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APHA Scientific Session and Event Listing

Sandra Goldsmith, MS, RD¹, Roy Grant, MA¹, Alan Shapiro, MD², Sharon Joseph, MD², and Marian Larkin, MD². (1) The Children's Health Fund, 317 East 64 Street, New York, NY 10021, 212-535-9779, sgoldsmi@montefiore.org, (2) Community Pediatrics, Children's Hospital at Montefiore, 317 East 64th Street, New York, NY 10021

The number of children that are overweight has tripled since 1980. African American and Latino children are disproportionately affected by this epidemic. Surprisingly, children living in homeless family shelters in NYC are not spared. As of December 2004, 15,000 homeless children were sleeping in NYC shelters, 90% of which are African American or Latino. In a representative sample of homeless children 6 – 19 years (n =200), our mobile medical program found that 30.5% were overweight and 12% were at risk of overweight. Among 2 – 5 year olds (n = 140), 16.4% were overweight and 14.3% were at-risk of overweight. The Starting Right Initiative, a program of The Children's Health Fund, focuses on early identification and intervention of childhood overweight to prevent associated morbidities. It includes screening for overweight (e.g. BMI %iles), associated physical (e.g. acanthosis nigricans) and lab (impaired glucose tolerance) findings and risk of T2DM and cardiovascular problems. Implementing effective weight management strategies implies immediate and long-term follow-up. A family-centered nutrition counseling approach addresses the barriers facing this transient population: psychosocial issues, limited access and financial barriers to healthy food choices and suboptimal cooking facilities. To be an effective program, immediate identification of weight and other health problems is critical in a transient population. The Starting Right model gives providers a protocol to identify such patients. It gives patients tools they can use both in the shelter and beyond, providing continuity of care as they transition into permanent housing.

Learning Objectives: At the end of this session participants will be able to

• Identify a protocol for screening for pediatric overweight and obesity in the homeless population.
• Discuss effective weight management strategies for the pediatric homeless population.

Keywords: Homeless Health Care, Children's Health

Presenting author's disclosure statement:

Not Answered