Environmental Change Strategies To Promote Healthy Eating and Physical Activity and Reduce Disparities

Abstract

[Author Affiliation]Jamie F. Chriqui. 1 Senior Research Scientist, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL.Christina D. Economos. 2 Associate Professor, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University; Director, ChildObesity180, Boston, MA.Kathryn Henderson. 3 Director, School and Community Initiatives, Rudd Center for Food Policy & Obesity; Research Scientist, Department of Psychology, Yale University, New Haven, CT.Harold W. Kohl III. 4 Professor of Epidemiology and Kinesiology, School of Public Health, Division of Epidemiology, Human Genetics and Environmental Sciences, Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center-Houston; Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX.Shiriki K. Kumanyika. 5 Professor of Epidemiology, Department of Biostatistics and Epidemiology and Department of Pediatrics ( Gastroenterology/Nutrition) , Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.Dianne S. Ward. 6 Professor, Department of Nutrition, Gillings School of Global Public Health and Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC.Address correspondence to: Jamie F. Chriqui, PhD, MHS, Senior Research Scientist, Institute for Health Research and Policy, University of Illinois at Chicago (MC 275) 1747 West Roosevelt Road, Room 558, Chicago, IL 60608, E-mail: jchriqui@uic.eduJamie Chriqui: This roundtable brings together experts in policy, systems, and environmental change strategies to discuss the role that such strategies can play in preventing obesity, with a particular eye toward reducing disparities in obesity and related conditions. The panel also identifies approaches for engaging the medical community in broader, population-based strategies for obesity prevention efforts, particularly in light of the American Medical Association's recognition of obesity as a disease.1From your perspective, what are some of the key environmental factors or determinants that have led to the obesigenic environment in communities throughout the United States?Kathryn Henderson: First, the availability of food 24 hours a day is a big change that we have seen over the last few decades. Not only is food available all the time, but the availability really cues us to think about food and eating in a way that we did not 30 or 40 years ago. A lot of research shows that our intake is driven by these cues to eat; that has been a really big factor.Shiriki Kumanyika: There are actually multiple things working together. There is the ubiquitous availability of food and, in certain communities, the types of food that are ubiquitous are biased toward unhealthy foods. In addition, you have advertising that pushes people to those foods that are particularly available. Some of the advertising plays on cultural preferences and norms and uses characters and scenarios that are designed to appeal to particular groups, including certain ethnic groups.Christina Economos: In the last couple of decades, the environment around us has also changed dramatically with respect to availability and accessibility of safe places to play and to be physically active. That has reduced the amount of recreational play that children and adults experience. Then, with the way we have built our schools and laid out our environments, there are not as many opportunities for children to be active. Some of that is related to crime rates in unsafe areas or the perception of danger and parents keeping children indoors.With respect to the physical structure of schools, some of them are clearly in environments where there is no green space at all. If the school does not have a gymnasium or a blacktop and there is no green space, it is really hard for children to be active, unless structured activity is programmed into the classroom or in the halls or any kind of open space that exists, but it can be really challenging. …