Children hear the message every day: Make healthy choices.
But sometimes they have no choice, concludes a major Washington State University study that linked childhood obesity in Spokane to factors beyond the control of kids and their families.
Perhaps the most surprising factor is fear, especially in low-income, high-crime neighborhoods in Spokane, where parents are reluctant to let their children go outside to play or exercise.
Ultimately, young children pay the price. Obesity in those neighborhoods is more than twice that of well-off schools.
“What’s surprising is how large the gap is in the prevalence of obesity,” said Pablo Monsivais, an associate professor at the Elson S. Floyd College of Medicine in Spokane.
“To see these gaps so early is really disturbing,” Monsivais said.
But along with the problem, WSU researchers offered some solutions. They include greater implementation of the federal Safe Routes to School Program, school-based initiatives to boost walking and cycling to school and better urban planning to lessen the effect of busy streets.
Researchers divided schools into three categories – those where at least 75% of students receive free and reduced-price meals; where 50 to 74% receive them; and schools with 50% or fewer students receiving the subsidized meals.
In low-income neighborhoods, the incidence of obesity – measured by a body-mass index in the 95th percentile or higher – was 19.4%, compared with 9.1% at the higher-income schools.
The national average is 18.4%.
“That was kind of an eye-opener,” said Monsivais, one of five researchers on the project, which focused on the environmental and social conditions within a 1-mile walking distance around 28 elementary buildings in the Spokane Public Schools district.
Crime rates (taken from 2015) were almost in lockstep with income demographics. Well-off neighborhoods had an average of 94 incidents per year, while the middle-tier group had 349 and the lower-income areas had 409.
“It’s a complex problem, but the neighborhoods we live in can have an influence on our habits,” Monsivais said.
The district provided most of the base data, which included the age, sex, height and weight of 10,327 students. Other data was obtained from the city of Spokane and the state Superintendent of Public Instruction.
It wasn’t a surprise that high-crime areas – primarily in north Spokane – coincided with higher percentages of free and reduced-price meals.
The ties to obesity are less obvious but make sense. Higher crime rates and the presence of nearby arterials engender fear among parents, who become reluctant to allow their children to do “kid things” such as running or bicycling to the park.
Among the school neighborhoods most affected are Arlington, Audubon, Holmes, Whitman, Bemiss, Willard, Garfield and Lidgerwood.
“Statistically, these areas have more crime,” Monsivais said.
Most of these schools cover a relatively small geographical area, meaning that many students live within a 1-mile walking distance and according to state regulations cannot take the bus.
One solution is the Walking School Bus. Since 2015, the Spokane Regional Health District has partnered with a handful of schools to make sure that children are picked up by volunteer mentor-walkers.
By 8 a.m., most of the students are at school and ready to eat breakfast. They’ve also burned a few calories and are ready to learn.
“Students arriving on time, and that’s the biggest thing,” said Jenny Arnold, who oversees the program. “We get to school on time, they get a healthy breakfast and now their attention rates are up and they’re happy.”
The program includes Logan, Stevens, Bemiss, Holmes and Roosevelt elementary schools. Grant and Sheridan “are interested” in getting on board, Arnold said.
The program is funded through the Washington State Department of Transportation, and funding has been secured through 2023.
More schools could participate, but volunteers – someone who could “build the program” – are needed, Arnold said.
“Our routes depend on adult leaders who are interested in spending an hour in the morning mentoring elementary students while modeling safe pedestrian behaviors,” Arnold said.
Schools are trying to set an example for healthy eating.
“One of our goals is to model the patterns they should be doing at home,” said Doug Wordell, director of Nutrition Services at Spokane Public Schools.
“When these kiddos come to school, they’re getting fresh fruit and vegetables and other healthy foods,” Wordell said. “Those are the items they’re often not seeing at home.”
The district also makes sure that parents are aware of what constitutes a healthy diet, with information distributed online.
Another contributor, according to the study, is lack of “walkability” in some neighborhoods. Usually that means the presence of major roads which inhibit travel for children.
Lack of nearby greenspace is another factor, the study concluded.
The study didn’t break down obesity rates by age, though it did so by school. WSU elected not to release those figures because, as Monsivais said, it would be unfair to blame school administrators.
Other researchers were Ofer Amran, Solmaz Amiri, Robert Lutz and Anna Crowley.
Subscribe to the Morning Review newsletter
Get the day’s top headlines delivered to your inbox every morning by subscribing to our newsletter.