Pediatric Healthcare in the South: Decreasing the Childhood Obesity Epidemic in Mississippi

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Despite national campaigns such as the First Lady’s Let’s Move initiative, the epidemic of childhood obesity still remains high, with the state of Mississippi affected the most out of all 50 states.   Stakeholders, such as the American Sugar Alliance, are less than committed to reversing obesity trends. Therefore, more emphasis needs to be placed on the importance of implementing state policies such as the Mississippi Healthy Students Act.

Some of the barriers to reversing childhood obesity have been well documented in the movie “Fed Up” (narrated by Katie Couric), noting that food labels still do not report the percent contribution of sugars to one’s daily recommended intake of sugars.  Major associations including the National Restaurant Association, whose vision includes promoting business of restaurant owners, do not always carry a commitment to halting the trend in childhood obesity either.

obesity-rates

Some evidence of positive movement and other initiatives that could be promoted at the state level are detailed below:

  • The Robert Wood Johnson Foundation (RWJF) awarded the Center for Mississippi Health Policy a $2 million grant to study the impact of the Mississippi Healthy Students Act on childhood obesity.image
  • The National Alliance for Nutrition and Activity promotes healthy eating and physical activity, with a goal of reducing chronic illnesses that may be caused by obesity.
  • The First Lady Michelle Obama’s Let’s Move Campaign emphasizes educating parents about healthy choices, creating healthy food and exercise environments, and improving access to healthy and affordable food.

Changes such as affordable high-quality food stores, recreational parks within walking distances of homes, mandatory physical education curriculum in schools and other strategies to create a healthier environment in Mississippi, will lead to modifications in individual behaviors that will hopefully bring about positive change for these children and give them the opportunity to live a healthy life full of potential.

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5 Responses to “Pediatric Healthcare in the South: Decreasing the Childhood Obesity Epidemic in Mississippi”

  1. drkhaira Says:

    Looking at the statistics on obesity listed above, 7 other states with similar rates are all located in the south as well. Further similarities include a higher than average poverty rate (Mississippi had a 21% poverty rate in 2009), a higher than average ‘convenience store’ number per capita, while a much lower per capita ‘grocery store’ number. Many counties in Mississippi have a ‘food desert’ designation by the USDA. Yet interestingly counties in states with similar poverty rates, and lack of access to grocery stores have lower than average obesity rates (Montana, New Mexico, Texas). Cdkjhsph (author) did mention that lack of exercise, and public facilities (ie: parks) was a major contributor. I agree that the south lacks an acceptable level of infrastructure (ie: sidewalks, public transportation), and the vast majority of the population use their cars as the primary mode of transport. City planners in similar states that have a lower obesity rate have devoted limited resources to have parks, greenbelts, bike paths, sidewalks, and ample public transportation.
    Instead of having increased access to fresh fruits and vegetables thru encouraging commercial grocery stores to invest in food deserts a more sustainable proposition is emulating the work of Mandela Marketplace in West Oakland, California.

    http://www.mandelamarketplace.org/

    Utilizing established convenience stores in rural and urban Mississippi with the grassroots approach espoused by MMP encourages a local farmers to sell produce to local vendors within the community they live. Implementing similar endeavors may result in a higher density contribution of community members.

  2. dancinginwater Says:

    The graphic above is for 2006 adult obesity. That said, a comparison between Colorado and Mississippi as extremes (or looking at extremes in more recent data), as well as the differences between adult and childhood obesity in each place is useful, maybe giving something ideas for positive intervention.

    To decrease obesity, people must understand their choices and increase good decision making at the preventative behavioral health level. Enhancing positive preventative habits is key. Since most food and lifestyle choices are habitual, children often adopt their parents’ habits.

    The components of the Ecological Model provide insight, as the intrapersonal and interpersonal levels are so significant to how we form habits and carry them through our lives. For example, consider how obesity shifts over a child’s life — CDC data on childhood obesity for 2011-2012, said “8.4% of 2- to 5-year-olds were obese compared with 17.7% of 6- to 11-year-olds and 20.5% of 12- to 19-year-olds.” (http://www.cdc.gov/obesity/data/childhood.html)

    The Task Force on Childhood Obesity report (http://www.letsmove.gov/sites/letsmove.gov/files/TaskForce_on_Childhood_Obesity_May2010_FullReport.pdf) recommends starting with prenatal care, encouraging breastfeeding and working in early education and childcare programs. This is a good start. Expanding on that with school programs for healthier food and better physical education can help. Ideally what children see and do in school is congruent with good habits.

    The community level is significant as well, as the context within which individual change occurs. The RWJ Foundation (mentioned above) discusses… “individual and community actions that promote lifelong health for all Americans”, as well as finding successes to use as models for change. The interaction between social change and individual change is useful, since improving the situation on the community level can help with obesity. (See CDC report “Recommended Community Strategies and Measurements to Prevent Obesity in the United States” (see http://www.cdc.gov/mmwr/pdf/rr/rr5807.pdf).

    Regarding the level of public policy and laws, it may be that national campaigns and state politics help… if past limitations are assessed and if they really reach people effectively. The Task Force report (Recommendation 1.10) states: “The Federal government… should provide clear, actionable guidance to states, providers, and families on how to increase physical activity, improve nutrition, and reduce screen time in early child care settings.” To me, this might be going too far. Do I really need the US government advising me how to get my children off the couch and what to feed them?

  3. dancinginwater Says:

    This is worth consideration:
    “Dr. Martin Blaser discusses his hypothesis that the overuse of antibiotics, c-sections, and antiseptics has permanently changed our microbiome and are causing an increase in modern diseases such as obesity, juvenile diabetes, and asthma. – See more at: http://martinblaser.com

  4. ericamckeonhanson Says:

    Childhood obesity is indeed an issue of serious concern. I appreciate the original blog post as well as the thoughtful subsequent comments. The map of adult obesity was powerful in the sense that children develop much of their behavior from the adult influences in their life, however, I also wondered what a similar map would look like of childhood obesity rates per state. I currently live in Montana, as I have nearly my entire life, and I was pleased to see that Montana is one of the “leanest” states. However, I have worked for over a decade on two of our American Indian Reservations where we experience childhood obesity rates that are some of the highest in the nation. In fact, childhood obesity has led to many our children developing type 2 diabetes at a very young age. There are many contributing factors to the development of obesity and type 2 diabetes among our youth most of which are related to the drastic life style shift among our tribal people. We have several photographs of our tribal ancestors from 100 to 150 years ago in the tribal college where I am faculty. I often facilitate a discussion with our students about what our people looked like then compared to now. The difference is quite profound. Our ancestors were very lean, by today’s standards they may have even been considered too skinny. Today a photograph of our tribal members would show the majority to be morbidly obese with many of the diseases that come with obesity such as type 2 diabetes, heart disease and stroke. In part as a result of obesity, the life expectancy of our American Indian populations is much shorter than among other populations, especially in the state of Montana. The main differences in life style between our American Indian ancestors and among our people today are that we were once a very active as a necessity for survival often moving from place to place based upon where the hunting and vegetation were good as sources of food. Today we are restricted to Reservations that are located in very rural and remote areas. The Federal Government provides food commodities to our people in exchange for placing us on reservations years ago, however the commodity foods provided are very high in sugars and fats, much different than our traditional diets. Our Reservations also see incredibly high poverty rates with very few available jobs. In addition, we have very few places to purchase food and those that are available have scarce quantities of healthy foods. The obesity epidemic within Indian Country continues to grow despite many efforts within the community to promote healthier diets and exercise. The generation of our people that learned how to live off of the land and prepare healthy meals from hunting for meat and harvesting naturally occurring vegetables are now considered our elders. Many of our young people are not learning these healthier ways, instead opting for the unhealthy “convenience foods”. This coupled with a dramatically sedentary life style has become a silent killer among our people. As with many communities that experience high rates of childhood and adult obesity, it is going to take a changes in all levels of the ecological model to reverse this epidemic. At the intrapersonal and interpersonal levels we must have community buy-in, the adults must become good role models for our children showing them how to live healthy life styles so that the children can internalize a healthier way of life. The community must come together to find ways to make healthy foods accessible such as community gardens and offering classes to show people how to prepare and preserve these foods. In addition, at the policy level, the tribal governments must incorporate into their by-laws parameters for the sale of these detrimental “convenience foods” and encourage the stores to offer a more healthy selection as a way to combat the “food desert” in which we live. The tribal governments also need to work with the federal government to revise the foods offered through the commodity program to reflect those that are healthier for our people.
    There are many similarities among the American Indian population and those of the south which suffer such high rates of childhood obesity. Poverty knows no state boundaries. Those living within poverty are faced with choosing less expensive, less healthy foods as a means to feed their families and are often confined to “food deserts” due to lack of transportation. This is truly a national epidemic that we must work hard to address. If we continue down the current path, we will set our children up for a lifetime of chronic illness and disease which will put an unbearable stain upon our already stressed healthcare system in the years to come.

  5. patelsuhad80 Says:

    This is a great post on a very important current issue of childhood obesity which can have both short term and long term effect on health like cardiovascular diseases, diabetes, bone and joint problems, increased risk of cancer etc. Eating of less healthy food and physical inactivity are two main reasons for childhood obesity.

    As per CDC, in Maryland 15.7% of children aged 2-5 years were obese in 2010 and 12.2% of adolescents in grades 9 through 12 were obese in 2010. Also 27.1% of adult population aged 18 years and over in Maryland were obese in 2010. http://www.cdc.gov/obesity/stateprograms/fundedstates/maryland.html
    All these facts suggest obesity is also a big issue in Maryland.

    There are lot of national child nutrition Program under the Hunger-Free Kids Act of 2010 which authorizes the funding and sets policies of these programs. These child nutrition programs include: The national school lunch program, the school breakfast program, special supplementation nutrition program for Women, infant and Children (WIC), the summer food service program and the child and adult care food program. The Healthy, Hunger-Free Kids act of 2010 allows USDA (United States Department of Agriculture) to make real reforms to school lunch and breakfast programs by improving the critical nutrition and hunger safety net for millions of children.
    http://www.fns.usda.gov/school-meals/healthy-hunger-free-kids-act

    The USDA has issued a new “Smart Snacks in School” nutrition standards for competitive foods and beverages sold outside federal reimbursable school meal programs during school day like in vending machines etc.
    http://www.fns.usda.gov/school-meals/smart-snacks-school

    I agree that state level policies would also be effective.

    As a part of state of Maryland’s response to obesity it has initiated Plan Maryland and Health Freedom circle of Friends, which are strategies to promote increase physical activity. Also there is Maryland Healthy Stores (MHS) which is a collaboration between the Maryland Department of Health and Mental Hygiene, Johns Hopkins Bloomberg School of Public Health, and County Health Departments across Maryland. Its goal is to increase access to and consumption of healthy food choices, and ultimately reduce the risks associated with obesity in members of the rural Maryland communities.
    http://healthystores.org/projects/maryland-healthy-stores/

    There are other factors which needs to be addressed as well which are educating of Parents on healthy eating habits and consequences of childhood obesity. Parents play an important role model for a childhood eating habits and physical activity.
    http://www.ncbi.nlm.nih.gov/pubmed/9877257

    Availability of food choices at home and within the community also plays an important role in what children eat. Availability of parks and recreational facilities and safety within the community determines the amount of physical activity in children.

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