Tuesday, September 07, 2010

InFatuated With Government Meddling

Over the weekend we learned that all of the Bloomberg efforts to thin New Yorkers down have done no such thing. As the NY Times reported-with a great headline, "City’s Efforts Fail to Dent Child Obesity," - "New York City schoolchildren are as heavy, or perhaps even heavier, than the national average, despite the Bloomberg administration’s dogged efforts to improve the health of city residents,
according to new data from the city’s health department."

Do you think this might be the right time to stop digging-before the hole gets even deeper? Not a chance; as in all things government, nothing succeeds-at least when it comes to funding public programs-like failure: "Among New York City children who were overweight, 22 percent were obese, compared with 19.6 percent nationally. “I’m sorry to say it’s in line with the nation, but we’re certainly working hard to get it down from here,” said Cathy Nonas, the director of physical activity and nutrition for the city’s Department of Health and Mental Hygiene."

Please Cathy, just cease and desist-and direct all of the DOH resources to a public health issue that you might be able to solve-like the bed bug epidemic. But what does the city survey show?  "The numbers were broken down by ZIP code and showed that less-affluent neighborhoods had the most severe problems. In the 2008-9 school year, the highest rates were found in Corona, Queens, where 51 percent of schoolchildren were overweight or obese. That was followed by parts of Harlem, with 48 to 49 percent, and Washington Heights, with 47 percent. In contrast, some of the city’s wealthiest areas had the healthiest children. The West 60s near the Hudson River in Manhattan had the smallest share of overweight or obese children (11.7 percent), followed by part of TriBeCa (15 percent), SoHo (17.7 percent) and the East 50s, including Turtle Bay and Sutton Place (18.3 percent)."

So all of those calorie posting and trans fat policy efforts aren't doing the job? Who knew? It may all come down to education and class-but Nonas treats us to the following nugget: "Yet she said it would be na├»ve to think that measures like banning trans fats and posting the calories of foods served in restaurants would be enough to bring about a decline in childhood obesity." Or have any impact at all.

But that didn't stop the Department of Nannies from imposing more financial and regulatory burdens on the already struggling city restaurants. But the regulatory demiurge is as difficult to control as binge eating disorder: "She added that the city would use the data to decide where to concentrate its exercise and nutrition programs. Since the data was collected, she said, the city had substituted milk that is 1 percent fat for regular milk, or skim for chocolate milk, and had banned sugar-sweetened beverages from school vending machines. The school system has also restricted bake sales to once a month. She said the health department and the school system were introducing a pilot project to train 3,000 teachers, from kindergarten through the third grade, in exercises that children can do during classroom breaks. One routine has children pretending they are cabdrivers who have to bend down to go through a tunnel and jump to get over a pothole."

Maybe the mayor should pay the kids to lose weight? But the issue remains a serious one, and some thinking outside of the box should be required. As the NY Post reported: "But it's not enough just to tell parents their kids are obese, said Keith Ayoob, a dietician at Albert Einstein School of Medicine. "This isn't a cosmetic issue -- it's a health issue. We're going to have an epidemic of Type II diabetes," he said. "It's a huge wake-up call."

But it's good to know that DOH won't stop its digging: "Cathy Nonas, director of physical activity and nutrition programs for the DOH, said the city is aggressively engaged in the battle of the bulge. The city's Fitnessgram program tracks individual students and provides annual reports on their health -- including their BMI. Students straying into the high end are targeted for special support and attention from school nurses. "We're taking it on like we've taken on tobacco," said Nonas. "We're really concerned."

But the comparison to cigarettes is misleading-and shows that the department doesn't have the right perspective; after all, you can't tax all of the fat and sweet foods, can you? Given the Bloomberg weltanschauung, however, we won't be surprised if it tries this approach. But in our view, we need to examine how to empower kids and communities-something we suggested to Dr. Oz and his Health Corps, a program that misguidedly focuses on high school kids, and has deteriorated into a classroom teaching effort that, like all such efforts, has a track record of failure (yet the program keeps getting inordinate funds because of its founder's notoriety).

No, the proper response needs to start much earlier-and must try to motivate parents, children and communities in the healthier living effort. This campaign needs to get out of the school and into the neighborhoods-but the bureaucratic, top down approach, of the Bloombergistas militates against this kind of targeting.

That being said, given the current economic climate, it seems reasonable to suppose that the folks in the areas of high obesity have more on their minds that healthier living. Still, if we are going to be more successful we need to get away from an exclusive school based approach. Does any one know a good community organizer?