Healthy children, healthy communities: schools, parks, recreation, and sustainable regional planning.

• Author: Garcia, Robert

INTRODUCTION

If current trends in obesity, inactivity, and disease continue, today's youth will be the first generation in this nation's history to face a shorter life expectancy than their parents. (1) Physical inactivity and poor nutrition habits are second only to tobacco use as a leading cause of preventable deaths each year and are responsible for an estimated 400,000 deaths annually. (2) Adult onset diabetes now increasingly strikes children at younger and younger ages. As a result, children are more likely to suffer long range effects including death, loss of limbs, and blindness. This health crisis currently costs the U.S. over $100 billion each year.

All communities suffer from obesity and inactivity, but communities of color and low income communities suffer first and worst. Communities of color and low-income communities are disproportionately denied the benefits of safe open spaces for physical activity in parks and schools, and disproportionately suffer from obesity related diseases. Urban areas like Los Angeles, for example, systemically fail to provide adequate open space for recreation in parks and schools, particularly in the inner city. (3)

The obesity and inactivity crisis is not just the result of individual eating or exercise habits. Advocates from different disciplines must shift from a primary focus on personal responsibility and individual choice to acknowledge the role of the environment and public policy in shaping lifestyles and activity patterns. (4) Children, adolescents, and adults cannot become more physically active and fit if they do not have accessible, safe, and affordable opportunities to be active. (5)

"[S]chools offer an almost population wide setting for promoting physical activities to young people, primarily through classroom curricula for physical education and health education." (6) Progressive park and recreation officials recognize the potential for promoting human health and wellness through physical activity as part of their mission. (7) Yet physical education is being squeezed out of the school day, and park and recreation budgets are among the first cut during fiscal crises.

Every public official from the President of the United States and down must address the relationship between physical activity, obesity, and disease. President John F. Kennedy launched the "(50) Mile Hike" Campaign, which many people still recall as a hallmark of his administration. (8) The nation's President, each of our governors, mayors, school board members, school superintendents, park and recreation professionals, law enforcement leaders, elected officials, and urban planners should focus on improving human health through active recreation and open space.

The Center for Law in the Public Interest (the "Center") advocates for a comprehensive approach to improve human health and community that includes: (9) 1) open space for recreation in parks, school yards, beaches, and wilderness areas including national forests and parks while ensuring the fair treatment of people of all races, cultures, and incomes; 2) the design and joint use of parks and schools to make optimal use of land and public resources; 3) physical education for every student every day in every school; 4) educational programs in schools and parks to instill the lifelong values of physical fitness and healthy nutrition; 5) public education campaigns to articulate the need for active recreation spaces in schools, parks, beaches, and wilderness areas as a matter of human health, educational reform, and sustainable regional planning; 6) healthier alternatives to junk foods in vending machines and cafeterias in schools and parks, as well as easy access to drinking water; 7) diversifying access to and support for wilderness areas including national forests and parks; and 8) federal funding and programs for active recreation in parks, schools, and wilderness areas. (10)

We are fighting for our children's lives. We are fighting for the quality of life for our children and their families and friends.

1. PUBLIC HEALTH CRISIS OF INACTIVITY AND OBESITY

   1. Obesity and Unfit Epidemic

      Overweight and obesity rates for all Americans have reached epidemic proportions. (11) Obesity in the U.S. has been increasing steadily over the last two decades--and severe obesity is increasing the fastest. (12) Between 1991 and 2001, obesity rates increased 75% among adults. (13) Thirty-four percent of American adults are overweight and 27% (forty-five million Americans) are obese. (14) Approximately eight million children are overweight, with obesity rates now double in children and triple in adolescents from just two decades ago. (15) Children today are over three times as likely to be overweight as were children in 1970. (16) Thirteen percent of children (ages 6-11) and 14% of adolescents (ages 12-19) are overweight. (17)

   2. Health Impact of Overweight and Obesity

      Poor diet and inactivity contribute significantly to four out of the six leading causes of death,is Overweight also shortens life expectancy by three years for an average forty-year-old adult and obesity shortens life expectancy by an average of seven years for women and six years for men. (19) If obesity trends continue through 2020 without other changes in behavior or medical technology, the proportion of individuals reporting fair or poor health would increase by about 12% for men and 14% for women over 2000 rates. (20)

      Diseases related to poor diet and inactivity include: obesity, high blood pressure, diabetes, coronary heart disease, osteoporosis, cancer, and stroke. (21) Overweight children face a greater risk of developing lung disease, diabetes, asthma, and cancer. (22) Diabetes rates have risen along with obesity rates, rising 61% during the last decade. (23) Diabetes, hypertension, and other obesity-related chronic diseases that are prevalent among obese adults have now become more common in children and adolescents who are overweight. (24) Formerly known as "adult-onset diabetes" because it only occurred in middle-age adults, Type 2 diabetes has been renamed to account for the millions of overweight and inactive children now also suffering from it. (25)

      Overweight and obese children face a lifelong health battle. Studies show that 80% of overweight children become obese adults, so that not only are overweight children becoming afflicted with obesity-related diseases they rarely faced a few decades ago, they continue to face obesity-related diseases as adults. (26) Additionally, overweight children and adolescents face a number of negative psychosocial factors, including lack of friends and support networks, feelings of depression and inadequacy, an overall poor sense of well-being, and a lack of resources to help with a weight problem. (27)

   3. Importance of Physical Activity and Active Recreation

      Along with good nutrition, physical activity is critical to combating the rising prevalence of obesity. The Surgeon General promotes physical activity as a way to prevent disease and premature death and urges the country to "accord it the same level of attention that we give other important public health practices that affect the entire nation." (28)

      Regular physical activity is associated with enhanced health and reduced risk for all-cause mortality, heart disease, diabetes, hypertension, and cancer. (29) Physical activity for children and adolescents helps to build and maintain healthy bones, muscles, and joints; prevent or delay the development of high blood pressure; and reduce feelings of depression and anxiety. (30) People who are inactive are twice as likely to experience symptoms of depression as are more active people. (31) Depression can lead to suicide, the ninth-leading cause of death in America. Physical activity relieves symptoms of depression and anxiety and improves mood by providing opportunities for social interaction, increased feelings of self-mastery and self-efficacy, and relief from daily stress.

      Physically fit students perform better academically. (32) Athletics build character, pride, self esteem, teamwork, leadership, concentration, dedication, fair play, mutual respect, social skills, and healthier bodies for children. (33) Athletics helps to keep children in school; helps develop academic skills to do better in school and in life; and increase access to higher education. (34) Male athletes are four times more likely to be admitted to Ivy League colleges than are other males: for female recruits, the advantage is even greater. (35)

      Recreation programs provide alternatives to gangs, drugs, violence, crime, and teen sex. A national survey of more than 14,000 teenagers found that those who took part in team sports were less likely to have unhealthy eating habits, smoke, have premarital sex, use drugs, or carry weapons. (36) The Los Angeles County District Attorney concluded that among the reasons young people join gangs is "[the exclusion] by distance and discrimination from adult-supervised park programs." (37) The study recommends that "alternative activities like recreation" should be part of every gang prevention strategy. (38)

   4. Inactivity

      Despite the benefits of physical activity, only 25% of adults in the United States report engaging in recommended physical activity levels, 29% report no leisure-time regular physical activity, and only 27% of students in grades 9-12 engage in moderate-intensity physical activity. (39) Only 50% of young people ages 12-21 years regularly participate in vigorous physical activity, while 25 % report no vigorous physical activity at all. (40)

      In California, 27% of children are overweight and 40% are unfit. (41) Only 24% of the state's fifth- seventh- and ninth-graders met minimal physical fitness standards last year. (42) The numbers are even lower within the Los Angeles Unified School District, where just 17% of fifth-graders, 16% of seventh-graders, and less than 11% of ninth-graders met all six of the minimum...