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From the Front Lines in the Fight Against Latino Obesity: Policy Examples

August 30, 2013 | Carolyn Newbergh

Recent reports that obesity is leveling off among Latino children are encouraging, but with one in six Latino children between ages two and five still obese, much more work must be done to eliminate it altogether, speakers told a Public Health Institute (PHI) Dialogue4Health Web Forum.

“What we’re seeing now is that for the first time in 30 years, we’re holding kind of steady in terms of the obesity rates,” said Amelie Ramirez, DrPH, MPH, founding director of the Institute for Health Promotion Research at the University of Texas Health Science Center in San Antonio, which researches health disparities among minorities, and director of Salud America! “I think we need to be careful and cautious with that. We really need to learn about what’s reversing the tide here, and we need to maintain that momentum and keep it going.”

The Forum, “New Findings and Policies to Advance Healthy Latino Communities,” was the second in a two-part Weight of the Latino Nation series. Its three speakers presented an array of solutions already in place that have resulted in progress in the fight against obesity.

Reigning in the Power of Big Beverage: Policy Change in El Monte, CA

The city of El Monte, in LA County, for instance, is in the forefront of efforts by cities to find ways to reduce high obesity rates – 28.3 percent of El Monte’s children and 27.9 percent of its adults are obese. El Monte is a food desert with junk food “everywhere” and too few streets that are walkable and conducive to riding bicycles, and policy changes were called for to address these environmental conditions, said Mayor Andre Quintero.

“We had a high incidence of obesity and we needed to do something about it,” said Mayor Andre Quintero, who is also a deputy city attorney for Los Angeles.    

The city’s most widely known policy effort was to place a measure on the November 2012 ballot assessing a small business license fee to retail outlets that sell sugary beverages. The measure, which failed, would have supported afterschool programming and upgrading parks to be more recreation friendly. The beverage industry invested at least $2 million to defeat the measure, in a city that spends at most $50,000 per candidate on a city council race, Quintero said.

The industry claimed not to know why childhood obesity is now such a problem, asking whether it is because of genetics or people having less will power today, he said. But Quintero said it would be more telling to ask instead, “Have we built a toxic environment? It’s a question a lot of cities have to ask themselves.”

Although the beverage industry insisted that cities should “stick to what you do” – like fixing potholes and providing police and fire services – cities have an important role to play, he said.

“When you have children who are not engaged in their studies because of health problems related to obesity and other issues, we [the city] get the cumulative effects,” Quintero said. “Our goal in El Monte is to see more of our children get ahead, go to college, and have good healthy, successful lives. But unfortunately, the industry is so powerful and our folks are consuming so much of these drinks, that it has a cumulative effect.”

He urged other cities to do as El Monte has done by adopting comprehensive policies that include nutrition standards, and encourage its people to be active physically and good grocery stores within the city to offer produce that low-income families can afford.

In using a policy approach, El Monte added a health and wellness element to its general plan that he invited other communities to take a look at. El Monte also stopped selling sugar-sweetened beverages in vending machines in public activity facilities and joined Healthy Eating Active Living Cities Campaign.

Building Physical Activity in Los Angeles

The third speaker, Robert Garcia, a civil rights lawyer and founding director of The City Project in Los Angeles, described how his program has increased opportunities for low-income children of color to be more physically active when at school and in the community.

Garcia chaired a school bond measure for the Los Angeles Unified School District that has raised $27 billion to build and modernize schools and their grounds, many in underserved communities - which increased jobs and revenues in the communities as well. The City Project also persuaded the district to comply with federal civil rights laws and state Education Code requirements for physical education and is monitoring progress. To learn more, see The City Project’s publications.

“If children of color and low-income children don’t have physical education in schools, they often don’t engage in physical education,” Garcia said. “There are no parks in the community where they live, and schools tend to be closed after school and on weekends. Parents tend to be concerned about the students’ safety. [So] if they don’t get physical activity at school, they don’t get physical activity. This is a civil rights issue, it’s an equity issue, and it’s a health issue.”

Throughout nine Southern California counties, children of color living in poverty have the worst access to parks and playing fields, the highest childhood obesity rates and are at great risk of gang activity and violence, he said.

Salud America: Research and Innovation to Reverse Obesity

Salud America! established a Latino-based research network of 2,100 leaders nationwide to identify innovative ways to reverse childhood obesity among Latinos.  It has funded 20 pilot research projects. Some of their findings so far are:

  • After a researcher documented trash, lack of sidewalks and a poor built environment in a community, a local affordable housing developer added hiking and biking trails, a recreation center and an outdoor exercise area in a new development.
  • Putting calorie counts on menus in Latino-serving restaurants in LA was a “tremendous benefit,” Ramirez said. Led by PHI vice president Carmen R. Nevarez, MD, MPH, the project developed a toolkit that other restaurants can use.
  • Latino children increased their likelihood of being fit within two years by 10 percent if they participated in afterschool fitness programs.
  • Latino students who played with active videogames in an afterschool program increase their physical endurance - improving performance in running a mile - and math scores
  • Latina teens were taught Photovoice and used it to advocate for city leaders to reopen city pools. They ended up getting PE credit for using a facility outside the school.

George Flores, MD, MPH, program manager for The California Endowment’s Healthy California Prevention team, moderated the forum, which was sponsored by PHI, TCE, Kaiser Permanente and the Latino Coalition for a Healthy California.

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See upcoming web forums on PHI's Dialogue4Health.

Carolyn Newbergh is a writer and editor in PHI's communications department