New York City and Philadelphia: A Tale of Two Obesity Declines

By Risa Lavizzo-Mourey and Nancy Brown

“Severe Childhood Obesity Shows a Decline in New York City.” You might have seen the headlines earlier this month.

It wasn’t long ago that we never saw stories like that.

For decades, it was nothing but bad news – one story after another about a rapidly growing epidemic. Just two years ago, the Robert Wood Johnson Foundation and Trust for America’s Health predicted that, if trends continued the way they seemed to be going, more than 60% of adults in 13 states would be obese by the year 2030 – and have the extremely high medical bills to prove it.

But now, we’re finally starting to see signs of progress against an epidemic that was once feared to be unstoppable. Overall childhood obesity rates have stabilized. For the first time in a decade, data show a downward trend in obesity rates among young children from low-income families in many states. And, we’re seeing reports from cities and states that their overall rates of childhood obesity are decreasing: from California to West Virginia; from Anchorage, Alaska to New York City.

New York is a great example of a place taking a comprehensive, community-wide approach to reducing childhood obesity. The city has required group child-care centers to improve nutrition and nutrition education, increase physical activity, and limit screen time. “Health Bucks” enable lower-income families to maximize their purchasing power for fresh fruits and vegetables at local farmers’ markets. The city’s Department of Design and Construction provides architects and urban designers with guidelines for designing buildings, streets and urban spaces that support physical activity. Chain restaurants are required to post calorie information on menus, enabling customers to make more informed decisions. The education and health departments have collaborated on the “Move-to-Improve” program, which helps teachers incorporate physical activity through the school day.

We’re thrilled that these approaches appear to be paying off, but here’s the thing about that recent study on the most severe obesity cases: White children saw a more significant decrease than Latino or African-American kids.

This was true for overall obesity rates as well: Childhood obesity rates among White K-8 students in New York dropped from 17.6% in 2006 to 15.4% in 2010 – an impressive 2.2 percentage point decline. But the drop among Hispanic and African-American students was far less, just 0.9 and 0.4 percentage points, respectively. The disparity among upper- and lower-income students was even greater, a 1.4 percentage point decline compared to 0.7 percentage points.

This means that despite the overall progress, the disparities gap may actually be widening in New York.

In this respect, New York City truly illustrates where we are in this epidemic. Progress is possible, and happening, but this progress runs the risk of leaving some of our young people behind, and too many of those at greatest risk.

There is one notable exception to this rule—Philadelphia.  In Philadelphia, they’ve managed to reduce childhood obesity prevalence while also reducing obesity-related disparities.

Philadelphia Decreases Childhood Obesity: Learning to Eat Healthy

 

Like New York, Philadelphia has addressed the obesity problem from many angles. The city, along with groups like the Food Trust, pioneered new financing strategies to bring full-service grocery stores back to underserved neighborhoods. The city improved food and physical activity in schools, and was one of the first jurisdictions in the country to remove all sodas and other sugar-sweetened drinks from public school vending machines.  In schools with American Heart Association Teaching Gardens, children grow their own healthy produce, and learn about the value of good eating habits. Complete streets policies make it easy and appealing for people to walk and bike throughout the city. More farmers’ markets are opening all the time across the city, and they use smart incentives to help lower-income residents afford fresh produce. Corner stores are offering healthy products and using in-store placement and marketing techniques that are boosting sales.

And guess what? Childhood obesity there fell 4.7 percent – and the biggest declines were reported for African American boys and Hispanic girls: 7.6 percent and 7.4 percent, respectively.

The challenge for all of us is this: How do we make the Philadelphia story everyone’s story, in every community?  How do we give every child in America an equal opportunity to grow up at a healthy weight?

On July 22, we’ll be addressing those questions and more at a TEDMED Google Hangout. Here’s who will be speaking:

  • Risa Lavizzo-Mourey, President and CEO of the Robert Wood Johnson Foundation
  • Nancy Brown, CEO of the American Heart Association
  • Don Schwarz, former Health Commissioner and Deputy Mayor for Health and Opportunity, City of Philadelphia
  • Elissa Epel, Associate Professor, UCSF School of Medicine
  • Lisa Simpson, President and CEO, Academy Health

Our conversation will be moderated by Richard Besser, Chief Health and Medical Editor for ABC News.

Do you have a question or comment for the speakers? A story about what’s happening in your community to promote healthy eating, or physical activity? An idea for helping kids achieve and maintain a healthy weight? We’d love to hear from you! Just comment on this post, or tweet using the hashtag #GreatChallenges.

We’re really looking forward to a lively, candid chat, and we hope you’ll tune in and contribute to the conversation!

 

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