I just returned from quick trip to Washington, DC to attend the Childhood Obesity Prevention Summit sponsored by the Leadership for Healthy Communities, a national program of the Robert Wood Johnson Foundation.

This was not, by far, my first exposure to the subject. The health impacts of community planning and public policy have been a theme of the Local Government Commission (LGC) for years and a mainstay of the annual LGC New Partners for Smart Growth conferences. Earlier this year, Contra Costa County Health Services put on the Leadership Forum on Health and the Built Environment conference in San Pablo.

However, it struck me yesterday that while violence and homicide continue to dominate the news about Richmond and absorb substantial energy of community activists and a growing part of Richmond’s General Fund, a broader, more enduring and more pernicious health threat is endangering the future of not dozens, but thousands, of Richmond’s young people.

There is no “Office of Active Living and Healthy Eating” down at City Hall, and no one has suggested a tent city to promote exercise and proper diet. Yet far more people will die young or have the quality of their lives severely curtailed by preventable chronic illness related to diet and physical activity than street violence.

Unlike fatal gunshots that rip through the night, there is nothing illegal about these killers -- the triple threats of childhood obesity, diabetes and asthma. Taken together, however, the impact is far greater and affects far more people than even that of our current unacceptable rate of homicides. The phenomenal rise in childhood obesity, diabetes and asthma has been caused by changes over just a generation or two in our environment, culture, lifestyle and community design.

While these trends are nationwide, they are accelerated in communities of color, like Richmond. With perhaps 30,000 children under 14 years of age and a combined African American and Latino population of 60%, or more, the implications for Richmond are staggering.

American children are growing fatter, and Richmond is surpassing the national averages In last year’s State fitness test, fewer than one in five students in the West Contra Costa Unified School District can run a mile or perform other fitness tests in aerobic endurance, body fat and flexibility, and abdominal, lower back and upper body strength to earn a passing grade. (District Officials Are Taking Steps to Increase Physical Fitness Among Students, By Kimberly S. Wetzel, Contra Costa Times, Walnut Creek, Calif. Nov. 25—“Think you could run a mile?”)

Running a mile in ten minutes should not be not a big deal. Three Council members, one over 50 and another over 60, ran three miles in the Home Front Festival 5K run last month (Festival Brings Thousands to Richmond for History and Sunshine, October 1, 2007).

In Contra Costa County, 35 percent to 43 percent of non-Hispanic white and Asian-American students passed the standards in all six areas compared to only 17 percent to 23 percent of African-American and Latino students. The results were similar in Alameda County. Between 35 percent and 47 percent of non-Hispanic white and Asian-American students achieved all fitness standards, compared to 18 percent and 27 percent for African-American and Latino students.

Thousands of Richmond kids will survive street violence only to succumb at a premature age to chronic illnesses that can largely be prevented. Diabetes is the sixth leading cause of U.S. deaths. Rising rates of type 2 diabetes among younger and younger Americans are a huge public health concern. Nationwide, African Americans and Hispanics are twice as likely as white adults to have diabetes. In Contra Costa County, African-Americans are 12% more likely to be diagnosed with diabetes compared to the bay Area as a whole (5%).

Africans Americans and Latinos, as well as people living in San Pablo, Richmond and Pittsburg, are more likely to die from diabetes compared to Contra Costa County as a whole.

Experts predict that if current trends continue, one in four African American and Latino children born in California will develop diabetes in their lifetime, resulting on increased chronic health conditions such as heart disease, strike, blindness, kidney failure and leg and foot amputations. By adulthood, obesity-associated chronic diseases – heart disease, some cancers, stroke and diabetes – are the first, third and sixth leading causes of death in the United States.

In Contra Costa County, 31% of fifth graders are overweight. In West Contra Costa, fifth graders are 42% more likely to be overweight than the rest of Contra Costa County.

Twenty percent of Contra Costa adults are obese, a rate slightly higher than that of California. African American (32%) and Latino (21%) Bay Area residents are more likely to be obese compared to bay Area adults overall (16%).

In Contra Costa County, about 15% of children 0-14 years have asthma. The hospitalization rate for children with asthma who live in Richmond and San Pablo is much higher than the state average. From 2001 to 2003, the percentage of African American children diagnosed with asthma in Contra Costa County increased from 14% to 26%. In Contra Costa, the hospitalization rate for African American children with asthma is almost five times that of white children.

Allergies often lead to asthma (although not all persons with asthma have allergies.) Numerous studies have shown that asthma attacks are triggered by exposure to allergens such as dust mites, cockroach droppings, animal dander and mold among children sensitive to these allergens. In addition to precipitating asthma attacks, exposure to allergens may play a role in inducing the onset of asthma itself. Exposure to fungal and cockroach allergens is more common in inner city homes, leading to more frequent sensitization to these allergens, and possibly to greater prevalence of asthma among children in U.S. inner cities.

Exposure to secondhand tobacco smoke is also an important and widely accepted contributor to childhood asthma. Children of parents who smoke have more asthma than children of parents who don't smoke.

Certain insecticides that are widely used in U.S. homes may be triggers for asthma. Studies indicate that exposure to organophosphate pesticides disrupts the part of the nervous system that regulates the motor functioning of the lungs. This has lead researchers to hypothesize that pesticides are among the preventable causes of asthma in children.

It is unlikely that any of these factors alone account for why asthma rates have climbed in urban areas since 1980. Studies indicating that cockroaches are the chief risk factor for asthma among inner city children do not explain the increase. Cockroaches are not new to U.S. inner cities and no data indicate that their prevalence has increased. However, other changes may be increasing children's exposure to cockroach and other allergens. Allergens in indoor air may be higher now than in the past due to increasingly tight, well-insulated buildings. Children also may be spending more time indoors. Finally, indoor air may be made worse by the increasing use of synthetic materials in homes such as synthetic rugs and pressed wood furniture that release toxic vapors into the air.

Evidence indicates that ambient air pollution, such as particulate matter and ozone, precipitate asthma attacks among persons with the disease.

Automotive exhaust is a complex mixture of thousands of chemical compounds. The significant components for childhood asthma are oxides of nitrogen, ozone, sulfur dioxide, sulfuric acid, fine particulates, and carbon monoxide. Also of importance are toxic organic compounds, including formaldehyde, acetaldehyde, and benzene. Of these materials, ozone, oxides of nitrogen, and small particulates appear to be most important.

Children growing up alongside freeways risk having their lung development impaired, which can increase the likelihood of serious respiratory diseases later in life, researchers report. Other studies have shown that children living next to highways are more likely to develop respiratory problems, such as asthma. Long exposure to car and truck exhaust actually affects the growth of the lungs, and hence their capacity.

"Exposure from tailpipe emissions from motor vehicles potentially carries chronic health risks to children's lung development," said lead researcher W. James Gauderman, an assistant professor in the Department of Preventive Medicine at the University of Southern California, Los Angeles. "We found that kids who live closer to freeways had significantly less lung capacity, compared with kids who lived further from freeways."

In the study, Gauderman and his colleagues followed 3,677 children for eight years, tracking their lung development. The children were 10 at the start of the study, and came from 12 southern California communities. The air quality differed in each community.

The researchers found that lung growth in children who lived within 500 meters of a freeway (about a quarter of a mile) was significantly less than children who lived 1,500 meters or more from a freeway.

Gauderman's group also found that exposure to freeways and regional air pollution had negative and independent effects on the growth of lung function. In addition, there was a significant drop in percentage of expected lung function among 18-year-olds who lived within 500 meters of a freeway.

Healthy eating and a physically active lifestyle can help children achieve and maintain a healthy weight and reduce obesity-related chronic diseases. Children spending more time outdoors in locations away from freeways and public agencies aggressively pursuing policies that result in cleaner air can reduce the incidence of asthma.

For lots of detailed information, see:

• Healthy Schools, Healthy Communities and Youth Obesity
• Obesity in Your Community
• Healthy Kids, Healthy Communities
• Planning Communities – What Health has to Do With It.
• Overweight Kids
• Assessment of Diesel pollution in Inner West Contra Costa County

Other resources include:

• Community Design and Joint-Use Resources Complete the Street, http://www.completestreets.org
• Safe Routes to School, National Center for Safe Routes to School. http://www.saferoutesinfo.org
• Safe Routes to School National Partnership, http://www.saferoutestoschools.org
• The National Clearinghouse for Educational Facilities, http://www.edfacilities.org
• The California Park and Recreation Society, http://www.cprs.org
• The Cities, Counties and School Partnership of California, http://www.ccspartnership.org/default.cfm
• Local Government Commission: http://www.lgc.org

There are many things the City of Richmond and the West Contra Costa Unified School District can do to improve the health of kids:

• Establish healthy food and beverage standards at jurisdictional facilities and for all meetings and events
• Consider health and active living when developing comprehensive zoning plans. Richmond has a Health Element in its new General Plan that is now underway. This need to be monitored and reviewed for adequacy.
• Establish a Wellness/Active Living Committee or Task Force that includes multi-jurisdictional representatives, community members, public health professionals and community-based organizations.
• Establish or revise zoning to create useful, attractive, accessible destinations, where residents can easily conduct daily business without a car.
• Utilize selected Crime Prevention Through Urban/Environmental Design (CPTED) and other strategies to create safe, crime-free public spaces; avoid those that create barriers between neighborhoods.
• Establish development with good connections to homes, shops, schools, and offices so people have many walking and bicycling choices.
• Take every opportunity to establish green space, from parks large and small to street tree and urban forest programs to edible landscaping and community gardens.
• Maximize the extent to which all community residents can walk to these facilities.
• Accommodate urban agriculture and community gardening in the Open Space Element.
• Create joint use agreements with school to allow use of playgrounds and community meeting space.
• Develop local policies that support the establishment of full-service grocery stores, farmers’ markets, and other fresh produce outlets.
• Limit the number and concentration of fast food restaurants and outlets that sell tobacco and alcohol.
• Improve access to transit and transportation alternatives; set high goals for getting people out of their cars.
• Revise local street standards and policies to create safer, more accessible environments for pedestrians, bicyclists and all users; including multi-modal goals and levels of service.
• Create a separate bicycle plan and pedestrian plan referenced in the Circulation Element of your General Plan; include designated Pedestrian Districts, and an interconnected network of sidewalks, on-street bike lanes, and designated bike trails.
• Establish Neighborhood Traffic Calming Plans throughout your jurisdiction to slow traffic and maintain neighborhood safety.
• Adopt and implement “Complete Streets” policies that call for accommodating all users of the road.
• Develop “Safe Routes to Schools” programs to improve pedestrian and bicycle safety, especially for children.
• Support the establishment of grocery stores that offer fresh, affordable produce and other healthy items in under-served neighborhoods.
• Support the development of safe, accessible parks and recreational facilities in under-served neighborhoods.
• Adopt and implement “complete streets” policies to provide safe and convenient roadway access for people who walk, bicycle, or use wheelchairs.
• Provide financial incentives for establishing physical activity facilities, grocery stores and farmers markets, and improving walkability, particularly in low-income communities.
• Institute healthy food and beverage standards for all items available to children in pre-schools, during school hours and during after-school programs Standards should address levels of fat, sodium, sugar and calories.
• Institute healthy food and beverage standards that apply to school fundraisers and classroom incentives.
• Ensure children receive physical education that meets minimum standards for quality, duration and frequency.
• Eliminate advertising of unhealthy foods and beverages to children and youth.
• Make school recreational facilities available to children and families for use during after-school hours.
• Incorporate active transportation, safety and health objectives in school siting decisions and planning.