Lean, mean learning machines
ALTHOUGH SUMMER was once about endless hours of outdoor activities, today children are just as likely to spend their vacation indoors with video games and television, soda and high-fat snacks. Today's lifestyle is feeding a childhood obesity epidemic that threatens children with shorter lives than their parents.
More than 30 percent of children in Massachusetts are overweight or obese, triple the rate three decades ago. While recent national data indicate that this rate might be holding steady, current levels are unacceptable, dangerous, and costly. Overweight children are at greater risk for hypertension, heart disease, and Type 2 diabetes. Being overweight contributes to lower self-esteem, poor body image, and social isolation.
It's tempting to blame children and their parents for bad choices, then shame the youngsters into eating better and exercising more. This approach is not only unfair, but will not work. Parents need to take more responsibility, but they are up against powerful forces. Junk food is cheap, convenient, subsidized, and everywhere. Huge restaurant portions, massive ice cream cones labeled "small," and vending machines in school cafeterias are just some of the ways we undermine healthy choices for children.
To compound the problem, youths aren't getting enough exercise. Less than 60 percent of children in the Commonwealth participate in physical education at least once a week. Despite evidence that physical activity is linked to improved academic performance and that recess can enhance students' concentration and improve behavior, MCAS test preparation and other academic priorities have supplanted time for recess and gym.
Nonschool time is also sedentary. Boston high school students, for example, spend 3.6 hours on an average school day watching television or playing video games. For many, inadequate parks and unsafe streets make it difficult to walk, bike, or play outside. Studies show that children actually put on more excess weight in the summer than during the school year.
Reversing this trend requires a coordinated community approach, according to a recent report by the Harvard Pilgrim Health Care Foundation. The foundation recently launched "Growing Up Healthy," a program that will invest $1 million in each of the next five years with the goal of preventing childhood obesity in Massachusetts, New Hampshire, and Maine.
Existing programs in Massachusetts underscore the community-level commitment required to reverse obesity trends. For example, the "Jump Up and Go" program from Blue Cross Blue Shield of Massachusetts works with schools, communities, and healthcare providers to teach children about nutrition, activity, and limiting screen time. Linking school-based programs with community efforts and parents can make even greater progress in changing the default conditions that lead to unhealthy eating and inadequate exercise.
A community-based approach has had success in Somerville. "Shape Up Somerville: Eat Smart, Play Hard" combined nutrition and activity to promote healthy choices among elementary school students. Somerville started in the schools with food service and physical education reform. It engaged children, families, educators, and the community. The city added crossing guards, fixed sidewalks, and made it safe to bike and walk to schools. Officials worked with convenience stores and restaurants to promote healthy food options. They improved the parks and playgrounds. The result was healthier children, as measured by a reduction in body mass index.
Success will require the coordination of statewide and community efforts. For starters, state laws need to be changed to get junk food out of the schools and make physical activity a routine part of the school day. Next, there needs to be coordinated efforts to replicate the Somerville experiment. The state can set standards and convene stakeholders. Communities can engage business leaders, parks departments, and schools to meet local needs.
Parents cannot teach healthy lifestyles if they are thwarted by abundant junk food, unsafe neighborhoods, or nonexistent parks. Local and school initiatives bolstered by state leadership and resources can give families the tools they need to eat well and play hard.
Representative Peter J. Koutoujian is chairman of the Joint Committee on Public Health. Philip W. Johnston is chairman of the Massachusetts Health Policy Forum at the Heller School for Social Policy and Management at Brandeis University.
