Lecture 13

Healthcare Patterns & Dispositions in Individuals with Obesity

Title Page

Title: Healthcare Patterns & Dispositions in Individuals with ObesityAuthor: Parmis Mirzadeh, Second Year Ph.D. StudentCourse: KINE2049 – Research Methods and Design

Introduction

Definition of Obesity:Obesity is a complex disease characterized by energy balance dysregulation, leading to excessive accumulation of fat in the body. The World Health Organization (WHO) defines obesity as having a Body Mass Index (BMI) of 30 or higher. It is crucial to recognize obesity as a disease rather than merely a lifestyle choice because it involves physiological, genetic, environmental, and psychological factors that affect an individual's health.Reference: Acosta et al., Obesity, 2021.

Continuation of Definition

Obesity Explained:Obesity results from an imbalance between energy intake (caloric consumption) and energy expenditure (caloric burn). This condition is influenced by various factors:

• Genetics: Genetic predisposition can affect body weight through appetite regulation, metabolism, and fat storage.

• Environment: Access to healthy food options and opportunities for physical activity can significantly influence individuals' weight.

• Psychological Factors: Emotional eating can contribute to weight gain.

• Socioeconomic Status: Economic barriers can limit access to nutritious food and healthcare.The increasing recognition of obesity in medical literature emphasizes the necessity for effective treatment and management strategies.Reference: Acosta et al., Obesity, 2021.

Complications of Obesity

Complex Nature of Obesity:Obesity is not merely a physical condition; it's a complex, chronic, and progressive disease with a broad spectrum of complications:

Complications Overview

Visual Representation:

Table 1: Complications Associated with ObesityMental Health Issues: The stigma associated with obesity can lead to isolation, depression, and anxiety. These mental health challenges further complicate management and treatment, leading to a vicious cycle. Metabolic Health Disturbances: Obesity impacts insulin sensitivity and hormonal balance, leading to metabolic syndrome, characterized by a cluster of conditions that increase the risk of heart disease and diabetes. Mechanical Problems: Excess weight places additional strain on the body, causing joint issues and pain, particularly in weight-bearing joints like the knees and hips. Cardiovascular Issues: Obesity contributes to an increased workload on the heart and can lead to high blood pressure and abnormal cholesterol levels, significantly heightening the risk of cardiovascular incidents.

Reference: Lingvay et al., Lancet, 2024.

Burden of Obesity

Global Statistics:

• Approximately 890 million adults worldwide are affected by obesity, as reported by the WHO in 2024.

• In the U.S., 40% of adults are classified as obese according to CDC statistics in 2024, while in Canada, the figure stands at 30% based on StatsCan data, reflecting significant public health concerns in both nations.

Visual Representation:

Table 2: Overview of Obesity Statistics

The substantial number of individuals suffering from obesity underscores the urgency for a robust healthcare system to actively support and manage this population effectively.

Healthcare Utilization

Literature Review Focus:This section examines patterns of care within U.S. healthcare settings, highlighting differences between the Canadian and U.S. healthcare systems. The literature review focuses on data and studies published after 2014, which have shaped the current understanding of obesity as a significant public health issue and have influenced policy and practice surrounding its treatment.

Methodology Overview

Dataset Details:The study utilizes data from the Canadian Institute for Health Information, specifically the National Ambulatory Care Reporting System (NACRS) covering the years 2018-2022. A thorough research proposal was submitted to the Research Ethics Board (REB) at York University to obtain data access.

Sample Characteristics:

• Sample Size: The study includes a total of 9,094 visits, providing a robust dataset for analysis.

• Categories: The sample comprises patients diagnosed with obesity (ICD-10 E66) and matched controls based on sex, age, and primary diagnosis to ensure a balanced comparison.

Study Results

Findings:This section highlights disparities in healthcare experiences for patients with obesity compared to matched controls, with a focus on accessibility and quality of care.

Statistical Insights:

• Patients with obesity demonstrated:

  • 54% greater odds of receiving a less urgent triage score when presenting for care.

  • Wait times for initial physician assessment were approximately 5 minutes longer than for matched controls.

  • Length of stay in the emergency department was, on average, 3.5 hours longer.

Visual Representation:

Table 3: Healthcare Disparities Observed

These findings emphasize the systemic challenges faced by individuals with obesity when navigating the healthcare system, highlighting the need for targeted interventions to reduce these disparities.

Upcoming Events

Event Announcement:A conference on healthcare outcomes and dispositions in persons with obesity is scheduled for April 3-6, 2024, in Banff, Alberta, featuring presentations from top researchers and healthcare professionals in the field.

Research Article Publication

Publication Info:The paper titled "Healthcare outcomes and dispositions in persons with obesity within emergency departments in Ontario, Canada: A cross-sectional analysis of NACRS, 2018-2022" has been published in PLOS ONE in 2024, contributing valuable insights into this critical area of healthcare.

Research Process Flow

Process Overview:The research process adhered to a systematic approach, which included the following steps:

1. Literature Review: Extensive review of existing studies and data on obesity.

2. Submission of Research Proposal: Formulating the scope of the study and ethical considerations.

3. Application to REB: Gaining necessary approvals for data use.

4. CIHI Data Request: Accessing the National Ambulatory Care Reporting System data.

5. Data Analysis: Employing statistical methods to interpret the data.

6. Manuscript Write-up: Compiling findings into a cohesive research paper.

7. Dissemination of Findings: Sharing results with the academic and medical communities.

References

Reference Citations:The references include multiple studies and reports regarding obesity, healthcare statistics, and outcomes to support the research findings and recommendations made throughout the document.

Closing

Thank YouContact Information:For queries, please contact: MIRZADEH@YORKU.CA

Community-Dwelling Older Adults

New Topic Introduction:Exploring the experiences of older adults during COVID-19, emphasizing how the pandemic has significantly increased isolation and highlighted ageism as major concerns.

Social Isolation and Ageism

Concept Overview:This section defines social isolation and ageism, detailing their detrimental impacts on mental and physical health, which have been exacerbated during the pandemic due to service disruptions and limited social interactions. In this context:

• Social Isolation refers to a lack of social connections, which can lead to feelings of loneliness and depression.

• Ageism is the stereotyping, prejudice, and discrimination against individuals based on their age, primarily affecting older adults during the COVID-19 pandemic.

Visual Representation:

Table 4: Impact of Isolation and Ageism

Research Questions and Ageism Experiences

Research Objectives:The study aims to explore the socioecological experiences of social isolation and ageism among older adults during COVID-19, including individual testimonials illustrating their experiences, seeking to provide a comprehensive understanding of the issues faced by this demographic.

Discussion and Implications

Discussion Points:The findings underscore the necessity for community responses to enhance health and wellness for older adults in the post-COVID environment. Suggestions may include tailored programs promoting social connections and combating ageist stereotypes within healthcare settings.

Adaptation for Autistic Children

Feasibility Study on Bingocize:This section explores physical activity interventions specifically tailored for autistic children, focusing on adapted Bingocize as a tool to increase engagement in physical activity through skill learning and social interaction in a supportive environment.

Final Sections and Findings

Key Findings Highlights:Crucial factors for effective participation include autonomy, belongingness, and masterful engagement. These factors reflect a maturing understanding of the need for adaptive interventions that cater specifically to the unique challenges faced by autistic children in various settings.

Final Notes:

The importance of community support and tailored approaches must be emphasized to enhance physical activity and well-being among autistic populations, promoting inclusivity and participation in planned physical activities.