health. Some of the actions local governments can take to make these changes happen are listed below. (Chapters 4 and 5, respectively, outline more specific actions that can be taken to promote healthful eating and physical activity.)

  • Improve coordination among agencies and organizations whose activities address determinants of health in such areas as education, housing, planning, agriculture, employment, and economic development.

  • Engage with communities in planning and implementing actions to improve health and health equity.

  • Find ways to increase the availability of healthy, affordable food in underserved communities and reduce access to unhealthy foods.

  • Create a built environment that encourages walking, cycling, and other physical activity.

  • Consider cultural barriers that keep lower-income, minority, and immigrant populations from purchasing healthier foods or seeking opportunities for physical activity.

  • Work with community partners to identify and build upon cultural assets, such as dance traditions or gardening for groups with a rich farming heritage.

Finally, it is important to recognize that many decisions made by local governments that appear unrelated to childhood obesity actually may have a significant effect. For example, decisions about employee income, education, public assistance, housing assistance, affordable housing plans, transportation, health insurance, commercial development, community involvement in government and decision making, and community policing, to name a few, may have positive or negative impacts on the prevalence of childhood obesity overall and especially among those who are most vulnerable.

Viewing local government decision making through a health equity lens is fundamental to preventing childhood obesity and promoting health equity. This is a matter of ethics and fairness, but it is also a practical necessity because of the financial and human costs associated with obesity. Efforts aimed at preventing childhood obesity should target those areas of the community where the problem is greatest and where social, economic, and environmental factors appear to promote obesity and act as barriers to its prevention. As policy makers and community partners review the strategies and action steps offered in this report, they should focus on those actions that are most likely to lessen health disparities related to childhood obesity and to bring the community’s children and their families closer to a state of health equity.

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