Good afternoon, everyone. I'm a researcher, so I will present some research results, some of which have already found their way into policy.
Schools are the focus of my research. Schools provide a wonderful opportunity for interventions for addressing childhood obesity--schools, school environments, and the neighbourhood at large.
I'll start off with lunches at schools. At some schools, Monday is McDonald's, Tuesday is Burger King, Wednesday is Wendy's, and so on. We all know that this is not the quality of diet we would like our children to eat.
I did a survey and demonstrated that those who purchase lunch at schools are 39% more likely to be overweight and 39% more likely to be obese. You may wonder whether maybe these are the children who are also physically inactive, who don't engage in sports and so on. We have the statistical models that take all that into consideration, so the increased risk of purchasing lunch at school is as it is. It's the exposure to and the consumption of those lunches. Those children are almost 40% more likely to be overweight and 40% more likely to be obese compared to children who brown-bag their lunches or just go home and have lunch there.
Following these observations, I provided some recommendations to the Nova Scotia government, and I was very happy to see that they came up with a policy response. They have now implemented a new school nutrition policy, and hopefully that will address this issue.
Another one, very much related to the school setting, is the amount of physical education that children receive. There's a clear correlation between the frequency of physical education classes and obesity and overweight. There is up to 40% more overweight and obesity among children who have a limited number of physical education classes. Again, my recommendations here are very clear. We need more physical education in the schools.
There is a policy response in Nova Scotia. More physical education teachers will be recruited and employed.
You may note that I'm not the only one who has made this observation. There's a lot of advocacy going on. The Province of Alberta, for example, has already implemented a policy of daily physical education.
It appears that there is a problem with the implementation of this policy. Why is that? Because often schools don't really have the capacity in terms of a gym and facilities to accommodate that policy. I would think that this goes towards a recommendation about the built environment: we need schools equipped with good physical education facilities.
One of the most remarkable findings of my research so far is a school program developed in a cluster of schools in the Annapolis Valley. They do a combination. They provide healthy lunches only. They have a no-junk-food policy in schools. They have daily physical activities. They have things like having the gymnasium open after school for the children. They have a comprehensive curriculum on health and nutrition. And they have been extremely successful in fighting childhood obesity. There is up to 59% less overweight in those schools and 72% less obesity in those schools. Those are very impressive numbers.
Obviously, this leads to a recommendation for a comprehensive approach to tackling childhood obesity. I was very happy to see that the Nova Scotia government followed up on that, in that they asked the successful program people to expand the program from the initial seven schools to all the schools in that school board. So we're talking about 40 or something schools.
Now I would like to move a little bit further and focus on neighbourhoods and how that affects obesity and overweight and health in general.
We know from studies using U.S.-based data that where you live determines your health, independent of individual factors like socio-economic status, etc.
I've been involved in this type of research here in Canada, and generally my observations were that we see less neighbourhood differential in health relative to the U.S. I tend to explain that in terms of our having a good public school system and a health care system, and for that reason we see less of a gradient over those neighbourhoods.
However, in my research on childhood obesity I did see a tremendous differential. Basically children living in better neighbourhoods have only 50% of the risk of becoming overweight and obese relative to children living in disadvantaged neighbourhoods. The background of information is all the same, and clearly this begs the question of why that is. We cannot explain it on the basis of individual factors. What is it in the neighbourhoods that explains those differences?
I looked at access to playgrounds and parks. Children who live in neighbourhoods that have good access to playgrounds and parks are much less likely to spend a lot of time in front of televisions and computers playing video games and much more likely to engage in outside activities. They also have a decreased risk of becoming overweight or obese.
Clearly there is a general recommendation to support more and better access to good playgrounds and parks. It is also a recommendation towards the school environment. They need to be equipped with good playgrounds and sports facilities. Playgrounds around schools are quite often financed through charity and through funding from the food industry that brings the food into those schools.
You may actually have an opportunity to double tackle this problem. First of all, you provide the playgrounds and in return you ask the school to implement a school policy and to ban the purchase of junk food in the schools.
I also looked at the level of the access to recreational programs is in schools, and also here there's a clear relationship. Those who live in neighbourhoods with good access to recreational programs are much more likely to be physically active and much less likely to be overweight or obese. Clearly another recommendation is to provide better infrastructure that supports the organization of recreational programs.
Further, I looked at very simple things like how kids travel to school. Are they walking? Are they biking? Do they take the bus? Clearly a benefit here is walking and biking. It's not always a choice, regretfully, but if you are in a position to have a choice, it's strongly recommended to do so because you're less likely to be overweight or obese. In terms of bus services, there's a clear gradient. The longer children spend sitting on the school bus every day, the more likely they are to be overweight. If we can address efficiency in busing and maybe other ways of limiting the travel time for children, that would benefit their weight and their health in general.
Further, I looked at safety, and we know from various studies that safety is a big issue in the U.S. I was not able to fully confirm that for the situation in Nova Scotia. Possibly safety in Nova Scotia, and maybe in Canada in general, is not as big an issue. I did see that there was more playing reported and less time spent in front of the screen. However, I could not find an association between neighbourhood safety and obesity rates.
In terms of deprivation--and I developed a deprivation score consisting of littering, youth making problems, drug trafficking, and the quality of housing--I did see an association, not too strong though, but there was an association. In deprived neighbourhoods, kids are more likely to spend more time in front of screens and less likely to be physically active and have healthy body weights.
Lastly, I'd like to report on good access to shops. We may note that deprived neighbourhoods tend to have a lot of fast food outlets, and access to general supermarkets for modestly priced healthy foods--fresh vegetables, fruits, etc.--is troublesome in those neighbourhoods. We see that also reflected in the Canadian situation. If you don't have access to good shops in your neighbourhood, the quality of your diet is likely to be lower, and the children are more likely to be overweight.
In summary, I think there are quite a few opportunities to address prevention of childhood obesity in this country by focusing on prevention activities in their school environment and in their neighbourhoods.
Thank you for your attention.