A joint blog post by Brett Dutra & Rahul Girijappan
Obesity is a complex disorder involving an excessive accumulation of body fat in relation to the lean body mass. It increases the risk of many health problems such as heart disease, diabetes and high blood pressure. Obesity is a complex phenomenon that involves a wide and interactive range of biological, behavioral and societal factors. While genetics play a role, genes do not operate in a vacuum; behaviors and social, cultural and physical environments also make important contributions (Public Health Agency of Canada). Figure 1 below highlights the chronic conditions to which people who are overweight and obese are at increased risk for.
There are variations of obesity rates in each province, as seen in the image below. Obesity rates across provinces have increased, decreased, or remained the same over a period of time. Our analysis will look at the individual and community levels of factors influencing obesity in Alberta (AB) and Newfoundland & Labrador (NL) in more detail. In Figure 2 below, the prevalence of obesity in adults by province and year is shown.
The Canadian Institute of Health Information calculated the following statistics of Obesity Rates from 2015-2016, for those aged 18 & older:
In Canada: 26.3%.
In Alberta: 27.7%.
In Newfoundland & Labrador: 41.1%.
Individual Level
Alberta:
Individual risk factors for obesity in Alberta include gender (more males are obese), age (obesity is more common at 45-64 years) and education (having no post-secondary education). The amount of physical inactivity, lack of healthy diet, and increased sedentary time all contribute to obesity rates. Some facts on the prevalence of obesity in Alberta is presented below in Figure 3.
Newfoundland & Labrador:
In Newfoundland and Labrador, individual factors of influence to obesity rates are similar to that of Alberta, with some differences worth highlighting. The image below indicates high levels of unhealthy behaviours in NL. There is a lack of awareness about healthy food choices and lack of availability of healthy options. Additional risk factors for obesity in NL includes lower education levels and lower income status. Additional statistics can be found in Figure 4 of NL prevalence of unhealthy behaviours.
Community Level
Alberta:
Certain factors of the community can help increase or decrease the rate of obesity levels. This includes the walkability and safety of neighbourhoods that encourage physical activity. Some Albertans do not have access to a place to be physically active and they tend to not reach sufficient levels of physical activity to promote good health. 94% of Albertans are not satisfied with their personal safety from crime (Government of Alberta, 2014). It is important to recognize that living away from the bigger cities and resource hubs of Alberta (Edmonton and Calgary), obesity rates increase. See below for the strategies implemented by Alberta to address obesity rates and improve community support.
AB Community Programs: Innovative strategies and programs are provided by Alberta Health Services, the single health authority of Alberta.
- Alberta's Strategic Approach to Wellness - Health for All, Wellness for Life: AB recognizes that wellness is affected by our personal behaviours and by the communities in which we live. This strategic approach targets improving the health knowledge, skills and behaviours of individuals and families as well as building communities that create wellness.
- Adult Weight Management: Clinics and Programs in AB that provide clinical treatment options for adults who struggle with obesity.
- Better Choices, Better Health: Self-management workshops which are free and do not require a referral. Available online or in person, this 6-week workshop provides education and tools for those managing chronic conditions.
Newfoundland & Labrador:
The community environment influences factors that can contribute to obesity rates. In NL, there is a high amount of people living in rural areas. This influences access to resources and adds barriers to obtain routine health services and valuable health information. Education and income status for those living in remote rural areas is often be lower than those living in urban areas. NL has a high percentage of people over 12 years of age who do not eat enough fruits and vegetables. All of these factors contribute to high obesity rates in NL. Community programs are necessary to address these concerns by implementing strategies to help improve these conditions.
NL Community Programs: Health promotion and wellness strategies implemented by Government of Newfoundland and Labrador to improve health of the people.
- Increase knowledge of health among public though various awareness programs
- Healthy eating is about more than the food you eat. It is also about where, when, why and how you eat. The Department of Health and Community Services of NL involved key stakeholders like Regional Health Authorities, schools, community centers to increase awareness about healthy food choices.
- Participation Partnership: The Government of Newfoundland and Labrador has teamed up with Participation and Recreation Newfoundland and Labrador, to provide communications and engagement initiatives to motivate, educate, and enable citizens of Newfoundland and Labrador to increase physical activity and reduce sedentary living. This partnership consists of various components including: Digital Mini-Campaigns, Canadian 24-Hour Movement Guidelines for Children & Youth, Early Years Toolkit, Teen Toolkit, and Physical Activity Toolkit for Older Adults (Department of Health).
- Dial a Dietitian: Dial-a-Dietitian is a new service now available through the provincial Health Line. Healthy eating advice, food safety, meal plans, and nutrition questions related to diabetes and chronic diseases.
- Active Schools: Recommend and encourage 30 min of physical activity per day.
The increasing prevalence of obesity among today’s generation is a global disquietude. In Canada, Newfoundland and Labrador has a higher than average rate of obesity and overweight compared to the rest of the country, as seen in Figure 5. Obesity is a global epidemic, it always associated with worst health consequences which can lead to poor quality of life and decrease life expectancy and become a hurdle for the development of the community by causing increasing expenditure for health problems associated with obesity. Causes of this epidemic are multi-factorial. Prompt identification of root causes, proper development of policies, the involvement of key stakeholder in planning will help to mitigate the pervasiveness of the obesity and overweight to a great extent since some of the risk factors behind it are modifiable.
It is relevant to note that obesity is not classified or recognized as a chronic disease by Canada, which affects how it is treated throughout the country. The Canadian Obesity Network provided a summary of access to medical care for adults with obesity throughout the provinces in their "Report Card on Access to Obesity Treatment for Adults in Canada 2017". Improvements to the way obesity is viewed and responded to will help Canadians to properly address this complex health issue.
References:
Canadian Institute for Health Information. (n.d.). Obesity (Age 18 and Older). Retrieved from https://yourhealthsystem.cihi.ca/hsp/inbrief?lang=en&_ga=2.28547263.2053885766.1551494075-149880135.1548532639#!/indicators/076/obesity-age-18-and-older/;mapC1;mapLevel2;/
Government of Alberta. (2014). Alberta's strategic approach to wellness : Health for all ... wellness for life. Retrieved from https://open.alberta.ca/publications/9781460108659
Government of Newfoundland and Labrador. (n.d.). Children, Seniors and Social Development. Retrieved February 28, 2019, from https://www.cssd.gov.nl.ca/healthyliving/physicalactivity.html
Health Quality Council of Alberta. (n.d.). Overweight & Obesity in Adult Albertans. Retrieved March 1, 2019, from https://www.hqca.ca/surveys/overweight-obesity/
Public Health Agency of Canada. (2011, June 23). Obesity in Canada. Retrieved February 28, 2019, from https://www.canada.ca/en/public-health/services/health-promotion/healthy-living/obesity-canada.html
Recreation Newfoundland & Labrador. (n.d.). "Get Started" Campaign. Retrieved February 28, 2019, from http://www.recreationnl.com/digital-mini-campaigns/
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