The Task Force to Reduce/Prevent Obesity in Children
In September 2001, Connecticut State Senator Toni N. Harp (D-New Haven), co-chair of the legislature's Public Health Committee, YSN Associate Dean for Research Affairs, Dr. Margaret Grey , and activists from a number of New Haven's community organizations formed The Task Force to Reduce/Prevent Obesity in Children. The Task Force was created to address the high rate of obesity among New Haven's youth; publicize the grave health risks associated with chronic obesity; generate action plans to assist those living with the condition; and help limit the number of future cases. The idea for the Task Force came out of Dr. Grey's involvement with the Robert Wood Johnson Executive Nurse Fellowship. "New Haven area children are among the most vulnerable to health risks associated with obesity," said Dr. Grey. "We formed a broad coalition of community organizations to address child obesity in New Haven because we knew that the most effective solutions will come from the community."
A study released by the Center for Disease Control and Prevention (CDC) in September 2001 linked the rising rates of obesity with the increase in diabetes. "This dramatic new evidence signals the unfolding of an epidemic in the United States," said CDC Director Dr. Jeffrey Koplan. "With obesity on the rise, we can expect diabetes rates to increase sharply as a result."
Children, particularly in minority populations, are among those for whom type 2 diabetes is a viable and growing threat. According to the American Diabetes Association, three decades ago about 2 percent of all cases of new onset type 2 diabetes were in people between 9 and 19 years old. Now, it is about 30 to 50 percent. "This trend has grave implications for the long-term health of our community" said Dr. Grey.
"Obesity rates among New Haven's children are running close to 50% higher than national averages and frankly, I'm shocked by that statistic," Senator Harp said. "We simply must address this issue and make it a priority, because if we don't, these kids face a grim future in terms of both physiological risks and psychosocial problems."
The Task Force has approached the issue on two fronts, addressing ACTIVITY decisions to promote a healthier, alternative lifestyle and better cardiovascular health, and EATING options, to counter self-destructive behavior and help develop better nutritional habits and healthier food choices among children.
"Our group envisions a comprehensive approach to this very serious matter," Senator Harp added. "A host of factors contribute to obesity in children, so it will take a similar effort to address the elements of diet, exercise, lifestyle, and self image that conspire against these kids."
"First and foremost, we are addressing it collectively among all children, because obesity tends to separate the afflicted from the rest and then their suffering is only intensified by that isolation," according to Dr. Grey. "The issue must be addressed at the family level as well as on a community level."
"If the task force succeeds in its efforts New Haven will become an example to other cities about how to reduce diseases in children that result from obesity," Dr. Dan Fox, President of the Milbank Memorial Fund, and member of the Task Force, added.
Other participants in this initiative include the Honorable Jorge Perez, Dr. Reginald Mayo, Superintendent of Schools; Melvin Wearing, Chief of Police; Ms. Karen Gilvarg, Director of City Planning; Mr. Scott Hastie, Ms. Sheila Bell, Director of Community Services; Ms. Jan Parker, member of the Mayor's Task Force on Child Care; Ms. Patricia McCann-Vissepo, Executive Director of Casa Otonal, Dr. Leota Tucker, Director of Family Resource Centers; Stephen Updegrove, M.D., Pediatric Medical Advisor for New Haven Public Schools; Mr. Carlos Ceballos, Director of School-Based Clinics for New Haven Public Schools; Mr. Paul Ruchinskas, the Rev. John Henry Scott, Ms. Vanessa McCray, Ms. Katrina Clark, and the Rev. Bonita Grubbs.
Rationale
New Haven's children are more obese than those in the United States as a whole. National studies document that up to 22% of third and fourth grade children are obese and that, by adolescence, obesity is present in approximately 35-40%. The prevalence of obesity continues to increase, particularly among inner city minority children and youth. In New Haven, recent studies have shown that up to 50% of adolescents are obese. Childhood obesity is associated with significant morbidity and mortality, including risks for type 2 diabetes and cardiovascular disease. Both type 2 diabetes and cardiovascular disease are reaching epidemic proportions in inner city children. In New Haven, type 2 diabetes is being diagnosed as young as age 5, and 40% of newly diagnosed cases of diabetes in youth are type 2, when this was once quite rare. These youth will be at risk for the devastating complications of diabetes by the time they reach their mid-twenties and the costs for health care will be devastating. Obesity in youth is also associated with lower self-esteem, altered body image, decreasing physical activity, and depression. The social and economic consequences of obesity during childhood and adolescence persist into adulthood, with fewer obese youth completing high school and college. Without intervention, these trends are likely to worsen because once obesity occurs, it is difficult to intervene effectively to reduce risk from chronic diseases.
Individual approaches to weight loss have proven ineffective. The most promising interventions seem to be local, state and federal policies that increase the availability of nutritional meals in schools, decrease the availability and the incentive to eat fast foods and high fat/high sugar snacks, create safe and accessible areas for exercise, integrate fitness and nutrition more effectively into school programs, and increase the opportunities to walk and the security of walkways.
Policy initiatives
The group is currently pursuing a number of initiatives which include:
- Educating health and behavioral care providers about the importance of calculating and monitoring the BMI (Body Mass Index) and reporting results on health forms
- Developing an action plan for follow-up on BMI > 25 or rapid increase in BMI
- Implementing nutrition changes in schools' lunches, vending machines, fresh fruits and vegetables
- Creating more opportunities for outdoor activity and organized sports
- Encouraging walking to school; addressing safety and security issues
- Mobilizing parents, older children to walk with younger children
- Advocating decrease of television time, and substituting the child's free time with physical activity-based alternatives
- Encouraging family interaction and family discourse about obesity
- Developing approaches for the WIC program to treat nutrition in infancy
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