How Does Obesity in Wales Compare and Contrast with Emilia-Romagna?

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There are various common health care issues that can serve as points of comparison among various countries, regions or provinces of different countries. There has been a growing concern over what are termed as modern diseases that have lifestyle predisposing factors. These have become the conversation on various platforms by both health care professionals and the general public. These health care issues are posited as having serious implications on the economies of respective regions and countries and the seriousness of the implications have evoked certain actions that are the ground upon which health care systems of different countries can be put on comparison. On the basis of this, this paper delves into the issue of obesity that is a current health care concern. Obesity has been a subject of discussion, arguments and counter arguments and the attention it continues to receive is the reason as to why it is a viable subject of research to understand its nature on a comparative basis.

Obesity is a term that is used to refer to the state of accumulating fat in the body. The term is different from overweight since the latter only captures the sense of a person tipping the balance beyond what is expected (Cavari et al 2011, 78). On the other hand, obesity captures the idea of a person accumulating fat, a condition that can manifest through other secondary conditions such as being overweight or a person having a bigger size than it would be deemed normal. Due to certain factors that come with changes in society, cultures and practices, obesity has become a household term that needs to be dissected for a better grasp of its various perspectives.

Image of an obese adult

Retrieved from World Health Organization http://www.euro.who.int/Document/EHI/ENHIS_Factsheet_2_3.pdf

Hypothesis

With the popularity of use of the term obesity and the ongoing researches into the subject, this paper focuses;

-To comparatively explore the issues of epidemiology, causation and remedial actions in Wales and Emilia-Romagna in Italy.


Rationale Aims and objectives

Image of the map of Emilia Romagna

Adapted from World Health Organization, http://www.euro.who.int/Document/EHI/ENHIS_Factsheet_2_3.pdf

Wales and Emilia-Romagna in Italy are about the same size of approximately 22,446km2. The two also represent regions of relatively equal capacity in economic terms and hence can make a viable juxtaposition based on this subject. It is important to compare healthcare systems in terms of their response to contemporary issues and the priorities of governments as an avenue through which they express their seriousness in addressing emerging concerns. This will be done with an aim of establishing various concurrent points in how the two regions bring themselves to the issue of obesity. The paper in the end has objectives to achieve which are;

– To present the common facts and figures regarding the issue of obesity.

– Portray the various points of difference as it regards to the issue of obesity in terms of its epidemiology, spread and control.

– establish from the various initiatives, programs and actions by the two regions which can be considered to have the most responsive public health initiatives and programs that are directed at addressing obesity.

Methodology

This paper will adopt both qualitative and quantitative research designs. This is because the methods of study will include the use of various methods that fit in the two categories. The investigation will have to express the Welsh perspective as well as that of Emilia-Romagna. This will be derived from archival study of literature that addresses the issue obesity both in Wales and Emilia-Romagna. There are already various types of literature in circulation that portray the state of the regions as it regards to causation, epidemiology and remedial initiatives tailored by different quarters in response to this issue. This means that there will be an overriding quantitative methodology that will explore the various facts about the subject matter. However, there will also be a reliance on analysis of various data, statistics and information which will be supposed to help boost the empiricism of the document. The analysis of these texts will lead to induction of reasoning that will be derived from synthesis to posit different comparative observations regarding the two regions in respect to the state of their public health systems.

Sources and Referential Considerations

Obesity is by no means a current subject that is well documented. It has attracted the attention of various individuals, groups and bodies in putting it into perspective. This investigation will borrow from existing literature information that defines the problem. This means that professional productions such as clinical articles and books that portray the causes of obesity will be resourceful. There are other articles authored by interest groups such as the media that will also be tapped to beef up the investigation. Besides, various online sites that are repositories of data and facts will also be navigated for purposes of eliminating speculation in presentation of the information on the matter. The various ways that data and information is presented will be adapted from various sources such as articles and web sites. Reliance on government authored articles and documents will be instrumental too in adding depth to the investigation to portray differences in initiative taking between the two regions of Wales and Emilia-Romagna

These sources will be synthesized and exposed to analysis as to the veracity of the information they present. Articles will be applied depending on the authority of the information they present judging from the methodology and the conclusions they make. The use of professional sources will be for purposes of application of data that have been exposed to litmus tests. This will help in differentiating opinion from fact and hence give the investigation utmost objectivity that a paper of this nature can secure. However, application of life experiences, and adapting of opinions from various personalities who will inform the advancement of the subject in the course it will assume. Opinion sources and articles will be important in keeping the perspectives of the peculiar contexts of Wales and Emilia-Romagna in sight throughout the investigation.

Review of Literature

There is a suggested postulation that a growing section of the population of the world is getting dissatisfied with their body shapes, figures or frames (cavari etal 2011, 84). This is as it relates to either their weight, size of their bodies or the proportionality of the body segments. However, dissatisfaction is portrayed to be affecting those with larger body sizes than those with smaller sizes. According to (Welsh Assembly Government 2007, 76), Wales is reaching the peak of obesity concerns that are affecting the population across the ages. In Wales, obesity for adults already hit news headlines a long time ago and an eye is fixed on how fast the problem could progress towards becoming endemic. However, this was not as serious as the smash news-break childhood obesity has hit in recent times. Most of those who reined in on the matter to research on it raised issues about the various lifestyle aspects that could be predisposing people to this condition. In Emilia-Romagna, the publicity about obesity is not as viral as in Wales which however does not downplay its presence in the population. On a blanket basis, obesity in Emilia-Romagna is more resounding among adults than it already is in childhood. This difference in the states of the two countries on the prevailing extents of obesity is occasioned by different factors.

Citizens in Wales as is the case with many other countries close to England more readily embrace advancement and progression. The culture of Wales as such is now a subject of technology to determine (Welsh Assembly Government 2007, 123). There is not known in Wales a culture of die-hard taboos, practices, conventions or beliefs over what is good and bad. This is the reason as to why people in Wales are apt to be affected by changes in technology and other social and economic factors. People in Emilia-Romagna Italy on the other hand still have a hangover of different traditional beliefs and practices that they hold on with conviction and have a strong will to perpetuate. This affects how they respond to different changes that happen around them that lead to a reluctance in embracing change. As such, Welsh parents are more permissive and buy the idea of giving children whatever comfort it may call for to make them experience good life (Kovalchik 2008, 3). Children have therefore developed voracious appetites for chunk food, inorganic consumer products and inactive lives. This may not be the case with parents in Emilia-Romagna who prevail upon their children more and determine what they do or do not consume as food (Cavari et al 2011, 78). This is so especially because Italy as a whole is a highly religious country from the times of the ancient Roman religion and the various religious and cultural dogmas and beliefs remain in perpetuation that place children in the stewardship and indeed control of their parents. With these controls, parents do not expressly in Emilia-Romagna as in Wales let children have their way on issues as their cravings drive them (Cavari et al 2011, 78). This may explain the reason as to why there is much childhood obesity in Wales when in the comparative region of Emilia-Romagna, it still remains a worry.

 

Wales and Emilia-Romagna both come from Western Europe an area that is tagged ‘inorganic.” In most regions of this continent, inorganic production and consumption has overturned organic. Even in the production of very basic consumer goods, there are certain elements and substances that take the form of chemicals involved for various purposes (Kovalchik 2008, 3). It could be for flavoring, coloration or preservation. Inorganic practices have entrenched themselves in the lifestyles of the people in both Wales and Emilia-Romagna. There is much publicity through promotions, advertisements and vibrant marketing strategies of inorganic fast foods that have much chemical composition. The chemicals assessed by various nutritional agencies and professionals have suggested that they could be playing a part in exacerbating the issues that public health in the two countries is fraught with (World Health Organization 2007, 49). With such vibrancy of chemical marketing, inorganic life has been preferred over organic and the natural ways of production and consumption have taken a subordinate position. This is the reason as to why obesity is a concern both in Wales as in Emilia-Romagna. Accordingly, it is vital to understand the various factors that lead to obesity which is what follows in the succeeding section.

Causes of Obesity

Overview of obesity statistics in Wales

Retrieved from http://wales.gov.uk/topics/statistics/theme/wimd2005/?lang=en

Obesity, according to Parry-Langdon and Roberts (2004, 11) is a condition that is characterized by an accumulation of fats in the body. This accumulation of fats could arise from various physiological processes in the body. One of such is metabolism of excess sugar. The body requires sugar for energy. Sugar is usually metabolized into glucose that can easily be absorbed into the blood stream to make energy. However, there is an internal homeostatic system that regulates the amount of glucose that is absorbed to be turned into energy since the body only needs limited amounts of it (National Institute for Health and Clinical Excellence 2006, 45). The excess glucose is usually turned into fat that is usually stored on the lining of the skin. It is claimed that when the fat accumulates on the skin, more of it is deposited on the linings of body vessels such as veins and capillaries. However, the vital thing to understand is how lifestyle plays a role in causing the accumulation. With technology and the busy life of the 21st century, people in both Wales and Emilia-Romagna do not find time to do outdoor physical exercise. Many people in the two regions are engaged in occupations that keep them at rest or with minimal movement if at all any. According to National Institute for Health and Clinical Excellence (2006), their bodies would require less energy reducing the amount of glucose that is turned into energy. This means more glucose is retained to be become fat. Besides, the inorganic lifestyle of this age encourages consumption of chunk food that contains too much fat and sugar. These include snacks and other oily foods. As such, inactive life with passive leisure spent on technological accessories, ingestion of much food with little activity and preference for fast moving foods forms the western culture in which the two regions belong. This creates a similarity of technology and lifestyle characterizing the contexts in which obesity thrives in respect to Wales and Emilia-Romagna.

Data

The approximate population of Wales in 2011 was 3.064M while that of Emilia-Romagna is 4.4M. In Wales, there is a higher rate of childhood obesity that stands at 32%. Childhood obesity among children in Emilia-Romagna is relatively lower it being 12% (Currie 2007, 16). In Wales, more households relate to obesity since 57% of adults are affected with 22% being obese. This means that in Wales, there is at least a member who could be obese, getting obese or recovering from an obese related program. On the other hand, Emilia-Romagna has a percentage of 16% obese adults and it is proposed that most of them are women. There are other accompanying statistics that inform on the nature of obesity and various predisposing factors. Currie (2007, 26) suggests that Wales, more children are likely to be introduced to deviant actions such as drug abuse and alcoholism at a tender age. This is not so with Emilia-Romagna considering the fact that the region is convicted to catholic parental guidelines. Among adults, welsh men are bound to drink excessively than can do men from Emilia-Romagna. According to a survey by welsh assembly government (2007), 43% of Welsh adults indicated that they could drink beyond the guidelines recommended for health reasons. Of this, 27% in fact, reported to have been taking twice as much the recommended. Other statistics from the survey by the same body are represented below;

Table 1: Obesity rates in Wales between 2003/04 and 2007

 

Source: Welsh Assembly Government. Welsh Health Survey [Online], 20073.

(BMI ≥ 30” means percentage with a BMI of 30 and over, which includes those with a BMI of 40 and over and also 50 and over.)

In line with the dynamism of the Welsh society, trends indicate that since 2003, obesity has been on the increase. It is to be noted that the rise in the obesity cases slowed down from 2007 (Lester 2008, 17). There was also reported a reduction in the rates of smoking in 2011 moving on. However, drinking behaviors in Wales remain binge. There is a revitalization of physical exercise with more people reporting to be involved in exercise five days of a week. This trend improved from 2004 and persists till 2011 (Welsh Assembly Government 2005, 83). This has seen a stagnation in obesity rates of adults in Wales in recent years although they remain comparatively high. Emilia-Romagna has been recording increase in obesity rates of adults since 2008 at a rate of 16%. The growth has therefore affected male adults than female since more males, according to statistics (11%), are obese as compared to females (5%) (National Obesity Observatory 2009, 4). Childhood obesity is not as surveyed in Emilia-Romagna as in Welsh where it is alleged more children are entering school obese than any other time in history. For a global portrayal of the epidemiology of obesity, statistics follow;

Table 2: Age Standardised overweight & obesity prevalence in EU countries from a range of surveys between 1999 and 2003

Obese
(BMI ?
30kg/m²)
Raised weight
(BMI ?
25kg/m²)
Obese
(BMI ?
30kg/m²)
Raised weight
(BMI ?
25kg/m²)
Austria
18.5
56.4
15.6
41.2
Belgium
8.2
48.9
15.2
41.7
Bulgaria
11.8
50.0
9.8
36.7
Cyprus
12.5
51.4
10.8
36.3
Czech Republic
13.1
55.7
13.9
33.3
Denmark
9.2
47.5
8.7
32.1
Estonia
15.0
48.8
14.8
40.4
Finland
17.0
63.2
16.9
47.8
France
15.3
56.2
17.0
40.0
Germany
18.8
61.7
18.2
45.2
Greece
22.3
61.0
20.2
48.3
Hungary
15.7
54.9
16.4
44.0
Ireland
19.3
65.4
16.0
47.9
Italy
7.9
44.4
8.6
29.5
Latvia
13.0
47.3
17.5
44.6
Lithuania
20.8
56.3
21.6
53.3
Malta
24.3
70.1
13.9
44.4
Netherlands
9.8
49.5
11.7
40.6
Poland
14.7
55.2
16.7
43.0
Portugal
15.3
60.6
15.6
52.1
Romania
7.6
45.0
9.0
36.3
Slovakia
14.7
59.8
16.0
40.0
Spain
12.3
55.8
12.1
37.7
Sweden
7.0
32.9
7.5
47.5
UK (English data)
23.2
65.8
23.2
54.3
EU
16.2
59.0
18.1
47.5
Source: WHO
7
Males
Females
Region

Source: World Health Organisation. Overweight & Obesity in the EU27 [Online]12.

 

Analysis

The statistics point apparent differences of the epidemiology of obesity in Wales as opposed to Emilia-Romagna. It is quite apparent that people in Wales are more predisposed to obesity than in Emilia-Romagna. The statistics indicate that drinking habits have a predisposing role since more alcoholism is witnessed in the current Wales that has higher statistics of obesity. Besides, obesity in Wales seems to have become an epidemic that requires more focused counteractive measures since its epidemiology indicates it is affecting people of different age groups almost evenly (World Health Organization 2007, 35). Cases of childhood obesity are one of the vital indicators of contextual differences between Emilia-Romagna and Wales with the former having a few cases while the latter the most. The cultural aspects that determine how lifestyles of people in the two countries are controlled come into light. The Welsh society appears to be more permissive to predisposing factors such as alcoholism, unhealthy nutritional practices and inactivity than Emilia-Romagna.

However, there is an indication of effectiveness of initiatives being tailored in Wales that counter obesity and its related predisposing factors. This is shown in the dwindling rates of smoking and in the escalating figures of people engaging in physical exercise. This could explain the slowed rise in the cases of adult obesity in recent times. This also shows awareness in the population of the various factors around obesity in Wales. However, the effectiveness does not extend to childhood obesity where trends are still worrying. Indicators of effectiveness of anti-obesity programs in Emilia-Romagna are not noted which could point to the region remaining naive about the issue (Cavari et al 2011, 89). This could make one predict a future rise in the figures if sensitization and awareness campaigns are not initiated when the situation is till in hand.

Conclusions

This investigation brings several issues on the surface regarding how the issue of obesity is developing. One is that while a region such as Wales is dealing with the problem with pressure to prevent and cure, other countries that are still safe with lesser epidemiological pressure are still idle not thinking about doing anything. This is the case with Emilia-Romagna that could possibly be waiting for its situation to get to that of Wales for public health initiative to be tailored. It is only wise that governments take preventive actions in order to avoid piling problems that may makeup a pandemic in the future. In comparing Wales and Emilia-Romagna, it comes out clear that the lifestyle choices have both direct and indirect implications on the standards of public healthcare and there is a need to regulate people’s freedom to exercise their free will when it can compromise welfare and wellness. However, steps should be taken to make lifestyle change, advancements and technology serve to better rather than degrade social and economic installations that were functioning to maintain sobriety and health. The various cultural beliefs and conventions maintained in Emilia-Romagna are saving its public health sector from a fast progression to epidemic levels of obesity as opposed to the eroded welsh society.

Delimitation

The paper focuses on an area of public health that continues to be treated with much analysis, opinion and research. In conducting the investigation, literature from various sources including government and interest groups was reviewed. This makes the paper a one-stop encapsulation of opinion, facts and figures. There is in the investigation a portrayal of various concurrent takes as well as others that could be countering. However, the investigation in its reliance on secondary sources prioritized fact over opinion and hence focused on portraying positions that are posited by professional authors. An authoritative investigation stands on the shoulders of heroes who delved into a subject earlier to tap their findings and experiences in invoking criticism, analysis and synthesis in order to create new knowledge. The investigation is by that not a perpetuation of known fact but a synthesis that inductively uses the known to present a new perspective oriented on a comparative juxtaposition of two regions, Emilia-Romagna and Wales.

In spite of the strengths that the investigation evinces, it also has limitations of which no work of such nature lacked. It is apparent from the flow of the investigation that it relied on the position obtained from quantitative exploration of various literatures. The paper was not interested in taking a position of any of the sources but to subject them to synthesis and analysis and assign them a comparative essence. This could easily lead to a perpetuation of subjective opinions and position of various authors without a conscious will to do so. It would therefore not be surprising to be found that the paper could have various points that cannot stand the test criticism and that can then be disapproved in future investigations. Given that the paper does not own its own collected data but had to depend on that done by others which it deemed empirical, it cannot stand to vouch for it even when it solely relies on it in the compilation.

Recommendation for future Investigation

While this investigation tried to set two countries against each other, it would better be of use for future research to be more comprehensive and extensive by using more cases such as four rather than two and have to be from various regions. This will help capture the global rather than simply regional state of obesity that could lead to limited generalization. Use of more empirical research methods also remains to be desired after this investigation something to be boosted in succeeding investigations.

Bibliography

CAVARI, M., HUFFAKER, C., MARI, R., REGAZZI, D., & SPEDANI, R. (2011). Educational farms in the Emilia-Romagna region: their role in food habit education. 73-92.

CURRIE, C. E. (2007). Ineaqualities in youg people’s health- helath behavior in school-aged children. International Report from the 2005/2006 Survey. Retrieved from : http://www.hbsc.org/

KOVALCHIK, S. (2008). Validity of Adult Lifetime Self-Reported Body Weight. Public Health Nutrition , 1-6.

LESTER, N. (2008). Brefing: Dr Foster ‘fat cap’. . Cardiff: National Public Health Service for Wales .

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE . (2006). Obesity: The Prevention, Identification, Assessment and management of Overweight and Obesity in adults and Children . Retrieved from www.nice.org.uk/nicemedia/pdf/CG43NICEGuideline.pdf

NATIONAL OBESITY OBSERVATORY. (2009). International Comparisons of Obesity Prevalence. 1-9. accessed from http://www.noo.org.uk/uploads/doc799_2_International_Comparisons_Obesity_Prevalence2.pdf

PARRY-LANGDON, N., & ROBERTS, C. (2004). Health Behaviour in School aged Children: Physical Activity, Sedentary Behaviour and Obesity. Cardiff: WAG.accessed from HYPERLINK “http://www.hbsc.org/countries/downloads_countries/Wales/BR1_PA&Obesity.pdf” www.hbsc.org/countries/downloads_countries/Wales/BR1_PA&Obesity.pdf

WELSH ASSEMBLY GOVERNMENT. WELSH HEALTH SURVEY. (2007). Retrieved from http://new.wales.gov.uk/topics/statistics/theme/health/health-survey/results/?lang=en

WELSH ASSEMBLY GOVERNMENT. WELSH INDEX OF MULTIPLE DEPRIVATION. (2005). Retrieved from http://wales.gov.uk/topics/statistics/theme/wimd2005/?lang=en

WORLD HEALTH ORGANIZATION. (2007). Prevalence of Excess Body Weight and Obesity in Children and Adolescents. acessed from HYPERLINK “http://www.euro.who.int/Document/EHI/ENHIS_Factsheet_2_3.pdf” http://www.euro.who.int/Document/EHI/ENHIS_Factsheet_2_3.pdf

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