Community Programs Fill Gaps in Childhood Obesity Policy

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Teens pass out information on childhood obesity and healthy eating outside Lutheran Medical Center (Courtesy Health Plus)

Teens pass out information on childhood obesity and healthy eating outside Lutheran Medical Center (Courtesy Health Plus)

By Faaria Kherani

Over the past year, Mayor Bloomberg has implemented a variety of policies to combat childhood obesity, but New York City doctors, health educators, and the Health Department’s own representatives are now saying the policies alone will not be enough to lower the childhood obesity rate.

“There’s no one answer,” says Health Department representative Cathy Nonas.

Nonas says the city’s policies, which include providing healthier foods in schools, stipulating 120 minutes of exercise per week in school, and providing food stamps for farmer’s markets, cannot inherently change children’s behavior outside of school. Children are strongly influenced by their home and community environments, which are difficult for the city to reach.

Nonas, many pediatricians, and families dealing with childhood obesity say the mayor’s policies need to be supplemented by local initiatives.

And that seems to be happening, at least in an incipient way in Brooklyn and across New York City, where community organizations are filling policy gaps by stepping up to provide individualized health alternatives in low-income, immigrant communities.

According to the Health Department, 40 percent of kindergartners through eighth-graders – over 250,000 kids – in NYC are overweight or obese. Compared to the national child obesity rate of 30 percent, New York City is one of the leaders in the childhood obesity count.

Some new initiatives are easy to spot, like “Let’s Move” in Brooklyn led by Michelle Obama to target childhood obesity. But there are countless initiatives happening every week that have the local resources to target specific neighborhoods and families. These initiatives include Lutheran Family Health Center’s adult and child educational programs in Sunset Park, local distribution of information on healthy eating in different Brooklyn neighborhoods, and events held by a number of community gardens and food co-ops by neighborhood.

One community program was created by Health Plus, a not-for-profit healthcare plan. In 2008 it started a Teen Advisory Board program as a way to change behavior by getting children involved in their own health. These teens believe that it is more effective to listen to each other than to a wide-sweeping government policy. So far the Teen Advisory Board has published pamphlets distributed throughout the community and invited guest speakers for educational meetings.

Health Educator Wendy Dominguez says the kids know how to reach other kids better than policies or teachers, because they know how a child’s mind works. This is one area where policy is currently less effective.

The Board’s participants come largely from the Sunset Park area, a neighborhood with a large Hispanic population.

Studies have shown a distinct correlation among high rates of obesity, race, and income.  Hispanics and African Americans tend to be heavier than Caucasians and Asians.

Mayor Bloomberg has been doing his part by targeting low-income, immigrant neighborhoods through the school system. School vending machines no longer carry sodas and vegetable portions have been increased in lunches.

In November, Journey for Change, an organization that encourages children in the Greater New York area to become active in social change, asked kids to comment on its blog why they think one in three children are overweight or obese in New York City, and what they think of Mayor Bloomberg’s policies.

“Today in the school ‘salad’ they served raw broccoli and tomatoes,” wrote Rochelle. “I notice that many children throw it in the garbage because they did not think it was right to serve raw broccoli and call it salad.” Many kids also asked for a variety of fruit throughout the week instead of the same one day after day. Some policy changes are unattractive to kids, who then throw out their lunch and go to McDonald’s when school is out.

“I think it’s hard to fundamentally change what kids eat in school, because then they go outside and could completely negate that,” says Dr. Mary McCord, Associate Professor of Pediatrics and Public Health at Columbia University. McCord works with children whose eating habits are too deeply ingrained to be completely overhauled in school. “A lot of kids I’ve worked with think that drinking soda is their birthright!”

Health Plus’ Teen Advisory Board encourages teens to talk about health and how to make healthy eating choices seem attractive to kids. Participants use bold fonts, bright colors, and easy to understand language to write articles on a variety of topics including healthy eating and exercise. The articles are personal and funny, written by teens themselves, which is a far cry from the standard, bullet-point Health Department pamphlets previously distributed.

“They thought the old pamphlets were boring,” says Dominguez. “They said, ‘No one’s going to read that!’”

Child participation in healthy living initiatives would also help solve problems like negative peer pressure, says one Chinese resident. When she first moved to the United States, her children hated fast food. But as time went by, her children wanted to fit in with their classmates, and now they eat McDonald’s regularly.

“It’s a social thing for them, to be able to go to McDonald’s with their friends and hang out,” she says.

Dominguez says children need to take part in changing the way kids eat and exercise because ultimately children have the most persuasive power over one another.

“If they invest in it, they’ll tell their friends, ‘Hey, look what I’m doing!’” says Dominguez. Dr. McCord and Nonas say community initiatives have the power to make Bloomberg’s policies work faster.

While Health Plus addresses teen participation in health education, other initiatives are working to supplement lack of exercise time in schools. According to Dr. McCord, the most effective way to combat childhood obesity is to make sure children get the 120 minutes of exercise per week that is mandated by New York State. This is not yet happening in many schools.

On October 28, NETS basketball player Daryl Dawkins greeted approximately 400 students from four schools in the Sunset Park area to talk about fitness and dietary habits at the third annual Shoot for Better Health event. Students were able to learn from someone they looked up to as a role model.

“It is essential that we aggressively prevent childhood obesity now, before these kids grow up with a disadvantage,” said Principal Jack Spatola of P.S. 172 at the first Shoot for Better Health event in 2008. “Many of our students’ parents don’t understand and don’t trust the healthcare system.”

Many low-income families find healthcare and healthy food too expensive to rely on regularly. Kids often show up to school with quarter water – artificially flavored sugar water – and chips for an unhealthy breakfast that costs only two quarters.

Rossman Fruit and Vegetable District on Third Avenue is one of the very few fresh food providers in Sunset Park.  Many shoppers are surprised the store even exists in Sunset Park, and they are worried it won’t last long. Its location across from a liquor story and adult video shop only increases the skepticism.

“I’ve been noticing a steady increase of Park Slope types as of late,” said a regular shopper, “which more than likely means that Rossman’s days as a reasonably-priced, unpretentious produce market are numbered.” He is worried the prices will jump and he will be forced to search for cheaper fresh produce in other areas.

Nonas says the city is trying to increase access to affordable, healthy food by giving out “health bucks,” which are food stamps that can be used at farmer’s markets only. For every $5 of food stamps a family receives, they then get $2 of health bucks. Nonas says the Health Department has given out a quarter of a million dollars in health bucks this year.

But the minute people run out of food stamps, it’s back to cheap meals at McDonald’s. Some families are also trading health bucks for normal food stamps so that they can buy more of their favorite foods. Children may be eating healthy in school, but they go home to an environment that endorses unhealthy behavior.

In an area like Sunset Park where the out-of-school environment promotes unhealthy behavior and Mayor Bloomberg’s policies are not necessarily changing children’s eating and living habits, community groups are necessary to supplement Bloomberg’s policies.

“You really need both,” says Columbia University’s Dr. Dodi Meyer of policy and community initiatives. “I think it’s not either or, it’s all of them working together.”

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