Childhood obesity has been on an upward trend over the last several decades in Michigan. Children are eating more high-calorie, high-fat foods and are less physically active, which increases the likelihood that they will face grave health consequences during their youth and into adulthood. Obese children are more likely to suffer from chronic disease and experience psychological problems such as depression and low self-esteem (Schneider, 2021). Furthermore, the prevalence of childhood obesity is not distributed equally across different populations. This article will examine how childhood obesity has changed over time, consider health inequities related to this issue, and describe the Fresh Fruit and Vegetable Program, which is attempting to influence the rates of childhood obesity.
The rate of childhood obesity has been rising at a steady rate in Michigan. In 1999, 10.9% of children were obese, in 2007 this increased to 12.4% of children (Michigan Department of Community Health, 2009). In 2019 this number grew to 15.3% (Center for Disease Control [CDC], 2019). The increase in childhood obesity is likely explained by a combination of unhealthy eating patterns and inadequate physical activity. Many American adults fall short of federal recommendations for food intake, and often kids’ eating habits mirror that of their parents (Schneider, 2021). In Michigan, 88.4% of adolescents eat vegetables fewer than three times per day and 68.4% eat fruits fewer than two times per day, when they should be eating five servings of each per day (CDC, 2012). The US Department of Health and Human Services developed guidelines for physical activity in 2006, recommending that children get 60 minutes or more of daily physical activity (Schneider, 2021). While 45.6% of youth in Michigan are physically active for 5 or more days a week (National Physical Activity Plan, 2018), they are not necessarily getting a full hour per day of activity In Southeast Michigan, it was found that only 13% of youth are physically active for one hour each day (Farrey & Isard, 2017). If these habits of poor nutrition and lack of physical activity persist, the trends in childhood obesity will most likely continue to grow.
In Michigan, childhood obesity is more common among racial minorities and children who come from families with a low socioeconomic status (SES). It is important to note that research suggests that these racial disparities in childhood obesity are strongly driven by disparities in SES, rather than by race (Fradkin et al., 2015) (Taveras, 2013). Because racial and ethnic minorities are disproportionately represented in lower SES groups, this likely explains why the disparities in childhood obesity exist more prevalently among racial minorities (Schneider, 2021). Poverty contributes to a lack of access to healthy foods not only due to its cost but also because healthy foods are less available in low-income neighborhoods. Furthermore, low-income neighborhoods may not have opportunities for safe, affordable physical activity, both indoors and outdoors.
The relationship between poverty and obesity is striking. In a study conducted in Massachusetts, low income was highly associated with being overweight and obese. As household income decreased, there was an increase in the overweight/obese status among one or more household members (Rogers, 2015). In Michigan, 19.4% of children live in poverty, and the prevalence of poverty is more than two times higher among non-Hispanic Black and American Indian/Alaska Native children than among non-Hispanic white and Asian children (United Health Foundation, 2018). This racial inequity related to poverty exacerbates the disparity that exists for obesity. In 2017, 14.4% of white children were obese, whereas 24.6% of non-Hispanic Black children and 26.5% of Hispanic children were obese (CDC, 2017). Across the entire country, 17.6% of children live in poverty and similar patterns of obesity exist among low-income and racial minority children (CDC, 2016). For example, obesity is 20.8% more prevalent among non-Hispanic Black and 22% more prevalent among Hispanic children compared with their white and Asian counterparts (Inyang et al., 2018). This disparity occurs during childhood, but it has a large impact on adverse health outcomes that develop in adulthood, such as heart disease or diabetes. Interventions implemented early in life to target childhood obesity could help curb widening racial health disparities that occur in adulthood as well.
Over the years, several initiatives aimed at reducing childhood obesity have been introduced in Michigan and throughout the country. In 2002, the Fresh Fruit and Vegetable Program (FFVP) began under the Farm Security and Rural Investment Act. The purpose of this act was to expose low-income elementary students to a wider variety of fresh fruits and vegetables (U.S. Department of Agriculture [USDA], 2013). Due to the success of the pilot programs, the US Congress passed the Farm Bill, which expanded the FFVP across the nation in 2008. At the state level, the FFVP is administered by state agencies, who operate the program through agreements with local school food authorities. Schools can apply to receive funding to provide fresh fruits or vegetables every day at school for free to their students (USDA, 2013).
Since the program’s passing, evaluations have shown that the program has mixed effects when it comes to reducing obesity rates in Michigan. According to findings from the Public Health Institute, more schools with racial minority students participate in the program and there is higher participation among schools that have a sizable population enrolled in the free and reduced-price meal program (2014). The FFVP prioritizes schools with the highest percentage of children certified as eligible for free and reduced-price meals because it is more likely that children from low-income families have fewer opportunities to consume fresh produce regularly. While this policy has increased the availability of fruits and vegetables to at-risk populations in Michigan, the same study showed that among 4th- and 5th-grade students, there was a non-significant increase in fruit and vegetable consumption (Public Health Institute, 2014). Childhood obesity rates have continued to increase in Michigan and the US since the passing of the Farm Bill, suggesting that more needs to be done to combat childhood obesity. While it has increased the accessibility of produce for at-risk populations and achieved small increases in produce consumption, these changes are not enough to eradicate or even slow the rising rates.
In conclusion, the rate of childhood obesity in Michigan is rising. A lack of adequate nutrition and physical activity are at the root of this issue, yet the solution is not as simple as telling people to change their lifestyle habits. The prevalence of childhood obesity is not distributed equally among social groups - it is more common among children living in poverty, and thus, more common among racial minorities. Due to the complexity of this issue, more research is needed to determine the most effective way to positively influence eating habits and physical activity among children across varying levels of income.
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