Both. These standards have been in place for 134 5/31/06 - PUBLIC HEALTH - RES. 060171 how long?
The snack standard has been in place since last September. Well, last July. Last July. It went into effect actually September when we started school. And the only tools that we have to measure that would be our sales data and our production data within the schools. And, yes, our sales have been affected. We talked about the economic impact, and students do not often choose a healthier item over an unhealthier item, but, once again, this is only the first year that we've implemented this, so we expect that it, as a learning tool, will encourage students to pick healthier food items.
Absolutely. And we truly believe by offering our meal service, the breakfast and lunch and the twilight meal, which is pretty much a dinner meal for the student, we truly 135 5/31/06 - PUBLIC HEALTH - RES. 060171 believe by offering those parts of our meal service, that they're the most important parts. And one example that I can give you is the Fairhill Elementary School serves breakfast to every single student in the school.
Ed Koch is the principal there. And to mention Marge's leap of faith, he took a leap of faith and required his students to come in 20 minutes earlier than the regular school day, and by requiring the students to come in 20 minutes earlier, he sets two 136 5/31/06 - PUBLIC HEALTH - RES. 060171 15-minute breakfast periods for kindergarten to like third grade or fourth grade and then the upper grades for the second minutes. And they come 6 in, and each child chooses four ounces of 7 100 percent fruit juice, either a cereal 8 or a grain and a milk, and they all sit 9 down. Teachers come in, supervise the 10 students, and then they go on to class. 11 And we believe that by doing that, they 12 make healthier choices at lunchtime. 13 They're not starving. You know what 14 you're like when you're really hungry and 15 you go home and you rip apart the cabinet?
Well, when they come to lunch, they're picking items that suit them. They're not overeating. So that healthy breakfast carries the healthy message throughout the day.
And we're just starting, the School District, is just starting to collect the BMI for K to 137 5/31/06 - PUBLIC HEALTH - RES. 060171 -- I mean K to 4, body mass index for K to 4. So we may have more information as we proceed with this to see if what we're doing is actually helping the youngsters as we track their body mass index.
My final 10 question is the BEEP program, B-E-E-P, 11 just elaborate on that, please. 12
Well, I surely can. We've had this program for how many years, Rick? Six years. And we've developed a curriculum to help youngsters learn how to safely ride their bicycle and navigate the streets to be able to develop safe routes in their community to ride bicycles. We have encouraged our group of schools -- And how many schools do we have, Rick? Twenty-nine. Rick Howard is 138 5/31/06 - PUBLIC HEALTH - RES. 060171 our Program Manager for Physical Education in the middle school athletics. Twenty-nine schools are participating in this grant-funded program, and we have been purchasing bicycles for the school so that they can use them in their after-school bicycle clubs, and it's been working tremendously. And we also, in addition to the bicycles, we bought bicycle racks to be installed. In fact, we just gave the City some through the Mayor's office, because they had wanted to put some in Center City. So we allowed them to have some of our racks to install, and we have put them in as many schools as wanted them. This is in an effort to encourage kids to ride their bikes to school.
And to learn more about their community and their environment.
Could you please forward to the Chair just a 139 5/31/06 - PUBLIC HEALTH - RES. 060171 program description and the list of the 29 schools?
Thank you. Thank you very much. The next panel is Mary Platt-Coles, Skip Wiener, Ms. Lehmann, Claudia Malloy and a representative from PCCY. DEPUTY COMMISSIONER PLATT-COLES: Good morning, Councilman and members of the Public Health and Human Services Committee.
Good morning. DEPUTY COMMISSIONER PLATT-COLES: I am Mary Platt-Coles, Deputy Commissioner of the Department of Recreation. With me today are Kate Maus, Director of Maternal, Child and Family Health Services for the Department of Health, and Michael Shelton, Director of 140 5/31/06 - PUBLIC HEALTH - RES. 060171 Camp William Penn operated by the Department of Recreation. In the fall of 2005, the Health Department convened the Philadelphia Childhood Obesity Task Force at the behest of the Director of the Division of Social Services. Task force member agencies include Departments of Public Health, Behavioral Health, Human Services, Recreation, Office of Emergency Shelter and Services, and the Mayor's Office of Health and Fitness. Member agencies understood that the purpose of the task force is to address childhood obesity through interagency collaboration. We have spent some time introducing member agencies to each other's child health-related programs particularly in obesity, and brainstorming for ideas for potential collaboration. Among some of those discussed are the Health Department initiatives such as the 215-GO and the KIC programs. These are comprehensive 141 5/31/06 - PUBLIC HEALTH - RES. 060171 weight management programs offered at three of the eight City healthcare centers. These are physical activity and nutrition programs serving youth. Also in the interests of primary prevention, the Health Department promotes breastfeeding, which research has shown to be a key preventive factor. Ms. Maus is here to answer any questions related to the details of Health Department's programs. In subsequent meetings, the task force has continued to focus on developing specific collaborations that may take advantage of current resources as well as the overarching structure of the Division of Social Services. More recently, representatives from Philadelphia Safe and Sound have joined the task force. As for the Department of Recreation, there has been discussion to connect youth clients from different departments to the Recreation 142 5/31/06 - PUBLIC HEALTH - RES. 060171 Department's recreation centers. Discussions centered on referrals from the other social services departments, such as children and families under care at healthcare centers or the children in foster care and shelters, linking these with structured programs that would be developed at the recreation centers for overweight/obese children. Recognizing that there are limited City resources available to address this public health crisis, the task force decided to tackle the funding issues by investigating grant funding opportunities that would be appropriate for this interagency task force, initiating discussions with managed care companies regarding reimbursement for recreation centers' programs as part of healthy life-style management benefits. Currently, the Department of Public Health is preparing to meet with the managed care companies to pursue this discussion. One of the outcomes of this 143 5/31/06 - PUBLIC HEALTH - RES. 060171 task force work is the development of the Healthy Kids initiative at the Department of Recreation's summer encampment program at Camp William Penn. This six-day program will encourage children to learn the joys of physical fitness, benefits of physical activity, benefits of good nutrition and healthy snacking, and attend body image workshops to feel better about one's body. The various agencies of the Division of Social Services are identifying and recruiting children for this encampment. The Healthy Kids initiative will take place the week of July 3rd through the 8th and is open to the general public. The Department of Recreation has also taken steps to increase physical activity and provide information on the benefits of proper nutrition through our programs at recreation centers. Recreation's teen centers are equipped with state-of-the-art fitness 144 5/31/06 - PUBLIC HEALTH - RES.
060171 equipment to encourage physical fitness for youth and adults. Our teen girls personal development program includes classes on nutrition, fitness and body image. The after-school program provided staff training to recreation specialty instructors on healthy eating, identifying healthy foods via food labels and combining proper nutrition with exercise. The after-school program, working in partnership with The Food Trust, provided educational sessions and games relating to nutrition and exercise topics. Over 600 children received information from this program. Every after-school site received nutrition education packets and an exercise video that was produced by the Philadelphia Department of Public Health. Children from the after-school program recently attended an obesity walk and health fair in Fairmount Park sponsored by Philadelphia Safe and Sound and the Beacon schools. Recreation has 145 5/31/06 - PUBLIC HEALTH - RES. 060171 also identified a Youth Fitness Trainer certificate program from the International Sports Science Association that would teach recreation leaders the skills and knowledge to work with this affected population. This course includes online instruction, class work and practical application and is reasonably priced for staff training. Thank you for your attention today and the opportunity for the Childhood Obesity Task Force to present our information to you.
My name is Skip Wiener. I'm a founder and Executive Director of the Urban Tree Connection. I think I'm the LDADD presentation portion of this hearing this morning. We're going to take an entirely different view of looking at this problem. I work with children on vacant lots in the streets building programs, which I'd like to describe to you. 146 5/31/06 - PUBLIC HEALTH - RES. 060171 The mission of the Urban Tree Connection is to assist low-income communities to revitalize their neighborhoods by transforming abandoned open spaces into safe and functional places that inspire and promote positive interaction. Could you go back, Brian? Urban greening is a very vital way for residents of all ages to bring about positive change in their neighborhood. Greening projects provide economic, environmental, health and social benefits, access to fresh vegetables, promoting opportunities for physical activity through greening. We've worked with hundreds of African-American children in disadvantaged Philadelphia neighborhoods to transform urban blight into urban oases. Over the years in just the Haddington section of Philadelphia, we've transformed an abandoned street into a pedestrian walkway, a paved factory lot 147 5/31/06 - PUBLIC HEALTH - RES. 060171 into a seniors rose garden, a corner lot where a house was raised into a charming perennial garden, an abandoned lot into a children's memorial garden to help grieving families commemorate their children lost to gun violence, the rear of a community center into a vegetable plot, a drug corner into a three-dimensional art and decorated sewer pipe project, and an entire block of neglected front yards into a thriving beautiful streetscape. Earning greening activities succeed when communities are involved in all aspects of the project. It is nationally recognized as a tool in efforts to revitalize low-income urban neighborhoods. In a Chicago housing project, a study has revealed that greening has resulted in lower rates of crime, both against people and property. It also provides opportunities for informal social interaction, fostering the sense 148 5/31/06 - PUBLIC HEALTH - RES. 060171 of community. And these studies are consistent with our experiences. Simply stated, youth in our neighborhoods lead a precarious life fraught with risks for reasons beyond their control. Obesity, as you've heard, is one of the significant issues that we're dealing with. I won't go into the statistics, which you've all heard. Sorry we've been dubbed the second fattest city in America and we have the third highest rate of diabetes among cities in the northeast. In response to some of these issues and our work in the neighborhoods, we've decided to build a children's farm in the Haddington section. This will create opportunities for health education and good nutrition, neighborhood beautification, produce a source of fresh produce, provide top-quality after-school and summer programs, community gardening, and especially collaborative 149 5/31/06 - PUBLIC HEALTH - RES. 060171 opportunities for non-profits to work with for-profits. We're converting a very large lot at Conestoga and Vine Streets to grow fruits, vegetables, herbs, flowers and medicinal plants. We've already cleared the lot and have started planting herbs, fruit trees, seasonal crops. We're running at this point three afternoons a week after school, where children are working with us on this lot to raise food. You have to understand when we do a project that there are no fences around any of the projects we produce, that when we attack a project, it's probably a three- to four-year process where we monitor the kids and how they're using the land. So we don't build something until we understand how the land is going to be used. We tend to squat on land given that there are 30,000 vacant lots in the City and the ownership of land is a boondoggle. So if somebody 150 5/31/06 - PUBLIC HEALTH - RES.
060171 came along and kicked us off and said, There's a better use, we'd go to the next one. So in Haddington, we're creating a complex of gardens and open spaces. When we work with children, usually we get them from school and they're extremely rammy. Hopefully they haven't stopped at the Bodega. I have a possible suggestion that if every child bent down and picked up every potato chip wrapper, that probably would occupy them for that 45 minutes a day in terms of activity. What we're trying to do is to expand what we're doing, in working with hopefully The Food Trust and Jefferson Hospital, to begin to not only grow the food that we're going to be doing with the children, but to help them figure out how to use this food. And we come and we provide snacks to the kids, and Whole Foods has been very generous in the 151 5/31/06 - PUBLIC HEALTH - RES. 060171 provision of snacks. We go to Produce Junction and we buy huge quantities of fresh fruit. And I'm here to tell you that if I put down all this food in front of these children, the first thing they go to is the fresh fruit, not the bags, not the containerized stuff, but they hit the fresh fruit. They can't get enough of it. We overbuy and just keep on supplying kids with fresh fruit every time we work with them. We also have been invited by one of the mental health facilities in the City to do something very unusual in one of the outdoor spaces that we're working in, which is develop a summer camp that has an art, dance, music and gardening component to it, where the culmination of this work would be an outdoor performance that is a coordinated community activity so people can really see intensified use of outdoor spaces. For ten years, our small organization has tended and protected 152 5/31/06 - PUBLIC HEALTH - RES. 060171 many children, providing daily supervised play, work, fresh food and art for public spaces. Because of our experience, we're accelerating this activity to produce this summer camp. This is the power of urban greening and neighborhood family engagement. We are creating healthy communities for people and the environment, and we're about building community one vacant lot at a time. Thank you.
My name is Yael Lehmann and I'm the Executive Director of The Food Trust in Philadelphia. I know we're on a time crunch here, so I'm going to go short. So basically I'm just excited to hear there's a task force for childhood obesity in Philadelphia. I came here today to ask City Council to 153 5/31/06 - PUBLIC HEALTH - RES. 060171 convene a task force for childhood obesity. Maybe that's something that we can continue to talk about. We are interested in developing a comprehensive plan for Philadelphia to reverse this epidemic. We do a lot of work in schools. We're really proud to work with the EAT.RIGHT.NOW Program with the School District, but today I'll focus on the environment, the food environment, and some of our programs that we work on, including supermarkets, corner stores and farmers' markets. Using maps to demonstrate that lack of supermarkets correlated with the incidence of diet-related diseases in neighborhoods, The Food Trust, in partnership with Councilwoman Reynolds Brown, convened a task force to look at the issue. The effort led to the creation of the Pennsylvania Fresh Food Financing initiative, an $80 million financing pool to bring supermarkets to 154 5/31/06 - PUBLIC HEALTH - RES. 060171 underserved areas. We have already funded and opened new supermarkets in Philadelphia and across the Commonwealth. Our farmers' markets promote 6 the consumption of fruits and vegetables 7 by bringing the freshest foods directly 8 to neighborhood residents. We've been 9 able to add wireless EBT machines to many 10 of our markets in the low-income 11 neighborhoods, making them accessible to 12 food stamp participants. Farmers' markets also leverage millions of federal and state dollars to help low-income moms and seniors through the Farmers' Market Nutrition Program where participants receive $20 in vouchers that can be used to purchase Pennsylvania-grown produce. Promoting and expanding farmers' markets in Philadelphia is a great way to increase fruit and vegetable consumption and prevent obesity. School children spend an average of $2 a day on snacks in corner stores and consume approximately 610 155 5/31/06 - PUBLIC HEALTH - RES. 060171 calories a day from snacks purchased at the stores. Changing consumption patterns at corner stores is, therefore, a significant way to impact children's daily caloric intake and affect weight gain and health. And thanks to funding from the Robert Wood Johnson Foundation, we've partnered with local stores to label and promote healthier options. So where do we go from here? With the progress that the Philadelphia School District has made, Philadelphia is already a shining example nationally for improving children's health and is poised to continue to innovate in obesity prevention. Other cities are taking bold steps at the community level. In Boston, Mayor Menino has announced a new plan to eliminate the disparities that exist with access to healthy food, and has provided funding for farmers' markets. Mayor Newsom recently announced the Shape Up San Francisco Program, which will expand the Mayor's summer lunch program to 156 5/31/06 - PUBLIC HEALTH - RES. 060171 include fresh fruits and vegetables. I envision a Philadelphia that has access to healthy food in every neighborhood, supermarkets, smaller grocers and farmers' markets, instead of only McDonald's, Dunkin Donuts and 7-Eleven's. It's a Philadelphia where every child eats a healthy breakfast, either at home or at school, where she learns how to grow up strong from her teachers and her parents, where she can walk from a school to a rec center and then reach home without being bombarded with enticements to consume junk food. By creating a childhood obesity task force, or working with one that already exists, we can develop a comprehensive plan that will put more fresh fruits and vegetables in the hands and bellies of our children. I look forward to working with you. Thank you.
Thank you. Is that Colleen McCauley-Brown? 157 5/31/06 - PUBLIC HEALTH - RES. 060171
The first two testifiers, do you have written testimony, sir?
All right, then. Thank you very much. MS. McCAULEY-BROWN: Good afternoon.
Good afternoon. I'm sorry. MS. McCAULEY-BROWN: My name is Colleen McCauley-Brown. I'm the Healthcare Project Manager at Philadelphia Citizens for Children and Youth, and we're the region's lead children's policy and advocacy organization. I'm also a registered nurse. And I want to begin by thanking you, Councilman Nutter, for holding this hearing to discuss this problem and to highlight what efforts are currently underway and then to hear about what needs to be done to reduce this 158 5/31/06 - PUBLIC HEALTH - RES. 060171 devastating, yet preventable, health problem. And so you've already heard from public health officials, researchers about the increasing prevalence of childhood obesity across the nation and in Philadelphia over the last several years and the serious impact it has on children's physical, social and emotional health and development. What is particularly significant is that its impact is felt well beyond childhood. Obesity in childhood paves the way for obesity in adulthood and all of the concomitant risks associated with it, not the least of which is the risk for the number one cause of death in the United States, heart disease. Nearly three out of four overweight teenagers are projected to be overweight adults, but this does not have to be. Childhood obesity is preventable and we can do more to help children maintain a healthy weight and enjoy better health and 159 5/31/06 - PUBLIC HEALTH - RES. 060171 well-being. At PCCY, we're particularly concerned that children have access to clean, safe outdoor places to play and engage in physical activities. This past year we conducted an assessment of all of the playgrounds attached to every rec center in the City, nearly 160 playgrounds in all, to assess their condition. What we found was truly disheartening. We observed that the equipment in many of the playgrounds is in major disrepair. Many had broken seesaws and dented slides. The swing sets' swings aren't there or the swings are wound up tight above the pole and rendering the swing useless for children. What's most concerning is the condition of the padding underneath the equipment. Most of the playgrounds had padding, 85 percent, but it was considerably worn, especially in areas under the swings and at the bottom of slides where kids are 160 5/31/06 - PUBLIC HEALTH - RES. 060171 more apt to tumble and to fall. Moreover, 90 percent of the playgrounds had rusty equipment and/or were tarnished with graffiti, really heavy graffiti. On top of that, about 75 percent of the playgrounds were littered with trash and broken glass, creating unsafe and unsanitary environments for kids to play. Now, the conditions I've just described don't paint a pretty picture, and we can't expect to tackle the childhood obesity problem if our City's children don't have clean, safe places to play. We can and must do better for children. So what more can the City do to stem the tide of childhood obesity? Well, the City needs to repair, upgrade, clean and maintain its playgrounds and recreation centers in good working condition. And we worked on this issue around the budget season, understanding again the balancing of many demands in the City budget. 161 5/31/06 - PUBLIC HEALTH - RES. 060171 We also recommend that the City explore the possibility of locating more farmers' markets near recreation centers and additional markets near schools where children can more readily access them. We urge the City to talk with proprietors of small convenience stores located near schools, where children often purchase high fat and high sugar foods, to explore incentives for these small business owners to sell more nutritious foods. And we just heard that The Farmers Trust is already engaged in these activities, but what more could be done, what could the City do to incentivize this. And as we've heard as well, the School District is engaged in any number of initiatives to improve students' nutritional status and increase their physical activity.
We recommend that the City work more closely with the District to see what it needs to strengthen and expand these efforts. 162 5/31/06 - PUBLIC HEALTH - RES. 060171 And then we recommend that the City expand initiatives undertaken by organizations like The Food Trust, like the Urban Nutrition Initiative, like the Urban Tree program we just heard about and the National Nursing Consortium to help these programs get to more communities and more kids and more families. I am a volunteer nurse for something called Students Run Philly Style, which is operated by the National Nursing Centers Consortium, and it teaches kids how to run marathons. It's really a tremendous program with committed staff and dedicated coaches that attracts students of all shapes and sizes, and most of them have none or very little running experience or really any kind of athletic engagement previously at all. Recently, 40 students successfully participated in the Broad Street Run, and I wish you could have 163 5/31/06 - PUBLIC HEALTH - RES. 060171 seen them cross the finish line. These are kids who started this program just in the spring and here they are running the Broad Street Run and can't believe that they did it. And I'm the nurse, so I check them out at the end, and they're in good condition. And so 40 students did that recently. And programs like this are helping youth discover the power of their bodies and minds, and more youth across the City really need this opportunity. Finally, we need our public officials to continue to promote the importance of good nutrition and physical activity at every possible opportunity. The Mayor and City Council need to integrate these issues into all the work you do with the public to help reinforce the significance of eating right and exercising, sponsoring public service announcements and health fairs and fun runs. All these things make an important difference to residents across the City. 164 5/31/06 - PUBLIC HEALTH - RES. 060171 And we know that you're engaged in many of these activities already. In closing, there are many exciting initiatives underway in Philadelphia, but we have a long way to go to ensure that children have safe places to play, have access to healthy food and are able to grow up healthy and strong, and we really hope that this hearing is an important first step towards making these goals reality. Thank you.
Good afternoon. I'm Claudia Malloy and I'm with the Center for Science in the Public Interest. We're a national non-profit health and nutrition organization. We have 42,000 members here in Pennsylvania, and I want to thank you for inviting me to speak this morning. Childhood obesity and poor nutrition are complex problems, but there 165 5/31/06 - PUBLIC HEALTH - RES. 060171 are steps we can take now to support parents' efforts to feed their children a healthy diet and help them maintain a healthy weight. One is to establish regulations or pass legislation to require fast-food and chain restaurants to list calories, saturated fat, plus trans fat, sodium and carbohydrates on printed menus and calories on menu boards where there's less space. S. Congress. Nutrition information on menus is needed because Americans are increasingly relying on restaurants to feed themselves and their families. We spend almost half of our food dollars on away-from-home foods. Both adults and children consume about one-third of their 166 5/31/06 - PUBLIC HEALTH - RES. 060171 calories from restaurants and other food service establishments. Studies show that when people eat at restaurants, they tend to eat more saturated fat and calories and less calcium, fiber, fruits and vegetables than when they eat at home. For example, children typically eat about twice as many calories when they eat a meal in a restaurant as compared to a meal at home. Although restaurants provide a range of food choices, without nutrition information, it is difficult to compare options and make informed decisions. For example, your coffee might have 160 to almost 800 calories, depending on what you choose at Starbucks. And ice cream at Haagen-Dazs can cost you as little as 120 calories or more than 1,200 calories. The current system of voluntary labeling at restaurants just isn't working. Half of the largest chain restaurants do not provide a single shred of nutrition information to their 167 5/31/06 - PUBLIC HEALTH - RES. 060171 customers. The chain restaurants that do provide information provide it on websites, which you have to access before leaving your home or office, or are on hard-to-find and difficult-to-read poster and brochures in their stores. CSPI urges the Philadelphia City Council to pass menu labeling legislation. Calorie and other nutrition labeling at chain restaurants could help people make more informed choices for a growing portion of their diet and spur restaurants to reformulate and improve the nutritional quality of their offerings. It would also help children and adults who watch what they eat to manage chronic health conditions, such as diabetes, high blood pressure and heart disease. Another important influence on children's eating habits is food marketing to children. Studies demonstrate that food advertising gets children's attention and affect their 168 5/31/06 - PUBLIC HEALTH - RES. 060171 food choices, food purchases and what they ask their parents to purchase. A recent study by the National Academies' Institute of Medicine concludes that marketing affects children's diets and health. If companies were marketing broccoli and bananas to kids, there would be no reason for concern. Marketing has a negative effect on children's diets, because virtually all the foods marketed to kids are high in calories, salt, saturated fat and refined sugars and are low in nutrients, and those foods are marketed aggressively to kids. Over the last ten years, overall marketing aimed at children doubled from 7 billion to 15 billion a year. About half of that is for food. Marketers reach children through many venues, including television, but also at grocery stores through characters, contests and toys on the packages and everything from 169 5/31/06 - PUBLIC HEALTH - RES. 060171 crackers, sugary drinks, ice cream to Pop-Tarts, fruit snacks and frozen dinners, also in children's magazines. Other ads children can play.
Food products, logos, company spokes-characters are built into "advergames" on company websites. Instead of passively watching a 30-second ad, kids can actually play these ads for hours. Advertising also masquerades toys, like McDonald's Fun Time Restaurant Playset or pretend food from Pizza Hut or Dairy Queen. These ads are so enticing that parents buy them and bring them home so their kids can play with them for hours. School-based marketing has become commonplace, including advertising on school scoreboards and signs, book covers, Channel One and school publications, and vending machines not only sell junk food but are mini billboards in school hallways. 170 5/31/06 - PUBLIC HEALTH - RES. 060171 CSPI urges the Philadelphia City Council to work with the Department of Health to develop nutrition standards for foods that are appropriate to market to children and then limit junk food marketing in schools. It also should fund the Department of Health to conduct marketing campaigns to promote healthy eating and activity. And the Council should urge fast-food restaurants, food manufacturers and TV stations to follow guidelines for responsible food marketing aimed at children. Finally, the School District of Philadelphia's comprehensive beverage and snack policies are a great start, but we encourage the Philadelphia City Council to work with the School District to do a little bit more. For example, the schools should allow only one percent and fat free milk be offered at all grade levels. Milk is the largest source of saturated fat in children's diets. In high schools, we urge that the School 171 5/31/06 - PUBLIC HEALTH - RES. 060171 District eliminate electrolyte replacement beverages, like Gatorade, which is nothing more than sugar water and added salt. And we also suggest reducing drink portion sizes to ounces 7 in high schools. We also recommend that 8 the snack policy include limits on trans 9 fats and portion sizes and that the 10 policy be extended to cover the whole 11 campus all day, including fundraisers. 12 And while school meals have improved over time, we all can do better. Nationally, only percent of schools 15 meet the saturated fat standards for lunches, and three out of four American high school students don't even get five servings of fruits and vegetables each day. To protect children's diets and health, the City Council should work with the school system to continue to make school meals more healthful and appealing to children. Thank you for giving me this opportunity to address you this 172 5/31/06 - PUBLIC HEALTH - RES. 060171 afternoon.
Thank you. A couple questions. Ms. Platt-Coles, let me go back to your testimony. You made mention probably in the most formal way -- it did kind of come up earlier, I think possibly from Ms. Maus -- about the task force, Philadelphia Childhood Obesity Task Force. DEPUTY COMMISSIONER PLATT-COLES: Yes.
Convened last fall. DEPUTY COMMISSIONER PLATT-COLES: Yes.
Involving a number of different agencies. So who is in charge of the task force? DEPUTY COMMISSIONER PLATT-COLES: The Department of Health. They take the lead in the task force.
And so is that Ms. Maus? 173 5/31/06 - PUBLIC HEALTH - RES. 060171
No. 3 DEPUTY COMMISSIONER PLATT-COLES: Could I invite Dr. Suet Lim to the table? She's one of the leads from the Health Department on the task force.
Good afternoon, Councilman Nutter. My name is Suet Lim. I'm Acting Director of Division of Chronic Disease Prevention at the Health Department.
Regarding the task force, that was at the behest of the Director of Division of Social Services. Deputy Commissioner Larry Robinson is the senior Health Department staff who convenes the task force meeting. The first meeting was held in November, I believe, 11, 2005. The second meeting was held in December about a month later. And since about, I would say, January the 174 5/31/06 - PUBLIC HEALTH - RES. 060171 task force has been meeting more regularly at an interval of two weeks.
And out of this will there come -- there's been discussion earlier. I don't know if you have been here from the beginning. There was a lot of discussion earlier about a plan for Philadelphia and a coordination of a variety of agencies in the government, outside the government, other public entities, of course the School District and the like. Is it anticipated that there will be a comprehensive plan developed for Philadelphia to address this issue?
The task force was not charged to develop a comprehensive plan. I believe it was primarily around departments under the Division of Social Services, and our intent was to try to figure out through collaboration between those agencies to address childhood obesity. At this point, the task force is working really with different agencies 175 5/31/06 - PUBLIC HEALTH - RES. 060171 within the City system.
So to your knowledge, no one is really working on a plan for the City to address this particular issue and have an entity or some authority in charge of moving it forward?
I don't believe the Health Department has been charged with producing such a plan.
Are you aware of anyone else being asked to develop or coordinate a plan?
Okay. Thank you. Ms. Platt-Coles, let me come back to a specific Recreation Department question. Can you provide to the Chair -- let me ask a different question. We have active recreational programs and activities at every recreation center in the City? 176 5/31/06 - PUBLIC HEALTH - RES. 060171 DEPUTY COMMISSIONER PLATT-COLES: When you say "every recreation center," do you mean the small D centers that are open seasonally? I'd have to forward that information to you. I can't sit here and say that there is some activity going on at every single center, because there are centers over and above the 160 program centers that are small buildings that some aren't utilized year round or not at all, and I'm not aware of what's going on at all of those centers. But currently there are 160 rec centers that have program services going on, A, B and C centers and a few D's.
And how many children do you think we serve a year through those programs? DEPUTY COMMISSIONER PLATT-COLES: We do have stats on that. I don't have those with me, but I can forward those to you. It's thousands and thousands. 177 5/31/06 - PUBLIC HEALTH - RES. 060171
Well, I would hope. DEPUTY COMMISSIONER PLATT-COLES: Hundreds of thousands.
We've got a couple hundred thousand kids in this City, probably close to about 400. DEPUTY COMMISSIONER PLATT-COLES: The way we count our participant numbers, it may be one child who comes five times a week to go swimming, so that's counted as five visits.
Right. But do we also have stats on actual numbers of children at a particular center who are -- DEPUTY COMMISSIONER PLATT-COLES: Registered for programs? Yes. We have statistics on the kids that are registered for programs. Now, the drop-in kids, I don't believe there's numbers particularly kept on those.
Okay. But 178 5/31/06 - PUBLIC HEALTH - RES. 060171 you'll get us through the Chair information on that? DEPUTY COMMISSIONER PLATT-COLES: Yes.
You mentioned two programs that I'm not familiar with. One seems to be kind of a take-off on our area code, 215-GO, and is this KIC? DEPUTY COMMISSIONER PLATT-COLES: Yes. Those are Health Department programs.
Right. But they're in your testimony. DEPUTY COMMISSIONER PLATT-COLES: Right, because the testimony was about the Childhood Obesity Task Force and to mention some of the programs that are existing that are addressing childhood obesity. That's why it's there.
Okay. Can you tell me anything about them? DEPUTY COMMISSIONER 179 5/31/06 - PUBLIC HEALTH - RES. 060171 PLATT-COLES: No. They're not Recreation programs. I believe we have someone here.
We're still working on that collaboration component, right?
Hi. It's Kate Maus from the Health Department. 215-GO, and I have a cheat sheet here that tells me exactly what it stands for, 215-GO is an acronym and its meaning is 2, less than two hours of television time or sedentary activity a day; 1, at least one hour a day of physical activity; 5, five servings of fruits and vegetables daily; and GO for Great Opportunities. 215-GO is a comprehensive pediatric obesity clinic that we started in two district health centers, Centers 5 and 9, and which has now been expanded to Health Center 6. We provide through 215-GO -- we serve children 3 to 17 who are enrolled in the health district's 180 5/31/06 - PUBLIC HEALTH - RES. 060171 family medical care programs, and it's open to kids with a body mass index of greater than 85 percent for their age or gender or who have experienced rapid weight gain with a BMI change of greater than two points per year. We also serve children who are failing to thrive who are sort of the other end of the nutritional problem area. Kids are referred by their pediatricians and nurses working in the family medical care clinics based on the above criteria, and what they get is comprehensive medical care from a pediatrician. They have a nutritionist who does a detailed nutrition and physical activity assessment involving how they use -- what's their diet, how do they use sweetened drinks, snack food and food intake outside the home. So addressing some of the issues that we've heard today. And then they have a health educator who is also a counselor, who does the really important work around 181 5/31/06 - PUBLIC HEALTH - RES. 060171 assessing a patient, a child, and a parent's attitudes and beliefs toward weight and eating and their self-image and what's going on in their family that may be contributing to their weight problem. And the Kids in Control program, the KIC program, Kids in Control, is a weekly exercise program that aims to involve overweight children 5 to 17. It's also held at the health center, and these are children who are referred by their pediatricians at the respective health centers. The program is run by a health educator, and it's our strategy to combine physical activity with the nutrition counseling and the health education and the pediatric assessment that we provide for the kids.
Let me just ask you one quick question and then we have one more panelist. This discussion going back to the beginning, and I hate to kind of keep 182 5/31/06 - PUBLIC HEALTH - RES. 060171 going back to it, about the kind of systematic infrastructure, the discussion now about a task force that exists and apparently the Health Department has not been charged to be the coordinating entity -- which maybe they should, maybe they shouldn't, I have no opinion on that at the moment, but from your perspective as a professional in the area, would you agree that there's a need for not only the collaboration and the task force, but the bringing together of in government, outside government, foundation community and the like, we need a plan, right?
Actually, the thing that came to my mind was the work that the asthma task force, the Allies Against Asthma group, has been doing looking at asthma and preventing it and managing it, and that task force includes public agencies, private agencies. It's supported by the Robert Wood Johnson Foundation. It looks to me like it would be an ideal model. 183 5/31/06 - PUBLIC HEALTH - RES. 060171
Well, that will be a perfect segue to our next panel. So thank you very much. Dr. Keshia Pollack. Could you please identify yourself for the record.
Good afternoon. My name is Dr. Keshia Pollack and I'm here today representing the Childhood Obesity Team at the Robert Wood Johnson Foundation in Princeton, New Jersey.
Dr. Pollack, first let me thank you for your tremendous patience. As a doctor, I'm sure you've acquired patience over a long period of time. We've had an extensive hearing today and you've heard a great deal. I want to thank you for your participation and also the great work of the Robert Wood Johnson Foundation, not only nationally but more directly specifically here in Philadelphia. In the best of terms, you would 184 5/31/06 - PUBLIC HEALTH - RES. 060171 in baseball, you would be considered the number four hitter. You would be the clean-up hitter, which is the premiere spot, because we assume that the first three individuals have gotten on base, we now expect you and the Robert Wood Johnson Foundation to wrap this all up for us, hit a home run and a grand slam and share some good information with us, but also tell us about some of the best practices across the country. And I really appreciate you being here.
Thank you very much. We really appreciate the invitation. It's a real pleasure to be here. My remarks today are going to be brief with the time constraints, but I'm going to focus on just three main areas that I want to leave you with today. I'm going to begin by talking about RWJF's approach to preventing childhood obesity and how local government play a critical role in our 185 5/31/06 - PUBLIC HEALTH - RES. 060171 strategy. S. And let me just say that I actually have to send you an updated copy of my testimony, which you'll have later this afternoon. At the Robert Wood Johnson Foundation, our goal is to help halt the rise in childhood obesity rates by 2015 by promoting healthy eating and safe physical activity in schools and communities. We use a three-pronged approach. First, because we still believe that there's a lot to learn, we focus on building the evidence by setting changes in policies and environments in schools and communities about food and physical activity, and trying to decipher which one of these will have the greatest impact on obesity. These include school 186 5/31/06 - PUBLIC HEALTH - RES. 060171 policies such as ending the sale of sugar, sweetened beverages in vending machines and cafeterias. And while this seems like common sense, RWJF studies policies like these to know again which ones will be effective and most effective. Second, we focus on testing innovative approaches to find out which ones really work, and we're also evaluating these innovations. For example, in 2004, we provided a grant to The Food Trust to develop school and community-level interventions to prevent and reduce obesity amongst 4th through 8th graders by assessing the foods available sold in corner stores and developing a social marketing campaign to promote healthy eating and physical activity. This is one example that we are very proud of of an innovative approach that everyone in the City of Philadelphia should be as equally proud of. 187 5/31/06 - PUBLIC HEALTH - RES. 060171 Third, we focus on sharing what we learn with civic leaders and advocates about what they can do now and in the future to curb the epidemic of obesity. One example of our work in this area is through a program called Active Living Leadership where we design and educate state and local officials on how -- the impact of changing environments on how that impacts physical activity. Since we focus on changing policies and environments, we believe that governments at all levels play a critical role in this effort. From our work with the National Council of the State Legislators, we know that state governments, for instance, have been very active in considering policy options. Most of these actually remain focused on the school system. For example, we know in 2005 22 states passed legislation for setting guidelines on physical activity or education, 11 states passed legislation talking including education 188 5/31/06 - PUBLIC HEALTH - RES. 060171 on nutrition and physical activity and health education curricula, and three states enacted measures that require reporting of body mass index. And it's interesting that many people wonder why are they focused most on the school systems, and we know based on data that overweight adolescents have up to an 80 percent chance of becoming overweight adults and, thus, lawmakers believe that mandating or recommending nutritional and physical education guidelines for schools will encourage children to make healthier choices in the future. Pennsylvania, like many other states, has shown interest in policy changes with proposed legislation targeting school settings, but many times some of these proposed bills have faced political barriers. But rather than letting these challenges stymie activity, other agencies have moved forward with action. For example, we've heard earlier 189 5/31/06 - PUBLIC HEALTH - RES.
060171 that the City of Philadelphia enacted efforts to modify school environments, including the ban on sodas that took place in 2004. S. Environmental changes like this deserve applause, but we still need to devote resources to evaluate and determine their effectiveness. I'm going to wrap and close with a few comments and just say we know that there's no silver bullet to combat this epidemic. We know that as our efforts over recent years to modify policies and environments for tobacco, for instance, it's only through a concerted, coordinated, multi-faceted approach that we will be equally effective in addressing childhood obesity. Childhood obesity prevention efforts need to focus on both sides of the energy balance equation. These 190 5/31/06 - PUBLIC HEALTH - RES. 060171 initiatives should not just focus on nutrition and healthy eating, but also how to provide access to safe and meaningful physical activity for kids. Let me leave you with a few easy and practical strategies drawing on some best practices from cities across the nation, recognizing physical constraints of the local government. First, since children need safe places to live, learn and play, you can enact policies that address safe physical activity. Improving the safety of roads and crosswalks to better facilitate walking and biking are one option. Encouraging crossing guards and the implementation of safe routes to school programs are another option. Providing and maintaining public restrooms near parks and open spaces, we found, is a key factor related to the length of time that individuals stay outside. And we also know that there are a number of after-school programs that can be 191 5/31/06 - PUBLIC HEALTH - RES. 060171 strengthened to provide opportunities for kids to continue to play. All of these strategies can increase opportunities for safe physical activity in the community. You're doing a great job here in Philadelphia with your Blueprint for violence to continue to address violence as a barrier, and this, we know, also prohibits children from playing outside. Most importantly, I think the local government has enough power to really ensure that these facilities and opportunities are equitably distributed. Another practical action for consideration is the use of joint use agreements. We heard earlier about an effort to build new gymnasiums across the City. In major cities, including Los Angeles and Seattle, they are employing these agreements that outline joint use of public facilities between the School District and the City parks or recreation. So, for example, in Philadelphia, there would be rules that 192 5/31/06 - PUBLIC HEALTH - RES. 060171 say school facilities can be used in evening times and on weekends, and the School District and the City are going to take a joint effort in terms of maintenance and really ensuring that these opportunities are available for people to go in and engage in safe physical activity. And, third, we really think it's important that you can build on the existing work you're doing that have been described in the earlier panel about the food environment. There are many practical strategies that are already here in Philadelphia that can be enhanced. Philadelphia is already known as this wonderful city with its beautiful murals. It could also be known as a place with beautiful community gardens, building on the work of the Urban Tree Connection, or it could be known as a place that has accessible grocery stores in every single community, building on some work with The 193 5/31/06 - PUBLIC HEALTH - RES. 060171 Food Trust. It could also be known as a place that has strong links with state farmers through farm-to-school programs and farmer markets. These are feasible, pragmatic, local efforts that are easy to implement. Let me end by saying policy changes in the community and schools are certain to not only affect childhood obesity, but are likely to make life easier for parents, older adults and all residents.
Each and every person, young and old, deserves to live in safe and healthy communities. You, the elected leaders of the City of Philadelphia, are in the position to enact policies that do exactly that. I thank you for your time today.
First, Dr. Pollack, thank you again very much and I do look forward to receiving your testimony. You have enhanced the weight of this hearing. Again, the Robert Wood 194 5/31/06 - PUBLIC HEALTH - RES. 060171 Johnson Foundation and certainly your personal presence is well recognized across the country. You have funded any number of initiatives here in Philadelphia, and your participation is significant. Just maybe two questions. One, to the extent that you can, I think your personal involvement and the involvement of the Robert Wood Johnson Foundation in efforts moving forward, the Foundation is the kind of entity that can utilize its prestige and reputation to not only encourage people to work together but also foster some of the changes in public policy that individuals like ourselves, whether local elected officials and certainly state elected officials, often will pay that much more attention to. So I want to assure you or reassure that the Foundation's work makes a difference and people do pay attention. And I can only ask as we move forward for your continued involvement to help keep all of us 195 5/31/06 - PUBLIC HEALTH - RES. 060171 focused on what's really important here, which is about the health of kids and the not so young. So hopefully you'll be able to keep working with us?
Yes. We are very committed to moving forward and to working with you and follow-up conversations here and really encouraging and bringing along some of our grantees and other individuals that we've heard from today. I just want to say, an earlier comment from Dr. Foster about the infrastructure issues here, I think that we can really draw on some expertise of individuals here in this room. I know The Food Trust has been moving forward with developing a plan. I think they need to be at the table. We need to think about who is involved in the Philadelphia task force already and make sure that the right organizations are involved. And I was talking to Ed Pollack at The Food Trust who says that 196 5/31/06 - PUBLIC HEALTH - RES. 060171 they're not in there. I'm not sure why they're not, but I think we need to go back and look and see who is involved in the task force. Again, not to swell this agency to have hundreds of organizations, but to make sure that the key ones are there.
Right. The second is less weighty. There have been a number of occasions where we've had individuals up at the table and so now I need to ask you. When you were a young person, did you grow up with seatbelts?
Okay. I thought you might be of age that they were available. Thank you.
Is there anyone else to testify on this resolution? (No response.)
We will 197 5/31/06 - PUBLIC HEALTH - RES. 060171 recess this Committee hearing until the call of the Chair. Thank you all for coming in and thank you for your testimony. I'm sorry I had to leave the room for a moment, but we had it on upstairs. The squawk boxes in the offices are on. We appreciate your coming, taking time out from your schedules to come. Thank you very much.
Madam Chair, I want to thank you again for your support and the coordination with staff, all of the participants. I think as was said earlier, there have been any number of great things happening here in the City. There, of course, is much more work to do, and I think the coordination and collaboration will move us in the right direction. I do at least lastly want to add for the record, and I teased him earlier, but now I want to more formally officially thank our 198 5/31/06 - PUBLIC HEALTH - RES. 060171 soon-to-be-in-a-couple-years doctor, Arthur Robinson Williams, who has operated all of the technical equipment over there, and thank him for his continued commitment to health issues here in Philadelphia, and wish him the best in his medical school study. Thank you. Thank you, Madam Chair.
Thank you. (Committee on Public Health and Human Services adjourned at 1:25 p.m.) - - - 199 CERTIFICATE I HEREBY CERTIFY that the proceedings, evidence and objections are contained fully and accurately in the stenographic notes taken by me upon the foregoing matter on May 31, 2006, and that this is a true and correct transcript of same. ______________________________ MICHELE L. MURPHY RPR-Notary Public (The foregoing certification of this transcript does not apply to any reproduction of the same by any means, unless under the direct control and/or supervision of the certifying reporter.)