It Takes a City

Community unites in effort to reduce obesity and encourage exercise

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HealthDay Reporter

MONDAY, July 21, 2002 (HealthDayNews) -- The residents of Marshfield, Wis. have had enough, and they're not going to take it anymore.

Officials of the small town have launched a community-wide effort to attack what they regard as an epidemic of overweight children and adults, and the associated health problems -- heart disease, diabetes, cancer -- and medical costs.

Called the Healthy Lifestyles Coalition, the effort involves doctors, school officials, teachers, businesses and community groups in this city of about 20,000 people.

The coalition was established this spring, and is currently developing education and other programs to encourage and help everyone in the community, especially children, to get more exercise and eat healthier foods.

"My sense is that people want to change, but they don't know how," says Marshfield Clinic cardiologist Dr. Charles S. McCauley, one of the coalition founders. "They need some help to try to find the way that they can make that change."

McCauley says he was distressed by the growing number of young people with heart disease coming to see him. He and other doctors at the clinic first formed their own coalition to promote healthier living, then took their idea to community leaders and got an enthusiastic response.

"This was a grassroots effort to get people involved and say, 'Hey, let's do something as a community,'" McCauley says.

While the Healthy Lifestyles Coalition wants to promote better health for everyone, the main focus at the moment is on children in elementary schools. McCauley says that's because heart problems and other adult health problems begin with behaviors -- inactivity, smoking and poor diet -- a person develops in childhood.

Local school officials were eager to sign on with the coalition's menu for change. They were alarmed by the decline in activity and health they've witnessed in their student population over the years.

"We need to educate our students. This type of lifestyle awareness needs to start young," says David H. Smette, superintendent of the Marshfield School District.

Smette says planning is still ongoing, and there aren't any fully developed programs yet. However, there are many ideas. They include offering healthier food choices in school cafeterias, introducing more active sports to physical education classes, and encouraging students and their parents to walk to school.

There's even a proposal to ban handheld computer games on school playgrounds to encourage students to be more active during recess.

"I don't think any one step is going to solve the problem, and so we're looking at a number of steps. Maybe some of them are small steps, but maybe that's what changes lifestyle," Smette says.

The schools are a crucial component in the effort to teach Marshfield's children about a healthy lifestyle. The schools also want to reach out to adults, and encourage them to set an example for their children by eating the right foods and staying active.

For example, schools may offer night classes in healthy Mediterranean cooking.

"How do you make a change in a community? I think it has to be efforts to reach the parents, efforts to reach the kids. It's a life change, like changing people's ideas of smoking or changing people's ideas of wearing a seatbelt. It's similar to that. It's a major change in habits from what you've been doing," Smette says.

This will be a difficult challenge that's going to take many years.

"We're not expecting or looking for some quick changes overnight," Smette says.

McCauley agrees. He says the key to success is getting the entire community to develop ideas and implement them. For example, employers can create programs for their workers and municipal planners can promote bicycle and pedestrian pathways.

"I think there's widespread support and participation. The buzz is out there. The whole thing is, how do you harness the energy to make the whole thing go forward?" McCauley says.

What To Do

In 1999, 61 percent of American adults were obese or overweight, and the same was true for 13 percent of children aged 6 to 11 and adolescents aged 12 to 19, says the Centers for Disease Control and Prevention (CDC).

The percentage of American children defined as overweight has doubled since the early 1970s, the CDC says.

If you're a parent looking for information and advice about childhood obesity, you can find it at the Mayo Clinic and the American Academy of Pediatrics.

For more about exercise, go to the President's Council on Physical Fitness and Sports.

SOURCES: Charles S. McCauley, M.D., cardiologist, Marshfield Clinic, Marshfield, Wis.; David H. Smette, Ed.D., superintendent, Marshfield School District, Marshfield, Wis.

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