Let's Move: America's Move to Raise a Healthier Generation
By Jessica Hawkins, MPH, CHES
Program Manager, Women's and Infant Health, AMCHP
The prospect of a generation of children living sicker and shorter lives than their parents is a crisis that requires urgent action. To combat the growing childhood obesity crisis in the United States, First Lady Michelle Obama launched the Let’s Move! campaign in February 2010.This campaign will work to build on effective strategies, through a comprehensive approach to mobilize public and private resources. The First Lady’s leadership offers a significant opportunity to focus on making real and sustainable changes to prevent and eliminate childhood obesity.
AMCHP was pleased to represent state maternal and child health programs in early stakeholder meetings with the First Lady’s staff and provide input to the president’s Task Force on Childhood Obesity, established by President Obama to develop an interagency plan to work the Let’s Move! campaign work forward. AMCHP highlighted the importance of a strong state role in coordinating programs and an approach that included the whole family in obesity prevention. We also highlighted examples of obesity prevention programs taking place in several states including Florida, Missouri, Virginia, Arizona, and Washington.
In May 2010, the Task Force released its report to the President, which included a plan and recommendations to address childhood obesity. The recommendations focus on the four priorities and form the “pillars of the First Lady’s Let’s Move! campaign: (1) empowering parents and caregivers; (2) providing healthy food in schools; (3) improving access to healthy, affordable foods; and (4) increasing physical activity”. Of particular interest for state MCH programs are those recommendations specifically addressing early childhood, which is a critical window of opportunity for obesity efforts. We’ve highlighted some below:
- Recommendation 1.1: Pregnant women and women planning a pregnancy should be informed of the importance of conceiving at a healthy weight and having a healthy weight gain during pregnancy, based on the relevant recommendations of the Institute of Medicine.
- Recommendation 1.2: Education and outreach efforts about prenatal care should be enhanced through creative approaches that take into account the latest in technology and communications. Partners in this effort could include companies that develop technology-based communications tools, as well as companies that market products and services to pregnant women or prospective parents.
- Recommendation 1.3: Hospitals and health care providers should use maternity care practices that empower new mothers to breastfeed, such as the Baby-Friendly hospital standards.
- Recommendation 1.4: Health care providers and insurance companies should provide information to pregnant women and new mothers on breastfeeding, including the availability of educational classes, and connect pregnant women and new mothers to breastfeeding support programs to help them make an informed infant feeding decision.
- Recommendation 1.5: Local health departments and community-based organizations, working with health care providers, insurance companies, and others should develop peer support programs that empower pregnant women and mothers to get the help and support they need from other mothers who have breastfed.
- Recommendation 1.6: Early childhood settings should support breastfeeding.
State health agencies can play an important role in addressing childhood obesity and can provide coordinated leadership and support for childhood obesity prevention efforts, particularly those focused on high-risk populations and those focused on health weight for pregnant women.
AMCHP commends the administration for already modeling this cross-agency approach in its creation of the Task Force on Childhood Obesity. The First Lady’s Let’s Move initiative and the Task Force on Childhood Obesity offer a significant opportunity for our country to focus on making real and sustainable changes to prevent and eliminate childhood obesity. With the leadership of state officials and maternal child health experts, AMCHP is committed to being active partners in reversing the course of childhood obesity.
For more information on the Let’s Move! campaign, please visit here.
AMCHP Recommendations for First Lady’s Obesity Prevention Initiative
The following observations and recommendations are based on the experience of state MCH program leaders:
- Recognize that Leadership and Education on Healthy Eating and Active Living is Essential and an Important First Step. Based on the continuing rise in obesity rates, guidelines that simply tell people to eat better and move more are ineffective. Individuals need supportive environments that facilitate affordable, healthy choices. Efforts to change individual behaviors are likely to be more effective if pursued along with changes to the policies that address the environmental factors influencing eating and physical activity patterns. This initiative should begin with calling for personal responsibility for healthy eating and active living and continue with support for community and governmental responsibility to create supportive environments with access to healthy foods and opportunities for daily exercise.
- Shift Focus from a Medical Model to a Public Health Approach. Change requires multiple partners working together, from health care provider guidance, to community leaders making environmental changes, to support systems offering behavioral health guidance and local, state and national health impact policies. America now has millions of well-insured but overweight and obese kids, whose inevitable future chronic diseases will become the major driver of future health care spending unless we shift investments to public health approaches.
- Build on the Capacity of State Public Health Agencies. State health agencies are essential to providing coordinated leadership and support for childhood obesity prevention efforts, particularly those focused on high-risk populations. State level support and leadership is essential to assure that policies and services are in place state-wide and that expertise and resources are integrated from all related programs (i.e. Maternal and Child Health, Women’s, Infant, and Children’s (WIC) Nutrition programs, Chronic Disease and Health Promotion, Oral Health, Injury Prevention, Environmental Health, etc). State health leadership regularly interfaces with colleagues in education, transportation, early child care and agriculture. Through these collective partnerships we are well positioned to support the prevention of childhood obesity.
- Involve Parents, Families, and Community Representatives from the Beginning. A hallmark of state Title V MCH programs is the involvement of parents, families, youth and community representatives throughout the policy and program development process. This assures that health messages and programs are culturally-sensitive and have local support.
- Develop strategies that target children with special health care needs, a particularly vulnerable population. Children and adolescents with physical and cognitive disabilities have a higher prevalence of overweight compared to their non-disabled peers. The health risks posed by obesity in this population can lead to a greater number of related secondary conditions (e.g., fatigue, pain, deconditioning, social isolation, difficulty performing activities of daily living) and can impose significant physical, emotional and economic hardship on the child and family in addition to increasing the costs associated with their health care.
- Link Benchmarks to Sufficient Resources. Since 1997, all states receiving Title V MCH Services Block Grant funds have been required to report annually on their progress toward achieving the targets for 18 National Performance Measures, including a measure on the percentage of children, ages 2 to 5 years, and receiving WIC services with a Body Mass Index (BMI) at or above the 85th percentile. However, since 2003 the Title V MCH Block Grant has been reduced by nearly $70 million. Not surprisingly, states have shown little progress on this measure despite indications that it is a priority.