The Centers for Disease Control and Prevention (CDC) have dubbed childhood obesity the “fastest growing health crisis” in America, so much so that “one out of every three American children is considered overweight.” Between 1980 and 1999 the prevalence of excess weight nearly tripled (from 5 to 14 percent) amongst adolescents and nearly doubled (from 7 to 13 percent) in children 6–11 years of age. Extra weight in youth leads to a lifetime of health issues, including diabetes, heart disease, and hypertension. Obese children aged 10–13 are reported to have a 70 percent likelihood of obesity persisting into adult years. Obesity can also have immediate effects on a child’s mental wellbeing. It has been shown that “obese and overweight children experience significantly higher rates of emotional problems including depression, suicide, eating disorders, and poor school performance.” Researchers have found that lowered self-esteem was associated with being overweight in girls as young as five.
CDC Youth Risk Behavior and other surveys suggest that the decline in physical activity is due to a decrease in moderate-to-vigorous physical activity (including decreased opportunities for physical education), as well as increased sedentary behavior (such as watching television, playing videogames, and computer activities.) Studies confirm that people are more active in neighborhoods that are perceived as safe and that a lack of facilities and supervision reduce opportunities for after-school physical activity.
As youth obesity increases, it is imperative to implement programs that promote active and healthy lifestyles. Currently, children spend much more time in front of the TV or computer than they do being active. Children who watch four or more hours of TV a day have a higher incidence of obesity than those who watch only one hour a day. Children often are driven from school to extracurricular activities or to do routine errands. Not only does this contribute to a sedentary lifestyle, but opportunities are lost to learn life skills about pedestrian and bicycle safety.
Research suggests the most effective steps to shape healthy, accessible and desirable alternatives for kids utilize an integrated, multi-pronged approach to tackle the problems that lead to obesity. Schools, families, government agencies, community institutions, and health care providers all have roles to play in designing healthy lifestyles for our youth. Indeed, an enormous number of task forces and committees across the country are making positive change through community design, media campaigns, and the implementation of child-based interventions in schools, clinical settings and communities (e.g., after school programs, YMCAs, Boys and Girls Clubs.)
The tools presented in the Youth in Motion toolbox offer a variety of programs and initiatives that can be promoted by a diverse range of stakeholders. The toolbox is designed to help individuals and organizations plan, implement, advance and evaluate the effectiveness of the programs they have chosen to deal with inactivity and unhealthy weight.
What can, and should, Mayors do?
What can mayors do to foster programs that support physical activity, good nutrition, and healthy lifestyles for our kids? A Mayor is uniquely positioned capacity to marshall the resources that can advance a healthy community agenda. A mayoral commitment to community health can entail some of the following steps:
Partnership building for effective implementation
Best practices become successful through effective implementation. This often requires adapting interventions within diverse environments, especially when programs or policies are applied in different populations, places, and situations. Conducting formative research, including interviews with potential youth participants and their parents, teachers, healthcare workers and individuals involved in community outreach, can help ensure programs are tailored to meet the needs of the target community. Consider engaging community youth to solicit input on promising interventions and outreach tactics. Mayors can play a role by hosting meetings and fostering a community approach to addressing the problem. They can assist in identifying potential partners and tapping resources for implementation of programs.
Equity concerns
A 2004 New Jersey Health and Senior Services survey of the state’s youth found rates of obesity significantly higher in low socioeconomic districts. In fact, New Jersey has the nation’s highest incidence of obesity among low-income 2–5 year
olds. Often, disadvantaged youth do not have access to physician counseling on weight loss, safe parks in their neighborhood, or transportation to after-school or community based programs. Program organizers should check that program fees are low, or that they be waived. Consideration should be given to providing childcare to ensure parental involvement, an integral element for the success of any child-focused weight loss or weight management program. These are equity issues that need to be addressed. Mayors and their staffs can help identify concentrations of at-risk youth in the community and work to ensure safe and barrier-free access to opportunities for physical activity.
Importance of evaluation
In preparing this toolbox, almost 100 school- and community-based weight management and obesity prevention programs for children were identified and reviewed. Of these programs, only a handful was supported by documented results attesting to their effectiveness. While hundreds, if not thousands, of innovative and promising obesity prevention programs are currently underway, an understanding of whether or not these programs work is limited because they lack an evaluation component. Evaluation is critical. Program planners must build an evaluation of outcomes and processes into their efforts to encourage physical activity and good nutrition in our youth. This is necessary if the goal is to build on existing models and identify new effective practices that can be disseminated to others. Mayors can help by encouraging community participation in the planning and implementation of evaluation tasks.
PLANNING FUN, FOOD & FITNESS IN YOUR COMMUNITY
This guide presents five steps to help you plan your program
Step 1. Getting started
Assess your community’s needs and resources and set clear objectives to help shape your program plan
Step 2. Gaining support from others
Form partnerships with individuals and groups within your community to help build and strengthen existing community programs and services, and to encourage community participation and ownership
Step 3. Working with the media
Use the media to promote your messages and activities to help increase awareness within your community
Step 4. Planning activities
Choose the activity modules that will work in your community and with your partners to add to your program’s success
Step 5. Measuring your success
Look at what you have accomplished and learned and evaluate whether the program is working. This will help you identify and solve problems and improve your program. Seeing how much you have accomplished will also help keep you and your partners motivated and enthusiastic about your program
Source: Fun, Food & Fitness, a Community Action Tool Kit, developed by The American Council for Fitness and Nutrition
References
Babey, S.H., Brown, E.R., & T.A. Hastert. (2005, December). Access to safe parks helps increase physical activity among teenagers. UCLA Health Policy Research Brief, PB2005-10.
Crespo CJ, et al. (2001, March). Television watching, energy intake, and obesity in U.S. children. Results from the Third National Health and Nutrition Examination Survey, 1988-1994. Archives of Pediatric and Adolescent Medicine. 155, 360-5.
Davison, K. & Birch, LL. (2001). Weight status, parent reaction and self-concept in five-year old girls. Pediatrics 107, 1, 46-54.
Eisenberg, M.E., Neumark-Sztainer, D., & M. Story. (2003, August). Association of weight-based teasing and emotional well-being among adolescents. Archives of Pediatrics and Adolescent Medicine. 157, 733-738.
Glendening, P.N., Hearne, S.A., Segal, L.M., Juliano, C., & M.J. Earls. (2005, August). F as in fat: How obesity policies are failing in America. Trust for America’s Health.
Ogden, C.L., Flegal, K.M., Carroll, M.D., & C.L. Johnson. (2002, October 9). Prevalence and trends in overweight among U.S. children and adolescents, 1999-2000. Journal of the American Medical Association 288, 1728-1732.
Whitaker, R.C., Wright, J.A., Pepe, M.S., Seidel, K.D., & W.H. Dietz. (1997). Predicting obesity in young adulthood from childhood and parental obesity. New England Journal of Medicine. 337, 869-73.
