A Health Equity Approach to Obesity Efforts Proceedings of a Workshop (2019) / Chapter Skim
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2 Setting the Stage: Key Definitions and Contexts
2 Setting the Stage: Key Definitions and Contexts
Pages 5-10
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From page 5... ...
• The issues involved in considering health equity and addressing disparities cannot be oversimplified. The average person who is in a socially disadvantaged situation is dealing with a cu mulative set of factors that must be overcome to work toward achieving a healthier weight.
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This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of ac cess to good jobs with fair pay, quality education and housing, safe environments, and health care. For the purposes of measurement, health equity means reducing and ulti mately eliminating disparities in health and its determinants that adversely affect excluded or marginalized groups.
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From page 7... ...
. The focus of prevention and treatment efforts tends to be on the weight-related behaviors and outcomes shown at the right of the figure, she explained, listing as examples food security, food intake, dietary quality, child feeding and parenting, physical activity, sedentary behavior, excess weight gain, ability to lose and maintain weight, body composition and fitness, and child growth and development.
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Reprinted with permission. BOX 2-2 Intermediate Variables That Influence Weight-Related Behaviors and Outcomes Food-related Physical activity–related Food access, affordability, appeal Options for safe, affordable recreation Exposure to food advertising Personal transportation Federal nutrition assistance Public transportation Food and nutrition literacy Exposure to violence Food norms Activity norms "Dieting" "Exercise" Chronic stress, including financial Resource limitations and other Discretionary time Discretionary income Sleep health Income stability Energy insecurity Housing stability Health care access SOURCE: Presented by Shiriki Kumanyika, April 1, 2019.
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From page 9... ...
In summary, Kumanyika stressed that the issues involved in considering health equity and addressing disparities cannot be oversimplified, adding that the average person who is in a socially disadvantaged situation is dealing with a cumulative set of factors that must be overcome to work toward achieving a healthier weight. Finally, she emphasized that political voice cannot be taken for granted, as it is an important tool for overcoming social disadvantage, especially for those experiencing discrimination.
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From page 10... ...
10 A HEALTH EQUITY APPROACH TO OBESITY EFFORTS BOX 2-3 Contextual Influences on Weight Control and Related Behaviors Legal Risks and Employment and Neighborhood/Locality Protections Occupation • Rurality • Education • Jurisdiction Institutionalized Racism • Employment • Public transportation or Other Forms of discrimination • Distance to health Discrimination • Health insurance care • Amenities • Retail outlets Economics • Physical demands of • Food access • Debt job; sitting • Racial/ethnic • Poverty • Job flexibility and segregation • Home ownership control • Percentage in • Wealth building poverty; wage deserts • Inheritance Education • Job access • Health and other • School districting • Aesthetics; community insurance • Neighborhood ecology • Minimum wage segregation • Housing stock • Public assistance • Housing • School quality • Housing costs discrimination • After-school programs • Employment • Public funding for • Walking and biking discrimination schools infrastructure • Market forces: cost • School quality • Community centers of food, health care, • Higher education • Neighborhood safety marketing access and exposure to violence • Parks and recreation • Neighborhood resources, including higher education institutions • Policing and law enforcement • Stigma and interpersonal racism • Blight; aesthetics; community ecology Political Voice • Voter registration SOURCE: Presented by Shiriki Kumanyika, April 1, 2019.
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