In today’s fast-paced society, many children spend more time with their teachers than they do with their own parents or guardians. So, as teachers, we may be the first to recognize problems that can lead to poor health outcomes.
One such problem is obesity. In fact, the Centers for Disease Control (CDC) has labeled this problem a health “crisis.” During the past 30 years, childhood obesity (also known as pediatric obesity) has increased by 300%. The consistent increase in pediatric obesity now exceeds all other pediatric diseases and health problems. It is considered an epidemic.
Pediatric obesity and its causes
A child whose BMI is greater than the 95th percentile is defined as obese. A child can be identified as overweight if the child’s BMI is between the 85th and 95th percentile. Updated guidelines also list severe obesity for children whose BMI is greater than the 97th percentile.
Multiple factors contribute to pediatric obesity. The primary cause is often lifestyle and eating habits of the child’s family. Similarly, predisposition for obesity may be partly genetic, but it is most typically related to the value placed on physical exercise and activities.
Short-term and long-term health problems
Health care researchers have documented both short-term and long-term health problems associated with childhood obesity.
Some of the short-term effects are:
- Poor self-esteem
Long-term health problems include, but are not limited to:
- Cardiovascular diseases
- Respiratory issues
- Some forms of cancer
The CDC has estimated that the annual healthcare cost of treatment for illnesses associated with obesity is about 150 billion dollars a year. The financial costs may be a fragment of the social costs of childhood obesity. The causes and possible interventions are well documented. So let’s take a closer look at this issue and see how we can help our students and their families.
Childhood obesity statistics
Children have become more sedentary and often spend more time playing virtual games than playing real games outside. For example, many play virtual tennis or baseball instead of playing real sports outdoors, where they would expend calories and interact with others. The startling fact is that childhood obesity is growing at an alarming rate. According to the CDC, in 2017, approximately one in five children were classified as obese and this number is expected to rise.
Family values related to eating habits and physical activity
A family’s cultural values associated with eating are also influential. Typically, children don’t choose their food all on their own; the family plays a large role in food selection. These choices have a critical influence on eating habits that last a lifetime. Some families don’t emphasize the importance of healthy eating. Their diet may be largely made up of fast foods and/or meals that are high in saturated fat and carbohydrates. This pattern of behavior continues and can have lasting health consequences as the child grows into adulthood and beyond.
How teachers and schools can influence families’ habits
Teachers and the school have a limited ability to influence family eating habits and exercise routines. But there are innovative schools offering workshops and incentives for families to learn about nutrition and exercise and their benefits. These sessions can be inconvenient for families on tight schedules, but one solution may be offering these programs online. It’s important to note that without an incentive or a true belief that childhood obesity, eating habits, and exercise play a critical long-term role in health, no program will be successful. The key is tapping into families’ health belief system.
How families’ needs and perceptions influence actions
In the 1950s, public health officials created the Health Belief Model to identify factors likely to lead to health-promoting behaviors. Without a perception of the seriousness of the potential problem, it is not likely that families will take action to engage in these positive behaviors.
Health Belief Model
Families who struggle to “make ends meet” are likely to focus more on immediate problems such as needing money to pay for heat rather than trying to address an intangible issue like a potential health problem. Additionally, when there is a perceived threat (such as childhood obesity relating to poor eating habits and lack of exercise), that issue may take a backseat to the perceived threat of having no food at all or other factors related to general safety (e.g., crime or domestic violence). The role of self-efficacy and taking action to promote healthy habits can be nonexistent for families who are simply trying to survive each day.
Maslow’s Hierarchy of Needs depicts the dubious relationship between moving toward self-actualization, which may include both short-term and long-term health goals and the ability to get to that higher level. If families are spending all of their time and resources on trying to have their basic needs met (food, water, safety, etc.), there is no opportunity to move up and realize their full potential, which means they aren’t able to achieve their optimal health.
Maslow’s Hierarchy of Needs
A family’s socioeconomic status plays a crucial role in the ability to turn cues into actions to create lifelong healthy patterns for children. Even education and a family’s perception of the critical nature of the problem may not provide an adequate solution to the issues of childhood obesity because of the barriers in their daily lives.
Here are some of the obstacles that low-income families may face:
- Those with limited transportation are reliant on supermarkets that are within walking distance. These food resources may not provide an adequate selection to allow for healthy eating.
- Many low-income families lack access to a range of fresh fruits and vegetables, so lower-cost, packaged foods that won’t spoil are often selected. Most of them have little to no nutritional value.
- The CDC recommends that children get at least 60 minutes of exercise each day. But in crime-ridden neighborhoods, children are often kept indoors for safety reasons, so they have fewer opportunities to exercise.
While these may seem like insurmountable obstacles, there are actions teachers and schools can take to address these issues, but it requires persistence, collaboration, and an approach that focuses on long-term solutions.
Collaborating to create long-term solutions
Long-term solutions require a joint effort from all involved: the government, the school system, primary providers, and parents. A collective effort can help change old habits and promote healthier lifestyles.
In 2010, Michelle Obama launched her “Let’s Move” campaign aimed at reducing childhood obesity. The goals for this project included bringing healthier food to school meal programs, creating a better food labeling system, and increasing physical activity among children.
According to research conducted on the campaign’s impact, “Let’s Move” also led to discussions acknowledging that “ending our nation’s childhood obesity crisis required a long-term ‘generational’ strategy” so the Partnership for a Healthier America (PHA) was established. The PHA wanted to motivate companies to provide healthier options, and now more companies are “making public commitments on their own, suggesting that a cultural change is underway…changes are occurring in nutrition and physical activity environments.” Over 200 private-sector partnerships were formed, but this type of change happens gradually.
Some schools and districts have formed partnerships with companies and local organizations to promote long-term health goals for children and their families. Concordia University-Portland and Faubion School (a PreK-8 Portland public school) collaborated with three other core providers: Kaiser Permanente, Basics (formerly known as Pacific Foods), and Trillium Family Services. Together, they created a community-centered, holistic educational model connecting students, families, and neighbors. This model is known as “3toPhD®” and it provides wraparound support services so that students are able to pursue their highest dreams.
The Faubion School addresses a range of needs and the 3toPhD® education model provides an integrated approach to health, wellness, and education.
- Over 80% of Faubion’s students are eligible for free and reduced lunch so Basics, a local, organic grocery line now maintains an on-site food club and pantry.
- Faubion facilitates monthly community cooking classes in an on-site demonstration kitchen so families and older children can learn to make healthy meals.
- Kaiser Permanente’s 3toPhD® Wellness Center offers on-site services for students and their families, including physical exams, dental care, and treatment of non-urgent and chronic health conditions.
- Trillium Family Services provides on-site wellness prevention and mental health services.
While many schools may not have the resources and support to provide such a comprehensive approach, schools that form community partnerships can impact their students’ long-term health and wellness. A community garden, a weekly open gym night, and/or nutrition workshops can all serve as components of a comprehensive, research-based plan to address childhood obesity in your learning community.
- Center for Disease Control (CDC) (2017). Available from: https://www.cdc.gov/obesity/childhood/index.html
- Maslow, A. H. (1962). Toward a Psychology of Being. Princeton: D. Van Nostrand Company.
- Moore, E. S., Wilkie, W. L., & Desrochers, D. M. (2017). All in the Family? Parental Roles in the Epidemic of Childhood Obesity. Journal of Consumer Research, 43(5), 824–859. https://doi-org.sunypoly.idm.oclc.org/10.1093/jcr/ucw059
- Obama, M. (2010). Available from: https://letsmove.obamawhitehouse.archives.gov/about
- O’Brien, A. (2015). When Schools Welcome Community Partners. https://www.edutopia.org/blog/when-schools-welcome-community-partners-anne-obrien
- Rosenstock, I. (1974). Historical Origins of the Health Belief Model. Health Education & Behavior. 2 (4): 328–335. doi:10.1177/109019817400200403.
- Simon, C., Kocot, S. L., & Dietz, W.H. (2017). Partnership for a Healthier America: Creating Change Through Private Sector Partnerships. US National Library of Medicine National Institute of Health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5488065/
Michelle Liken PhD, RN has over 32 years of nursing experience, including pediatric nursing. Her clinical focus has been related to community health, including health promotion and risk reduction.