In 2005, over 35% of children were overweight or obese in San Diego County, California. Through advocacy, education, and policy development, the San Diego County Childhood Obesity Initiative (COI) works to reduce and prevent childhood obesity by creating healthy environments for all children and families. COI is a public-private partnership founded in 2006 that engages a variety of stakeholders, including governmental agencies, private institutions, community organizations, and individuals, to implement collaborative approaches to combat childhood obesity. COI’s efforts focus on increasing opportunities for children and families to eat healthy foods and engage in physical activity as well as empowering stakeholders to enhance their communities through policy and environmental change.1 COI’s evidence-based evaluation uses the Centers for Disease Control and Prevention’s Recommended Strategies and Measurements To Prevent Obesity to measure clinical outcomes (e.g., body mass index) as well proximal outcomes of changes in environment, policy, and behavior.2
One innovative program run by COI is Youth Engagement & Action for Health (YEAH!), which trains youth to plan and implement projects to create policy and environmental changes that improve the health-supporting characteristics of neighborhoods. To determine where change is most needed to support healthy eating and physical activity, youth first conduct a community needs assessment that focuses on neighborhood characteristics like walkability, availability of fresh fruits and vegetables, the number of fast food restaurants and their proximity to schools, the number of advertisements for unhealthful products, and the availability and design of parks. Once they identify an area where change is needed, youth participants in YEAH! work with community stakeholders to develop an action plan and implement and advocate for changes in the community environment and community schools, businesses, and organizations. For example, some communities have partnered with policymakers and school districts to develop safe walking routes to schools, while other communities have worked with franchise owners of local fast food outlets to add healthy, affordable meal choices to their menus. Through their involvement with YEAH!, youth participants are encouraged to pursue careers in public health, advocacy, nutrition, and public safety.
San Diego’s commitment to supporting nutrition and physical activity through COI and other initiatives may have helped decrease overweight or obesity by 3.7% in children age 10–15 compared with the state-wide 1.1% decrease between 2005 and 2010.3 To date, the YEAH! program has helped 21 communities improve neighborhood walkability, implement physical activity programs, and increase access to healthy food and beverages. Communities’ diverse accomplishments include establishing water stations throughout a middle school where water fountains were not available, installing lighting near a recreation center for safe biking, and establishing female-only physical activity options for young Muslim females. YEAH! participants have been recognized by local media outlets and partner organizations for their work to improve community health.
1 Call to action: San Diego County childhood obesity action plan [Internet]. San Diego, CA: San Diego County Childhood Obesity Initiative; 2010 [cited 2013 Mar 2]. Available from: http://ourcommunityourkids.org/media/17878/action%20plan%20revision%202010%20final.pdf [PDF - 2.7 MB] .
2 Recommended community strategies and measurements to prevent obesity in the United States [Internet]. Atlanta, GA: Centers for Disease Control and Prevention; 2009 [cited 2013 Mar 4]. Available from: http://www.cdc.gov/obesity/downloads/community_strategies_guide.pdf [PDF - 2.6 MB].
3 Babey SH, Wolstein J, Diamant AL, et al. A patchwork of progress changes in overweight and obesity among California 5th, 7th, and 9th graders, 2005–2010. Davis, CA: UCLA Center for Health Policy Research and California Center for Public Health Advocacy; 2011.