In June of 2005, Hispanic Outlook reported on the health of the children living in Rio Grande City, a border town in Starr County, Texas, one of the poorest counties in the U.S. Most of the children living there were Mexican American, and at the time, their rates of obesity were among some of the highest in the nation.
Unfortunately, little has changed in the past 11 years for the children of Starr County and for Hispanic children in general, according to Nancy F. Butte, Ph.D, professor of pediatrics, Baylor College of Medicine, Houston, Texas. “In the U.S. we do see higher rates of childhood obesity amongst the lower socio-economic groups, and that tends to be a predominance of Hispanic and African American children and also Native Americans,” Butte said.
According to the U.S. Department of Health and Human Services Office of Minority Health, from 2009-2010 Mexican American children were 1.6 times more likely to be overweight than non-Hispanic White Children. In 2013, the CDC looked at children and adolescents ages six-11 years of age. It found that the percentage that were overweight among Mexican American girls was 22.4 as compared to 14 for non-Hispanic White girls. The percentage for Mexican American boys was 24.3 as compared to 18.6 for non-Hispanic white males.
Let’s Move, the initiative launched by Michelle Obama, indicates that childhood obesity in the Hispanic population is growing faster than all other population segments with nearly two in five Hispanic children ages two–19 being overweight or obese. And the National Council of LaRaza says that Hispanic children are more likely to experience obesity than other children. Obese children are more likely to struggle with weight gain throughout adulthood and could have poorer health outcomes. Childhood obesity can contribute to higher risks for diabetes, heart disease, high blood pressure, cancer and asthma. To exacerbate the situation, the treatment of childhood obesity is not a reimbursable healthcare cost. “You can’t refer a child just for childhood obesity. That is an ongoing issue and fight,” Butte said.
Stemming the Tide
Butte has spent a significant portion of her career trying to prevent, or at least curtail, childhood obesity. Although she has not seen the results she would like, she’s seen steps in the right direction. “The good news in all of this is that we think that childhood obesity has plateaued in the past decade. Although we’d like to see it going south a lot faster, at least a plateau is some degree of success,” Butte said. In fact, there is some evidence that obesity is declining among preschoolers.
Another step in the right direction is an increase in funding for obesity researcher. More groups than ever are studying the issue. In 2011, Butte and researchers from San Diego State University and the Massachusetts State Department of Public Health received funding from the CDC to perform obesity intervention on children ages two-12 in underserved areas. The Childhood Obesity Research Demonstration Project (CORD) intervened in the diets of children in rural and urban communities in Massachusetts and in border towns in Texas and San Diego from 2011 to 2015. Although the intervention was not restricted by ethnicity, 85 percent of participants were Hispanic. Butte submitted the results in April and will make them public later this year.
Obesity is not a simple issue. Because of its complexity the CDC insisted CORD be multi-sector and multilevel. Nutritionists, doctors and researchers can easily intervene in children’s diets in schools and in clinics but have little influence over dietary preferences at home. This reality means their success in reversing childhood obesity can be limited. To turn the wave, Butte said, nutritionists need to attack the problem from several angles and levels. “There is not going to be one bullet to turn this around,” Butte said.
During CORD, Butte and her fellow researchers intervened using both primary and secondary prevention. Using secondary prevention, researchers identified children who were already obese and offered them a more intense program. During primary prevention, as its name implies, researchers intervened in schools, clinics, pre-schools and Head Start Programs before children became obese.
Many low-income parents can’t afford to offer nutritious meals at home. Some can’t afford to offer any meals. Consequently, low-income students are often forced to eat two meals in their school cafeterias. Districts are sensitive to the needs of these students and now provide a variety of healthy selections. “Here in Texas there was an effort to really change the amount of deep fried foods and bring in healthy food options,” Butte said. Some schools removed vending machines. “There’s definitely efforts at many levels to improve the school environment. I think that is an important step in countering obesity,” Butte said.
Diet alone may not be enough to stem the tide of childhood obesity. Physical activity and physical education are key components in healthy living. Unfortunately, Butte said, many school districts had eliminated physical education programs. And those that still offered them didn’t make them mandatory. In recent years, however, there has been an upswing in more effective physical education programs in U.S. schools. “There is recognition of the importance of physical activity and it’s being reintroduced at various levels depending on the resources of the school,” Butte said.
Butte is a researcher intent on gathering and presenting data. But that was just part of her role in CORD. She truly cares for the individuals she is studying and is dedicated to improving their quality of life. During the project, Butte got to know her subjects and found that the families she encountered, be they Hispanic or African America, were seeking a better life for their children. In most cases the families who participated in CORD have a long family history of obesity. “There is a very strong genetic component. They know obesity runs in their families. They have family members who have diabetes and have lost limbs. They are very motivated to find a better lifestyle for their children. They seek out information; they seek out resources, and they seek out these types of programs,” Butte said. •