Statistical Analysis Division then analyses the health data for public surveillance and public health policy making process. On this basis, the chart is prepared for mortality, rate of disease, natality and other statistics (Health Stats – Home, 2017). 

Threats to privacy and confidentiality during data collection and reporting for population health of Alabama

As the disease and health related data for Alabama is mainly collected by means of survey among patients and in health care organization, it might lead to privacy and confidentiality issues. This may be seen if person-identified data is present. As there is strong pressure for health care organization to document health data in detail, third party payers access patient record information. As majority of patient related information are now recorded in electronic health record (EHR), concern is raised regarding the confidentiality of health information. Large volumes of data can now be accessed easily threatening privacy of patients. Confidentiality issue also increases once data is stored electronically, once can access network of databases from remote locations (Networks,  Donaldson, & Lohr, 2017).  Hence, if the security system for EHR is not enhanced, the risk is going to prevail.  

Comparison of statistics in your state to national statistics

The obesity statistics of Alabama revealed second highest adult obesity rate in U.S. compared to other states. This is reflected from the figure of 35.6% adult obesity in rate in Alabama with higher percentage found in people between 45-64 years (age), women (gender) and Black (race). On comparison with national statistics data, it has been found that the obesity rate of 35% is seen in almost four states of USA with Luisiana having the highest adult obesity rate. According to Alabama data for childhood obesity rates, the current rate is 16.3% and it has not increases much since 2010. Similar trend is also seen from the national statistics on childhood obesity rates, which shows that the obesity rate has leveled after increasing for decades. The obesity rate on the basis of age in Alabama is also consistent with national obesity rates by age group. In Alabama, the rate was high for 45-64 year age group. Similarly, in U.S. the rate has found to be high in middle age adults (40-59 years) (Obesity Rates & Trends: The State of Obesity, 2017). 

Description and synopsis of noticeable trends

From the evaluation of the epidemiological data for obesity rate in Alabama, the noticeable trend is that it is mostly seen in middle age in adults and in children between 10-17 years of age in childhood obesity rate.  In addition, health issues of hypertension and diabetes was a common health issues for obese people. On the other hand, the obese people were also found to suffer from heart disease, arthritis and cancer (Adult Obesity in the United States: The State of Obesity, 2017).

Opinion of contributing factors (social, environmental, behavioral, etc.)

There might be many factors contributing to high rate of obesity in Alabama. The behavioral factor includes little physical activity and poor nutrition among people. People in Alabama do not engage in moderate intensity exercise and physical activity very often. Unhealthy dietary habits such as consumption of sugar sweetened beverage and junk food might be high in adults and children. According to obesity rate data by race in Alabama, Black had the highest rate of obese people. This indicates that socioeconomic factors like unemployment and poverty might be a cause for high obesity rate. Consumption of low quality foods due to economic issue increase BMI of people (Akil & Ahmad, 2011, p. 58). Environment factors contributing to obesity may include life style preference and cultural environment of a population.

Suggestions to address the issue in Alabama

To reduce the rate of adult and childhood obesity, government agency of Alabama must focus on improving the quality of food for people living in poverty line. Secondly, more health promotion programs and adequate space is needed to maximize physical activity among people in Alabama. Dissemination and planning of resource list is needed for weight management, improving food choices and physical activity levels in the population.

Reference

Hurt, R. T., Kulisek, C., Buchanan, L. A., & McClave, S. A. (2010). The obesity epidemic: challenges, health initiatives, and implications for gastroenterologists. Gastroenterol Hepatol (NY), 6(12), 780-92.

Too many Alabama kids are unhealthy, 'food insecure,' say speakers at Birmingham conference. (2017). AL.com. Retrieved 15 June 2017, from http://www.al.com/news/birmingham/index.ssf/2015/07/too_many_alabama_kids_are_unhe.html

Adult Obesity in the United States: The State of Obesity.  (2017).  Stateofobesity.org. [online] Available at: http://stateofobesity.org/adult-obesity/ [Accessed 15 Jun. 2017].

Obesity Rates & Trends: The State of Obesity. (2017). Stateofobesity.org. Retrieved 15 June 2017, from http://stateofobesity.org/rates/

Networks, I., Donaldson, M., & Lohr, K. (2017). Confidentiality and Privacy of Personal Data. Ncbi.nlm.nih.gov. Retrieved 15 June 2017, from https://www.ncbi.nlm.nih.gov/books/NBK236546/

Hammond, R. A., & Levine, R. (2010). The economic impact of obesity in the United States. Diabetes Metab Syndr Obes, 3(1), 285-95. 

Akil, L., & Ahmad, H. A. (2011). Effects of socioeconomic factors on obesity rates in four southern states and Colorado. Ethnicity & disease, 21(1), 58.

Alabama State Obesity Data, Rates and Trends: The State of Obesity. (2017). Stateofobesity.org. Retrieved 15 June 2017, from http://stateofobesity.org/states/al/

FastStats. (2017). Cdc.gov. Retrieved 15 June 2017, from https://www.cdc.gov/nchs/fastats/obesity-overweight.htm

Health Stats - Home. (2017). Adph.org. Retrieved 15 June 2017, from http://www.adph.org/healthstats/