A Tale Of Two Super-Sized Cities

Public health experts at CUNY and its London counterpart jointly offer ways to halt the growing childhood obesity epidemic.

In the fight against childhood obesity, zoning and tax incentives may be new weapons. So might universal free school lunch and even tap water.

These are some of the recommendations made by public health experts from London and New York City. Students and professors from The City University of New York and London Metropolitan University recently collaborated in a study that looked at each city's response to the childhood obesity epidemic, which has more than doubled in the last 25 years.

The final report, a "Tale of Two ObesCities: Comparing Responses to Childhood Obesity in London and New York City," presents a comprehensive municipal strategy for battling obesity and health-related inequalities, which are becoming heavily concentrated among children in low-income neighborhoods.

Unlike other studies on obesity, which have identified the causes and possible solutions that individuals can take to reverse the trend, this one calls on cities to take part in the effort.

"We think cities are particularly well equipped to take on obesity because of their close connection to families and communities," says Nicholas Freudenberg , distinguished professor at Hunter College and director of CUNY's Doctor of Public Health Program, who co-authored the study. The other authors are Kim Libman, a public health and environmental psychology student at CUNY, and Professor Eileen O'Keefe, Director of London Metropolitan University's health programs.

Freudenberg has been working with communities in New York City for nearly 30 years to identify and solve health issues, including substance abuse and diabetes. "We were looking at what is the cumulative impact of all the things that these two cities are doing and what are the strengths and gaps of those responses," he says. One of the bigger problems, they found, is the lack of a coordinated effort in both cities. Neither city, for example, paid attention to improving food in both schools and communities, leaving kids who don't buy school lunch with unhealthy options for eating outside of school. The study identifies zoning as a possible solution, pointing to efforts in Los Angeles, where a zoning change barred the establish-ment of fast-food places near schools. "You need to get the maximum impact from all these different strands," Freudenberg says.

City-wide programs like New York City's FRESH (Food Retail Expansion to Support Health) which offers tax benefits and zoning incentives for grocery store development to increase the availability of healthy foods, are also encouraged.

The study also recommends making tap water readily available to schoolchildren. There are not a lot of incentives to keep water fountains in schools, says Freudenberg. "Just by that relatively easy step, which we can do in both cities, we can reduce the amount of soda kids are drinking, which seems to contribute a lot to obesity." Recommendations such as providing free school lunches for all students will require a much heavier political lift. The two-track system in New York City that provides lunch only to those who financially qualify puts a stigma on school food, says Freudenberg.

"It seems like a welfare service instead of an entitlement," he says. Although it would be expensive, you can really establish better lifetime eating habits by making healthy, tasty and free food available in each school.

"We see this report as a tool for activists and advocates in both cities," he says. London and New York City are exchanging and implementing some of these ideas. Public health advocates in London, he says, are watching New York's efforts at calorie labeling on chain-restaurant food.

Similarly, New York has begun to follow in London's footsteps by expanding opportunities for physical activities by creating parks and bicycle lanes.

Michelle Obama's nationwide campaign to combat obesity, launched in February, is a big step forward, says Freudenberg. "We are hoping that our municipal efforts can strengthen national, local and family efforts," he says. "What we really found is that this is a global problem." He has traveled to the cities of Cape Town, South Africa and Lisbon, Portugal to form a larger research collaborative and hopes to team up with five to eight more cities around the world. Copies of the report are available at http://web.gc.cuny.edu/che/childhood_obesity.pdf <pdf>