Heroes for Health: A Comprehensive Plan for Combating Childhood Obesity

Proposed for Texas Health Resource

Bio-Music Facilitators
Amanda Buhrkuhl

Shelby McCraw

Daniel Moore

Kevin Nguyen

Jimmy Njoroge

If we, Texas Health Resources (THR), as a responsible and caring business could make a
difference for improving health, extending life, increasing productivity, and lowering costs
shouldn't we eagerly pursue it? What problem could be so pervasive that it affects us in such an
overarching way? Obesity is the problem. Obesity is a problem that affects a significant
percentage of people in the United States.

Figure A. Percentage of Obese Adult Population. Adapted from Mississippi is the

fattest state for 6th straight year, Colorado still leanest, Rhode Island getting fatter,
Alaska slimmer, CalorieLab, CalorieLab Diet Blog News, Retrieved November 14,
2013, from http://calorielab.com/news/categories/fattest-states/.

Though obesity is a problem for Americans at any age, childhood obesity is particularly
concerning. Children who have habits causing obesity are more likely to remain obese in
adulthood (Centers for Disease Control and Prevention, 2013). Observe the trend in rates of
obesity in children since 1974:

Figure B. Percentage of U.S. Children Who Are Obese. Adapted from Michelle Obama
kicks off anti-obesity drive with White House events, L. Sweet, February 2, 2010,

Politics Daily, Retrieved November 10, 2013, from

http://www.politicsdaily.com/2010/02/09/michelle-obama-kicks-off-anti-obesity-drive-inoval-office-event/

Obesity among children is also a concern here in Dallas. In 2012, Texas ranked 7th
among states with the most obese children and Dallas was listed as one of the 10 most
overweight cities in the nation (Fancher, 2012). At Texas Health Resources (THR), we want to
continue the ongoing fight against childhood obesity. We intend to use our resources to improve
the community by combating childhood obesity.
Is childhood obesity a problem that can be addressed? Is there action a business can take
that would make a difference? Abigail Arons (2011), in her work for the Childrens Hospital
Association of Texas, declared innovative policies can reach children while they are still young,

reversing their unhealthy weight trends, and preventing weight gain in the first place. One of the
benefits of these policies would be prevention. Education is clearly one of the most powerful
tools in prevention. THR can most certainly be involved in educating children, and by
association their families, about the dangers of obesity and the benefits of maintaining a healthy
lifestyle. Furthermore, any program that can educate and reduce obesity would be a boon for
everyone involved.
Although no singular action by a company could eliminate childhood obesity, the cumulative
efforts of businesses, schools, communities and government can combine to have a positive
impact on youth. It is important to understand that this proposal will complement efforts that
have already been started in the public sector; however, the ideas we will recommend create a
model for how a business could address the issue in the community. Our proposal shows how
Texas Health Resources can engage the community to be visibly involved in combating
childhood obesity. The most prominent example is the efforts of First Lady Michelle Obama,
who has been at the forefront of the Obama administrations Task Force on Childhood Obesity
(Sweet, 2010).
Through our community action plan, Heroes for Health, we will provide a vehicle for
educating children and their families about the implications of lifestyle decisions, specifically
diet and exercise habits, with the intention of reversing trends in obesity. In this report, we will
discuss:
1. The nature of childhood obesity including its causes and effects.
2. The structure of our proposed community action plan for Heroes for Health.
3. The human resources necessary to make Heroes for Health a reality.
4. The financial resources required to mobilize Heroes for Health.
Heroes for Health provides a solution for businesses to be visibly involved in combating
childhood obesity.
Childhood Obesity: Description, Causes, and Effects
Obesity is a problem that affects millions around the world, with Texas ranking 12th in the
nation in the number of obese people in 2011 (CBS Local CBS DFW, 2011). Our main focus
for Heroes for Health is children from age six to twelve. Studies have shown that out of the
young people in the nation, approximately one-third of them are obese. Child obesity rates have
more than doubled and adolescent rates have more than tripled over the past 20 years (Odum,
2013, Pg. 3).
Obesity is a complex and multifactorial chronic disease that usually becomes manifest in
childhood and adolescence (Serra, 2013, Pg. 2). The CDC determines the degree of obesity in
children based on where they fall on the BMI Charts. BMI, or Body Mass Index, is calculated by
[weight in pounds] divided by [Height in inchest^2] multiplied by 703 (Centers for Disease
Control and Prevention, 2013). Children who are calculated to be in the 85th to 95th percentiles
are viewed as being overweight. Those children who surpass the 95th percentile are considered
obese. Children in the 99th percentile are considered severely obese (Hellmich, 2013).

One of the causes of obesity is sedentary lifestyle. Studies show that behavior and
environment greatly affect childhood obesity. Children that practice sedentary behavior, rarely
engaging in physical activity, are at a greater risk of becoming obese. In a National Institutes of
Health study, elementary school personnel reported that technology played a major role in the
inactivity among elementary school children, namely televisions, computers, and gaming
systems (Odum, 2013, pg. 2). Either at school or home, children would rather play on their
game systems or other electronic rather than going out to play or doing some kind of physical
activity. This study also highlights the profound amount of parents who are in denial about the
weight status of their child and the lack of education about the health concerns of being
overweight.
Furthermore, our research reveals that too many environmental influences deter families
and kids from making the correct decisions to produce an active lifestyle. Those influences
include video games, TV, and computers as far as electronics. Children 818 years of age
spend an average of 7.5 hours a day using entertainment media, including TV, computers, video
games, cell phones, and movies (Centers for Disease Control and Prevention, 2013). These
influences promote a sedentary lifestyle. Another contributing cause is a lack of access to safe
play areas for children. A lack of safe play areas can contribute to childhood obesity if children
are unable to find an appropriate place to participate in physical activity. For many children this
is a concern (Centers for Disease Control and Prevention, 2013).
Unhealthy diets also contribute to childhood obesity. In a study conducted by the
National Institutes of Health, elementary teachers were interviewed and agreed that parents and
the home environment had the largest impact on childhood obesity (Odum, 2013, pg.2). The
reasoning for this view stems from a lack of education about health by parents most likely caused
by time constraints because of work or other obligations. In turn, parents are unable to spend
enough time and effort into providing a healthy life for their children. Specifically, this time
constraint reduces the time needed to prepare home-cooked healthy meals. Instead, most parents
resort to other processed, canned, or fast foods.
In addition, dollar menus and combo meals encourage overindulgence of less healthy
options in food. Commercialization of dollar-menus incentivizes poor food choices. Furthermore,
obtaining access to healthy food can be difficult for families of certain socioeconomic
backgrounds. Large chains such as Wal-Mart or McDonalds are more available than healthier
options like Central Market or Whole Foods store in disadvantaged areas. (Centers for Disease
Control and Prevention, 2013).
Socioeconomic forces also encourage poor food choices. A study conducted in 11
OECD countries, including several European countries, Australia, Canada, Korea and the USA
showed that obesity is more prevalent in areas that are socioeconomically disadvantaged (Serra,

2013, pg. 25). In the US, it is not surprising that a lower income results in a greater reliance on
processed food and fast food.
Though diet and exercise are the most frequently observable causes of obesity, there are
other contributing causes. First, it is important to note that our goal is not to merely encourage
weight loss, but to promote a healthy lifestyle. Our culture often oversimplifies the issue of
obesity, merely encouraging being thin instead of being healthy. Instead of society promoting
thin as the goal and obesity as the devil, we could promote eating healthy as a first priority
(Taylor, 2013). Children often face discrimination due to their size and a preconceived notion
that the perfect body is the skinny, Hollywood-model figure. There is not enough awareness
about the importance of living a lifestyle that leads to a healthy body. An imbalance of physical
activity and food consumption, along with cultural changes has had profound effects on the
obesity epidemic.
Also, family and genetic factors play an important role in the development of obesity
(Odum, 2013, pg. 1). Studies have shown that lifestyle a mother lives during the prenatal period
of her pregnancy could have a profound effect on whether her child develops obesity. Excessive
or low nutrient intakes during the prenatal and perinatal period play a role in the appearance of
obesity in other life stages (Serra, 2013, pg. 2). While you may think that pregnant mothers who
overeat would give a greater chance of their child developing obesity, actually, mothers who had
significantly low intake in the first 3-6 months caused an increase in the potential for childhood
obesity.
The effects of obesity include a number of health disorders, such as heart disease,
diabetes, asthma, blood pressure, and sleep apnea (Centers for Disease Control and Prevention,
2013). However, health disorders are not the only concern; many obese children are affected by
social discrimination. Obesity can be a contributor to low self-esteem, unpleasant social
interactions, and poor body image. Struggling with self esteem can consequently hinder
academic and social functioning, and persist into adulthood (Lets Move, 2013).
Heroes for Health: A Community Action Plan
Now we examine the purpose, structure, and benefits of our proposal. Childhood
obesity is a topic that has already moved many people to action. However, the primary portion of
the work that has been done has occurred in the public school system. Across the nation, there
have been initiatives to feed children healthy lunches and promote exercise in the schools. In a
report specifically addressing the issue of childhood obesity in Texas, Abigail Arons (2011)
clearly showed what has worked and what could work in the future. Specifically, Texas has
already addressed or is addressing:
1. Implementation of healthy school menus in public schools and a reduction in the
availability of unhealthy alternatives like processed snacks and soft drinks.

2. Requirement of physical education in public schools and an effort to improve these

programs across all age levels.
3. Initiation of comprehensive plans to address childhood obesity supported through the
schools. (Arons, 2011, pg.7)
It is this third point - the comprehensive plan - that shows the most potential for a
business to address. A comprehensive plan is a plan that addresses the issue of obesity by
promoting a healthy diet and encouraging exercise. Comprehensive plans have the greatest
impact since both primary causes of obesity are addressed sedentary lifestyle and unhealthy
diet (Arons, 2011, pg. 5). Though schools have begun to implement comprehensive plans, it
would be unwise for our business to become directly entangled in the programs promoted by the
public schools. There would be greater restriction working through the schools and a reduced
sense of presence for THR. Part of our goal is to show how THR cares about the community and
how we want to be active in making a positive difference in the lives of members of the
community. Therefore, our proposal is a comprehensive one that is supported without the school
structure.
The purpose of the proposal is to address the issue of childhood obesity on three fronts:
education, healthy diet, and active lifestyle. To have any sort of lasting effect, it is important to
educate children and their families particularly parents about how the choices they make
have an effect on their weight and overall health. Though understanding how obesity is caused
can be relatively simple, it is not always easy for individuals within families to be aware of the
impact of their habits. Education can show how small choices in diet add up to
overconsumption. Educated parents will know how choices in preferred family activities can
change how active a childs lifestyle is. If sedentary activities, like television and video games,
are the prevalent activities, children will be less likely to get enough exercise. Our proposal will
address all three of these issues.
Heroes for Health is a plan in two parts. First a three-month participation program for
children and their parents. During this time a child will log, with their parents help, the food that
they eat at home and the physically activity they participated in that day. We will supply a childfriendly booklet for participants that would suggest different family activities and healthy meal
options. Included in the booklet would be simple facts such as calories burned by different
activities or calories contained in foods. Second, after the 3 month participation program, there
would be a community celebration at White Rock Lake Park. This would be a carnival style
event with healthy food, fun activities, entertainment, day prizes, and special prizes for those
children who participated in the three-month program.
One of the highlights of our event is our collaboration with nutrition expert Amy
Goodson. She is a local nutritionist for the Dallas Cowboys, Texas Rangers and many athletes in
the Dallas-Fort Worth area. Goodson also teaches nutrition courses at Texas Womens University.
She would be available to speak to children and their parents about the importance of a healthy
diet. In an interview conducted by e-mail, she was able to make several recommendations for
children:
1. Develop Healthy Eating Habits
Start your day with a powerful breakfast. Include a powerful protein, nutrientrich whole grains, and a fresh fruit and/or vegetable. One meal example is

whole wheat English muffin with Canadian bacon, a scrambled egg, fresh
spinach, and a low-fat cheese slice.
Choose beverages wisely. Eliminate soda and energy drinks, replace high
concentrated fruit drinks with fresh fruit, choose low-fat milk instead of whole
milk, and prioritize water over other sugar-filled drink choices.
Fuel throughout the day. Provide a healthy lunch and snacks for children such
as a peanut butter sandwich on whole-grain bread with reduced sugar jelly or
sliced bananas or multi-grain wheat thins with a mozzarella string cheese.
Eating healthy snacks will discourage eating junk food between meals.
2. Participate in physical activity everyday
Regular physical activity is just as important to a healthful lifestyle as healthy
eating. Children and teenagers should be physically active for 60 minutes
every day or most days. Set aside time each day to engage in active play
such as tossing a ball, playing tag, going for a walk, or participating in a sport.
3. Get kids involved in nutrition
If children are involved in the planning, purchasing, and preparation of
healthy items, they are more likely to try the food. Involve children in the
planning of the weekly menu, picking out the ingredients from the grocery
stores, and preparation in the kitchen. The whole family will feel better and
benefit from eating delicious, nutritious meals together. (A. Goodson,
personal communication, October 18, 2013)
Immediately, one can consider the potential problems for abuse. Perhaps participants in
the three-month program would not accurately log their behavior. Maybe parents would only
bring children to the Heroes for Health event without concern for the message of adopting a
healthy lifestyle. However, this proposal is a huge benefit because, regardless of the degree of
participation, Heroes for Health promotes awareness and shows how children can change their
habits to improve their health.
Heroes for Health is targeted toward all children to promote a healthy lifestyle which will
lead to a reduction in the number of obese children. Even if only a few children and families are
impacted, it moves in the direction of reducing childhood obesity. Furthermore, it allows THR
the opportunity to show that we care about the well-being of the community; this project shows
that regardless of the degree of success. In other words, we do not have to strongly push for
accountability in this setting. This makes it a low-risk, easy to implement, and highly successful
plan.
Heroes for Health: People as the Driving Force
In preparation for approximately 1000 participants for the community-wide event portion
of Heroes for Health, we are planning for about 300 volunteers to help run the event. We plan on
using volunteers from our 25 hospitals throughout the metroplex, consisting of more than 21,000
employees (Texas Health Resources, 2013). These volunteers will help by being involved with
small activities on the day of the event. All volunteers will be coordinated by a paid event

manager. We plan on offering a day of paid vacation as an incentive for employees to volunteer
for the event.
We want to promote the program throughout our hospitals, so each hospital will compete
with each other to produce volunteers for Heroes for Health. Hospitals with the most volunteers
will get additional funding to their Christmas party, which the amount will be determined at a
later date. Furthermore, families of employees who participate in the participation component of
Heroes for Health will have their kids automatically entered into our company-only raffle
drawing.
We will also be bringing in hired staff members for the event from outside our company.
A private security firm would be employed so that no employee of THR will be responsible for
any security issues. We will have event staff to handle parking, set-up and clean-up. Additionally,
we have the flexibility to add sponsors for our event which can bring in more volunteers to help
with our staffing and additional funding for the event. However, we will not be reliant on the
extra sponsorship. With our numbers, we are confident we have enough people to run a safe and
wonderful event, with involved and excited employees of THR.
Heroes for Health: How much would it cost?
The budget for Heroes for Health consists of six categories: site costs, decorations, prizes,
miscellaneous costs, refreshments, and program expenses. The total expenses for this event are
about $86,600. Figure C details the expenses by item, and Figure D shows the division of
expenses by category. These expenses are based on an estimated attendance of 1,000 people.

Figure C. Expenses.

Figure D. Expenses by Category.

In summary, Heroes for Health creates a community event that will educate children and
their families about the impact of obesity and the methods to combat it. Children will experience
first-hand what a healthy diet and an active lifestyle consists of. This proposed model would
show Texas Health Resources commitment to the community and its concern for reducing
childhood obesity.
We have detailed the two-part plan of Heroes for Health the three-month participation
program followed by the community event at White Rock Lake Park. Our proposal is a flexible
model that can be easily adjusted to accommodate other venues and could become an annual
event. Furthermore it can be regarded as a success simply by having a large enough presence at
the event something that can partially be supplied by participation from within Texas Health
Resources. However, the more people we can engage in the community, the greater impact we
can have in promoting a healthy lifestyle for children and reducing childhood obesity.
Heroes for Health allows for clear sponsorship, so the chamber of commerce will be able
to show its desire to connect business and the community in a positive way. Combating
childhood obesity is a worthy cause and Heroes for Health provides a wonderful method for
businesses to make an impact in the lives of children and the community as a whole.

References
Arons, Abigail. (January, 2011). Childhood obesity in Texas report. Childrens Hospital
Association of Texas. Retrieved from http://www.childhealthtx.org/issues-and-advocacy/
CBS Local CBS DFW. (July 7, 2011). Texas ranked as 12th most obese state. CBSLocal.
Retrieved from http://dfw.cbslocal.com/2011/07/07/texas-ranked-as-12th-most-obesestate/
Centers for Disease Control and Prevention. (October, 2013). Basics about childhood obesity.
Childhood Overweight and Obesity. Retrieved from http://www.cdc.gov/obesity/
childhood/basics.html
Fancher, Julie. (October 30, 2012). Coalition unveils plan to eliminate
childhood obesity in Dallas by 2020. The Dallas Morning News.
Retrieved from http://www.dallasnews.com/news/communitynews/dallas/headlines/20121030-coalition-unveils-plan-to-eliminatechildhood-obesity-in-dallas-by-2020.ece?nclick_check=1
Hellmich, Nanci. (September 9, 2013). Heavy kids face health problems, have few options. USA
Today. Retrieved from http://www.usatoday.com/story/news/nation/2013/09/09/severelyobese-medical-risks/2781343/
Lets Move. (2013). Health problems and childhood obesity. Lets Move: About Lets Move.
Retrieved from http://www.letsmove.gov/health-problems-and-childhood-obesity
Odum, M., McKyer, E., Tisone, C., & Outley, C. (January 24, 2013). Elementary school
personnel's perceptions on childhood obesity: Pervasiveness and facilitating factors. The
Journal of School Health, 83(3), 206-212. doi:10.1111/josh.12016
Serra-Majem, L., & Bautista-Castao, I. (September, 2013). Etiology of obesity: Two "key
issues" and other emerging factors. Nutricion Hospitalaria, 2832-43.
doi:10.3305/nh.2013.28.sup5.6869
Sweet, Lynn. (February 2, 2010). Michelle Obama kicks off anti-obesity drive
with White House events. Politics Daily. Retrieved from
http://www.politicsdaily.com/2010/02/09/ michelle-obama-kicks-off-antiobesity-drive-in-oval-office-event/
Taylor, Sydney. (September 11, 2013). Tackle child obesity with diet, exercise: Your say. USA
Today. Retrieved from http://www.usatoday.com/story/opinion/2013/09/11/childhoodobesity-treatment-your-say/2802257/
Texas Health Resources. (2013). About us. Texas Health Resources. Retrieved from
http://www.texashealth.org/about