School Health Education Dilemma Deepens
Crackdown in NYC Schools Rekindles School Vending Machine Issue
Jun 11, 2009
When New York State Comptroller Thomas DiNapoli announced the findings of a state audit showing that 21 of 30 schools in New York City sold junk food in vending machines, he signaled a renewed emphasis on school nutrition programs that some see as central in the fight to slow the epidemics of obesity and type 2 diabetes that are raging across the U.S.
“This is not just about kids eating doughnuts, but saving taxpayers dollars,” DiNapoli said at a news conference reported by the New York Times. Earlier, DiNapoli’s office reported that more than a million New York students are obese and that more than $6.1 billion in public and private medical funding was spent to treat the condition in just one year.
School Health Programs Seen as Critical
Of the public dollars spent, 81 percent of the total, Medicare and Medicaid shoulder the lion’s share of the burden. Across all states the average public share of obesity-related costs is about 52 percent, the report said. The figures underscore the high stakes in other public health care debates, with Medicare primarily funded by the U.S. government while states shoulder as much as 50 percent of Medicaid spending.
With no quick fix to the obesity epidemic in sight, the type 2 diabetes epidemic is unlikely to rapidly disappear. From 1980 to 2006, diabetes tripled in the U.S. from 5.6 million to 16.8 million, according to the Centers for Disease Control and Prevention (CDC). The agency’s latest estimate, released last year, puts the prevalence of diabetes at nearly 24 million Americans. An estimated 57 million more have pre-diabetes, which increases the risk of developing type 2 diabetes.
School Nutrition Programs Not Enforced
While many states and local school districts have approved similar junk food bans, there appears to be little evidence that they have made a dent in the obesity trends. A month before the New York audit, a parallel review in the Los Angeles Unified School District found startlingly comparable results. There, the audit reported that a number of school administrators weren’t even aware of the policies or didn’t know how to enforce them.
A 2008 study funded by the Robert Wood Johnson Foundation showed that of 395 schools surveyed across 38 states, 96 percent of high schools have vending machines and 91 percent of them sell junk food. More than half of the schools have exclusive agreements giving soft drink companies sole rights to sell beverages in the school’s machines, lucrative contracts that many schools may be reluctant to end.
There is little to balance off the scales or tip them towards the healthy end of the spectrum, the report indicates. For example, only 43 percent of the schools surveyed participate in a government program that provides fresh fruits and vegetables to schools.
School Vending Machines Only Part of the Problem
School health program supporters may applaud the audits as evidence that at least someone is paying attention to force full implementation of policies intended to improve school nutrition by regulating vending machines in school. Yet, according to the CDC, that’s only one component of a comprehensive approach schools need to adopt to prevent childhood obesity.
The CDC prescription suggests nine other elements in an evidence-based strategy:
- Address both physical activity and nutrition through a coordinated school health program
- Convene an active school health council including parents, teachers, students, health care professionals and other community leaders
- Assess school health policies and programs, and develop an agenda for improvement
- Adopt and strengthen school nutrition and physical activity policies
- Implement a substantive health promotion program for school staff to develop healthy role models for students
- Implement a quality curriculum for health education study, such as the Michigan Comprehensive School Health Education K-12 curriculum
- Require study of physical education as part of the student’s academic discipline, emphasizing knowledge and skills for lifelong physical activity
- Provide more opportunities for students to participate in physical activity that are accessible to all students, not just those in sports or gym class
- Implement a quality school meals program, including professional development for school food service staff
School Health Education a Key Element in Solution
The stakes have never been higher, according to CDC figures that show the proportion of students who are overweight more than tripling since the 1960s. While schools can play a more assertive role, it’s not exclusively their burden, the CDC says. Noting that healthy eating and physical activity are complex behaviors influenced by family, community, health care providers, business, government and others, the CDC believes an inclusive approach involving all sectors is required to turn the epidemic around.
Sources
Robert Wood Johnson Foundation
CDC
