August 2005

Grant Results

SUMMARY

From September 2000 through December 2003, the American Public Health Association (APHA) convened an advisory group to develop a national action plan to reduce the prevalence of obesity and overweight in children in the United States.

Key Results
Working from the action plan, project staff accomplished the following:

  • Convened a summit meeting of 35 national leaders in the field on October 16, 2002, in Washington, D.C. to discuss how APHA can combat childhood obesity.
  • Prepared two policy statements:
    • "Food Marketing and Advertising Directed at Children and Adolescents: Implications for Overweight" identifies television advertising and in-school marketing as two prevalent forms of marketing to children foods that are high in sugar and fat.
    • "Support for WIC and Child Nutrition Programs" states that the federally funded Special Supplemental Nutrition Program for Women, Infants and Children (WIC) and the Child Nutrition Programs (National School Lunch Program, School Breakfast Program, Child and Adult Care Feeding Program, Summer Food Service Program and the Special Milk Program) provide foods that support optimal nutrition and can potentially reduce the epidemic of childhood overweight by promoting healthy eating.
  • Developed a toolkit, available online, which provides basic information for parents, teachers, students and community leaders to prevent and control childhood overweight and obesity.

Funding
The Robert Wood Johnson Foundation (RWJF) provided $20,051 in funding from September 2000 to December 2003 to support the work.

 See Grant Detail & Contact Information
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THE PROBLEM

According to a 2001 report by the Surgeon General (The Surgeon General's Call To Action To Prevent and Decrease Overweight and Obesity), 13 percent of children aged six to 11 years and 14 percent of adolescents aged 12 to 19 years are overweight. During the past two decades, the percentage of children who are overweight has nearly doubled (from 7 to 13 percent), and the percentage of adolescents who are overweight has almost tripled (from 5 to 14 percent).

Approximately 300,000 U.S. deaths a year are associated with diet and physical inactivity (compared to more than 400,000 deaths a year associated with cigarette smoking), and the total direct and indirect costs attributed to overweight and obesity amounted to $117 billion in the year 2000. Poor diet and lack of exercise are largely to blame. Only 3 percent of Americans met at least four of the five federal recommendations for intake of grains, fruits, vegetables, dairy products and meat, and less than a third of Americans exercised at least 30 minutes five days a week. The report concludes with a call to action to assist Americans in balancing healthful eating with regular physical activity.

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RWJF STRATEGY

This grant project was developed in the early stages of RWJF's interest in physical activity and obesity before staff narrowed its focus to childhood obesity. During the course of this grant, RWJF's Childhood Obesity Team developed a strategy to contribute to efforts to halt the increase in the prevalence of obesity in children by the year 2015, with a focus on children and families in low-income and minority populations, concentrating on ages three to 12, an age range that represents a critical period for developing lifelong habits.

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THE PROJECT

As originally conceived, this project would allow the Washington-based American Public Health Association (APHA), an organization of U.S. public health professionals, to partner with the U.S. Department of Health and Human Services to convene a steering committee for the Initiative to Eliminate Racial and Ethnic Disparities. The project grew out of a White House meeting on health disparities. Steve Schroeder, M.D., then RWJF's president, was a participant in that meeting, and according to Michael McGinnis, M.D., M.P.H, then a vice president and director of the health group at RWJF, and program officer on this vice president's grant, it was "a good-faith gesture to provide modest resources for some follow-up by APHA."

This initiative, announced by President Clinton in 1998, sought to eliminate the differences in health status between the U.S. population as a whole and its racial and ethnic minorities. However, when a change in strategies within the new Bush administration obviated the need for a steering committee, project staff consulted with RWJF to revise the project's objectives. The revised goal was to develop a national plan of action for reducing the prevalence of obesity and overweight among children who are members of racial and ethnic minorities in the United States.

As the project unfolded, however, the target population shifted from minority children to children in general. Project staff convened a 13-member Advisory Group on the Prevention of Childhood Obesity to make recommendations to and guide future actions of the APHA and other organizations represented in the group.

Advisory group members, representing leading organizations dealing with the obesity epidemic, included public health and health care experts, community planners, nutritionists, food industry representatives and staff from government agencies. (See the Appendix for a list of members.) Working from an action plan created by the advisory group, project staff convened a summit meeting of national leaders in the field, prepared two policy statements and developed an online toolkit.

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RESULTS

The project accomplished the following:

  • The Advisory Group on the Prevention of Childhood Obesity developed an action plan addressing overweight and obesity in childhood. The plan, intended to guide future actions of the APHA and other organizations represented in the group, focuses on two main strategies:
    • Strengthening public health policies to address the problem of overweight in children, including:
      1. Charge leadership at the federal, state and local levels with promoting prevention of overweight in children.
      2. Raise public awareness of the issue.
      3. Advocate for legislative and regulatory policies that promote child nutrition and health.
    • Improving public health practice, chiefly by strengthening education and training of health care workers, public health professionals and educators in healthy nutrition, healthy behaviors and physical activity.
  • Project staff convened a summit meeting to discuss how the APHA can combat the epidemic of overweight in U.S. children. The meeting, held on October 16, 2002, in Washington, brought together some 35 experts in the field (including the members of the advisory group): public health educators, community planners, nutritionists, food industry representatives, exercise advocates and staff from government agencies. Attendees endorsed the advisory group's action plan and discussed establishing a coalition of organizations aimed at decreasing obesity rates.
  • In November 2003, the APHA adopted two policy statements regarding children and healthy nutrition:
    • "Food Marketing and Advertising Directed at Children and Adolescents: Implications for Overweight" identifies television advertising and in-school marketing as two prevalent forms of marketing to children foods that are high in sugar and fat. The statement encourages: (1) the elimination of food advertising aimed at young children on children's television programs, and (2) the federal government, states and school districts to designate schools as food advertising-free zones.
    • "Support for WIC and Child Nutrition Programs" states that the federally funded Special Supplemental Nutrition Program for Women, Infants and Children (WIC) and the Child Nutrition Programs (National School Lunch Program, School Breakfast Program, Child and Adult Care Feeding Program, Summer Food Service Program and the Special Milk Program) provide foods that support optimal nutrition and can potentially reduce the epidemic of childhood overweight by promoting healthy eating.

      The statement encourages:
      1. Additional federal funding for WIC and Child Nutrition Programs to support healthy eating, physical activity and overweight prevention for children and their families.
      2. Making grants to states and school districts to help children get better nutrition in school through the use of farm-to-school programs (which connect school lunch programs with local farms), salad bars, school gardens, cold storage and other infrastructure developments.
      3. Creating policies that allow school districts flexibility in the type of milk they offer with school meals (current policy favors whole milk, rather than one percent and nonfat).
  • Project staff developed an online toolkit, entitled "Toolkit for Intervention of Overweight Children and Adolescents: Tools for Parents, Teachers, Students, and Community Leaders to Eliminate Overweight Children and Adolescents." The toolkit, which is available online, provides basic information for parents, teachers, students and community leaders to prevent and control childhood overweight and obesity. It contains:
    1. Definitions, statistics and health consequences of childhood overweight and obesity.
    2. A discussion of the roots of the childhood overweight and obesity epidemic.
    3. Interventions and practical tools for addressing childhood overweight and obesity.

Communications

Project staff published a project-related article in the APHA's newspaper, the Nation's Health, in November 2002 available online to APHA members; the "Toolkit for Intervention of Overweight Children and Adolescents" is available online. The overweight in childhood action plan is available online to members of the APHA with their passwords. See Bibliography for details.

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AFTER THE GRANT

The Advisory Group on the Prevention of Childhood Obesity continues to meet on an informal basis. According to the project director, next steps in regard to the action plan on overweight in childhood are contingent upon additional funding.

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GRANT DETAILS & CONTACT INFORMATION

Project

Project Creates Action Plan and Online Tool Kit to Fight Childhood Obesity

Grantee

American Public Health Association (Washington,  DC)

  • Initiative to Eliminate Racial and Ethnic Health Disparities
    Amount: $ 20,051
    Dates: September 2000 to December 2003
    ID#:  040401

Contact

Barbara Hatcher, Ph.D., M.P.H., R.N.
(202) 777-2490
Barbara.hatcher@apha.org

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APPENDICES


Appendix 1

(Current as of the time of the grant; provided by the grantee organization; not verified by RWJF.)

Advisory Group on the Prevention of Childhood Obesity

Elaine Auld, M.P.H, C.H.E.S.
Executive Director
Society for Public Health Education
Burtonsville, Md.

Stuart Below
Association of State and Territorial Health Officers
Washington, D.C.

Susan Borra, R.D.
Executive Vice President
International Food Information Council
Washington, D.C.

Patricia Crawford, Dr.P.H., R.D.
Department of Nutrition Science
University of California-Berkeley
Berkeley, Calif.

Robert Earle, R.D., M.P.H.
Senior Director of Nutrition Policy
National Food Processors Association
Washington, D.C.

Philip Griner, D.N.Sc., R.N.
School Of Nursing
American Public Health Association Nursing Section
Fairfield University
Fairfield, Conn.

Ellen Harris, Dr.P.H.
Beltsville Human Nutrition Research Center
American Public Health Association Food and Nutrition Section
Beltsville, Md.

Marc S. Jacobson, M.D.
American Academy of Pediatrics
Elk Grove Village, Ill.

Barbara McCann
Director, Quality of Life Campaign
Smart Growth America
Surface Transportation Project
Washington, D.C.

Geraldine Perry, Dr.P.H., R.D.
Centers for Disease Control and Prevention
Tucker, Ga.

Tracey Self
Office of the Secretary
Department of Health and Human Services
Washington, D.C.

Margo Wootan, D.Sc.
Director, Nutrition Policy
Center for Science in the Public Interest
Washington, D.C.

Peggy Yen, R.D., L.D., M.P.H.
Nutrition Consultant
Association of State and Territorial Public Health Nutrition Directors
Division of Cardiovascular Health and Nutrition Program
Maryland Department of Health & Mental Hygiene
Baltimore, Md.

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BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Articles

"APHA Joins with Partners on Overweight in U.S. Children." Nation's Health, November 2002.

Reports

Lee S and Crawford P. Overweight in Childhood Action Plan. Washington: American Public Health Association, 2002. Available online to APHA members with membership password.

Food Marketing and Advertising Directed at Children and Adolescents: Implications for Overweight. Washington: American Public Health Association, 2003. Available online.

Support for WIC and Child Nutrition Programs. Washington: American Public Health Association, 2003. Available online.

World Wide Web Sites

www.apha.org/programs/resources/obesity/proresobesitykit.htm. "Toolkit for Intervention of Overweight Children and Adolescents: Tools for Parents, Teachers, Students and Community Leaders to Eliminate Overweight Children and Adolescents." A toolkit containing basic information aimed at preventing and controlling childhood overweight and obesity. Washington: The American Public Health Association, 2003.

www.apha.org/programs/resources/obesity/obesityactplan.htm. This site contains the overweight in childhood action plan. Available to APHA members with their passwords.

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Report prepared by: Barbara Matacera Barr
Reviewed by: Robert Crum
Reviewed by: Molly McKaughan
Program Officer: J. Michael McGinnis