Robert Wood Johnson Foundation Health Snapshot

Obesity in Young Is Seen as Falling in Several Cities

By SABRINA TAVERNISE for the NY Times

PHILADELPHIA — After decades of rising childhood obesity rates, several American cities are reporting their first declines.

The trend has emerged in big cities like New York and Los Angeles, as well as smaller places like Anchorage, Alaska, and Kearney, Neb. The state of Mississippi has also registered a drop, but only among white students.

“It’s been nothing but bad news for 30 years, so the fact that we have any good news is a big story,” said Dr. Thomas Farley, the health commissioner in New York City, which reported a 5.5 percent decline in the number of obese schoolchildren from 2007 to 2011.

The drops are small, just 5 percent here in Philadelphia and 3 percent in Los Angeles. But experts say they are significant because they offer the first indication that the obesity epidemic, one of the nation’s most intractable health problems, may actually be reversing course.

The first dips — noted in a September report by the Robert Wood Johnson Foundation — were so surprising that some researchers did not believe them.

Deanna M. Hoelscher, a researcher at the University of Texas, who in 2010 recorded one of the earliest declines — among mostly poor Hispanic fourth graders in the El Paso area — did a double-take. “We reran the numbers a couple of times,” she said. “I kept saying, ‘Will you please check that again for me?’ ”

Researchers say they are not sure what is behind the declines. They may be an early sign of a national shift that is visible only in cities that routinely measure the height and weight of schoolchildren. The decline in Los Angeles, for instance, was for fifth, seventh and ninth graders — the grades that are measured each year — between 2005 and 2010. Nor is it clear whether the drops have more to do with fewer obese children entering school or currently enrolled children losing weight. But researchers note that declines occurred in cities that have had obesity reduction policies in place for a number of years.

Though obesity is now part of the national conversation, with aggressive advertising campaigns in major cities and a push by Michelle Obama, many scientists doubt that anti-obesity programs actually work. Individual efforts like one-time exercise programs have rarely produced results. Researchers say that it will take a broad set of policies applied systematically to effectively reverse the trend, a conclusion underscored by an Institute of Medicine report released in May.

Philadelphia has undertaken a broad assault on childhood obesity for years. Sugary drinks like sweetened iced tea, fruit punch and sports drinks started to disappear from school vending machines in 2004. A year later, new snack guidelines set calorie and fat limits, which reduced the size of snack foods like potato chips to single servings. By 2009, deep fryers were gone from cafeterias and whole milk had been replaced by one percent and skim.

Change has been slow. Schools made money on sugary drinks, and some set up rogue drink machines that had to be hunted down. Deep fat fryers, favored by school administrators who did not want to lose popular items like French fries, were unplugged only after Wayne T. Grasela, the head of food services for the school district, stopped buying oil to fill them.

But the message seems to be getting through, even if acting on it is daunting. Josh Monserrat, an eighth grader at John Welsh Elementary, uses words like “carbs,” and “portion size.” He is part of a student group that promotes healthy eating. He has even dressed as an orange to try to get other children to eat better. Still, he struggles with his own weight. He is 5-foot-3 but weighed nearly 200 pounds at his last doctor’s visit.

“I was thinking, ‘Wow, I’m obese for my age,’ ” said Josh, who is 13. “I set a goal for myself to lose 50 pounds.”

Nationally, about 17 percent of children under 20 are obese, or about 12.5 million people, according to the Centers for Disease Control and Prevention, which defines childhood obesity as a body mass index at or above the 95th percentile for children of the same age and sex. That rate, which has tripled since 1980, has leveled off in recent years but has remained at historical highs, and public health experts warn that it could bring long-term health risks.

Obese children are more likely to be obese as adults, creating a higher risk of heart disease and stroke. The American Cancer Society says that being overweight or obese is the culprit in one of seven cancer deaths. Diabetes in children is up by a fifth since 2000, according to federal data.

“I’m deeply worried about it,” said Francis S. Collins, the director of the National Institutes of Health, who added that obesity is “almost certain to result in a serious downturn in longevity based on the risks people are taking on.”

Obesity affects poor children disproportionately. Twenty percent of low-income children are obese, compared with about 12 percent of children from more affluent families, according to the C.D.C. Among girls, race is also an important factor. About 25 percent of black girls are obese, compared with 15 percent of white girls.

Some experts note that the current declines, concentrated among higher income, mostly white populations, are still not benefiting many minority children. For example, when New York City measured children in kindergarten through eighth grade from 2007 to 2011, the number of white children who were obese dropped by 12.5 percent, while the number of obese black children dropped by 1.9 percent.

But Philadelphia, which has the biggest share of residents living in poverty of the nation’s 10 largest cities, stands out because its decline was most pronounced among minorities. Obesity among 120,000 public school students measured between 2006 and 2010 declined by 8 percent among black boys and by 7 percent among Hispanic girls, compared with a 0.8 percent decline for white girls and a 6.8 percent decline for white boys.

“The needle is actually moving,” said Gary D. Foster, director of the Center for Obesity Research and Education at Temple University.

He first noticed the change while conducting a study of middle school students. Even children who made up the control group that did not take part in anti-obesity measures had a weight drop of nearly 4 percent, compared with 5.5 percent for those who did.

Here at William H. Ziegler Elementary in Northeast Philadelphia, where most students qualify for free or reduced-price lunch, the day begins with a nutrition tip over the loudspeaker. Teachers give out colorful erasers and stickers instead of Tootsie Rolls. Fund-raising events feature fruit smoothies instead of chocolate.

Some students had never seen broccoli or cauliflower, so Jill Dogmanits, a sixth-grade teacher, started taste tests to acquaint students with those vegetables and healthy snacks like hummus, fresh pineapple and whole-wheat bagels.

But school is only part of the day. Children buy an average of 350 calories worth of snacks in corner stores every day, according to a study by Dr. Foster’s center at Temple University. About 640 corner stores are now part of a program of stocking healthier food, according to the Food Trust, a nonprofit group that runs it.

“Parents tell their kids, ‘Take this money and go buy a snack,’ ” said Josh, as children streamed into a store across from his school where crayon-colored sugar drinks called Hugs sell for 25 cents and generic soda is 40 cents.

Dr. Donald F. Schwarz, a pediatrician who is the city’s health commissioner, said: “I think we are beginning to turn the tide with the many things that have gone on now for a decade.”

It is too early to tell whether the trend will hold.

“I’d like to see another year of measurement before I go out and party over this,” said Mary Currier, Mississippi’s state health officer.

And some public health experts say that without broader policy actions like a soda tax, which Philadelphia tried but failed to pass in 2010 and 2011, deeper change will be difficult. Still, new data from Philadelphia — from more than 20,000 children in first through sixth grades — show a further 2.5 percent obesity decline from 2011 to 2012, Dr. Foster said.

Josh lost weight this summer, exercising outside with his stepfather, an Army reservist. But now that it’s cold he has gained some back. Still, he believes he can influence others. His 2-year-old cousin now asks for bananas instead of chips at the corner store. Josh takes full credit.

School Wellness Weekly, 12.07.2012

Thousands of runners, including students, joined DOE Chancellor Dennis M. Walcott this past Saturday morning for The New York Road Runners’ (NYRR) Jingle Bell Jog.  The proceeds from the four-mile run in Prospect Park, Brooklyn, help support NYRR’s Youth Programs, serving more than 100,000 students in NYC public schools through programs such as Mighty Milers, Young Runners, and the Developmental Track and Field Series.  In addition to providing physical activity programming during and after school hours, the ongoing partnership with NYRR has helped to raise awareness about the importance of physical activity, while helping students learn valuable lessons about endurance, commitment, and enthusiasm for fitness in and out of school.

Opportunities and Recognition

·         Does Your School Need Support on a Health and Wellness Project? On behalf of the Partnership for Healthier New York City, The Fund for Public Health in New York (FPHNY) seeks proposals (click here) from organizations, including schools, to work with Borough Lead Organizations to advance the work of New York City’s Community Transformation Grant. The 30 mini-grants of up to $10,000 will be awarded in February and tasks associated with grant must be completed by 9/30/2013.  The RFP deadline is 12/17 at 3:00 p.m. For more information, contact Liz Nguyen.
·         Employment Opportunity as a Health Education Mentor: The DOE Office of School Wellness Programs (OSWP) needs a qualified educator to join our team.  This new Teacher Assigned position will support middle and high schools in delivering medically accurate, skills-based health instruction, as well as identify and share best comprehensive health education practices. To be eligible for this position, applicants must be current licensed, appointed, and tenured NYC DOE teachers.  Interested individuals may email here.
·         2012 Updated HIV/AIDS Curriculum Available: Check out the OSWP website to learn more about medical updates to this K-12 curriculum. New parent letters and brochures are also available, or request a hard copy of the curriculum. Also, teachers can register for professional development or request an “At Your School” training for 15 or more teachers—for either a refresher for those who have attended the 101 training prior to September 2012, or an HIV 101.

• Do Your Elementary School Teachers Move-to-Improve? If your school hasn’t signed up for this structured classroom fitness break program, the MTI team just gave you more reasons to be an MTI school. Not only do participating teachers receive a stipend for participating in the MTI workshop, as well as free equipment and materials, but schools that train more than 85% of teachers and schools committing to be MTI host sites can receive additional wellness related goods. Find out more from the fact sheet here, or register here.

·         DOT's Bike to School RFP: All middle and high schools are invited to apply to the Bike to School program, a three year commitment for schools interested in working closely with DOT to designate safe Bike to School routes, implement in-class curriculum and recommend street safety improvements. Click here to apply before the 12/12 deadline.

• Game On! The Ultimate Wellness Challenge grants: Action for Healthy Kids (AFHK) announces $1,000 grants to support elementary schools, PTAs and SWCs with their wellness initiatives for 2013.  Applications are due 12/14.

Wellness in the News

• L.A. District's Student Stores Feed Appetite for Alternative Lunches (The LA Times, 11/19)
• Olympic Champion Teaches Kids Lessons For Life (Canarsie Courier, 11/22) 
• Obese kids more susceptible to food advertisements, brain scan study suggests (CBS News, 11/30)

·         Facebook and Twitter May Help Fight Obesity in Kids (ABC News, 12/7)

Additional Resources

·         Download a copy of Teens in NYC, a wallet-sized guide from NYCDOHMH about free or very low cost sexual health services and clinics that are teen friendly, also available from 311.
·         See the NASPE/AAHPERD draft document of proposed national K-12 PE standards available for comment here.
·         Check out the CDC’s strategy toolkit for involving parents in school health.
·         The CDC has announced changes to the 2012 School Health Index to include: sexual health as a new topic, updates to nutrition questions to reflect the Institute of Medicine’s Nutrition Standards for Foods in Schools, and revised cross cutting questions to be more integrative.

Bronx Health REACH e-blast

 Neighborhood Grants – Deadline December 17^th

The Fund for Public Health in New York (The Fund), on behalf of the New York City Department of Health and Mental Hygiene (DOHMH) and the Partnership for Healthier New York City, has announced a Request for Proposals (RFP) for community organizations and residents to work with Borough Lead Coalitions to advance the work of NYC’s Community Transformation Grant (CTG).  The Bronx Health REACH Coalition led by the Institute for Family Health is the Bronx Borough Lead Coalition. Bronx Health REACH, the Partnership and neighborhood contractors selected in the RFP will work together to support the development and implementation of environmental, infrastructure and systems changes around healthy eating, active living, alcohol and tobacco in the Bronx.  Details about the project and the RFP can be found online at http://fphny.org/whatsnew/rfps  The deadline for receipt of proposals is December 17th.  For more information, please contact Emma Rodgers at [email protected]

  

Bronx Health REACH Coalition meeting – December 7^th

The next Coalition meeting for Bronx Health REACH will be Friday, December 7^th from 9:30am-12:00pm, at Walker Memorial Baptist Church (120 E. 169^th St, Bronx NY 10452).  The meeting will focus on presentations from housing groups highlighting exciting community development projects that are improving the health and wellness of Bronx residents.  To RSVP, please contact Yvette Holland at [email protected] or call 212-633-0800 x 1232

Bronx Health REACH Nutrition and Fitness Workgroup meeting – December 20^th

The next Nutrition and Fitness Workgroup meeting will be Thursday, December 20^th from 10am-12pm at the Morrisania Diagnostic & Treatment Center (1225 Gerard Ave, Bronx NY 10452), room 214.  We will continue to discuss strategies and a workplan for nutrition and fitness initiatives in both school and community settings.

Office of School Wellness Council Grantees Announced

Congratulations to the schools that received grants from the NYC Department of Education Office of School Wellness.  The School Wellness Council (SWC) program is awarding 125 schools with resources, tools and incentives to create a SWC, or further develop the work of an existing council. SWCs are charged with developing practical and innovative ways to address various components of wellness for students and the school community, e.g., PE, health education, physical activity, school nutrition, staff wellness, mental health, and other wellness-related programs. Grantee schools receive funding along with technical assistance through mentoring and networking events.  Bronx Health REACH’s partner schools that received the grant include: PS 43, PS 385, Health Opportunities High School, PS 55, PS 64, JHS 145, PS 204, P/IS 218, Validus Prep, Bronx Writing Academy, and Sheridan Academy.  P/IS 218 and Sheridan Academy have been designated Mentor schools and can share best practices with other schools looking to implement school wellness initiatives.

Bronx Academy of Promise Charter School in the News!

Congratulations to Bronx Academy of Promise Charter School (BAOP) for its innovative use of technology and achieving an “A” on their school report card!  BAOP is a Bronx Health REACH partner school and participates in the Obesity Prevention Program with nutrition education for third graders.  http://www.nydailynews.com/new-york/bronx/verizon-foundation-launches-app-challenge-bronx-school-article-1.1209733

The BLK Projek Veggie Bus Project

The BLK Projek has received partial funding to start a Veggie Bus project in the Bronx. In collaboration with Wassaic Community Farm, the BLK project will rehab a beautifully painted school bus that runs on veggie oil to deliver and sell pesticide free produce and added value food.  To raise the remaining funds necessary for the project, Tanya Fields will be creating a video for a fundraising platform site.  If you would like to be interviewed about why this kind of project is important, and especially if you are a Bronx-Based resident, practitioner who works in the Bronx and/or Food Justice advocates, please contact Tanya Fields ASAP at [email protected].  

Bronx River Alliance “Bridge the Gap” campaign

The Bronx River Alliance and several other organizations are asking Mayor Bloomberg and Governor Cuomo to complete the construction of Starlight Park, Phase 2.   Starlight Park, which straddles both sides of the Bronx River in the Crotona Park East and Bronx River sections of the South Bronx, is a critical link for the Bronx River Greenway.  By completing the construction of the park, over 100,000 residents in adjacent neighborhoods will could gain access to the Bronx river, the new parks along its banks, and an invaluable bike and walking trail system.  To find out more information and support this request from Mayor Bloomberg and Governor Cuomo, please visit the Bronx River Alliance website.

New York State to Hire 5000 New Yorkers for Sandy Cleanup   
Governor Andrew M. Cuomo has announced that the state has secured a $27 million federal grant that will help put more than 5,000 unemployed New Yorkers to work helping clean-up communities still recovering from Hurricane Sandy.  The State Department of Labor will assist local communities to identify and hire workers. The full-time, temporary positions range from Community Relations Specialists providing outreach to the disaster-stricken communities, to administrative assistants. Individuals who are interested in applying for a job under this grant are encouraged to contact the Department of Labor at 1-888-4-NYSDOL (1-888-469-7365) or by visiting www.labor.ny.gov/sandyjobs.   All individuals must be unemployed to be eligible. Once hired, workers will earn approximately $15 per hour to work on short and long-term projects. In addition to offering benefits and on-the-job experience, each worker will be given assistance in finding their next job. Eligible youth will also be certified in the Governor's New York Youth Works program. 
 

Vote for Coqui the Chef in Online Childhood Obesity Challenge

Coqui the Chef, a Bronx-based social enterprise organization promoting healthier alternatives to traditional Latino cuisine, provides innovative cooking demonstrations and nutrition workshops throughout the tri-state area.  Coqui the Chef has entered an online challenge from the American Journal of Preventive Medicine, focused on seeking innovative solutions aimed at reducing obesity.  You can vote for Coqui the Chef’s proposal to reduce childhood obesity in the South Bronx, by visiting:  http://ajpmchallenge.calit2.net/submissions/entry/id/126 .  Remember to leave an inspiring comment!

Bronx Music Heritage Center Living Legends Event – December 5^th

Bronx Health REACH Coalition member, WHEDco, has established the Bronx Music Heritage Center to celebrate the rich history and creative spirit that defines Bronx music.  On Wednesday December 5^th, the Center will honor Andy Gonzalez at Hostos Center for the Arts and Culture at 450 Grand Concourse. For free tickets, call 718.518.4455. There is a $5 suggested donation to support BMHC programming.  http://www.whedco.org/images/whedco/pdf/Flyers/fall2012_livinglegendsposter_whiteband_nocropmarks.pdf

Cancer rates slightly up in NY, deaths down

Written by Jessica Bakeman Albany Bureau for ithicajournal.com

ALBANY — The number of cancer cases in New York grew slightly since last year, up 2 percent to more than 109,000 incidences.

But the number of cancer deaths in New York dropped by about 200 deaths, a less than 1 percent decline, a study from the American Cancer Society estimated.

The rise in cancer cases -- 109,440 cases in 2012, up from 107,620 the year prior -- was driven mainly by a surge in melanoma and prostate cancer, according to the study. The American Cancer Society uses data from past years to project incidence and mortality rates.

Incidences of melanoma, a type of skin cancer, increased by 25 percent from last year. There are now more than 4,700 estimated cases in New York, up from 3,750 in 2011.

Melanoma deaths increased 6.8 percent; there are an estimated 470.

“It’s not a surprise, as we’ve seen melanoma on the rise. It reflects the sun-worshipping, indoor-tanning experience culture in New York, and it’s taking its toll,” said Blair Horner, vice president for advocacy for the American Cancer Society of NY and NJ.

The “tan ban,” a law Gov. Andrew Cuomo signed earlier this year to prohibit 14- to 16-year-olds from using tanning booths, will help, Horner said, but tanners are still unaware of the serious consequences of ultra-violet radiation exposure.

“To get young people who view themselves as invulnerable to understand the potential consequences, you have to come up with very aggressive public education,” Horner said.

He added that anti-smoking campaigns, including graphic advertisements, have been effective in encouraging smokers to quit.

Lung cancer mortality rates increased 3.5 percent since last year, with an estimated 8,880 related deaths in 2012. The number of cases, though, declined. There were 13,620, about a 4.1 percent drop from last year.

Horner said the increasing mortality rates for lung cancer are consistent with a “disturbing trend.”

“No one needs to smoke, and no one needs to go to an indoor tanning facility, unless they have a prescription from their doctor,” he said. “So those are lifestyle experiences that drive up the cancer rate and the mortality rate, and the government needs to do everything they can to drive those rates down.”

The state Department of Health operates a tobacco control program, which began in 2000. The office coordinates smoking cessation media campaigns and crafts state policy. Also, the state will soon launch a federally funded Medicaid incentives program encouraging smokers to quit.

The cancer with the highest incidence in New York, prostate cancer, increased 7.2 percent since last year, bringing the number of cases to 17,090. There was a 9 percent drop in deaths, down to 1,610.

Breast cancer incidence and death rates decreased. There were 14,730 cases and 2,420 deaths in 2012.