CHILDHOOD OBESITY: IMPROVING THE SCHOOL HEALTH INDEX IN URBAN SCHOOL DISTRICTS LeShonda WallaceEaste

1
CHILDHOOD OBESITY IMPROVING THE SCHOOL HEALTH
INDEX IN URBAN SCHOOL DISTRICTSLeShonda
Wallace-Easterling, RN, APN-BC

• BURSTING OUT OF OUR SEAMS CONFRONTING THE
  CHALLENGE OF
• OBESITY IN OUR COMMUNITIES
• University of Medicine and Dentistry of New
  Jersey
• Sponsor, Congressional Black Caucus Health
  Braintrust
• Host, Congressman Donald Payne and the
• UMDNJ-Institute for the Elimination of Health
  Disparities
• May 31, 2007

2

• Childhood obesity has more than doubled for ages
  2-5 12-19
• Childhood obesity has tripled for ages 6-11
• Consequently, this increase resulted in the rise
  of obesity related chronic diseases (Type II
  diabetes, hypertension, psychosocial, orthopedic,
  respiratory, hyperlipidemia, steatohepatitis,
  sleep apnea, gallstones menstrual
  irregularities)
• Prevalence is rampant among African Americans and
  Hispanics, and those of low-socioeconomic status

3
Contributing Factors

• Poor nutritional intake and behaviors
• Media, culture, society, and inheritance
• Minimal physical activity (lt30 minutes daily for
  50 of children)
• Working parents
• 10 hours/day for Caucasians homes
• 12 hours/day for African Americans
• Increased television time (average of 4 hours
  daily)
• Increased food portions (195-700)
• Out of home eating (school, community programs,
  fast food)
• Gym and recess times replaced with efforts to
  increase academic standards and test outcomes (an
  attempt to decrease the educational disparity)
• 1991, 57 of adolescents were active physical
  education participants
• 1999, 35 of adolescents were active physical
  education participants
• 3 yearly decline for males, 7 yearly decline
  for females
• Food used as incentives

4
Improving the School Health Index At a Newark
Public School

• Addressed 2 focus areas of
• Healthy People 2010
• Nutrition and Overweight
• Physical Activity and Fitness

5
School Health Index A Self Assessment and
Planning GuideDeveloped by the Centers of
Disease ControlSchools with CDC implemented
programs demonstrate less obesity and overweight

• Organization of a planning team
• Self Assessment
• Identification of strengths and weaknesses in
  the schools nutrition and fitness program (part
  of the schools improvement plan imposed by the
  state)
• Planning to enhance the strengths and improve the
  weaknesses

6

• SHORT TERM GOALS
• Decrease the presence of high fat and high
  cholesterol contents for meals and snacks served
• Decrease use of high fat and high cholesterol
  food as rewards
• Use physical activities such as roller skating as
  an incentive
• Strictly enforce prohibiting junk foods bought
  into the school
• Make health (nutrition/exercise) a mandatory
  topic of the elementary curriculum
• Educate the school's community (students, staff
  and parents) about good nutrition, exercise and
  their benefits and consequential effects
• Parent workshops
• Staff meetings
• Visual Aids
• Readily accessible literature
• Journals

7
(No Transcript)
8
LONG TERM GOAL

• Decrease the BMI of 5th and 6th graders with
  BMIs gt30 (14 of total participants)
• PCP referrals
• Individual counseling
• Nutrition/exercise education
• Reassess within 1.5-2 years

9
Limitations

• No Child Left Behind limited flexibility/creativi
  ty of academic learning time
• Food marketing
• Lack of parental support
• Funds
• Staff participation
• Urban low socioeconomic environment
• Broad spectrum scorecard
• Self assessment bias

10
What are the major challenges associated with
curtailing childhood obesity in our communities,
especially among inner city children from racial
and ethnic neighborhoods?

• Low-socioeconomic status
• Culture
• Gender
• Academic competitiveness
• Myths and Perceptions

11
What strategies have been successful in reducing
childhood obesity and why?

• Primary Care Providers diagnosis of obese clients
• Once diagnosed, PCP are more likely to conduct
  diagnostics, referrals and implement treatment
  guideline
• School based interventions
• Start with elementary primary grades
• Implementation of programs with expectations of
  healthy behaviors across of lifespan (Give a man
  a fish and you feed him for a day. Teach a man to
  fish and you feed him for a lifetime.)
• Reinstate home-economics
• Decreasing sedentary lifestyles and increasing
  activity
• Family interventions

12
Recommendations

• Serve culturally familiar healthy foods (i.e. yam
  sticks)
• Offer training to unions and food service workers
  for staff development and career ladders
• Mandatory district approach
• Entice policy makers and administrators
  cooperation to include nutrition and health
  education into the curriculum with evidence based
  programs such as Action for Healthy Kids
• Leave No Parent Behind
• Interventions must target entire student
  population
• Keep schools open longer with quality,
  supervised, after school physical activities that
  are inclusive, fun for all ages, influenced by
  culture and modified for all sexes and skill
  levels
• Advocate for community involvement in the
  co-morbidity campaigns (i.e. American Heart
  Association, American Diabetic Association)
• PCP involvement in public advocacy and policies
  within the communities they practice
• Neighborhood design