On Child Obesity

On July 30, 2008, NewTalk hosted an online discussion on obesity. NewTalk is nonpartisan Web site, organized under the auspices of Common Good, a nonpartisan coalition instituted to restore reliability to America’s legal system. Common Good was founded in 2002 by Philip K. Howard, author of " The Collapse of the Common Good." The moderator was Joe L. Frost. As the NewTalk site reminds us, the National Center for Health Statistics reports a third of American children are overweight, and 70 percent of these children will become adults with weight problems. And that often leads to health concerns. A July 26, 2008 New York Times article cited recent data indicating hundreds of thousands of American children are being treated for chronic conditions related to obesity — " Type 2 diabetes, high blood pressure, high cholesterol and acid reflux — all problems linked to obesity that were practically unheard-of in children two decades ago," according to the Times.

NewTalk invited 16 experts to discuss the role of physical activity in combating the crisis, including Stuart L. Brown, National Institute for Play; Charlene R. Burgeson, National Association for Sport and Physical Education; William H. Dietz, Centers for Disease Control and Prevention; Sheila Franklin, National Coalition for Promoting Physical Activity; Joe L. Frost, University of Texas; Joxel Garcia, U.S. Department of Health and Human Services; Darell Hammond, KaBOOM!; James O. Hill, University of Colorado at Denver; Kevin Jeffrey, New York City Parks and Recreation Department; Lee M. Kaplan, MGH Weight Center and MGH Obesity Research Center; Hara Estroff Marano, Psychology Today; Elliot Pellman, ProHEALTH Care Associates; Dwayne Proctor, Robert Wood Johnson Foundation; Lynne Vaughan, YMCA of the USA; Jean Wiecha, Harvard School of Public Health; and Children & Nature Network chairman Richard Louv.

The discussion is posted in its entirety at NewTalk.

Richard Louv’s comments are excerpted below.

It’s important to acknowledge that the greatest increase in child obesity in our history occurred during the same decades as the greatest increase in organized sports for children. Soccer is good, and part of an overall solution, but we do need a wider array of approaches—including a greater focus on nature experience, and better message framing. Last year, I was honored to share a byline with Howard Frumkin, Director of the National Center for Environmental Health /Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention. The article pointed to research that has linked nature experience and “green exercise” to surprisingly broad and special benefits, including more likelihood of physical activity, greater use of the imagination and the senses, enhanced ability to focus, stress reduction, and cognitive advantages. Researchers in England and Sweden have found that joggers who exercise in a natural green setting with trees, foliage, and landscape views, feel more restored, and less anxious, angry, and depressed than people who burn the same amount of calories in gyms or other built settings. Green exercise not only adds value to physical movement, it’s less expensive than joining a gym. As Dr. Frumkin says, " there is still much we need to learn.… But we know enough to act." During the past three years, we’ve seen a burgeoning national movement to get kids into nature. Some of the actions involve urban design and architecture, changes in government policy, and organized programs. In some cases, families are acting independently. For example, one of the approaches that the Children & Nature Network hopes to encourage involves the spread of home-grown nature clubs for families.
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While considering the environments that shape kids, we need to review the connection between child obesity and fear of litigation and the legal structures of both public and private governments. As a powerful deterrent to natural play, fear of liability ranks right behind the bogeyman. Public government restricts children’s access to nature and independent play. So does private government. Most housing tracts, condos and planned communities constructed in the past two to three decades are controlled by strict covenants that discourage or ban the kind of outdoor play many of us enjoyed as children. These private regulations are not enforced evenly, but in some communities, young people who try to recreate their parents’ childhoods may face misdemeanor charges or see their parents sued. (One woman told me that her community association banned chalk-drawing on the sidewalks.) Just try to put up a basketball hoop in some of these neighborhoods, let alone let the kids build a tree house or a fort. Regarding the issue of choice, in areas such as Southern California and much of Florida—as well as the suburban rings around most cities in the U.S.—there isn’t much of a choice anymore.
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One goal should be a nationwide review of public laws and private rules that restrict play. [We also need what I have called a National Conference on Children, Nature and the Law -- bringing together the legal profession, insurance companies, urban planners, parents and others -- to identify ways that government, the private sector, and families can deal with this issue, now and in the future.] Also, as Common Good has recommended, we need to establish public risk commissions to examine areas of our lives that have been radically changed by litigation. We should encourage lawyers, insurance agencies and the public to embrace the concept of comparative risk as a legal and social standard. (Yes, there is risk out there, but there are also huge risks to physical and mental health when we raise a generation of children under protective house arrest.) In the new edition of " Last Child in the Woods," I report a provocative idea suggested by a California environmental lawyer: Create a Leave No Child Inside Legal Defense Fund that would, using pro bono attorneys, help families and organizations fight egregious lawsuits that restrict children’s play. [Such a campaign could bring media attention to the legal barriers to physical play and also to methods to encourage independent play while not sacrificing safety.]
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On a positive note, real estate developers are taking notice of a potential new market. Last year, Clint Eastwood sponsored a gathering in Carmel of some of California’s largest developers to consider the issues raised in the book, and to discuss how they can design, build, and market future communities that connect children to nature. Among the ideas proposed by these and other developers: leave some land and native habitat in place (that’s a good start); employ green design principles; incorporate nature trails and natural waterways; throw out or reduce the conventional covenants and restrictions that discourage or prohibit natural play and rewrite the rules to encourage it; allow kids to build forts and tree houses or plant gardens; and create small, on-site nature centers. In such a discussion, it’s a short conceptual leap from excusing more sprawl by giving it a green patina to redeveloping decayed portions of decaying urban and suburban neighborhoods, into eco-communities where nature would be an essential strand in the fabric of daily life. The fact that developers, builders, and real estate marketers—at least the ones I met with—would approach this challenge with such apparently heartfelt enthusiasm was encouraging. We’ll see how serious they are.
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Clearly, the causes and solutions are complex, and there are no magic bullets. But as the society moves toward solutions, it would be useful to focus on nature experience at two levels. First we need more research on the impact of the natural world on child development and health. Second, growing public concern about the disconnect between children and nature can serve as a strong organizing tool to increase public awareness and action regarding child obesity. To many adults, particularly those who are overweight themselves, the topic of child obesity, per se, may be an abstract and uncomfortable issue to confront. Progress may be especially slow in states where the majority of the adult populations are overweight or obese. But people of all sizes and political points of view can relate to the fact that so many children are missing out on the gifts of nature. Therefore, the children and nature movement has a special utility on the child obesity front. As Joe Frost said earlier, the nature deficit is an emotionally charged issue—in a positive way. People feel it viscerally. Their concern transcends political and religious boundaries. As a consequence, bills are being passed or considered, including the federal No Child Left Inside Act. In the U.S. and Canada, the Children & Nature Network has identified over 50 state and regional campaigns, organized as community-based, multi-sector collaboratives. In addition, tools for more direct cultural change are emerging. For example, nature clubs are being launched by families—on their own, without waiting for funding or formal programs. In inner cities, suburbs and rural areas, families can turn to other families to arrange for weekend hikes and other nature adventures, and feel safer doing so. What if such networks [Nature Clubs for Families] spread as quickly as Neighborhood Watch programs did in the 1970′s? Two weeks ago, the Today Show produced a segment on the idea, which can be viewed at the Children and Nature Network, along with a map of the regional campaigns and other information. A focus on childhood obesity is already a part of this movement. With new partnerships, the potential is even greater.

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SELECTED QUOTES FROM THE CONVERSATION:

Stuart L. Brown, president, National Institute for Play: Play is the product of many millions of years of evolutionary trial and error. It is a primary element in crafting the human social brain, and by its nature, particularly in childhood, fosters movement and joyful activity.

Dwayne Proctor, Childhood Obesity Team Leader and Senior Program Officer, Robert Wood Johnson Foundation: The young African American girl who confronts threats of interpersonal violence, gang recruitment, or vehicular traffic patterns that do not allow walking or biking to school, or the Latino boy who may attend schools without a functioning gymnasium, physical education classes, recess or opportunities to be active in before- or after-school programs are not likely to be active. The rural children separated by distance between neighbors and who have no access to safe places for play and exercise are not likely to move in any meaningful way. And in each case, there are the parents who love their children and who know of the real threats outside of their doors—they are not likely to encourage their children to be outside unsupervised. These scenes play out every day in urban, rural and suburban settings. Our children need physical activity built back into the places where they live and learn in order for them to play and be active.

Joxel Garcia, Assistant Secretary for Health, U.S. Department of Health and Human Services:… a few basics from the CDC’s report on the contributing factors of obesity and overweight: " One of the reasons for children being less active is that children are spending less time engaged in physical activity during school. Daily participation in school physical education among adolescents dropped 14 percentage points over the last 13 years—from 42% in 1991 to 28% in 2003. In addition, less than one-third (28%) of high school students meet currently recommended levels of physical activity.

Joe L. Frost, Parker Centennial Professor Emeritus, University of Texas: A century ago sedentary activity and obesity were rare, but more common among the affluent. Children in both country and city worked alongside adults at home and enjoyed two or three recesses for play each day at school. Food came directly from the land. Playgrounds in the country were the challenging streams, forests and farm yards. In larger cities, a major child saving movement was underway, including sub-movements for playgrounds, school gardens, organized camps, and nature study—all intended to protect children from the poverty and dangers of the street, and improve health, fitness and civic responsibility. Up to 200,000 children, including many orphans and immigrants, were sent to live with farm families on “orphan trains” to escape the degradation of the slums. Theodore Roosevelt was playing a significant role in helping ensure the health and fitness of future Americans – preserving the national forests, creating national parks, encouraging fitness, creating small park playgrounds in cities, even helping create and serving as honorary president of the Playground Association of America…
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Children need both organized activity and free, spontaneous play. The research program at Redeemer School in Austin has operated continuously since 1976 with the assistance of University of Texas faculty and graduate students…The grounds include a schoolyard habitat certified by the National Wildlife Federation, wet-lands, green houses and gardens, all integrated with the three playgrounds. Food from the gardens is donated by the children to Meals on Wheels and served in the school cafeteria… The Redeemer children participate in daily PE and recess. There are few restrictions on free, spontaneous play. Contact games, chase, rough and tumble, tag, dodge ball, and using increasingly challenging play structures at full speed in these games is allowed. The obesity rate is less than five percent in a state where the rate is 19 percent.

Darell Hammond, CEO & Co-Founder, KaBOOM!: I think that we can’t talk about our current sedentary lifestyles without talking about the outdoor and free play deficit in our country right now.
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Three weeks before Hurricane Katrina I was contacted about a plan to cut recess in New Orleans’ schools. The school district was able to remove recess all together, as the superintendent stated " without consequence" , because only three parents showed up to voice their opposition. What is needed is 300 parents fighting for a child’s need for time outdoors, engaged with their peers, reaping the benefits of unstructured play. We need to change passive agreement about the benefits of play and physical activity for children into active engagement with communities raising their civic voices together.
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In communities where beautiful playspaces have been installed without input from the people who live there, usage isn’t as high as it is in places where community members have come together to design, fundraise for, and build the space themselves. Where there is no investment from children and adults in the surrounding community, there is no value placed in that space. Vandalism and undesirable usage can result, along with simple lack of use. Any public space in the built environment should be designed and implemented with the user community’s input. Organizing your community to build a great place to play is one way to begin to expand the social capital in a neighborhood.

Hara Esteroff Marano, Editor-at-Large, Psychology Today magazine: Obviously, it’s not enough for one brave parent to push a child out the door. There must be others to play WITH. At the grassroots level, parents have to be encouraged to get together with a couple of their neighbors. So yes, a massive public education campaign about the value of activity and the need for play, but also nitty-gritty suggestions for how to do it…local “organizing” seems to be desirable and necessary. This is the level at which parents seem to be receptive.

Jean Wiecha, Senior Research Scientist Harvard School of Public Health: I’d recommend that residents dialog with town engineers to ensure that road reconstruction projects favor walking and cycling. We’ve just done this in my town and it will result in a significantly safer roadway. And all of us need to drive less, of course.…. In our area we are inundated with warnings about ticks and mosquitoes. Common sense suggests that bug spray and a good scrub will prevent most problems, but parents keep their kids inside anyway. And kids internalize this and add it to why they won’t go out: there are bugs outside (bad) and my computer is inside (good). I’m not trying to minimize the impact of these illnesses, but everyone benefits from time immersed in nature.

Kevin Jeffrey, Deputy Commissioner for Public Programs, New York City Parks and Recreation Department: Under PlaNYC, 290 schoolyards in underserved neighborhoods will be open and accessible after school, on weekends, and during school breaks ….Parks, in collaboration with the NYC Department of Education (DOE) and the Trust for Public Land will transform the remaining 221 schoolyards into model community parks … that will include children, parents and teachers in the planning. Parks will utilize its design expertise and incorporate current technology that promotes imaginative play, while leaving room for traditional recreation.
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On a federal level, it would be heartening to see at least a portion of the public dollars now dedicated to medical treatment of obesity and its related health issues diverted to support preventive programs. David Rockwell’s imagination playgrounds and the play worker movement, Richard Louv’s design concepts that incorporate natural elements as features, programs like the YMCA’s assessment initiative, and the refunding of legislated programs such as the Land and Water Conservation Fund and the Urban Parks and Recreation Recovery fund that helped develop and maintain open recreation spaces throughout the country, as Sheila Franklin mentioned yesterday are, as we have discussed over the last two days, examples of effective responses to this crisis.

William H. Dietz, Director of the Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention: With respect to getting the population moving again, there is probably no more important legislation than the transportation bill, which will be up for reauthorization in the next session of Congress. The bill is known as the Safe, Accountable, Flexible, Efficient Transportation Equity Act : a Legacy for Users (SAFTEA-LU).This bill includes support for public transportation, safe routes to school, and community infrastructure that supports physical activity, such as recreational trails, bicycle transportation and pedestrian walkways. This bill is to physical activity what the farm bill is to nutrition.

Sheila Franklin, Executive Director, National Coalition for Promoting Physical Activity: …it is essential that this become a united effort…across organizations but most importantly across departments in government, at the local and state level, but especially at the federal level. The need for a united cross-departmental federal effort towards a reduction in obesity has been a topic at several meetings I have recently attended. I agree that it is essential that policies be enacted that foster engineering physical activity back into people’s lives. I think that there is no one policy or program that is going to solve the problem (physical inactivity) at all levels and that it will take a multi-pronged approach that targets specific populations.

Charlene R. Burgeson, Executive Director, National Association for Sport and Physical Education: The Partnership for Play Every Day wants to see all communities gather key stakeholders to create a community environment that encourages play.

Lynne Vaughan, Senior Vice President and Chief Innovation Officer, YMCA of the USA: Our collective efforts in tackling this nationwide challenge often start with what we can do — rather than engaging kids of all ages in the solution. When young people are engaged in creating activities, preparing meals, solving problems they often land on solutions that we as grown-ups can no longer see. I recognize that we need a multi-pronged approach yet we often forget that kids have a voice and an opportunity to contribute. How do we allow kids of all ages to be part of the solution?

James O. Hill, Professor of Pediatrics and Medicine, University of Colorado at Denver: We may be at a critical stage if we are going to reverse the high rates of obesity and the high rates of inactivity. Some people believe we will all end up being obese. Further, the impact of the physical environment on reducing physical activity is not static, but is getting worse. We have to implement more strategies now, even if some of them will not pay off for a while.

Read the full discussion at NewTalk.

New Development: A new study linking improvement in child obesity to nearby nature in urban neighborhoods.

New Development: First Lady to launch campaign against child obesity.

New Development: C&NN and partners launch Nature Rocks campaign to help parents get their families outside in nature.
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