Innovative State Policies in the Child Care and After School Care Setting to Prevent Childhood Obesity

Introduction: Approximately 24% of children preschool-aged and 33% of elementary school-aged children are classified as overweight or obese. Mounting evidence points to intervention at earlier ages. Preschool aged children who are obese are more likely to be obese as young adults and older children who are obese are at higher risk of obesity into adulthood. Obesity prevention recommendations concentrate on changing behaviors related to dietary intake, physical activity and sedentary behavior. Focusing on environments where children spend the greatest time could improve these outcomes.

Program Design: Promoting healthier environments in child care and after school care settings could have potential to reach many children since over 74% of children ages 3-6 in daily child care and 50% of children kindergarten through eighth grade are in after school care. In study of child care and after school policies, only 5 states addressed some of the key recommendations for obesity prevention including increasing water availability, reducing sugar-sweetened beverages, requiring physical activity, requiring that food is not used as a reward or punishment, and reducing screen time. Two states, Tennessee and Delaware, developed physical activity and nutrition policies that address all key issues to promote obesity prevention in child care and after school care.

Discussion: More research needs to be done to understand how policies affect health outcomes. However, learning how to address barriers and promote best practices from exemplary states and cities implementing evidence-based policies will help create the optimal environment for obesity prevention.