Why we must address the social determinants of health to truly reduce childhood obesity

by Steve Barnes

Steve BarnesChildhood obesity is increasing in Ontario and across Canada, and this has caused concern amongst governments, communities, and families. For kids, obesity can also lead to a lifetime of poor health, but by tackling childhood obesity now we can lead kids toward a healthy adulthood.

In Canada:

  • 26 percent of children and adolescents aged 2-17 are overweight or obese
  • 24 percent of children growing up in the most well-off neighbourhoods are obese, compared with 35 percent of children in the poorest neighbourhoods
  • Over the past 25 years the rate of young people aged 12-17 who are overweight doubled, while the obesity rate tripled
  • Adolescent boys are more likely to be overweight or obese (34 percent) compared with girls (23 percent)
  • It is estimated that if the current childhood obesity rates persist, children will live three to four years less than today’s adults due to obesity.

Obesity in childhood can contribute to significant health issues, such as higher risk of cardiovascular disease and type 2 diabetes, stress, and asthma. These risks and health conditions continue into adulthood: obese adolescents are more likely to be obese as adults and face greater risks for heart disease, stroke, osteoarthritis, some cancers, and depression.

As rates increase, the costs to the health care system are becoming more significant and governments are looking for ways to reverse this trend. But not all children face the same risks of obesity childhood and obesity is about more than just individual and family behaviours; obesity is deeply rooted in the social determinants of health.

Children who fare poorly in social determinants of health, such as those who grow up in poverty, who have inadequate housing or food, or who are socially marginalized, are more likely to be obese and are disproportionately affected by its associated health problems. In order to reduce the health burden of childhood obesity, we must address these underlying determinants of health.

The built environment is one significant determinant of childhood obesity that is often overlooked. The presence of amenities such as parks, recreational centres, and places at which healthy food can be purchased reduces the risk of children being obese. Research shows that children tend to be less physically active in newer neighbourhoods that are designed primarily for vehicles and often lack sidewalks, thereby reducing walkability. These neighbourhoods also tend to lack safe outdoor spaces for children to play. But by supporting municipalities to incorporate health as a foundation of their planning activities, the province can make progress toward reducing childhood obesity.

A new paper, Reducing Childhood Obesity in Ontario through a Health Equity Lens, prepared by the Wellesley Institute for the Ontario Healthy Kids panel, sets out a framework to reduce childhood obesity and its associated health problems by taking a health equity and social determinants of health approach. We argue that strategies to reduce childhood obesity must prioritize reducing poverty, focusing on early childhood development, addressing neighbourhood factors, and enhancing coordination with a health promotion and whole-of government focus.

Wellesley InstituteSteve Barnes is a Policy Analyst at the Wellesley Institute, a Toronto-based non-profit and non-partisan institute that engages in research, policy, and community mobilization to advance population health. Steve participated in the 2012 CEHE Knowledge Leaders in Children’s Environmental Health program.