Can My Clinic Fix Childhood Obesity?

Of the 10 children in my family, I was the only one who was obese. I didn’t know it at the time, but my family mirrored obesity trends in Holtville, the small town in California where I grew up. In Imperial County, which borders Arizona and Mexico, 1 in 10 people were considered obese in the 1970s and ’80s. I hated being obese and fantasized about a magical solution that could transform me overnight.

Fast forward to the present: My weight is under control and I’m the director of programs at Clinicas de Salud del Pueblo, a non-profit community clinic in Imperial County.

Unfortunately, obesity is more common here than when I was a kid. Today, 4 in 10 children in Imperial County are considered obese or overweight. Couple this with a poverty rate of 22 percent, and you have a recipe for an unhealthy community.

To determine if a child’s weight is a problem, a key measure is body mass index—measuring the child’s weight against a national standard for their height, age, and gender. A child in the 85th percentile or more is considered overweight; at the 95th percentile and above, a child is obese.

One major problem is that many parents see obesity as something their children will outgrow—not a major health concern that requires treatment. The clinic used to tell families to eat healthy and exercise, and to come back next year for a physical exam. This method didn’t work. Most kids don’t grow out of being overweight or obese and many parents don’t know how to help them make healthy choices around food and exercise.

In 2011, my clinic saw an opportunity to join forces with other agencies—including San Diego State University’s Institute for Behavioral and Community Health and the Imperial County Public Health Department—to come up with a new strategy for controlling obesity. One focus is identifying problems much earlier, and monitoring them more closely over time.

In order to get real money, we applied for a 4-year research grant from the Childhood Obesity Research Demonstration (or CORD) study of the Centers for Disease Control and Prevention. The grant program is part of the Affordable Care Act and aims to tackle childhood obesity in impoverished communities. We were fortunate to be one of three sites funded—the others are in Massachusetts and Texas.

Last year, we invited 600 children to participate—and we allow any family to access the services. Three to four times a year, the child sees a clinician for a weight management and wellness exam. A patient care coordinator also works with the family. Finally, community health workers (or promotoras) lead a series of workshops on parenting skills, setting goals, and incorporating fun games into physical activities.

One of the first families to participate in Clinicas’ family wellness program was the Padillas, whose 11-year-old daughter had been struggling with her weight. It was difficult for them at first. The family doesn’t have a car and needed to find a ride or take the bus, which can be tricky. And, like many families, they felt reluctant to visit the clinic when they lapsed.

The Padillas eventually figured out how to manage the plan. They went on walks, watched less TV, gave up drinking sweet tea, and ate less fattening foods. Today, they eat more fruits and vegetables, drink more water, go to sleep earlier, and include more physical activities in their daily routine.

But it’s not just families that need to commit to change. As part of Our Choice/Nuestra Opción, experts conducted training with the staff of clinics, childcare facilities, schools, recreation agencies, and restaurants. There’s work to do in improving our own health.

The magical solution to childhood obesity that I wished as a kid doesn’t exist. Tackling this problem means making a long-term commitment—and understanding that change won’t happen overnight.

Leticia Ibarra is director of programs at Clinicas de Salud del Pueblo, Inc. She has 16 years of professional experience in research, project management, working with clinics, and consulting in community-based, collaborative health communication and promotora interventions to improve the health and well-being of Latino and immigrant communities. She wrote this for Zocalo Public Square.