BRIEFING PAPER: CHILDHOOD OBESITY IN ORANGE COUNTY

Partners for Health Funding Deadline: November 6, 2006

NOTE: This briefing paper, developed for the Foundation's internal use, is being shared to encourage nonprofit hospitals in Orange County and their community partners to apply for Foundation "Partners for Health" funding by November 6, 2000. Inquiries regarding this initiative should be directed to: Susan G. Zepeda, Executive Director, The HealthCare Foundation for Orange County (714) 245-1650 or szepeda@hfoc.org. The Partners for Health Application may be downloaded from the Foundation website at www.hfoc.org.

Background

Obesity is on the rise in the United States and much of the developed world; it is a major risk factor in diseases such as diabetes, respiratory diseases, heart disease and stroke, and reduces the average lifespan. In children, obesity - being in the 95th percentile on pediatric height/weight charts - is also on the rise. Articles such as the recent cover story in Newsweek (7/3/00) readily catalog contributing factors: reduced exercise (increased TV/computer time and the reduction or elimination of school based sports and physical education); changes in diet - more Americans eating out more often, often at fast food outlets with "super-sized" portions; sodas with empty calories replacing milk and other options as the childhood beverage of choice; schools signing franchise agreements with Pepsi, Coca Cola, McDonalds and others.

In Orange County, 14.6% of low income children are obese, compared with 14.1% throughout the State of California and 10.7% nationwide (1998 data from the County Health Care Agency and the Centers for Disease Control).

Opportunities for Change

In Orange County, a collaborative Children and Weight Task Force has been meeting since early 2000. Its four work groups focus on Policy, Treatment, Nutrition and Activity/Exercise. With limited funding from the California Nutrition Network , itself State (Department of Health Services) and federally (US Department of Agriculture) funded, the group has sponsored mini-grants and supported a ?TV Turnoff? campaign with outreach in English, Spanish and Vietnamese, and a Walk to School program in conjunction with Thomas Bros. Map publishers. California Nutrition Network (CNN) provides 50% match to locally raised project funds, as well as offering statewide competitive grants.

A Public Health Institute Study, funded by the California Endowment, "2000 California High School Fast Food Survey" reports that in 71% of school districts surveyed, "a la carte items, including pizza, hamburgers, submarine sandwiches, french fries, chips, cookies, yogurt, bagels, ice cream and sodas account for up to 70 percent of all food sales at the school. Brand name products proliferate: more than half the schools either carry Taco Bell, Subway, Dominos, Pizza Hut or other branded foods." They note that a la carte items do include some healthier items - fruit, yogurt, packaged salads. Further, a small but growing percentage (14% in the study) of the districts control production of traditional fast food items, offering the opportunity to prepare more healthful variants. The study concludes with some recommendations for local change:

Promote the link between a nutritious diet and learning
Investigate the reasons more eligible students do not participate in the National School Lunch Program, and develop strategies to increase participation
Offer students more healthy options that are as convenient, inexpensive and appealing as fast food
Involve students in choosing the healthy foods available in their schools through taste tests, surveys and classroom activities
Hold forums to inform students, parents, decision-makers and the community about the effects of fast food on health
Examine the use of schools as a channel for food and beverage company promotions
Explore new opportunities to generate financial support for schools that are not based on the sale of unhealthy foods

A Statewide "Policy and Community Action Summit"on Healthy School Environment, scheduled in Sacramento September 27 - 28, brings together many constituencies with an agenda that includes the following policy areas:

Advertising, contracting and implementing standards for food and beverage sales on school campuses
Providing school-based nutrition education
Halting the "childhood obesity epidemic"
Meeting the needs of hungry children
Implementing school nutrition and physical activity policies
Linking nutrition and physical activity to academic performance

Presently there are four pediatric weight management programs in the County, recognized by public health nutritionists. Three are run by hospitals: Weigh Cool (Mission Hospital). Weigh In Work Out (UCI Medical Center), and Weight Busters (CHOC) - all are reportedly underutilized; only UCI offers Spanish-language services, none offer service in any Asian languages. A nonprofit program which is not hospital affiliated, KidShape, proposed to offer English and Spanish services in Orange County in multiple sites by September 2000 but has had to scale back its efforts for lack of resources.

Next Steps

The Foundation believes that there are clear opportunities to shape institutional, organizational and governmental policies which directly impact the efforts of families to make healthy nutritional and exercise choices and to reshape community attitudes and responses to children struggling with obesity.

It is recommended that:

The HealthCare Foundation seek out one or more interested hospital partners, to work with local stakeholders interested in addressing childhood obesity
Viable local strategies be identified, and productive partnerships with organizations which impact childhood exercise and nutrition
A portion of the 2000-2001 Foundation "Partners for Health" funding (November 6, 2000 due date) be dedicated to support and assess collaborative community ventures to reduce childhood obesity.