Issues in the obesity debate : The World Health
Organization (WHO) defines overweight and obesity as "abnormal or
excessive fat accumulation that may impair health." The recognition of
obesity as a public health problem has only occurred in recent decades. In 2005
the disease was described as a "global epidemic" and considered by
WHO as a worldwide public-health crisis.
There is clinical evidence that overweight and obesity is a risk factor for
a range of diseases, including cardiovascular disease, Type II diabetes, some
musculoskeletal conditions and cancers. Further, the longer a person is obese,
the higher the risk of premature mortality.
In 2008, the economic cost of obesity to Australia was estimated to be $58.2
billion; with a cost of $19 billion in NSW.
Classifying overweight and obesity : Body Mass Index
(BMI) is the main measure used in international obesity guidelines and is
relied on by WHO as a population measure for obesity. BMI is defined as a
person's weight in kilograms divided by the square of their height in
Prevalence of Obesity : According to the WHO 2012
report, 2.8 million people world-wide die each year as a result of being
overweight or obese. In 2008, it was estimated that half a billion men and
women over the age of 20 were obese, with women more likely to be obese than
men. Worldwide the prevalence of obesity almost doubled between 1980 and 2008.
In 2011-12, based on measured BMI, 28.3% of Australian adults and 7.6% of
children (aged 5-17) were obese. This represents a 3.3% increase of Australian
adults since the last National Health Survey 2007-08, when there were
approximately 3 million obese Australians. The national rates of overweight and
obesity do not differ markedly between the States or Territories with Western
Australia having the highest prevalence of overweight or obesity (63%) and the
ACT the lowest (59%). Australia's obesity prevalence is comparable to Canada,
the United Kingdom and Ireland (20-24%), and reflects the same level recorded
for the United States in the early 1990s.
Although obesity is widely distributed amongst the Australian population, its
distribution is not even. The greatest prevalence occurs in the following
population sub-groups: Aboriginal and Torres Strait Islanders peoples; those in
the most disadvantaged socioeconomic groups; those living in rural and remote
areas as opposed to urban areas; and people born overseas in particular in
Southern & Eastern Europe, the Pacific Islands and the Middle East.
New South Wales Prevalence and Trends :The NSW Adult
Population Health Survey results for 2011 reveal that there has been a
significant increase in the proportion of adults who are overweight or obese
(41.5% in 1997 compared to 52.6% in 2011), with the prevalence being higher
amongst males than females.
The NSW Child Population Health Survey for 2009-2010 reported that 18.5% of
children were overweight and 10.1% were obese. The findings for NSW reflect the
national trend of obesity being more prevalent amongst certain population
Factors Contributing to the Development of Overweight and
Obesity : Australia's Health 2012 states that "A
person's health and well-being is influenced by a complex interplay of
societal, environmental, socio-economic, biological and lifestyle
factors". Each of these is considered.
The NHMRC acknowledges that genetics and epigenetic changes (changes in gene
expression caused by mechanisms other than changes in the DNA sequence)
may in part explain why some individuals have an increased risk of
developing overweight and obesity than others.
There are five key urban characteristics comprising both the natural and built
environment that influence physical activity and may therefore impact on
· Facilities for physical activities, which may include outdoor sports
facilities, playgrounds and natural green spaces such as bushland and parks.
· Street connectivity and design, which reflects the ease of travel between
households, shops and places of employment.
· Mixed land uses (residential, commercial, industrial and agricultural) as
well as community and recreation facilities are often associated with shorter
· Residential density, a higher residential density may mean that there are
more people to use a range of activities and institutions within a smaller
area, often leading to shorter walking distances (as opposed to use of a car)
to such destinations.
Subsequent to the "NSW 2021: A Plan to Make NSW Number One", the
NSW Office of Preventative Health was opened on 29 June 2012 with Professor
Chris Rissell of the University of Sydney's School of Public Health being the
inaugural Director. A Ministerial Advisory Committee on Preventive Health was
also established in June 2012. The NSW 2021 plan includes the performance
benchmarks for obesity set under the NPAPH and the following specific targets
for overweight and obesity:
· Stabilise overweight and obesity rates in adults by 2015, and then reduce
by 5% by 2020.