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The objective chosen is 19-3 – To reduce the proportion of adolescents and children who are overweight or obese. Childhood obesity has reached epidemic proportions and is a public health problem.

Choosing this objective is critical in improving the health of people in the future. Obesity can predispose to other health problems like heart disease, diabetes etc which have huge health as well as economic implications on the nation.

The National Health and Nutrition Examination Surveys (NHANES) showed increasing prevalence of overweight in not only adults but also adolescents, in the past 15 years. According to this study obesity/overweight was in the range of 11 to 15% across various age groups and the objective aims at decreasing the proportion to 5 %.( Ref: 19-3, To reduce the proportion of adolescents and children who are overweight or obese).

This goal is not unachievable but requires policies to be made to have quicker results. Increasing awareness or knowledge would prevent few people from unhealthy choices/behaviors. Policy is an effective answer. Biological factors and genetics have a role to play in the development of childhood obesity but the behavioral traits and certain common behaviors have an important role to play and practical interventions can be made in this aspect.

Thus decreasing the number of obese children is a crucial objective to prevent many diseases in adulthood.  Policy proposal: Banning the advertising of bottled drinks/soft drinks and junk food/fast food in and around schools with a ban on the use of children as part of advertisements for these products.

Bottled drinks, soft drinks, liquid candy, soda, chocolates, fast food are easily accessible and easy on the pockets of children and the trend of changing food habits among children andteenagers have been found to be associated with the alarming increase in childhood obesity in recent decades. A study conducted in the state of Missouri in collaboration with the Center for Disease Control examined the relation between the consumption of sweetened drinks and  overweight among pre school children.

The results of that study indicated that for  children who were normal or underweight at baseline (BMI <85th percentile), the association  between sweet drink consumption and development of overweight was positive.

(Jean A. Welsh et al, Overweight Among Low-Income Preschool Children Associated With the Consumption of Sweet Drinks: Missouri, 1999–2002). James et al (James J, Thomas P, Cavan D, Kerr D. BMJ. 2004) in a cluster-randomized controlled trial demonstrated that a reduction in carbonated beverage consumption was associated with a decrease in the prevalence of overweight among 7- to 11-year-olds.

Representative Howard in 2001 proposed a bill to introduce nutritious breakfasts for kids in kindergarten while at the same time, placing a tax on the sale of soft drinks by the vending machines and this bill proposal was well received. (Representative Julia Howard and Senator Ellie Kinnaird, Soft Drink Pouring rights, NCMJ, Nov/Dec 2002).

This example shows that policy can be an effective solution and is well accepted and the elected legislators  should participate in improving the health of the people by making the objectives of Healthy people 2010 their targets.

PART 2:
The objective chosen is to aim to reduce the proportion of children and adolescents who are overweight or obese. The policy suggested has been outlined as above. The different steps in making a policy effective include the first step of formulation of a policy which is aimed to achieve the objective followed by implementation of the policy by passing the bill and bringing it into effect.

Evaluation of the effects of the implementation of the policy is the third step and provides us information as to how effective the policy has been in achieving the objective. It also shows whether the target audience chosen is correct or not. Evaluation for different age groups will show which group has been positively affected by the policy. It suggests the corrections that may need to be made. Modification of the policy is the final step when the necessary changes can be made to the policy as per the suggestions got from evaluating the results.

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