HJAR Nov/Dec 2022

HEALTHCARE JOURNAL OF ARKANSAS I  NOV / DEC 2022 37 Joseph W. Thompson, MD, MPH President and Chief Executive Officer Arkansas Center for Health Improvement foods, such as farm-to-school programs, deserve to be funding priorities. Early child- hood education programs should always include targeted information about the im- portance of eating healthy foods and being physically active. Parents should establish healthy eating patterns at home, replacing sugary, high-fat foods with a balanced diet that includes fruits, vegetables, whole grains, lean proteins, and low-fat and fat-free dairy products. At school and at home, healthy foods should be available to kids so that the healthy choice is the easy choice. Policymakers also need to acknowledge and address the food desert crisis in our communities. I am honored to have been chosen by Gov. Asa Hutchinson to help study this issue as a member of the Gover- nor’s Food Desert Working Group. A recent ACHI analysis found that in 1 in 4 census tracts inArkansas, 50% or more of residents had low access to healthy food in 2019, with “low access” defined as living farther than 1 mile from the nearest large grocery store in an urban area or farther than 10 miles from the nearest large grocery store in a ru- ral area. 10 For many Arkansas families, es- pecially those with low incomes, the most easily accessible food sources are fast-food restaurants and gas stations. Children also need regular physical exer- cise, in and outside of school. Policymakers should ensure that communities provide en- vironments where young people can safely engage in physical activity. Parents should encourage their kids to reduce screen time and spendmore time being active. And while they’re at it, parents should lead by example — it wasn’t only children who put on some pandemic pounds. n REFERENCES 1 Vahratian, A.; Blumberg, S.J.; Terlizzi, E.P.; Schiller, J.S. “Symptoms of Anxiety or Depressive Disorder and Use of Mental Health Care Among Adults Dur- ingtheCOVID-19Pandemic—UnitedStates,August 2020–February 2021.” Centers for Disease Control by the time this column is published. Pre- liminary analyses show that the rates of stu- dents with BMI measurements classified as obese remained above pre-pandemic levels for all measured grades, suggesting that the pandemic’s impact on childhood obesity in Arkansas may linger for some time. Our analysis of Arkansas BMI data for the 2020-2021 school year is consistent with national findings. A study published by the Centers for Disease Control and Prevention reviewed medical records for a cohort of 432,302 people ages 2–19 and found that the percentage of people classified as obese in- creased from 19.3% inAugust 2019 to 22.4% a year later. 7 The pandemic disrupted all our lives. To limit the spread of COVID-19, schools made temporary shifts to remote learning, reduc- ing students’ access to organized physical activity and healthy school meals. Nation- al test scores show that students have lost ground academically during the pandemic, 8 and we are beginning to see that ground has also been lost in the fight against childhood obesity. Routines were upended and stress factors increased, likely contributing to overeating and consumption of unhealthy foods. Isolation led to more screen time and less social interaction, including organized sports and recreational activities. This is a fight we cannot afford to lose. Overweight or obese children are more likely to be overweight or obese as adults, which can lead to diabetes, high blood pres- sure, heart disease, and many other health problems that can shorten life and reduce quality of life. 9 Obesity-related health prob- lems are estimated to cost the United States’ health care system $190 billion each year. The rise in childhood obesity should be a call to action for policymakers and parents. School meal programs, including those that provide meals outside of lunch, and pro- grams that provide schools with healthier and Prevention, Morbidity and Mortality Weekly Report 70, no. 13 (April 2, 2021): 490-494. https:// www.cdc.gov/mmwr/volumes/70/wr/mm7013e2. htm?s_cid=mm7013e2_e&ACSTrackingID=USC DC_921-DM53115&ACSTrackingLabel=MMWR%20 Early%20Release%20-%20Vol.%2070%2C%20 March%2026%2C%202021&deliveryName= USCDC_921-DM53115 2 Sidney, S.S.; Lee, C.; Liu, J; et al. “Age-Adjusted Mortality Rates and Risk-Associated Contributions to Change in Heart Disease and Stroke Mortality, 2011–2019 and 2019–2020.” JAMA Network Open 5, no. 3 (March 23, 2022): e223872. doi:10.1001/ jamanetworkopen.2022.3872 3 Tanz, L.J.; Dinwiddie, A.T.; Snodgrass, S. “A quali- tative assessment of circumstances surrounding drug overdose deaths during early stages of the COVID-19 pandemic.” Centers for Disease Control and Prevention, SUDORS Data Brief, no. 2 (August 2022). https://www.cdc.gov/drugoverdose/data- briefs/sudors-2.html#:~:text=There%20were%20 91%2C799%20drug%20overdose,began%20accel- erating%20in%20March%202020.&text=The%20 COVID%2D19%20pandemic%20was,stay%2 Dat%2Dhome%20orders. 4 American Psychological Association. “One year on: Unhealthy weight gains, increased drinking reported by Americans coping with pandemic stress.” Press Release (March 11, 2021). https:// www.apa.org/news/press/releases/2021/03/one- year-pandemic-stress 5 Arkansas Act 1220 of 2003. 84th General Assem- bly. https://www.arkleg.state.ar.us/Acts/FTPDocu ment?path=%2FACTS%2F2003%2FPublic%2F&fi le=1220.pdf&ddBienniumSession=2003%2FR 6 Arkansas Center for Health Improvement. “Assessment of Childhood and Adolescent Obe- sity in Arkansas: Year 18 (Fall 2020–Spring 2021).” (January 2022). https://bmi.achi.net/BMICon- tent/Documents/220222A_Year_18_(2020-21)_ Arkansas_BMI_Report_FINAL.pdf 7 Lange, S.J.; Kompaniyets, L; Freedman, D.S; et al. “Longitudinal Trends in Body Mass Index Be- fore and During the COVID-19 Pandemic Among Persons Aged 2–19 Years — United States, 2018– 2020.” Centers for Disease Control and Preven- tion, Morbidity and Mortality Weekly Report 70, 37 (Sept. 17, 2021): 1278-1283. https://www.cdc . gov/mmwr/volumes/70/wr/mm7037a3.htm?s_ cid=mm7037a3_w 8 TheNation’sReportCard.“Readingandmathemat- ics scores decline during COVID-19 pandemic.” Ac- cessedOct.1,2022 .https://www.nationsreportcard . gov/highlights/ltt/2022/ 9 Goudie, A.; Lewis, K.; Thompson, J. “Arkansas Child Obesity Growth Patterns and Evaluations of Pre- school Interventions on Obesity in Kindergarten.” Arkansas Center for Health Improvement (2021). https://achi.net/wp-content/uploads/2021/08/ FINAL-Medicaid-Match-Scientific-Document.pdf 10 Arkansas Center for Health Improve- ment. “Food Deserts in Arkansas.” Accessed Oct. 1, 2022. https://achi.net/wp-content/ uploads/2022/09/220928F_Food-Deserts-Fact- Sheet-Update.pdf