Mark Reynolds: More fountains can mean less obesity in Latino teens

December 15, 2012 

Adolescent Latinos 13-17 have the highest obesity rates in California. Obesity in childhood is associated with an increased risk of developing a number of serious health conditions, including type 2 diabetes, heart disease, hypertension and a variety of musculoskeletal disorders, as well as a higher risk of obesity in adulthood. The high prevalence rates among low-income Latino adolescents can be attributed to less access to healthy foods, more sedentary activities, and high consumption of sugar.

Socioeconomically disadvantaged families live in areas with a 20 percent lower prevalence of chain supermarkets that sell fresh produce; in comparison to the 130 percent prevalence of convenience stores within reasonable distance, according to the Food Trust and Policy-Link in their report "The Grocery Gap."

The lower physical activity in many adolescent Latinos can be attributed to the increase in television, video game and computer usage, due to the fact that oftentimes the community they live in is not very safe. The average low-income Latino youth spends about 13 hours a day engaging in these forms of activities; in comparison to a 4.5 hour decrease in white children, according to a report by Salud America, an organization working to reduce obesity among young Latinos.

In addition to unhealthy lifestyles, there is a higher rate of sugar-sweetened beverage consumption by this particular group, a 14-16 percent daily calorie intake. Structural violence to this particular group is occurring because they are economically disadvantaged; these groups are forced to purchase and eat unhealthy foods because they are restricted by transportation, time and money. Economically challenged groups are forced to consume unhealthy foods, live in unsafe neighborhoods that limit physical activity and are exposed to sugar-sweetened beverages more often. These particular lifestyles are persistent cycles throughout generations due to the lack of exposure to health-conscious living. And as a result, adolescents sometime aren't aware of nutritional values and effects of their consumption.

My study group has chosen to address the issue of high consumption rates of sweetened beverages among low-income adolescent Latinos males, ages 13-17 in California. Our solution to prevent or decrease the rates of obesity among these teens is to reduce consumption of sugar-sweetened beverages. Our solution is a two-part community-based intervention to increase water intake. First, by increasing the amount of public drinking fountains, we can increase accessibility of water and promote healthier options. Second, we would propose to decrease the amount of sweetened beverages sold and provided in public schools to decrease the amount of sweetened beverage consumption and furthermore promote healthier options.

Studies have shown that individuals without ready access to drinking water may consume more sweetened beverages. Many rural areas lack ready access to potable drinking water and have a twofold rate of sweetened beverages consumption, according to the Centers for Disease Control and Prevention.

We propose to regulate accessibility of sweetened beverages through taxes. Low-income teenagers consume more soda than the average person; however, they are also more sensitive to price changes than the average person. Imposing a tax would decrease sugary beverage consumption and generate a significant amount of revenue. We propose using the increased revenue to fund our first proposed community intervention, installing more easily accessible drinking fountains in community areas such as schools. It is estimated that a tax on sugar-sweetened beverages in California could generate around $1.8 billion per year, wrote Dr. Kelly D. Brownell et al. in an article in the New England Journal of Medicine.

Based on the community interviews we conducted regarding obesity among low income Latino males through their peers, there were several factors contributing to the high rates of soda consumption. This age group is heavily influenced by media and peer interactions. Therefore, we are proposing an intervention based in the school. By limiting soda access and substituting with water among all adolescents we are creating a culture of healthy behaviors, that are more likely to be reinforced. In addition, we learned that this age group is geared towards easy access and immediate satisfaction. Based on this information we assumed that, by increasing access to clean and safe water, we could increase their water intake. By restricting soda in public schools we decrease their access to sweetened beverages and increase the accessibility of water. We recognize that this intervention would also involve strategic planning of high traffic areas within each school and require funds to build and maintain these drinking fountains, which is why we have proposed the taxation of sweetened beverages.

We have tested our solution to the "seven characteristics of behavioral technology" a notable criterion offered by Stephen B. Fawcett in the Journal of Applied Behavior Analysis. The substitution of water is highly effective and inexpensive. Levying a tax on sugar-sweetened beverages will indirectly lower the risk of obesity and certain cardiac diseases due to an unhealthy diet. Increasing more water fountains is environmentally sustainable as well as replacing soda with water in vending machines. This idea is decentralized as it can in any low income community or school. Our approach is simple and compatible with low-income youth because this would save them time and money. Most adolescents spend a majority of their day in school, thus exposure to healthier options would promote healthier consumption behavior, therefore reducing the risk of adolescent obesity.

Our solutions could be furthered applied in other settings to better promote healthy lifestyle options. For example, the increase of safe drinking fountains could be implemented within all public areas such as parks and community centers. In addition to restriction of sugar-sweetened beverage sales, addressing the previously mentioned issue of high rates of convenience stores offering limited healthy foods would further benefit communities.

Editor's note: Reynolds, an undergraduate at UC Merced, wrote this as part of a course assignment to identify solutions to local public health issues. It is one of several student essays that will be appearing in the Sun-Star.

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