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All Children Prenatal to Age 8 are Healthy

Percentage of Wethersfield Children with BMI in Overweight/Obese Range 6th Grade

Current Value

34.1%

2025

Definition

Line Bar Comparison

Summary

The Wethersfield Early Childhood Collaborative, in partnership with the Wethersfield Board of Education, has been tracking student BMI in kindergarten and sixth grade over the past several years. Information has been collected on the classes of 2015-17 and the classes of 2019 and 2020. Data collected has shown a troubling increase in the number of students with BMIs in the overweight and obese range. In the time WECC has been analyzing student BMI data, we have seen a 19% baseline percent change in 6th graders who are obese or overweight (31% to 36.9%). Student data also shows BMI has increased significantly as children age.

Why Is This Important?

The Center for Disease Control (CDC) describes Body Mass Index (BMI) and BMI Percentiles as follows:

BMI is a number calculated from a child's weight and height. BMI is a reliable indicator of body fatness for most children and teens...For children and teens, BMI is age- and sex-specific and is often referred to as BMI-for-age.

After BMI is calculated for children and teens, the BMI number is plotted on the CDC BMI-for-age growth charts (for either girls or boys) to obtain a percentile ranking. Percentiles are the most commonly used indicator to assess the size and growth patterns of individual children in the United States. The percentile indicates the relative position of the child's BMI number among children of the same sex and age.

BMI-for-age weight status categories and the corresponding percentiles are shown in the following table.

Weight Status CategoryPercentile Range
UnderweightLess than the 5th percentile
Healthy weight5th percentile to less than the 85th percentile
Overweight85th to less than the 95th percentile
ObeseEqual to or greater than the 95th percentile

The combination of healthy eating and physical activity are essential to a child's overall health and development. According to the CDC, “healthy eating and regular physical activity can prevent many chronic conditions." The CDC also notes that “unfortunately, few Americans make healthy food choices on a regular basis and many do not get enough physical activity to receive health benefits."

The New Britain Health Department report Childhood Obesity and Asthma in the Consolidated School District of New Britain, Connecticut (2014), prepared in partnership with UConn Health's Department for Public Health and Public Policy, explores the devastating impact of childhood obesity:

Children born in the United States at the beginning of the 21st century may be the first generation since U.S. Census data have been recorded not to have a longer life expectancy than their parents[1]. The decrease in life expectancy is entirely attributable to prevalence of obesity in this generation[1]. The escalating costs of obesity will bankrupt cities with high rates of obesity. 2009 data reported an estimated cost of over $50 million per 100,000 residents. Children are entering into obesity early on, which translates into an often unchangeable life course of chronic disease, with "adult" conditions such as type 2 diabetes and hypertension starting in childhood. Obesity has started to outpace cigarette smoking, another risk factor commonly beginning in adolescence, as the greatest risk factor for death and illness.

Besides decreasing life expectancy, childhood overweight or obesity may severely affect a child's physical and psychological development. Hospital costs attributed to childhood overweight have increased three-fold in the last 20 years [3, 4]. From 1979 to 1999, the occurrence of type 2 diabetes, previously called adult onset diabetes doubled in adolescents, particularly among minority children [5]. In the same time period, diagnoses for sleep apnea and gall bladder disease, not usual pediatric problems, have tripled. A majority of overweight children (61%) have problems such as asthma, orthopedic problems resulting from excess weight, hypertension, dyslipidemia, and greater susceptibility to infectious disease [5]. These problems follow into adulthood where obesity is the direct antecedent to diabetes, heart disease, and many types of cancer, kidney failure, respiratory disease, and infertility. In many cultures, overweight stigmatizes the school age child[6]. This discrimination contributes to depression, low self-esteem, poor school performance, and interference with family functioning [7].

The American Academy of Pediatrics uses body mass index (BMI) as one screening tool that helps explain the overall health of a child. Body mass index (BMI) of Wethersfield's children gives us a better indicator of their overall health, and allow us to track their progress over time. This data was collected and reported by school personnel, using the Connecticut Student Health Assessment Record ("blue form"). No individual student identification was shared.

Story Behind the Curve

Data collected over time shows the number of children who are overweight or obese in Wethersfield has grow dramatically in a short period of time. The first group WECC analyzed data on was the class of 2015. The BMI of the children when they entered kindergarten and during their 6th grade year was recorded and compared. For the class of 2015, BMI remained the same over time: 31% of children in that group had BMI's in the overweight or obese range in both kindergarten and 6th grade.

Since then, data indicates that the number of children with BMI's in the 85th percentile and above has consistently grown during the elementary school years. Overall, we have seen a 19% increase in the baseline. 32% of children in the class of 2016 were overweight/obese as kindergartners. By 6th grade, 34% of the children were overweight or obese. 30% of children in the class of 2017 were overweight/obese as kindergartners. By 6th grade, 35% of the children were overweight or obese. The latest data collected shows 30.5% of children in the class of 2020 were overweight/obese as kindergartners. By 6th grade, 36.9% of the children were overweight or obese. A notable exception is the class of 2019 who defied this trend . This group showed a decline in BMI between kindergarten (33.5%) and 6th grade (32.2%).

A closer look at the class of 2020 shows significant changes during the elementary school years, especially in the number of boys who are overweight or obese:


Class of 2020

Kindergarten BMI in

Overweight/Obese Range

6th Grade BMI in
Overweight/Obese Range

Total Overweight/Obese30.5%36.9%

Total Overweight

15.1%19.2%
Total Obese15.4%17.7%
Girls Total29.6%32.6%
Girls Overweight12.8%18.5%
Girls Obese16.8%14.1%
Boys Total31.3%41.2%
Boys Overweight16.419.9
Boys Obese14.921.3

Over time we have also noted that the number of children entering kindergarten with a BMI in the healthy range has increased. The most recent data collected on the class of 2027 shows the number of children in the overweight/obese range is at 27.9. Time will tell if they are able to maintain and/or improve on that number or if they will follow the general trend of haiving a significant increase in their BMI during the elementary school years.

The Wethersfield Early Childhood Collaborative has met with numerous groups including parents, teachers, school nurses, and school administration, and Wethersfield Food Services to share BMI data and collect feedback on the issue:

Physical Education Teachers:

Wethersfield vs. State Guidelines: On May 12, 2015 representatives from WECC meet with elementary physical education teachers to share the BMI scorecard and get feedback.A number of important issues emerged from this discussion, including the recent reduction in PE time for elementary school students.In the past, students had two 30 minute PE classes each week.In order to accommodate a change to block scheduling in the elementary schools, students now take one class every four days.

Previous Schedule - 8 classes/240 minutes in a month

Monday

Tuesday

Wednesday

Thursday

Friday

Class 1

Class 2

Class 3

Class 4

Class 5

Class 6

Class 7

Class 8

Block Schedule – 5 classes/150 minutes in month

Monday

Tuesday

Wednesday

Thursday

Friday

Class 1

Class 2

Class 3

Class 4

Class 5

The State of Connecticut does not mandate a specific amount of time for PE in elementary schools.The State Department of Education does provide guidelines.For primary grades, the state suggests 60-100 minutes week (240-400 in four weeks).For intermediate grades, the state suggests 80 to 120 minutes a week (320-480 in four weeks).For middle school, the state suggest three class periods a week of PE.Silas Deane Middle School is following this guideline.As a consequence of the change to block scheduling, WECC estimates that K-3 students are getting 63.5% and grade 4-6 students are getting 47.7% of the minimum amount of physical education recommended by the state of Connecticut

Given that this change represents a significant decrease in the amount of physical activity embedded into the school day at a time when WECC is forecasting that the BMI of Wethersfield's elementary school children will continue to increase, WECC's Health Committee is concerned about this issue and plans to engage school officials and the community in a discussion about the potential impact.

School Nurses

Wethersfield's school nurses to discuss the data they collected. Nurses reported that the data reflects changes they have observed in students over the last several years and they consider this a vital issue that we must tackle in order to prevent our children from facing lifelong health issues. When asked to reflect on the story behind the trend, they had several comments, questions and concerns:

  • Student Physical Activity: Nurses questioned if Wethersfield children have enough opportunities to be active during the school day. Are there more ways to integrate physical activity into the day? Can we develop a plan for children to be active when cold weather, snow and rain keep them inside for recess? Can we encourage more active play during recess? Nurses have noted that children are increasingly challenged by medium and high impact physical activity. Is there a way to use physical education classes to progressively train them to tolerate and eventually enjoy higher impact physical activities?
  • Space for Physical Activity: Nurses asked if we were utilizing fields and gym space in a way that supports active play? An example discuss was the limited use of fields at Webb School because most of the grassy area was being maintained as a football field for the high school. Consequently, Webb students play on black top and have limited space to run around. It was also noted that due to the number and positioning of recess moderators, children were often contained to a limited area of school grounds. Is there a way to allow children to utilize more space both inside and outside of buildings for active play?
  • School Lunches: Nurses had two specific concerns about school lunches. Their first concern centered on "A la Carte" items children were allowed to buy along side lunches, specifically cookies and ice cream. Nurses noted that students are allowed to purchase an unlimited number of cookies with their lunch and reported seeing some children buy as many as a half dozen. They wondered if an item like ice cream could be offered as a "treat" on certain days to help teach children that sweets can be taken in moderation. Secondly, nurses questioned if the number of carbohydrates in typical school lunch meal such as "Popcorn Chicken, Seasoned Corn, and a Dinner Roll" was more than a child should consume in a meal and encouraged a dialogue on that topic with our food service partner.
  • Sensitivity of the Topic: Wethersfield school nurses recognize that that parent action is essential for improving the fitness of Wethersfield children. They noted, however, that a child's weight is an especially sensitive subject that must be dealt with carefully. One nurse observed that if there was a child she suspected had a vision issue, she would give the child a vision test and then send a note home suggesting the child be taken to a specialist. When a nurse notes that child's health form shows their BMI puts them in the overweight or obese range, the way to approach that with a family is not so clear cut. Nurses have encouraged a community dialogue about how we can support children and families without shame or judgment.

At the invitation of Wethersfield's nursing supervisor, WECC meet with the Boards of Education's Wellness Committee in June of 2015 to discuss how BMI information can shape the schools wellness policy and will be partnering with them to discuss a school and community strategy.

Parents:

WECC meet with all five elementary PTOs in the spring of 2015 to share BMI data. Discussion with parents centered on how to increase student activity both in and out of school, use of our school facilities and grounds, the quality of school lunches, and the availability of for purchase snacks along side school lunches (e.g.- the ability to buy an unlimited number of cookies in some school cafeterias). We also discussed the delicacy of nurses reaching out to parents who has a child with a high BMI iand/or is showing difficulty with rigorous physical activity. No clear answers on this from parents but a productive dialogue has begun. A few positive related health notes also came out of the meeting. In the spring of 2015 elementary school initiated the 95210 program and Silas Deane Middle School brought back a modified form of their intramural sports program.

Social Factors

Research has shown a number of factor contribute to the rise in childhood obesity. "Lifestyle practices and changing dietary habits may help explain why more children are overweight or obese today." (Miguel Cavazos, Livestrong.com, May 2011) When asked "What makes a child healthy?", in WECC's community survey, Wethersfield residents echoed this statement.Their responses included the need for positive parent/family role models in terms of diet, exercise, and sufficient sleep. Parents are the biggest influence on their children's choices, particularly in the early years, when dietary and lifestyle practices are formed.

Dietary Habits

  • Children do not always eat nutritious meals and often consume too many sugary beverages.
  • Children and their families are bombarded with marketing from fast food restaurants and companies selling processed convenience foods.
  • Perceived lower cost and convenience of takeout meals and processed "ready-to-eat" food items are two factors that can negatively affect families' meal choices, at home and on the go.

Lifestyle Practice

  • Wethersfield is a densely populated town.Although many neighborhoods have sidewalks, main roads are not conducive to walking or bike riding, This may limit children's and families' abilities to exercise safely.
  • Many children don't walk to and from school. Elementary school children in Grades 1-6 are eligible for busing if they live 1.0 mile or more from their school; all kindergarten students are eligible for bus service.Some parents prefer to drive their children for reasons including safety concerns, work schedules and inclement weather.
  • Many children have televisions, computers, phones and other electronic devices in their bedrooms, resulting in poor sleep habits, which is linked to increased body mass index (Sleep Duration, Sleep Regularity, Body Weight and Metabolic Homeostatis in School-Aged Children, American Academy of Pediatrics.)
  • According to the CDC, children ages 6 month to six years old view television or videos an average of two hours per day, and approximately 4 out of 5 children do not get the recommended level of daily exercise.
  • Parents have concerns about their children being outdoors without supervision.This has an impact on children using parks, playgrounds and other outdoor spaces where they can play and exercise.Research shows that during the summer "without activities to keep their minds and bodies active, kids are likely to gain weight twice as fast" as during the school year.(Fighting Brain Drain and Weight Gain, YMCA.net)
  • Work schedules and other commitments leave families with limited time for physical activity.
  • For some families, cost and transportation can be barriers to participation in fitness programs.

What Works

Childhood obesity is a complex national issue with a variety of causes. A comprehensive community strategy that brings together parents, community organizations, schools, town government, local businesses and more will be required to reverse the trend we have seen in Wethersfield. "Shape Up Somerville" is an example a successful collaborative approach to the issue:

SHAPE UP SOMERVILLE

Partner Spotlight: YMCA's 95210

95210 is a community-wide strategy for promoting child health and life-long healthy habits. With simple health messages behind each number, it’s a great tool for helping children improve their well-being. In addition to incorporating 95210 into after school programs, the YMCA has partnered with Wethersfield Public Schools to introduce the program at all five elementary schools.

95210 Tenets
Get at least 9 hours of sleep
Eat 5 servings of fruits and vegetables
Limit screen time to 2 hours or less
Get at least 1 hour of physical activity
0 sugary drinks and tobacco


http://www.sde.ct.gov/sde/lib/sde/PDF/deps/Student...

Strategy

Strategy 3:Promote healthy eating and physical activity for Wethersfield children and families.

Actions:

  • Collaborate with community groups (health district, YMCA, etc.) to provide parent education classes related to nutritious meals, exercise (including unstructured play), electronics, sleep habits, and food marketing.
  • Raise awareness of subsidized nutrition programs (WIC, free/reduced price school meals) and physical fitness activitiesavailable for families.
  • Increase participation in and use oftown farmer's markets, community gardens, bike trails, fun runs and other fitness and nutrition programs and events.

Strategy 4: Collaborate with Wethersfield Public Schools on comprehensive campaign to help students and their families develop/demonstrate healthy lifestyle behaviors including regular exercise and a healthy diet.

  • Review school wellness policies and programs to identify and/or develop strategies specific to youngest students.
  • Investigate community engagement campaigns, including the 95210 program.
  • Explore options to track and analyze student BMI data and provide feedback to parents in aggregate form through PTOs or school newsletters.
  • Work with parents to explore community walk-to-school initiatives.
  • Work with Chartwells to continuously improve nutritional value of school meals.
  • Support efforts to increase use of free/reduced meal programs in school district, and research opportunities for summer meal programs.

Assigned To

WECC's Health Committee

The strategic focus of the Health Committee includes:

  • Implementing the Health strategies outlined in Wethersfield's Community Plan for Young Children and Families.
  • Focus on addressing non-adequate prenatal care, and engaging the broader community in efforts to address lifestyle for our youngest children that result in healthy eating and adequate physical activity.
  • Taking a lead in data collection and reporting for WECC.

For more information, contact wethersfieldchildhood@gmail.com

Partners

  • State of Connecticut
  • CT Department of Social Services (DSS
  • Central Connecticut Health District (CCHD)
  • Town of Wethersfield
  • Town of Wethersfield Department of Youth and Social Services
  • Town of Wethersfield Department of Parks and Recreation
  • Wethersfield's Medical Community
  • Wethersfield Families
  • Wethersfield Board of Education

Brainstorms

  • Afternoon tennis program - sponsored by Pine Acres
  • Before school - Mommy and me exercise programs
  • Afterschool baseball clinics
  • Share Scorecard with Wethersfield Soccer, little league, football, basketball coaches
  • Work with WSPC on Walk/Bike Initiative
  • Produce 5 minute fitness videos with students for teachers to use on snowy/rainy days
  • Parent outreach - photos of fruits and vegetables in school cafeteria, make sure parents understand children can take unlimited frutis and vegetables when they buy school lunch
  • Share data with BOE and Town Council

Data Resources and Development Agenda

Fall 2015: Collect data on current K and 6th grade students

Can we collect data on grade 2, 3, 4, and 5 students?

Clear Impact Suite is an easy-to-use, web-based software platform that helps your staff collaborate with external stakeholders and community partners by utilizing the combination of data collection, performance reporting, and program planning.

Scorecard Container Measure Action Actual Value Target Value Tag S A m/d/yy m/d/yyyy