Childhood Obesity


Fully half of Americans will be obese by 2030. Within this already-bleak context of societal health, childhood obesity is perhaps the most pressing issue. Obese youth are likely to develop into obese adults, resulting in significantly increased risks of developing the chronic illnesses that plague our adult population. In light of this epidemic of chronic diseases and their costs, disease prevention— principally through health and wellness promotion—is critically important.

Local governments are uniquely poised to tackle this health issue. They have both access to children via public education and youth programming, and historical experience in related efforts and campaigns, such as immunization and safety. As the Institute of Medicine notes, local governments have jurisdiction over a range of policies that can support children and adolescents in reaching a healthy weight, including infrastructure, land use, public-space planning, and health and nutrition programs. There are a range of local policy approaches that can help reduce childhood obesity.

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What Cities Can Do

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Healthy Diet

Cities can encourage good nutrition in large part through equitable access to healthy foods. Cities can partner with schools and afterschool programs to make sure kids are getting healthy meals and education about how to eat healthy all the time.

One serious impediment to a healthy diet is the abundance of sugar-sweetened beverages. Cities should adopt policies that limit access to these, from stopping sales on city property to working with restaurants to reduce availability to implementing a sugar-sweetened beverage tax. Berkeley, CA was the first city in the US to pass a sugar-sweetened beverage tax. In its first year, the tax raised $1.5 million, which is being used to fund health-related programs in the city.

Fontana, CA’s multi-pronged effort to combat obesity, diabetes and heart disease includes programs on nutrition, active living, and smart growth. The city has formed partnerships and received grants for this work, which includes a junior chef class where kids learn to cook healthy food, complete streets projects, and educational programs. And it’s working: Mayor Warren reports a 47% reduction in Fontana’s hospitalization rates for obesity-related illnesses in both children and adults and a 46% reduction in obesity rates in both children and adults between 2008 and 2012.

New Haven Connecticut’s Health in Your Hands program provided cooking classes and dance lessons to two low-income neighborhoods.

Active Transportation

This includes traffic-calming and complete-streets policies to make physically active forms of transportation such as walking and biking safer. Safe Routes to Schools campaigns are also important.

In Oakland, CA, traffic-calming policies have significantly reduced the number of pedestrian injuries and fatalities by adding 1,600-speed humps. Other cities have widened sidewalks, added streetscaping, or created barriers that slow traffic and enhance safety for walkers and cyclists.

Physical Activity

The Boston Schoolyard Initiative, or BSI, has supported the revitalization of more than 80 schoolyards. Their goals are encouraging active play, as well as providing spaces for outdoor classroom education. A recent project study found that BSI has increased physical activity in all schools, as well as improved student behavior and school relationships with parents and the community. The BSI is managed through a public-private partnership between the city, the school district, and a funding collaborative.

KaBOOM!, a national nonprofit organization, has helped create more than 2,000 playgrounds in 70 cities as part of its goal to establish a place to play within walking distance for every child in America. They work with cities, schools, and even individual neighborhoods to meet this goal.

Staffing efforts, such as supervision of schoolyards during nonschool hours and citizen park patrols, have led to a significant increase in children’s physical activity in New Orleans, LA, and Madera, CA.

In Cincinnati, OH, the police worked with community organizations and private businesses to transform an abandoned lot into a community gathering area. Not only did crime decrease, but residents increased their involvement with community police as well.

The innovative Shape Up Somerville program in MA uses a holistic approach to address childhood obesity. It has strong coordination across city government departments, nonprofits, universities, civic organizations, businesses, and the school district. Along with making significant improvements to student lunch options, the school district implemented an active-living curriculum to use in several subjects, as well as after-school programming. Parent education and outreach have been key to success, with schools giving parents nutritional and activity guides, as well as updates on kids’ health indicators.

Another unique initiative, funded by the Partnership for a Healthier America, is Play Streets. Expanding to 40 new locations this year, Play Streets are blocks or entire streets that are “closed to traffic but open to the community.” Each city adapts its activity to meet local needs, such as closing miles of streets in Chicago and Portland, Oregon. The New York City program has had tremendous success. Building on decades of similar, often informal, efforts of communities around the city, it ensures that kids have access to activities and a safe space to do them. Program data found that almost two-thirds of kids in New York City’s Play Streets programs reported that they would have been engaged in sedentary activity if their Play Street had not been available. During the summer of 2012, kids at these sites accessed free programming in team sports, karate, yoga, nutrition, and arts and culture.