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Robert Wood Johnson Foundation Takes Aim at Childhood Obesity

By Tom Watson on April 11, 2007No Comment

child obesity_smallRobert Wood Johnson Foundation Takes Aim at Childhood Obesity
By: Elliot Kipnis, 4/11/07

As a young doctor working at Temple University’s School of Medicine, Dr. Risa Lavizzo-Mourey, President and Chief Executive Officer of the Robert Wood Johnson Foundation, first noticed the lack of fresh produce available in poor neighborhoods. Temple University is located in Lower North Philadelphia, a neighborhood of 20,000 primarily low-income African-Americans and Hispanics.  In the Foundation’s 2006 President’s Message, she wrote “Walking home after teaching with my preschooler in tow, we quickly realized we couldn’t find a grocery or supermarket with fresh fruit, produce and other healthy foods we were accustomed to eating.” Combined with a lack of safe playgrounds and cutbacks in school physical education programs, the absence of healthy food alternatives is one of the factors leading to an alarming increase in childhood obesity rates, not just in Philadelphia, but across the country.

These rates have soared among all age groups of children, more than quadrupling among those between the ages of 6 to 11 in the past 40 years.  Today, more than 33% of children in the United States—approximately 25 million kids—are reported to be overweight or obese. The crisis is particularly acute in minority and low-income populations, which have significantly higher rates of obesity.  To combat this epidemic, the Robert Wood Johnson Foundation recently announced the largest single commitment in the Foundation’s history, a $500 million program over the next five years, with a goal of reversing this disturbing trend by 2015.

“This is an all-American crisis,” says Dr. Risa Lavizzo-Mourey, “It affects all Americans, and it will require all of America working together to turn it around. Our commitment is a call to action for families, schools, government, industry, health care and philanthropy. To reverse the obesity epidemic and create a culture of health, we must provide families with better access to healthy choices.”

The Robert Wood Johnson Foundation has been working over the past several years to support programs that offer potential for wide-scale change in communities and schools. These include efforts to bring supermarkets back to underserved communities and programs to improve nutrition, physical activity, and staff wellness in schools nationwide.

The Foundation partnered with the Food Trust, a non-profit in Philadelphia, whose mission is to ensure that everyone has access to affordable, nutritious food. The Food Trust’s research on childhood obesity led the Philadelphia school system to ban soda vending machines from all of its schools, the strongest measure in the country. Another study conducted by the Food Trust identified a pattern of increased death from diet-related illnesses in low-income neighborhoods. According to the Trust’s report, Food Geography: How Food Access Affects Diet and Health, (available at http://www.thefoodtrust.org/) “There is a strong association between poverty, poor health, and lack of access to fresh food through supermarkets.” Translating its research into action, the Trust has initiated the “Fresh-Food Financing Initiative,” a public-private partnership to increase the number of supermarkets in underserved communities throughout Pennsylvania.

While the programs in Philadelphia offer successful lessons in what can be done on a micro-level to combat the obesity problem, the Foundation is also drawing upon its experience combating smoking to help develop programs that address the issue on a macro-level. According to James S. Marks, MD, MPH, Senior Vice President and Director, Health Group at the Foundation, “A key focus of our grant-making strategy is to fund programs and research that influence public-policy. We feel that effective policy change is important because even after the program is over, policies remain in place, becoming a part of our ‘social DNA,’ and leave a lasting impact.”  As an example, Dr. Marks pointed to studies supported by the Foundation that highlighted the inverse relationship between cigarette prices and smoking rates among children and minorities. These studies helped lead to the adoption of tobacco tax laws in many states across the country.

1,172 miles from Pennsylvania, in Arkansas, Governor Mike Huckabee, reacting to Arkansas’ dismal rating as the 47th healthiest state (ranking ahead of only Mississippi, Louisiana, and Tennessee) signed Act 1220, a statewide initiative with the purpose of improving children’s health. As part of the legislation, which began in 2003, Arkansas became the first state to collect body-mass index measurements for every child in public schools. Results of the Body Mass Initiative (BMI) were tracked in a database which was developed with support from the Robert Wood Johnson Foundation. The results were as alarming as they were in Philadelphia, with 37% of Arkansas’ public school students determined to be overweight or at risk of being overweight.
 
Besides the annual BMI measurement, Act 1220 mandated healthier foods in school lunches, barred student access to vending machines in grade schools, and increased physical activity in schools. It was also designed to engage the community and support parents, including giving them information annually on the dangers of high BMI and the importance of nutrition and physical activity. Three years later in 2006, reporting on data supplied through the BMI database, Governor Huckabee was able to announce that “…the progression of childhood obesity among Arkansas public school students has been halted. The percentage of overweight children and adolescents has decreased, and the percentage of kids at a healthy weight has increased.”

Speaking about their role in evaluating the effectiveness of Act 1220, Dr. Marks said, “Our role is in keeping with RWJF’s commitment to provide high-quality, objective information to policy makers about health issues so that they can make informed decisions.” The Robert Wood Johnson Foundation’s $500 million effort to end childhood obesity by 2015 is an ambitious example of how a Foundation can tackle big issues.

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