Obesity
Obesity is on the rise, and is linked to a number of chronic conditions, including diabetes, depression, asthma, cardiovascular disease, and cancer in adulthood. In 2005, the Physician Council formed the Childhood Obesity Workgroup, comprised of medical directors who are pediatricians, to address the growing prevalence of this condition among clinic youth patients.
For children ages 2 to 19 years, "overweight" is defined as a body mass index (BMI) equal to or greater than the 95th percentile of the 2000 CDC growth charts for age and gender, and "at risk for overweight" is defined as a BMI between the 85th at 95th percentile. According to Call to Action: San Diego County Childhood Obesity Action Plan 2006, published by the County Health and Human Services Agency (HHSA), 25.8% of all children in San Diego County are overweight. In an analysis of the 2004 California Physical Fitness Test of fifth, seventh, and ninth graders, the rates childhood obesity were further broken down by geographic area, and four cities in the county above the statewide average:
San Ysidro (39.8%);
National City (35.2%);
Imperial Beach (34.4%);
and Escondido (28.9%).
In neighboring Imperial County, 36.5% of all children are
overweight, ranging from 34.3% in Brawley to 35.9% in El Centro to
36.5% in Calexico.
Being overweight increases the risk for other health
conditions including diabetes, depression, asthma, cardiovascular
disease, and cancer in adulthood. In fact, the striking
increase in the prevalence of childhood obesity over the past 30
years has been associated with a marked increase in the incidence
of type 2 diabetes among adolescents. In order to slow or reverse
the increase in childhood obesity and the health risks associated
with pediatric obesity, it will be necessary to treat obesity as
soon as it is detected. Even more appealing would be the prevention
of childhood obesity entirely by identifying children at risk and
providing interventions designed to prevent inappropriate weight
gain.
The rate of children in California who are physically active is
decreasing. Statewide in 2003, 7.3% of adolescents between the ages
of 12 and 17 had "no physical activity," and close to one-quarter
(22.0%) had "some physical activity." San Diego high school
students have exhibited this same behavior, as documented in the
Centers for Disease Control and Prevention (CDC) 2003 Youth Risk
Behavior Survey. This report indicated that among San Diego high
school students, 73% had not participated in sufficient moderate
physical activity during the past 7 days. Following this, the CDC
estimated that 10% of San Diego high school students are overweight
and 16% are at-risk for becoming overweight.
Obesity disproportionately affects children who are uninsured or
covered by public health insurance such as Medicaid. Children
covered by Medicaid are nearly six times more likely to be treated
for a diagnosis of obesity than children covered by private
insurance. In 2004, 195 of every 100,000 privately insured children
were treated for a diagnosis of obesity. That is 0.2 percent of
children, which represents a small fraction of the 16 percent of
children who are overweight. For children covered by Medicaid, the
rate was 1,115 per 100,000 - nearly six times higher than the rated
for those with private insurance.
