The prevalence of overweight and at-risk children and adolescents has rapidly increased over the past 40 years, and Alabama currently has the third-highest prevalence of obese adults and the 11th-highest prevalence of obese youth in the nation. The adverse health problems that can result from obesity are leading members of the healthcare community to seek population-based intervention programs to help these children.
Such interventions might include school or community programs that attempt to change institutional policies as well as individual behaviors, according to the American Academy of Family Physicians. Population-based prevention strategies can target a large number of children, adolescents and their families, and some of the methods being discussed include planning communities to encourage physical activity, applying pressure to restaurants and food manufacturers to reduce portion sizes and fat content, restricting access to “junk food” in schools and adopting the format of “New P.E.,” in which the typical school gym class takes a health club approach by focusing on personal fitness rather than competitive sports.
Dr. Heather Austin, director of the Children’s Center for Weight Management at Children’s Hospital of Alabama, works with children and adolescents who have weight issues, and she agrees that family and community involvement is imperative in preventing overweight children, who most likely will grow up to be overweight adults. The center has been working with these children since 2002 and is seeing results.
“Our programs have more of a counseling focus, and we work with the patients and their families regarding lifestyle choices. Often, the parents have the same issues that the children have related to genetics or lifestyle issues. Having the family understand how important it is to change small daily behaviors to ensure long-term health is a key part of our treatment,” said Austin.
Austin and the Center for Weight Management joined community efforts earlier this year when the center was selected as one of eight in the nation to participate in the Youth Obesity Prevention and Reduction Learning Collaborative. The national effort is being led by the Association for Community Health Improvement and the American Hospital Association to identify and refine elective practices to prevent and reduce youth obesity. “It is hoped that this peer network ‘think tank’ will help us share knowledge and expertise and to foster effective prevention and treatment programs for overweight youth and their families.”
Austin also works with the Jefferson County Childhood Obesity Task Force, a grassroots movement that aims to halt future increases in the prevalence of overweight and obese children (ages 5-18) living in Jefferson County. The task force was started by the Jefferson County Department of Health and is led by Edwin Marty, director of the Jones Valley Urban Farm. Shatomi Kerbawy, a summer intern at Jones Valley Urban Farm and a graduate student at the UAB School of Public Health, has worked with Marty and the task force to find local long-term solutions to this preventable epidemic.
“The childhood obesity task force is a network of local individuals and organizations involved with promoting child nutrition and physical activity. The concept is to build partnerships between children, families, recreation programs, schools, churches, community gardens, healthcare providers, policymakers and corporations to tackle childhood obesity in Birmingham,” said Kerbawy. “Our goals can be achieved by emphasizing prevention and collaborative action, as well as the early recognition and treatment of childhood obesity.”
The task force’s objectives are to:
- connect overweight or at-risk children with the resources and support they need to maintain a healthy and active lifestyle.
- raise public awareness about the adverse long-term health effects of childhood obesity.
- eliminate real or perceived barriers that prevent children and families from eating healthy diets and exercising regularly.
Kerbawy says that the task force is currently working to launch a small-scale pilot project that will help make healthy choices easier choices for families with multiple risk factors for childhood obesity. “We’re looking at several candidate neighborhoods to assess community interest in participating in this endeavor. We know what resources are available in Jefferson County. Now we’re developing the partnerships and a plan to make them more accessible to children and families looking for help to attain a healthier lifestyle and weight.”
The Trust for America’s Health organization has challenged policymakers to act on identifiable common-sense-based policy actions, some of which include:
- Bolstering preventive care: Employers, including the government, and Medicaid should provide routine obesity screening and more benefits for preventative care, obesity-related disease management, and subsidizing and encouraging fitness activities.
- Leveraging change in food options: The federal government should leverage its clout as a major food purchaser to require greater emphasis on nutritional value as a priority in the bidding process for food contracts.
- Smarter community design: Communities and the government must stress smarter community design, including requiring the evaluation of the health impact of new building efforts and encouraging design that promotes and integrates space for physical activity, such as recreational space, sidewalks, public transportation and safe staircases.
- Improving school nutrition and physical education: School districts should take the position that minimum standards are not good enough for America’s students. They should re-evaluate food contracts to focus on maximum nutrition as a priority in the bidding process. Physical education must also be given greater priority in the school’s curriculum.
Kerbawy says that the task force is evaluating such efforts in the Jefferson County area and is working with local public health officials and the statewide Obesity Task Force. “Obesity interventions have been tried in other U.S. cities. We want to take the strategies that worked and adapt them to meet the needs of children and families living in the Magic City,” he said.