Combating the Obesity Epidemic

EmilyBOver the past 30 years, childhood obesity has more than doubled in children and quadrupled in adolescents, according to the Centers for Disease Control. The obesity epidemic has come to the forefront of America’s health agenda in the past years, and even the First Lady has taken on the issue since entering the White House in 2008. Many people are aware of the various approaches that have been made to combat obesity, but with so many resources put in without sufficient returns, we must reconsider the most effective ways to combat this epidemic.

Dr. Ross Brownson and his fellow co-authors have some ideas.

Brownson, a professor at the Brown School and Washington University School of Medicine (WUSM), researched three policy initiatives to combat childhood obesity. In “Reducing Childhood Obesity Through Federal Policy: A Microsimulation Analysis,” Brownson and his co-authors looked at the predicted efficacy of school-based activity programs, an excise tax on sugar-sweetened beverages (SSBs), and a ban on TV advertising fast food directed at children. They concluded that all three policies would have an impact on reducing childhood obesity by 2032, but the excise tax would be the most effective measure. Excise taxes are taxes paid on purchases of a specific good, like gasoline, or on activities, such as on highway usage by trucks. Brownson said the predicted success of the excise tax on SSBs relies on “the power of economics,” referring specifically to price elasticity. In this context, as prices of SSBs change, the demand for these beverages would change as well.

Some states have made an effort to limit access to SSBs. In New York City, for example, former Mayor Michael Bloomberg tried to limit drink size. However, the state court overturned the ban after beverage companies sued. Other cities have tried to impose the excise tax Brownson said would be most successful. Failed attempts to impose excise taxes on SSBs include Washingon, D.C., and California cities El Monte and Richmond. On November 4, two more California cities put the issue on the ballot to try to change America’s drinking habits – Berkeley and San Francisco. The proposal passed in Berkeley, but failed in San Francisco. Berkeley is now the city with the nation’s first soda tax of one penny per ounce. Depending on the success of Berkeley’s tax, it will be interesting to see if other cities begin to enact similar taxes.

So how do we see these policies adopted and implemented in order to effect change in health of America’s youth? Brownson said implementing any of these policies would entail some difficulty. “None of these is simple,” he said. “I suspect that the after-school physical activity may be the easiest to implement from a political point of view.” Although after-school activity may be the best option, political considerations often come before what is best for the public. It is often hard to find a balance between the desired impact of a change and the willingness of politics to allow for the change to be enacted. “The way the federal government often tries to hold state/local governments accountable is with funding strings,” Brownson said. “For example, if a state does not pass the federally recommended limit for blood alcohol (drinking and driving), the feds can withhold highway funds. I think the same could apply for nutrition services in schools.” This means the federal government may not provide a state with the necessary money for state-level nutrition policies if a state does not follow certain federal guidelines for nutrition, like those of the US Food and Drug Administration (FDA).

An important issue within the prevalence of the childhood obesity epidemic is the disparity amongst races. According to Brownson and his co-authors, the prevalence of obesity in 2009-2010 was 21.2 percent among Hispanics, 24.3 percent among non-Hispanic blacks, but only 14.0 percent among non-Hispanic whites, Additionally, the study noted that low-income children have higher rates of obesity.

One place that may present the greatest opportunity to make a significant difference in this epidemic is schools, especially in regard to disparity amongst races. The United States Department of Agriculture’s (USDA) National School Lunch Program looks to address inequality in access to food by providing nutritionally balanced meals to children for free or a small price. This program is voluntary, but St. Louis public schools do follow the program. However, even though school lunches must agree with federal requirements, the decisions about which foods to offer are made by local school authorities. St. Louis County also tries to address the issue of food inequality in relation to obesity through its Summer Food Service Program, so those from the lower-income bracket can still have access to quality food when school is out.

As Brownson’s study has shown, obese adolescents tend to remain obese as adults, making childhood the ideal time to prevent obesity. With this in mind, it is of the utmost importance that steps are taken now through effective federal policy to ensure the obesity epidemic is tackled sooner rather than later.

For more information on other policies that could make a difference in the childhood obesity epidemic please visit the following web pages recommended by Dr. Brownson:
Increasing Physical Activity: Environmental and Policy Approaches
Behavioral and Social Approaches to Increase Physical Activity: Enhanced School-Based Physical Education




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