SMARTSMART

Detroit Health Department

SMART

• Background (Why)

• Methods / Approaches (What We Did)

• Results (What We Found)

• Conclusions ( What We Think About What We Found)

• Public Health Implications

SMART

BACKGROUND

BackgroundYouth Obesity: A Public Health Crisis

• The Prevalence of increased obesity and overweight among teens that adversely affect the quality of health and academic performance

• Today, there are nearly twice as many overweight children and almost three times as many overweight adolescents as there were in 1980.

• Increase in Type II diabetes among children, estimated eight times the

pre-1992 level.

• Overweight in children and adolescents is generally caused by lack of physical activity, unhealthy eating patterns, or a combination of the two

(2001 Surgeon General's Call to Action) 

BackgroundYouth Obesity: A Public Health Crisis

• Considered a national epidemic• Threefold increase in overweight children and teens

in last two decades• Children’s health at further risk due to

undernourishment.• Sedentary lifestyle compounds problem• Unhealthy/sedentary lifestyles result in $100 billion

in costs and 300,000 deaths annually (U.S. Surgeon General’s Report, 2002)

BackgroundYouth Obesity: A Public Health Crisis

• Increased prevalence of overweight children in each age group

• Between 1988-94 and 1999-2000, weight increased by 10% among African American and Mexican American adolescents!

• 15% (1 in 6) of children 6 years and older are overweight Study

(Journal of the American Medical Association)

Prevalence of Overweight Children in U.S.--NHANES

BackgroundYouth Obesity: A Public Health Crisis

• One third of Michigan school children are overweight. In fact, they are among the heaviest in the nation. For example, a typical 17-year-old child is 7 pounds heavier than the national average.

• One of five African-American girls, one of six African-American boys, and one of twelve Caucasian children have significantly elevated resting blood pressures.

• 2-4% of Michigan school children have "severely high" blood pressure, compared to a national average of 1%.

• 39% of Michigan children have elevated cholesterol levels compared to a national average of 25%.

(Kuntzleman C.T. University of Michigan Dept. of Movement Science)

BackgroundYouth Obesity: A Public Health Crisis

• Only 22% of male and 19% of female teens meet the minimum average daily goal of at least five servings of vegetables and fruits.

• 1/3 of students do not receive the recommended amount of both moderate and vigorous physical activity during the week.

• Younger students were more likely to watch three or more hours of television each day on an average school day.

(2001 Youth Risk Behavior Survey Results – Detroit High School Survey)

SMART

METHODS/APPROACHES

What We DidMethods & Approaches

• Brought stakeholders and partners together• Committed resources from three district

bureaucratic organizations to address a common public health problem adversely impacting teens

• Enhanced coordination among the local health department and the local school district to leverage resources as a mechanism to achieve health and academic goals of students

What We DidMethods & Approaches

• Complied health data from the school-based health centers, physical education activity data from the school district and geographic recreation service delivery data from the City’s Recreation Department

• Assisted in the development and submission of a Michigan collaborative grant application

• Participated in the development of a “Coordinated School Health Program (CSHP) for the Detroit Public School District

• The SMART initiative will be implemented more effectively with the infrastructure of CSHP

What We DidInventory of Programs, Services and Supports

• Faith Based Initiatives

• Parks & Recreations

• Project FRESH

• EFNEP

• Mall-walking Programs

• MDCH Cardiovascular Health Program

• Governor’s Council on Physical Fitness and Health Sports

• MoTown in Motion

• African American Health Initiative

SMART

RESULTS

What We FoundResults: Schools’ Critical Role

• Key environment identified in U.S. Surgeon General’s

report

• Potential significant influencing power

• Extraordinary opportunity to guide and shape healthy eating and physical activity habits

• Key link to parents and community

• Growing trend: commercial interests target schools and compete with healthy choices, i.e., vending machines

What We FoundResults

• Youth Risk Behavior Survey• Physical Education in Schools• Students Eating Habits (9 - 12th graders)• Self Reports of Students Weight

• School Based Health Center Data•Random Sample Student Chart Review Heights & Weights

• Community / Recreational Data•Recommended Time Allotment for Students’ Physical Education

What We FoundResults: 2001 YRBS

Detroit High School Survey

Percent of students who attended physical education (PE) class daily

Grade Percentage Number

9th 39.4 462

10th 26.6 473

11th 25.1 331

12th 15.4 253

What We FoundResults: Recreational/Non-School Hours

Principal Survey

Elementary

(%)

Middle

(%)

High

(%)

Academic/Tutorial 79 65 79

Sports 58 83 67

Recreational 38 25 8

Computer 29 33 25

Dance 22 28 38

Detroit Public Schools, prepared by Moore & Associates, June 2002

What We FoundResults: 2001 YRBS

Detroit High School Survey

Percent of students who watched three or more hours of TV per day on an average school day

Grade Percentage Number

9th 62.6 535

10th 60.3 526

11th 59.3 381

12th 54.0 289

Coordinated School Health Program ModelCoordinated School Health Program Model

What We FoundCoordinated School Health Program’s Eight Components

• Health Education• Physical Education• Health Services• Family / Community Involvement• Mental Health Services• Nutrition Services• Healthy School Environment• Health Promotion for Staff

What We FoundAchievement Tied to Good Health

• Physical Activity• Improves self esteem

• Reduces anxiety and stress in teens

• Documented Facts• Good health and nourishment enhance performance

on cognitive testing

• Improved tests scores are a result of participation in school breakfast program

SMART

CONCLUSIONS

What We Think About What We Found

CONCLUSIONS

• Big picture realized, however, data gaps remain

• Efficient way to leverage existing resources among local governmental entities to ensure program implementation, program operation and program sustainability

• Collaboration is effective

• Collaboration works

• Partners/stakeholders committed

What We Think About What We Found

CONCLUSIONS CONT’D

• Obesity problem brought to the forefront and able to obtain buy-in from Public Health Director, Public Schools CEO and the Mayor

• The Coordinated School Health Program is a vehicle to address health initiatives, particularly the prevalence of obesity among school age children

SMART

PUBLIC HEALTH IMPLICATIONS

Compelling Message forPublic Health

• Advocacy and resiliency is needed to reverse the obesity epidemic among school age children

• National and local resources are required

• Buy-in of the community; students, parents, private sector, clergy, businesses, media and other stakeholders

Compelling Message forPublic Health

• HEALTHY YOUTH MAKE BETTER STUDENTS

• BETTER STUDENTS MAKE HEALTHY COMMUNITIES