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.