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Violence a Risk Factor for Obesity

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by Michael Hopps
Obesity is going in the wrong direction. Since the World Health Organization began keeping records on global obesity in 1980, not a single country has gotten thinner.1

The habits that augur a lifetime of obesity—and the maladies that can follow that condition, such as heart disease, type-2 diabetes, osteoarthritis, sleep apnea, and several types of cancer2—begin in childhood. In 1980, only 7 percent of American children ages 6 to 11 and 5 percent of U.S. adolescents (12- to 19-year-olds) were obese.3 By 2012 those numbers had ballooned to 18 percent of 6- to 11-year-olds and 21 percent of adolescents. More than one of every three American children are overweight4 or obese,5 according to the Centers for Disease Control and Prevention (CDC).6, 7

The United States, the world's richest nation, is among its most overweight.8 But those Americans most beset by obesity are not the nation's wealthiest. Rather they are the poor—particularly the inner city poor—who lack access to healthy food options and also to safe walkable areas.

Many low-income communities in America do not have sufficient opportunities to purchase healthy, affordable food.9 They are less likely to have grocery stores with vast produce sections, less likely to have park and playground facilities where children can run around and burn off their caloric intake. Interpersonal violence—higher in low-incomes than elsewhere—appears to be a risk factor for obesity.10 Because the streets and playgrounds in such communities are often violent places, many parents who live in low-income neighborhoods prefer to keep their children indoors, watching television instead of exercising.11

Too Scared to Run: Many factors contribute to obesity in low-income neighborhoods. One of those less publicized is fear—of assault while jogging alone.

Simply put, children who are born, grow up, live, work, and grow old in low-income, inner city environments are more likely to be obese than children from affluent backgrounds.

School Is Where Habits Can Change
As explained by the CDC, excess weight and obesity result from caloric imbalance—that is, not enough calories are expended to balance the amount consumed.12 Though various genetic, behavioral, and environmental circumstances can contribute to overweight and obesity, the two key protective factors are healthy diet and proper exercise. And schools—even those in low-income, inner city communities that lack open real estate—are the best place to instill good diets and exercise.

"Ninety-five percent of American children are enrolled in schools for 13 years13 of their lives for at least 6 hours a day," says Allison Nihiser, a health scientist with CDC, who works on obesity prevention in the school setting. "This is where we can help students learn about and practice healthy behaviors."

Dr. Sarah Lee, team leader in the School Health Branch of CDC's National Center for Chronic Disease Prevention and Health Promotion, notes the following strategies used by physical education teachers lacking space or facilities:
  • In classrooms, P.E. teachers often put tennis balls or other similar material on desk legs to easily slide desks out of the way and conduct physical education in the classrooms themselves.
  • They often set up joint-use agreements with community organizations and take the children to other nonschool facilities for exercise.
  • For outdoor physical education, some gym teachers will use blacktop surfaces—empty lots or nearby spaces that might have courts, small fields, and the like—when they are close enough to the school.
Nihiser also emphasizes before- and after-school opportunities. "Sometimes kids are dropped off really early," she stresses. Seeking opportunities for physical activity, the CDC will inquire, "Is there equipment they can share?" Noting that not every child is an Olympic athlete, Nihiser says that a growing number of U.S. public schools "are offering noncompetitive before- and after-school activities—walking clubs, running clubs, dancing clubs."

The federal government requires the nation's school districts participating in the school meals program to develop wellness policies that include mandates for physical activity and nutrition education, promotion, and standards. Nihiser notes that districts may also leverage the policies to include language on violence prevention.

Chicago, Philadelphia Cities With Model Policies
Nihiser cites Forum city Chicago, Ill., as one of the public school systems with a comprehensive wellness policy.14 The Chicago Public Schools Policy Manual, recognizing "the relationship… between academic achievement and student health and wellness," sanctions a sequential K–12 nutrition education curriculum and physical education that engages all students in moderate to vigorous activity during two thirds of all gym class time.

In 2010, Forum city Philadelphia, Pa., launched Get Healthy Philly, an initiative combining the resources of local government, community-based organizations, academia, and the private sector to address obesity reduction and smoking cessation.15

"We've tried to incorporate brief physical activity into every school day," says Dr. Giridhar Mallya, director of policy and planning for the Philadelphia Department of Public Health, which created the initiative. "Not every kid may have gym class, but every kid can move. So the schools have implemented movement breaks."

He explains: "As the kids are coming into the classroom, teachers are leading kids in simple but fun exercises such as jumping jacks or running in place. The teachers also use this as a tool to get the kids focused."

Though the nature of these movement breaks varies from school to school, every public school in Philadelphia has a wellness council, made up of teachers, staff, students, and parents who ensure that wellness policies are put into place. Each school has a designated School Wellness Champion. Though the policies, too, vary, some standards are that soda isn't sold in school, that candy bars aren't used for fundraisers, and that there are guidelines for youths on nightly television and computer time.

As part of Get Healthy Philly, the city has expanded the infrastructure for walking and biking throughout the city and expanded after-school activities in recreation centers—"a safe haven for kids," notes Mallya.

With some of these practices already in place, the Philadelphia School District saw about a 5 percent reduction in childhood obesity for the 4-year period of 2006–07 through 2009–10.16

1Margaret Chan. 2012. "Obesity: Bad Trouble Is on Its Way." Lecture delivered to Women's International Forum. New York, N.Y., Sept. 21.

2Cathy Newman. N.d. "Why Are We So Fat?" Washington, D.C.: National Geographic Society.

3The CDC calculates overweight and obesity using a formula called body mass index. Loosely, obesity is defined as weighing at least 20 percent more than one's healthy weight for one's height. Source: CDC. N.d. "Overweight and Obesity."

4Obesity is defined as having excess body fat. Source: Nancy F. Krebs, John H. Himes, Dawn Jacobson, Theresa A. Nicklas, Patricia Guilday, and Dennis Styne. 2007. "Assessment of Child and Adolescent Overweight and Obesity." Pediatrics 120:S193–228.

5Overweight is defined as having excess body weight for a particular height from fat, muscle, bone, water, or a combination of these factors. Source: National Institutes of Health, National Heart, Lung, and Blood Institute. 2010. Disease and Conditions Index: What Are Overweight and Obesity? Bethesda, Md.

6CDC. N.d. "Childhood Obesity Facts."

7Cynthia L. Ogden, Margaret D. Carroll, Brian K. Kit, and Katherine M. Flegal. 2014. "Prevalence of Childhood and Adult Obesity in the United States, 2011–12." Journal of the American Medical Association 311(8):806–14.

8With 33.0 percent of its adult citizens classified as "obese," the United States ranks no. 18 among the world's 191 countries in obesity rate. Source: Central Intelligence Agency. 2014. The World Factbook. Langley, Va.

9Sarah Treuhaft and Allison Karpyn. N.d. The Grocery Gap: Who Has Access to Healthy Food and Why It Matters. Oakland, Calif.: Policy Link and The Food Trust.

10A.J. Midei and K.A. Matthews. 2011. "Interpersonal Violence in Childhood as a Risk Factor for Obesity: a Systematic Review of the Literature and Proposed Pathways." Obesity Reviews 12(5):e159–72.

11Xavier Bonnefoy. 2007. "Inadequate Housing and Health: An Overview." International Journal of Environment and Pollution 30(3–4):411–29.

12CDC. N.d. "Childhood Obesity Facts."

13National Center for Education Statistics. 2013. NCES Digest of Education Statistics. Washington, D.C.: U.S. Department of Education, Institute of Education Sciences.

14Chicago Public Schools 2012. Chicago Public Schools Policy Manual. Chicago, Ill.

15Philadelphia Department of Public Health. 2013. Get Healthy Philly Annual Report. Philadelphia, Pa.

16Jessica M. Robbins, Giridhar Mallya, Marcia Polansky, and Donald F. Schwarz. Prevalence, Disparities, and Trends in Obesity and Severe Obesity Among Students in the Philadelphia, Pa., School District, 2006–1010. Preventing Chronic Disease 9:120118.
Funding Opportunities

Education Department Awards $14.7M+ in School Counseling Grants to Districts in 20 States
The U.S. Department of Education has awarded more than $14.7 million to 41 school districts in 20 U.S. states to establish or expand counseling programs in elementary and secondary schools. "These grants will allow school districts to hire more professionals and provide additional services to those students who are struggling with mental health and emotional issues, and their families," said U.S. Secretary of Education Arne Duncan in a prepared statement, as the awards were announced.

The awards will aid schools in hiring qualified mental health professionals, with the goal of expanding the range, availability, quantity, and quality of counseling services. Research indicates that having adequate counseling services can help reduce the number of disciplinary referrals in schools, improve student attendance and academic performance, and enhance students' social skills. Parents of participating students will have input in the design and implementation of counseling services supported by these grants.

As reported by the Education Department's Prevention News Digest, the states (with the number of school districts in each and the amount of funds provided in parentheses) are as follows: Alaska (2, $470,257), Arizona (1, $380,313), California (9, $3,417,968), Colorado (1, $363,112), Connecticut (1, $396,673), Idaho (1, $270,968), Indiana (1, $396,436), Kansas (1, $361,057), Kentucky (4, $1,463,682), Massachusetts (1, $366,605), Nebraska (1, $397,016), New Hampshire (1, $395,469), New York (5, $1,910,716), North Carolina (2, $727,263), Oklahoma (4, $1,257,244), Oregon (1, $326,291), Pennsylvania (1, $396,000), South Carolina (1, $306,409), Texas (2, $772,416), Wisconsin (1, $394,169).

For further information on the Elementary and Secondary School Counseling grants programs, go here.

Training Opportunities

G.R.E.A.T. Trainings for Officers and for Families on Tap
Gang Resistance Education and Training (G.R.E.A.T.) Officer Training is a classroom certification course teaching the fundamental aspects of G.R.E.A.T.—a school-based life-skills competency program taught by uniformed police officers. G.R.E.A.T.'s primary goal is violence prevention, especially through resistance to gang activity. This sequential course, hosted by the Institute for Intergovernmental Research, presents an effective course of interaction with communities and schools and demonstrates how to implement elementary and middle school curricula for the school year and summer. Upcoming trainings are Oct. 6–15 in La Crosse, Wis.; Nov. 3–12 in New Orleans, La.; and Nov. 10–19 in Newark, N.J. Register here for a course near you.

Gang Resistance Education and Training (G.R.E.A.T.) Families Training is designed to show active G.R.E.A.T. instructors how to effectively and consistently teach the G.R.E.A.T. families curriculum. The 2-day classroom course models each curriculum session, provides strategies for interacting with families, and gives an overview of other resources for families. Register here to attend Nov. 20–21 at Newark Police Training Academy in Newark, N.J.

Webinar Offered on Alcohol and Evidentiary Issues
Research has shown that alcohol use—especially excess use—is a risk factor for perpetrating youth violence. Depending on state laws and the offense, underage drinking offenses may be referred to numerous courts, including juvenile court, traffic court, criminal court, or family court. "A Judicial Conversation on Emerging Evidentiary Issues and Alcohol," a Webinar on Nov. 13, beginning at 3 p.m. EST, discusses how courts should regard this topic. It covers electronic identification scanners, portable breath test devices, and passive alcohol sensing devices and whether they are admissible in court, while also exploring evidentiary issues that courts are finding on underage drinking. Register here.

Registration Open for National Mentoring Summit
The National Mentoring Summit 2015 will be hosted by the National Mentoring Partnership Jan. 28–30, 2015 in Washington, D.C. Summit workshop sessions will explore how mentoring can help youths achieve positive outcomes. This event is intended for mentoring practitioners, researchers, corporate partners, government and civic leaders, youth-serving organizations, and MENTOR's network of affiliate Mentoring Partnerships. Early registration is now open, with early bird rates until Oct. 3. Register here.

by Marla Fogelman and
Alison Lake Benadada

In Detroit, Mich., a city that has suffered severe economic decline, bankruptcy, crime, and urban decay, some high schools are now requiring students to address these problems and take steps to improve their community before they can graduate.

During the 2013–14 school year, seniors at Edwin C. Denby High School in northeast Detroit were the school's first students to embark on a series of efforts to transform their neighborhood, which faces such challenges as crime, poverty, and abandoned buildings. This program, in partnership with the Detroit Future City (DFC) organization,1 requires students to design capstone projects and work with school staff, community members, and DFC representatives to put them into action.

Denby High School's newest graduation policy has quickly evolved into a successful model for both academic achievement and civic engagement. And the Denby–DFC partnership has proven to be a major force for aiding neighborhood revitalization.

Denby seniors cleaned up 16 blocks around the school, boarded up 11 vacant homes, mowed lawns, created tire gardens, put in street lights, and began to clean a six-acre playing field next to the school to change it into a community space. With assistance from DFC members, the students petitioned the city to demolish the most blighted apartment building in the neighborhood, and they are now transforming the land into a botanical laboratory. These are just a few ways that Denby students have worked to improve their neighborhood, and further plans are in the works for this year's senior class.

Integrating Youth Community Activism With School
The DFC Strategic Framework Plan calls for integrating the "engagement of youth who hold a stake in the present and future of Detroit," which dovetails with Denby's requirements for students' senior capstone portfolio projects.

Through the DFC–Denby partnership, the city's renewal has been directly tied to the Denby high school curriculum. DFC works with the school to integrate its framework with major subjects in the school curriculum. One goal of the capstone experience for last year's Denby seniors was to demonstrate mastery of high-level skills across four core competencies—inquiry, textual analysis, research, and creative expression.

Denby HS
A Transformative Experience: Senior Class Historian Kaija Sherrell (center) addresses the crowd at the 'Pathway to Transformation' ceremony in May 2014.

The Glossary of Education Reform calls a capstone project "a multifaceted assignment that serves as a culminating academic and intellectual experience for students, typically during their final year of high school or middle school, or at the end of an academic program or learning-pathway experience."2

Capstone experiences culminate in a thesis that students defend before graduation, providing "a well-defined opportunity for students to refine high-level skills and to synthesize, integrate, and apply the knowledge gained throughout their training."3

Denby's capstone model is unique in its adoption of the DFC Strategic Framework Plan as the basis for students' choice of topics for their long-term assignments. The model integrates students' proposed solutions for issues, such as community safety and stability, within the primary subject areas—math, science, English, and social studies—of Denby's core curriculum.

For example, in English classes, students were required to read the DFC Strategic Framework Plan and study the sociological and historical underpinnings of urban planning in Detroit.

The Denby–DFC Senior Portfolio Project originated with staff conversations about how to "actively engage students in their own learning," explained Denby High School resource and curriculum specialist Jay Haffner.

Although staff supported aligning DFC's goals with the school's capstone projects, Haffner said that the students were initially very resistant to the idea of being required to complete these complex projects before they could graduate, Haffner said. "Torches and pitchforks were gathered," he remembered with humor. "There was griping and moaning."

Yet students' attitudes changed quickly once they began talking to then–social studies teacher Jonathan Hui. They realized that their projects could both serve their needs and help their community.

Student Projects Contribute to a Safer Detroit
"We wanted to equip our students with making a difference," Hui said, and began to ask the students what community issues concerned them most. Safety, not surprisingly, was number one.

While Haffner assumed the responsibility for implementing the curriculum component, Hui reached out to the larger community and brokered other partnerships, in addition to the DFC, with more than 20 other organizations.

Hui said that, once the students realized adults in their community were listening to them, they took on the mission of neighborhood revitalization and "ran with it." The group of seniors highlighted community problems and solutions, by researching blight, poverty, hunger, unemployment, education, and other topics.

Through the DFC partnership, the students also received supplemental materials, gained community mentors, and received continuing feedback on their capstone efforts.

According to capstone project requirements, students must develop a list of "actionable ideas" and present and defend their proposed solutions before a panel of judges. Hui said that as students generated ideas for community revitalization, while engaging both their neighbors and the DFC team in their efforts, they were able to create "an actionable, sustainable model to mitigate youth violence."

This approach of community outreach is supported by research that shows "social cohesion among neighbors, in combination with their willingness to intervene on behalf of the common good, is also associated with reduced violence in disadvantaged neighborhoods."4

Graduation Rate Soars to 93 Percent
In May, Denby seniors defended their capstone projects for 50 minutes before a panel of judges. That same month, they celebrated both their capstone and community accomplishments during a unique ceremony. Each senior laid a brick on the school lawn, forming a walkway called the "Pathway to Transformation." The path is to grow with each graduating class.

"It changed my life," said Kaija Sherrell, former senior class historian and psychology major at Wayne State University in Detroit, when speaking about the partnership project. "It gave me hope to know that Detroit has people behind it to bring out its full potential."

There is no doubt that the initiative has motivated more students to work toward achieving their own potential. Denby now has a 93 percent graduation rate, according to Haffner, which is a significant increase from a rate of roughly 62 percent in 2012.5

Haffner noted with pride that student perceptions of the project have changed. Students now approach him to ask when they can start on their projects.

"Eleventh graders are talking about their portfolios now," Haffner said. "They are saying, 'I don't just want to pass. I want to pass with distinction.'"

1Detroit Future City. 2014. Denby High School Curriculum.

2Great Schools Partnership. 2014. Glossary of Education Reform.

3Georgeta D. Vaidean, Sandeep S. Vansal, Ronnie J. Moore, and Stuart Feldman. 2013. "Student Scientific Inquiry in the Core Curriculum." American Journal of Pharmaceutical Education. 77(8):176.

4A.K. McGowan, A.E. Crosby, M. La Hasbrouck, M.L. Boulton, S. Kanluen, and N.A. Maseru. 2006. "Child and Adolescent Violent Deaths: An Epidemiologic Investigation." Journal of the National Medical Association 98(2):158–64.

5Detroit Public Schools. 2012. Denby High School Annual Education Report. Detroit, Mich.
Reports National Academies Offer OJJDP Recommendations for Research-Based Role in Juvenile Justice Reform NAS Cover
The juvenile justice system can be most effectively reformed through application of adolescent development research. And the federal government can play a key role in such reform, according to a new report. Implementing Juvenile Justice Reform: The Federal Role is "a prioritized plan to implement a developmental approach in juvenile justice reform," intended as a blueprint for the federal government's support of juvenile justice and delinquency prevention in state, local, and tribal jurisdictions.

The Committee identifies seven hallmarks of a developmental approach to system reform of juvenile justice:
  1. Accountability without criminalization
  2. Alternatives to justice system involvement
  3. Individualized response based on needs and risks
  4. Confinement only when necessary for public safety
  5. Genuine commitment to fairness
  6. Sensitivity to disparate treatment
  7. Family engagement
Education Dept. Briefs Educators on Problem of Sex Trafficking of Minors, How Schools Should Be Involved
The National Center for Homeless Education has published Sex Trafficking of Minors: What Schools Need to Know to Recognize and Respond to the Trafficking of Students. The brief outlines how schools can respond to signs that trafficking is occurring among students. The intent is to help guide states and school districts to address the problem of trafficking, with particular attention to homeless youth and other at-risk student populations. Specifically,
  • Learning to recognize the signs of potential trafficking among minors is the first step in identifying victims.
  • Schools can help end the physical, emotional, and mental trauma suffered by young victims of sex trafficking.
  • School districts and state departments of education are encouraged to train staff and establish protocols for recognizing and responding to trafficking.
OJJDP Cautions Healthcare Sector to Increase Its Capability to Recognize and Develop Solutions to Trafficking Crimes
A new Office of Juvenile Justice and Delinquency Prevention guide for the healthcare sector highlights the frequent contact of healthcare professionals with youths who are victims of sex trafficking or at risk of involvement. Confronting Commercial Sexual Exploitation and Sex Trafficking of Minors aims to reduce barriers to identifying victims and offers helpful strategies for professionals who see children and adolescents for prevention and treatment of injury, illness, and disease.

OJJDP Releases Handbook for Law Enforcement Response to Child Abuse
This step-by-step guide—Law Enforcement Response to Child Abuse: A Portable Guide to Investigating Child Abuse—is a series of responses and protocols that emphasize the central role of law enforcement in child abuse cases and the need for a multidisciplinary team approach and "speaking a common language." The handbook provides information to help law enforcement personnel ensure consistency in child abuse investigations, understand their role on a multidisciplinary child protection team during a child abuse case, and establish procedures and protocols for working with other professionals to meet the needs of abused children.


DEA Has New Drug Education Web Site
The Drug Enforcement Administration launched its new, a drug education Web site for parents, educators, and caregivers. The appealing site redesign allows easier navigation, and its updated content includes useful drug information and resources, videos, fact sheets, and short informative articles.

On 40th Anniversary of Juvenile Protection Law, Listenbee Details Progress
On the 40th anniversary of the signing of the Juvenile Justice and Delinquency Prevention (JJDP) Act into law, OJJDP Administrator Robert L. Listenbee reviews the law's impact on juvenile justice in a new blog post. Noting that "violent crime arrest rates for youth are at their lowest point since at least 1980," Listenbee highlights significant progress by OJJDP and its partners in juvenile justice reform. Challenges persist regarding youth in custody for nonviolent offenses and confinement rates for minority youth, Listenbee said. Learn more about the JJDP Act, which President Ford signed into law 40 years ago this month.

Seven in Eight Detroit Students Affected by Violence
In Detroit, Mich., 87 percent of 1,301 Detroit Public Schools students surveyed in the past year said they knew someone who had been killed, disabled, or wounded by gun violence, according to the Detroit Youth Violence Prevention Initiative.


Murder Rate Down Dramatically in Camden
Forum city Camden, N.J., is one of the nation's most crime-ridden and violent cities of its size. As Dave Marsden reported in the National Forum on Youth Violence Prevention News in January, the city tried a bold experiment in 2013, replacing its entire police force with another run by Camden County.

Actually, many of the old officers reinterviewed for their old jobs and got them back. Since a tenfold increase in police–citizen contact, crime and violent crime have plummeted.

As reported in the New York Times, the number of summer murders in Camden fell from 22 in 2012 to 6 in 2014. National Public Radio also reported on the phenomenon.

Other Resources

OJJDP's Beyond Detention Bulletins Available in Convenient Formats
The Northwestern Juvenile Project is the first large-scale longitudinal study of drug, alcohol, and psychiatric disorders in a diverse sample of juvenile detainees. These findings, detailed in bulletins from the OJJDP Beyond Detention series, are now available in EPUB and MOBI formats. The series covers suicidal thoughts and behaviors, posttraumatic stress disorder, and trauma among juvenile detainees; functional impairment after detention; psychiatric disorders in youth processed in juvenile or adult court; barriers to mental health services; violent death among delinquent youth; and psychiatric disorders in youth after detention.
Contact Us

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The National Forum on Youth Violence Prevention Newsletter is prepared under Office of Juvenile Justice and Delinquency Prevention (OJJDP) Cooperative Agreement No. 2012–MU–FX–K009 with Development Services Group, Inc.

The views, opinions, and content of this newsletter do not necessarily reflect the views, opinions, or policies of OJJDP.