December 23rd, 2002
Fast Food, Fat Kids
By Gerald Hass
Boston Globe
OBESITY IS NOT A SUPERFICIAL QUESTION OF APPEARANCE, IT IS THE NUMBER ONE HEALTH CRISIS FACING INNER-CITY CHILDREN - ONE THAT WILL SHORTEN THEIR LIVES AND COST SOCIETY BILLIONS OF DOLLARS IF WE DON’T START WORKING SERIOUSLY TOWARD SOLUTIONS.
Obesity leads these children to heart disease, hypertension, respiratory ailments, orthopedic problems, and diabetes. The skyrocketing rate of obesity among lower income children is also dramatically reducing the quality of these young lives. I see obese children and teens every day. As their pediatrician, I see the depression and hopelessness that go hand-in-hand with the physical problems.
The problem is relatively new and rapidly worsening. Thirty-three years ago, when I began treating the children of the South End and Lower Roxbury, I was not confronted with 300-pound 14-year-olds. We worried about chicken pox and measles in children, but not Type II diabetes in teens.
Now, a shocking 40 percent of our 8,000 pediatric patients at the South End Community Health Center are clinically obese. On a recent Friday, 75 percent of the children I saw were obese. Why is this?
* Diets have changed. Inner-city children of immigrants who once ate home-cooked meals of rice and beans now consume fast food once a day or more. Cheap, tasty, on every corner, and buttressed by a barrage of advertising, fast food has become an almost inescapable option for overworked, often single parents with few economic resources. Adding to the problem is the fact that low income neighborhoods have 30 percent fewer supermarkets than more affluent areas.
* Television confines children and teens to the couch, burns no calories, and bombards children with a constant stream of ads for soda, hamburgers, and snack food.
* Exercise has virtually vanished from public schools. In safer suburbs children and teens have opportunities to play outside and to use yards, public parks, and playgrounds. Where and when can inner-city children burn off calories and build their bodies?
The causes are simple. The solutions, unfortunately, are not. What is required is a change in lifestyle. At the community health center level we are ideally situated to recommend the needed changes and monitor and reinforce those changes over the months and years needed to see that lifestyle and health improve.
We are launching the WIN - Weight Initiative Now - pilot program aimed at shaping lifestyle changes for 20 boys and 20 girls. WIN will set guidelines for the children’s diets and exercise. South End Community Health Center personnel will help parents with shopping, cooking, and nutritional advice. We will help to design exercise programs that are workable for inner-city children. Follow-up will include visits in the home as well as at the health center. Our counselors will address the sense of hopelessness that so often accompanies obesity in children and limits their ability to change their situation.
Society at large must act, too. Educators, parents, politicians, and responsible business leaders need to recognize the impact of the problem and find the will to do something about it.
* Soda and snack food vending machines have no place in schools. We can replace them with machines that provide revenues, but sell water, juice, and fruit.
* Bring back the old-fashioned phys-ed requirement. Currently, only Illinois requires daily physical education classes. Children with few other options for safe exercise need a program of activity every day to be both physically and emotionally well.
* School meals must be better balanced and nutritional guidance should be part of what cafeterias offer with their meals.
Finally, let’s stand up to the purveyors of fast food. As a society we took on tobacco and alcohol when their health ravages became too high a price to pay. Junk food is addictive, its advertising pervasive, and its health effects pernicious. Our politicians need to find the courage to stand up to corporations that are selling our children shortened lives.
It is fashionable in some circles to laugh at such talk, to say that "personal responsibility" should drive better health behavior and the market remain unregulated. That is a hard argument to make in the face of a depressed, obese child whose health is failing, who has no safe place to exercise, and is under siege by adults selling him salt, fat, sugar, and a shorter, sadder life. As adults, we have an obligation to do better.
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Dr. Gerald Hass is physician-in-chief at the South End Community Health Center, assistant clinical professor of pediatrics at Harvard Medical School, and a senior associate in medicine at Children’s Hospital.
Comments
- Posted by Cindy on October 20th, 2005
How can we get the outside to reward with other things besides sugar treats?