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Problemas de saúde nos países desenvolvidos e planeamento estratégico: evolução das políticas e estratégias de prevenção e combate à pré-obesidade e obesidade infantil e dos jovens em Portugal
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A obesidade é uma doença crónica e constitui um factor de risco para outras patologias, como a diabetes ou as doenças cardiovasculares, contribuindo para a diminuição da qualidade de vida de adultos, crianças e jovens, e para o aumento dos custos directos e ndirectos com a saúde. Entre as suas múltiplas causas, destacam-se as mudanças comportamentais, nomeadamente as alterações ao padrão alimentar e a diminuição da actividade física, que resultam num balanço energético positivo.
A pré-obesidade e obesidade são um grave problema de saúde nos países desenvolvidos e em desenvolvimento, sendo consideradas como epidemia global e um dos maiores desafios da saúde pública do início do século XXI.
Verifica-se que a obesidade tem efeitos negativos imediatos na saúde individual dos mais jovens, aumentando-lhes também o risco de obesidade e suas co-morbilidades na idade adulta. O crescimento do problema entre crianças e jovens, bem como uma maior facilidade na introdução de mudança aos seus comportamentos, está na base de recomendações para que seja dada prioridade à prevenção e combate à pré-obesidade e obesidade nestas faixas etárias.
Em Portugal, diversos estudos indicam o agravar do problema entre a população, sendo a prevalência entre crianças e jovens uma das mais ao nível europeu. Este facto, associado aos custos individuais, sociais e económicos da doença, constitui um foco de interesse para quem estuda a evolução dos sistemas de saúde.
Com esta investigação procurou-se compreender a evolução das políticas e estratégias de prevenção e combate à pré-obesidade e obesidade infantil e dos jovens e como ela se projecta no futuro. Para tal, fez-se uso de uma metodologia qualitativa, através da análise da semântica e conteúdos de um Corpus documental que incluiu, entre outros, a Estratégia de Saúde para o Virar do Século (1998-2002), o Plano Nacional de Saúde 2004-2010 e a versão preliminar do Plano Nacional de Saúde 2011-2016.
Os resultados mostram que o aumento de prevalência de excesso de peso na população portuguesa levou a que o problema ganhasse importância nas preocupações das autoridades de saúde. Verifica-se no entanto que a preocupação com o aumento da prevalência nas crianças e jovens se reflectiu mais tardiamente nos documentos estratégicos.
Conclui-se ainda que a centralidade política da prevenção e combate ao problema, em particular, nas idades infanto-juvenis, surge após a aprovação da Carta Europeia de Luta Contra a Obesidade (WHO-Europe, 2006), de que Portugal é signatário. É possível estabelecer uma correspondência entre os princípios da Carta e as orientações estratégicas do PNS 2011-2016, recomendando-se o reforço deste alinhamento.
PALAVRAS-CHAVE: Pré-obesidade, Obesidade, Portugal, Infantil, Crianças, Adolescentes, Jovens, Excesso de Peso, Plano Nacional de Saúde, Sistemas de Saúde, Planeamento em Saúde, Carta Europeia de Luta contra a Obesidade, Planeamento Estratégico.
Obesity is a chronic disease and a contributing risk factor for other conditions, such as diabetes or cardiovascular diseases, associated with the decrease of life quality of adults, children and youth, and with the increase of direct and indirect health costs. Its most common causes are behavioural changes, like dietary changes and decrease of physical activity, that lead to a positive energy balance and gain of weight. Overweight and obesity are becoming a major problem in developed and developing countries, being considered as a global epidemic and as one of the greatest public health challenges of the twenty-first century. Obesity has immediate negative effects on individual health of young people, increasing the risk of obesity and its co-morbidities in their adult age. The fact of being a growing problem among children and youth, coupled with a relatively high permeability of members of this age group to behavioral changes is at the basis of recommendations to prioritize these groups for the prevention and combat against overweight and obesity. In Portugal, several studies show that the problem is growing among the population, being the prevalence among children and youth one of the highest in Europe. This fact, together with the individual, social and economic burden of the disease, is of interest to those who study the evolution of health systems. With this investigation, we analyzed the evolution of policies and strategies for preventing and combating overweight and obesity among children and young people and how they are projected in the future. For this, we used a qualitative methodology to analyze the semantic and content analysis of a set of documents, including the Health Strategy (1998-2002), the National Health Plan 2004-2010 and the draft of the National Health Plan 2011-2016. Our results show the increasing concern of Portuguese health authorities with the growing impact of obesity in the population. However the concern with its increase among children and young people risen later in the strategic document. We established that prevention and combat obesity, particularly within children and adolescents, became a political priority after the approval of the European Charter on Counteracting Obesity (WHO-Europe, 2006) of which Portugal is a signatory member. It is possible to establish a correspondence between the principles of the European Charter and the strategic guidelines of the National Health Plan 2011-2016, and we recommend the strengthening of this alignment.
Obesity is a chronic disease and a contributing risk factor for other conditions, such as diabetes or cardiovascular diseases, associated with the decrease of life quality of adults, children and youth, and with the increase of direct and indirect health costs. Its most common causes are behavioural changes, like dietary changes and decrease of physical activity, that lead to a positive energy balance and gain of weight. Overweight and obesity are becoming a major problem in developed and developing countries, being considered as a global epidemic and as one of the greatest public health challenges of the twenty-first century. Obesity has immediate negative effects on individual health of young people, increasing the risk of obesity and its co-morbidities in their adult age. The fact of being a growing problem among children and youth, coupled with a relatively high permeability of members of this age group to behavioral changes is at the basis of recommendations to prioritize these groups for the prevention and combat against overweight and obesity. In Portugal, several studies show that the problem is growing among the population, being the prevalence among children and youth one of the highest in Europe. This fact, together with the individual, social and economic burden of the disease, is of interest to those who study the evolution of health systems. With this investigation, we analyzed the evolution of policies and strategies for preventing and combating overweight and obesity among children and young people and how they are projected in the future. For this, we used a qualitative methodology to analyze the semantic and content analysis of a set of documents, including the Health Strategy (1998-2002), the National Health Plan 2004-2010 and the draft of the National Health Plan 2011-2016. Our results show the increasing concern of Portuguese health authorities with the growing impact of obesity in the population. However the concern with its increase among children and young people risen later in the strategic document. We established that prevention and combat obesity, particularly within children and adolescents, became a political priority after the approval of the European Charter on Counteracting Obesity (WHO-Europe, 2006) of which Portugal is a signatory member. It is possible to establish a correspondence between the principles of the European Charter and the strategic guidelines of the National Health Plan 2011-2016, and we recommend the strengthening of this alignment.
Descrição
Palavras-chave
Saúde e desenvolvimento Nutrição Obesidade Controlo e prevenção Crianças Jovens Países desenvolvidos Pré- obesidade Portugal Infantil Adolescentes
Contexto Educativo
Citação
Editora
Instituto de Higiene e Medicina Tropical