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Institute on Urban Health Research - Obesity

Article from Boston Herald on Obesity

OP-ED; AS YOU WERE SAYING... Obesity's shadow looms large over poverty-stricken youths:[All Editions]
D. Franko and H. Amaro. Boston Herald. Boston, Mass.: Jan 11, 2004. pg. 020

Full Text (702 words)
Copyright Boston Herald Library Jan 11, 2004

According to a recent study released by the obesity program at Children's Hospital in Boston, nearly one-third of U.S. children ages 4 to 19 eat fast food every day, dramatically increasing their risk of obesity and obesity-related illnesses. Distressing as these statistics are, they don't paint a complete picture of childhood obesity, a problem that is far more likely to affect poor children.

Obesity is a problem for all demographic groups, but the poor and ethnic minorities suffer disproportionately and the rates of obesity in these groups are growing the fastest.

In 2000, there were twice as many obesity-related deaths among Hispanics as among Caucasians and even more for African-Americans, although Hispanics constitute only 14.4 percent, and African- Americans one-quarter, of Boston's population.

What accounts for such pronounced disparities? And what can we do about this epidemic in our urban poor and ethnic populations?

Historically, poor people used to be the leanest, by virtue of malnutrition. The modern rise in obesity in poor and ethnic minority groups is due primarily to changes in the social landscape. Obesity results from an imbalance between caloric intake and energy expenditure, both of which disproportionately affect the urban poor.

Quality fruits, vegetables and whole-grain products are more expensive and less accessible than cheap high-fat foods. Advertising dollars also have an impact. McDonald's alone spent $1.1 billion on advertising in 2001; the government's budget for a pro-fruit and vegetable campaign was $1.1 million. A recent study found that people in the poorest urban areas have 2 1/2 times more exposure to fast-food outlets than people in the wealthiest category.

Poverty also impedes exercise. Fewer health facilities exist in poor neighborhoods, and gyms can be costly. In unsafe neighborhoods, children are more likely to watch television indoors after school than ride a bike or play outdoors. Television-watching is linked to obesity, due to advertising of high-calorie foods, eating while watching TV and increased sedentary time. Poorer schools are more likely to cut physical-education programs, resulting in even fewer hours of activity in a child's day.

Poorer schools are also more likely to make franchise deals with snack-food companies that stock vending machines as part of an effort to supplement their low budgets. By starving school budgets, poorer kids get less physical education, more fatty snacks and end up heavier than their more affluent counterparts.

All told, the urban poor are at considerably greater risk for obesity, due to a confluence of dietary- and activity-related factors that hinge on socioeconomic status.

Despite a health-care system that is more likely to fund treatment than prevention, a few recent efforts at prevention are promising. Dr. Jessica Blom-Hoffman of Bouve College of Health Sciences at Northeastern University demonstrated that involving lunchroom paraprofessionals in education campaigns can increase fruit and vegetable consumption in elementary-age children.

Northeastern's physical therapy department has implemented a multidisciplinary after-school exercise program called FitKids in Roxbury. Dr. Karen Peterson from the Harvard School of Public Health is working with the Women, Infant and Children program to provide nutrition information and obesity-prevention strategies to new mothers. Blue Cross and Blue Shield of Massachusetts has initiated "Jump Up and Go," a campaign to assist communities, schools and health-care practitioners in addressing childhood obesity. Programs like these offer hope, but there is much work to be done.

It's time to tackle the problem of obesity with the same energy directed toward preventing smoking. Already, Surgeon General Dr. Richard H. Carmona has identified obesity as a major target of U.S. health policy. A comprehensive campaign, however, demands commitment from schools, parents, health-care providers, researchers, urban planners and transportation officials, the media, the fast-food industry, health-insurance companies and private foundations. Together, we can curtail obesity, helping millions lead healthier, longer lives.

Debra L. Franko, Ph.D., and Hortensia Amaro, Ph.D., work at the Institute on Urban Health Research, Bouve College of Health Sciences, Northeastern University. As You Were Saying is a regular feature of the Boston Herald. We invite our readers to contribute pieces of no more than 600 words. Mail contributions to the Boston Herald, One Herald Square, Boston, MA 02118, fax them to 617-542- 1315 or e-mail to oped@bostonherald.com. All submissions are subject to editing and become the property of the Boston Herald.

Reproduced with permission of the copyright owner. Further reproduction or distribution is prohibited without permission.
Section: EDITORIAL
ISSN/ISBN: 07385854
Text Word Count 702

Copyright 2004 The Boston Herald


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