* WARNING: THIS IS AN UNOFFICIAL, INTRODUCTORY COPY OF THE BILL.
THE OFFICIAL COPY CONSIDERED BY THE CITY COUNCIL IS THE FIRST READER COPY.
INTRODUCTORY*
CITY OF BALTIMORE
COUNCIL BILL R
(Resolution)
Introduced by: Councilmember Welch
A RESOLUTION ENTITLED
A COUNCIL RESOLUTION concerning
Title
Organizational Hearing - Baltimore City Council Task Force on Childhood Obesity - A Call to Action
FOR the purpose of calling together school, preschool, and after-school personnel, health care providers, parents, community groups, faith-based organizations, and other stakeholders in a campaign to address the critical problem of childhood obesity by creating a partnership across sectors with the mission to identify the specific roles that must be undertaken to prevent the onset of childhood obesity, to formulate a plan to combat the escalation of the problem among those children at-risk, and to devise a medical and behavioral treatment model to treat the diseases caused by this epidemic and to prevent the onset of sickness in the target population.
Body
Recitals
In a research brief published in August 2004, the National Institute for Health Care Management (NIHCM) Foundation reported that childhood obesity in the U.S. is threatening child health gains made over the past 3 decades. A study by the Centers 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 and that at this rate the current generation of children will not live as long as their parents.
The prevalence of childhood obesity in the United States, it was reported, is growing rapidly for children of all ages - over 15% of children ages 6-19 were overweight in 2000; for 6-11 year olds, the percentage is double the prevalence in 1980; the impact is even greater for 12-19 year olds with triple the rate; and even more alarming is the increase in overweight among young children 2-5 years old, from 7% 10 years ago to 10% in 2000.
By 2004, the Centers for Disease Control (CDC) reports that overweight among children aged 6-11 had reached 18.8% and for 12-19 year olds, 17.1%, and that an estimated 61% of overweight young people have at least 1 additional risk factor for heart disease, such as high cholesterol or high blood pressure. In addition, children who are overweight are at greater risk for bone and joint problems, sleep apnea, and social and psychological problems such as stigmatization and poor self esteem.
The American Obesity Association reports that many adverse health effects associated with overweight are observed in children and adolescents:
* Asthma: Prevalence of overweight is reported to be significantly higher in children and adolescents with moderate to severe asthma compared to a peer group.
* Diabetes (Type 2): The increase of Type 2 diabetes in children and adolescents in a dramatically short time is most significantly impacted by a parallel increase in childhood obesity. Obesity is the most significant factor in the skyrocketing increase in Type 2 in children - from 2-4% of childhood diabetes before 1992, to 16% by 1994.
* Hypertension: Persistently elevated blood pressure levels have been found to occur 9 times more frequently among obese children and adolescents (ages 5 to 18) than in non-obese.
* Orthopedic Complications: Among growing youth, bone and cartilage in the process of development are not strong enough to bear excess weight. In young children, excess weight can lead to bowing and overgrowth of leg bones, and increased weight on the growth plate of the hip can cause pain and limit range of motion.
* Psychosocial Effects and Stigma: Adolescent females who are overweight have reported experiences with stigmatization such as direct and intentional weight-related teasing, jokes, and derogatory name calling, as well as less intentional, potentially hurtful comments by peers, family members, employers, and strangers. Overweight children and adolescents also report negative assumptions made about them by others, including being inactive or lazy, being stronger and tougher than others, not having feelings, and being unclean.
* Sleep Apnea: Sleep apnea, the absence of breathing during sleep, occurs in about 7% of children with obesity. Deficits in logical thinking are common in children with obesity and sleep apnea.
A study performed by officials from the Johns Hopkins School of Medicine, the Johns Hopkins School of Public Health, and the Baltimore City Health Department, Social Economic Status and Obesity Among Urban Youth: A Geographic Analysis, found, in part, that many patients in urban school-based health centers are overweight or at-risk for overweight and that gender, age, and individual level measures of poverty are associated with BMI Given the number of affected students overall, exploration of the potential role of school-based interventions for obesity prevention and intervention is essential.
To address this problem, the Baltimore City Council Task Force on Childhood Obesity is formed, based on a model formed by the Institute of Medicine that was established in 1970 under the charter of the National Academy of Sciences to provide independent, objective, evidence-based advice to policy makers, health professionals, the private sector, and the public. The Institute of Medicine, in its role as adviser to the nation to improve health, was charged by Congress, in 2002, with developing a prevention-focused action plan to decrease the number of obese children and youth in the United States.
The Institute of Medicine's charge followed the 2001 U.S. Surgeon General's Call to Action to prevent and Decrease Overweight and Obesity to stimulate the development of specific agendas and actions targeting this public health problem that, in 2000, was causing 30% of boys and 40% of girls to be at risk of developing Type 2 diabetes and causing obesity-associated annual hospital costs to triple over 2 decades, rising from $35 million in 1979-1981 to $127 million in 1997-1999. After adjusting for inflation and converting 2004 dollars, the national healthcare expenditures related to obesity and overweight in adults alone range from $98 billion to $129 billion annually.
According to the 2005 Institute of Medicine report, Preventing Childhood Obesity: Health in Balance, an aspiration for local governments is to provide coordinated leadership and support for a collaborative effort of stake holders to increase resources and opportunities:
* Schools should provide a consistent environment that is conducive to healthful eating behaviors and regular physical activity by, in part, (1) developing and implementing nutritional standards for all foods and beverages sold or served in schools; (2) ensuring that all school meals meet the Dietary Guidelines for Americans; (3) ensuring that all children and youth participate in a minimum of 30 minutes of moderate to vigorous physical activity during the school day; (4) enhancing school health curricula; (5) ensuring that schools are as advertising-free as possible; (6) conducting annual assessments of students' weight, height, and body mass index and making that information available to parents; and (7) assessing school policies and practices related to nutrition, physical activity, and obesity prevention.
* Industry should make obesity prevention in children and youth a priority by, in part, (1) developing and promoting products and information that will encourage healthy eating and regular physical activity; and (2) food and beverage industries should develop product and packaging innovations that address total calorie content, energy density, nutrient density, and standard serving sizes to help consumers make healthful choices.
* Parents should (1) promote healthful eating behaviors and regular physical activity for their children; (2) provide healthful food and beverage choices for children by carefully considering nutrient quality and energy density; (3) assist and educate children in making healthful decisions regarding types of foods and beverages to consume, how often, and in what portion size; (4) encourage and support physical activity; (5) limit children's television viewing and other recreational screen time to fewer that 2 hours per day; (6) discuss weight status with their child's health care provider and monitor age and gender specific body mass index (BMI) percentile; and (7) serve as positive role models for the children regarding eating and physical activity behaviors.
* Community Programs: Local governments, public health agencies, schools, and community organizations should collaboratively develop and promote programs that encourage healthful eating behaviors and regular physical activity, particularly for high-risk populations.
* Built Environment: (1) Local governments, private developers, and community groups should expand opportunities for physical activity, including recreational facilities, parks, playgrounds, sidewalks, bike paths, routes for walking or bicycling to school, safe streets and neighborhoods, especially for high-risk populations; (2) communities should prioritize capital improvement projects to increase opportunities for physical activity; and (3) communities should improve the street, sidewalk, and street-crossing safety routes to school, developing programs to encourage walking and bicycling to school and building schools within walking and bicycling distance of the neighborhoods they serve.
* Health Care Sector and Providers:(1) Pediatricians, family physicians, nurses, and other clinicians should engage in the prevention of childhood obesity by routinely tracking BMI, offering counseling and guidance, and providing leadership in their communities for obesity prevention efforts; and (2) professional organizations should disseminate evidence-based clinical guidance and establish programs on childhood obesity prevention and training programs, and certifying entities should require obesity prevention knowledge and skills in their curricula and examinations.
* Government Leadership: at all levels should provide coordinated leadership for the prevention of obesity in children and youth. State and local government should (1) provide coordinated leadership and support for childhood obesity prevention efforts, particularly those focused on high risk populations, by increasing resources and strengthening policies that promote opportunities for physical activity and healthful eating in communities, neighborhood, and schools; and (2) support public health agencies and community collaborative efforts to promote and evaluate obesity prevention interventions.
In what might serve as an advisory model for the Baltimore City Council Task Force on Childhood Obesity, San Mateo County, California translated the Institute of Medicine's guidelines for a childhood obesity initiative into the Blueprint For Prevention of Childhood Obesity - A Call To Action: A Community Health Improvement Initiative to Eliminate Health Disparities. The county's action plan incorporates 5 priority areas:
* Priority Area 1: Community/Environment - goal to improve and sustain access to healthy food and physical activity at the community organizational, and environmental levels.
* Priority Area 2: Schools - goal to improve and sustain access to healthy food and physical activity in the school setting.
* Priority Area 3: After School - goal to improve and sustain healthy eating and physical environments in the "after school"setting.
* Priority Area 4: Preschool/Child Care Services - goal to improve nutrition and physical activity environments in the preschool and child care services setting.
* Priority Area 5: Healthcare - goal to improve and sustain access to healthy nutrition and physical activity information and environments in the healthcare setting.
In forming this Task Force on Childhood Obesity, the City Council will work to ensure that our children live healthier, happier, educational childhoods that transition into personally rewarding, socially meaningful and economically productive adult hoods.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF BALTIMORE, That this Body is calling together school, preschool, and after-school personnel, health care providers, parents, community groups, faith-based organizations, and other stakeholders in a campaign to address the critical problem of childhood obesity by creating a partnership across sectors with the mission to identify the specific roles that must be undertaken to prevent the onset of childhood obesity, to formulate a plan to combat the escalation of the problem among those children at-risk, and to devise a medical and behavioral treatment model to treat the diseases caused by this epidemic and to prevent the onset of sickness in the target population.
AND BE IT FURTHER RESOLVED, That membership on the Task Force shall include, but not be limited to, representatives from:
* Baltimore City Health Department
* Baltimore City Public Schools
* Baltimore Parent/Teacher Associations and Organizations
* Community Associations listed in the Planning Department Directory
* Mayor's Office of Children and Youth
* Interdenominational Ministerial Alliance
* NAACP
* Pepsi Cola, Inc.
* Baltimore Ravens
* Baltimore Orioles
* Johns Hopkins School of Public Health
* area hospitals
* area institutions of higher learning
* the Greater Baltimore Committee
* the Chamber of Commerce
AND BE IT FURTHER RESOLVED, That a copy of this Resolution be sent to the Mayor, the Commissioner of Health, the CEO Baltimore City Public School System, Community Associations of the Planning Department Directory, the Executive Director of the Mayor's Office of Children and Youth, the Chair of the Interdenominational Ministerial Alliance, the President of the Baltimore NAACP, the Dean, Johns Hopkins School of Public Health, and the Mayor's Legislative Liaison to the City Council.
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