1. SMART Detroit Health Department

2. SMART Background (Why) Methods / Approaches (What We Did) Results (What We Found) Conclusions ( What We Think About What We Found) Public Health Implications

3. SMART BACKGROUND

4. Background Youth Obesity: A Public Health Crisis The Prevalence of increased obesity and overweight among teens that adversely affect the quality of health and academic performance Today, there are nearly twice as many overweight children and almost three times as many overweight adolescents as there were in 1980. Increase in Type II diabetes among children, estimated eight times the pre-1992 level. Overweight in children and adolescents is generally caused by lack of physical activity, unhealthy eating patterns, or a combination of the two (2001 Surgeon General's Call to Action)

5. Background Youth Obesity: A Public Health Crisis Considered a national epidemic Threefold increase in overweight children and teens in last two decades Children’s health at further risk due to undernourishment. Sedentary lifestyle compounds problem Unhealthy/sedentary lifestyles result in $100 billion in costs and 300,000 deaths annually ( U.S. Surgeon General’s Report, 2002)

6. Background Youth Obesity: A Public Health Crisis Increased prevalence of overweight children in each age group Between 1988-94 and 1999-2000, weight increased by 10% among African American and Mexican American adolescents! 15% (1 in 6) of children 6 years and older are overweight Study (Journal of the American Medical Association)

7. Prevalence of Overweight Children in U.S.--NHANES

8. Background Youth Obesity: A Public Health Crisis One third of Michigan school children are overweight. In fact, they are among the heaviest in the nation. For example, a typical 17-year-old child is 7 pounds heavier than the national average. One of five African-American girls, one of six African-American boys, and one of twelve Caucasian children have significantly elevated resting blood pressures. 2-4% of Michigan school children have "severely high" blood pressure, compared to a national average of 1%. 39% of Michigan children have elevated cholesterol levels compared to a national average of 25%. (Kuntzleman C.T. University of Michigan Dept. of Movement Science)

9. Background Youth Obesity: A Public Health Crisis Only 22% of male and 19% of female teens meet the minimum average daily goal of at least five servings of vegetables and fruits. 1/3 of students do not receive the recommended amount of both moderate and vigorous physical activity during the week. Younger students were more likely to watch three or more hours of television each day on an average school day. (2001 Youth Risk Behavior Survey Results – Detroit High School Survey)

10. SMART METHODS/APPROACHES

11. What We Did Methods & Approaches Brought stakeholders and partners together Committed resources from three district bureaucratic organizations to address a common public health problem adversely impacting teens Enhanced coordination among the local health department and the local school district to leverage resources as a mechanism to achieve health and academic goals of students

12. What We Did Methods & Approaches Complied health data from the school-based health centers, physical education activity data from the school district and geographic recreation service delivery data from the City’s Recreation Department Assisted in the development and submission of a Michigan collaborative grant application Participated in the development of a “Coordinated School Health Program (CSHP) for the Detroit Public School District The SMART initiative will be implemented more effectively with the infrastructure of CSHP

13. What We Did Inventory of Programs, Services and Supports Faith Based Initiatives Parks & Recreations Project FRESH EFNEP Mall-walking Programs MDCH Cardiovascular Health Program Governor’s Council on Physical Fitness and Health Sports MoTown in Motion African American Health Initiative

14. SMART RESULTS

15. What We Found Results: Schools’ Critical Role Key environment identified in U.S. Surgeon General’s report Potential significant influencing power Extraordinary opportunity to guide and shape healthy eating and physical activity habits Key link to parents and community Growing trend: commercial interests target schools and compete with healthy choices, i.e., vending machines

16. What We Found Results Youth Risk Behavior Survey Physical Education in Schools Students Eating Habits (9 - 12th graders) Self Reports of Students Weight School Based Health Center Data Random Sample Student Chart Review Heights & Weights Community / Recreational Data Recommended Time Allotment for Students’ Physical Education

17. What We Found Results: 2001 YRBS Detroit High School Survey Percent of students who attended physical education (PE) class daily GradePercentageNumber 9 th 39.4462 10 th 26.6473 11 th 25.1331 12 th 15.4253

18. What We Found Results: Recreational/Non-School Hours Principal Survey Elementary (%) Middle (%) High (%) Academic/Tutorial796579 Sports588367 Recreational38258 Computer293325 Dance222838 Detroit Public Schools, prepared by Moore & Associates, June 2002

19. What We Found Results: 2001 YRBS Detroit High School Survey Percent of students who watched three or more hours of TV per day on an average school day GradePercentageNumber 9 th 62.6535 10 th 60.3526 11 th 59.3381 12 th 54.0289

20. Coordinated School Health Program Model

21. What We Found Coordinated School Health Program’s Eight Components Health Education Physical Education Health Services Family / Community Involvement Mental Health Services Nutrition Services Healthy School Environment Health Promotion for Staff

22. What We Found Achievement Tied to Good Health Physical Activity Improves self esteem Reduces anxiety and stress in teens Documented Facts Good health and nourishment enhance performance on cognitive testing Improved tests scores are a result of participation in school breakfast program

23. SMART CONCLUSIONS

24. What We Think About What We Found CONCLUSIONS Big picture realized, however, data gaps remain Efficient way to leverage existing resources among local governmental entities to ensure program implementation, program operation and program sustainability Collaboration is effective Collaboration works Partners/stakeholders committed

25. What We Think About What We Found CONCLUSIONS CONT’D Obesity problem brought to the forefront and able to obtain buy-in from Public Health Director, Public Schools CEO and the Mayor The Coordinated School Health Program is a vehicle to address health initiatives, particularly the prevalence of obesity among school age children

26. SMART PUBLIC HEALTH IMPLICATIONS

27. Compelling Message for Public Health Advocacy and resiliency is needed to reverse the obesity epidemic among school age children National and local resources are required Buy-in of the community; students, parents, private sector, clergy, businesses, media and other stakeholders

28. Compelling Message for Public Health HEALTHY YOUTH MAKE BETTER STUDENTS BETTER STUDENTS MAKE HEALTHY COMMUNITIES