Child and Family Health Services:

Childhood Obesity

From 1970 to 2002 the prevalence of childhood overweight increased by 300%. Today, nearly 20% of children are overweight. For young children, between the ages of 2-5, the rate of overweight is 10%. Thirty percent of preschool age and fifty percent of school age children will grow up to be overweight. The risk of a child becoming an obese adult is three times greater if one parent is obese and thirteen times greater if both parents are obese. These numbers are, and should be, very sobering. Childhood overweight and obesity have reached epidemic proportions in this country.

According to the Center for Disease Control and Prevention in 2002, 16% of children between the ages of 6-19 were overweight, up from 11% in 1994.  By the year 2010, the number of overweight children is expected to triple, making nearly half of all children of that same age group overweight.

Overweight children tend to grow into overweight adults. They also are more likely to have high blood pressure, cholesterol and insulin levels. Due to this, the children of today are predicted to have a shorter average life span than their parents for the first time in history. Obesity will soon surpass smoking as the leading preventable cause of death in the United States according to the Surgeon Generals Office.

In a recent report released by the Ohio Department of Health, Division of Family and Community Health Services, it was found that 20.6 percent, or 1 in 5, of Ohio’s third grade public school students were overweight. In addition to this, another 17 percent, 1 in 6, were at risk for overweight. The study sampled students from each county throughout Ohio. 387 schools were selected, contributing 14,543 children to the study. These students were weighed and measured by trained health professionals, with the results being 14,451 valid BMI estimates.

BMI, or Body Mass Index, is one method of assessing body composition. It provides a standard way to estimate body composition and is relatively easy to use. It involves taking an accurate weight and height measurement and running those two numbers through a mathematical formula to obtain an end product, i.e. 22. That end product allows the subject to be placed into a category. The categories are: underweight, normal, at risk for overweight and overweight. It is important to note that the CDC does not recognize any scientific standards for obesity in children, thus there is no obese category.

In children, due to the differing rates of growth from year to year and between the sexes, BMI category placement is based on age and gender. For example, an eight year old boy with a BMI of 20 would be considered overweight while a nine year old boy with the same BMI would be considered at risk for overweight. Another example, an eight year old boy with a BMI of 20 would be considered overweight, while an eight year old girl with the same BMI would be considered at risk for overweight.

While using BMI is an acceptable method of measuring body composition, it isn’t without faults. According to BMI standards, a six foot three inch office worker who weighs 210 pounds has a BMI of 26.2 and is considered overweight, while a six foot three inch professional football player who plays linebacker weighs 260 pounds has a BMI of 32.5 and is considered obese. Thus it is apparent that BMI is not a measure of body fat percentage, but an estimate of total body composition. It does not and cannot take into account muscle weight versus fat weight.

According to the ODH report, 33.2 percent, 1 in 3, of Henry County third graders were either overweight or at risk for overweight while 16.4 percent were strictly overweight.

To help combat this increasing epidemic the Henry County Health Department has developed a weight loss/overweight prevention program called Trim Trax. Trim Trax is a 10 week program designed to help children and their families not only lose weight but also enact an overall lifestyle change so that any weight loss can be made more permanent. Trim Trax has been designed for children between the ages of 8-12 who are either at risk for overweight or overweight. 

Lead Poisoning

What is the problem?  Lead poisoning is the NUMBER 1 preventable environmental health threat for children.  Every year in Ohio, the number of children who are lead poisoned would fill 15 elementary schools to capacity.  Approximately 310,000 children in the United States aged 1- 5 years have elevated blood lead levels as defined by the Centers of Disease Control.  The goal is to eliminate lead poisoning by 2010.  (See Ohio Department of Health website for Ohio’s Plan to Eliminate Lead Poisoning by 2010 http://www.odh.ohio.gov select “About ODH” then select “ODH programs” then select “Lead Poisoning-Children” then “submit” then select “Ohio’s Plan to Eliminate Childhood Lead Poisoning by 2010”)

Lead poisoning can affect nearly every system in the body.  Because lead poisoning often occurs with no obvious symptoms, it frequently goes unrecognized.  Lead poisoning can cause learning disabilities, behavioral problems, and, at very high levels, seizures, coma, and even death.

How are children exposed to lead?  The major source of lead exposure among United States’ children is lead-based paint and lead-contaminated dust found in deteriorating buildings.  Other sources of lead poisoning are related to:  hobbies (stain-glass making, fishing sinkers, target shooting, home remodeling, pottery, painting), work (welding, automobile batteries, construction workers), and home remedies (azarcon and greta, pay-loo-ah).

Who is at risk?  Children under the age of 6 years old are at risk because they are growing rapidly and because they tend to put their hands and other objects into their mouths.

Risk Assessment Questionnaire:  Does your child…

Live in or regularly visit a house built before 1950? 
   (This includes a day care center, preschool, or home of a baby sitter or relative.)

Live in or visit a house that has peeling, chipping, dusting or chalking paint?

Live in or visit a house built before 1978 with recent, ongoing, or planned renovation/remodeling?

Have a sibling or playmate who has or did have lead poisoning?

Frequently come in contact with an adult who has a hobby or works with lead?

A blood lead test should be done if the answer to ANY question is “yes” or “unknown”.

If you live in a high risk zip code, your child should be tested for lead.  High risk zip codes in Henry County: 43502 /  43511  /  43516  /  43567

For a list of other high risk zip codes in Ohio, visit the Ohio Department of Health’s website at http://www.odh.ohio.gov select “About ODH” then select “ODH programs” then select “Lead Poisoning- Children” then “submit” then select “High Risk Zip Codes”

How is a child tested for lead poisoning?  A child’s blood is tested to determine the amount of lead in the blood. 

What is considered a safe level of lead in my child’s blood?  Lead is not a natural part of the environment and has no nutritional value.  There is no safe level of lead in a child’s blood.  The Centers of Disease Control and Prevention considers all child blood lead levels above 10 micrograms per deciliter to be elevated and a concern.  Lead levels as low as 5 micrograms per deciliter have been shown to have negative effects on cognitive development.

Can lead poisoning be prevented?  Lead poisoning is entirely preventable.  The key is stopping children from coming into contact with lead and treating children who have been poisoned by lead. Lead hazards in a child’s environment must be removed.  Children who are at risk need to be tested and if necessary, treated.

How can the Henry County Health Department assist you with lead poisoning prevention?
The Henry County Health Department provides:
-  Lead Case Management Services for those children with elevated lead levels.
-  Education materials about lead poisoning prevention.
-  Pediatric Lead Assessment Network Educational Training (PLANET) for healthcare providers.

For Lead Poisoning Prevention Lists:  Licensed Lead Assessors, Licensed Lead Abatement Contractors, and Licensed Lead Inspectors visit the Ohio Department of Health’s website at http://www.odh.ohio.gov select “About ODH” then select “ODH programs” then select “Lead Poisoning Prevention” then “submit” then select “Lists”. This information can also be obtained calling 1-877-NOT-LEAD.

Injury Prevention

The Injury Prevention Program at the Henry County Health Department is funded by the Preventive Health and Health services Block Grant from the Centers for Disease Control and Prevention (CDC) and administered by the Ohio Department of Health, Bureau of Health Promotion & Risk Reduction, Injury Prevention Program. Its contents are solely the responsibility of the Authors and do not necessarily represent the official views of the CDC. We here at the Henry County Health Department are proud to offer a variety of programs designed to prevent unintentional injuries through this four year grant. Unintentional injuries are the leading cause of death in the United States for people between the ages of 1 and 45. They are also the fifth leading cause of death overall.

The Henry County Health Department’s injury prevention efforts are directed by the Henry County Safe Communities Coalition (HCSCC) which includes the Henry County Health Department, the Henry County Hospital, the Henry County Sheriff’s office, the Henry County EMS, the Henry County OSU Extension office, the Napoleon Police Department and the Napoleon Fire Department as members. These efforts include car seat safety checks and classes, safety days for young children, farm safety for school-age children and teens, and a fall prevention program for senior citizens.

4 out of every 5 children in car seats are riding in seats that are being used incorrectly. There are various reasons a car seat may be incorrectly used: the car seat is the wrong seat for a child’s age, weight or height; the seat is not installed tightly enough; the seat is facing the wrong direction; the seat is old or damaged. That doesn’t include those who are riding without a car seat. In Henry County, only 92% of parents placed their infants, toddlers and children up to four years old in a child restraint every time they traveled in a car. In Ohio, the child passenger laws stat that children under the age of 1 year and 20 pounds MUST ride in an appropriate rear facing child restraint and that children under 4 years old and 40 pounds MUST be restrained in some type of car seat or booster. To help insure that our children are riding as safely as possible, the Henry County Health Department and the Henry County Safe Communities Coalition offer Car Seat Classes and Check-ups. Car Seat Classes are held once a month, and take approximately 1 hour to complete.  A Trained Child Passenger Technician will show a video and then demonstrate how to properly install a car seat. Registrations are required for car seat classes as space is limited. Car Seat Check-ups are free to the public and can be scheduled or taken as a walk-in, though walk-ins are not guaranteed a check-up due to technician availability.

Child Safety issues are addressed by the HCSCC in conjunction with the Napoleon Police Department through Safety City. Safety City is a week long program that is held twice during the summer for 4-7 year olds; one week is morning only and the second is evening only. Each day lasts approximately 2 hours during which children learn about a wide variety of subjects including bike safety, water safety, pedestrian safety, proper usage of 911 and fire safety. Another way child safety is addressed is by means of a half-day Safe Communities Camp which is also held for younger children, ages 3-4. During this half-day camp, the children are taught many of the same topics as at Safety City. Registration is required for both Safety City and Safe Communities Camp.

Every year across the U.S and the state of Ohio teens and younger children are injured and killed in preventable agriculture related accidents. More than 24,000 children were seriously injured last year alone, while over 100 were killed. It’s not just those that live on farms that are affected. In fact, children who do not live on farms but visit them are more likely to be seriously injured. The reason is simple enough; they have less experience and exposure to the hazards of life on a farm. Most children who live on farms learn at an early age that agricultural equipment such as tractors and combines are not toys. Unfortunately not all those who live on farms get the chance to learn these lessons before a tragedy occurs. In hopes of preventing accidents such as those that occur on a farm setting from happening, the members of the Henry County Safe Communities Coalition offer a program for teens and a Farm Safety Day for school age children. In Ohio it is against the law for youth under the age of 16 to operate machinery on another farm other than their own family farm, unless they receive certification through training. In the past, the HCSCC has offered a program that has allowed teens to receive the proper training and certification. The HCSCC also holds Farm Safety days to help teach younger children about the dangers on a farm including tractors and livestock.

One third of those over the age of 65 will suffer a fall this year, according to statistics, and one half of those that do fall will experience more than a single fall. We call falls accidents, sometimes horrible, tragic accidents. We should, however, call most of them Preventable. According to statistics, again, most falls that occur in the senior population are completely preventable and could be avoided by taking just a few steps. The reasons people fall are widespread and vary from person to person. In general, though, there are two main reasons that people fall; something near them makes them fall, or something about the person themselves makes them fall. These are called External and Internal Risk Factors, respectively. Rarely is a fall caused by any one single risk factor, though it does happen. Most of the time falls occur because there are more than one factor involved, such as poor eyesight and loose carpeting on stairways. The more risk factors involved in any one situation, the higher the chance of a fall.

Since 75% of falls occur in the home, take a few minutes to look around each room in the house and try to identify any and all possible external risk factors that exist. Have someone help you do this, after all, two heads are better than one. Make certain there is adequate lighting in each room and stairway and that all rugs and carpeting are secured to the floor. Clear at least one pathway of debris in each room. These are the easy fixes.

A fall prevention program is offered to area nursing homes and to the Senior Center. Fall prevention among the elderly is an important area of injury prevention. A half an hour presentation is followed by distribution of safety items such as grab bars, reachers, and walker/cane tips.

Youth Tobacco Prevention

Based on information in the 2005 Henry County, Ohio Health Assessment Program 16% of Henry County youth, ages 12-18 are current smokers. A current smoker was anyone who had smoked in the past 30 days and 85% of the current youth smokers were smoking everyday. Based on this information the Henry County Health Department currently offers two Youth Tobacco Prevention Programs that target youth early in the elementary and middle school level.

Life Skills Program

The Life Skills Program is a substance abuse program developed by Dr. Gilbert J Botvin. The curriculum is broken up into three different curriculums; elementary school curriculum, middle school curriculum, and a high school curriculum. Each curriculum is designed to reinforce the ideas of the previous curriculum.

Currently, in Henry County the elementary school curriculum is being implemented within third grade classes. The elementary curriculum covers eight different topics; self-esteem, decision-making, smoking information, advertising, dealing with stress, communication skills, social skills, and assertiveness. These eight topics help to give youth the necessary skills and confidence that are vital for them to resist peer pressure and remain substance free. Students complete different activities that help to reinforce the main objectives of the program. 

The following 3rd and 4th grades participate or have participatied in the Life Skills Program:
St. Augustine Catholic School, CD Brillhart Elementary School, West Elementary School, Central Elementary School, Holgate Elementary School, Liberty Center Elementary School

STAMP

The Stay Tobacco-free Athlete Mentor Program (STAMP) is a youth tobacco prevention program of the American Cancer Society. Tobacco-free students are trained to present four 45-minute curriculum-based classroom sessions to students in 5, 6, and/or 7^th grades in their district.  Each session is activity based and incorporates role-play, problem-solving, games, and discussion. The mentors work in small groups and present to the same group of students for all four sessions.  This allows the younger students and mentors to begin a relationship that supports tobacco-free choices. 

Mentors are selected based on their tobacco-free choices, their performance and leadership skills as a high school student, their discipline as a student-athlete, and their dedication to delivering a tobacco-free message.  The students must attend four-hour training that includes instruction on classroom guidelines and program sessions.  STAMP educates the students on the danger of secondhand smoke, tobacco products, and the physiological and social consequences of tobacco use.

This program is funded by the Cardiovascular Health Grant.