“All states are losing the fight,” said report co-author Terry Spradlin, director for education policy and the High School Survey of Student Engagement at CEEP. “In fact, there was an initiative in 2000 that called for all states to have an obesity rate of 15 percent or less by 2010. Here we are at a 35 percent rate for the nation today. Roughly a third of our adult population is considered obese; for our childhood population nationwide, that obesity rate is roughly 17 percent.”
Indiana is among the most obese states for the adult population with the 15th highest percentage (up from 16th in 2009, according to the Trust for America’s Health and the Robert Wood Johnson Foundation). Indiana’s percentage of overweight and obese children moved past four states since 2009 to 27th in the nation.
Spradlin noted that federal and state government has put forth efforts in recent years to address the problem of childhood obesity, requiring wellness policies for school districts and changing school lunch and breakfast offerings. The changes have come in response to grim numbers a few years ago, reported in the first CEEP brief on the topic in 2005. Still, the U.S. has become a world leader in obesity, with the sixth most obese population among all countries according to the World Health Organization.
“Despite the heightened attention and awareness of the topic of the epidemic of obesity, we’re seeing very little ground gained in fighting the epidemic,” Spradlin said. “In fact, we’re losing ground.”
The consequences are immense for the nation’s budget, its citizens’ health and school achievement. One estimate put the direct cost for overweight and obese children ages 6 to 19 at $14.1 billion from 2002 to 2005. By 2008, obesity-related health care in the U.S. reached nearly $147 billion, or nearly 10 percent of all medical expenses.
The health risks for children are far reaching and severe. Major diseases associated with obesity include Type 2 diabetes, cardiovascular disease, asthma, joint problems and fatty liver disease, to name a few. Numerous studies reviewed by the Centers for Disease Control and Prevention link increased physical activity to increased academic performance and likewise link decreased physical activity to decreased academic performance.
“We know from statistics that children and teens who are obese are more likely to be overweight or obese as an adult,” Spradlin said. “So we really need to do something very proactive and aggressive when they’re in school as children. That’s the prime opportunity to educate children on healthy habits and wellness behaviors.”
The report outlines federal and state efforts aimed at the issue, such as the “Let’s Move” public awareness campaign launched by first lady Michelle Obama in 2010. The Healthy, Hunger-Free Kids Act of 2010 puts more money into the National School Lunch Program and School Breakfast Program while promoting more fresh produce for school meals. The report notes that one critique of the program is it is funded by money diverted from the food stamp program.
Some states have implemented taxes on sodas to discourage consumption and generate revenue to offset governmental expenses with obesity-related health care. In 2011, 19 states set or raised taxes on sodas; Indiana has the second highest soda tax in the country. While the CEEP report cites research that indicates the tax is too small to affect consumer choices, it also notes that money raised by the taxes could fund measures to combat childhood obesity.
While school districts are federally mandated to have a wellness policy, the report’s analysis of 41 wellness policies from various Indiana school districts found a variety in quality. The brief authors used an evaluation tool from the Robert Wood Johnson Foundation to examine the policies and found that less than a third fully meet federal guidelines. Given the amount of time students spend in school, Spradlin suggests that education leaders of schools have an important role to play in combating the childhood obesity epidemic.
The report concludes with several recommendations for schools and education leaders, parents and policymakers. Schools and education leaders should:
- Strengthen and enforce wellness policies. “The policies actually need to be living policies that are enforced, that the community knows exist and are fully implemented,” Spradlin said.
- Limit vending machines in schools and open their fitness facilities to the general public for use in the evenings and weekends.
- Encourage participation in the School Breakfast Program and ensure sufficient nutritional content in those meals.
- Teach students the value of healthy foods through measures such as school gardens, promotion of farmers markets, or partnering with locally supplied produce providers to ensure fresh fruits and vegetables are readily accessible in schools throughout the day.
- Eliminate wasteful spending in food service and encourage providers to improve offerings.
- Work with the community, business leaders and government officials to increase availability of fresh produce and community gardens in areas with limited consumer options.
- Promote physical activity. “With the push for academic rigor and students meeting standards on state assessment tests, there’s been a de-emphasis on physical activity, physical education and health as well as other specialty areas like music and art,” Spradlin said. “I think there’s not only risk for students healthwise, but also to the creativity of students.”
- Offer health services that may screen for health problems and provide students with health information.
- Encourage healthy eating at home.
- Encourage physical activity. Spradlin said, “According to a CDC statistic, only 18 percent of students in Grades 9 to 12 meet the daily recommended amount of aerobic physical activity of 60 minutes.”
- Encourage walking or biking to school where it can be done safely.
- Ask questions of school leaders about nutritional value in meal offerings.
- Limit money given to children to spend on à la carte offerings and vending machines while in school.
- Limit the amount of time children watch television.
- Make sure children get the full benefit of initiatives included in the Healthy, Hunger-Free Kids Act of 2010 and encourage school, community member and child care agency discussion on implementation of the act.
- Re-evaluate wellness policies for schools written under the 2004 Child Nutrition Reauthorization Act, incorporating physical activity, locally produced food and healthier school meal options.
- Advocate against cutting spending for the food stamp program.
- Increase the proportion of fresh fruits and vegetables the federal government purchases for the school lunch program.
- Develop nutrition guidelines for food processors to align food commodities often used in the school lunch program with the Dietary Guideline for Americans developed by the U.S. Department of Agriculture and the U.S. Department of Health and Human Services.
The report also includes a “Policy Perspective” from U.S. Sen. Richard Lugar. Indiana’s senior senator co-sponsored the Healthy, Hunger-Free Kids Act of 2010. He discusses ways in which federal, state and local authorities can work together to combat childhood obesity.
Along with Spradlin, the report co-authors are Greta Gard, director of project implementation at CEEP; former CEEP undergraduate research assistants Vivian Huang and Beth Kopp; and Alanna Malik, a former CEEP graduate research assistant. A “Fast Facts” summary of the report is available online.
CEEP, Indiana’s leading nonpartisan program evaluation and education policy research center, promotes and supports rigorous evaluation and research primarily for educational, human services and nonprofit organizations. Center projects address state and national education questions. CEEP is part of the IU School of Education.