Childhood Obesity -- An Ecological Solution

This from “Childhood obesity,” JAMA 2007;298:920:

“In addressing this disturbing trend and preventing its spread, physicians are challenged to look to the broader environment. Successful treatment will require improving the health of individual patients and the larger community (an “ecological model.”) For physicians, this means reviving their traditional role as trusted advocates for good health of the public.”

Amen: as doctors, we need to recapture our community role in public health. The greatest improvements in longevity and health have come from simple interventions in the community, such as sanitation and clean water, and not from drugs or expensive technologies. We need to step out of our busy offices to meet the health challenges threatening our fellowmen, especially our children. There is no bigger threat than the epidemic of obesity cutting short their lives.

The JAMA specifically mentions what we could be doing in this arena:

“The “ecological model” suggests that doctors must get involved in the community, not just in their exam rooms. Doctors are to (1) demand that all food available in schools meet USDA nutrition guidelines; (2) require daily physical education and active recess for K-12 grades; (3) help parents and kids organize energy-burning “walking school buses” along safe routes; (4) campaing for sidewalks, playgrounds, bike paths and recreational facilities; (5) advocate for eliminating unhealthy foods; (6) call for supermarkets to provide affordable produce; (7) insist that hospitals eliminate fast food outlets and (8) advocate healthy lifestyles and healthy communities using public venues.”

Next month, docs at the Utah Medical Association will begin a program called “Adopt a School,” whereby UMA members and any other community doctor will adopt a school of their choice to implement these measures. Dr. Wheeler, a former UMA president is spearheading this worthy endeavour.