NURS3015 Essay – Policy Brief for Cardiovascular Disorders

NURS3015 Essay – Policy Brief for Cardiovascular Disorders Questions:

NURS3015 Essay – Policy Brief for Cardiovascular Disorders Answer:

Context and importance of the problem: defining your chosen priority area:

Brief idea:

Obesity is the term that is used in describing overweight individuals with a high degree of body fat (Hayes et al., 2017). Eating more calories than burnt in daily activities as well as exercises can result in the development of the obesity. In course of time, these extra calories are seen to add up and results in causing weight gain in the individuals. Other contributing factors are having sedentary lifestyles (Wolfenden et al., 2015). Many of the studies have also linked obesity with individuals who do not have enough sleep as that can lead to hormonal changes. These hormonal changes make individuals feel hungrier and can crave certain high calorie foods (Newman et al., 2014). Growing older remains associated with less muscle mass along with the slower metabolic rates and this makes easier for the individuals go gain weight.

Complications associated with obesity:

Obesity has become one of the current health concerns in the nation of Australia. This disorder results in the development of many chronic conditions which not only causes suffering but also hamper the quality of the lives of the individuals. Obesity is considered to be one of the significant risk factor for the type 2 diabetes (Overweight & obesity, 2018). Studies suggest that gaining of weight and accumulation of fat in the cells reduces the capability of the cells to respond to insulin. They become insulin resistant and so the cells cannot take part in glucose absorption (Marks et al., 2015). This raises the blood sugar level making the individuals suffer from diabetes. Cancer researchers are also seen to be associated with the development of cancer in many individuals. Many other complications are also associated with obesity (Street et al., 2017). These are seen to include the cardiovascular disorders such as the high blood pressure, accelerated artherosclerosis, heart disorders and stroke. Chronic lower back pain, fatty liver disorders , gastroesophagal reflux disorder (that causes inflammation of the esophagus) along with the osteoarthritis particularly the knees. Affected individuals also face different types of psychological problems that include social stigmatization as well as depression.

Magnitude of the problem:

In the nation of Australia, reports collected by the Australian Institute of Health and Welfare have shown that 2 in 3 adults were overweight or obese in the year 2014 to 2015. About 5% of the burden of the diseases in the nation is attributable to overweight and obesity issues in the year 2011 (Roberto et al., 2015). About 28% of the Australian adults were seen to be obese in the year 2014 to 2015 that is an increase from 19% in the year 1995. Besides, children are also seen to be affected by the disorder. 1 in 4 of the Australian children aged between 2 and 17 were found to be overweight or obese in the year 2014-2015.

Mortality associated with the disorder:

Different investigations carried by the concerned departments over the years have found that people who have class one obesity has the life expectancy about 2-4 years lesser than the individuals who have normal BMI. In case of individuals who have class-three obesity, the life expectancy is seen to be reduced by 8 to 10 years (Clarke et al., 2016). In the year 2011, 7% of the total burden of the disorders in the nation was contributed to overweight as well as obesity (A picture of overweight and obesity in Australia 2017, 2017). Burden of the disorder, which is attributable to overweight, as well as obesity is seen to differ. 53% of the burden of diabetes is mainly due to the obesity and overweight while 45% of the burden of osteoarthritis is also because of this region. About 38% of the burden is the disorders are mainly attributable to the overweight and obesity is mainly from the cardiovascular disorders (Olstad et al., 2016).

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Policy implications of the issue:

Community based healthcare plans need to be developed which will have two sets of goals. The first set of goal would be the short-term goals where the professionals of both governmental and non-governmental agencies should be working together to develop strategies and help people overcome the disorder. The long-term set of goals would be changing the health behaviors of the individuals, making them well aware about the negative outcomes and thereby ensure effective lifestyle interventions which are healthy (Pate et al., 2016).

Critical analysis:

The healthcare policies that had been developed over the years had correctly identified the negative outcomes of the disorder. They have tried to make the citizens of the nation aware of the extent to which the disorders are affecting the economic condition of the nation. These policies have tried to educate people about the different approaches that can help them to overcome the chances of getting affected by this chronic disorder (Pate et al., 2015). One of the policy guideline paper that had been developed by the AIWH is called the “A picture of overweight and obesity in Australia 2017”. This policy had given detailed analysis of the statistics of the condition of obesity in the nation and had described how it had affected the economic situation of the nation. This is indeed one of the most important aspects that every citizen should know so that they can modify their health behaviors (Salas et al, 2016). By, this information, they can prevent the nation from spending huge funds on the treatment of disorders that can be prevented with health behavior changes (Lowe, 2014).

The NSW Healthy Eating and Active Living Strategy 2013-2018 is also another policy paper which is highly appreciated all over the nation. This policy paper has not only provided enough information to the individuals about the changes they can bring into the lives by appropriate intake of diets, proper physical exercises and many others (Delany et al., 2015). They have been also seen to develop a government framework helping the readers to understand the different collaborative approaches required among different concerned authorities of the nation. This policy helped in promoting, supporting healthy eating, active living, and thereby reducing the impact of the lifestyle chronic disorders (Newson et al., 2019). They had also provided suggestions by which the environment can be modified for supporting the healthy eating as well as active listening in the nation.

“Policy-at-a-glance – Promoting Healthy Weight Policy” is another such policy that the Public Health Association of Australia had developed. This policy is indeed one of the best policies that had promoted the importance of collaborative work outputs among the different departments of the government and non-government sections to come together and work for betterment of health condition in the nation. On critical analysis of the approach of the policy, it can be seen that the recommendations that had been provided had stated that the governments and other agencies should be contributing as well as coordinating efforts to achieve a national integrated, multi-sectoral and multidimensional approach. This collaborative approach would help in tackling obesity as well as overweight situations (Brownell et al., 2017).

Australian Government Response to: Weighing it up: Obesity in Australia published on February, 2013 had stressed on development of preventative strategies than curative strategies for handling of the obesity epidemic in the nation. Studies show that such approaches result in saving of the excessive fund flow in curative strategies and also prevent individuals from mental and physical sufferings due to the disorder in the nation. Development of infrastructure, legislation, funding, healthcare services and policy development were proposed (Health.gov.au, 2013).

Recommendations:

Analysis of the different healthcare policies also helped to point out certain negative aspects that need to be overcome. It is identified that the healthcare professionals, governmental professionals, members of the legal court system, non-governmental agencies and many others are asked to work together and given suggestions to be collaborative in action (Lobstein et al., 2015). However, they have not discussed the specific roles of each of the members. The policies have not described the roles and responsibilities of the individual members in details but have given broad goals of working together with other teams (Crino et al., 2016). Therefore, policies should be published which would be based on explanation of the roles of each department and the functions of the members in details. This can be explained with the help of an example. The schools are asked to collaborate with other departments in the nation to work for obesity prevention. However, the separate roles of the teachers, food canteens, administrations, game coaches and others are not explained. These should be taken into considerations.

Another very important aspect noticed in the healthcare policies is that all of them had provided a generalized overview of the conditions of the people in the nation that had been affected by obesity. They had mainly taken an education-based approach where strategies are provided to help the individuals be aware of the situation and develop good lifestyle practices. Unlike the tobacco control policies where government had taken legislative and non-legislative interventions, the federal government is seen to have taken a “light touch” approach in designing the policies for obesity prevention (The conversation, 2017). However, only this approach is not sufficient to develop the condition of the nation and make it adopt healthier lifestyle changes (Puhl et al., 2015). Researchers are of the opinion that all the governmental and non-governmental sectors need to make more policies that address the social determinants of health in the nation that are contributing to this disorder. Employment, income, socio-economic classes, accessibility to healthcare centers and many others need to be also worked upon and new innovative ways should be developed by which these aspects can be addressed.

Part B:

Obesity is considered to be one of the health concern that are affecting huge number of population in the nation. This disorder is mainly characterized by weight gain that affects the health in different ways.  Basal metabolic index or the BMI is the ratio of the height of the individual to the weight and helps to determine whether individuals are of normal weight, overweight and obese. Obesity is often considered as the risk factors for many other chronic health conditions. These disorders often include cardiovascular disorders, diabetes, high blood pressure, osteoarthritis and many others. All these disorders result in humongous impact on the disease burden of the nation resulting in poor economic condition of the nation as well as the healthcare centers. Direct financial costs remain associated with the health system. This is mainly seen to include the higher healthcare costs as well as higher demands on the healthcare services. Indirect costs are also seen to remain associated with the poor health outcomes. Loss of productivity, carer costs, welfare payments as well as forgone taxation revenue remains associated with occurrences of the disorders resulting from obesity.

Over the years, huge number of polices have been published. Most of the policies have helped in providing a wide overview of the disorders thereby describing the statistical reports of the individuals being affected by obesity. Moreover, these policies have mainly provided importance to community based approaches. Different governmental and non-governmental sections are seen to have understood the importance of collaborating and working as one unit for prevention of obesity in the nation. However, until date, most of the policies that had been developed are mainly education based and help in educating the citizens to learn about effective changes that they need to bring in their health behaviors.

One of the most important recommendation that the policies need to consider is that only talking about different agencies working together to achieve goals are not enough to ensure a safe nation free from obesity. The policies should singly consider the roles of each of the departments and the professionals and would discuss each of their roles in details and help them to know the functions they need to perform, this would help in proper teamwork when they would be acting as a part of the team and would have positive outcomes. Another important arena that the policies also need to put more focus is the addressing the social determinants of health. All these factors need to be properly researches and innovative strategies need to be developed so that the nation can ensure healthy individuals in the future and stable economic condition.

References:

Aihw.gov.au (2017) A picture of overweight and obesity in Australia 2017, Australian Institute of Health and Welfare [online], retrieved from: https://www.aihw.gov.au/reports/overweight-obesity/a-picture-of-overweight-and-obesity-in-australia/contents/table-of-contents Accessed on 30th September, 2018

Aihw.gov.au (2018),,Overweight & obesity,  Australian Institute of Health and Welfare, [online] retrieved from : https://www.aihw.gov.au/reports-statistics/behaviours-risk-factors/overweight-obesity/reports Accessed on 30th September, 2018

Brownell, K. D., & Walsh, B. T. (Eds.). (2017). Eating disorders and obesity: A comprehensive handbook. Guilford Publications. https://books.google.co.in/books?hl=en&lr=&id=b85EDwAAQBAJ&oi=fnd&pg=PP1&dq=obesity+and+policies+in+australia&ots=0dyJXxAbuV&sig=yZLOmbeW1yqUKFCUVGCdpVlpnh4#v=onepage&q=obesity%20and%20policies%20in%20australia&f=false

Clarke, B., Swinburn, B., & Sacks, G. (2016). The application of theories of the policy process to obesity prevention: a systematic review and meta-synthesis. BMC public health, 16(1), 1084. https://doi.org/10.1186/s12889-016-3639-z

Crino, M., Sacks, G., & Wu, J. H. (2016). A review of population-level actions targeting reductions in food portion sizes to address obesity and related non-communicable diseases. Current Nutrition Reports, 5(4), 323-332. https://doi.org/10.1007/s13668-016-0181-7

Delany, T., Lawless, A., Baum, F., Popay, J., Jones, L., McDermott, D., … & Marmot, M. (2015). Health in All Policies in South Australia: what has supported early implementation?. Health promotion international, 31(4), 888-898. https://doi.org/10.1093/heapro/dav084

Hayes, A. J., Lung, T. W. C., Bauman, A., & Howard, K. (2017). Modelling obesity trends in Australia: unravelling the past and predicting the future. International journal of obesity, 41(1), 178. https://www.nature.com/articles/ijo2016165

Health.gov.au, 2013, Australian Government Response to: Weighing it up: Obesity in Australia, House of Representatives Standing Committee [online] retrieved from: https://www.health.gov.au/internet/main/publishing.nsf/Content/C1B49DF81928E336CA257BF0001A8DAE/%24File/Govt%20Response%20-%20Obesity.pdf accessed on 2^nd October, 2018

Lobstein, T., Jackson-Leach, R., Moodie, M. L., Hall, K. D., Gortmaker, S. L., Swinburn, B. A., … & McPherson, K. (2015). Child and adolescent obesity: part of a bigger picture. The Lancet, 385(9986), 2510-2520. https://doi.org/10.1111/1468-0009.12162

Lowe, M. (2014). Obesity and climate change mitigation in Australia: overview and analysis of policies with co?benefits. Australian and New Zealand journal of public health, 38(1), 19-24. https://doi.org/10.1111/1753-6405.12150

Marks, J., Barnett, L. M., & Allender, S. (2015). Peer Reviewed: Change of School in Early Adolescence and Adverse Obesity-Related Dietary Behavior: A Longitudinal Cohort Study, Victoria, Australia, 2013–2014. Preventing chronic disease, 12. doi:  10.5888/pcd12.150042

Newman, L., Ludford, I., Williams, C., & Herriot, M. (2014). Applying health in all policies to obesity in South Australia. Health promotion international, 31(1), 44-58. https://doi.org/10.1093/heapro/dau064

Newson, R., Rychetnik, L., King, L., Milat, A., & Bauman, A. (2018). Does citation matter? Research citation in policy documents as an indicator of research impact–an Australian obesity policy case-study. Health research policy and systems, 16(1), 55. https://doi.org/10.1186/s12961-018-0326-9

Olstad, D. L., Teychenne, M., Minaker, L. M., Taber, D. R., Raine, K. D., Nykiforuk, C. I. J., & Ball, K. (2016). Can policy ameliorate socioeconomic inequities in obesity and obesity?related behaviours? A systematic review of the impact of universal policies on adults and children. Obesity Reviews, 17(12), 1198-1217. https://doi.org/10.1111/obr.12457

Pate, R. R., Flynn, J. I., & Dowda, M. (2016). Policies for promotion of physical activity and prevention of obesity in adolescence. Journal of Exercise Science & Fitness, 14(2), 47-53. https://doi.org/10.1016/j.jesf.2016.07.003

Pate, R. R., O’Neill, J. R., Brown, W. H., Pfeiffer, K. A., Dowda, M., & Addy, C. L. (2015). Prevalence of compliance with a new physical activity guideline for preschool-age children. Childhood obesity, 11(4), 415-420. https://doi.org/10.1089/chi.2014.0143

Puhl, R. M., Latner, J. D., O’brien, K. S., Luedicke, J., Danielsdottir, S., & Salas, X. R. (2015). Potential policies and laws to prohibit weight discrimination: public views from 4 countries. The Milbank Quarterly, 93(4), 691-731. https://doi.org/10.1111/1468-0009.12162

Roberto, C. A., Swinburn, B., Hawkes, C., Huang, T. T., Costa, S. A., Ashe, M., … & Brownell, K. D. (2015). Patchy progress on obesity prevention: emerging examples, entrenched barriers, and new thinking. The Lancet, 385(9985), 2400-2409. https://doi.org/10.1016/S0140-6736(14)61744-X

Salas, X. R., Forhan, M., Caulfield, T., Sharma, A. M., & Raine, K. (2018). A critical analysis of obesity prevention policies and strategies. Can J Public Health, 108(5-6), 598-608. https://journal.cpha.ca/index.php/cjph/article/view/6044

Street, J. M., Sisnowski, J., Tooher, R., Farrell, L. C., & Braunack-Mayer, A. J. (2017). Community perspectives on the use of regulation and law for obesity prevention in children: a citizens’ jury. Health Policy, 121(5), 566-573. https://doi.org/10.1016/j.healthpol.2017.03.001

Theconversation.com, 2017, Fat nation: the rise and fall of obesity on the political agenda, The Conversation [online] retrieved from: https://theconversation.com/fat-nation-the-rise-and-fall-of-obesity-on-the-political-agenda-72875 accessed on 2nd October, 2018

Wolfenden, L., Finch, M., Nathan, N., Weaver, N., Wiggers, J., Yoong, S. L., … & Gillham, K. (2015). Factors associated with early childhood education and care service implementation of healthy eating and physical activity policies and practices in Australia: a cross-sectional study. Translational behavioral medicine, 5(3), 327-334. https://doi.org/10.1007/s13142-015-0319-y