Advancing health through science, education and medicine

Fit Kids Can Create Fit Cities

By: Craig Samitt, M.D., M.B.A.
Chief Clinical Officer, Anthem, Inc.

For the past nine years, the Anthem Foundation has proudly supported the American College of Sports Medicine (ACSM) American Fitness Index® (AFI). In that time, we have watched the AFI Data Report become a recognized and credible resource that can positively influence health and well-being in communities across the country. We've also created a number of resources to help support this effort, including the AFI Community Action Guide.

One startling "fitness" trend in the past four decades is soaring U.S. obesity rates among all age groups. As of 2015, more than one-third (36.5 percent) of U.S. adults are considered obese1. Even more alarming is the rise in obesity rates with our youth. Childhood obesity has increased more than fourfold among those ages 6 to 11. More than 23 million children and teenagers in the U.S. ages 2 to 19 are obese or overweight, a statistic that health and medical experts consider an epidemic. We also know children and adolescents who are obese are likely to be obese as adults2-5 and are, therefore, more at risk for adult health problems such as heart disease, type 2 diabetes, stroke, several types of cancer and osteoarthritis6.

The AFI Data Report captures the percent of adults who are obese in the 50 largest MSAs in the U.S. All the data sources included in the AFI Data Report are for adults only. As the AFI Data Report evolves in the future, adding youth data to the index would provide a holistic picture for all age ranges in a community. The lack of reliable and comparable youth data at the city or MSA-level makes this currently not feasible. For example, the Youth Risk Behavioral Surveillance Systems (YRBSS) includes national, state, territorial, tribal government and local school-based surveys of representative samples of 9th through 12th grade students only.

If our goal with AFI is to create more fit cities in the future, it is critical that we focus on the fitness of children today- including the prevention and reduction of childhood obesity cases. While the causes of obesity are complex, experts know healthy lifestyle habits, including healthy eating and physical activity, can lower the risk of becoming obese and developing related diseases6. The dietary and physical activity behaviors of children and adolescents are influenced by many sectors in a community, including families, communities, schools, child care settings, medical care providers, faith-based institutions, government agencies and the media to name a few. We know schools play a particularly critical role in supporting healthy behaviors by establishing a safe and supportive environment with healthy policies and practices. The school environment also provides opportunities for students to learn about and practice healthy eating and physical activity behaviors. 

It is imperative that all sectors reinforce and support foundational education about healthy lifestyles starting at an early age in elementary school. In order to reverse the childhood obesity trend, all of these important sectors in society must work together and take responsibility for changing cultural trends to emphasize health. 

To help mobilize key stakeholders in this effort and ensure everyone is doing their part, last year Anthem Foundation partnered with Trust for America's Health and The U.S. Chamber of Commerce Foundation to foster a conversation about the important role all sectors of our communities play in helping prevent childhood obesity. To help begin that dialogue, we created a research-based infographic that addresses how a network can be built and the role that different community stakeholders such as business, government agencies, families and nonprofits play in helping to reduce childhood obesity. The "Households" excerpt from the infographic can be found below, or you can view the entire infographic and learn more about this effort.

Because our children are our future, the Anthem Foundation and ACSM will continue to work diligently to educate stakeholders and provide the resources needed to ensure their future is a healthy one.

1. Read CDC National Center for Health Statistics (NCHS) data brief
2. Guo SS, Chumlea WC. Tracking of body mass index in children in relation to overweight in adulthood. American Journal of Clinical Nutrition. 1999;70: S145-148.
3. Freedman DS, Kettel L, Serdula MK, Dietz WH, Srinivasan SR, Berenson GS. The relation of childhood BMI to adult adiposity: the Bogalusa Heart Study. Pediatrics. 2005;115:22-27.
4. Freedman D, Wang J, Thornton JC, et al. Classification of body fatness by body mass index-for-age categories among children. Archives of Pediatric and Adolescent Medicine 2009;163:801-811.
5. Freedman DS, Khan LK, Dietz WH, Srinivasan SA, Berenson GS. Relationship of childhood obesity to coronary heart disease risk factors in adulthood: the Bogalusa Heart Study. Pediatrics. 2001;108:712-718.
6. Office of the Surgeon General. The Surgeon General's Vision for a Healthy and Fit Nation.[PDF - 840 KB]. Rockville, MD, U.S. Department of Health and Human Services; 2010.

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