How parents can confront childhood obesity by fostering environmental change in their communities

Excess weight and obesity in childhood and adolescence has become a serious public health concern in the United States. The “obesity epidemic” has particularly exploded in the last 25 years. According to the Centers for Disease Control and Prevention, the prevalence of obesity has more than doubled among children ages two to five (5 percent to 12.4 percent) and ages six to 11 (6.5 percent to 17 percent). In teens ages 12 to 19, prevalence rates have tripled (5 percent to 17.6 percent).

This has significant implications for the life expectancy of obese youth who are likely to experience higher rates of hypertension, elevated cholesterol, and Type 2 diabetes than their parents. This may be the first generation to have a shorter life expectancy than the one immediately before them. There is some encouraging news that growth in childhood obesity prevalence has slowed in recent years, however serious efforts are still required to fully reverse the trend.

So what can be done? It is well established that changes to diet and physical activity are key to combating obesity. However, changes to environmental conditions are rarely discussed. Obesity reflects the complex mix of influences that both genetics and environment have on physical health. It is no accident that there are disproportionately higher rates of obesity among children and families living in underserved communities where environmental resources to support healthy behaviors are scarce.

Environments (particularly in underserved communities) can undermine healthy behaviors in the following ways:

There is a lack of ready access to healthy foods (i.e., fruits, vegetables, whole grains and lean protein). Families in poorer communities often live in “food deserts” where supermarkets and grocery stores are scarce or charge higher prices for healthy foods than processed foods. They must often rely on convenience stores and small neighborhood stores that offer few, if any, healthy food choices. To make matters worse, many underserved communities, particularly in urban areas, have an overabundance of fast food establishments that are often located near schools and playgrounds.
The built environment in poorer communities (with fewer parks, bike lanes, playgrounds, recreational facilities or walkways) restricts opportunities for children and teens to get exercise.
Families living in high crime neighborhoods are understandably reluctant to allow children and teens outside of the home to play or exercise.
Underresourced schools in many communities have eliminated or cut back on physical education, an invaluable way to introduce exercise into children’s lives.

Work with local or city government

Let’s Move — the federal government’s new initiative against childhood obesity — is devoting $400 million in grants to bring grocery stores and farmers’ markets to underserved communities. Parents can encourage their local leaders to apply for these grants.
Parents can also push for the introduction of affordable transportation (e.g., bus or shuttle lines) to supermarkets or grocery stores currently located outside their communities.
Parents can call for local leaders to improve their land use policies by encouraging the construction of parks or playgrounds and restricting further encroachment by fast food establishments into their neighborhoods. Local governments can also promote the use of vacant land for community gardens or farmers’ markets.
Parents can advocate for increased community policing to enhance neighborhood safety for their children.

Work with schools and the local community

Schools are ideal sites for community gardens from which healthy fruits and vegetables can be harvested and sold cheaply to local residents. These gardens can be used to benefit children’s education as they learn about basic biology as well as healthy eating and nutrition.
Parents can push for more after-school programs that incorporate physical activity or nutrition education.
Parents can pressure schools to eliminate the use of vending machines on school grounds.
Parents along with members of the community can volunteer to coach afterschool sports (e.g., Little League, softball, basketball, etc).

What parents can do:

Incorporate healthier foods into the family’s diet (e.g., fruits, vegetables, whole grains, and lean protein) and limit consumption of processed foods (e.g., sugary beverages and meals with high amounts of refined sugar, starch, salt or fat).
Sit down to enjoy nutritious meals with their children. Research has shown that children readily like foods presented in positive contexts.
Monitor and limit children’s media use (i.e., TV, internet and video games) as prolonged television and computer use have been linked to childhood obesity.

American Psychological Association (2004). Report of the APA task force on advertising and children (PDF, 618KB). Washington, D.C.: Author.

American Psychological Association (2009). Resolution on promotion of healthy active lifestyles and prevention of obesity and unhealthy weight control behaviors in children and youth. Washington, DC: Author. Retrieved from http://www.apa.org/about/governance/council/policy/chapter-12b.aspx#active-lifestyle.

Centers for Disease Control and Prevention (2006). NHANES data on the prevalence of overweight among children and adolescents: United States, 2003–2006. Atlanta, GA: CDC National Center for Health Statistics, Health E-Stat.

Institute of Medicine (2009). Local government actions to prevent childhood obesity. Washington, DC: Author. Retrieved from http://iom.edu/Reports/2009/ChildhoodObesityPreventionLocalGovernments.aspx.

Institute of Medicine (2009). The public health effects of food deserts. Workshop summary. Washington, DC: Author. Retrieved from http://www.iom.edu/Reports/2009/FoodDeserts.aspx.

Ogden, C. L., Carroll, M. D., Curtin, L. R., Lamb, M. M., & Flegal, K. M. (2010). Prevalence of high body mass index in US children and adolescents, 2007-2008. JAMA, 303(3), 242-249.

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Confronting childhood obesity