Center for Health Transformation Georgia Project

Social Determinants of Health

Gail Wilensky and David Satcher co-authored an interesting article in Health Affairs discussing the social determinants of health.  Both served the past three years as commissioners on the World Health Organization's Commission on the Social Determinants of Health.  A major purpose of the commission was to identify strategies that could improve health for people around the world as well as reduce the differences in health outcomes.  While recognizing the need to improve the performance of the delivery system, they identified a more fundamental set of issues that need attention - the social determinants of health which include the effects of poverty, education, early childhood education, treatment of women, employment opportunities, and individual empowerment on humans' health status and life expectancy.

As we work at the community level to improve the health of our country, there is much to learn from this article.  One suggested focus is on children since improving the conditions that shape early child development can improve opportunities for health throughout a lifetime.  Many of the health problems we face today have their roots in early childhood.  These include obesity, cardiovascular disease, cancer, and mental health problems.  Interventions in early childhood could reduce the incidence and prevalence of these conditions or decrease their effects resulting in large payoffs for future health costs and improved health.  Areas of intervention discussed included nutrition [during gestation and after delivery]; education; reducing substance abuse; and improving access to care.

Be Well Columbus, Georgia Awards Ceremony

The Be Well Columbus, Georgia Awards Ceremony was held on May 18th at Arnold Magnet Academy, school of the winning homeroom.  The Be Well Columbus, Georgia Project is a pilot project instituted through the Muscogee County School District 7^th graders and was made possible by a grant the Columbus Research Foundation received from the Microsoft HealthVault Be Well Fund.  During a three month period from January 17 until April 24, 2009, participating students were encouraged to increase their physical activity as they took a virtual walk across the United States and to check their daily meal, snack and drink intake.  This data was logged on the Be Well Columbus, Georgia/Walk to Microsoft website, which was developed specifically for this project. 

 

After words from Mayor Jim Wetherington, Bill Reid of Microsoft Corporation, Laura Linn of the Center for Health Transformation, Mike Gaymon of the Greater Columbus Chamber of Commerce, Valerie Fuller of the MCSD, and Susan Wood of the Muscogee County Council of PTA's, awards were presented to the students by Royce Ann Adkins and Pam Tinkler of the Columbus Research Foundation.

 

First place went to Mrs. Ronda Allen's homeroom at Arnold Magnet Academy.  The 7th grade students in this homeroom were the first to log enough miles walked to reach Bellevue, Washington, home of the Microsoft Corporation.  The 2nd place winner was the homeroom of Mrs. Sara Davis at Marshall Middle School; 3rd place went to the home room of Mrs. Melissa Niemi at Arnold. 

 

The overall goal of the project was to teach and instill healthy lifestyle choices in the area’s adolescents, thereby preventing diabetes and other metabolic disorders associated with being overweight.  Over 1000 students participated in the project.  It was encouraging to see adolescents engaged in their health.  This project serves as a great model for other communities interested in improving the health of their children.

Let's Commit to Changing the Trends in Childhood Obesity

Overweight and obesity is increasing in children.  CDC reports that data from NHANES surveys (1976–1980 and 2003–2006) show that the prevalence of obesity has increased  for children aged 2–5 years from 5.0% to 12.4%; for those aged 6–11 years from 6.5% to 17.0%; and for those aged 12–19 years from 5.0% to 17.6%.  According to the CDC, the increase in childhood obesity is due to the interaction of a number of factors, including genetic, behavioral, and environmental factors.  The result is a child who consumes more calories than they use and that causes overweight and obesity.

The major behavioral factors that lead to obesity include:

·         food intake

o   sugar-sweetened drinks

o   large portion sizes

o   frequent snacking on energy dense foods

·         physical activity

o   Daily participation in school physical education among adolescents dropped 14 percentage points over the last 13 years — from 42% in 1991 to 28% in 2003.

o   Less than one-third (28%) of high school students meet currently recommended levels of physical activity.

·         sedentary behavior

o   increased time spent watching TV, playing video games, and other computer activities.

Environmental factors that can influence a child’s behavior related to food intake and physical activity include home, child care, school, and community environments.

·         Home environment: parents are role models for their children.  A home environment that models healthy eating and physical activity has a positive impact on the health of the children.

·         Child care: almost 80% of children aged 5 years and younger with working mothers are in child care for 40 hours a week on average.  The approach to food and physical activity during this developmental time is critical to developing healthy habits.

·         Schools: physical education and healthy meals are basic responsibilities of the schools.  Implementing programs that create a culture of health in the schools is a goal that should be set.

·         Communities: access to physical activity opportunities and access to affordable and healthy foods in the community are keys to a healthy community.

As we develop ‘21^st Century Healthy Communities’ these factors are important to consider as a basis for solutions to the problems of overweight and obesity in our nation.  As we approach the summer months, make a resolution to implement one solution to improve food choices and one solution to increase activity in your family.  This can be as simple as changing from ‘sweet’ to ‘unsweet’ tea and taking a family walk after dinner.  Start your family on a healthier path today.