Obesity in the Early Childhood Years State of the Science and Implementation of Promising Solutions: Workshop Summary (2016) / Chapter Skim
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5 Promising and Innovative Cross-Sector Solutions
5 Promising and Innovative Cross-Sector Solutions
Pages 55-68
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From page 55... ...
(Gertel-Rosenberg) • Building trust, forging partnerships, and continually reassess ing and resetting system goals can advance cross-sectoral work on obesity prevention.
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Concannon particularly emphasized the potential to link WIC more closely to federally qualified health centers and other health care centers. At the local level, he said, many WIC clinics are collocated with public health care centers and health departments to facilitate integrated services.
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The first is the SNAP nutrition education program, which includes $400 million in nutrition education grants to states spent annually under SNAP. The law now allows USDA grantees to promote policy systems and environmental change strat egies and interventions to prevent obesity, Concannon observed, which will strengthen obesity prevention efforts in many feeding programs.
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For its part, he said, USDA is working "diligently to cross-sector our partnerships in an effort to leverage resources and enhance our public health impact." OBESITY PREVENTION IN NEW YORK CITY According to Jeni Clapp, director of Healthy Eating Initiatives, New York City Department of Health and Mental Hygiene, obesity is respon sible for more than 5,000 deaths annually in New York City, second only to tobacco as a cause of preventable deaths (according to a 2012 internal analysis by the New York City Department of Health and Mental Hygiene, Bureau of Epidemiology Services, and Bureau of Vital Statistics)
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. Figure 5-1, fixed image, type replaced In 2005 the New York Department of Education implemented New York City FITNESSGRAM®, Clapp reported, and a partnership with the New York City Department of Health and Mental Hygiene has yielded a database in which the height and weight of individual students can be tracked over time.
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Child care staff received education and training on structured physical activity and healthy eating to support the changes, particularly in low-income neighborhoods, she noted. In addi tion, food procurement standards for all city agencies that purchase and serve food or beverages, which cover about 250 million meals served by the city annually, were established to encompass nutrition criteria that include sodium limits, calorie limits, and fiber guidelines.
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Inspectors go into child care centers at least once a year, providing data for evaluation and further refinement of the approach. OBESITY PREVENTION THROUGH HEALTH CARE PARTNERSHIPS As a nonprofit pediatric health system, the Nemours Children's Health System has a vested interest in the health of children, said Allison
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This approach reflects the fact that messages regarding healthy eating and physical activity need to extend across the life cycle, Gertel-Rosenberg observed, with consistent messaging from all of the key influencers in children's lives, including parents, early care and education (ECE) providers, and physicians.
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• Asking center staff to become leaders and train their entire center is innovative, and it requires time and coaching to develop peer leaders and leadership teams. • Buy-in and sustainability typically require balancing fidelity to a national model with state and local customization.
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"Through this ongoing collaborative example, I have come to appreciate how much it takes to work across sectors," Huang said. He also has been involved with an initia tive at the National Institutes of Health involving a series of forums focused on building trust that have brought together sectors including the food and beverage industry, the media, public health, government, and academia to develop an environment in which the parties can devise innovative solutions for moving forward.
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"If I can keep these kids all in school throughout the academic year and get them involved in the summer, there are all sorts of great things that will happen for [them] down the road apart from health impacts." These lessons derive in part from what Huang called "translational systems science" -- the idea that insights from diverse fields and disciplines about complex systems can inform innovative public health solutions.
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DISCUSSION SESSION Creating Systems Change Across Sectors In the discussion session, the panelists and the panel moderator dis cussed an issue at the heart of the Roundtable on Obesity Solutions: t ranscending place-based success stories to create the kinds of systems change needed for a sustainable solution. As was observed by moderator Lisel Loy, director of the Nutrition and Physical Activity Initiative at the Bipartisan Policy Center, bringing together talent from all of the sectors involved poses many challenges.
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Business initiatives geared toward health can be profitable, he noted, even for the food and beverage companies, but "a strategic, coordinated, and managed effort with clear accountability mechanisms built in" is required. As an example, he cited the need for a cohesive effort across the public, private, and academic sectors to shift social norms, whether around portion sizes, the value of healthy products, or the pleasure of wellness.
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premiums." Similarly, he noted, the Healthy, Hunger-Free Kids Act is creating systemic change in school meals, partly as a result of government's engaging other organizations at the state and local levels. "We are trying to see what else can we do at the state level," he said.
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