RACHEL RAM
Health Education and Behavior
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Ensuring Healthy Lives for Florida’s Youngest Residents: A Policy Proposal
By Rachel Ram
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Executive Summary.
As stated in the Journal of Nutrition, “The long-term health and vitality of entire nations depends on the wellbeing of its individual children.” The urgency of ensuring early childhood nutrition is more prevalent than ever. The consequences of investing in early childhood nutrition are substantial: early childhood nutrition protects health, boosts economic productivity and saves lives. According to the Centers of Disease Control, in Florida, 14.8% of children aged 2 to 5 are overweight (85th to < 95th percentile BMI for age) and 13.4% are obese (≥ 95th percentile BMI for age). The numbers are substantially higher for adults, and children that are overweight or obese are much more likely to be that way as adults. This number will keep increasing if proper interventions are not put in place. Florida ranked 33 in the nation for overall health in 2012, as measured by the United Health Foundation as it has a higher rate than average of obesity and preventable hospitalizations. The young children are the future of this statistic.
The purpose of this proposal is to change policy that would increase the outcomes of early childhood nutrition education and as a result save many lives and dollars spent in health care in the long run. My recommendations for improving early childhood nutrition include increasing funding for nutritious foods in preschools, training preschool teachers in health topics and increasing breastfeeding awareness.
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Statement of issue or problem.
The state government of Florida should fund programs that educate preschool aged children (2-5 years) about healthy nutrition and feed them nutritious meals.
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Background (of the issue or problem).
To understand this problem, it is important to understand the outcome of breastfeeding and high quality nutrition on growth, success and chronic disease prevention. According to Healthy People 2020 and the American Heart Association, the goals of optimal nutrition and healthy eating habits in early childhood (12-48 months) are as follows: physical growth and development, visual and cognitive development, healthy immune system development, healthy body functions and organ systems, age-appropriate weight gain, achievement of expected physical and cognitive development and enjoyment of healthy foods as a part of daily life.[i] If a child is malnourished early in their life, they will be at greater risk for many problems at the time and later in life. In Florida, early childhood nutrition is largely funded by the Department of Children and Families and the United States Department of Agriculture. Programs in place to address this issue already are WIC, Child and Adult Care Food Program, Head Start, Family Nutrition Program, and Florida Health departments. Generally speaking, Early Learning Coalitions provide resources and partnerships for early learning services. Specifically, the Early Learning Coalitions in Martin County works to offer subsidized child care assistance and programs that give children a competitive start in life and is responsible for the planning and implementation of school readiness and voluntary pre-kindergarten services. In St. Lucie County, its mission is to provide a collaborative delivery system of quality child development programs and services to ensure children become competent and productive individuals. Both coalitions have partnerships with organizations that provide nutrition services, such as the Department of Children and Families, Healthy Start, and the county Health Departments, but these organizations only dedicate a small portion of their time and funding to childhood nutrition specifically and even less to children under the age of 5. There are also several locations at various elementary schools, Boys and Girls clubs, Parks and Recreation buildings and other community buildings where any child 18 and under can get a free breakfast and lunch every day during the summer, regardless of whether or not the child goes to the school or center. However, with the limited funds these programs already receive, there is not nearly enough funding to provide all of the necessary nutrition services and education children under 5 need.
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Statement of the state’s interests in the issue.
So why does this issue matter? 26.7 percent of households with children under 6 are food insecure in Florida, almost double the national data of 16.9 percent of households with children under 6 being food insecure. This means that these children don’t know when their next meal will be. Growing up without proper nutrition from such a young age sets a child up for delayed growth, obesity, lower IQ, and many other issues. Additionally, in a study including nearly 8000 children done by the New England Journal of Medicine, the 14.9% of five-year-olds who were overweight at kindergarten were four times more likely to become obese nearly a decade later than five-year-olds of a healthy weight. Therefore, obesity and poor health in young children caused by poor nutrition will most likely lead to obesity and associated long term health issues in adulthood. This will cause a weaker workforce in Florida with more sick days and higher health care costs for all Floridians. According to the Florida Department of Health, over the next 20 years in Florida, obesity is expected to contribute to millions of cases of preventable chronic diseases such as type 2 diabetes, heart disease and cancer, costing an estimated $34 billion. This all goes to show that the economy in Florida depends on healthy adults and the healthy children that will eventually become them.
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Pre-existing policies or laws.
Fortunately, there have already been solutions put in place to help support early childhood nutrition. Some of which are through the USDA, a federal agency.
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WIC (Women, Infants and Children) Program’s target population is low income pregnant women (through pregnancy and up to 6 weeks after birth or after pregnancy ends), breastfeeding women (up to infant’s 1st birthday), nonbreastfeeding postpartum women (up to 6 months after the birth of an infant or after pregnancy ends), infants (up to 1st birthday) and children up to their 5th birthday. This provides specific nutritious foods to these individuals.
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Child and Adult Care Food Program (CACFP) provides nutritious meals and snacks to infants and children as a regular part of their day care. A variety of public or private nonprofit child care centers, Head Start programs, outside-school-hours care centers, and other institutions which are licensed or approved to provide day care services participate in CACFP. For-profit centers that serve lower income children may also be eligible. CACFP reimburses centers at free, reduced-price, or paid rates for eligible meals and snacks served to enrolled children, targeting benefits to those children most in need.
Within the state of Florida, local school districts and some preschools also have nutrition programs for children under 5 statewide. In addition to free summer lunch programs and free and reduced lunch during the year, nutrition education is supplied by the UF IFAS Extension Family Nutrition Program and the Martin County and St. Lucie County Health Departments locally. The Family Nutrition Program helps people who receive SNAP (Supplemental Nutrition Assistance Program) benefits learn better eating and physical activity habits to reduce the risk of obesity and chronic disease, including young children. The Health Departments provide programs such as cooking classes, dental services, immunizations, Healthy Start and Healthier Weight programs. The Treasure Coast Food Bank distributes food to low income children and families from several locations across the Treasure Coast, such as House of Hope food pantry locations. Thanks to early learning programs, these counties have also received improved nutrition education and services through the partnered organizations and resources.
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Policy options.
Three potential courses of action for this issue include:
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Increasing funding for scientifically backed nutritious foods in preschools by one million dollars to cover the 9,264 preschools within the state of Florida.
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Training preschool teachers in scientifically backed health topics such as nutrition and physical activity through a required online course offered by a university such as the University of Florida.
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Increasing breastfeeding awareness through public campaigns by Florida Health Departments and health care providers.
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Advantages and disadvantages of each policy option.
While each of these options’ advantages outweigh the disadvantages, individual advantages and disadvantages of all three options are listed below.
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Option No. 1 Advantage: There will be consistency as serving a set amount of nutritious food will be required and there is a statewide system to measure and monitor food distributed to children. This also almost guarantees desired growth and brain development for young children.
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Option No. 1 Disadvantage: The cost of this option would initially be highest and doesn’t allow for education about the food being consumed to promise long term maintenance.
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Option No. 2 Advantage: This option is cost effective with an already existing, effective curriculum within the state that can be monitored with quality control within preschools.
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Option No. 2 Disadvantage: Education does not guarantee changed behavior, and the young children may not retain the information taught or share it with their parents.
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Option No. 3 Advantage: This option would be low cost and reach many people as almost every pregnant and lactating woman visits a healthcare provider or health department, and Florida Department of Health already runs a breastfeeding campaign.
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Option No. 3 Disadvantage: This would be much harder to enforce and may be more difficult with consistency across areas and demographics.
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My recommendation.
After prioritizing the relative advantages and disadvantages of the above options, my recommended option is to increase funding for nutritious meals in preschools. My reason for choosing this option is that it reaches the most children and is the easiest to monitor for quality. Therefore, 766,009 children, which is the number of Florida children enrolled in preschool, will benefit as each of them will have nutritious meals throughout their preschool day, which ranges from 3 to 8 hours a day for one to five days a week. This should lead to desired development and growth outcomes. Nutritious meals in Florida preschools only make up less than 5% of the nutritional meals provided to all children in school.This policy change will make a positive impact and should be funded because preschool aged children are under-represented in Florida’s nutrition programs despite their great need.
According to Harvard’s School of Public Health, daycare is the new frontier for obesity prevention. It is also the first, integral step for a successful future of the state of Florida. This option would benefit society most because the education would trickle down from the preschool caregiver to the children to the parents and ultimately benefitciety as a whole.
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Sources consulted or recommended.
Joint UNICEF/WHO/World Bank Child Malnutrition Database. Estimates for 2013 and
interactive data dashboards (http://www.who.int/nutgrowthdb/ estimates2013/en/, accessed 20 October 2014).
World Health Organization’s Brief provides a background on Childhood Obesity globally and offers solutions and references for the reader to learn more. This was an excellent source as it was very holistic and used many useful sources.
Early Childhood Nutrition: Toddlers to Preschoolers 12–48 Months. (2016). Retrieved June 16,
Gerber for Medical Professionals Childhood Nutrition offers targeted information for medical professionals working with infants and young children in nutrition. It was a scientifically reviewed source of information that was extensive yet concise.
Key Statistics & Graphics. (2016, October 11). Retrieved June 16, 2017, from
Food Security Status of U.S. Households with Children in 2015 offers statistics on food security for several demographics and family situations. It is an excellent source of information.
Child Nutrition in Florida. (n.d.). Retrieved July 27, 2017, from
https://www.feedingflorida.org/programs/child-nutrition
Child Nutrition is Florida provides statistics on food insecurity for all ages in the state of Florida. It had concise statistics that were relevant to this report.
Overweight and Obesity. (2012). Center of Disease Control. Retrieved July 27, 2017, from
https://www.cdc.gov/obesity/stateprograms/fundedstates/pdf/florida-state-profile.pdf.
The CDC included information on childhood and adult obesity as well as solutions to combat it. It was a reliable and statistically oriented piece of information.
Florida Health Care Ratings. (n.d.). Retrieved July 27, 2017, from
http://www.floridastatehealthinsurance.com/florida-health-care-ratings/
Florida Health Care Ratings provides a review of each state’s health ranking based on various factors such as obesity and hospitalization. It was an excellent source of information.
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[i] https://medical.gerber.com/nutrition-health-topics/infant-early-childhood-nutrition/articles/early-childhood-nutrition-toddlers-to-preschoolers