Around 17 percent of American children from age 2 to 19 are classed as “obese”. That’s a level that has remained fairly steady over the last decade. And it’s growing.
Obesity is measured in terms of Body Mass Index (BMI) – a measure that can be used to compare children in terms of their weight. BMI is calculated by dividing a person’s weight in kilograms by the square of their height in meters. For children and teens, BMI is so age- and gender-specific that it is referred to as BMI-for-age. BMI levels among children and teens need to be expressed relative to other children of the same age and gender. Every child is different and that makes it difficult to generalize on something like this.
Overweight is defined as a BMI at or above the 85th percentile and below the 95th percentile for children and teens of the same age and gender. Obesity is defined as a BMI at or above the 95th percentile for children and teens of the same age and gender.
To give an illustration, a 10-year-old boy of average height (56 inches) who weighs 102 pounds would have a BMI of 22.9 kg/m2. He would be considered obese because this calculation puts him in the 95th percentile for BMI-for-age. His BMI is greater than the BMI of 95% of 10-year-old boys in his “reference population”.
I have worked with Save the Children in some capacity for the past five years whether seeing their work around the world, blogging on pro-Bono campaigns or partnering as a consultant. That’s why I can personally vouch for the amazing work they do for the most vulnerable children who have experienced psychological trauma from all-too-routine natural and man-made disasters. Many people think Save the Children solely provides aid during global catastrophes that happen in far away places, but they also provide substantial aid here in the United States. Save the Children was instrumental during hurricanes Katrina and Sandy as well as the tornadoes that continually tear through the mid-west. They also were there for both the Lousiana and eastern North Carolina floods last year. I am confident in their ability to focus on not only the physical but the mental well-being of the smallest among us.
In a climate where some national organizations are coming under increased scrutiny about their ability to adequately help families with simple supplies, supply lines, and logistics during stateside national disasters, Save the Children continues to be a rock for children and their families. I wasn’t asked to write this post, but feel strongly it’s necessary to urge as many people to donate to Save the Children during Harvey relief efforts. Thus far Save the Children has brought truckloads of infant and toddler supplies to four shelters in Austin while strengthening its work to support children in area shelters.
Officials anticipate that more than 30,000 Texas residents will need shelter including in three mega shelters located in Dallas, Houston, and San Antonio. Save the Children has teams on the ground, and at the request of the City of Austin, is en route to the city’s four major shelters with essential items including portable cribs and sheets, strollers, baby wash basins, hygiene kits and lotion packs.
Save the Children is also opening child-friendly spaces in Dallas, Houston, and San Antonio.
“Child-Friendly Spaces are a hallmark of Save the Children’s emergency response, and are essential in helping children cope and build resiliency during disasters,” said Jeanne-Aimee De Marrais, the organization’s senior director of U.S. emergencies. “We are working hard to make sure that children and families in Texas are getting the supplies and care they need.”
“We are evaluating the immediate needs of families who are being rescued in Houston, and those who are still stranded,” added De Marrais. “We know the longer-term needs will be in Houston and we’re determined to get child care and early education programs up and running as quickly as possible.”
An anonymous tip to federal authorities, cell phone records, and surveillance video have put two doctors behind bars for carrying out female genital mutilation (FGM) on young girls as young as seven in Michigan. Dr. Jumana Nagarwala and Dr. Fakhruddin Attar are currently awaiting a detention hearing next week. Attar’s wife was also arrested at she and her husband’s suburban Livonia, Michigan clinic on Friday.
The girls who live in Minnesota were taken by their parents to Michigan in February for the FGM procedure that was performed by Nagarwala at Attar’s clinic. Nagarwala denies performing FGM, but rather removing membranes for burial by the girls’ parents. While the parents have not been arrested one girl was put in the care of the state for a short period.
A federal law passed in 1996 officially made FGM illegal across the country. 25 states also have anti-FGM laws on their books. Despite FGM’s illegality, it is estimated that there are 500,000 young girls in the United States who have either undergone FGM or are at risk for having the procedure done in secret.
Those involved are alleged to be a part of the Dawoodi Bohra community in Michigan.
Surveillance from the unsealed complaint revealed 20-minute FGM procedures performed by Nagarwala after hours and phone records showing Mrs. Attar telling the girls’ parents to deny everything if they were contacted by investigators.
The detention hearings are expected to take place on Wednesday. Nagarwala was already deemed a flight risk after being caught trying to take a flight to Kenya.
After eight years of practicing obstetrics and researching childbirth in the United States, I know as well as anyone that the American maternal health system could be better. Our way of childbirth is the costliest in the world. Our health outcomes, from mortality rates to birth weights, are far, far from the best.
The reasons we fall short are not obvious. In medicine, providing more care is often mistaken for providing better care. In childbirth the relationship between more and better is complicated. Texan obstetricians, when compared to their counterparts in neighboring New Mexico, are 50% more likely to intervene on the baby’s behalf by performing a cesarean section. Nonetheless, Texas babies still have a lower survival rate than New Mexican babies.
I long assumed that our most puzzling American health care failures were idiosyncrasies–unique consequences of American culture, geography, and politics. But a trip to India for the 2017 Human Rights in Childbirth meeting led me to a humbling realization: when it comes to childbirth, both countries fall short in surprisingly similar ways.
Human rights in childbirth
I take care of patients in at a well-funded teaching hospital in Boston, where pregnant women seem well-respected and have clear, inviolable rights.