Childhood Obesity

Overview

Childhood obesity is a serious public health epidemic. During the past four decades, obesity rates have soared among all age groups, increasing more than four times among children ages 6 to 11. Nearly one-third of all U.S. children and adolescents, more than 23 million, are either overweight or obese. In addition, rates of childhood obesity have increased disproportionately among African-American, Latino, Native American and low-income children. 123

The Causes

Several factors contribute to the rapid increase in obesity rates—among them is the consumption of unhealthy foods and beverages in ever-larger portions. During the past 20 years, the typical calorie content of menu items like French fries and sodas has increased approximately 50 percent. 4 American youth also have become less physically active. More than 90 percent of elementary schools do not provide daily physical education classes in school. 5 At the same time, youth have adopted more sedentary lifestyles during their out-of-school hours. Instead of engaging in physical activity, American kids spend an average of four to five hours per day on “screen time”—watching television, playing video games or using a computer. 6

In many communities, families have few opportunities to make healthy choices. A study of more than 200 neighborhoods found that there are three times as many supermarkets in wealthy areas as in poor areas. The same study found four times as many supermarkets in predominately white neighborhoods as in predominantly African-American communities. 7 Furthermore, residents of lower-income communities have less access to places where they can be physically active, such as sports facilities, parks, green spaces, bike paths and lanes, walking trails and public pools. 8

The Consequences

Obesity takes a steep toll on the health and well-being of children. Overweight and obese children are at higher risk for a host of serious illnesses, including heart disease, stroke, asthma and certain types of cancer. And, these children already are being diagnosed with health problems that previously were considered to be “adult” illnesses, such as type 2 diabetes and high blood pressure. 9 These negative health consequences are especially concentrated for African-American, Latino and Native American children. 10 The Centers for Disease Control and Prevention projects that the number of people affected by type 2 diabetes is expected to increase from 11 million to 29 million by the year 2050. 11 The evidence suggests that, if we don’t reverse these trends, we’re in danger of raising the first generation of American children who will live sicker and die younger than the generation before them.

Obesity also has serious consequences for the health care system and the nation. Studies estimate that, overall, our nation’s obesity epidemic is costing the country more than $117 billion per year in direct medical costs and indirect costs related to reduced productivity and absenteeism. 12 Medicaid and Medicare pay for about half of the direct medical costs. Rising childhood obesity rates suggest that these costs will continue to increase—at greater expense to taxpayers—if nothing is done to reverse the trend.

What We Do

Leadership for Healthy Communities works with local and state government leaders because they make important decisions that affect people’s opportunities to eat healthy foods and be physically active within their communities. At first glance, you might think these daily decisions are about budgets, laws, regulations or zoning, but they are also about sidewalks, bike trails, playgrounds, recreation centers, school meal programs, neighborhood farmers’ markets and fast-food billboards near schools. We help government leaders make the connection between their policy priorities and decisions and the health of their constituents—and we support them in their efforts to create healthier communities by developing tools and materials that educate and engage diverse policy-makers, and by facilitating cooperation between leaders at all levels of government.


  1. Ogden CL, Carroll MD, Flegal KM. “High Body Mass Index for Age Among US Children and Adolescents, 2003-2006.” Journal of the American Medical Association, 299(20):2401-2405, May 2008.
  2. Crawford PB, Story M, Wang MC, et al. “Ethnic Issues in the Epidemiology of Childhood Obesity.”
    Pediatric Clinics of North America 48(4): 855–878, 2001.
  3. Powell LM, Slater S and Chaloupka FJ. “The Relationship Between Physical Activity Settings and Race, Ethnicity, and Socioeconomic Status.” Evidence-Based Preventive Medicine 1(2): 135–144, 2004.
  4. Nielsen SJ and Popkin BM. “Patterns and Trends in Food Portion Sizes: 1977–1998.” JAMA, 289: 450, 2003.
  5. “School Health Policies and Programs Study.” Journal of School Health, 71(7): 2001. Available at
    www.cdc.gov/healthyyouth/shpps/overview/index.htm .
  6. Roberts DF, Foehr UG and Rideout V. Generation M: Media in the Lives of 8–18 Year Olds. Menlo Park, CA: Kaiser Family Foundation, 2005.
  7. Morland K, Wing S, Diez Roux A, et al. “Neighborhood Characteristic Associated with the Location of Food Stores and Food Service Places.” American Journal of Preventative Medicine, 2002, 22[1]:23-9.
  8. Powell LM, Slater S, Chaloupka FJ. “The Relationship Between Community Physical Activity Settings and Race, Ethnicity and Socioeconomic Status.” Evidence-Based Preventive Medicine 2004,1(2):135-44.
  9. Must A and Anderson SE. “Effects of Obesity on Morbidity in Children and Adolescents.” Nutrition in Clinical Care, 6(1): 4–11, 2003.
  10. Narayan KMV, Boyle JP, Thompson TJ, et al. “Lifetime Risk for Diabetes Mellitus in the United States.” JAMA, 290: 1884–1890, 2003.
  11. Boyle JP, Honeycutt AA, Narayan KM, et al. “Projection of Diabetes Burden Through 2050: Impact of Changing Demography and Disease Prevalence in the U.S.” Diabetes Care, 24(11): 1936–1940, 2001.
  12. Overweight and Obesity: At a Glance. Washington: U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General. Available at http://www.surgeongeneral.gov/library/calls/obesity/fact_glance.html

Leadership for Healthy Communities is a national program of the Robert Wood Johnson Foundation.

Robert Wood Johnson Foundation