African Americans experience a disproportionate burden of morbidity and mortality in this country. Cardiovascular disease, cancer, stroke, renal disease, respiratory conditions, arthritis, and depression are increasing at an alarming rate in the Black community. Much of this excess health risk is attributed to modifiable factors, such as obesity, which largely results from poor lifestyle choices. The Surgeon General reported that in 1999, 61% of adults in the United States were overweight or obese.Particularly alarming is the fact that the prevalence sof obesity has nearly tripled for adolescents over the last twenty years. Eleven year olds are 11 lbs. heavier today than they were in 1973. If the current trend continues, 1/3 of children born today will be diabetic. The roots of ethnic health disparities begin during early childhood. A study based on the National Health and Nutrition Survey (NHANES) found that the prevalence of overweight children ages 2 through 19, is continuing to grow especially among Blacks and Latinos. The future health of African American girls and Latinas is in particular jeopardy because their trajectory to obesity begins significantly earlier than in white girls.
The pathway to overweight/obesity is complex. However sedentary lifestyles and poor diet are at the root of the problem. The cause and effects of these lifestyle choices are not distributed evenly among the population. African Americans face many social andstructural disadvantages that lead to limited access to nutritious food, and few outlets for physical activity. Neighborhood setting also has a profound effect on physical activity levels among children. A common observation in poor communities is that fearful parents keep their children indoors to protect them from violence in the neighborhood. In these settings, sedentary behaviors are fostered through excessive television watching, playing video games, and eating unhealthy snack food.
The decline/lack of structured sports programs is also blamed for contributing to the youth obesity epidemic. An informal survey of local athletic team coaches found that limited access to facilities was a major cause of the decline in Bay Area community sports programs. For example, the Westside Kickers is a youth track club based in West Oakland. Seven years ago, the team had over 200 members. Last year the team had dwindled to 7 members.
How did this happen?
A few years ago, all of the local high school and junior college tracks were dirt, and community athletic clubs enjoyed free use of the facilities. When local track facilities were upgraded to all-weather, state-of-the-art facilities, rental fees of up to $2000 per day were assessed, effectively shutting out local track clubs. The cost of insuring athletes and events, requirements for providing security and emergency medical services added to the difficulty in sustaining community after-school sports programs.
School based intervention programs are one of the best strategies for preventing overweight/obesity among children. Girls in particular have an opportunity to improve their health while in school.A recent study found that an extra hour of exercise per week could significantly reduce obesity in young overweight girls. However, the level of participation in physical activity is declining largely because schools are demanding less of them. State and local school district policy requires that children receive 100 minutes of physical activity. However, overcrowded schools in poor neighborhoods lead to converting gymnasiums into classrooms. Furthermore, with pressure to improve math and reading scores, many principals are opting to ignore physical education programs altogether. Ironically, research shows that exercise and movement enhances academic achievement. Furthermore, physical activity relieves anxiety and stress.
How did we get here?
A big reason often cited for the decline in school physical fitness programs is budget cutbacks. In 1978 California voters passed Proposition 13, an initiative that cut local property taxes by nearly 60 percent, capped property tax rates at 1 percent and, except for an annual 2-percent inflation adjustment, prohibited all reassessment of California property unless the property changed ownership. The initiative had a profound and immediate effect on state services. In the years prior to Proposition 13, California was fifth among the states in per pupil spending in its public schools, by the mid-1990s, it had dropped to forty-first. Currently, California ranks 29th in the nation in per pupil expenditures.
Characteristics of the high SES schools are that they have a strong parent-teacher associations, community support and have the ability to raise additional funds to subsidize cash strapped neighborhood public schools, and to provide consistent volunteer support to shore up various school programs/activities. These are the schools that can afford to maintain a viable physical education curriculum.
To stem the tide of chronic disease among African Americans, creative fitness programs in our communities are desperately needed. The success of such programs depends on collaboration between parents, teachers, community organizations, businesses, foundations, and government agencies.