Childhood Obesity Our Shared Problem and Mutual Responsibility
by Chris McKenzie
Ten years ago, the leadership of the League, California State Association of Counties (CSAC) and the California School Boards Association (CSBA) realized that they had a collective responsibility to put their heads together on a regular basis and advocate policy solutions that advance the interests of children. Then-Governor Pete Wilson had just sponsored a number of summits across the state on the condition of children, and it seemed timely to explore what could be done to bring the leading local government groups together to advance such an agenda.
The joint venture that sprang from that effort was the Cities, Counties and Schools (CCS) Partnership (www.ccspartnership.org/who.html), a groundbreaking nonprofit organization dedicated to improving the condition of California’s children, families and communities by encouraging local collaborative efforts among cities, counties, schools, community-based nonprofit organizations, and business and civic leaders.
Over the past 10 years, the CCS Partnership has undertaken a number of projects, most notably advocating for the funding of “joint use” facilities by schools, cities and counties and collaborative programming of services for children and families. Along the way, the leadership of all three sponsoring organizations has come to a better understanding of the challenges of working within the city, county and school district environments.
While these ventures have been important, the just-completed work of the CCS Partnership’s Condition of Children Task Force, chaired by League Past President and Novato Council Member Pat Eklund, may be the most important yet. It deals with the growing epidemic of childhood obesity and what all of us can do about it.
While I recommend reading the task force’s entire report, which was presented to the League board at its February meeting (and can be found online at www.ccspartnership.org under “Action Agenda”), my column this month is devoted to some of its most disturbing findings and most promising recommendations. I deeply appreciate the excellent work of the task force and am very proud to share some of their work with you.
A Growing Epidemic
When he was in California a few years ago to talk to the CSBA, U.S. Surgeon General Richard Carmona described obesity as “... the fastest growing, most threatening disease in America today.” In California, public health data show nearly 30 percent of children and teens are overweight or obese. These numbers have more than doubled in the last 10 years. In 2004, seven of the 10 largest cities in California had childhood overweight rates ranging from 36.3 percent in Los Angeles to 24.4 percent in San Francisco (see The Growing Epidemic: Childhood Overweight Rates on the Rise in California Assembly Districts, California Center for Public Health Advocacy, August 2005).
By most public health measures, this is an epidemic, but somehow we don’t think of it that way until we talk about the economic costs of neglecting this public health crisis. According to the UCLA Center for Health Policy Research, California spent $7.7 billion in 2003 on direct health care costs attributed to obesity alone. For the first time in U.S. history, children no longer have a life expectancy greater than their parents’. Collectively, today’s children will have less productive school and work lives, higher medical expenses and a decreased quality of life.
The Anti-Obesity Formula: Physical Activity and Nutrition
Like many people of my generation, I walked to and from school, even walking home for lunch and returning to school for the afternoon session. Children who walk to school are now an endangered species. Parents either shoulder the responsibility of driving their increasingly obese children to school (sometimes only blocks away) because of safety concerns, or car pools or buses are used. In most cases, however, kids simply do not get themselves to school; they have become used to being chauffeured.
While the growing trend of children being driven to school may be traced to a certain level of hysteria fueled by a 24-hour-a-day news cycle that celebrates local crime on a national level, it’s clear that communities need to ensure that children have safe routes to walk, skate or bicycle to and from schools. No one can feel good about children trudging to school along streets and roads that don’t have sidewalks and through intersections that are not staffed with crossing guards. In fact, even when crossing guards are in use, motorists often show a high level of disregard for the safety of the guards and children. We have to find ways to staff these functions and crack down on motorists who blatantly ignore the safety of pedestrians.
Children also need safe places to be active before, during and after school hours such as parks, ball fields, pools, gyms and recreation centers. These facilities need to be in locations that are accessible, well-maintained and staffed with supervising personnel in many cases. Not all activity areas need adult supervision. In fact, some of the most physically vigorous activities of children can occur on foot or bicycle when the aim is to avoid adult supervision. I have personal experience that can attest to that claim, and I imagine most people do as well.
Access to healthy foods is also critical. Young people need nutritious foods in reasonable portions at home, at school and in their neighborhoods. Children and families rely on what is available in their community. In some areas, the only sources are fast food outlets, convenience and liquor stores.
The California Center for Public Health Advocacy (CCPHA) recently released another alarming report entitled Searching for Healthy Food: The Food Landscape in California Cities and Counties. It documents that in 2005 the state had more than four times as many fast food restaurants and convenience stores as supermarkets and produce vendors. Two counties and two cities had nearly six times as many. Given the increasing evidence that the foods available in neighborhoods influence what we eat and the likelihood of being obese, CCPHA calls on policy-makers to take steps to ensure that every California community has a healthy food environment (see www.publichealthadvocacy.org/searchingforhealthyfood.html).
While the issue of providing healthy foods and adequate physical activity for children is challenging and directly linked to land use patterns and decisions, it is not insoluble. Decisions made about where to locate schools, parks, convenience stores and fast food restaurants — and the design of new (particularly infill) housing — all have an impact on the overall health of children. Many neighborhoods lack access to fresh food, open space, sidewalks and parks. Parents, concerned about their children’s safety, keep them indoors where they engage in sedentary activities. Surfing the web and watching television exposes them to the $15 billion junk food advertising industry, and playing video games further exacerbates an unhealthy lifestyle.
Call to Action
The CCS Partnership report clearly calls on public policy-makers to acknowledge and embrace the important role they have as leaders and conveners in efforts to promote active healthy living. Community wellness and childhood obesity are communal responsibilities. It will take everyone — government, educators, the business community and residents — working together to make a difference.
The CCS Partnership calls on cities, counties and schools to work together to address this critical issue. It recommends using a coalition to develop a local plan of policies and programs that will support healthy, active living, especially for children. In cases where there is an existing collaborative or coalition (such as a children’s planning council or an ongoing wellness task force), this body should be encouraged to take on the task of developing a plan of action. Where there is no local collaborative or commission dedicated to children and their health, local regions are encouraged to develop one.
It’s Our Joint Responsibility
City officials know that no serious public problem that cuts across local governments was ever solved by looking the other way. The same can be said of the childhood obesity epidemic. It will take extensive collaboration to make progress on this issue, but the city, county and school officials of California are up to the challenge. The CCS Partnership’s Action Guide on this issue provides many practical ideas for reaching across the jurisdictional divide to get this job done. I strongly recommend it to city officials. It can be found on the CCS Partnership website (at www.ccspartnership.org under “Action Agenda”).