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Childhood Obesity Initiative addresses daunting problem

Body composition testing for fifth graders shows that 20 out of 24 City Heights schools have higher levels of students not in the healthy zone than the state average, as measured by the California Department of Education’s 2012 Healthy Fitness Zone test.Tackling a problem like childhood obesity means looking at every part of a family's life.

"Childhood obesity is the result of so many causal factors: virtually everything, [including] how our society been shaped over the last 20 to 30 years," said Cheryl Moder, director of the San Diego County Childhood Obesity Initiative at Community Health Improvement Partners.

She gave some common examples.

"Fast food is everywhere: cheap food that is calorie dense and virtually has no nutritional value," she said. Another problem is "the fact that we have basically engineered out of our society any real need for physical activity."

That gives the Childhood Obesity Initiative a daunting task: one the group has been working on for almost 10 years.

Community Health Improvement Partners, or CHIP, facilitates the Childhood Obesity Initiative. County Supervisors Ron Roberts' and Pam Slater-Price's concern about the effect of childhood obesity on the San Diego population led to the push for the Initiative's formation.

"This really brought together some traditional and nontraditional partners to the table to discuss the issue," she said.

Those partners include city and county governments, health-care agencies, schools, early childhood care providers, community partners, community-based organizations and residents, the media and businesses. This broad partnership is necessary to attack such a pervasive problem.

"Our efforts are really focused not on individual behavior change, not on things like nutrition education and physical activity programming per se, but really focusing more upstream on the root causes, really looking at the environments people are living in and the policies that shape those environments," Moder said.

Moder said three major funders support the group's work: The County of San Diego Health and Human Services Agency, Kaiser Permanente and The California Endowment.

The Endowment work includes policy stewardship, designed to increase the awareness among elected officials about community prevention strategies related to childhood obesity, she said. The Endowment also drives participation in the farm-to-school task force, which is working to bring more locally grown produce to school meals and support farmers.

"That's a very exciting project," she said. "We've seen San Diego Unified really be a leader in this area."

According to CHIP, the amount of local produce purchased by San Diego Unified has increased dramatically, from 172,081 pounds in the 2011-12 school year to 369,861 pounds from September to December in 2013.

The Initiative also worked with the school district and the County Department of Environmental Health to create guidelines for using produce from school gardens in meals.

As part of the group's City Heights specific work, the Initiative has a youth development program, called Youth Engagement and Action for Health or YEAH!, where it trains young people to do assessments and advocate for improvements. The Initiative also participates in the Mid-City CAN Food Justice Momentum Team, a work group that focuses on increasing access to healthy, affordable food. The Food Justice team is looking at mobile food vending, and the restaurant meals program, which allows seniors, disabled and the homeless to use their CalFresh benefits, or government food assistance, to get a hot meal.

"It's really no coincidence that the same communities that have suffered from years of disinvestment also have issues relating to infrastructure, to issues around transportation, ... are suffering from bigger issues like education, poverty, what we call the social determinants of health," she said. "What your environment looks like really does shape your health outcome."

City Heights proves her point. Body composition testing for fifth graders shows that 20 out of 24 City Heights schools have higher levels of students not in the healthy zone than the state average, as measured by the California Department of Education's 2012 Healthy Fitness Zone test.

Moder said the Initiative looks at two groups of factors that contribute to this.

"Do people have access in their neighborhoods to fresh, affordable healthy food?" is one question, she said. "Ideally, food that has been grown locally and not traveled a great long distance."

The Initiative also looks at active living and safety.

"Does the community have sidewalks, bike paths, safe routes to schools, playgrounds, parks, etc.?" she asked. And if so, "are there other issues that prevent families from allowing their children to go outside and play: public safety issues, gangs, homelessness, violence?"

Ultimately, the initiative has to look at a problem with causes that include almost every part of the environment.

"Where you live, where you work, where you play, where you go to school, where you worship, every one of these places influences the decisions you make on a daily basis," Moder said.

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