1. Elizabeth Stanley
Childhood Obesity NJ
ABSTRACT
Childhood obesity is now an epidemic. Per the CDC, the rate of obesity has
tripled in children and adolescents from 1980 to present day, specifically in low income
areas. Although there is no one reason why, one can assume that both behavioral and
environmental factors are to blame. The fight against childhood obesity became a
primary concern on the nation’s agenda when Michelle Obama initiated the “Let’s Move”
program in 2010 and shortly after, President Obama signed off on “The Healthy Hunger-
Free Kids Act”. Since then, programs have developed at both the federal and state
levels. New Jersey joined in with several interventions to combat the epidemic. It is very
hard to find present day studies on the rates of childhood obesity, and nearly impossible
to say that said rates have dropped because of an intervention. Program progress is
measurable, however, and one can assume that with healthier choices being instilled
into children’s daily lives, the epidemic will soon begin to decline.
This paper will first define childhood obesity, prevalence, causes, and effects.
Next, it will localize the epidemic by listing New Jersey statistics. Finally, a discussion
on “Let’s Move” and The Healthy Hunger-Free Kids Act as well as New Jersey’s
umbrella intervention, Partnership for Healthy Kids will be addressed. With program

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statistics trending toward success, one can assume that more children are learning and
adapting skills to lead healthy lives which will in turn stop an epidemic from getting any
worse.
INTRODUCTION: CHILDHOOD OBESITY DEFINITION, PREVALENCE, CAUSES,
AND THE LONGTERM EFFECTS
Childhood obesity is calculated using BMI or Body Mass Index measurements.
This is a simple calculation of total weight in kilograms divided by the square of height in
meters. BMI calculations are age and gender specific for children, and obesity
determinants are made by comparisons. A child is considered overweight if they range
at or above the 85th percentile. An obese child is above the 95th percentile. CDC growth
charts are the most commonly used indicator to measure these patterns. 1
As of 2013, 17% of American children are obese. If overweight children are
included in this figure, then 31.7% of American children and adolescents are affected by
this epidemic. This equates to more than 23 million American children being overweight
and over 12 million of these children being obese. Hispanic, Latino, and African
American low income families have the highest rates of obesity overall, which includes
childhood obesity.2
1 "Childhood ObesityFacts." Centers for Disease Control and Prevention.Centers for Disease Control and
Prevention, 19 June 2015. Web. 17 Nov. 2015.
2
"CHILDHOOD OBESITY LEGISLATION - 2013 UPDATE OF POLICY OPTIONS." National Conference ofState
Legislature.National Conference ofState Legislature,1 Mar. 2014.Web. 17 Nov. 2015.

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The following figure from the CDC MMWR January 21, 2011, shows the prevalence of
obesity in American children arranged by age, gender, and ethnicity. 3
CAUSES OF CHILDHOOD OBESITY
“Childhood obesity isn't some simple, discrete issue. There's no one cause we can
pinpoint. There's no one program we can fund to make it go away. Rather, it's an issue
that touches on every aspect of how we live and how we work.” --Michelle Obama
Obesity is caused by taking in more energy than one expels. Simply put, children
are eating too much and moving too little. There are many factors that go into this. First,
is unhealthy diets. Children are consuming sugary beverages and drinking less water.
3
CDC Grand Rounds:Childhood Obesityin the United States." MMWR. Centers for Disease Control and
Prevention.Centers for Disease Control and Prevention,21 Jan. 2011.Web. 17 Nov. 2015.

4. Stanley 4
Children are eating calorie dense, minimally nutritious food like fast food and snacks.45
The majority are not consuming the recommended amounts of fruits and vegetables.
Portions have increased drastically.
The second big factor is inactivity. Children are spending drastically more time in
front of televisions, computers, tablets, phones, and video games. Roughly 20% of kids
walk to and from school in contrast to about 80% in the 1980’s. There are no federal
laws requiring physical education to be part of the American school curriculum. In 2011,
The National Association of Sports and Physical Education suggested that school
children participate in at least 150 minutes a week of physical education, and only 6
states adhered to that. 6
Third, socioeconomic factors play a huge role in childhood obesity. Although
children of all race and status are affected, obesity is most prevalent in low income
families. Obesity rates increased by 10% for all U.S. children 10 to 17 years old
between 2003 and 2007; but by 23% during the same time period for low-income
children.7 It should also be noted that low income children are two times as likely to be
4
Office of the Surgeon General (US). The Surgeon General's Vision for a Healthy and Fit Nation. Rockville (MD): Office of the
Surgeon General (US); 2010. Background on Obesity.
5
Sahoo, Krushnapriya etal. “Childhood Obesity:Causes and Consequences.” Journal ofFamily Medicine and
Primary Care 4.2 (2015):187–192.PMC. Web. 17 Nov. 2015.
6
National Association for Sport and Physical Education & American Heart Association.(2012).2012 Shape of the
Nation Report: Status of Physical Education in the USA. Reston,VA: American Alliance for Health, Physical
Education,Recreation and Dance
7 Singh,Gopal K. et al. “Dramatic Increases in Obesityand Overweight Prevalence and Body Mass Index Among
Ethnic-Immigrantand Social Class Groups in the United States,1976–2008.” Journal ofCommunity Health 36.1
(2011):94–110.PMC. Web. 20 Nov. 2015.

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obese. Low income children are less likely to have access to high quality foods such as
fresh produce. Many low income families reside in food deserts, where grocery stores
are inaccessible by foot or public transit. Therefore, they are forced to shop at local
convenience stores and bodegas for their food. These businesses do not provide fresh
produce and healthy options because they are too expensive.
EFFECTS OF AN EPIDEMIC
“If we continue to have these rising trends of childhood obesity, this generation of
children will be the first generation of American kids to live sicker and die younger than
the previous generation.” - Dr. Dwayne Proctor
Today’s children are growing up with diseases once thought to only affect adults.
Perhaps the biggest concern is the cardiovascular system8. Doctors are now finding
arteriosclerosis and hypertension in children as young as early school age. There have
been epidemiological studies done showing that this generation of children has the
highest blood pressure measurements in many decades. The early onset of heart
disease will impair children’s ability to be physically active and live long lives.9
Metabolic disorders such as dyslipidemia (high cholesterol stemming from
diabetes), and diabetes are also being diagnosed in children. Type 2 diabetes was
8
Daniels, Stephen R. “The Consequences of Childhood Overw eight and Obesity”. The Future of Children 16.1 (2006): 47-67 Web.
17 November 2015.
9
Reversing Childhood Obesity:Signs of Progress.Steve Adubato. Youtube, 2014. Film.Web. 17 November 2015

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originally called Adult Onset diabetes, but as more children were developing this chronic
condition, the name was changed to Type 210. This type of diabetes is not insulin
dependent and can be managed or sometimes reversed with proper diet.
The flowing graph shows trends in childhood obesity from 1963 to 2008, paired with the
rise of juvenile diabetes from 2002 to 2005.
There have been cross-sectional studies done that possibly correlate pulmonary
disorders such as asthma to obesity. The rate of asthma has increased in the past few
decades, a parallel to rising obesity rates. While there is no direct correlation yet,
obesity does cause inflammation and also creates more work for vital organs because
10
Daniels, Stephen R. “The Consequences of Childhood Overweight and Obesity”. The
Future of Children 16.1 (2006): 47-67 Web. 17 November 2015.

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of pressure from adipose tissue. These two factors could contribute to the increased risk
of asthma.11
Psychosocial effects of childhood obesity are also prevalent. Depression is a
common diagnosis in adolescents. Body dissatisfaction, especially in girls, and the
inability to relate to peers are common problems stemming from obesity.
Economically, the effects of Childhood obesity present a huge burden. Roughly
$150 to $190 billion is spent annually on obesity related health issues, whether directly
or indirectly. About $15 billion of that is related to childhood obesity2
.
The physical, mental, and economic effects of childhood obesity do not dissipate
as children mature. All of these problems are carried into adulthood and exacerbated,
making obesity one of the largest burdens on the healthcare system today.
THE NATION RESPONDS
"The physical and emotional health of an entire generation and the economic health and
security of our nation is at stake."- First Lady Michelle Obama at the Let’s Move! launch on
February 9, 2010
The state of America’s health, including healthcare programs and funds, is one of
the most prevalent issues being addressed during the Obama administration, with
childhood obesity at the forefront for First Lady Michelle Obama. In 2010, the First Lady
11
Han, Joan C., Debbie A Lawlor,and Sue Y.S. Kimm.“Childhood Obesity-2010:Progress and Challenges.” Lancet
375.9727 (2010);1737-48.PMC. Web. 17 Nov 2015.

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launched Let’s Move!, a “comprehensive initiative”12
,designed to combat childhood
obesity by implementing interventions at the federal and local levels.
Following the initiative, The Healthy Hunger-Free Kids Act was passed. The
Healthy Hunger-Free Kids Act of 2010 allows funding for healthy food for low-income
children. The bill reauthorizes child nutrition programs for five years and includes $4.5
billion in new funding for these programs over 10 years. Many of the programs do not
have an expiration date, but are reviewed yearly for refunding. This reauthorization
presents an opportunity to strengthen programs designed to make American children
healthier.
The Healthy Hunger- Free Kids Act allows the USDA to set nutritional standards
on food given at schools. Schools that meet the new nutritional guidelines are given
more money for federally subsidized breakfast and lunches. It helps communities build
Farm to School programs, school gardens, and expands the availability of drinking
water13
.
12 Letsmove.gov
13
“Child Nutrition Reauthorization Healthy Hunger-Free Kids Act of 2010”.Whitehouse.gov.Let’s Move. Web. 17 Nov
2015

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New Jersey: An Epidemic Hits Home
“It wasn’t easy to produce a generation of overfed kids— but it might well have been
inevitable.” Time magazine, 2008
Rutgers Center for State and Health Policy, or RCHSP, began a five-year study
in 2009, funded by the Robert Wood Johnson Foundation, to provide vital statistics
needed to create and implement interventions to effectively reverse the childhood
obesity epidemic particularly found in low income families. The areas of study are
Camden, Newark, New Brunswick, Trenton, and Vineland. The first statistics were
presented in 2010. All five cities were found to have high obesity rates among school
age children, with Trenton having the highest.
Children from all five cities were more likely to be overweight and obese than
their national peers. The majority of these children did not meet the national
recommendations from the FDA for fruit and vegetable consumption. They often drank
sugary beverages and ate calorie-dense and minimally nutritious food such as fast food.
Most parents shopped at supermarkets, although many Hispanic parents shopped at
local corner stores. The majority of parents reported that there was limited availability of
fresh produce and low fat foods. The cost of fresh food and the access to the stores
were two main barriers to healthy eating.
The majority of children did not meet the daily physical activity guideline of 60
minutes per day. Many children spent more than two hours per day watching television

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or playing video games. Most children didn’t walk or bike to school. Many of the
neighborhoods didn’t have sidewalks, some didn’t have working street lights, and many
neighborhoods didn’t have parks. Additionally, many parents felt that the parks and
recreation areas that were available to their children, were not safe14.
Despite the evidence, the majority of parents were not concerned with the weight
of their children. Though they did believe that it would be better to have healthier food
options and better recreational outlets, the majority felt their kids were healthy. This
means that truly effective interventions would have to take place primarily in school,
where children spend the majority of their time. Interventions would have to focus on
education for parents and caretakers on healthy eating habits and physical activity.
Interventions would also have to provide community areas for fresh fruit and vegetable
access and recreational facilities.
New Jersey Takes Initiative: PARTNERSHIP FOR HEALTHY KIDS
“We’re testing the idea that if we’re going to whip [childhood obesity], there are going to
be some policy issues that are national and some that come out of state government.
And, more and more, we’re also starting to think a lot of progress is made [by] getting
communities to see the importance and value of creating healthier environments.” -
14
"New Jersey Childhood Obesity Study: New BrunswickChartbook." RWJF. Rutgers Center for State and Health Policy,1 July
2010. Web. 17 Nov. 2015.
** Chartbooks for Trenton, Camden, Vineland, and New arkalso referred to”

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William Lovett, Director of New Jersey Partnership for Healthy Kids and Executive
Director of the YMCA State Alliance
New Jersey Partnership for Healthy Kids, or NJPHK, is a statewide program
funded by the Robert Wood Johnson Foundation with technical assistance and direction
provided by the New Jersey YMCA. The following are the six NJPHK policies for
improving nutrition and physical activities that provide a basis for program development:
1. Ensure that all foods and beverages served and sold in schools meet or exceed the
most recent dietary guidelines.
2. Increase access to high-quality, affordable foods through new or improved grocery
stores and healthier corner stores and bodegas.
3. Increase the time, intensity and duration of physical activity during the school day and
out of school programs.
4. Increase physical activity by improving the built environment in communities.
5. Use pricing strategies – both incentives and disincentives – to promote the purchase of
healthier foods.
6. Reduce youth exposure to unhealthy food marketing through regulation, policy and
effective industry self-regulation15
.
15
Assessing the Local Partnership for Healthy Kids in Camden,Newark,New Brunswick,Trenton,and Vineland.
New Brunswick,NJ: Rutgers Center for State Health Policy, 2011.

12. Stanley 12
New Jersey Partnership for Healthy Kids has three components: local activities
sponsored by local coalitions to combat childhood obesity, technical assistance to these
coalitions, and state-level activities to support policy changes that will support local
activism15
. The three components work together for one cause, to stop the childhood
obesity epidemic. The program works with coalitions in Camden, Trenton, Newark, New
Brunswick and Vineland, with the hope that proven success in these cities will spark
change across the state and nationally.
Camden’s Partnership for Healthy Kids is supported by The Campbell Soup
Company, which gave a $10 million grant to enhance school wellness, physical activity
and community food access with the goal of reducing the Camden childhood obesity
rate by 50% over ten years. It is also supported by the Burlington and Camden county
YMCA and The United Way of Philadelphia and Southern New Jersey. The
collaborative initiative launched in 2011. Within the first 2 years, health and wellness
policies have gone into effect in all 26 Camden city schools, 12 day-care centers, and
several faith- based organizations. Camden school district has been recognized as one
of the top 20 districts in New Jersey having the highest number of eligible children
eating breakfast16.
Under the umbrella of New Jersey Partnership for Healthy Kids, New Brunswick
created the Community Food Alliance15, a council committed to enforcing adequate
16 Moynihan, Michael. New Jersey Partnership for Healthy Kids Camden.Amazonws,com.N.p., n.d. Web. 18 Nov.
2015

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access to healthy food in stores and schools as well as developing community gardens.
July 2015, marked the launch of The New Brunswick Community Farmer’s market,
giving many low income families access to fresh fruit and vegetables. The market
supports the “Market Bucks Program”17, a return on EBT purchases from farmer’s
markets. Consumers using food stamps to purchase groceries from the farmer’s market
get 50% back on the EBT card.
One of Trenton’s largest programs under The New Jersey Partnership for Healthy
Kids is The Healthy Food Network, a coalition helping neighborhood stores promote
healthy food purchases such as fruit, vegetables, and whole grains. The Partnership for
Healthy Kids supplied the Healthy Food Network with labels, billboards, and baskets for
shopping. Stores agreed to run promotions like “buy 5 healthy foods - get one for free”15
Live Healthy Vineland18, is a partnership of organizations whose goal is to make the
city of Vineland a healthy place to “live, work, and play” An extension of Partnership for
Healthy Kids, Live Healthy Vineland invests in initiatives to create healthier schools,
parks and other recreational areas for children. Vineland has created bike lanes and
cleaned up many parks and recreation areas to provide children with safer places to
play. Newark’s New Jersey Partnership for Healthy Kids reached out to the state
chapter of the American Academy of Pediatrics for help with their efforts. The New
Jersey chapter of The Academy began implementing Let’s Move!, First Lady Michelle
18 Livehealthyvineland.org

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Obama’s throughout pediatrician offices. The Newark program is called Let’s Move in
the Clinic15, and it aims to educate both medical staff and families about obesity and
how to combat it.
SIGNS OF PROGRESS
“We’ve been a boots-on-the ground effort to try and achieve change, and now we are
seeing really great results from the [places] where we’ve worked most closely.” -William
Lovett
The New Jersey Partnership for Healthy Kids claims to have made strides in the
fight against child obesity. Environmental signs of progress include bike lanes in
Trenton and Newark and new playgrounds built in Trenton and Camden. Policy
changes include district-wide wellness programs in Camden County and Complete
Street Policies in four of the five targeted cities. As of 2013, the five targeted cities have
raised more than $4 million in public and private funding for their local activities. By the
end of 2013, New Jersey Partnership for Healthy Kids recognized the following as its
greatest achievements:
- Enrolled 50 corner stores and bodegas in a healthy foods initiative
- Trained 100 health care providers in advocacy to address childhood obesity
- Engaged 525 volunteers in building playgrounds and parks
- Exposed 3,500 children to healthy nutrition through improved school wellness
policies and breakfast in the classrooms

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- Exposed 500,000 residents to safer streets and environments conducive to
physical activity19
THE FUTURE: WILL THESE INTERVENTIONS WORK?
“If we’re going to have a culture of health in America, we’ve got to take care of the
epidemic of childhood obesity. And if we can reverse childhood obesity—and we’re
seeing lots of signs of progress—that’s proof positive that we can have a culture of
health in America.” – Dr. Dwayne Proctor
The childhood obesity epidemic is still prevalent in New Jersey even though
progress has been made. The Robert Wood Johnson Foundation issued two grants in
2013 and 2014, which will expand The New Jersey Partnership for Healthy Kids
strategies to build healthy communities and change policies. One future goal is to take
The Healthy Food Network and its partner, The Healthy Corner Store Initiative state-
wide. New Jersey Partnership for Healthy Kids will partner with the U.S. Department of
Agriculture to build on school wellness policies and strengthen coalitions in order to
keep the progress going even after Robert Wood Johnson Foundation funding ends20.
19 "Declining Childhood Obesity:Where Are We Seeing Signs ofProgress?" RobertWood Johnson Foundation.
RobertWood Johnson Foundation,Feb.2015.Web. 17 Nov. 2015.
20
Robert Wood Johnson Foundation. NewJersey Partnership for Healthy Kids: Communities Making a Difference to
Prevent Childhood Obesity.2013 Progress Report. RobertWood Johnson Foundation. May, 2015.Web. 17
November 2015.

16. Stanley 16
CONCLUSION
"Reversing obesity is not going to be done successfully with individual effort. We did not
get to this situation over the past three decades because of any change in our genetics
or any change in our food preferences. We got to this stage of the epidemic because of
a change in our environment and only a change in our environment again will allow us
to get back to a healthier place.” – Thomas R. Frieden, Director of the CDC
Obesity is one of the leading causes of sickness and disease in the United
States. With $150 to $190 billion spent annually on obesity and its related issues, it is
one of the largest healthcare costs. $19 billion of that money is spent annually on
childhood obesity. If this continues, the United States will have a population of sick
people. The promising part: Obesity, especially childhood obesity is preventable. It is a
behavioral problem that requires a change in environment and behaviors.
With interventions such as The New Jersey Partnership for Healthy Kids showing
signs of progress, one can see that the fight against the obesity epidemic is making
headway. However, more needs to be done to spread awareness about the implications
of the epidemic as well as education on how to correct it. It has to be an “all hands on
deck” effort. Public Health officials and enthusiasts can aid in the fight against obesity
by ensuring that low income families have access to healthy food and by helping the
general public and stakeholders understand the impact of obesity and how important
policy and planning changes are. There is no one way to end child obesity, however

17. Stanley 17
educating oneself on the successful interventions implemented thus far, a reverse of an
epidemic could be in sight.

18. WORKS CITED
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Trenton, and Vineland. New Brunswick, NJ: Rutgers Center for State Health Policy,
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Disease Control and Prevention. Centers for Disease Control and Prevention, 21 Jan.
2011. Web. 17 Nov. 2015.
“Child Nutrition Reauthorization Healthy Hunger-Free Kids Act of 2010”.
Whitehouse.gov. Let’s Move. Web. 17 Nov 2015
"Childhood Obesity Facts." Centers for Disease Control and Prevention. Centers for
Disease Control and Prevention, 19 June 2015. Web. 17 Nov. 2015.
"CHILDHOOD OBESITY LEGISLATION - 2013 UPDATE OF POLICY OPTIONS."
National Conference of State Legislature. National Conference of State Legislature, 1
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"Farm To School." Farm To School. Web. 17 Nov. 2015.
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