Why Excellent Public Schools Should Be a Top Priority for Public Health
Widespread environmental attributes are “obesogenic” for low income and/or ethnic minority youth, and obesity is a handy proxy for all of the factors threatening this generation of children with shorter life expectancies than their parents. The proportion of low nutrient density school food choices and fast food restaurants is higher in communities with higher poverty rates, lower household median incomes and higher concentrations of ethnic minority residents. Exposure to food-related television advertising is greater, especially fast food, both because of targeted marketing and higher TV viewing rates. In schools, there are lower rates of participation in varsity and intramural sports among female, racial/ethnic minority and lower income students, while revenues from “pouring rights” contracts and soft drink availability are higher. Most of this “evidence” comes from modest cross-sectional associations between the availability of health-promoting resources and reported behaviors.
The contribution of school environments to obesity is underscored by the finding that school socioeconomic status and racial/ethnic composition are inversely correlated with BMI (body mass index), even after controlling for individual race/ethnicity and socioeconomic status.
This suggests that unsafe neighborhoods deter active commuting to school and playing outdoors after school, at home or in parks. Busing, meanwhile, not only adversely affects students’ activity levels, but also creates a “brain drain,” and further depletes these schools of resources because of per capita funding allocation. Less time spent outdoors not only displaces physical activity but also increases television viewing and, thereby, exposure to ethnically targeted commercials for fast food and fatty and/or sugary snacks. Low family incomes and longer working hours and commuting time absorb precious parenting resources needed to transport children to extracurricular recreation, not to mention the burden of registration fees and equipment costs. Such financial challenges and time constraints also promote reliance on inexpensive fast food, and fast food restaurants are much more accessible than full-service ones, just as convenience stores are more prevalent than chain supermarkets in low-income neighborhoods and communities of color. Thus, from a social marketing perspective, the cost of healthy eating and active living is quite high, with quite limited “choices” available. Thus, for the established behavioral determinants of obesity – fruit and vegetable consumption, fast food intake, breakfast frequency, soft drink and low nutrient density snack intake, exposure to television, sleep, physical activity frequency and intensity, sports participation – ethnic minority and low income youth are at a considerable disadvantage.
This brings us back to schools. Excellent neighborhood public schools would not only help improve kids’ fitness and educational trajectory, but may also increase parent involvement, provide opportunities for joint use of fitness facilities such as gyms and tracks by community members, increase pedestrian traffic on streets to assist in community policing and increase demand for sidewalk maintenance and streetlight repair… the list goes on. Educational attainment is the best single correlate of health and healthy longevity. It really is time to break down the silos between public health and public education.
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