The Body Mass Index (BMI) is the primary measurement to determine how children’s weight and height reflect their overall health- in other words, whether they’re underweight, at a healthy weight, overweight, or obese. Children are classified as overweight when their BMIs land between the 85^th and 95^th percentiles; obesity describes anything in the 95^th percentile or higher. The data for this measure is collected from parent responses to a telephone survey known as the Behavior Risk Factor Surveillance System (BRFSS), which is used by the federal government and many of the states. Connecticut data, provided by the state Department of Public Health (DPH), shows the rates of obesity among children in Connecticut tend to be at or above the national averages. Based upon reports from the Department of Public Health, the primary contributing factors that impact obesity are dietary habits and physical inactivity.

The National Heart, Lung, and Blood Institute call inactive lifestyles a significant contributor to increasing rates of overweight and obese children. Watching more than two hours of television a day and increased use of modern technology (smartphones, computers, etc.) contribute to inactivity in children. Additionally, the CT YMCA Alliance estimates that preschoolers and an children aged 6-11 respectively saw 39% and 25% more PepsiCo television advertisements for sugary drinks in 2013 than they did in 2010. A lack of availability of healthy foods, heavy advertising of unhealthy food, and a lack of safe recreational areas are frequently listed among the environmental factors that contribute to obesity. Nine percent of the total U.S. population lives in communities that do not provide adequate access to healthy food retailers within a reasonable distance from their homes. Cities like Hartford, New Haven, and Bridgeport often lack grocery stores with healthy food. Recreation areas like trails, parks, & affordable gyms can also be difficult for the average city resident to find. Also, as noted by the Central Connecticut Coast YMCA, the perception of danger through various media outlets enforces the notion that cities lack safe play spaces.

These factors and others related to childhood obesity have a distinct impact on the outcomes for children. The physical health issues associated with childhood obesity range from basic vitamin deficiencies and metabolic complications to developing diabetes and heart disease. Also, the likelihood for low self-esteem, incidences of bullying, depression, and outright discrimination increase in children who are obese. The development of those psychological issues has the potential to negatively impacting their school experience through absenteeism and the effects of peer pressure or bullying.

Both policy initiatives and organizational efforts have been undertaken in order to curb unhealthy eating practices and increase physical activity over the past 10 years. Since 2006, foods and beverages deemed unhealthy have been banned from sale in schools. The State Department of Education has also established a Health Food Certification program for schools that follow the Connecticut Nutrition Standards. Efforts by the Connecticut General Assembly have included revised school recess laws to improve regular physical activity or students. Outside of state government, Connecticut’s YMCAs have adopted the Healthy Eating and Physical Activity (HEPA) standards for their after school programs to encourage active lifestyles and restrict unhealthy foods/activities. Their organization has also noted that, in seven communities across the state, a Pioneering Healthier Communities (PHC) initiative has been undertaken to strengthen public policies at the local level.

• Department of Public Health
• Department of Education
• End Hunger CT!
• Latino and Puerto Rican Affairs Commission
• American Heart Association of Connecticut
• Connecticut YMCAs
• UConn Rudd Center for Food Policy and Obesity

• Review and revise local/school wellness policy annually as part of the Healthy Food Certification process. (DPH)
• Increase healthy food options in vending machines by reducing the price of healthy choices and increasing the proportion of healthy choices. Increase availability of water and promote its consumption. (DPH)
• Implement age-appropriate policies that support increased physical activity. (DPH)
• Advocate for universal screening for overweight and obesity in schools, and for appropriate reimbursement for nutritional counseling, medical follow-up, and weight loss programs. (DPH)
• Provide training and technical assistance to teachers on the implementation of early childhood programs' nutrition standards. (DPH)
• Provide age-appropriate health education with pre- and post-testing on topics such as heart disease and healthy living. (DPH)
• Educate providers concerning proven strategies to promote healthy behavioral change. (DPH)
• Identify or develop surveillance system with age-appropriate data collection methodology on diet and physical activity. (DPH)
• Develop a population level data base to track BMI. (CHDI)

Strategies contributed by staff from the Connecticut Department of Public Health (DPH) and the Child Health and Development Institute of Connecticut. (CHDI)