Identification and Discussion of the Public Health Roles of Nurses, or Health Visitors Regarding a Health Issue.

University Degree Subjects allied to Medicine

606910

A particular issue, which is pertinent in today’s society, is that of obesity, in particular affecting children. Obesity is caused when the amount of energy consumed exceeds the amount of energy used. The obesity epidemic, affecting boys and girls, race and ethnic groups, is a serious public health problem that needs immediate action to reduce its prevalence as well as its health and social consequences (Childhood Obesity Prevention Study 9/04). This modern epidemic has developed with the changes in society. The major issue is that this is a potential time bomb for the future, as obesity is not only persisting but continually growing. About 20% of children are now overweight and 2.5% are obese (). According to NHS figures, this is costing the health service around £2.6 billion every year, therefore causing huge concern ().

The immediate consequence of obesity as perceived by children themselves is social discrimination, which is associated with poor self- confidence and esteem, ultimately affecting many aspects of their life’s, including schooling. However, physical problems also come into play, such as, obese children are 70% likely to become obese adults, and obese adults are at huge risk of developing health problems such as heart disease, type 2 diabetes and hypertension. (www. surgeongeneral.gov/topics/obesity). Therefore, obesity can influence physical, intellectual, emotional and social development influencing adulthood. For that reason the best time to make an influence on long term eating and exercise habits in order to promote health and stop obesity is in childhood years.

The increasing amount of obese children can be blamed on a number of complex social and environmental issues, such as the inconvenience of walking, financial restraints minimising food expenditure including affordability of fresh foods, lack of time for food preparation, lack of physical education at schools and increased sedentary lifestyles. Thus, the issue of obesity needs much work and consideration, including looking closely at the lifestyles of children and working alongside their parents and schools in order to attempt to dramatically reduce the percentage of obese children in Britain.

Obviously promoting healthy lifestyles for the ...

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Obviously promoting healthy lifestyles for the people of Britain is an important governmental responsibility. Since obesity became apparent the Department of Health have put together several schemes to try to combat the problem, such as lottery funded Healthy Living centres. These centres are aimed at the more disadvantaged members of society, offing help with a range of activities, including the making of cheap healthy meals and exercise regimes. The Department of Health have also put together the Food and Health Action Plan and the Local Exercise Action Pilots aimed to also encourage healthy lifestyles (www.doh.gov.uk). However, these are not enough to tackle the issue of obesity. Everyone who works with children needs to take part, including the nations schools.

Schools as well as homes are an excellent place to begin, because children do not know if they have a healthy weight or if they are eating nutritionally, they need to be taught it. Studies have even shown that parents do not even recognise overweight in their children (). This is where the role of health care professionals, such as school nurses comes in to play. School Nurses as well as community Nurses can help identify when weight is an issue and help target positive action to resolve it. Professor Mike Kelly, Health Development Agency, said that school nurses play an important role in preventing childhood obesity. Many schools are already trying to tackle the problem by providing children with nutrition education, modifying school meals and promoting physical education (Mike Kelly 9/10/03, cited in ).

Unfortunately, the current health care system is not yet focused on the ways the prevent childhood obesity. Nevertheless, the health care system, including public health nurses still can have an impact on the issue. Public health nurses have the ability to influence family’s awareness of obesity. Ashton and Seymour (1988) argue this contemporary health problem is a social one and not an individual one; therefore, it is the role of public health nurses to resolve it.

There are a number of things nurses can carry out to reduce obesity, for instance routinely measuring young peoples height and weight in order to obtain their body mass index (BMI), to establish the level of obesity. Being overweight is often a family problem, so it is useful to measure the BMI of everyone in the family. So importantly nurses can monitor the family problem, helping them all work together, giving the child the emotional support they need. BMI has to become as important as routine immunisations or medical checks ups. This can help to combat childhood obesity, since public health nurses are aiming for prevention and not cure.

After determining the child’s weight status, public health nurses have the job to communicate the results to the parents and to the child, in a way that they can understand the severity of the problem, so that all the risks are known, good communication skills are vital. Public health nurses need to promote improved nutrition and increased physical activity. They should also take leadership roles in advocating for childhood obesity prevention in local schools and communities.

According to Naidoo and Wills’ (2000), there are different approaches that public health nurses can take to tackle childhood obesity. One of the approaches is that of the medical approach, which would include the monitoring of BMI’s in a targeted risk group. A different method is that of the educational approach, which would include teaching children about nutrient and the importance of exercise, enabling them to make informed choices about their lifestyles. Another slant would be that of the empowerment approach, which is a significant aspect of health promotion. This approach takes on the idea that people should act on their own problems, rather than professional’s ideas. Nurses can in addition help people to change their diet or take more exercise; this is classed as the behaviour change approach. Therefore, if all approaches where to be integrated, obesity in children would be dramatically reduced.

However, with such a sensitive public health issue, turning the problem around is not as easy as it seems. In the reflection of childhood obesity, it is obvious that public health nurses need to use appropriate health promotion approaches, taking into account other branching issues such as parental income, cultural practices and parent’s knowledge of food. But, ultimately if public health nurses work with families and schools, seeing obesity as a nation wide problem as well as an individual problem, using health promotion as well as health education enabling children to work towards their own health potential, then this time bomb for the future will be stopped.

Word Count. 1095

References-

Ashton. J and H. Seymour (1988) The New Public Health. Milton Keynes: Open University Press.
Ashton. J and H. Seymour (1988) cited in Manson. T and Whitehead. E (2003) Thinking Nursing. Pg 172. Glasgow: Open University Press.
Department of Health (1999) Saving Lives-Our Healthier Nation. London. HMSO
General. S (2004) Call to Prevent and Decrease Overweight and Obesity.[ Online] Available @ (27.12.04)
Grandis. S, Long. G, Glasper. A and Jackon. P (2003) Foundation Studies for Nursing. Basingstoke: Palgrave Macmillan.
Institute of Medicine (2004) Childhood Obesity Prevention Study- Preventing Childhood Obesity- Health in Balance [Online] Available @ (29/1204)
Kelly. M (2003) Obesity in Children on the Increase. [Online] Available @ (27.12.04)
Naidoo. J and Wills. J. (1995) Health promotion Foundations for Practice. London: Bailliere Tindall.
Reid. W (2004) The Prevalence of Obesity in Children and Young People. [Online] Available @ (27/12/04)