OBESITY EPIDEMIC

Discuss how a societal model of health may be used to deal with this obesity epidemic

Discuss how a societal model of health may be used to deal with this obesity epidemic

Introduction

Obesity continues to be a serious public health concern in Scotland as the prevalence rises. The main purpose of this report is to review population data on obesity in Scotland in order to provide policy makers and practitioners with data to support decisions, strategies and action on obesity.

This is the first in a series of reports by ScotPHO on key public health issues in Scotland. The report provides an overview of the epidemiology of obesity in Scotland, describing geographical and social variations in obesity, health inequalities and related morbidity and mortality. The report concludes by identifying some important information needs and gaps for public health intelligence on obesity in Scotland.

Societal Model of Health

The social model of health is a conceptual framework within which improvements in health and wellbeing are achieved by directing effort towards addressing the social and environmental determinants of health, not just biomedical determinants (DHS 2002, p. 42).

The social model of health is based on the understanding that in order for health gains to occur, people's basic needs must be met first, such as access to shelter, safety from violence and reliable, affordable food supplies. The social model of health takes into account the social and environmental factors that affect health and produce inequities. Inequities are determined by experience through life, especially the early years, education levels, unemployment levels, patterns of work, youth and family issues, social support and so on (WHO 2003, pp. 10-29). These factors are commonly referred to as the social determinants of health. The social determinants of health can also be described as the social and environmental conditions in which people live and work.

The epidemic of obesity is now recognised as a global public health problem. The disease burden of obesity is similar to that of smoking. Preliminary analysis from the Institute of Public Health in Sweden suggests that 4.5% of disability adjusted life years (DALYs) are lost in EU countries due to poor quality nutrition, with an additional independent loss of 3.7% and 1.4% due to obesity and physical inactivity. The total percentage of DALYs lost related to poor nutrition and physical inactivity is therefore 9.6%, compared with 9% due to smoking alone. With realisation of the health benefits of the introduction of the ban on smoking in public places, obesity will become a proportionally larger contributor to ill health in the future, unless it can be prevented.

In Scotland, 62% of men and 54% of women are classed as either overweight or obese. When obesity alone is considered, the figures for Scotland are: 19% of men, 22% of women, 8% of boys and 7% of girls. The Lothian Health and Life Survey (LH&LS) (4) showed that in Lothian, 52% of men and 41% of women were overweight including obese, with 13% of men and 14% of women being classed as ...