Preventing Childhood Obesity - Evidence Policy and Practice.pdf

Socio-cultural issues and body image
Americans. 12 Although African Americans are well -
integrated into many aspects of US society, they
remain a distinct ethno - cultural group. 15 There are
numerous demographic differences between African
Americans and whites, 11,15,16 with the former having
higher rates of poverty and unemployment, lower
educational attainment, more female - headed households,
residence in racially - segregated urban areas,
and greater representation in South and South - eastern
regions compared to other parts of the country.
Compared to whites and other minority populations,
African Americans have poorer health status and a
shorter life expectancy. 17 Some aspects of adverse
health profiles are confined to African Americans
with low social position, while others — like high
rates of low birth weight — are observed in all social
strata.
The prevalence of obesity among African Americans
is greater than among whites, particularly among
females. Data from the US National Health and
Nutrition Examination Survey ( NHANES ) show a
higher obesity prevalence in non - Hispanic black
(primarily African American) and Mexican American
children than non - Hispanic white children. 18 More
Mexican American boys aged 2 – 19 years are obese
(i.e., at or above the 95th percentile of the age - sex
appropriate Centers for Disease Control and
Prevention BMI reference) than non - Hispanic black
or white boys: 22.0% vs. 16.4% and 17.8%, respectively.
Non - Hispanic black girls have a higher prevalence
of obesity than either Mexican American or
white girls: 23.8% vs. 16.2% and 14.8%, respectively. 18
Obesity prevalence has been higher in black than
white women in the USA since the 1960s, 19 but the
relatively high prevalence of obesity in African
American girls has emerged only in recent decades. 20
This may reflect greater impact of recent socio -
cultural and environmental changes for African
American girls than other children. 21
Sub - Saharan African migrants are a culturally - and
linguistically - diverse ethnic minority group comprising
43 different cultures; about half are from the Horn
of Africa (Somali, Ethiopia and Eritrea), South Sudan,
Sierra Leone and Liberia. 22 Each subgroup has different
socio - cultural contexts and holds different value
systems from mainstream Australians. The term
“ African migrant group ” is used to refer to this heterogeneous
group of migrants with a recent history of
migration to Australia, the majority of whom
are refugees or humanitarian entrants who immigrated
directly from refugee camps or transitional
countries.
Africans appear to be at increased risk of obesity
and related diseases such as diabetes following migration
to Australia and other Western countries.
23 – 25
Recent work indicated that 27% of 3 – 12 - year - old
African migrant children were obese. 26 While this
obesity prevalence is similar to that reported for other
Australian children, African migrants have been in
Australia for only six years on average. Further, many
African migrant children have come from deprived
environments where undernutrition prevails (20– 40%
have chronic malnutrition). 27 It is highly likely that
African migrant children entered Australia with lower
BMIs, which have increased following arrival. 26
Obesity among African migrant children in Australia
has been associated with lower household income
level, fewer siblings, single - parent households and
western African background. 26
As illustrated, children in each of these ethnic
“ groups ” have been exposed to recent changes, including
greater access to fast foods, sweetened drinks and
greater exposure to the media compared to previous
generations. African migrant children in Australia
have experienced marked dietary acculturation 28 and
changes in language, religion and cultural values, 29
especially children who were born prior to arriving in
Australia.
We examine some environmental factors that may
explain the high prevalence of obesity among Fijian
and African American children relative to other ethnic
groups in their respective countries, and African
migrant children in their new (Australian) environment.
The Analysis Grid for Environments Linked to
Obesity (ANGELO) framework is used as part of the
priority - setting process for obesity prevention action
in communities. The ANGELO framework conceptualizes
four environments (socio- cultural, physical,
political, economic), 30 and is premised on individuals
or groups interacting with environments in multiple
settings, including homes, schools and neighborhoods.
The family is the most fundamental influence
on children ’s behaviors.31,32 Next, we consider ways
that the socio - cultural environment influences actual
and ideal body size, as well as eating and activity
patterns.
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