THE UNITED STATES OF AMERICA & ALASKAN HEALTH OBJECTIVES AND

INDICATORS

The United States of America has always indicated within the premises of its

constitution, specifically under the Ninth Amendment that “...“...unenumerated rights

include such important rights as...the right to make important decisions about one's

health care or body.” Therefore, the American government itself must consider public

health to be more accessible to the common citizen, where in this case, Alaskans,

which have known higher concentrations of indigenous people. With it, there are known

instances that for the sake of advancement through society by means of a healthy

lifestyle, Alaskans and the general Americans themselves had therefore set numerous

goals to achieve a so-called “a society that does care for the well-being of its citizens”.

Named Healthy Alaskans 2020 and Healthy People 2020 respectively, these

goals and indicators are much known for their use of health indicators i.e. dietary

intakes, public health infrastructure and mental health to gain a much better picture of

the status quo of the wellbeing of their citizens. Furthermore, the two goals. Whilst being

catered to serve both purpose of informing the general public in regards to the health

sector structure of the society, this paper aims to look at a deeper and research-inclined

approach in order to look at a deeper perspective of the goals. In this case, the writer

will aim at comparing the two goals with one of the country’s main problems: the

heightening problem of obesity amongst adolescents and adults.

The Healthy Alaskans 2020 goal on obesity is summarized firsthand on their

Scorecard 2018 Update, from indicators 4.b to 5.b.ii. It can be observed that the attempt
in reducing obesity amongst those age groups had failed drastically. Further data from

the scorecard itself reveals that the current data percentage has exceeded the HA2020

target percentage. According to the Alaskan Department of Health (2018), over the past

20 years, obesity in the United States has increased dramatically and rates remain high.

Over a third of U.S. adults (35.7 percent) and about 17 percent (or 12.5 million) of

children and young adults aged 2 - 19 years are obese. They also noted that obesity is

considerably higher in middle - aged adults, 40 - 59 years of age (39.5 %) than

adolescents, 20 - 39 years of age (30.3 %) or grown ups over 60 years of age (35.4 %).

A research by Murphy et. al. (1995) concludes that obesity amongst Alaskan

natives are to be caused by their dietary change due to glucose intolerance. In the

study, the researchers found out that their carbohydrate intake had increased from 3%

to 5% in 1971, a direct contrast to their aboriginal states. Furthermore, outright

investigations revealed that carbohydrates had constituted 50% of the daily meal intake

amongst the Alaskan natives, including high doses of soft drinks that are three times

higher than the average American teen intake of soft drinks. The researchers then

concluded that in subjects aged 30 years, a pattern of increased frequency of non -

native protein, low - nutrient - density carbohydrates and fat content with lower

consumption of indigenous carbohydrates and fat was found.

A review by Bell et. al. (1997) observed that the dietary intakes amongst Alaskan

natives are medically unique, however they are linked to severe cases of various

cardiovascular diseases and are at risk of having cancer. The researchers observed

that diabetes plays a very important role in the epidemiology of heart disease in AIANs.

Researchers documented 35 deaths from ischemic heart disease in men and women
with Pima diabetes between 1975 and 1984, compared to only one death in non-

diabetics (DRR = 43.4; 95% CI = 5.9-317.0).

In this context, the HA2020 goal on obesity is directly linked to the dietary

patterns amongst the natives and little knowledge on proper dietary intake allowances.

However, this does not immediately disparage the concept of giving access to public

health to the Alaskan natives, therefore information drives are very important-and are

highly practiced in order to achieve the health goal.

On the other hand, the HP2020 goal on overweight and obesity is very complex,

but can be also patterned to the goal of HA2020, where the goal percentage is being

surpassed by the current status percentage. According to the official data from the

official website of the Healthy People 2020, the 17.9 percent of adolescents aged 12 to

19 years were considered obese in 2005–08.

According to a supplemental research by Kumanyika (2018), the conduction of

the Healthy Communities Study (HCS) has a significant investment to provide

perspectives into how efforts to control childhood obesity in societies around the United

States have developed. The study documented Community policies and programs

(CPPs) carried out in each of 130 ethnic communities between 2010 and 2016. The

researcher also stated that results suggest that most of the techniques enacted work

and improve the actions and weight status of children. However, the findings also show

that children in racial and ethnic groups with the highest risk of obesity have less reach.

Overall, HCS insights can guide so the next phase of endeavours to bolster existing

CPPs and encourage other alternative approaches to the fight against obesity in

children.
 Another research by Collie-Akers et. al. (2018) state that 9681 separate CPPs

were confirmed by key informants in all 130 communities. Of all of these, 5574 (58 %)

focused on improving physical exercise, 2596 (27 %) committed to improving nutrition

and 1511 (16 %) focused on both behaviors. The average number of CPPs per local

community in all communities was 74.0. The majority of CPPs happened more than

once (63 percent) and spanned 6.1 years on average. In school settings, the highest

number of reported CPPs (44 percent). Furthermore, the research clearly states also

that Prescribed strategies to improve the health as well as equity of the population

suggest that universally accepted strategies must be matched by CPPs concentrated in

places / neighborhoods where health inequities live, work and play.

In terms of general research, Rosenthal et. al. (2017) had found out that 81

percent of Americans believe that obesity is the nation's most serious health issue,

linking cancer as the main problem and landing before diabetes (72 percent), heart

disease (72 percent), mental illness (65 percent) and HIV / AIDS (46 percent). Almost

all Americans (94 percent) entirely agree that obesity itself raises the risk of early death,

even if there are no other diseases. The effectiveness of some obesity treatments such

as diet and exercise alone is overestimated by most Americans. Many overweight and

obese Americans are not talking to a doctor about their excess weight problems at all.

They also found out that The obesity rate in African Americans is strongest (48.1

percent), followed by Hispanics (42.5 percent), followed by whites (34.5 percent) (5)

Those from different races and ethnic backgrounds have different opinions on some of

the most important obesity outcomes. Whites (63 percent) are far more likely to say that

heart disease is among the most important outcomes than African Americans (46
percent) and Hispanics (48 percent). When it goes to diabetes, African - Americans (38

percent) are far less likely than both whites (58 percent) and Hispanics (48 percent) to

say that it is a significant result, despite the fact that African - American women face a

life time risk of diabetes that exceeds 50 percent - greater than the risk for whites and

African - American men.

A research by Brown & Perrin (2018) states that in order to attain obesity

prevention, community based projects and researches inclined to this should be based

off on four principles: 1) Providers of primary care should offer "Prevention Plus," the

use of motivational interviews to achieve healthy changes in family traits or situations. 2)

Children who require the next level of obesity treatment, "structured weight

management," need further support beyond the primary care provider. 3) Children with

severe obesity and disciplined families may benefit from a reference to a "complete

interdisciplinary intervention," such as a clinic for obesity treatment. 4) "tertiary care

interventions" are carried out in a multidisciplinary pediatric obesity treatment clinic with

new standard clinical procedures for the evaluation of treatments, including drugs and

surgery.

In this juncture, whilst being similar to the goals being manifested in their goals

and researches, both of the goals have different approaches in attaining a percentage

that will be included within the acceptable perimeters of their goal.

HA2020 is more focused on the health and physical aspect of obesity and

overweight prevention. In their data within their website, their recommendations in

preventing obesity is by being advised to follow health-related advices, such as linking

to the Dietary Guide for Americans 2015-2020. On the other hand, HP2020 is more
focused on community-based projects in order to alleviate the heightening percentage

of adults being categorized as abnormally overweight. This includes information drives

and community immersions to deliver the message.

Whilst being having total different messages, both goals have significant positive

impacts to the people of Alaska. On the HA2020 side, they helped in attaining the

aspect of regulations in their dietary intake. Alaskans, especially Alaskan natives, have

learned such as the daily calorie intake, proper distribution of nutrition in their daily

meals, to name a few. In short, HA2020 helped in terms of medical aspects.

On the other hand, HP2020 is responsible to raise awareness on this seemingly

common health issue yet being ignored due to increasing popularity of unhealthy

choices that in turn had been converted into guilty choices. Such community policies

and programs have been a great ordeal to give knowledge amongst Alaskans into what

should be done to be included in the normal aspect of the body mass index (BMI).

REFERENCES:

● Alaska Department of Health. (n.d.). Weight Status. Retrieved from

http://ibis.dhss.alaska.gov/topic/risk_resiliency/behaviors/WeightStatus.html
● Alaskan Department of Health, A. (2018, November 30). Healthy Alaskans 2020

Scorecard 2018 Update. Retrieved February 20, 2019, from

http://hss.state.ak.us/ha2020/assets/HA2020_Scorecard_2018.pdf

● Baltzell, G. W. (n.d.). Constitution of the United States - We the People.

Retrieved February 20, 2019, from http://constitutionus.com/

● Bell, R. A., Mayer-Davis, E. J., Jackson, Y., & Dresser, C. (1997). An

epidemiologic review of dietary intake studies among American Indians and

Alaska Natives: Implications for heart disease and cancer risk. Annals of

Epidemiology, 7(4), 229-240. doi:10.1016/s1047-2797(97)00018-5

● Brown, C. L., & Perrin, E. M. (2018). Obesity Prevention and Treatment in

Primary Care. Academic Pediatrics, 18(7), 736-745.

doi:10.1016/j.acap.2018.05.004

● Collie-Akers, V. L., Schultz, J. A., Fawcett, S. B., Obermeier, S. M., Pate, R. R.,

John, L. V., . . . Webb, K. (2018). The prevalence of community programmes and

policies to prevent childhood obesity in a diverse sample of US communities: The

Healthy Communities Study. Pediatric Obesity, 13, 64-71. doi:10.1111/ijpo.12475

● Healthy People2020.gov. (n.d.). Nutrition and Weight Status. Retrieved February

20, 2019, from

https://www.healthypeople.gov/2020/topics-objectives/topic/Nutrition-and-Weight-

Status/objectives#4927

● Kumanyika, S. K. (2018). Supplement overview: What the Healthy Communities

Study is telling us about childhood obesity prevention in U.S. communities.

Pediatric Obesity, 13, 3-6. doi:10.1111/ijpo.12478

● Murphy, N. J., Schraer, C. D., Thiele, M. C., Boyko, E. J., Bulkow, L. R., Doty, B.

J., & Lanier, A. P. (1995). Dietary Change and Obesity Associated with Glucose

Intolerance in Alaska Natives. Journal of the American Dietetic Association,

95(6), 676-682. doi:10.1016/s0002-8223(95)00184-0

● Rosenthal, R. J., Morton, J., Brethauer, S., Mattar, S., Maria, E. D., Benz, J.

K., . . . Sterrett, D. (2017). Obesity in America. Surgery for Obesity and Related

Diseases, 13(10), 1643-1650. doi:10.1016/j.soard.2017.08.002