Childhood Obesity: The Role of Health Policy - Association of ...

ty/policy components (e.g., working with farmers markets). By partnering with local communities,
health plans have been able to combine their resources and broaden their impact. Clinicians and health
care programs that have reached out to work proactively with the schools are another promising avenue
for action. Coordinating resources across public and private sectors (e.g., health departments and
health plans) can also serve to communicate more effectively the impact of obesity on children and their
families by developing collaborative educational activities (NICHM, 2005).
Exhibit 2:
• Aetna
• Affinity Health Plan (NY City)
• Blue Cross Blue Shield of Massachusetts
• Blue Cross Blue Shield of North Carolina
• Empire Blue Cross Blue Shield (New York state)
• HealthPartners (Minnesota)
• Highmark, Inc. (New Jersey)
• Horizon Blue Cross Blue Shield
• Kaiser Permanente (California)
• Premera Blue Cross (Washington)
• WellPoint Health Networks (California)
Raising Public and Policymaker Awareness
For coalitions to be successful in advancing policy proposals to address childhood obesity, they must not
only raise the awareness of the issue with the public and policymakers, they must also help to reframe
the issue from one of solely personal responsibility to one that acknowledges the role of government in
helping to support healthy choices on the part of individuals. Indeed, we are confronting the need for
a dramatic cultural shift in this country’s view of obesity and our deeply rooted beliefs about the meaning
of food to family and success (Katz, 2005). In this capacity, clinicians play a key role as they serve
as trusted sources of scientific and credible information for the lay public. As difficult as it is to engage
clinicians in the public policy process, it is—perhaps— even more challenging to do so in childhood obesity,
given the complex mix of factors that contribute to the problem and the many policy dimensions
beyond health policy that need to be addressed. Tackling childhood obesity policy will require health
professional engagement in discussions and debates about familiar topics such as coverage and reimbursement
for obesity-related services, as well as perhaps less familiar issues such as school nutrition
and physical activity requirements, food supplement programs (e.g., WIC, food stamps, etc), the design
of healthy communities, the availability of healthy food choices, particularly among low- income communities,
and advertising to children. Recently developed resources are, however, available to assist clinicians
in this role, including a 2006 report from the Future of Children, advocacy materials from the
AAP, and reports such as those referenced in this review. Health plans can also serve as a funder and
convener of policy-focused discussions. For example, in New Jersey, Horizon Blue Cross Blue Shield
sponsors an annual Health Policy Forum to discuss obesity.
Identifying and Developing Champions
From this review, it is clear that, regardless of the level or type of health care stakeholder (state, employer,
health plan, community or professional association) the ability to focus effectively on childhood obesity
is often driven by the passion, charisma and personal relationships of one or more key leaders. The
role of individual champions in quality improvement and community mobilization has been well recognized
(Mastal et al., 2007; Wang et al., 2004; Wang et al., 2006), however, few efforts that we identified
in childhood obesity include a specific focus on developing or nurturing the skills of such champions.
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