Childhood Obesity Prevention: Successful Community-Based Efforts

• Author: Shannon Lee Denney,Laure DeMattia
• DOI: 10.1177/0002716207309940
• Published date: 01 January 2008
• Date: 01 January 2008
• Subject Matter: Articles

ANNALS, AAPSS, 615, January 2008 83

One out of every three children is overweight. Obesity

is linked to increased risks of diseases such as type 2

diabetes, liver disease, hypertension, and heart disease.

As the numbers of children with chronic disease goes

up, so will the strain on the U.S. health care system,

including the cost of health care. The Ecological Model

of Childhood Overweight allows one to consider how

an individual child’s weight is influenced by character-

istics ranging from the individual to the society. This

article focuses on community characteristics that inter-

act with children’s weight status. It reviews community-

based programs and whether they are successfully

slowing the rate of childhood obesity, including demon-

strations of recipe preparation, community gardens,

and school-based curricula. It concludes with sugges-

tions for intervention efforts and funding priorities

focusing on high-risk populations of low-income over-

weight women of childbearing years. Interventions that

occur during preconception may be true primary pre-

vention of childhood obesity.

Keywords: community; childhood obesity; interventions

Childhood obesity continues to be a major

and increasing public health problem. The

rates of childhood obesity have tripled since the

1960s, with more than 33.3 percent of children

now at risk for obesity, defined as having a body

mass index (BMI) between the 85th and 95th

percentiles.1According to Ogden et al. (2006)

Childhood

Obesity

Prevention:

Successful

Community-

Based Efforts

By

LAURE DEMATTIA

and

SHANNON LEE DENNEY

Laure DeMattia is a community family physician.

She recently completed a Primary Care Research

Fellowship at the Medical College of Wisconsin, where

she serves as assistant clinical professor for Family and

Community Medicine. She has authored several peer-

reviewed articles on prevention and treatment of child-

hood obesity. She also has been a clinician for

Children’s Hospital of Wisconsin’s NEW Kids program

and serves on the Milwaukee County Nutrition and

Physical Activity Coalition.

Shannon Lee Denney is an adjunct instructor at the

University of Wisconsin–Milwaukee. She received her

Juris doctorate from the University of Oklahoma and

her master’s in communication from the University of

Wisconsin–Milwaukee. She has focused the majority of

her research on ethics and communication.

DOI: 10.1177/0002716207309940

84 THE ANNALS OF THE AMERICAN ACADEMY

17 percent of today’s children already have BMIs higher than the 95th percentile.

The resulting excess weight puts children at risk for complicating diseases such

as type 2 diabetes (Fagot-Campagna 2000), hyperinsulinemia (Klein et al. 2004),

hypertension (Gidding et al. 1995), dyslipidemia (Gidding et al. 1995), joint

abnormalities (Taylor et al. 2006), polycystic ovarian syndrome (Gulekli et al. 1993),

nonalcoholic fatty liver disease (Clark, Brancati, and Diehl 2002), and sleep dis-

turbances (Mallory, Fiser, and Jackson 1989). These complications or comorbidi-

ties are likely to persist into adulthood (American Academy of Pediatrics 2003).

If a child is obese at the age of four, he or she will have a 20 percent likeli-

hood of being overweight as an adult. By adolescence, the likelihood of remain-

ing overweight as an adult reaches 80 percent (Guo and Chumlea 1999). Annual

hospital costs related to childhood obesity totaled $127 million from 1997 to

1999 (in 2001 constant U.S. dollars), up from $35 million from 1979 to 1981

(Wang and Dietz 2002). As these overweight and obese children age, their

health will continue to deteriorate and will further burden our health care sys-

tem. Their ability to care for themselves and live independently will decrease,

their chronic medical conditions will increase, and they will incur greater health

care costs compared to their normal weight peers (Sturm, Ringel, and

Andreyeva 2004).

These data should be disconcerting

enough to spur a national movement

to reverse the trend of the “obesity epidemic.”

While it may seem inequitable for the nation

to incur the cost of prevention for what is

largely considered an individual’s problem, the

taxpayers’ current cost is astonishing.

These data should be disconcerting enough to spur a national movement to

reverse the trend of the “obesity epidemic.” While it may seem inequitable for

the nation to incur the cost of prevention for what is largely considered an indi-

vidual’s problem, the taxpayers’ current cost is astonishing. According to the U.S.

Department of Health and Human Services (2001), the total costs of obesity in

2000 were $117 billion. Using current 2007 U.S. population data, this is an addi-

tional $387 per person per year (U.S. Census Bureau 2007). Unless Americans

can reverse this epidemic, this figure will continue to increase.