SUMMARY:

Overview:
Today’s action will support the creation, coordination, and implementation of a Childhood Obesity Master Plan.

Recommendation(s):

VICE CHAIRMAN ROBERTS AND SUPERVISOR SLATER-PRICE:
1.    Direct Community Project Funds allocated in this letter to the Community Health Improvement Partners to work in partnership with the Coalition on Children and Weight, County’s Department of Health and Human Services, and other community stakeholders to create and implement a Childhood Obesity Master Plan.

2.     Direct the Chief Administrative Officer to work with the Coalition on Children & Weight to solicit an additional $25,000 toward the cost of a consultant to assist in the creation of the Master Plan and to provide a status report in 30 days on the availability of funds.

3.     Allocate $25,000 from the Community Projects Budget unit (0264) to Community Health Improvement Partners for the Childhood Obesity Master Plan.

4.     Allocate $25,000 from the Community Projects Budget unit (0263) to Community Health Improvement Partners for the Childhood Obesity Master Plan.

Fiscal Impact:
There is no impact to the General Fund associated with this action. Community Projects Funds in the amount of $50,000 will be provided to Community Health Improvement Partners (CHIP). Half of these funds, totaling $25,000 will serve as a challenge grant to hire a consultant for the Childhood Obesity Master Plan. Contracting with a consultant is contingent on securing the remaining funds needed from outside sources. The remaining $25,000 in Community Projects Funds will go toward supporting activities associated with implementing the Childhood Obesity Plan.

BACKGROUND:

Obesity is a societal health problem with significant implications for the quality of life and economic stability of our health care system. A study recently published by the Center for Disease Control and Prevention (CDC) concluded that poor diet and inactivity are close to overtaking cigarette smoking as the leading cause of preventable death.

Statistics show that childhood obesity is a rapidly emerging health issue for children of all ages and is continuing to get worse. Nearly 9 American million children ages 6-9 were overweight in 2000. This number represents over 15 percent of the youth in this age group. Since 1980 the number of overweight children ages 6-11 has more than doubled, and the number of overweight children age’s 12-19 has tripled. More alarming is the increase in the number of overweight 2-5 year olds, from 7 percent ten years ago to10 percent today. In the County of San Diego alone, there are an estimated 125,000 overweight children. In 2003, 16 percent of San Diego low-income children between the ages of 2-4 were overweight and 21.2 percent of low-income youth 4-19 years were overweight.

With the number of overweight children rising to epidemic levels, it is clear that we need effective prevention and early intervention to reduce its prevalence. New tactics are important because we know that 50-70 percent of overweight adolescents will become obese adults. Experts conclude that if obesity continues to be a problem, the current generation of children will not live as long as their parents.

Health and social consequences associated with obesity are extensive. It is the leading cause of pediatric hypertension, is associated with type II diabetes, increases risk of coronary heart disease, high blood pressure, non-alcoholic fatty liver disease, stroke, and some types of cancer. It can also lower self-esteem and affect relationships with peers. Supervisor Pam Slater-Price has been a strong advocate for nutrition and regular physical activity as the most effective way to maintain one’s health.

In March 2002 Supervisor Slater-Price sponsored a Town Hall Forum titled “Health and Well-Being of School Aged Children” where she convened parents, school officials and service providers to discuss programs aimed to keep Escondido’s children healthy and ready to learn. Most recently, Supervisor Slater-Price highlighted the relationship between good oral healthcare and good physical health through her “Something to Smile About” dental health initiative. The link between oral health and poor nutrition, particularly excessive sugar consumption, may have important implications on the rising prevalence of obesity and overweight among children and adolescents in the U.S. Recently, several states have begun to focus attention on the connection between increased soda consumption and rising rates of dental caries and obesity among children and adolescents. According to the National Soft Drink Association, soft drink consumption continues to grow, and accounts for nearly 30 percent of the beverages Americans drink. Heavy consumption of soft drinks can lead to dental caries and tooth erosion. Such consumption is also tied to excessive intake of sugar, which may be associated with obesity and Type II diabetes in children. In addition to the harmful risk factors associated with those personally affected by the disease, we must recognize the fiscal impact it has on our community, economy, and health care system.

Nationally, the annual cost of obesity and overweight is estimated at $177 billion. This includes direct costs associated with diagnosis and treatment, physician visits, medications, hospitalization and nursing homes. The indirect costs include lost wages and productivity due to illness. Obesity now costs more in annual medical care expenditures than cigarette smoking — around $75 billion in 2003 — because of the long and costly treatments for the complications caused by obesity. A large percentage of these costs are borne by Medicare, Medicaid, private health-insurance companies, and ultimately by the population at large.

The Childhood Obesity Master Plan will play a significant role in preventing, curbing, and reducing this epidemic affecting our youth. The intent of this countywide Childhood Obesity Master Plan is to define the scope of the problem in San Diego County and identify broad strategies that can be implemented to diminish the prevalence of childhood obesity and associated risk factors. By coordinating these strategies into one plan, we can maximize our efforts and execute programs systematically in communities countywide.

The specific goals of this plan are to: 1) Define the extent of childhood overweight and obesity in San Diego County; 2) Identify key strategies across multiple disciplines that would contribute to the prevention and reduction of childhood obesity; 3.) Outline how these strategies can be achieved and implemented in our communities; 4.) Coordinate with similar efforts already underway throughout the county; 5.) Identify funding opportunities to assist in the implementation of this plan.

Strategies in this Plan will include issues such as the availability of parks and community centers, fresh produce, advertisement of unhealthy foods targeted toward children, school nutritional programs, physical education, recreational opportunities, cultural barriers and social habits. As we strive to create a plan that explores a variety of subject matters, it will be important to recruit a cross-section of people representing these disciplines to be part of the planning process.

The Coalition on Children and Weight San Diego will share a leadership role with Health and Human Services Agency in the formation and implementation of this plan. In 2002, Supervisor Roberts sponsored a Children’s Weight Initiative in response to concerns about the increasing child health problems associated with obesity. As an outgrowth of that initiative the Coalition on Children and Weight was formed. It is now a countywide organization whose purpose is to address the complex risk factors of childhood obesity, and create sustainable policy and environmental changes to improve the health of children in San Diego. The Coalition’s achievements are the products of an all-volunteer group of more than 250 individuals representing health organizations, physicians, schools, parents, and community agencies. They will be instrumental in providing input toward the creation and implementation of a Childhood Obesity Master Plan.

The Coalition will work in partnership with the County’s Department of Health and Human Services and Community Health Improvement Partners (CHIP) to hire a consultant to facilitate the creation of the Childhood Obesity Master Plan, recruit a Steering Committee and an Advisory Committee, and to implement the Plan’s strategies. The Steering Committee will consist of a small group of experts who will drive the process of completing this plan and be responsible for the consultant contract. A larger group of individuals will be assembled to form the Advisory Committee. This Committee will represent a variety of disciplines, including pediatric health, public safety, planning and land use, agriculture, nutrition, schools, childcare, media, recreation, and culturally diverse community leaders. Together these participants will be able to provide insight into the behavioral, environmental and medical aspects of this disease and hence design the Childhood Obesity Master Plan.

Having a comprehensive plan of this magnitude in place puts San Diego in a unique position to compete for large scale grant funding. It puts us ahead of others that do not have a systematic approach to affect childhood obesity. To further support the success of this effort, we have allocated $25,000 toward hiring a consultant to facilitate meetings, build consensus among stakeholders and write the Childhood Obesity Master Plan document. We have challenged the Coalition to come up with matching funds to support the cost of a consultant. In addition, we have allocated $25,000 to support activities related to the implementation of the Childhood Obesity Master Plan.

Ultimately, this Childhood Obesity Master Plan will provide a road map for change. It will define the scope of the childhood obesity epidemic in San Diego County, and provide community organization and direction on how to implement strategies in our County to reduce the prevalence of childhood obesity. This initiative is consistent with the Board’s strategic plan, and we urge your support.

Respectfully submitted,

PAM SLATER-PRICE Vice Chairwoman Third District

RON ROBERTS Supervisor Fourth District