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Unformatted text preview: PART TWO FIGHTING CHILDHOOD OBESITY Resources to help the community pediatrician curb this epidemic SARAH C ARMSTRONG, MD; JULIA WACKER, MSW, MPH; DEBRA BEST, MD; MARIANNE E MCPHERSON, PHD, MS Childhood obesity has escalated into one of the mostif not the nnost^serious public health concerns of the 21st century. You can play a powerful role in addressing this epidemic, not only in the clinic, but also in the community and the legislative settings. S ince 1980, the prevalence of obesity (body mass index [BMI] > 95th percentile) in the United States has tripled. Currently, 9.5% of infants and toddlers are overweight (>95th percentile of weight-for-length), 16.9% of children aged 2 to 19 years are obese, and 31.7% of all children are overweight (BMI > 85th percentile).' Although the obesity epidemic has stabilized in the past few years, prevalence rates remain unacceptably high, particularly among Hispanic boys, non-Hispanic black girls, and low-income preschool-aged children.^ Overweight and obesity in childhood often leads to adult obesity' and obese adults are at risk for diabetes, cardio- vascular disease, and early mortality."'* At higher BMIs, health consequences such as elevated lipid concentrations and blood pressure emerge in the pdiatrie years,' requiring the pediatrician to gain new expertise in the screening and management of these once-considered "adult" diseases. In 2007, the American Academy of Pediatrics (AAP) released evidence-based recommendations for screening, prevention, and treatment of high BMI in children.'" However, many clinicians continue to struggle with treatment barriers such as lack of time, reimbursement, and perceived efficacy." Prevention is critical, but with multiple targets (school, commu- nity centers, policy, legislation), it is less clear what the pediatrician can do to effect environmental change. The AAP policy statement on community pediatrics (2005) emphasizes that in a rapidly changing society, pediatricians must become integrated with the com- munity to prevent and treat disease and disability'^ Former AAP President Robert Haggarty, MD, FAAP, reminds us, "We must become partners with others, or we will become increasingly irrelevant to the health of children."'^ CONTINUED ON PAGE 42 D R A R M S T R O N G is assistant professor. Department of Pediatrics, Duke University Medical Center, and director. Duke Healthy Lifestyles Program, Durham, North Carolina, and Raleigh, North Carolina. M S W A C K E R is director. Community Outreach, Duke Healthy Lifestyles Program, Durham. D R B E S T is assistant professor. Department of Pediatrics, and director. Community Pediatrics, Duke university Medical Center, Durham. D R M C P H E R S O N is director. Applied Research and Evaluation, National Initiative for Children's Healthcare Quality, Boston, Massachusetts. The authors have nothing to disclose regarding affiliation mti\, or financial interests in, any organization that may have an interest in any part of this article....
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This note was uploaded on 02/02/2012 for the course COM 450 taught by Professor Veronicahefner during the Fall '11 term at Chapman University .
- Fall '11
- Mass Communication