By Kara D. Ryan, Senior Research Analyst, Health Policy Project
Francisco has big brown eyes and a round face with a dimpled chin. He is serious, but grew excited when he spotted the crayons and paper that we had brought for children to play with as we talked to their parents. At three years old and just under forty pounds, Francisco is overweight for his age and height. He is also among the minority of Latino children whose families receive health care advice about their children’s weight.
I met Francisco and his mother, Esperanza, at La Clínica del Pueblo, a community health center and NCLR Affiliate that serves hundreds of low-income Hispanic families in the Washington, DC metro area. Esperanza moved from El Salvador years ago; despite better economic opportunities in the U.S., she has always struggled to get by. When she became pregnant, La Clínica staff provided her with affordable, culturally and linguistically appropriate care for her pregnancy with Francisco and, later, his little sister Roxana. The entire family has been patients of the clinic ever since.
At one of these check-ups, Francisco’s doctor noted that the boy was gaining too much weight. By age two, he was 45 pounds and gaining. Although Esperanza was concerned about Francisco’s health, it turned out that she had a hard time assessing his weight and body size as too heavy. According to executive director Alicia Wilson, this situation is all too common; her staff see children struggling with obesity nearly every day. But armed with La Clínica’s budget-friendly healthy-eating strategies and regular pediatric monitoring, Esperanza had been able to reduce her son’s weight by more than ten pounds in five months—and she planned to keep him on that path until he reached a healthier weight for his height and age. (Read Esperanza’s full story here.)
Francisco is one of nearly ten million Latino children who are overweight or obese; approximately 1.5 million are toddlers who, like him, are already too heavy before they even start school. The latest estimates place one-third of Hispanic and Black children between ages two and five in the overweight/obese category, along with nearly one-quarter of White children in the same age bracket. Those rates only climb as children get older—by the time they are teens, about 42% of Latinos are either overweight or obese. They are more likely than children with a healthy weight to grow up to be obese as adults and have a greater risk of developing chronic diseases. Just last week, a new report found that an estimated 37% of Mexican American adults had undiagnosed diabetes by 2006, up from 20% in the early 1980s. If we do nothing about the child obesity rate, we can only expect rates like these—along with a whole host of other obesity-related conditions—to climb higher.
Yet Francisco is in the minority when it comes to Latino children who are receiving regular, appropriate health care and counseling about weight status. One obstacle is that, although uninsurance rates among children are lower than those for adults, Latino kids are still twice as likely to be uninsured than non-Hispanic White children. That often translates to poor access to the pediatrician in the first place—although uninsured Latino children were still less likely than their uninsured White peers to have ever had their height and weight measured by a health care provider.
But even more troubling is that regular access to health care is no guarantee that kids are receiving weight monitoring or counseling. In a nationally representative sample, 58% of pediatricians and family physicians reported that they never, rarely, or only sometimes tracked the weight and weight-related behaviors over time for their pediatric patients. Despite Hispanic children’s increased propensity to be overweight or obese, researchers have found that Latino children were less likely than White or Black children to receive obesity prevention counseling at well-child visits. And although kids may receive intervention when they have reached an obese weight, physicians seem to be less likely to monitor and discuss weight with healthy weight and at-risk overweight Latino youth.
As we address the obesity epidemic, we need to find ways to incorporate regular nutrition and weight counseling into our children’s lives. One of the solutions is not only getting children better access to health care, but also ensuring that it becomes a part of health professionals’ regular training and practice to consistently measure, prevent, assess, and treat obesity for each and every child and ensure that families have the support they need to carry out the advice and counseling they receive. Because the pediatrician at La Clínica measured and monitored Francisco’s weight and provided his mother with accessible nutrition counseling, Francisco is a success story. This story should be the rule, rather than the exception, if we want to move the needle on child obesity for our kids.
Sign up for health and nutrition updates from NCLR’s health policy team!