My teaching career began in a suburban high school where the lunchroom was a happy place. Posters advertising fruits, vegetables, and exercise covered the walls, and every day the kids could choose from a hot meal or the salad bar. The line for the salad bar was often longer than the pizza line. Few of the kids were overweight, even fewer were obese.
I spent the next two years teaching at an inner-city high school where, as my friend Sarah put it, "half the girls in my Algebra class are too obese to fit in their desks." The cafeteria served hot meals, but fruits and vegetables were few and far between. Posters advertising cookies and pizza covered the walls. Instead of a salad bar, there was a slushy machine.
Michelle Obama's recent decision to make childhood obesity her personal cause struck me deeply. Childhood obesity isn't just a public health issue, it's a social justice issue. It disproportionately affects the poor and minorities. It's also one of those rare cases where the major domestic challenges of our time -- education, health care, poverty -- intersect, and where small changes can have a big impact.
Consider this: a study published this month in Health Affairs found that children from poor families are twice as likely to be obese as children from well-off families (45% vs. 22%). Minority children are far more likely to be obese than white children (41% of black and Hispanic children vs. 27% of white non-Hispanic children are obese). Regardless of race and class, kids who grow up in neighborhoods with rundown housing are more likely to be obese than those in neighborhoods with less decay (36% vs. 31%).
Poverty and minority status don't just cause childhood obesity, though. The biggest problem with childhood obesity is that it doesn't end when the kids grow up. Obesity can lead to a host of medical conditions throughout the lifespan -- diabetes, hypertension, asthma, gallstones -- and even to poverty itself. That's right: obese children are more likely to become impoverished adults, spawning a vicious cycle in which poverty begets obesity, in turn leading to further poverty.
How do we break this cycle? The first step is to make healthy food more affordable and available. Not only did my inner-city students have limited options at school, many of them came from neighborhoods where there were literally no grocery stores that sold fresh produce. If kids can't get fruits and vegetables at home or at school, they're not likely to find them elsewhere.
Another step is education. Researchers at NIH and the University of Pittsburgh found that parental education has more impact on children's' eating habits than household income. In other words, if you go to college, your children are less likely to be obese regardless of how much money you make.
Targeted nutritional education can also help. School-based programs to combat obesity show promise -- a recent initiative in the Philadelphia public schools reduced the number of overweight students by 50%, but unfortunately had little effect on obesity. We're learning how to mitigate the problem, but we don't yet know how to solve it.
Our First Lady is right to tackle this issue head-on. As our nation works to combat childhood obesity, we must focus especially on low-income and minority communities. We need to ensure that healthy foods are available and affordable, and that all parents understand the consequences of their children's diets. Those of us working for educational justice need to create schools where salad bars, not slushies, are the norm.
Finally, the results from school-based programs show that we need to do more research on what works, especially in communities where many parents haven't completed high school or college. Our children's future depends on it -- so too, by the way, does our national health care bill.
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