San Diego County Childhood Obesity Initiative: Ways Physicians Can Get Started

San Diego County has received some very welcome news about its regionwide fight against childhood obesity. A recent study by the UCLA Center for Health Policy Research and the California Center for Public Health Advocacy shows that between 2005 and 2010, the number of overweight and obese students in San Diego County dropped 3.7 percent. Statewide, the drop was 1.1 percent, and 31 of California’s 58 counties actually saw an increase during the same time period.

While this news of declining obesity rates in San Diego County is certainly welcome, we still have a lot of work ahead of us to turn the tide of both adult and childhood obesity in our county. Just as the etiology of the obesity epidemic is multifactorial, our response must bring together partners from multiple sectors and communities to address the issue head on.

For the past six years, the San Diego County Childhood Obesity Initiative (COI) has provided key support to partners throughout our region, and a place for these partners to converge and work together to find real solutions to the obesity challenges in our communities. Facilitated by the nonprofit Community Health Improvement Partners (CHIP), the COI is a public/private partnership that engages community partners from multiple sectors to work together in an effort to impact childhood obesity through environmental, systems, and policy change throughout San Diego County.

The Initiative was formed to assure effective implementation of the strategies outlined in the San Diego County Childhood Obesity Action Plan, a groundbreaking comprehensive plan that identifies strategies in seven domains with the most influence on developing healthy community environments (government; healthcare; schools; early childhood; community; media; and business). With centralized coordination and leadership of COI, leaders from hundreds of public and private agencies and organizations have voluntarily stepped forward to champion the cause, guide work in and across sectors, and engage their peers and colleagues to work together to create communities that support health by improving access to healthful foods and opportunities for physical activity in local neighborhoods.

With much work in progress, this tremendous effort has resulted in policy change, advancement, and implementation of childhood obesity prevention strategies and development of best practice models that have been replicated throughout San Diego County and elsewhere. Some examples include:

• Numerous food/physical activity policies have been passed by the San Diego County Board of Supervisors.
• Partnerships created between public health and land use/transportation planning professionals have led to integration of public health into community design and transportation strategies.
• With technical assistance, numerous municipalities have incorporated health elements into city general plans and implemented “healthy” redevelopment projects.
• Regular forums educate elected officials and have gained support for healthy food/physical activity policies.
• A free, centralized resource and referral network for community-based nutrition and physical activity programs via telephone or website was created through 211 San Diego.
• Youth Engagement and Action for Health (YEAH!), a training program for youth leaders to encourage neighborhood assessments and advocacy for policy and environmental change, has helped to create a new generation of public health advocates.

As the COI has shown, a robust response that brings together partners from across our communities offers the best chance at improving health in our region. While physicians are certainly on the forefront of this battle, significant progress will only be made if we turn the walls of our clinics inside out to make strong connections with the communities in which our patients live. Making sure that our patients can see us in the office is only part of the solution to finding better health.

We know intuitively that it may not be the 15 minutes we spend in the doctor’s office that can make the greatest impact on health, but rather the other 23 hours and 45 minutes of the day in the places where we live, work, learn, and play that have the greatest impact on health. The simplest recommendations — things like improved nutrition and increasing exercise — can often fall flat when the communities where our patients return to are struggling to support these recommendations. For example, a suggestion to increase consumption of fruits and vegetables might be especially challenging for patients who have no supermarkets in their neighborhoods, inadequate access to transportation, and limited income.

By increasing our own “community competence,” better understanding the barriers our patients face as they translate our recommendations into positive action, and advocating for communities that support health, we can increase the power of the clinical moment and improve the health of our patients.

Where to start? Luckily, with its Physician Advocacy Menu, the San Diego County Childhood Obesity Initiative has made it easier than ever to give physicians the options that work best for them. This menu of ideas offers ways physicians can engage communities and create the kind of strong community collaborations that support the hard work that physicians do in their offices. Employing these ideas can make a huge difference in our efforts to improve the health of our patients who depend on us. The menu offers a wide range of ideas about ways physicians can get started, even those with a busy schedule. From engaging your local schools to providing healthy tips to patients or simply learning more about the communities we serve, this “menu” is designed to help physicians find the advocacy tool that works best for them.

For more information about the San Diego County Childhood Obesity Initiative or to download a copy of the Physician Advocacy menu, please visit the COI website at www.OurCommunityOurKids.org or call (858) 609-7964.