Connecticut doctors and health care workers are battling childhood obesity by helping low-income families make healthier food choices, and coaching busy parents on fast but healthy ways to feed their children.
Children are more likely to be obese if they grow up in low-income families, the U.S. Centers for Disease Control and Prevention (CDC) reports. And when parents work long hours at low-wage jobs, that can contribute to childhood obesity as well, according to health experts, because time-squeezed parents struggle to provide home-cooked meals and family activities.
Colleen Shaddox explores how teens in New Britain learn how to make healthy food choices.
The CDC defines obesity as “having excess body fat,” and says it is affected by genetic, behavioral and environmental factors.
In Connecticut, 15.8 percent of children aged 2 to 4 in low-income homes are obese, according to the State of Obesity, a September 2016 report by Trust for America’s Health and the Robert Wood Johnson Foundation. That figure has remained constant since 2007, according to the report. Of 10- to 17-year-olds, 15 percent are obese, the report said.
Fair Haven Community Health Center (FHCHC) Nurse Practitioner Elizabeth Magenheimer said that more than 60 percent of the families she serves do not eat meals together because of work and other obligations, which contributes to bad eating habits and a lack of what she calls “meal culture,” a time for family conversation and introducing children to healthy cooking and eating.
Understanding the reality of life for low-income families is key to helping their kids get to a healthy weight, said Melissa Santos, a pediatric psychologist at the Connecticut Children’s Medical Center and assistant professor at the University of Connecticut School of Medicine. “We all know what we’re supposed to do, but a lot of things get in the way,” she said.
Helping these families eat healthier is a process, according to Santos, because their lives are already overwhelming. “We always start small because we never want to overwhelm families in terms of making changes,” she said.
At Children’s Medical Center, Patricia Esposito, clinical nutrition manager, shows working parents how to pull together easy meals for busy days. She steers them to items like pre-washed salad greens and pre-cooked chicken—and stresses that though these may be among the pricier items in the grocery store, they end up being cheaper than fast food.
But that solution isn’t perfect, she said, because it requires easy access to a grocery store—something low-income families often don’t have.
Such families often live in “food deserts,” described by the U.S. Department of Agriculture as mostly urban areas—such as some neighborhoods in Hartford, New Haven and Bridgeport—where access to healthy food is limited or non-existent due to a lack of grocery stories, farmers markets, and other providers of healthy food. Consumers in these areas instead depend on “quickie marts,” which offer processed, sugar- and fat-laden foods, according to the USDA.
But even if there is access to vegetables and healthier food options, children living in poverty often don’t get the chance to try them. “If you’re not sure your kid’s going to eat it, you’re not going to put some expensive vegetable in front of your kid. For a low-income parent, that’s a huge deal,” said Marlene Schwartz, director of the UConn Rudd Center for Food Policy. The center’s mission is to promote solutions to childhood obesity through research and policy.
Food preferences are formed in early childhood. But kids can learn to accept more foods, like fruits and vegetables, through repeated exposure—exactly the process Schwartz said poor parents can’t afford.
In New Britain, a community grassroots project, called PhotoVoice, is teaching young teens about healthy lifestyles, including making good food choices and incorporating exercise daily. For one project, teens fanned out in their neighborhoods and took streetscape photos full of fast food restaurants, convenience stores and torn-up sidewalks.
They compiled a report, which they presented to the city council, asking for access to more public pools. The council said no, but did set up a water play area for kids in one of the city’s parks.
Dayjah Green, 19, an assistant PhotoVoice teacher who participated as a student in the program two years ago, said, “A lot of these kids will tell me that they eat more fast food than they eat a home-cooked meal.”
Dr. Dara Richards, chief medical officer at Southwest Community Health Center in Bridgeport, said that parents who aren’t coming home to make dinner aren’t taking their children outside to exercise either.
“The families cannot go outside because they are working. It has created a perfect storm for a culture of inactivity,” said Magenheimer, the nurse practitioner at Fair Haven Community Health Center.
Low-income parents frequently are unfairly blamed when their children are obese, Magenheimer said. “The number of slackers I have met in my 40 years at Fair Haven Community Health Center is so small as to be absurd,” she said.
Richards said obesity and nutritional counseling can be discussed during primary care visits, which insurance covers. “The more we get to know them, they share more,” she said.
Obese children with weight problems at FHCHC get referred to Bright Bodies, a Yale program that provides nutritional education for parents and children as well an activity program with exercise physiologists. They are also encouraged to exercise outside the program.
Green said that it is critical that children in low-income areas have more access to opportunities for safe exercise: “People complain about us not being healthy or not getting enough exercise,” she said. “If you give us something to do … we’ll be exercising.”
While there are programs throughout the state to work with obese children and families, the underlying economics that contribute to the problem are not improving. Private sector jobs in low-wage industries have risen by 20 percent, while the share of private sector jobs in high-wage industries have decreased by 13 percent, according to a September report by Connecticut Voices for Children. That means more low quality jobs, where parents need to work long hours to pay the bills. The child poverty rate has held steady at 14.5 percent overall, though in New Haven and New London it tops 20 percent.
“I think that the obesity epidemic can’t be solved from the food perspective,” Magenheimer said. “It has to be solved from a much more broader society perspective.”