September is National Childhood Obesity Month, as well as the start of school for many children across the country. Unfortunately, childhood obesity has reached record levels nationwide in recent years and has become a major public health problem. About 19 percent of children ages 2 to 19 are obese; nearly 6 percent of children have severe obesity, with the highest rates (about 8 percent) among children ages 12 to 19. Obese children are more likely to have high blood pressure, asthma, sleep apnea or Type 2 diabetes, and are at higher risk as adults for heart disease, the nation’s leading cause of death. Rates of obesity are especially high among black and Hispanic children, about a quarter of whom are obese. As a researcher who studies childhood obesity at the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health, I want to encourage everyone, particularly teachers and parents, to think about how their schools and communities can address this public health epidemic.

Childhood obesity is a complicated, hard-to-treat problem, and all of us need to think about how we can work with our local schools and communities to create healthier environments for children.

Promoting healthier schools

Schools can be a major force in the prevention and treatment of childhood obesity. In 2010, the Healthy Hunger-Free Kids Act enabled reforms in school lunch and breakfast programs and strengthened school wellness policy implementation. A more recent study assessed the relationship between body mass index (BMI) — a measure of body fat — and the implementation of school wellness committees and nutrition policies in 420 schools in the NHLBI-led Healthy Communities Study. In the 2018 study, researchers found that schools that had active wellness committees — even those meeting just once a year — had children with significantly lower BMI (a good thing) than those schools that did not have wellness committees or schools where the committees did not meet. The findings suggest that encouraging school wellness committees and activities can lower BMI scores in children. Parents may want to consider encouraging their local parent-teacher association or similar organizations to promote active school wellness committees, whose actions can include producing healthy policies (such as improving food and beverage choices) or expanding physical activity options during and after school.

Promoting healthier communities

The community where one lives can also influence childhood obesity. A recent research paper, also part of the NHLBI-led Healthy Communities Study, found that across 130 diverse communities in the United States, those that had higher-intensity programs and policies (strong behavior-change strategies of long duration and wide reach) targeting childhood obesity, had children with lower BMI than those communities with lower-intensity programs and policies. For example, a community that implements higher-intensity policies, such as installing new bike lanes or sidewalks, tends to have more success in lowering childhood BMI than a community that tends to only implement one-time events like a health fair or health literature handout. The study also uncovered health disparities among families and communities. Researchers found that the relationship between community programs and policies and BMI was strongest among families with higher socio-economic status, and weakest in Hispanic families and urban communities. Findings from this study suggest that programs and policies may need to be tailored for those most at risk.

Looking forward

In short, childhood obesity is a complicated, hard-to-treat problem, and we all need to think about how we can work with our local schools and communities to create healthier environments for children. NHLBI’s Healthy Communities Study, which will be highlighted in a suite of research articles scheduled to appear in the September print issue of the journal Pediatric Obesity The Healthy Communities Study: Examining Community Programs, Policies and Other Characteristics in Relation to Child Weight, Diet, and Physical Activity, is just one of many efforts to curb this growing epidemic. Let’s keep this momentum going year-round — beyond Childhood Obesity Month. Our children’s health depends on it.