For decades people have fretted about the growing number of obese children and the increasingly adult health dangers they face.
But when it comes to solutions the chatter quickly shifts from public epidemic to problem parenting, with all the blame associated with it.
For Lincoln pediatrician Dr. Karla Lester, who left her medical practice in 2008 to start her nonprofit public health organization Teach a Kid to Fish, the lack of coordination and cross-organization cooperation is a long time frustration.
But now, thanks to Children’s Hospital & Medical Center’s new statewide initiative, Center for the Child & Community, Lester is eager to move the issue from talk and statistics to action.
Lester is director of the newly established center, which aims to integrate health care and public health efforts to improve the overall well-being of children across the state.
The center is headquartered at Lincoln’s Innovation Campus. Down the hall is Teach a Kid to Fish. Lester also serves as medical provider for Children’s HEROES pediatric weight management clinic in Lincoln.
The Center for the Child & Community integrates three basic building blocks needed for a healthy and happy childhood:
* Safe environment
* Sound nutrition
* Healthy relationships
The center’s goal: “To make sure that every child in Nebraska has these three critical needs met,” and that “every child has the opportunity to reach his or her full potential,” Lester wrote in the center's vision and mission statement.
Turning lofty goals into visible realities will be a collaborative effort, Lester said. The center will provide the resources and education so communities across the state can create local solutions to address large-scale children’s health issues such as child obesity, poverty, injury prevention and food insecurity. It also will serve as matchmaker -- building partnerships with individuals and organizations across Nebraska to improve the health of children and strengthen Children’s Hospital’s role in advocacy and health care policy.
For Lester, Children’s Center for the Child & Community is the dream she has doggedly pursued for the past eight years, since starting Teach a Kid to Fish.
Nebraska's statistics are dismaying and urgent, she said. They include:
* Half of Nebraska children live in or near poverty.
* Nearly half qualify for free and reduced meals at school.
* One in three Nebraska children are considered overweight or obese -- a disproportionate number of them living in poverty.
* More than 40 percent experience at least one adverse childhood experience (ACE) or trauma; more than one in 10 have three or more ACEs.
Increasingly, research confirms a strong link between poverty and childhood stress to lifelong health challenges and higher risks for chronic disease. The more ACEs, the higher the risk of poor health, national studies show.
But for all the research and hand-wringing there has yet to be a solution -- the “what are we going to do about it?” answer, Lester said.
The Center for the Child & Community will find those answers and efforts, and then coordinate and implement successful programs in other communities, Lester said.
“There are a lot of positive efforts happening, but there hasn’t been a hub of coordination to ensure the biggest impact,” she said. “Children’s is a high-level partner that has the expertise and infrastructure to offer communities the support they need. Children’s brings the vision and the resources to move the needle.”
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She gives Children’s President and CEO Dr. Richard Azizkhan much of the credit. “It is our vision for Nebraska to have the healthiest population of children in the Midwest and the in the United States,” Azizkhan said in announcing the new center. “The children and families we serve deserve nothing less; we owe it to them to think bigger, take action and work more collaboratively.”
Lester knows this from professional -- and personal -- experience. It is not enough to tell kids to exercise more, to tell parents to turn off the screens and serve more fruits and vegetables.
Childhood obesity and the health problems it creates -- from heart disease, to metabolic issues to type 2 diabetes -- are far more systemic than simply pointing accusing fingers at parents, Lester said.
What causes childhood obesity?
“Everything,” Lester said.
What’s the remedy?
“Social solutions,” she said.
She points to the American lifestyle: the allure and reliance on processed foods; dashboard dining; the spoonfuls of sugar we consume mindfully and mindlessly; “to an entire food system that allows for unhealthy food,” Lester said.
“Unhealthy food is cheaper. Acquiring quality, nutritious food is difficult. … The marketing of unhealthy foods to younger and younger ages … Increasing copious opportunities for sedentary living. It is exceedingly difficult to find balance with screen-time. … It’ a tough thing for parents,” she said.
Then look at society: Urban sprawl, lack of safe routes to walk or ride a bike to school, less time for physical education classes, reduction -- and even the elimination-- of recess.
“All kinds of things happening in one fell-swoop,” Lester said.
And while some issues are higher among families living in poverty, the reality is the issues affect all socio-economic levels, Lester said.
“It’s the reality of the society we live in. It is tough to raise healthy children, but it is possible,” Lester said.
Which is where Children’s Center for Child & Community can make the kind of difference Lester has long sought.
“Teach a Kid to Fish has done great things, but to have a big impact, it needed to become part of something bigger,” Lester said.
Children’s is that “something.” With its statewide clout and vast expertise it can team up with communities sharing resources that allow them to build upon and expand successful programs.
“The center allows us to improve the quality of health care while we’re also preventing and reducing diseases and reducing healthcare costs,” Lester said.
“Children’s understands the issue is broader than ‘health,’” Lester said. “It is keeping children safe. Healthy and active lifestyles. Social and emotional well-being for children. It’s not just a single factor, we look at the whole of child’s health.”
The Center, which opened earlier this summer, is in the process of identifying critical needs and potential partners, Lester said.
Asset mapping is the next step -- the center will analyze existing efforts and data before developing a formal plan. The focus will start in Lincoln and Omaha and radiate to more rural communities with time, Lester said.
“Health care providers, educators and other community health champions across the state need more support than they’ve been getting,” she said. “We hope to be additive -- to arm these champions with resources and, ultimately, make all children healthier.”
Because as Lester knows all too well: “We’re not going to get anywhere with the blame game,” she said.