Rural scholars report highlights Island childhood obesity
Martha's Vineyard children are at risk in the national epidemic of childhood obesity, and about one-third of Island students recently surveyed now fall into the category of overweight or obese, although those numbers are likely to improve. At the same time, Island schools and organizations have begun promising programs aimed at combatting the problem of childhood obesity.
Those were some of the conclusions a team of second-year medical students, known as Rural Scholars, from the UMass Medical School in Worcester presented in West Tisbury on October 31.
Preliminary measurement data shows that Island children are at least on a fitness par with their statewide counterparts and a tad healthier than the national average. The team also concluded that programs are in place, particularly in Island elementary schools, that offer a blueprint for lowering the number of overweight or obese 5- to 18-year-olds on the Island.
The scholars recommended that the successful Island Grown Schools program ought to be combined with efforts to create more affordable food for Island families, increased family education on diet and food preparation, and efforts to integrate more exercise in the lives of Island kids.
The Rural Scholars program provides research teams to Massachusetts communities to study specific health issues. Each year, Rural Scholars teams are presented with proposals from which they select studies relevant to their professional interests. In the past 12 years, Rural Scholars have come to the Island to study Lyme disease, risk of falling, and substance abuse. A separate Rural Scholars team recently completed a study on the potential effects of a rapidly aging population on the Island community.
BMI lightning rod
The latest study and recommendations were included in a 32-page presentation (available at mvtimes.com) titled, "Healthy Weight of Vineyard School Children, Assessing the impact of BMI letters."
BMI refers to body mass index, a screening tool that takes height, weight, and age into account and is used to identify children at risk of obesity.
The study was sponsored by the Dukes County Health Council, which acted on a proposal by the steering committee of the Island's Mass in Motion group, which asked the rural scholars to study this issue.
Mass in Motion is a four-year-old initiative created by the Massachusetts Department of Public Health (DPH) to combat obesity. DPH said that two thirds of Massachusetts adults and more than one third of children are overweight or obese.
In 2011, DPH required schools to weigh and measure students in grades 1, 4, 7, and 10 and to continue to track their body mass index annually. In 2012, schools began mailing each student's BMI index home with medical referral suggestions for students in the bottom five percent and top 15 percent of the weight/height scales. The Mass Public Health Council scrapped the program in October following complaints from parents.
Carol Kenney, a member of the Island Mass in Motion steering committee, said that while the letter campaign may have been a lightning rod, the issue of obesity is a real concern.
"Peg Regan [former Martha's Vineyard Regional High School principal] designed the BMI proposal last spring after the first letters went out to parents," she said in a conversation with The Times. "She has worked hard on this, jumping through all the hoops and hurdles of paperwork and filing. The real issue is what do you do about the problem after the letter goes out,"
Ms. Kenney and the Rural Scholar team said that the first-year Island BMI results are an indicator, but an early and imprecise measurement, and that the letter campaign would have had limited effect in the absence of solutions in place.
"We wanted to bring the Rural Scholar team here to identify gaps and areas where we could make improvements," Ms. Kenney said.
Prior to arriving on the Island for two weeks of field work this month, the Rural Scholars researched the issue and identified three objectives: to evaluate the use and utility of BMI letters, to identify existing school and community resources to promote healthy weight among school children and to develop recommendations for Mass in Motion and the community to improve the health of Island kids.
Once the state suspended the letter policy, the team focused on identifying resources and recommendations, the Rural Scholars said in their presentation last Thursday.
The team reported that, given the preliminary nature of the data, Island kids are about on par with childhood rates of state overweight/obesity rates. The Island figure is 33.9 percent, compared with 32.9 percent for the state and 34.7 percent for the USA.
The researchers approached Island BMI numbers gingerly because, given the relatively small sample, 593 students, the limited history of measurement and a system which measures by grade rather than by individual, the year to year changes can vary wildly, researcher Jeremy Malin told about two dozen audience members at the West Tisbury Public service building last Thursday.
Several of the researchers predicted that future Island BMI scores will be dramatically better than the preliminary results they gathered.
The team interviewed several dozen Island educators, medical and social service professionals, and went to Island schools where they ate in cafeterias and interviewed schoolchildren, including 40 high school sophomores and seniors to develop their findings and recommendations. They also visited Island supermarkets, food stores, restaurants and exercise venues, including the YMCA and the bike path system.
During a 35-minute powerpoint presentation, members of the team said that unrecognized poverty on the Island contributes to poor eating habits, as does accessibility to nutritious food. They said that lack of time to prepare nutritious meals and lack of meal preparation knowledge are contributing factors to unhealthy eating habits here.
Among the Island's healthy eating accomplishments, the team accentuated the positive healthy food and eating impact of the Island Grown Schools program, which integrates gleaning, education, and school garden components into its work.
The team found high participation in healthy school lunch programs at elementary schools which also make free fruit available to students. The team noted that some schools have eliminated unhealthy snacks and promote wellness in newsletters, wellness fairs, cooking classes at schools and libraries and scholarships to the YMCA.
They noted that some schools have safe bike access and encourage biking to school with Bike to School Day.
The team had high praise for elementary school food choices but said MVRHS menus are a challenge to student palates, particularly since elementary school kids give high marks to their school food choices.
The Rural scholars made numerous recommendations on food, exercise and food education.
They included: Support for Island school nurses in developing an island-wide policy to screen children for unhealthy weight; developing Island-wide wellness goals and choosing measurables to track improvements, while allowing each school to achieve the goal in their own way; improving access to dieticians or nutritionists for children, families and schools; Raising the MVRHS quality of food to match that of island elementary schools; Increasing availability of healthy snacks at school and afterschool programs; and consider providing free or low-cost healthy snacks for all students involved in afterschool programs and making a fruit bowl available before and after school; Increasing use of the individual and family scholarships at the YMCA and increasing awareness of this scholarship to all school nurses so that they can refer students who are struggling with weight; increasing activity throughout the school day by considering alternative, non-competitive Physical Education classes; opening school gyms before school; and continuing to integrate parents and teachers into school exercise-related activities.