Childhood Obesity: A Reversible Epidemic

Wietzman SymposiumJune 10, 2010

Jessica CollinsDirector, Special Initiatives

Why are you here today?

One third of our nation’s children have threatened healthy futures due to obesity.

The rates of childhood obesity have tripled since 1980.

We spend $150 billion every year to treat obesity-related conditions, and that number is growing.

This is the first generation of American children whose life expectancy may be shorter than their parents.

Text adapted from Let’s Move!

Support the movement to transform two systems.

Systems that will enhance the lives of future generations!

Production Processing Packaging

Distribution Retailing

The Food System: Farm to TableThe potato story

Marketing

FARM

TABLE

The Built Environment -Transportation System

What activity happens where

How we move

Access to opportunities and choices (activity, food, and healthcare)

Community character

There is NO Magic Pill•Each community has different strengths and resources

•Social change is slow and very dependent on health/strength of relationships

•Focus on interventions that have:–Designated leadership–Build on existing platforms–Flexibility and Strategic Alignment–Sustainability potential

Two Communities Respond

We Changed the EnvironmentsWe Enhanced the Systems

We Nurtured Local Leadership

We decreased BMI-z score in high risk, vulnerable children ages 6-9 years old in

nine months.

Somerville, MA• ~ 78,000 pop• 4.1 square miles

• 3% open space

• 83% traffic cut- thru

• Heart disease / lung cancer leading cause of death

Social Fabric•Gentrification & increasing immigrant population•Community coalition rich • Few $ resources •65% of students eligible for free/reduced meals•50+ reported languages spoken at home

WHAT: An environmental intervention to prevent childhood obesity

WHO: 1st – 3rd grade children in Somerville, MA and two controls

WHERE: Homes, before, during, and after school programs, and the community

GOALS: 1) Create opportunities for children to expend an additional 125 kcal/day

over baseline to achieve energy balance

2) Create sustainable infrastructure that encourages physical activity and healthy eating

Early MorningEnvironment

During School Environment

Afternoon Environment

At HomeSafe Routes to School Maps

Walking to School (-30 kcals)Healthier Home Breakfast

Fiber, Sugar, FatAppropriate Portion Sizes

Before School ProgramHealthier School Breakfast

Fiber, Sugar, FatAppropriate Portion SizesIncreased Fresh Fruits Breakfast Coordinator

Reinforcing Environments

Home Environment (~15 kcal)Parent Newsletter w/ couponsGrowth Reports Screen TimePromotional Gifts

Community EnvironmentCommunity “Champions”Restaurant ParticipationPediatrician Training & SupportCommunity TV AppearancesEthnic Group OutreachCommunity PA Resource GuideCommunity Events

At homeSafe Routes to School Maps Walking Home (-30 kcals)Healthy Home Snack Fiber, Sugar, Fat

After School ProgramCurriculum:

Cooking LessonsPhysical Activity (-30 kcals)Nutrition EducationProfessional Development

Classroom Micro UnitsPhysical Activity (- 25 kcals) 5 days/wk (10 min)Nutrition & Physical Activity Education 1 day/wk (30 min)

Healthier Fundraising Alternatives

Professional DevelopmentTeachersAdministratorsFood Service StaffPE Teachers

Physical Activity Equipment for Recess Physical Activity (- 25 kcals)

Healthier School LunchFiber, Sugar, Fat

Increased Fresh Fruits & VegetablesAppropriate Portion SizesImproved Presentation and AtmosphereSocial Marketing in CafeteriaAlternative “Healthier” A La Carte ItemsNew Food Service Equipment

Food Service - Menu and a la carte changes

- Professional skills development

- Taste tests

- Social Marketing

HEAT Club: In School Curriculum-All 90 1-3rd grade teachers were trained

-Created opportuniteis for physical activity

-Changed PreK-12 Curricula Standards for the District

HEAT Club: After School Curriculum - Piloted with 6 programs; 14 after school programs by the end - Professional Development- School Gardens- Cooking and Nutrition Education- Physical Activity for life

Wellness Policy: a team effort

Parental acceptance/understanding Economic health of school Leadership of principals

Built Environment

Family Outreach Child’s Health Report Card sent home (4 languages) Newsletters every other month (basic reading) TV Turnoff Week (sensitivity to working parents) School Events (making everyone feel welcome)

Community Leaders are key!

2004 - 2010

Partner with targeted CBOsEthnic CelebrationsFBOsTailor around their issues

Restaurant Campaign

•F/Vs as side dish

•Signage

•Smaller portion size options

•Low-fat dairy

Family Responses to SUS – Spring ‘04

• “I really appreciate the emphasis on nutrition and healthy lifestyles it brings to my, kids, the schools, and the city. It makes it easier as a parent when these values are shared and made public.”

• “I’ve stopped watching TV and limited my home computer use and ate better foods to set a good example. I took my kids walking more and walked with them to school everyday.”

Community Results Engaged 90 teachers in 100% of 1-3 grade classrooms (N=81)

Participated/conducted 100 community events Held 4 parent forums for non-English speakers Trained 50 medical professionals Increased walking to school by 5% Recruited 21 restaurants Reached 811 families through 9 parent newsletters, Reached 353 partners through 6 community newsletters  Reached over 20,000 through a monthly media piece (11 mos) Recruited all 14 after-school programs Developed community-wide policies to promote and sustain change

(Wellness Policy, Pedestrian Safety) Helped bring in an additional $1.5 million

Efforts live on through

PEPEnhance physical activities for

4th - 8th Grades during and afterschool environment

Schools, ICH, Tufts, BG,EPH, YMCA, SPC

HEBDUnion Sq. farmers market

To increase healthy eating opportunitiesfor low income families

FMFM, MAPS, USMS, CHA, CIty

Growing HealthySchool Garden initiative

To increase healthy eating for families inSomerville

GWS, FMFM, ICH, SPS

Fire DepartmentPhysical activity and

nutrition initiative

Tufts, City

Shape Up CoordinatorCitywide health

promotion campaign

City, Tufts

WIC ProgramTo provide nutrition education andawareness to low income families

CHA

Shape of Somerville 5KOne day family fitness fair hospital

initiative

HH, CHA, Tufts, LB, R, City

Healthy Mind Healthy BodyTo educate Portuguese speakingcommunity on physical activity &

nutrition

MAPS

Greenline Community ForumEnsure the extension of Greenline & community path through

Somerville

STEP, SCC, BC, MVT,City, ESNC, WB,LSA, USMS,

FCP, Tufts

ALBDAddresses walking promotion, policyand the extension of the community

path, traffic safety, and land utilization

City, GWS, WB, CHA, MAPS, FCP, BC

Safe StartTraffic safety

City, Tufts, CHA, SPD

SHAPE UP SOMERVILLE TASKFORCESHAPE UP SOMERVILLE TASKFORCE

Vision: A comprehensive, collaborative, functioning coalition . . . to create a healthy sustainable Springfield with regard to physical activity and healthy eating.

•Transform the local food system

•Prioritize Bike and Pedestrian access

•Champion Health Equity Policies

Live Well Springfield Eat Smart. Stay Fit. Stakeholders:TFB; The Food Bank of Western MA

CCMS: Concerned Citizens of Mason Square

DTA: Department of Transitional Assistance

PHC: Partners for a Healthier Community

City: Parks and Recreation; Planning

CoC: Chamber of Commerce

LB: Local Businesses

NC: Neighborhood Councils

MLKJr.: Martin Luther King Community Center

EEC: Early Education and Care Orgs

YMCA

NNCC: New North Citizen’s Council

HS: Head Start

SQ: Square One

ECC: Early Childhood Center

SECEP: Springfield Early Childhood Education Partnership

DEEC: MA Dept of Early Education and Care

SPCA: Springfield Partners for Community Action

GG: Giggle Gardens

NOFA: North East Organic Farm Association

MHC: Mount Holyoke College

NCCJ: National Council Community & Justice

UROC: Undoing Racism Organizing Committ

MSHTF: Mason Square Health Taskforce

NECC: North End Campus Committee

NEON: North End Outreach Network

MIT: MA Institute of Technology

FB: Faith Based Institutes

BHS: Baystate Health Systems

DHHS: Dpt of Health and Human Services

R2TC: Rails to Trails Conservancy

PVPC: Pioneer Valley Planning Commission

CM: Community Member

CC: Catholic Charities

AHA: American Heart Association

Target: Hunger initiative in Mason Square – food stamps; farmers market; intergenerational meals; advocacy

TFB; CCMS; DTA; PHC; City; LB; CoC; NC; MLKCC

Farm to Preschool and Families: cooperative buying local produce

TFB; YMCA, NNCC; HS; ECC; SO; SECEP; DEEC; PHC;

Springfield Food Access initiative providing mini-grant funding and “learning circle” for community based work to enhance food access at neighborhood level

TFB; # of mini-grantees

Gardening the Community youth based initiative cultivating community gardens

NOFA; MHC; GTC

SNAP initiative increasing access to food stamp program

TFB; DTA; PHC; City; CC

Mason Square Food Justice Project building capacity at neighborhood level to “undoing racism” with specific focus on access to food

TFB; SPCA; UROC; PHC; MSHTF; Dunbar; NCCJ; NC; MLKCC; Holy Trinity Church

North End Food Access: Mapping identifying food sources and gaps; community garden

NNCC; MIT; NECC; NEON

LWS is the convening umbrella for all community initiatives specifically working on access to healthy eating and/or physical activity through community based, cross sector collaborations, convened by PHC.

Grow Fit/LAUNCH preschool initiative training in classroom curriculum; food service; physical activity

SO; SPCA; GG; ECC

FIT+ neighborhood level diabetes prevention project in North End, South End, Mason Square for communities of color

PHC; BHS; NC; FB;

Faith Based Health Alliance project organizing congregation based health education programs through training lay health educators

SPCA; AHA; FB; PHC

River Walk Way grassroots body advocating for upgrades and maintenance on the 3 mile riverfront walk/bike trail

CM; City; BHF; PVPC;

McKnight Neighborhood Trail Neighborhood council doing feasibility study of potential ½ mile trail through McKnight neighborhood

NC; City (PD)

Complete Streets planning group for citywide zoning policy to promote mixed transit

CM: City (PD; P&R); R2TC; PHC; PVPC

South End Revitalization Project infrastructure upgrades and economic development

City; NC; CM; LB

Springfield Food Policy Council –special body at the Mayoral level guiding decisions on food policy for the city

Access to foodAccess to p.a.Both

MA in Motion: Wellness Leadership Council assessment of City leadership/environment/policy in healthy eating/physical activity/tobacco/chronic disease

ACHIEVE

YMCA

Farm To Preschool & Families

Existing network of early education and care organizations

Policy umbrella of MA DEEC

Network of providers already convened

Leadership of Food Service Directors

Catalyst for other institutions to support the system

Farm of the Pioneer Valley, Chester, MA

Pilot Results•$12,000 generated for farmer•32% cost savings for produce for EEOCs•Increased student nutrient consumption (fiber and vitamin A)•Number of EEOCs involved doubled -10•Over 80 EEOC staff trained in 3 professional development trainings

Just like they do for seatbelts, smoking and recycling… This Next Generation Will Ask….

Which farmer provided the fresh fruits and vegetables offered to me at preschool or school?

Why was this street built with out a sidewalk? Why can’t I have gym everyday at school it helps me

learn? Why isn’t there a bike rack at my school?

Join the Movement!