OBESITY 101: LESSONS from MISSISSIPPI, TENNESSEE, and NEW ZEALAND

OBESITY 101: LESSONS from MISSISSIPPI, TENNESSEE, and NEW ZEALAND Ben Dyson, Ph.D. The University of Memphis

Theoretical Framework This study is grounded in the cognitive theory of social constructivism (Cohen & Lotan 1997; Gillies, 2006; Rovegno & Dolly, 2006).

Social Constructivism • Not passive recipients of knowledge but are involved learning and understanding. • Construct knowledge through social interaction • Discover knowledge-- Individuals draw on prior knowledge and experiences to construct new knowledge

CDC data • Center for Disease Control and Prevention (CDC) data -- slides show trends that have emerged in the last 20 years.

Obesity Trends* Among U.S. AdultsBRFSS, 1991 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1997 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%

Obesity Trends* Among U.S. AdultsBRFSS, 2001 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Obesity Trends* Among U.S. AdultsBRFSS, 2005 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends* Among U.S. AdultsBRFSS, 2006 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends* Among U.S. AdultsBRFSS,1990, 1998, 2006 (*BMI 30, or about 30 lbs. overweight for 5’4” person) 1998 1990 2006 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

CDC data Center for Disease Control and Prevention (CDC) data -- trends that have emerged in the last 20 years. The measure may not be as precise as we would like (the BMI) but you can not deny the trend.

Childhood Obesity • 27%of children 6-19 years old in the U.S. are overweight. This prevalence has nearly tripled for adolescents in the past two decades. (AHA, 2005).

The Cost of Obesity • The health costs of people being overweight in TN were $2 Billion in 2004-2005. • Obesity-associated annual hospital costs for children more than tripled between 1979 and 1999. • The estimated annual cost of obesity in the U.S. is $123 billion (AHA, 2005).

AHA facts on Obesity • Risk factors for heart disease, such as high cholesterol and high blood pressure, occur with increased frequency in overweight children and adolescents compared to children with a healthy weight. • Overweight adolescents have a 70% chance of becoming overweight or obese adults. This increases to 80% if one or more parent is overweight or obese (AHA, 2005).

Tennessee and Mississippi • Mississippi ranks # 1 and Tennessee ranks # 3 in the nation for childhood obesity. • Mississippi and Tennessee are in the top 5 states for the incidence of Childhood Type II Diabetes.

Demographics on Obesity • African American, Hispanic, and Native American children and youth are more likely than Caucasian students to be overweight -- 33% of Tennessee’s African American students are overweight. • African American and Hispanic students were less likely to participate in regular moderate or vigorous physical activity (YRBS, 2005).

Physical Education • Illinois is the only state in the U.S. that has daily PE. In other states only 8% of elementary schools, 6% of middle/junior high schools, and 6% of senior high schools provide PE daily. • Students participating in daily PE classes decreased significantly from 1991 to 2003 (from 41.6% to 28.4%). • Only 38% of Tennessee students attended physical education (PE) class one or more days during an average school week.

Contributing factors to Obesity • Students don’t often walk or bike to school any more in the U.S. A study of 8 urban and suburban schools in 1 city found the vast majority of students rode a school bus or were driven to school; only 5% walked or rode a bike to school (Sirard et al., 2005).

The Effect of No Child Left Behind No Child Left Behind is a federal law that has increased high-stakes testing and increased the accountability of schools, districts, and states. Schools must meet Adequate Yearly Progress (AYP) requirements or face a series of sanctions. Many districts are trying to allocate more time to “core” subjects such as math and reading. As a result, time for students to engage in physical activity during recess and during structured PE is often being reduced.

Lack of Recess • In the U.S. many school principals have cut recess dramatically since the 1980s. Now many kids have minimal time to play. • Atlanta schools almost did away with recess until a state law mandated that elementary school and middle school children receive a 15 minute break for physical activity. New schools in Atlanta are built without playgrounds. • According to Benjamin O. Canada, the (former) superintendent of Atlanta schools, "We are intent on improving academic performance and you don't do that by having kids hang on monkey bars" (Johnson, 1998).

TN and MS • AHA pressured legislators to increase the number of minutes of PE required each week in schools – 150 min/week • TN law now requires: A state PE coordinator, 90 minutes of Physical Activity (PA) per week K-12, and Coordinated School Health was funded. • MS law now requires: one unit/class of PE and wellness at the HS, 90 minutes of PA per week K-12. • Implementation problem: no one is regulating the law, no one is held accountable as yet, and no one is ensuring the quality of the program – more is not necessarily better as Kirk (1992) and Sparks (1991) found. • We have found in our study that unfunded mandates produce weak accountability. If the superintendent of the school district does not push PE or PA the principals focus on their own agenda.

TN and MS • We need to clarify the difference between PE and PA. PA can be educational but we need to make sure that it’s done by competent folks: qualified, knowledgeable people who understand the developmental needs of the learner. • Physical Activity in an educational setting is defined as a behavior consisting of bodily movement that requires energy expenditure above the normal physiological (muscular, cardio-respiratory) requirements of a typical school day. • Physical education -- is defined as a series of structured classes taught by a knowledgeable licensed teacher, that is based on state standards and has required minutes per week. • In TN and MS at the legislature -- PE costs money and PA does not cost money.

TN and MS data • School change is not linear, it is chaotic and has no blueprint (Fullan, 1999). • Internal and external factors impact the implementation of the new state law at schools in MS and TN.

Student themes -- emerged from the data • “All they care about is standardized tests” • “There’s other sports besides basketball” • “They just LAZY!” • “Gotta love your burger king” • “It’s just PE” • “It’s got me more active”

Lessons learned • Don’t reduce required PE – in US since 1990s states have reduced required minutes of PE. • Don’t reduce advisory support for PE. In TN and MS there was no PE coordinator until last year – this led to marginalization and deterioration of PE -- there was no advocacy for PE at the Dept of Education. • Do work with allies in the field. AHA in each of the Southern States of the US has legislation to increase the number of required minutes of PE per week. • Increase the opportunity for youth to be Physically Active – not just team sports but dance and adventure education, school/ community trips, field days, etc... • Guide students’ nutrition habits at school.

Funding Robert Wood Johnson Active Living Grant

Important Questions: • What are the most effective ways to combat youth becoming overweight? What strategies and tactics have worked for you? • To increase Physical Activity and Physical Education, • To improve nutrition • What are some strategies? • school based initiatives, • community based initiatives

Questions • Issues • Concerns

Informative websites: Healthy Schools Program Web site: www.healthiergeneration.org/hsb Centers for Disease Control and prevention: www.CDC.gov American Heart Association: www.americanheart.org American Dietetic Association: www.eatright.org

We want a healthier generation

OBESITY 101: LESSONS from MISSISSIPPI, TENNESSEE, and NEW ZEALAND