On the Front Lines

toddFall 2012

kids in a pool

The children of Cheryl and Kevin Breedlove of Cabot are on the swim team at the Cabot Community Center, built with funding for joint use by schools and community groups.

By Susan Van Dusen

It’s so much more than measuring a child’s body mass index (BMI).

Act 1220 of 2003, called Arkansas’ Childhood Obesity Law, is best known for mandating schools to measure students’ BMI, a method of determining overweight and obesity based on a person’s height and weight.

And indeed, three years later, state health officials declared a halt to the progression of childhood obesity.

But the Arkansas Center for Health Improvement (ACHI), which, along with health and policy professionals across the state, championed Act 1220, has not stopped working on the obesity epidemic that hit Arkansas as hard as any place in the country.

“We’ve got to get it where most, if not all, communities recognize that this is a major threat to families,” said Joe Thompson, M.D., M.P.H., ACHI director and the state’s surgeon general.

ACHI is an independent, nonpartisan health policy center funded by UAMS, Arkansas Blue Cross and Blue Shield, Arkansas Children’s Hospital, the Arkansas Department of Health, and Delta Dental of Arkansas.

It was established in 1998 as a catalyst for improving the health of Arkansans. G. Richard Smith, M.D., now chair of the UAMS Department of Psychiatry and director of the Psychiatric Research Institute, was founding director. Thompson, a pediatrician, took the mantle five years later.

Thompson said the childhood obesity epidemic can be traced to 1970. Just 5 percent of kids were obese. That number shot up over the next 25 years across America, with Arkansas no exception at 38 percent of school-aged children either overweight or obese.

Around 2000, people started waking up to the epidemic, he said. The Institute of Medicine and the American Academy of Pediatrics said every parent should know their child’s BMI.

In 2002, Arlo Kahn, M.D., a professor in the UAMS College of Medicine Department of Family and Preventive Medicine, led efforts to convene the Arkansas Preventive Nutrition and Physical Activity Summit. A year later, the Legislature passed Act 1220. ACHI was tasked with implementing the BMI portion.

In addition to BMI screening, the Act set up a Child Health Advisory Committee, whose recommendations went directly to the state Board of Education. Its efforts led to school districts prohibiting junk foods and changes in the contracts they have with soft drink companies. Also, school superintendents worked to allow more time for physical education and activity.

As ACHI continues to fight childhood obesity, it is working with school wellness committees to engage communities. Arkansas has become the first state to provide funding to expand safe opportunities for physical activity and to make school facilities available for public use during non-school hours. Through joint-use agreement funding provided through the Department of Education, the city of Cabot has built a community center with an indoor pool and four gyms used by both the schools and community groups.

Looking toward the future, ACHI hopes to provide an evidence base showing the impact of physical education in the schools on health and behavior.

Some communities are starting to see a decrease in childhood obesity, Thompson said, but not enough to claim success. Still, it’s the little things. Like the mayor replacing a missing basketball net at the city park, or offering healthy options at vending machines. “It is a social mindset shift that we have to achieve.”