Public awareness of the issue of childhood obesity is at an all-time high, and actions are being taken to solve this crisis on a local and federal level. Local organizations — such as the Buncombe County school district, Buncombe County Health and Human Services, the city of Asheville, Mission Health Partners, Mountain Area Health Education Center and many others — are working together to increase awareness and implement new strategies to help overweight and obese children lose weight and to prevent other children from straying outside a healthy weight in the first place.
Debbie Bryant, healthful living coordinator for Buncombe County Schools who oversees the health and physical education of K-12 students, notes that things are at least heading in the right direction. “We’ve made some progress over the past 10 years,” says Bryant. “We collect information every year on how many of our Asheville City and Buncombe County K-5 students are at a healthy weight as part of annual health screening. In the 2003-2004 school year, 61 percent of our students were at a healthy weight, with 36 percent overweight or obese. In the 2014-2015 school year, 64 percent of our students were at a healthy weight, and 33 percent overweight or obese.”
The American Heart Association’s startling statistic shows that obesity in children has more than tripled from 1971 to 2011. For the first time in two centuries, the youths of today are at risk of being unhealthier and having a shorter life expectancy than their parents due to increasing rates of obesity. Federal programs like Michelle Obama’s Let’s Move! and the increased national discourse on the subject show there’s an active countrywide effort toward reversing these dangerous trends. The American Heart Association says that childhood obesity is now the No. 1 health concern among parents in the U.S., topping drug abuse and smoking.
‘A Perfect Storm’
The major challenge is that there’s no simple solution for childhood obesity. There’s no single factor that causes a child to be overweight; rather, it’s a confluence of many factors ranging from behavioral issues like unhealthy eating habits and physical inactivity to environmental factors such as family, community or geographic settings that aren’t conducive to healthy lifestyles and even unavoidable factors like genetics.
“Health experts often refer to obesity as a perfect storm,” says Terri March, health improvement specialist in the Healthy Living Division of Regional Services at MAHEC. March works in partnership with Buncombe County Health and Human Services to address community health priorities identified in the Community Health Assessment, which takes place every three years.
Buncombe County Health and Human Services developed the Community Health Assessment document in partnership with Mission Hospital, CarePartners and MAHEC as part of a local community health needs assessment process. Priority issue No. 1 from the 2015 CHA document is “obesity and chronic disease prevention.”
“Obesity is defined differently for adults and children,” says March. “Although the body mass index is an imperfect measure, it’s generally where we start. Overweight is defined as a BMI at 25 or above. Because children are growing, we use a measure that considers their age as well as height and weight. Children with a BMI at the 85th percentile for their age are considered overweight and obese at the 95th percentile.
“The most basic explanation [for the obesity epidemic],” says March, “is one of energy balance — more calories in and few calories burned. Our calorie consumption is a little higher than it has been in the past, and that small increase every day adds up. Couple this with a more sedentary lifestyle, and it really adds up.”
March continues, “It is so much more than eating and activity behavior. Sugary foods are much more available and inexpensive. Our communities and lifestyle make it harder to be active … many drive everywhere because communities are spread out, and many parents feel it is more dangerous for their children to play outside. It’s hard to walk or bike because we often lack sidewalk connections and bike lanes or we feel unsafe.” March also notes how kids spend much more time glued to their digital devices than in previous years.
It’s costing us more than our lives
The effects of excess weight and obesity can really take a significant toll on the body, explains Melanie Batchelor, health management programs coordinator for Harris Regional and Swain Community Hospitals. “According to the Centers for Disease Control and Prevention, childhood obesity has both immediate and long-term health effects. Obese children and adolescents … are at greater risk for joint problems, sleep apnea, as well as social and psychological problems. [They] are likely to be obese adults and therefore are at risk for heart disease, Type 2 diabetes, stroke, several types of cancer and osteoarthritis.”
Batchelor notes that the negative effects of obesity extend beyond physical and mental health of individuals and into the realm of economics. “The cost of obesity is in the billions of dollars and ultimately provides a hardship economically for our society,” says Batchelor.
The 2015 Buncombe County Community Health Assessment states that because obesity impacts over 30 chronic health conditions, it is responsible for nearly a quarter of all health care costs.
Dr. Calvin Tomkins, assistant medical director of Mission Health Partners, notes that “economic pressure on the health care industry is driving two things: improved quality (and demonstration of it) and containing costs. The U.S. has a poor track record with these two attributes: It is ranked 37th by the World Health Organization’s “Overall Health System Performance” paper and has the most expensive health care on the planet. This translates to $200 billion annually or 21 percent of health care costs,” notes Tomkins.
All hands on deck
Awareness and understanding of these widespread obesity-induced hardships have led to an enthusiastic, coordinated effort among communities and organizations in the region. The fact that Buncombe County has seen a slight improvement in children’s healthy weight levels over the past decade is not the result of any one organization or program, but what Batchelor says is an “overall societal change that promotes healthy environments in all sectors.”
“It really is a team effort for us,” says Bryant, referring to Buncombe County Schools. “We work with the school nurses, teachers, guidance counselors; we try to hit students in as many different directions as possible to reinforce the messages.”
One major tool that Bryant and other Buncombe County organizations are using to communicate the message of developing and maintaining healthy weights in children is the 5-2-1-Almost None program. Developed and led by Erin Braasch of the WNC Health Network, the program is a marketing tool that reinforces four healthy habits to live by each day: five fruits and vegetables, no more than two hours of screen time, one hour of physical activity and “almost none” when it comes to sugary drinks.
Other efforts from Bryant and the Buncombe school district include: the implementation of produce fairs, which educate students about healthy foods; a revised core curriculum that focuses on including physical movement in each class; and the improvement of fitness centers at each of the district’s high schools (using funds from a $2.25 million federal grant the school system received for physical education).
Additionally, each community is required by the state to have a School Health Advisory Council — an advisory group composed of individuals selected primarily from the health and education segments of the community. The group acts collectively in providing advice to the school system on aspects of the school health programs. The members of the council are appointed by the school system for advisory purposes. SHAC meetings are open to the public, and parents and families interested in getting involved are encouraged to join.
Local government and community organizations are also working to provide healthy food and economic resources for those who are food insecure, says the 2015 Community Health Assessment. According to the CHA, the plan is to “increase access to healthy foods in low-resource communities and increase access to local and healthier choices in our schools and throughout the community, through initiatives such as farm-to-school programs, farmer support initiatives and our many tailgate and farmer’s markets.”
Pathways to success
Furthermore, the CHA notes that Buncombe County is also making progress in improving community infrastructure. Programs such as Watch for Me NC and the Bicycle Friendly and Pedestrian Friendly Cities initiatives make it safer for walking and biking, and schools are beginning to support Safe Routes to Schools programs.
Another major infrastructure program is the massive greenway project that is currently in the works. “The city of Asheville is about to construct a series of greenways that will be connected and create our first greenway network, called the River to Ridge Greenway Network,” says city greenway coordinator Lucy Crown. “When finished, it will be 10.25 miles of connected greenways spanning from the River Arts District to Beaucatcher Mountain.”
“The goal of having a connected system of greenways along with sidewalks and bike lanes is to provide opportunities for people to incorporate active living into their everyday lives,” says Asheville landscape architect Mary Weber. “It’s important to design our communities so that people of all ages and abilities can easily walk or bicycle throughout the city both for recreation and transportation. Generally, if people incorporate healthy habits such as walking and/or bicycling into their regular routines as a child, they tend to carry these habits into adulthood, resulting in a healthier lifestyle.”
“I think we all need to remain hopeful that we’ll be able to change this and turn things around,” says Bryant. “But again, it’s a combined effort … not just from schools and medical providers, but from the entire community, parents and individuals as well. As long as we continue to work together, I think we’ll be able to see some change.”
Local School Health Advisory Council meetings are held the second Monday of each month at the Lenoir-Ryne University campus on Montford Avenue from 4-5:30 p.m.
More community organizations and programs involved in the fight against childhood obesity include: Asheville Buncombe Community Christian Ministries; Asheville-Buncombe Food Policy Council (and member organizations); Asheville-Buncombe Institute for Parity Achievement; Asheville-Buncombe Youth Soccer Association; Arc of Buncombe County; Asheville Greenworks; Appalachian Sustainable Agriculture Project; Asheville City Schools; Asheville Area Bike & Pedestrian Task Force; Blue Ridge Bicycle Club; Buncombe Bike Ed Network; Bountiful Cities Project; Buncombe County Cooperative Extension , Buncombe County Parks, Greenways and Recreation, Buncombe County Schools Child Nutrition; Buncombe County Health and Human Services, WIC Nutrition and the Office of Minority Health Equity Grant; MAHEC School Health; CarePartners Health Services; Asheville Parks & Recreation and Transportation; Community Care of WNC; FEAST/Slow Food Asheville; Healthy Buncombe Eat Smart Move More Coalition; Innovative Approaches; Land of Sky Regional Council; MANNA FoodBank; Mission Health Community Investments, Health Education and Children’s Hospital Weight Management; North Carolina Center for Health and Wellness; Rainbow in My Tummy; Smart Start – Shape NC; Black Mountain Greenways Health Initiative; MountainTrue; WNC Pediatric Care Collaborative; WNC Trips for Kids; Youth Empowered Solutions (YES!); YMCA of Western North Carolina; and YWCA of Asheville.