As kids and teens return to school during the ongoing COVID-19 pandemic, advocates, politicians, school administrators and others are rightfully focused on addressing the achievement gap in schools. We’ve seen this gap widen after a year of remote learning, and it has placed an even greater strain on children of color. As we work to close the achievement gap, we must also address the health gap our children face, which is in part driven by another pandemic: childhood obesity.
For years, inequities in our country and health system have given rise to disproportionate rates of childhood obesity among students of color. Obesity is a complex disease that puts children at risk for other conditions like type 2 diabetes, asthma, anxiety and depression. Disparities in rates of obesity among Black and Hispanic children are present by age 2, largely driven by long-standing systemic inequities such as limited access to quality health care, lower rates of insurance coverage and less access to quality education. And now, as we see children with obesity are also at a higher risk for severe outcomes from COVID-19, we have been reminded of the urgency of addressing obesity as a disease.
The prevalence of childhood obesity increased from 13.7 percent up to 15.4 percent in just the first nine months of the pandemic. Experts have concluded that some efforts to reduce COVID-19 transmission likely contributed to this change, as sedentary behaviors increased with remote learning and access to fresh, affordable food, often provided by schools, declined. This increase in obesity was most pronounced in youth ages 5-9 and those who are Hispanic, non-Hispanic Black, publicly insured or from lower-income families – which exacerbates inequities in the same populations that have been disproportionately impacted by COVID-19.
We know that COVID-19 and its implications for our children are far from over and will continue to take a toll on their physical and mental health. We are already seeing this come to light, as pediatric emergency room visits for mental health increased 31 percent from April to October in 2020. And we know that weight stigma, bias and bullying associated with obesity can further compound mental health challenges for children living with the disease.
Given the unique challenges for children living in the midst of these health crises, it has never been more important to address the disease of obesity in children. We must work in partnership with health care and community wellness providers to implement a continuum of care approach for childhood obesity. This means that a full spectrum of prevention and treatment options should be available to children and families dealing with obesity, as is the case with other chronic conditions. We must also encourage public and private health insurers to cover these obesity prevention and treatment options.
Pediatricians also play a critical role. Regular childhood wellness visits provide an opportunity for doctors to build healthy habits with families, and to prevent, diagnose, treat and manage this disease early on, reducing the risk of developing obesity into adulthood and potentially avoiding future health risks from the disease. Pediatricians should also be trained to refer children to community-based interventions as appropriate.
Schools and out-of-school time providers, health departments, businesses and other community groups are also valued partners that can work together to improve child health by providing access to low-cost physical activity opportunities and healthy, affordable food options. For instance, the YMCA’s Healthy Weight and Your Child program is an evidence-based lifestyle change intervention designed to address childhood obesity by empowering children and families through education, healthy eating and physical activity. Furthermore, opportunities for physical activity at school and after-school settings — sometimes the only safe opportunity that children have to play outside — must be a high priority as students return.
Supporting these and other programs is a critical first step to minimize the larger health inequities that make healthy eating and physical activity less attainable for children of color and of lower socioeconomic status. Much like addressing the achievement gap, closing this health gap requires a concerted effort. It will take wide-scale recognition of obesity as a disease, a continuum of care approach for childhood obesity both utilized by providers and covered by insurers, funding of community interventions for obesity prevention and treatment, and policy change to support all children in achieving their optimal health.
There are many factors to consider as schools reopen this year, but addressing childhood obesity must be a top priority.
Kathleen (Katie) Adamson is the vice president of health partnerships and policy for YMCA of the USA.
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