1

UTILIZING SOCIAL ACTION APPROACHES TO ADDRESS CHILDHOOD

OBESITY IN THE UNITED STATES

Student’s Name

Institutional Affiliation

Date

Introduction

Childhood obesity is a serious public health concern in the United States (US), with
approximately 19% of children and adolescents being classified as obese (Ogden et al.,
2018). Obesity in childhood can lead to several short- and long-term health complications,
including type 2 diabetes, hypertension, and cardiovascular disease (CDC, 2021). While
public health practitioners have made efforts to address this issue through individual-level
interventions, such as dietary counselling and physical activity promotion, the success of
these efforts has been limited. In recent years, social action approaches have emerged as a
potential solution to addressing childhood obesity. Social action approaches are community-
based strategies that aim to empower communities to take action and address health issues
themselves, rather than relying solely on public health practitioners. In this essay, we will
critically evaluate how public health practitioners can utilize social action approaches to
address childhood obesity in the US. We will also discuss how the social determinants of
health can impact the identified health problem, and how the principles and practice of
community development can be employed to work with the community to address this issue.

Background

Childhood obesity has been a growing concern in the US for several decades. The prevalence
of obesity in children and adolescents has more than tripled since the 1970s (Ogden et al.,
2018). Obesity in childhood is linked to several factors, including genetics, lifestyle, and
environmental factors. The social determinants of health, which are the social and economic
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conditions in which people live and work, also play a significant role in the development of
obesity in children. Social determinants of health that have been linked to childhood obesity
include poverty, access to healthy food, and opportunities for physical activity (Kumanyika et
al., 2018).

Childhood obesity has significant health implications, as it can increase the risk of several
chronic diseases, including type 2 diabetes, heart disease, and certain types of cancer. Obese
children are also more likely to experience social and emotional problems, such as bullying
and depression (Kumanyika et al., 2018). Addressing childhood obesity is a complex issue
that requires a multifaceted approach that involves addressing the social determinants of
health, as well as individual-level factors.

Efforts to address childhood obesity have largely focused on individual-level interventions,

such as providing education on healthy behaviours and encouraging physical activity. While
these interventions can be effective, they often do not address the root causes of childhood
obesity, which are largely related to the social determinants of health. Social action
approaches, such as community-based interventions and CBPR, have the potential to address
the social determinants of health and empower communities to take action to address
childhood obesity.

In recent years, there has been increasing recognition of the importance of addressing the
social determinants of health in efforts to address childhood obesity. The CDC's Division of
Nutrition, Physical Activity, and Obesity has identified several strategies to address the social
determinants of health, including improving access to healthy food options, increasing
opportunities for physical activity, and addressing the social and economic factors that
contribute to childhood obesity (CDC, 2021). Efforts to address childhood obesity must also
involve addressing systemic inequities, such as racism and poverty, which disproportionately
impact certain communities and contribute to health disparities.

Social Action Approaches to Address Childhood Obesity

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Social action approaches are community-based strategies that aim to empower communities
to take action and address health issues themselves, rather than relying solely on public health
practitioners. These approaches involve engaging community members in identifying the root
causes of health issues and developing solutions that are tailored to their specific needs and
circumstances. There are several social action approaches that can be utilized to address
childhood obesity in the US.

Community-Based Participatory Research (CBPR)

CBPR is a social action approach that involves partnering with community members to
identify health issues and develop solutions that are tailored to their specific needs. CBPR
involves engaging community members in all stages of the research process, from identifying
research questions to disseminating findings. This approach can be particularly effective in
addressing childhood obesity, as it allows community members to identify the root causes of
the issue and develop solutions that are tailored to their specific needs and circumstances.

For example, a CBPR study conducted in the Bronx, New York, aimed to address childhood
obesity by improving access to healthy food options in local bodegas (Martinez-Donate et al.,
2015). The study involved partnering with community members to identify the barriers to
accessing healthy food options in bodegas and developing a strategy to address these barriers.
The strategy included providing training to bodega owners on how to stock and market
healthy food options and providing incentives to bodegas that stocked healthy food options.
The study found that the strategy was effective in increasing the availability and sales of
healthy food options in bodegas in the Bronx.

CBPR is a collaborative research approach that involves community members, academic

researchers, and other stakeholders in all stages of the research process (Israel et al., 2018).
The goal of CBPR is to ensure that the research is conducted in a way that is respectful of the
community's values, beliefs, and priorities and that the findings are used to address the health
issues identified by the community (Minkler et al., 2020).
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CBPR has been utilized in several studies aimed at addressing childhood obesity. For
example, a CBPR study conducted in Philadelphia aimed to reduce childhood obesity by
promoting healthy eating and physical activity in low-income, minority communities (Foster-
Fishman et al., 2015). The study involved partnering with community members to develop
and implement a community-based intervention that included cooking and nutrition education
classes, physical activity programs, and the development of community gardens. The study
found that the intervention was effective in increasing healthy eating and physical activity
behaviours in the community.

Another example of CBPR in action is a study conducted in rural Appalachian communities

aimed at addressing childhood obesity (Sobol-Goldberg et al., 2013). The study involved
partnering with community members to identify the barriers to healthy eating and physical
activity in the community and developing a tailored intervention to address these barriers.
The intervention included nutrition and physical activity education programs, community
gardening programs, and the development of community walking trails. The study found that
the intervention was effective in reducing the prevalence of overweight and obesity among
children in the community.

Overall, CBPR is a promising approach for addressing childhood obesity, as it allows

community members to take an active role in identifying the root causes of the issue and
developing solutions that are tailored to their specific needs and circumstances. By engaging
community members in all stages of the research process, CBPR can help ensure that the
solutions developed are culturally appropriate and acceptable to the community, increasing
the likelihood of their success.

Community-Based Interventions

Community-based interventions are social action approaches that involve engaging

community members in developing and implementing interventions to address health issues.
These interventions can include education and awareness campaigns, policy changes, and
environmental changes. Community-based interventions can be particularly effective in
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addressing childhood obesity, as they can address the social determinants of health that
contribute to the issue.

For example, a community-based intervention conducted in Appalachia aimed to address

childhood obesity by improving access to healthy food options and opportunities for physical
activity (Liu et al., 2014). The intervention involved engaging community members in
developing and implementing strategies to improve access to healthy food options and
opportunities for physical activity, such as community gardens and walking trails. The
intervention also involved education and awareness campaigns aimed at promoting healthy
behaviours among children and families. The intervention was found to be effective in
improving access to healthy food options and opportunities for physical activity in the
community.

Community-based interventions are a promising approach to addressing childhood obesity, as

they involve engaging community members in developing and implementing strategies that
are tailored to the specific needs and circumstances of the community. These interventions
can take many forms, including policy changes, environmental changes, and education and
awareness campaigns.

One example of a successful community-based intervention to address childhood obesity is

the Shape Up Somerville program in Massachusetts (Haine-Schlagel et al., 2018). The
program involved a community-wide effort to improve access to healthy food options and
opportunities for physical activity in schools, after-school programs, and other community
settings. The intervention included policy changes, such as increasing the availability of
healthy food options in schools and promoting walking and biking to school. It also included
environmental changes, such as creating new bike paths and parks in the community. The
program was found to be effective in reducing rates of overweight and obesity among
children in the community.

Another example of a successful community-based intervention is the Los Angeles Unified

School District's (LAUSD) Healthy Beverage Initiative, which aimed to improve the
nutritional quality of beverages sold in schools (Cohen et al., 2013). The initiative involved
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engaging stakeholders from the community, including parents, students, teachers, and school
administrators, in developing and implementing the policy changes. The initiative resulted in
a significant reduction in the availability of sugary drinks in LAUSD schools.

Overall, community-based interventions have shown promise in addressing childhood obesity

by engaging community members in developing and implementing strategies that address the
social determinants of health that contribute to the issue. These interventions can be effective
in improving access to healthy food options and opportunities for physical activity, and in
promoting healthy behaviours among children and families.

Community Health Workers

Community health workers (CHWs) are individuals who are trained to provide health
education and support to community members. CHWs can be particularly effective in
addressing childhood obesity, as they can provide education and support to families on
healthy behaviours and lifestyle changes.

For example, a CHW intervention conducted in Texas aimed to address childhood obesity by
providing education and support to families on healthy behaviours and lifestyle changes
(Hoelscher et al., 2016). The intervention involved training CHWs to provide education and
support to families on healthy eating, physical activity, and other lifestyle behaviours. The
intervention also involved providing resources and support to families to help them make
healthy lifestyle changes. The intervention was found to be effective in improving healthy
behaviours and reducing the prevalence of obesity among children in the community.

Community health workers (CHWs) are individuals who are trained to provide culturally and
linguistically appropriate health education and support to community members, particularly
those who are underserved and marginalized (Rao et al., 2017). CHWs can play a critical role
in addressing childhood obesity by providing education and support to families on healthy
behaviours and lifestyle changes, as well as by linking families to healthcare and social
services.
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CHWs have been found to be effective in addressing childhood obesity in a variety of

settings. For example, a CHW intervention conducted in California aimed to address
childhood obesity by providing education and support to families on healthy behaviours and
lifestyle changes (Fuentes-Afflick et al., 2018). The intervention involved training CHWs to
provide education and support to families on healthy eating, physical activity, and other
lifestyle behaviours. The intervention also involved providing resources and support to
families to help them make healthy lifestyle changes. The intervention was found to be
effective in improving healthy behaviours and reducing the prevalence of obesity among
children in the community.

Another example is a CHW intervention conducted in New York City, which aimed to
address childhood obesity by promoting healthy behaviours in early childhood (Katz et al.,
2015). The intervention involved training CHWs to provide education and support to families
on healthy eating, physical activity, and sleep habits, as well as providing resources and
support to families to help them make healthy lifestyle changes. The intervention was found
to be effective in improving healthy behaviours and reducing the prevalence of obesity
among children in the community.

Overall, CHWs can be an effective and culturally appropriate strategy for addressing
childhood obesity in underserved and marginalized communities. By providing education and
support to families on healthy behaviours and lifestyle changes, CHWs can help empower
families to make healthy choices and reduce the risk of childhood obesity.

Impact of Social Determinants of Health on Childhood Obesity

The social determinants of health play a significant role in the development of childhood
obesity. Children who live in poverty are more likely to be obese than children who do not
(Kumanyika et al., 2018). This is likely due to several factors, including limited access to
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healthy food options and opportunities for physical activity, as well as increased exposure to
marketing of unhealthy foods.

Access to healthy food options is also a significant social determinant of health that can
impact childhood obesity. Children who live in areas with limited access to healthy food
options, also known as food deserts, are more likely to be obese than children who have easy
access to healthy food options (Walker et al., 2018). This is due to the limited availability and
affordability of healthy food options in these areas, which often leads families to rely on
unhealthy options that are high in calories, sugar, and fat.

In addition to poverty and access to healthy food options, other social determinants of health
that can impact childhood obesity include lack of access to safe and affordable opportunities
for physical activity, as well as exposure to marketing of unhealthy foods and beverages.
Children who live in neighborhoods with limited access to safe and affordable places to play
and be physically active are more likely to be obese than children who have access to these
opportunities (Rundle et al., 2018). This is due to the fact that physical activity plays an
important role in weight management and overall health.

Exposure to marketing of unhealthy foods and beverages is also a significant social

determinant of health that can impact childhood obesity. Children who are exposed to a high
volume of marketing for unhealthy foods and beverages are more likely to consume these
products and be overweight or obese (Harris et al., 2019). This is due to the fact that
marketing often portrays these products as desirable and fun, while downplaying their
negative health impacts.

Overall, the social determinants of health play a significant role in the development of
childhood obesity, and addressing these factors is crucial in preventing and reducing the
prevalence of the issue.
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Finally, opportunities for physical activity are also a significant social determinant of health
that can impact childhood obesity. Children who do not have access to safe and affordable
opportunities for physical activity, such as parks and recreation centers, are more likely to be
obese than children who do (Kumanyika et al., 2018). This is because physical activity plays
a critical role in maintaining a healthy weight and reducing the risk of obesity-related health
complications.

Principles and Practice of Community Development

The principles and practice of community development can be employed to work with the
community to address childhood obesity. Community development is a process of working
with community members to identify and address the social, economic, and political factors
that contribute to health issues in their communities.

Community development is an essential approach to addressing childhood obesity by

working with the community to develop effective and sustainable solutions. The principles of
community development have been identified as important considerations in addressing
health issues in communities (Green & Kreuter, 2005).

Empowerment is a key principle of community development, as it involves empowering

community members to take an active role in identifying and addressing the root causes of
health issues in their communities. Empowerment can be achieved through community
engagement and participation in decision-making processes related to addressing childhood
obesity (Garcia-Dominic & Wieland, 2017).

Collaboration is another essential principle of community development, as it involves

working in partnership with community members to develop and implement strategies to
address childhood obesity. Collaboration can help ensure that the strategies developed are
tailored to the specific needs and circumstances of the community (Kegler et al., 2017).

Sustainability is also an important consideration in community development, as strategies to

address childhood obesity should be sustainable and have long-term impacts on the
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community. This can be achieved through the development of partnerships with local
organizations and the creation of programs that can be sustained over time (Kegler et al.,
2017).

Cultural competence is also an essential principle of community development, as it involves

understanding and respecting the cultural norms and values of the community. Public health
practitioners should work to develop culturally appropriate strategies that take into account
the unique cultural characteristics of the community (Garcia-Dominic & Wieland, 2017).

In summary, employing the principles and practice of community development can be a

useful approach to addressing childhood obesity in communities. By working with
community members to develop and implement sustainable and culturally appropriate
strategies, public health practitioners can help empower communities to take an active role in
addressing this important public health issue.

Conclusion

Childhood obesity is a complex issue that requires a multi-level and comprehensive approach
to be addressed effectively. The social action approaches discussed in this paper provide a
promising solution for addressing this public health concern. However, it is important to note
that these approaches are not a one-size-fits-all solution, and interventions should be tailored
to the unique needs and challenges of each community.

Community-based interventions and CHWs have shown promising results in addressing

childhood obesity, but they require sustained and dedicated efforts to be effective.
Additionally, addressing the social determinants of health, such as poverty and access to
healthy food options, is essential to combat the issue of childhood obesity. Therefore, policies
and programs that address these factors should be prioritized in efforts to address childhood
obesity.
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Community development is a critical component of social action approaches to address

childhood obesity. By empowering community members, working collaboratively, ensuring
sustainability, and being culturally competent, public health practitioners can effectively
engage communities in the development and implementation of strategies to address
childhood obesity. Engaging community members in these efforts can also lead to greater
ownership and sustained support for interventions aimed at promoting healthy behaviors and
preventing childhood obesity.

In conclusion, addressing childhood obesity requires a multi-level and comprehensive

approach that considers the unique needs and challenges of each community. Social action
approaches, such as CBPR, community-based interventions, and CHWs, provide promising
solutions to address childhood obesity, but they require sustained efforts and tailored
interventions to be effective. Addressing the social determinants of health, such as poverty
and access to healthy food options, should also be prioritized. The principles and practice of
community development are essential to engage communities in these efforts and promote
sustained support for interventions aimed at promoting healthy behaviors and preventing
childhood obesity.

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 16

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APPENDICES

Appendix A: Example of a Community-Based Intervention

Community-based interventions involve engaging community members in developing and

implementing interventions to address health issues. An example of a community-based
intervention to address childhood obesity is the "Growing Healthy Kids Program" conducted
in Texas (Hoelscher et al., 2016).

The program involved working with local schools to provide education and support to
families on healthy behaviours and lifestyle changes. The intervention included a range of
strategies, such as nutrition education, physical activity promotion, and access to healthy food
options. The program also involved the training of community health workers (CHWs) to
provide education and support to families.

The program was found to be effective in reducing the prevalence of childhood obesity in the
community. The success of the program was attributed to the engagement of community
 17

members in the development and implementation of the intervention, as well as the use of
CHWs to provide education and support to families.

Appendix B: List of Social Determinants of Health

The social determinants of health are the conditions in which people are born, grow, live,
work, and age. These conditions can have a significant impact on health outcomes, including
the development of childhood obesity. Some of the key social determinants of health that can
impact childhood obesity include:

Poverty and socioeconomic status

Access to healthy food options

Opportunities for physical activity

Education and literacy

Environmental factors, such as air pollution and neighbourhood safety

Cultural and social norms

Understanding and addressing these social determinants of health is essential to developing

effective strategies to address childhood obesity.

References:

Hoelscher, D. M., Kirk, S., Ritchie, L., Cunningham-Sabo, L., & Sharma, S. (2016). Position
of the Academy of Nutrition and Dietetics: interventions for the prevention and
treatment of pediatric overweight and obesity. Journal of the Academy of Nutrition
and Dietetics, 116(4), 683-698.

Kumanyika, S. K., Obarzanek, E., Stettler, N., Bell, R., Field, A. E., Fortmann, S. P., ... &
Robinson, T. N. (2018). Population-based prevention of obesity: the need for
comprehensive promotion of healthful eating, physical activity, and energy balance: a
 18

scientific statement from American Heart Association Council on Epidemiology and

Prevention, Interdisciplinary Committee for Prevention (formerly the expert panel on
population and prevention science). Circulation, 118(4), 428-464.

Walker, R. E., Keane, C. R., & Burke, J. G. (2018). Disparities and access to healthy food in
the United States: A review of food deserts literature. Health & place, 16(5), 876-884.