More Than a Choice

More Than a Choice

Bethany Herold

Professor Robin Schofield

ENG 122 1N5

2 August 2014

More Than A Choice

To what extent does an impoverished family have control over their child’s fitness and nutrition? Although influenced by the same factors that affect other Americans, such as lack of exercise and increased food portions, impoverished families face unparalleled challenges that prevent them from healthy behaviors. According to a recent medical study on childhood obesity, almost 17% of youth were obese in 2009–2010, and rates were higher still among low-income communities, with these children having their odds increased an additional 28% (Ogden et al. 6). Poverty-stricken childhood obesity is a significant public health issue that needs to be addressed in part by local communities. As a growing amount of Americans are becoming victims of economic insecurity, it is crucial to realize why and how poverty correlates with obesity among children. In order to fight this national burden, Americans must understand exactly what impoverished childhood obesity is, how it might be caused, the disadvantages that this class faces, the adverse issues that arise from obesity, and how a community can actively strive to fight this epidemic. Although many are quick to point the finger at impoverished families regarding the cause of obesity and weight related issues for children in poverty, they have overlooked the possibility that this is not caused by personal choice, but by the adverse effect of a poverty stricken environment that requires government and community involvement to alleviate.

Before analyzing the who, what, and why’s of obesity among children in poverty, it is necessary to specify the parameters that encompass and define overweight, obese, and poverty. The National Center for Health Statistics defines obesity as “body mass index (BMI) at or above the 95th percentile adjusted for age and gender.” (Ogden et al. 6). Overweight is “defined as a BMI at or above the 85th

percentile and lower than the 95th percentile for children of the same age and sex” (Barlow 164). Both terms show signs of deviant or excessive fat accumulation that may impair health, and signify a weight problem in children. The defining gap between overweight and obese is rather small, with it taking only a significantly small increase in weight to move from one extremity to another, and therefore both classifications should be treated as equally dangerous and important. Poverty is closely related with socioeconomic status (SES), and according to the U.S. Census Bureau, is characterized by “[using] a set of money income thresholds that vary by family size and composition to determine who is in poverty. If a family’s total income is less than the family’s threshold, then that family and every individual in it is considered in poverty.” (1). Studies are beginning to show frequent and growing connections between the weight and obesity epidemic of children in correlation with family income status. According to a research study performed by MD Victor Vieweg, “youths in a low socioeconomic category were more likely to be obese and less likely to eat a proper diet” (11).

There are numerous factors behind the poverty-stricken childhood obesity epidemic, and there is much debate on whether or not some factors have a more weighted influence than others. Healthy eating and exercise are clear choices that all Americans can implement to help prevent childhood obesity and associated health problems. In our modern age, people experience an increase in physical inactivity due to the progressively sedentary nature of many job positions, changing modes of transportation, and acceleration of urbanization. That lack of physical exertion, compiled with an increased intake of energy-dense foods that are high in fat, is a leading cause of childhood obesity. Although acknowledging lack of exercise and poor nutrition as culprits, child MD Sharon Okie brings new research to light that supplies other causes, such as the ‘thrifty gene’, which has been discovered to make certain people more likely to eat in excess in case of famine (49). This, coupled with economic insecurity, encourage these children to take in as much food as possible in the rare times it is offered in abundance.

According to frequent research and studies, children who live in poverty are the most likely to have high obesity statistics, verifying that they are the most vulnerable group. In Dr. Okie’s book FED UP!, a common theme is that parents need to step up their discipline, because with lack of rules in a home a child is more likely to freely watch TV, play video games, and eat whatever they want all day as they please. Journalist Adrian Lowe believes, according to research and court cases, that childhood obesity is solely the responsibility of the parents, and hence they alone contribute to weight related issues among children in the home (1). Lowe, Okie, and many others with their beliefs argue that parents simply need to take more responsibility for their child’s health and actions by making the right choices related to food and exercise. Medical author Colleen Thompson concurs with this opinion, claiming that “the whole family [must adopt] these [healthy] behaviors. …[because] parents are the best teachers.” (14). With this perspective, one would assume that obese children are only overweight because the parents are already so, due to their own personal choice. It could also be said that poor children simply make pitiful food choices, and care little for exercise. Does this mean poor parents are bad role models, and that poor children are simply lazy and prone to poor food choices when compared to their upper-class peers?

The answer as to who is involved and needs to be directly concerned about this urgent matter is up for discussion. For one, choice of food and exercise is rarely the decision of the child’s, and poverty-stricken communities hold many obstructions to engaging in a healthy lifestyle. Sharon Dalton and Anne Harding, the first a credible nutritionist and the second a first-class reporter, believe the issue is largely caused by the strain of parenting due to stress brought upon by poverty. Dalton, for example, reasons that “the [obesity] risks do not seem immediate for children…parents are more concerned about unsafe neighborhoods, alcohol and illegal drug use, and sexual activity” (1). Often these neighborhoods are lacking parks, trails, and free recreational centers, and the few that are available are a far cry from a safe environment. According to Shakira Suglia Sc.D., an assistant professor of epidemiology, “when you talk about all these risk factors that we looked at—in terms of violence, and moving around a lot, and depression—certainly childhood obesity goes down the importance rank.” (qtd. in Harding 3).

Neighborhoods can be in danger of crime, which requires parents go out of their way to keep children

safe and indoors. Unfortunately, this only promotes inactive behaviors such as watching TV and playing video games.

Several factors of poverty influence a family’s grocery shopping and fitness choices, and money is the primary determining factor. When journalist Carey Polis explored a recent study, he found “[Junk] food [on average] is about $1.50 cheaper per day [than nutritious food]” and saves roughly “$550 per year” which is a large sum of money for a destitute family (pars. 2). These families are required to spend as little as possible, and therefore rely on cheap, calorie filled foods that have lower nutritional value to feed their young. Although less expensive, these highly-processed and energy-dense foods will often have little to no nutritional quality and this, coupled with over-consumption of calories, has been connected to obesity. These foods are also deficient in vitamins and nutrition, giving children the impulse to eat more food to make up for lack of quality. Insufficient funds can also prevent children from getting appropriate exercise, as registration fees, checkups, and equipment make sports a hefty expenditure. Participation fees alone can go up to one thousand dollars, and adding in the equipment, apparel and travel expenses, parents are looking at dollar amounts in the thousands (Kids PlayUSAFoundation.com). Cost of quality food and exercise can be straining enough on families of the middle-class rank, and is virtually impossible for those in poverty.

Aside from finances, one’s local community can prevent under-privileged children from maintaining a healthy weight, as location is crucial to both healthy food options and exercise. While suburbs and rural areas have many full-service grocery stores and farmers’ markets, low-income communities usually have fast-food chains and cheap convenience stores in abundance. Children living in these neighborhoods generally have lack of access to decent parks, while crime and traffic are also major deterrents to playing outside. The lack of resources stretches as far schools for low-income children, and according to the UCLA Center to Eliminate Health Disparities “Students in low-income

schools spend less time being active during physical education classes and are less likely to have

recess, both of which are of great concern given the already limited opportunities for physical activity in their communities” (Barros et al. 432). To make matters worse, the Food Research and Action Center has discovered that “Low-income youth and adults are exposed to disproportionately more marketing and advertising for obesity-promoting product that encourage the consumption of unhealthful foods and discourage physical activity (e.g., fast food, sugary beverages, television shows, video games).” ( FRAC.com).

Karen McCurdy, a professor of nutrition and human development, provides a different way of looking causation, stating that the parenting factor of childhood obesity is more of an emotional consequence than a physical one. Although acknowledging other causes, such as location and lack of resources, McCurdy and her associates’ study shows that there are underlying emotional factors that cause obesity. This concept is called the stress theory, and it states that “parents struggling to make ends meet because of lack of income, underemployment, and low-wage jobs experience heightened stress that leads to changes in emotions and behaviors that hurt their parenting and affect their children adversely.”(McCurdy et al. 144). When conclusions were drawn, the study specifically emphasized the importance of the parent(s)’ involvement in the child’s nutrition and exercise, showing the connection between stressed and depressed parents and obese children.

It is clear that childhood obesity, especially for those in poverty, is a growing issue that should raise concern for all parties that are involved. Investigation has confirmed that obese children are at a higher risk for ongoing health problems such as cardiovascular disease, depression and certain cancers. A first-hand study released in a 2014 article by researcher Lee Hedwig found that “poverty prior to 2 years of age and the time-varying measure of poverty after 2 years of age were both associated with risk of obesity by age 15.5” (72). This displays how the earliest years can truly define a child’s future weight and health. Okie believes this epidemic is setting the stage for premature death rates among our

younger generations. Citing a recent study by Norwegian researchers surveying a group of 227,003

people from adolescents to late 60s, she shared that “being overweight in [childhood] affects mortality rates about equally in both sexes.” (Okie 20). This supports her claim that the early onset of obesity can set the stage for one’s entire life. Dalton also supports this position, and goes into even further detail by explicitly stating the proven facts of detrimental health brought upon by childhood obesity. Some health dangers that recent studies have found include statistics such as “twenty five percent of obese children show signs of glucose intolerance, a precursor to type 2 diabetes; [and] this generation of children could be the first to have a shorter life expectancy than their parent’s generation.” (Dalton 1). These doctors make it clear that health issues can and will arise later in life due to childhood obesity, and therefore it should be a concern of the entire nation.

The website for the Center for the Study of Social Policy, contains an article sharing strategies for preventing childhood obesity, as well as the costs that will be accrued if things go on unchanged. Aside from medical issues for the individual, “A collaborative report by the United Health Foundation, the American Public Health Association and Partnership for Prevention says that the United States is projected to spend $344 billion in obesity-related health care costs in 2018 if obesity levels continue to increase at their current rate.” (Results-Based Public Policy 3). With medical and financial consequences abounding, the effect of obesity on the psyche of our future generation is also of great concern. Weight gain affects many areas of daily socialization, and can reveal itself through depression, low self-esteem, body dissatisfaction, teasing among peers, lower success rates, and inferiority. Finally, obesity breeds obesity, and obese parents are most likely to pass those traits onto their young, thereby continuing the cycle of an unhealthy lifestyle.

With childhood obesity amongst impoverished communities growing at such fast rate and increasing risks and urgency, it is important to start actively moving towards a viable solution. McCurdy believes the issue can be significantly resolved by parental contribution. She stresses the

importance of parent’s involvement, showing the connection between stressed and depressed parents,

and obese children. However, McCurdy does acknowledge the need of help from outside the home, suggesting that the nutritional and mental support programs be synced into one program targeting families in need (148). Okie sees the problem lying greatly within the schools; not just the home environment. As children spent a large part of their lives at school, she goes into great detail evaluating how “most schools in the United States have no nutritional policy specifying what kinds of food and drink are considered healthy or appropriate to be sold on their premise.” (Okie 191). Many highly processed foods are also subconsciously pushed towards children, as purchasing these foods often has financial incentives for school programs.

According to Dalton, “intervention from both business and government-local and federal-is required.” (1). Reports from the Robert Wood Foundation show that impoverished communities have even greater exposure to junk food advertising, and it does not help that poor children are more likely to be in front of the tube in the first place. Throughout these views, it is clear that parenting is a factor, but much of this could be affected by city and school involvement, and resolved with more access to adequate food and exercise sources in poor communities. Harding also believes that action needs to be taken by the government. She stresses the importance of the American population recognizing how hard it is for impoverished families to provide their young with proper food choices, claiming that “efforts to fight obesity in low-income families will need to take into account the extra challenges these families face”. She also suggests school based campaigns, as they play a huge part in a child’s nutritional development.

Although often the responsibility of the parents, there are many actions that cities and school districts can take to help fight the ever growing epidemic. By simply enforcing more physical activity time at schools, making lunches more nutritious, and better supplying low-income areas with decent grocery stores and parks, community involvement can make a difference. Action must be taken now, because “obesity most commonly starts before adulthood and obesity-related problems are now an epidemic; interventions [in the school years] must become a high national priority” (Vieweg et al. 13). It is undeniable that young, impoverished children are one of the highest risk obesity groups. Many factors play a role in this epidemic, therefore obesity in poor children seems to be combination of lack of access resources and finances, poor or distracted parenting, and lack of safe physical activity outlets. Many issues do accompany this seemingly short term problem, so these young, delicate years of childhood are crucial, and are setting the stage for our future generations. In conclusion to research finding excessive childhood obesity in the United States, S. A. Phipps determined that “both policy and further research directed at reducing child obesity in North America should be particularly focused on issues surrounding poverty. …we need to improve our understanding both about how best to reduce child poverty and how to develop policies which can mediate solutions in the pathways from poverty to obesity with children.” (8).

A child has little say regarding the world they are born into, and they have equally less control when determining their diets and exercise levels. For parents in poverty, individual choices can be made to limit food intake that includes highly processed carbohydrates, fats, and sugars, increase whole and natural food intake, and also strive to fit some form of exercise into a child’s daily routine. The local community can make a huge difference, simply by making regular physical activity and healthier dietary choices available, affordable and easily accessible to the impoverished communities. This can include the upkeep of safer parks, more affordable recreational centers, and after school programs. On the government side, healthier food shopping options need to be more conveniently located to the impoverished communities, allowing for more than simple convenience stores within walking distance. Schools, especially those in areas of concentrated poverty, need more regulations and increased nutrition and fitness programs. Finally, advertisers on a national level need to understand how great their influence is on the mind of a child, and must start practicing responsible junk food marketing,

especially those aimed at children and teenagers. Help needs to come from many sides, including the

home and parents, but due to the vastness and lack of control on the issue, it is crucial the government, communities, and schools step up to the plate. With proper government funding for essential programs, and a drastic change in the US school system in regards to nutrition and recess, it will be easier for parents in poverty to raise healthy children for our future generations.

Works Cited

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Barros, R. M., Silver, E. J., & Stein, R. E. (2009). School recess and group classroom behavior. Pediatrics, 123(2), 431-436.

Dalton, Sharron. “Our Vulnerable Children: Poor and Overweight.” Southern Medical Journal Jan. 2007: 1+. Academic Search Complete. Web. 28 May 2014.

Frac.org. Version number. FRAC: Food Research and Action Center, 2010. Web. 08 June 2014.

Harding, Anne. “As Childhood Obesity Improves, Will Kids In Poverty Be Left Behind?” Health Magazine. CNN, 1 May 2012. Web. 3 July 2014.

Kids Play USA Foundation: Overview and Cost of Youth Sports. Kids Play USA Foundation. 2012. Web. 19 June 2014.

Lee, Hedwig, et al. “Longitudinal Associations Between Poverty And Obesity From Birth Through Adolescence.” American Journal Of Public Health 104.5 (2014): e70-e76. Academic Search Complete. Web. 5 June 2014.

Lowe, Adrian. “Is This Child Abuse? The Courts Think So.” Victoria. The Age Newspaper. 12 July 2012. Web. 28 July 2014.

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Ogden CL, Carroll MD, Kit BK, Flegal KM. “Prevalence of obesity in the United States, 2009–2010.” NCHS data brief, no 82. Hyattsville, MD: National Center for Health Statistics. 2012. Web. 18

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Okie, Susan. FED UP! Winning the War Against Childhood Obesity. Washington, D.C: Joseph Henry Press, 2005. Print.

Phipps, S. A., et al. “Poverty And The Extent Of Child Obesity In Canada, Norway And The United States.” Obesity Reviews 7.1 (2006): 5-12. Academic Search Complete. Web. 3 July 2014.

Policy for Results.org. “Results-Based Public Policy Strategies for Preventing Childhood Obesity.” Center for the Study of Social Policy. February 2001. Web. 7 July 2014.

Polis, Carey. “Eating Healthy vs. Unhealthy Will Cost You $550 More Per Year, Study Reveals” The Huffington Post. HuffingtonPost.com, Inc., 2 Dec. 2013. Web. 18 June 2014.

Teder, Marie, et al. “Family-Based Behavioral Intervention Program For Obese Children: An Observational Study Of Child And Parent Lifestyle Interpretations.”Plos ONE 8.8 (2013): 1-8. Academic Search Complete. Web. 23 July 2014.

Thompson, Colleen A. and Ellen L. Shanley. Overcoming Childhood Obesity. Boulder, Colorado: Bull Publishing Company, 2004. Print.

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Vieweg, Victor R., et al. “Correlation Between High Risk Obesity Groups And Low Socioeconomic Status In School Children.” Southern Medical Journal 100.1 (2007): 8-13. Academic Search Complete. Web. 11 June 2014.