As an Exercise and Health Science Major some of my posts will focus on pressing health issues in our community. I was recently tasked with writing an epidemiological analysis of diabetes and obesity as a consequence of poor diet. For the past ten years the “obesity epidemic” has been touted as America’s next major health crisis. I was not fully aware of how serious this problem is getting or how difficult it will be to reverse the trend. Feel free to read the entire analysis below or download this PDF Version. I hope that after reading this report your reaction will be similar to mine.

Epidemiological Analysis of Diabetes and Obesity

The prevalence of obesity tips the scales at nearly forty percent of the United States population meaning over 120 million Americans are grossly overweight (Flegal, Carroll, Ogden, and Curtin). Because such a large number of people are obese the prevalence of diabetes jumped to 8.3 percent in 2010 affecting 25.8 million Americans (“National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011”). Unfortunately, because Americans are living more and more sedentary lifestyles and consuming both nutrient-poor and sugar-laden foods the incidence rate of both these conditions continues to rise.

While there are no hard numbers on new diagnoses of obesity, the increased incidence of it can be inferred from the Department of Health and Human Services which states, “the hospital costs alone associated with childhood obesity were estimated at $127 million during 1997–1999 [...] up from $35 million during 1979–1981” (“Childhood Obesity”). That report accounts for inflation, which shows just how much strain obesity began having on the United States health care system just ten years ago. Since “obesity is a major risk factor for [...] type 2 diabetes” the rise of new diabetes cases is dramatic with almost “1.9 million people aged 20 and older [being] diagnosed with diabetes” in 2010 (National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011”, “U.S. Obesity Trends”) While the incidence and prevalence data clearly shows the link between obesity and diabetes, the morbidity and mortality statistics put it into stark relief.

Because these conditions are usually listed as contributing factors that lead to cardiovascular disease, kidney disease, neuropathy, certain types of cancer, and stroke it is difficult to properly document morbidity and mortality rates for diabetes and even more difficult for obesity (“American Diabetes Association”, “Childhood Obesity”). “In 2007, diabetes was listed as the underlying cause on 71,382 death certificates and was listed as a contributing factor on an additional 160,022 death certificates. This means that diabetes contributed to a total of 231,404 deaths” making it the seventh leading cause of death in the United States (“American Diabetes Association”, “National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011”). It is troubling that many of the diabetes statistics note that the actual number of deaths may be far higher than reported because of undiagnosed diabetes.

Even more troubling is the lack of data regarding morbidity and mortality rates of obesity. The American Journal of Public Health reported in 2004, “estimates of deaths attributable to obesity can vary widely depending on the assumptions about the relative risks of mortality associated with obesity among the elderly. Thus, it may be difficult to estimate deaths attributable to obesity with adequate accuracy and precision” (Flegal, Williamson, Pamuk, Rosenburg). Considering how often the obesity epidemic comes up on the news it is surprising that the AJPH must call for better methods of studying obesity statistics, but even with broad statistics it is possible to get an idea of the damage obesity is doing in America. “It is frequently stated in scientific and lay literature that obesity causes about 300,000 deaths per year in the United States. It has been suggested that obesity is second only to smoking as a preventable cause of death” (Flegal, Williamson, Pamuk, Rosenburg). Even though the research is too broad for detailed rates of morbidity and mortality the fact that obesity is regarded as the second leading preventable cause of death in the United States is enough to demonstrate how serious poor diet and a sedentary lifestyle is to American people.

While diabetes and obesity continue growing at an alarming pace one rate remains fairly constant. Nearly all of the statistics indicate that diabetes and obesity are far more prevalent in low-income African-American and Hispanic communities (“Childhood Obesity”). Dr. Adam Drewnowski, Director of the Center for Public Health and Nutrition, states, “The present model holds that obesity is [...] a socio-economic phenomenon. The lower cost diets tend to be higher in refined grains, added sugars and fat. Energy dense foods are not only palatable, but satisfy hunger at the lowest cost (Drewnowski). Poor people are essentially incapable of providing their families with food that is healthy because of their socio-economic status. “Some low-income families limit their food budget to $100 for four people per week, or less than four dollars per person per day” (Drewnowski). Remarkably, healthier products are not worth the money because they receive far more energy from processed food and more for their money with “supersized” portions. It is actually more economical for poor people to stay unhealthy, which increases the incidence and prevalence of diabetes and obesity. That in turn, puts a greater strain on the American health care community to treat these individuals as they grow older.

I should feel fortunate that I am blessed to live in an upper middle-class family because having healthy food choices is always an option for me. I can spend nearly $100 dollars a week on food for myself, yet a Hispanic mother living in a project can only purchase $28 dollars worth of food for herself. I received home cooked meals nearly every night of the week since I was a child and it pains me to say that I still take that for granted as Dr. Drewnowski’s report indicates it is a rarity for families to eat anything but snacks and fast-food. With the continued immigration of low-income Hispanics into America I am afraid that the problem of obesity and diabetes is only going to get larger.

My impression of these statistics is one of overwhelming concern for the future health of the United States. I still cannot fathom that almost forty percent of Americans are obese and that many diabetics will lose sight and limbs from a preventable disease. The only comparable disease is smoking which took nearly thirty-five years of constant ad campaigns and general education to start stigmatizing the damaging effects of inhaling nicotine and carcinogens. Sadly, people continue to smoke even though they know it is unhealthy, and sadly, people continue to live sedentary lifestyles and eat to excess even though they know it is unhealthy. I am dismayed over these statistics, but I am hopeful that with more general education and an even greater ad campaign than stopping smoking, it is possible to curb the prevalence and mortality rates of diabetes and obesity. Really, there is no other option. Like an obese diabetic America is rotting from the inside out unless people are rallied to change their individual behavior.

Featured Image Credit: www.smh.com.au

Proper Citations for all sources used in this analysis may be found in the PDF Version.

Cheers,
Gordon