310 assignment 2

1

Running head: HEALTH

6

Veteran Obesity

Veteran Obesity

Steven Jenkins Jr

HMGT 310

02 NOV 2021

Veteran Obesity

In 2014, VA estimated that 78 percent of Veterans are overweight or obese (Health services research 7 development, VA, 2019). At the federal level, the Farm bill has the most decisive influence on the food supply in the United States. Over 54% of the finances obtained via this bill are allocated to nutrition programs. Besides, about 15% of these funds are utilized to subsidize corn and soybean production since these crops are more affordable and vastly used in food production, thus reducing the cost of foods. The Farm Bill also allocated $1.3 billion in funds over ten years to produce fruits, vegetables, and nuts (Mozaffarian, Griffin & Mande, 2019).

Overview of Veteran Obesity

Obesity has become an enormous health problem in the U.S., especially in the past three decades. The Veteran Affairs estimated that more than 165,000 Veterans who received health care had a BMI higher than 40, morbid obesity. Obesity refers to a health condition involving having an excessive body fat level associated with chronic illnesses such as HB pressure, type II diabetes, etc. Obesity is responsible for high mortality and morbidity rates, where it causes 1 in 5 Veteran deaths in the U.S. per year. Studies show that obesity has become the second leading preventable cause of disease and dying immediately after tobacco use in the United States. Evidence shows that obesity has an estimated medical cost of $147 billion per year in the U.S. since the people suffering from obesity encounter higher prices than those with average weight (Biener, Cawley & Meyerhoefer, 2018). More than two-thirds of the veterans in the U.S. and about one-third of the active duty service members are obese or overweight, and some low-SES and minority groups are also disproportionally affected.

Impact of Obesity on veterans

On Veteran and Active Service Members.

Obesity is a critical health condition that is associated with mental health issues and reduced quality of life. Veterans with this condition are at a higher risk of other severe diseases and health conditions than people with a healthy weight. The veteran and active duty service member also incur medical costs to the military's budget with such diagnostic and treatment services and indirect costs associated with death and sickness, and lost productivity. Productivity refers to increased absenteeism in the workplace, reduced productivity while at work, and even premature death and disability.

On health care providers

Studies show that physicians look at obese veterans as less self-disciplined, less compliant, and even more annoying as compared to veterans with an average weight (Kaplan et al., 2018). Besides, as the BMI of patients increases, doctors have a higher likelihood of being less patient and less willing to help obese veterans. Some health care providers have even reported that seeing such patients was a waste of time, and they exhibited signs of disrespect to such patients. Physicians are also less likely to discuss weight management with such patients. Additionally, both registered and student nurses stereotype obese patients (Kaplan et al., 2018). For instance, some nurses view such patients as lazy, non-compliant to treatment, and lacking in self-control. Generally, most health care providers have been found to stigmatize obese patients and even give an impression of blaming the patients for their weight.

On military health organizations

Military hospitals are forced to consider ordering new bariatric equipment, including wheelchairs, hospital beds, walkers, and bedside commodes, to handle obese patients better. Typically, a standard-size bedside commode goes for about $80, and a bariatric version of the same common has a higher cost of more than $170. Evidence shows that health care organizations experiencing a rising number of obese patients are opting for design experts to assist with creating new hallways and doorways to manage the increasing physical size of their patients (Kushner & Kahan, 2018).

On health care insurers/payers and the government

April 5, 2019, writer Jim Absher with Military.com states, "Obesity cannot be considered a service-connected disability, according to a new ruling by the Department of Veterans Affairs General Counsel expected to be published in the April 8, 2019, edition of the Federal Register." Evidence shows that obese people are more likely to contract chronic diseases at a higher rate than non-obese people and thus consequently pay more for medical care (Tremmel et al., 2017). The medical costs incurred in a lifetime associated with chronic diseases among the obese are $10000 more than among the non-obese (Tremmel et al., 2017). However, these costs can be slightly reduced as long as the veterans reduce their body weight. Obesity is also linked with externalities, particularly costs dealing with death and health insurance. Since there are more medical costs for people with obesity and premiums are not based on weight, individuals with an average weight in the same category pay for the exercise/food choices of people with obesity. Moreover, the adverse health impacts of obesity reduce the number of individuals with obesity to pay for different social programs created by the government.

Healthy People 2020

HP2020 objective NWS-9 monitors the number of obese adults whose BMI is 30 or above. From 2005 to 2008, the obesity rate was 33.9% among adults aged 20 years and above, the HP2020 Baseline. The HP2020 Target was 30.5%, which was a 10% rise from the Baseline. HP2020 objective PA-2.4 also monitors the number of adults that report meeting the current federal guidelines for physical activity. HP2020 objective NWS- 10.4 also monitors the number of obese children and adolescents. The results from HP2020 help guide Americans on nutrition and being physically active to prevent and manage obesity. According to HP2020, some social factors influence nutrition, obesity, and physical activity, such as socioeconomic status and education level ("Nutrition, Physical Activity, and Obesity | Healthy People 2020", 2020).

The World Health Organization

WHO defines obesity as an excessive or abnormal accumulation of fat that poses a health risk. A BMI of over 30 characterizes obesity. According to WHO, at least 4 million people die from obesity each year.

Farm bill

The government has majorly focused on policies and interventions to deal with obesity. An example of a federal policy is the Farm bill which is currently referred to as the Agriculture Improvement Act of 2018. According to this Act section 28(c), "the secretary shall establish an online clearinghouse that makes available to State agencies, local agencies, institutions of higher education, and community organizations best practices for planning, implementing, and evaluating nutrition education and obesity prevention services to ensure that projects carried out with funds received under this section are appropriate for the target population" (Text – H.R.2 – 115th Congress (2017-2018).

Status

The Agriculture Improvement Act 2018 is designed to educate and train people about nutrition, which will reduce obesity rates. It is currently at the implementation stage of the Policymaking cycle.

Analysis of the Public Policy Response

Under this Act, about 76% of the outlays will take care of nutrition programs, 9% will cater for crop insurance programs, 7% will focus on the conservation programs, 7% will cater for commodity programs, and the other 1% will take care of all other programs such as rural development, credit, and trade ("Agriculture Improvement Act of 2018: Highlights and Implications", 2019). The nutrition programs will educate people on healthy living, such as diet and physical exercise, which will ultimately reduce the cases of obesity.

Policy and Social Determinants of Health

This policy facilitates health determinants by making them more accessible, such as nutritious food, education, and awareness about healthy living.

Conclusion

I believe that this policy does enough in addressing obesity to all Americans by highly focusing on nutrition. If the military could focus this policy towards veteran obesity and then allocate funds to a nutrition program, this would be a significant step towards combating obesity in the veteran community.

Resources for Updates

Health organizations can check updates on this policy via the government website: https://www.ers.usda.gov/agriculture-improvement-act-of-2018-highlights-and-implications/

References

Absher, J (2019) Obesity Is Not A Service-Connect Disability: Va. Https://Www.Military.Com/Militaryadvantage/Veteran-Benefits/2019/04/05/Obesity-Not-Service-Connected-Disability-Va.Html

Agriculture Improvement Act Of 2018: Highlights And Implications. U.S. Department Of Agriculture. (2019). Retrieved 2 November 2021, From Https://Www.Ers.Usda.Gov/Agriculture-Improvement-Act-Of-2018-Highlights-And-Implications/.

Biener, A., Cawley, J., & Meyerhoefer, C. (2018). The Impact Of Obesity On Medical Care Costs And Labor Market Outcomes In The Us. Clinical Chemistry, 64(1), 108-117.

Kaplan, L. M., Golden, A., Jinnett, K., Kolotkin, R. L., Kyle, T. K., Look, M., ... & Dhurandhar, N. V. (2018). Perceptions Of Barriers To Effective Obesity Care: Results From The National Action Study. Obesity, 26(1), 61-69.

Kushner, R. F., & Kahan, S. (2018). Introduction: The State Of Obesity In 2017. Medical Clinics, 102(1), 1-11.

Mozaffarian, D., Griffin, T., & Mande, J. (2019). The 2018 Farm Bill—Implications And Opportunities For Public Health. Jama, 321(9), 835-836.

Nutrition, Physical Activity, And Obesity | Healthy People 2020. Healthypeople.Gov. (2020). Retrieved 2 November 2021, From Https://Www.Healthypeople.Gov/2020/Leading-Health-Indicators/2020-Lhi-Topics/Nutrition-Physical-Activity-And-Obesity/Determinants.

Text - H.R.2 - 115th Congress (2017-2018): Agriculture Improvement Act Of 2018. (2018, December 20). Https://Www.Congress.Gov/Bill/115th-Congress/House-Bill/2/Text

Tremmel, M., Gerdtham, U. G., Nilsson, P. M., & Saha, S. (2017). Economic Burden Of Obesity: A Systematic Literature Review. International Journal Of Environmental Research And Public Health, 14(4), 435.