TRANSFORMING ENVIRONMENTS TO REDUCE OBESITY

IN SOME AREAS OF LOS ANGELES COUNTY, nearly 60 percent of the children are obese or overweight. Lack of exercise, too much television and junk foods often get blamed for the rise in obesity, diabetes and the fact that more than half of the students in the 7th and 9th grades fail their physical fitness test for aerobic capacity. No matter what the cause, the result is the same: 63 percent of Californians die from heart disease, stroke, diabetes and some cancers related to unhealthy eating and inactivity.

To prevent chronic disease and disparities in health that plague certain populations and places throughout the state, in October 2004 The California Endowment launched the four-year, $26 million Healthy Eating, Active Communities (HEAC) Initiative. HEAC assumes that reversing the obesity epidemic will take more than encouraging personal action, like starting a diet or a daily exercise routine. The Endowment's groundbreaking approach is based on the belief that to change deeply ingrained behaviors, like habits of eating and activity, you must also change the environmental conditions that shape choices and opportunities where people live, work and go to school.

A MICROCOSM OF CHANGE
The mostly Latino city of Baldwin Park (pop. 80,200) is located 20 miles east of downtown Los Angeles. It is home to a community coalition with six years of experience working to prevent obesity and diabetes. The coalition includes the California Center for Public Health Advocacy, the Baldwin Park Unified School District, the Los Angeles County Department of Health Services, the city of Baldwin Park, Kaiser Permanente, Citrus Valley Health Partners, the CHOICES Program and their teen sub-committee. They received a total of $1.8 million over four years from The Endowment for the People on the Move project, which will create better conditions for healthy eating and physical activity in schools, afterschool programs, neighborhoods, health care, and in the media and marketing of products to children. The coalition advocates for change in local and state policies and shares its experiences with community groups throughout the state.

"The Baldwin Park area has the youngest population in the county, so our focus is on children and teens," says Jeanette Flores, a volunteer with the California Center for Public Health Advocacy and a Project Manager for Government and Community Relations at Kaiser Permanente. "A big part of what we do relies on strategies for building youth leadership so they can advocate for needed changes in their environment."

In 2003, Baldwin Park became the first city in California whose City Council adopted a requirement that healthy snacks and beverages must be available in municipal facilities where teens congregate. The policy mirrors the standards set by SB 19 and SB 677 for healthy snack foods and beverages sold to children during school hours. The Baldwin Park Unified School District has also expanded implementation of the state legislation to grades K-12.

A MESSAGE RECEIVED
At a production of "Play H.E.A.L.S: The Amazing Food Detective," dozens of Baldwin Park Pleasant View Elementary School pupils watch fellow students take the stage with professional actors. Kids in the audience eagerly respond when the food detective finds an on-stage character having soda and chips for breakfast. Produced by Kaiser Permanente, the interactive theater production results from a partnership with the school district, the city and other HEAC partners. Marcela Ruiz and her two sons David, 11, and Alejandro, 10, watch the food detective recommend a school breakfast program to replace junk food meals. Says David, summing up the day's message, "The play teaches good eating choices so we can be healthy."