Implementing policies in schools to help solve childhood obesity (Mel Sukonik)

Context

Reference to a current Michigan bill or law that relates in some way to your proposal:

House Bill 4696 is an amendment to the Public Act 170 of 1964, which sets standards for municipal liability. Originally, the act stated that a municipal corporation was not responsible for maintaining public sidewalks unless the plaintiff proves that at least 30 days before a death or injury (related to the condition of the sidewalk) officials knew about the sidewalks defect. Now, municipal corporation in which a sidewalk is installed adjacent to a municipal, county, or state highway must maintain that sidewalk in reasonable repair 

Michigan Merrit Curriculum

The Michigan Merit Curriculum, passed in 2006, says that it is no longer acceptable for a student to graduate High School with credit based on seat time. It outlines in each subject what is required in order to be proficient in each subject area. This relates to reforming the physical education program because the current standards do not provide adequate physical activity practices, and provide opportunities for students to be exempt from participating.

State Transporation Revenue Package

The State Transportation Revenue Package signed November 10, 2015 by Governor Rick Snyder, is effective beginning in FY 2017 with an anticipated increase in new state transportation revenue in the amount of $465 million. Revenue will increase to annual amount of $1.2 billion total in 2021. These additional revenues will help to address the backlog of critical infrastructure needs and allow new enhancements to Michigan’s transportation network. This new source of revenue can be used to fund the safe walking and biking routes to school. 

Why this proposal will make a difference in the lives of students of all ages across Michigan, or a significant subgroup (by age, background, economic status, and/or region, etc.) of students in Michigan:

If any of the solutions in this proposal are passed, it will be a significant step in reducing obesity rates and providing students with the knowledge and desire to maintain healthy lifestyles as they grow older. Specifically, obesity is more common in lower socioeconomic families because they do not have the extra money for intramural sports for their children, gym memberships, or healthy home cooked meals each evening. Therefore, this proposal will most significantly impact lower socioeconomic families in Michigan.

How and where did you learn about the issues underlying your proposal?

Many forms of media, such as television shows and advertisements, are increasingly relaying the message of high obesity rates. This has been a problem for decades meaning it has not begun the decline. Additionally, once coming to school at the University of Michigan, I was exposed to students that came from very different areas and had very different primary school experiences. By reflecting on my experience and recognizing the discrepancy, I was able to determine what schools are and are not doing in order to mitigate this problem. 

How has your service activity influenced your thinking about this proposal?

My service activity at 826 Michigan has given me the opportunity to work with students ages 6-18 multiple times per week. I help students with their homework assignments as well as practice writing skills each session. About half way through each session, the leaders at 826 Michigan put out a snack for the students. I have enjoyed seeing what the different snack is each time, and noticed that they are very healthy options. They are nicely portioned out, and usually contain a protein such as yogurt, cheese, or hummus. All of the kids gladly eat and enjoy the snack that they are offered. This made me realize the importance of offering a healthy snack, and portioning it out accordingly. By making this the only option, kids are willing to eat it even if they would have preferred something else. This inspired my second solution for having healthy options in the cafeteria, and supports the fact that students will want to eat it.    

Link to your media artifact(s) giving background on the issue:

Infographic on childhood obesity

Consultations

Talk directly with at least 3 real live people who have special knowledge about this topic or the impact your proposal would have, and summarize their comments. These may include people appearing in your media artifact (video, podcast, etc.).

CONSULTATION 1: Julie Stocks is the UHS Registered Dietitian Nutritionist. She works with college students to make improvements to their nutrition that contributes to lifelong health. I asked Julie a number of questions about weighing the importance of diet vs. exercise, and different ways that students can incorporate physical activity into a busy schedule. Julie explained how the split in importance of diet and exercise is about 60% diet and 40% exercise. This allowed me to think about my different solutions in terms of the impact they can have on students. According to this statistic, changing school lunches would have a greater impact on students than changing physical education or setting up safe walking and biking routes. Additionally, she explained how the foods we choose to eat is a habit that begins when we are young. From the time we are born, our parents calm us down by feeding us. As we get older, what we choose to eat and how much of it we choose to eat, is based mainly on actions that we see our parents do. Therefore, having healthy meal options in schools may only be a temporary solution that deteriorates as soon as students leave and go to college, where they will resort back to their old habits from growing up. Julie’s comments were very insightful and provided a bit of opposition to my proposed solutions. I took this new knowledge and have continued to edit and reform my solutions. 

CONSULTATION 2: April Morrison-Harke is the Safe Routes to School Contract Manager and works for the Michigan Fitness Foundation. She explained further in depth how the two different types of grants work, and where the funding comes from. I learned that originally, the funding came from the Michigan Toll booths, however they do not have access to those funds anymore. Currently they receive a certain portion of the funding from the Michigan Department of Transportation. They have not had to turn down any grant applicants, but she does not think they receive enough funds to be able to fund all Michigan schools—at least not in the near future. This encouraged me to think about alternate sources of funding for setting up these programs. Additionally, April ensured me that all schools in Michigan are capable of setting up safe walking and biking routes, regardless of their location. Therefore, my main conflict to overcome in my third solution is funding.  

CONSULTATION 3: Taj Colantoni is a Fitness Trainer and Director of Operations at Lifestyle Performance. She provides one-on-one sessions with her members where she develops and leads individualized fitness plans. She helps her members work towards their health goals, and even provides dietary recommendations. I spoke with Taj about the importance of starting physical activity at a young age, and she assured me that as you get older it becomes much more difficult to shed body fat. Additionally, we spoke about alternative exercises such as yoga and Pilates. She said “Yoga and Pilates definitely count as cardio (since you are using oxygen as fuel). They also offer other equally important health benefits such as increased strength, mobility, flexibility and relaxation. I feel as a starting point they are less intimidating than running or spinning.” This was great support for my first proposed solution about reforming the physical education program, and gave me the idea that yoga and Pilates are two great forms of physical activity that students can learn to do without significant hand eye coordination or endurance. They can also do it at home alone or with friends without having to join a team or belong to a gym.  

Prospectus:

Describe the specific issue or problem, being sure to provide sufficient context so that someone less familiar with the issue has a sense of the bigger picture, but know that your focus here is on a more detailed spelling out of the specific problem or issue that you’ve identified. (250 words minimum)

    In the United States, the number of children who are considered to be overweight has tripled over the last 30 years. Currently 1 in five children is considered overweight, or 20%. Children, for the purpose of this explanation, are considered ages 6-19. It is important to clarify the distinction between being overweight and being obese. They are calculated using a measurement called Body Mass Index, or BMI. This measurement not only takes into account your weight, but also your height and gender. These three factors in combination make for a more accurate and meaningful measurement than weight alone. Children who have a BMI at or above the 95th percentile for age and sex are considered obese, while children at or above the 85th percentile but under the 95th are considered overweight.

    There are a number of factors the contribute to childhood obesity/overweight, such as genetics, metabolism— how your body changes food into energy, eating and physical activity behavior, environmental factors, and social/individual psychology. Unfortunately, many individuals simply have a genetic predisposition that can lead to obesity. This is often very difficult to combat without serious medical attention. Your metabolism, on the other hand, seems like a factor that would come from your genes, however there are many ways to speed up and slow down the processes in your metabolism based on your health choices. This is why children who are obese tend to have slower metabolism than thin children, thus contributing to worsening problems. Another contributor is social and individual psychology, which can define your mood and mental state. Children who are unhappy and depressed often choose to engage in unhealthy eating habits, and reduce their activity levels. Eating behaviors and physical activity level are often directly associated with environmental factors. Your environmental factors are where you spend the majority of your time. For children, this is often their home, school, and community. There are many people and occurrences in your daily environment that can influence what foods you choose to eat, and how much physical activity you are getting. This is why schools have the potential to play a critical role in obesity rates. How much you are moving during the day in most often dependent upon how often students are given this opportunity during the school day, including recess and physical education class. Additionally, many students eat two out of their three meals at school, suggesting that the cafeteria menu is also an important contributor.

Obesity is a serious condition that has extreme implications for the future health of children. Some of the most common health consequences include cardiovascular disease, diabetes, musculoskeletal disorders, certain types of cancer, and even premature death. In fact, the most significant of these health consequences often do not become apparent until late adulthood. Due to the fact that these are so far removed from a child’s current life, people are less motivated to act in the present. This has come to be a serious public health issue and one of the top healthcare costs in the United States, spending about $147 billion to $210 billion per year. Therefore, it is imperative that policy be implemented to combat this public health crisis.

Potential Solutions:

Describe three reasonable, feasible potential solutions or approaches that would help address this problem.

SOLUTION 1: The first in-school solution that I am proposing is to develop a reformed physical education program. Currently, the Michigan Merit Curriculum, or MMC, outlines the standards and expectations of school students at specific stages of their schooling career. As I was looking through the requirements of different ages, I found that almost all of them build up to teaching children hand-eye coordination skills such as “net/wall activities” and “target activities”, as well as team sports such as “basketball and ultimate Frisbee”. I believe that this creates a misperception that in order to be active, children must have proficient hand-eye coordination and be able to participate on a team. Activities such as running, weight lifting, yoga, Pilates, and aerobics are able to be completed alone, and often focus on individual growth and accomplishments. Shifting the physical education curriculum to enforce and promote these types of activities will hopefully make it more enjoyable for those who are less athletic, and will give ideas of activities that children can do on their own at home or with friends. While this solution may require physical education teachers with more training or experience, there are many online resources that are free of charge that can help develop easy and achievable fitness programs. Additionally, the MMC requires .5 credits of physical education that can be substituted for other extra-curricular activities, such as extra math and language arts. I propose that this exception be removed, as it is crucial to expose all children to the same physical education program and encourage healthy lifestyles beyond their studies.

http://www.michigan.gov/documents/mde/PE_Stnds.Bench_FINAL_2.14.07_246701_7.pdf

http://www.michigan.gov/mde/0,4615,7-140-28753_38924---,00.html

 

 

SOLUTION 2: The second in-school solution that I am proposing is to reduce/eliminate unhealthy food choices in the cafeteria. Currently, Michigan follows the National School Lunch Program which focuses mainly on providing low cost, “nutritionally balanced” options. However, nutritionally balanced is defined as getting everything you need from your diet, not necessarily doing it in the healthiest way. Looking to other states, Lower Merion School District in the state of Pennsylvania took a leadership role in the effort to promote healthy choices in the cafeteria. They were among the first in Pennsylvania to eliminate the use of cooking oils that contain trans fats and became the first district in the state to eliminate all items with trans fats from the menu. Additionally, all snacks served must be a grain which contains 50% of whole whole grains by weight or have whole grains as the first ingredient. All other snacks must contain as the first ingredient one of the non-grain main food groups (fruit, vegetables, dairy, or protein). There are numerous other guidelines outlined in the source given below. The goal of this change is not only to feed students healthy food throughout the school day, but also the hope is to inspire them to make healthy choices outside of the school day when they realize they enjoy these healthy foods just as much as junk food. The downside to this plan is that overweight/obese students, as well as any others, may simply compensate by going home and binge eating unhealthy foods after the school day is over. However, this does regulate consumption within the school day, which is the goal of this proposal.

http://www.michigan.gov/mde/0,4615,7-140-66254_50144-194515--,00.html

https://www.fns.usda.gov/school-meals/nutrition-standards-school-meals

https://www.lmsd.org/departments/nutritional/index.aspx

https://www.lmsd.org/data/files/gallery/AnnualNotifications/11A_Link_A_LMSD_Nutritional_Standards.pdf

 

 

SOLUTION 3:  The third solution is to make it mandatory for schools to have safe walking and biking routes in the surrounding area of the school zone. Safe Routes to School is a federal program committed to achieving this goal. Currently, they provide two types of grants that schools can apply for. The mini grant is a programming grant that helps schools build a culture of walking and biking. Schools can apply once a year for up to $5,000 each or up to $25,000 for multiple schools. The major grant helps communities to build sidewalks and other infrastructure needed for safe walking to school. A school can receive up to $200,000 for infrastructure building, and an additional $8,000 for other programming such as biking/walking education in schools and paying law enforcement officers over time. Although schools can apply to this grant, only a small portion of schools actually can receive the grant money. By implementing these programs in all Michigan schools, students will be able to integrate physical activity into their regular school day free of charge and without having to utilize any additional time. Countries where walking and biking are most common as proven to have the lowest obesity rates. Each .62 mile walked per day is associated with a 5% decrease in likely obesity. The main challenge of this solution is where the funding would come from, and whether all Michigan schools are in optimal locations to have walking and biking routes.

http://www.saferoutespartnership.org/healthy-communities/101/facts

http://www.michigan.gov/documents/mdch/SRTS_Presentation_Houghton_11-16-10_337946_7.pdf

http://saferoutesmichigan.org/about/

Reaction or advice from a Topic Coordinator:

You must solicit a critique from a topic coordinator, and explain the impact that advice has had on the final draft of this proposal.

I met with Topic Coordinator Justin Levine to receive feedback on my proposal. We discussed my three solutions in depth and recognized how they were all very different from each other, and presented such widely different issues, therefore it would be most beneficial if I focused on one of them in my formal proposal. We both agreed that my solution to set up safe walking and biking routes around all Michigan schools was the best to focus on. I found Justin’s advice on this matter to be very beneficial for my proposal moving forward because it has allowed me to further dive into all aspects and issues that arise from setting up these safe walking and biking routes. I was also able to follow up with the April Morrison-Harke (my consultation from Safe Routes to School), in order to ask follow-up questions and acquire more in-depth knowledge about the program. 

Research process:

Describe your research process — indicate who you talked to (including but not limited to consultants), what you read, what your thinking was, how it changed over time, and how your consultants changed your thinking. This description of your research process definitely could include “dead ends,” or ideas you had that didn’t ultimately bear fruit.  In short, we want to know what you did and how it led to your legislation, and we also want you to give us a window into your thought process.

I am very interested in health and fitness and lived in a school district where these habits were highly promoted and encouraged. Once coming to Michigan, I was more exposed to students from all over the country and started to hear about their school experiences. I realized that not all schools were like my own, and that the majority of students did not grow up with healthy lifestyles. The idea to develop solutions within schools to decrease childhood obesity sprung from this new knowledge, and thus, my research process began. After significant brainstorming of possible solutions, I came across my initial three, two of which are still written. I replaced my third solution that was initially about changing classroom styles by promoting physical activity in the classroom, to promoting it in a way that wouldn’t take away from class time—setting up safe walking and biking routes to school. While researching initiatives that have started in schools around the country, I came across the Safe Routes to School program and was extremely interested and inspired. I was fortunate enough to live close to my middle school and lived in a neighborhood with safe walking routes so that I could walk to and from school each day. I knew that having this opportunity in all Michigan schools would encourage students to be physically active for at least 15-20 min per day, which is nearly half of the recommended amount per day. When I met with a topic coordinator, he heard the passionate way that I was talking about this solution and recommended that I proceed with just this one, thus shaping the focus of my final formal proposal. A lot of other resources helped me along the way, such as the Safe Routes to School program information and statistics, the Michigan Department of Transportation Annual report, April Morrison-Harke from the Michigan Fitness Foundation, and a number of other websites and primary sources. 

Author contributions:

Please delineate--in detail--who made what contributions to the process and to the finished proposal? Who took on which responsibilities in researching ideas, drafting language, etc.?

I worked alone on the proposal therefore I was the author for all aspects of this write up. I consulted a variety of people along the way, including my assigned Topic Coordinator, instructors, and other members who have taken this course before, however the final product is entirely my own work. 

===FORMAL PROPOSAL===

The sections below should comprise your final proposal language, submitted for consideration by your peers and potential inclusion in the MSC Platform.

Preambulatory clauses

These set up the PROBLEM, but not the solution.

WHEREAS.... Michigan has the 13th highest high school and 24th highest elementary/middle school obesity rate in the nation

WHEREAS....Medical costs associated with obesity are an estimated $147 billion

WHEREAS.... Children (6-19yrs old) with obesity are at higher risk for having other chronic health conditions and diseases that impact physical health, such as asthma, sleep apnea, bone and joint problems, type 2 diabetes, and risk factors for heart disease

WHEREAS.... Childhood obesity has been called one of the most serious public health challenges of the 21st century

WHEREAS.... Childhood obesity rates have tripled in the U.S over the last three decades

WHEREAS.... 23% of children get no free time or physical activity at all.

WHEREAS.... The number of students in Michigan who walk to school has decreased from 42% to 15% since 1969.

(Add more "Whereas" clauses if necessary.)

Operative clauses

These describe in detail, the solution you are proposing (not the problem itself; those should go in the "Whereas" clauses above).

THEREFORE BE IT RESOLVED....

1. That infrastructure such as sidewalks, signs, street paint, ramps, and islands, be in installed for safe walking and biking routes in a 2-mile radius from all Michigan Public Schools

2. That programs be established and implemented to raise awareness of traffic/walking safety

3. That townships enforce rules and laws that keep pedestrians and bicyclists safe

4. That walk and bike to school groups be established for safe walking

5. That high traffic, speeding, and unlawful motorist behavior areas be identified and avoided

6. That there be periodic police presence during school access hours at identified problem areas (traffic safety or personal security concerns)

7. That students increase their daily physical activity and develop healthy lifelong habits

8. That children are more focused and ready to learn after being physically active

(Add more "Resolved" clauses if necessary.)

Counter-arguments:

What are three reasonable arguments against this proposal?

1. High crime rates both locally and nationally would deter this proposal from being passed. Locally, certain areas of Michigan, such as Flint and Jackson, would be difficult places to build and establish safe walking routes because it is hard to find a large enough area that students would be safe walking to school with or without parent supervision. Nationally, there is a greater awareness of safety and parents are not as willing to let their children outside alone as they used to be just a few decades ago.

2. Funding is a serious argument against this proposal because of the lack of funds that already exist for Michigan schools. The majority of Michigan school districts are among the poorest in the country. Therefore, many would question why money should be allocated to implement safe walking and biking routes to schools when there are more pressing educational issues that should be addressed first. Physical development of youth almost always comes secondary to mental and cognitive development.  

3. The weather in Michigan is certainly a counter-argument to this proposal. While walking and biking to school each day seems feasible in a southern state, such as Florida, Michigan experiences temperatures below 30 degrees for a large portion of the academic school year. Additionally, snowfall and powerful winds deter students from wanting to walk, and parents from feeling comfortable letting their kids walk. When snow accumulates, the township will also need to shovel and pave the routes in order for them to be able to be utilized. This will call for additional funds that may be infeasible given the allocated amounts to install and maintain them. 

Costs and funding:

What will your proposal cost (in direct expenses, lost tax revenue, lost economic opportunity, and/or non-monetary costs)? How will you pay for your proposed legislation? Where will/could the funding for your proposal come from?  Who might object to dedicating resources to your proposal (competing interests)?  

The estimated cost for this proposal is $205.9 million for the initial set up, and an additional $1.8 million per year to maintain the programs, likely decreasing as the programs further develop. Safe Routes to School provides schools with $200,000 to build infrastructure, and an addition $8000 to set up non-infrastructure related programs such as education and safety measures. They also require the school to be able to match 10% of these funds. This means that the estimated total cost to set up and maintain safe walking and biking routes for a single school is about $228,000. There are 900 public schools in the State of Michigan, meaning that the total cost required to implement safe routes for all Michigan public schools is $205.9 million. There is an estimated $1.8 million cost per year thereafter in order to continue safety education and pay officers and cross guards overtime. This will also cover costs to maintain the infrastructure as needed, such as clearing sidewalks and keeping signs and paint clear and visible. Currently, the Michigan Department of Transportation provides the funds for the Safe Routes to School program. They allocate funds as they see accordingly through the Transportation Alternatives Program which is a $29.6 million program. This grant money would be the ideal source of funding for keeping/maintaining the infrastructure after the initial set up because it has a specific budget set aside for “areas as needed”. The initial set up will likely be dispersed over a number of years. According to the Michigan Department of Transportation 2016 Annual Report, “The state transportation revenue package signed November 10, 2015 by Governor Rick Snyder, is effective beginning in FY 2017 with an anticipated increase in new state transportation revenue in the amount of $465 million. Revenue will increase to annual amount of $1.2 billion total in 2021. These additional revenues will help to address the backlog of critical infrastructure needs and allow new enhancements to Michigan’s transportation network.” As a result of the $465 million increase, $50 million allocated to setting up safe walking routes each year for 4 years will cover all costs necessary to complete this project, without taking away a significant portion of the newly allocated funds.

However, there will certainly be competing interests for the newly allocated funds over the next few years. Currently the Department’s focus has been on preserving existing public transportation services and highways. Road rehabilitation and new lane construction is a pressing issue in the State of Michigan that will effect a significantly higher amount of residents than will building safe walking routes. The State and the Department must weigh both the current and future benefits in order to decide on the proportions of investments for each category in the foreseeable future. 

Interview with April Morrison-Harke from the Michigan Fitness Foundation and Safe Routes to School

http://www.michigan.gov/documents/mdot/MDOT_FinancialReport-2016_554076_7.pdf

https://www.michigan.gov/documents/numbsch_26940_7.pdf

References:

These can include websites or other information you have found about the issue.

 

https://www.michigan.gov/documents/numbsch_26940_7.pdf

http://www.michigan.gov/documents/mdot/Section172_PA51_2015__508676_7.pdf

http://www.michigan.gov/documents/mdot/MDOT_FinancialReport-2016_554076_7.pdf

http://www.michigan.gov/documents/mdot/MDOT_TEA_Overview_175763_7.pdf

http://www.saferoutespartnership.org/healthy-communities/101/facts

http://www.michigan.gov/documents/mdch/SRTS_Presentation_Houghton_11-16-10_337946_7.pdf

http://saferoutesmichigan.org/about/

http://www.who.int/dietphysicalactivity/childhood_consequences/en/

http://www.michigan.gov/documents/mde/PE_Stnds.Bench_FINAL_2.14.07_246701_7.pdf

http://www.michigan.gov/mde/0,4615,7-140-28753_38924---,00.html

http://stateofobesity.org/healthcare-costs-obesity/

https://www.metaboliceffect.com/metabolism-and-obesity/

http://obesity.ulaval.ca/obesity/generalities/genetic.php

https://www.cdc.gov/healthyschools/obesity/facts.htm

http://www.obesity.org/resources/facts-about-obesity/childhood-overweight

http://www.michigan.gov/mde/0,4615,7-140-66254_50144-194515--,00.html

https://www.fns.usda.gov/school-meals/nutrition-standards-school-meals

https://www.lmsd.org/departments/nutritional/index.aspx

https://www.lmsd.org/data/files/gallery/AnnualNotifications/11A_Link_A_LMSD_Nutritional_Standards.pdf

 




 

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