After increasing steadily for decades, the national childhood obesity rate has leveled off, but it is still alarmingly high compared with to a generation ago. The obesity rate among children ages 6 to 11 has more than quadrupled in the last 40 years; for adolescents 12 to 19, it has more than tripled. Among young children 2 to 5, rates more than doubled between the mid-1970s and 2000s before beginning a decline.
Children who are overweight or obese are at greater risk for high blood pressure, type 2 diabetes, and heart disease. The longer children are overweight or obese, the more likely they are to remain so into adulthood. Obesity also carries a hefty price tag: childhood obesity is estimated to cost $14 billion every year, and adult obesity could cost between $147 billion and $210 billion annually. Helping children maintain a healthy weight from an early age is essential to preventing a wide range of health problems and avoiding billions in health care costs.
States and Communities Take Action
Places where childhood obesity rates have been reduced have implemented a wide range of strategies to make healthy foods and beverages available in schools and communities and have integrated physical activity into daily life. Each community has taken a unique approach and no single strategy is directly linked with declining rates, but the collective effect of their far-reaching changes may be helping to support healthier choices and behaviors among kids and families.
New York City requires childcare centers to offer healthier foods, improve nutrition education, increase physical activity, and limit screen time. A Mississippi law sets specific requirements for physical education, health education, and wellness policies in schools, as well as nutrition standards for school meals, snacks, and drinks. Lincoln, Nebraska, started a “Rethink Your Drink” public service campaign and encouraged employers to stock, promote, and competitively price healthy beverage options. Other communities have created incentives to bring supermarkets to underserved areas, expanded use of Supplemental Nutrition Assistance Program benefits at farmers’ markets, healthier options on local restaurant menus, and developed walking and biking trails connecting homes to schools, parks, and businesses.
Collaboration among diverse partners is a common theme for many of the places reporting declining obesity rates. In Cherokee County, South Carolina, the school district, local government agencies, faith-based organizations, hospitals, and other health care providers are working together to host healthy field day events, build school gardens, and offer free courses that teach families how to shop for and prepare affordable, healthy meals. Kaiser Permanente has partnered with the city of Whittier, the Safe Routes to School National Partnership, the National Parent Teacher Association, and many local organizations to offer a variety of community programs that help children throughout Southern California eat healthier and be more active.
Childhood obesity disproportionately affects communities of color, and in communities with high levels of poverty, families often lack access to healthy foods and beverages and safe places to be physically active. There has been limited progress to reduce childhood obesity rates among these populations, but some places have seen modest success.
For example, the widespread progress in reducing obesity among preschool children reported by the Centers for Disease Control and Prevention marks the first time in decades that rates have dropped among young children from low-income families. Between 2008 and 2011, 18 states and one U.S. territory measured declines in obesity rates among children ages 2 to 4 who were enrolled in federal health and nutrition programs, like the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Colorado recently reported a 7.4 percent relative decline in rates of overweight and obesity among preschoolers participating in the state’s WIC program, from 22.9 percent in 2012 to 21.2 percent in 2015.
In 2012, Philadelphia reported significant reductions in obesity rates among youth from low-income families and among African-American males and Hispanic females, making the city the only place to see such progress within ethnic/racial groups traditionally at greatest risk. However, data released in 2015 show the obesity rates among Hispanic females in Philadelphia may be going back up. Additionally, while obesity rates among youth overall in several locations have declined, those declines have been most pronounced among whites and higher-income students, an indicator that disparities are getting worse.
Building a Culture of Health
More efforts are needed to implement broad, far-reaching changes that support healthy eating and regular physical activity, especially among underserved communities and populations. The experiences and lessons learned from places reporting progress can help other communities identify and pursue a mix of policy and environmental approaches that may work best for them. Building an inclusive Culture of Health in this country, in which every person has the equal opportunity to live the healthiest life they can, will require: making health a shared value, fostering cross-sector collaboration, creating healthier communities, and integrating health services and systems.
In order to spread progress to every community, our nation must place a higher priority on increasing investments in policies and programs that give all children the opportunity to grow up at a healthy weight. Some recommendations include:
The federal government, states, and localities should continue to prioritize and fund efforts to increase access to affordable healthy foods and beverages among low-income families.
Every community should build and support sidewalks, bike lanes, parks, playgrounds, and safer road crossings to make it easier and safer for children and adults to be active.
Child care and other early childhood education facilities should provide healthy food and beverages and ample physical activity opportunities for our youngest children.
School districts, with support from local, state, and federal governments, should provide regular physical education and physical activity opportunities to help children and adolescents be active for at least 60 minutes each day.
The U.S. Department of Agriculture should continue to provide training and technical assistance to help school administrators and staff achieve and continue to meet the healthier school meals and snacks standards.
As USDA updates its guidelines for local school wellness policies, it should use the Smart Snack standards—at a minimum—for school marketing to maintain consistency with the school food sales environment, facilitate implementation, and help reduce confusion.
Schools and communities should sign shared-use agreements to provide access to school recreational facilities outside of school hours.
Obesity Among WIC Participants
Obesity rates declined in 31 states and three territories, increased in four states, and remained stable in the rest from 2010 to 2014 among 2- to 4-year-olds enrolled in WIC.