Paying off

The Educare early childhood center, a Head Start preschool on Chicago's South Side, opened over a decade ago inside crime-ridden Robert Taylor Homes housing project.

The children “couldn't go outside, they wouldn't play, and most of the time they had to huddle because there were bullets flying,” said Brenda Eiland-Williford, program and curriculum director for the center. “It was very dangerous back then.”

It was that lack of access to physical activity that led to the construction of the program's current facility, a large structure that houses 13 classrooms, two indoor gyms and an outdoor play area. In addition to the play areas, each classroom is connected to an outdoor patio where children can go for unstructured play time.

“We understand the importance of physical activity,” she said. “Not only for children's weight in terms of obesity, but also in terms of their cognitive abilities.”

Policymakers, public health experts and educators across the country have come to a similar realization, and there are signs that their efforts are paying off. After rising for years, the childhood obesity rate in the U.S. showed the first signs of finally beginning to decline. A new report from the Centers for Disease Control and Prevention last week found a slight drop in 19 states among low-income children between the ages of 2 and 4. Illinois, however, was not one of those states. Its rate of obesity among low-income preschoolers remained stable at about 14.7% from 2008 to 2011.

The CDC's findings highlighted questions about the root causes of high rates of obesity found in the country's low-income communities, which suffer higher rates of childhood obesity than other income groups.

For many low-income communities across the country, the combination of violence and a lack of economic development over the years have resulted in a lack of safe parks and limited access to fresh fruits and vegetables, both of which have contributed to the problem of obesity in such areas.

“Historically, there has been a pretty strong link between poverty and obesity,” said Marlene Schwartz, director of the Rudd Center for Food Policy and Obesity at Yale University. “There seems to be extra vulnerability to obesity among low-income families particularly because they often don't have the same kind of access to healthy food and might not have the sort of time to prepare the food. (There) are extra stressors that make it particularly difficult for low-income families,” she said.

Such has been the case for the Grand Boulevard neighborhood on Chicago's South Side, which is filled with empty lots, convenience food stores stocking snack food and fast-food restaurants but few full-service supermarkets.

The Educare center staff has worked hard to address that problem. With bright, colorful walls filled with pictures showing the smiling faces of the 149 children the center serves, it seems a world away from the program's beginnings more than 13 years ago.

The center has an onsite nurse and nutritionist. Upon enrollment, children are given a physical assessment that includes measuring height and weight, and they are required to answer questions about their eating habits at home.

Those children found to be overweight or obese—about 10%, according to Eiland-Williford—are given an individualized health plan. Counselors work with children and their families on improving eating habits and encouraging more-active lifestyles.

Eiland-Williford and others are on the front lines of an ongoing struggle against childhood obesity, whose rate has more than doubled in children over the past 30 years and has been called an epidemic.

Not until last week's CDC study has there been evidence pointing to a decline in childhood obesity rates. Many researchers and anti-obesity advocates found the study encouraging because the decline was among preschool children who came from low-income households.

The study included 12 million children from 40 states, and found the most significant declines in Florida, Georgia, Missouri, New Jersey and South Dakota, where the obesity rate in each of those states fell by 1 percentage point. Increases were found in three states studied—Tennessee, New Mexico and Pennsylvania—while 21 states saw no significant change.

Schwartz argued that the CDC findings most likely reflect gains made through federal, state and local policy changes to reduce obesity. A key change is in the types of foods families receiving assistance under the federal government's Special Supplemental Nutrition Program for Women, Infants and Children are allowed to purchase.

Eiland-Williford said many parents of the children who attend her center—a majority of whom receive government assistance—have expressed dismay over their lack of access to fresh vegetables.

So the Educare center did something about that. “We actually got a bus for our families and took them to a nice supermarket where there was fresh food available,” Eiland-Williford said. “They had the opportunity to buy a variety of fresh fruits and vegetables.” In addition, the center has a garden that grows vegetables for local food pantries and holds regular nutrition and yoga classes for parents.

Such efforts have had positive results for a majority of the children, with parents taking greater responsibility for improving the nutrition of their kids, she said. Despite the progress, she thinks the center could play an even larger role in helping improve the health of parents.

“We need to look into doing more things that can help families with weight loss,” Eiland-Williford said. “We could do more with our families in educating them about the importance of good nutrition.”

Follow Steven Ross Johnson on Twitter: @MHsjohnson