Impact of an Elementary School-Based Wellness Initiative on Child Obesity Prevalence: LiveWell Kids.

Despite major public health investments over the past several decades, little progress has been made in reducing the prevalence of obesity among school-aged children in the United States. In 2007, the Redondo Beach Unified School District (RBUSD) and the Beach Cities Health District launched a wellness initiative, LiveWell Kids, that included multi-level interventions to improve nutrition and increase physical activity. The initiative also included annual measurements of height and weight among all kindergartners and first, third, and fifth graders in the eight elementary schools in the RBUSD. To assess trends in obesity prevalence, we analyzed height and weight data collected during the 2008 to 2009 to 2018 to 2019 school years. To more fully assess the impact of the initiative, we conducted a least-squares regression difference-in-differences analysis of data from the California Physical Fitness Testing Program on measured height and weight among fifth graders from the RBUSD, three neighboring school districts, and Los Angeles County overall. Among elementary school students in the RBUSD, obesity prevalence decreased from 13.9% in 2008 to 2009 to 6.4% in 2018 to 2019. Significant declines in prevalence were observed in all eight elementary schools, and across all grade levels and demographic groups. Among fifth graders, a similar decline in obesity prevalence was not observed in the other school districts or the county overall. The findings suggest that interventions that adhere to the socio-ecologic model and engage students, parents, and school personnel at all levels while also addressing school and community environments may reduce obesity prevalence among elementary school-aged children.

Turning the Curve on Obesity Prevalence Among Fifth Graders in the Los Angeles Unified School District, 2001-2013.

INTRODUCTION: After multiple decades of increasing childhood obesity prevalence in the United States, findings from recent studies suggest that prevalence has leveled or is decreasing in some populations. However, demographic and socioeconomic disparities in prevalence remain and may be increasing. METHODS: To assess recent trends and disparities in childhood obesity prevalence in Los Angeles County, we analyzed data from 2001 through 2013 in fifth graders in the Los Angeles Unified School District (LAUSD). Obesity was defined as a body mass index at or above the 95th percentile for children of the same age and sex as compared with Centers for Disease Control and Prevention growth charts, on the basis of measured height and weight. Trends were examined by sex, race/ethnicity, and socioeconomic status (SES). SES was determined by using school-level data on the percentage of students participating in a free and reduced-price meal program. RESULTS: Obesity prevalence increased from 27.5% in 2001 to 31.6% in 2005, was stable from 2005 through 2010, and decreased from 31.6% in 2010 to 28.5% in 2013. Similar trajectories in prevalence were observed for all demographic and SES subgroups, although the decline in prevalence began earlier among whites and students attending schools in the highest SES group. Disparities in prevalence by race/ethnicity and SES were observed during the entire study period but narrowed slightly from 2010 through 2013. CONCLUSION: Although obesity prevalence among fifth graders in LAUSD declined from 2010 through 2013, prevalence remains higher than in 2001, and demographic and socioeconomic disparities in prevalence persist. Future interventions in the county should prioritize Latinos and students attending low SES schools.

Potential Gains in Life Expectancy from Reductions in Leading Causes of Death, Los Angeles County: a Quantitative Approach to Identify Candidate Diseases for Prevention and Burden Disparities Elimination.

Despite overall gains in life expectancy at birth among Los Angeles County residents, significant disparities persist across population subgroups. The purpose of this study was to quantify the potential sex- and race/ethnicity-specific gains in life expectancy had we been able to fully or partially eliminate the leading causes of death in Los Angeles County. Complete annual life tables for local residents were generated by applying the same method used for the National Center of Health Statistics US life tables published in 1999. Based on 2010 Los Angeles County mortality records, sex- and race/ethnicity-specific potential gains in life expectancy were calculated using scenarios of 10, 20, 50, and 100 % elimination of 12 major causes of death. Coronary heart disease, the leading cause of death, was found to be most impactful on life expectancy. Its hypothetical full elimination would result in life expectancy gains ranging from 2.2 years among white females to 3.7 years among black males. Gains from complete elimination of lung cancer and stroke ranked second, with almost an additional year of life for each gender. However, marked disparities across racial/ethnic groups were noted from the elimination of several other causes of death, such as homicide, from which the gain among black males exceeded 13 times more than their white counterparts. By differentially targeting specific causes of death in disease prevention, not only can findings of this study aid in efficiently narrowing racial/ethnic disparities, they can also provide a quantitative means to identify and rank priorities in local health policymaking.