NOV. 23, 2004 | Arkansas’ landmark battle against childhood obesity is entering its second year for taking body mass index (BMI) measurements of public school students and now that the health issue has been identified, the continued measurements can chart trends and be used to develop solutions.
BMI-for-age is a screening tool for assessing risk of overweight and overweight in children and adolescents. The formula was developed by the Centers for Disease Control and Prevention and is supported by the
The Arkansas Center for Health Improvement (ACHI), a collaboration of the University of Arkansas for Medical Sciences (UAMS), the Arkansas Department of Health and Arkansas Blue Cross Blue Shield, which oversaw the BMI Project last year, distributed measurement forms to Arkansas school districts in October and is now preparing to analyze the data from year two of the project.
In the 2003-2004 academic year, the first-ever legislatively mandated BMI measurements showed nearly 40 percent of Arkansas’ public school students as either overweight or at risk for being overweight.
“As we continue to collect data, we will be able to identify trends and also chart what policy changes and programs are having a positive impact on addressing the epidemic of childhood obesity,” said Joe Thompson, M.D., M.P.H., ACHI director. “One thing we have already accomplished is a dialogue among families, schools, physicians and policy makers to focus on how all of us can fight obesity.”
ACHI points to feedback from school officials across the state showing that the dialogue has been successful at prompting districts to make more health-conscious decisions. The incentives offered to students in some areas have changed from pizza parties or ice cream to yogurt parties or other more healthy food choices.
Some schools have begun walking programs for students. Others have replaced high-sugar, high-calorie sodas in drink machines with juices and water or even removed the machines altogether.
“I think the numbers quantified something that many school officials and parents already knew – that childhood obesity, which increases the risk of developing a range of health problems – was at epidemic levels in Arkansas,” Thompson said. “We are seeing obesity-related diseases starting in earlier and earlier in life that were once unheard of before middle age. These illnesses, such as heart disease and arthritis, are beginning in adolescence and may continue throughout adulthood.
More than 345,000
Overall, 38 percent of
The information, broken down by race, gender and other categories, showed that children at any age, economic status or ethnic group were vulnerable. When ACHI reported the results of the first measurements in September, it came in conjunction with an announcement by Gov. Mike Huckabee of plans to increase the number of community health specialists to assist advisory committees being formed to develop local solutions to the obesity problem.
Moving into the second year of the process, ACHI will continue to maintain and analyze the BMI data and work for health solutions as set forth by the 2003 law. The state Health Department is becoming more involved in working with schools for data collection. Next academic year, the Health Department will take over management of the BMI screening process, though ACHI will continue to calculate BMI, generate health reports and track obesity trends. The Health Department has hired a community health nurse to work with ACHI in learning first-hand the details involved in successfully implementing this massive endeavor.
ACHI officials have looked to schools and families for feedback on how to improve the measurement process and refine information given to parents. Act 1220, passed by the Arkansas General Assembly in 2003, offers a multi-faceted approach to reducing childhood obesity in
One component called for the formation of a School Nutrition and Physical Activity Advisory Committee in each school district to develop and implement local policies that encourage health programs and activities. The panels are made up of members from school district governing boards, school administrators, food service personnel, teacher organizations, parents, students and professional groups, such as nurses and local businesses.
The law mandated the BMI measurements of every public school student to alert parents to possible health problems and to assess the prevalence of childhood obesity. A state Child Health Advisory Committee was created and meets monthly to coordinate statewide health efforts to combat childhood obesity.
The agency has addressed concerns about using the BMI as the screening tool to assess obesity in children and adolescents. ACHI and other health officials acknowledge that an elevated BMI does not necessarily label a child as obese; for example, a stocky, muscular child can have a deceptively high BMI. In addition, a child’s BMI is not calculated in the same manner as an adult’s. Children’s body fatness changes as they grow, and girls differ from boys as they mature.
“We urge parents with concerns to visit with their child’s health care provider, who can assist with reading the BMI report and what it means on an individual basis,” Thompson said.
Thompson said he is pleased with response from the schools in completing the BMI measurements. In the first year of the BMI initiative, 93 percent of the state’s 1,135 schools reported results with individual data forms submitted for almost 95 percent of the state’s 449,485 public school students. A 100 percent completion rate is a goal of the second year of measurements.
“We hope that schools embrace this and not treat it as just one more thing they have to do. Scoliosis screening is mandated in
Links on This
Arkansas Department of Health: http://www.healthyarkansas.com/
Institute for Medicine
Centers for Disease Control and Prevention BMI-for-age: http://www.cdc.gov/nccdphp/dnpa/bmi/bmi-for-age.htm
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