Mary Regan has witnessed a transformation outside the front door of her Union Square office in Somerville — new “corrals” provide more parking spaces for bicyclists, angled parking has replaced parallel parking for cars to keep doors from flying open into bicycle lanes, and those lanes have been freshly painted.
At the nearby farmers’ market, $1 in food stamps is worth $2 in produce to help low-income customers afford fresh fruits and vegetables.
“I’ve heard people here say that farmers’ markets used to seem like an elite, foreign thing,” said Regan, a community organizer at a nonprofit organization for affordable housing. “But now that they can use their [food stamps] and get twice as much for the same amount of money, they are buying more healthy foods.”
A decade after an ambitious experiment dubbed Shape Up Somerville was launched to lower obesity rates in elementary school children, the campaign has been expanded and woven into the fabric of everyday life in this diverse city of 78,000, where 52 languages are spoken in the public schools and almost two-thirds of students come from families so poor that they receive free or reduced-price school lunches.
City decisions about roads, bridges, other transportation projects, real estate development, and parks include an analysis of how the plans might affect residents’ physical activity or ability to shop for healthy food. Two city employees ensure healthy goals are considered at every step, particularly by collaborating with community groups.
Restaurants that meet specific nutrition standards win a Shape Up Somerville sign for their door and campaign logo to display on the menu items that pass muster. So far 40 of the city’s 200 eateries have notched that distinction.
At Mr. Crepe in Davis Square, a Shape Up Somerville menu is displayed prominently behind the counter, featuring crepes with vegetables and lean meats. Absent are those filled with chocolate and Nutella. “I wish they had this everywhere,” said Angela Borges, 28, of Watertown, who stopped in one day last week while getting her bike repaired. “Someone already did the work for you to say which were the healthiest items.”
But measuring whether the trail-blazing initiative has, in fact, lowered the city’s obesity rates and improved health is a much trickier proposition, in Somerville, as well as in the dozens of communities nationwide that are receiving federal and private grants to try to replicate Somerville’s early success.
Tufts University researchers, collaborating with Somerville in 2002 for a three-year study, found that boosting whole grains, fruits, and vegetables in school, adding physical activities during and after school, running family nutrition forums and sponsoring many community-wide fitness events helped 8-year-old children gain, on average, one pound less during the school year than children from two similar communities who did not participate in the program.
The results were considered significant because nearly half of Somerville's youngsters in first through third grade at that time were overweight or at risk of being overweight, so even the modest weight loss translated into large numbers of children moving out of that category.
But the researchers have not published any other results, so it’s hard to know how lasting the intervention was.
Their study was funded, in part, by the federal Centers for Disease Control and Prevention, which has since handed out roughly $600 million in grants to dozens of states and communities nationwide for similar community-level programs to combat obesity and related chronic ailments such as heart disease and diabetes.
Rebecca Bunnell, acting director of the agency’s Division of Community Health, said it is just starting a five-year project to more closely evaluate the effectiveness of some of the local programs.
“We know at the individual level, people who use public transportation or bicycle will lower their weight and that is something we have proven in several studies across the country,” Bunnell said.
But measuring the effectiveness of these types of programs, which worked for much smaller groups of individuals, is much more challenging when attempted across an entire community involving thousands of people, Bunnell said. It is difficult on this scale to have a control group, which is considered a gold standard for scientific studies. Giving one community resources for programs, and withholding funds from another similarly-matched one over a period of years specifically to compare the outcomes, could raise ethical questions, she said.Continued...