In evaluating approaches to addressing obesity, the 85th Legislature may consider one study’s findings that a state-funded fitness program did not achieve its goal of reducing obesity among Texas middle school students. Lawmakers are studying state programs targeting chronic disease and obesity as part of a House interim charge.
A University of Texas study published this year found that Texas Fitness Now, a state program to reduce obesity rates for students at low-income middle schools, improved students’ physical fitness but failed to reduce obesity. Results of the study have raised questions about how the Legislature should approach this issue. More than 60 percent of Texans are either overweight or obese, according to the Department of State Health Services (DSHS), which can negatively affect long-term health and lead to higher rates of chronic disease. This also can lead to increased Medicaid costs, according to the Brookings Institution.
From 2007 to 2011, the Texas Fitness Now program provided grants to fund in-school physical education and fitness programs, with the goals of reducing obesity, increasing fitness, and raising academic achievement. While the university study found that the program did not significantly reduce obesity as measured by body mass index, its authors noted that there is little evidence that physical fitness programs can successfully reduce obesity without also focusing on nutrition. Texas Fitness Now required 25 percent of program funds to be spent on nutrition, but the study found school districts did not meet that requirement.
The Legislature may consider a variety of approaches to address obesity. The Centers for Disease Control and Prevention (CDC) published a list of 24 strategies, such as increasing the availability of affordable, healthier food and beverage choices in school cafeterias and other venues and reducing screen time for children in state-licensed child care facilities. Texas has implemented some approaches consistent with CDC recommendations, such as making it easier to buy food from farms and requiring physical education in schools. The Texas Department of Agriculture, DSHS, and the Texas Education Agency (TEA) also run several federal- and state-funded programs that target obesity.
The 84th Texas Legislature this year considered, but did not enact, a bill that would have created a program similar to Texas Fitness Now. HB 711 by Raymond would have required DSHS to implement a grant program to support initiatives on childhood health, fitness, and obesity prevention. The department would have awarded grants based on an initiative’s quantifiable effectiveness and potentially positive impact on the health of participating children.
The finding that Texas Fitness Now was not successful in reducing obesity has led to debate about the types of programs the state should fund. While some stand behind the accomplishments of Texas Fitness Now and support funding similar approaches, some critics say the state should use only obesity programs with demonstrated effectiveness and evaluate them regularly to ensure state funds are spent wisely.
Supporters of programs like Texas Fitness Now say the state should continue to fund similar measures to prevent and reduce obesity. The program was influenced by research indicating that high-quality physical education is associated with lower rates of obesity and Type II diabetes, a related, chronic health challenge. It achieved its goal of increasing the fitness of middle school students and allowed low-income school districts to buy needed fitness equipment. A TEA evaluation also found that Texas Fitness Now campuses with high physical fitness scores were positively correlated with high academic performance, another aim of the program. State-funded, school-based programs like Texas Fitness Now are essential to helping children establish lifelong, healthy behaviors during the large part of the day they spend at school.
Critics of programs like Texas Fitness Now say it is potentially a waste of money to provide grants for interventions that are not evaluated using best practices and that do not have a clear record of previous effectiveness. Texas Fitness Now did not meet its primary goal of reducing obesity. The program did not require districts to implement a specific fitness and anti-obesity curriculum, and fewer than half of districts reported using one, according to the University of Texas study. In evaluating the program’s effectiveness, TEA did not compare school districts that participated in Texas Fitness Now to those that did not, and the lack of curriculum requirements also prevented evaluation of which district’s anti-obesity approach was most effective. Some critics favor broader interventions that also would encourage healthier eating habits among students during the school day, while others contend that the state should not intrude upon the authority of parents to make decisions about their children’s health and nutrition.
by Lauren Ames