About one in six adolescents has obesity, according to a new report from the Robert Wood Johnson Foundation. Rates are highest for youths of color and those from low-income homes.
Experts say the COVID-19 pandemic is exacerbating the societal conditions that contribute to obesity and are calling for federal policies to mitigate this impact.
“Knowing families are struggling with food insecurity … our nation’s safety net is fragile, outdated and out of reach for millions of eligible kids and their caregivers,” said Jamie Bussel, senior program officer at the Robert Wood Johnson Foundation. “Safe, affordable housing is scarce, forcing families often to make really hard choices about how to spend really limited resources. And the structural racism embedded in our policies, practices and systems underlies all of these challenges.”
The new report “From Crisis to Opportunity: Reforming Our Nation’s Policies to Help All Children Grow Up Healthy” analyzed data from the 2019-’20 National Survey of Children’s Health that showed 16.2% of youths ages 10-17 years have obesity. The rate has been steady for the past five years.
Obesity rates were highest for American Indian/Alaska Native adolescents (29%), followed by Black (24%), Hispanic (21%), White (12%) and Asian adolescents (8%).
Bussel pointed to the impact of structural racism on children’s access to nutritious food, affordable housing, quality health care and education.
“These patterns and practices reinforce discriminatory beliefs and values and the distribution of resources, all of which affect our health,” she said. “To make real change, we have to push back on these systems.”
There were significant differences in obesity rates based on household income. Adolescents from homes in the lowest income group had an obesity rate of 23% compared to about 9% for the highest income group. There also were significant gaps between states. Rates were highest in Kentucky (24%) and lowest in Montana (10%).
While the data did not show an increase in adolescent obesity rates during the pandemic, Bussel pointed to several other studies that have found an increase. For example, a recent Centers for Disease Control and Prevention report showed that among youths ages 2-19 years, obesity rates rose from 19% in 2019 to 22% in 2020.
“Economic stressors, food insecurity, less consistent access to healthy meals at school, combined with increased sedentary time, sleep dysregulation, reduced physical activity, and social isolation have made it harder for families to stay healthy,” Sandra G. Hassink, M.D., M.S., FAAP, medical director of the AAP Institute for Healthy Childhood Weight, said in a news release. “This challenge is compounded by the fact that many of the consequences of obesity — including breathing problems, high blood pressure and diabetes — increase the risks of serious COVID-19 disease. As we look out now and beyond the pandemic, we must create environments that support children and families in sustaining healthy lifestyles.”
The Robert Wood Johnson Foundation made five federal policy recommendations to help address obesity:
- Make universal school meals permanent.
- Extend eligibility for the Special Supplemental Nutrition Program for Women, Infants, and Children.
- Expand other programs that reduce poverty and food insecurity such as the Child Tax Credit.
- Close the Medicaid coverage gap.
- Collect timely data on nationwide obesity rates.
Bussel noted many of the supports Congress has put in place during the pandemic are temporary.
“So we need to be thinking bigger and bolder about lasting policy solutions,” she said, “to ensure that every child in America has a fair shot at growing up as healthy as possible.”
- AAP interim guidance Obesity Management and Treatment During COVID-19
- AAP clinical report The Role of the Pediatrician in Primary Prevention of Obesity
- AAP Institute for Healthy Childhood Weight
- Bright Futures health initiative
- Change Talk: Childhood Obesity initiative
- Information from HealthyChildren.org on obesity