富裕的城市之间的广袤儿童肥胖的差距, 较低收入1

曼哈顿海滩具有最低的儿童肥胖率在洛杉矶. 县, 贝尔花园最高. 他们的人口是截然不同的, 和居民’ 对这个问题的看法可能会大幅对比.

多丽丝常限制她的三个儿子’ 摄入甜食，不喂它们任何处理或冷冻食品. 在他们的曼哈顿海滩的家, 监视她的男生’ 时间在电视机前，并让他们忙于棒球, 篮球和空手道.

关于 20 英里到东北, 奥埃尔南德斯把她6岁的女儿到麦当劳至少每周两次，并经常给她库尔急救和苏打水. 他们去公园常, 但是当他们在他们的贝尔花园的家, 电视通常是在.

家庭’ 对食物和锻炼不同的态度反映了面临的官员，因为他们试图关闭在肥胖率一个庞大而昂贵的差距在该地区挑战的只是其中的一部分.

只要 4% 在富裕的孩子, 多为白色曼哈顿海滩被认为是肥胖, 率最低全县范围, 根据公共卫生官员. 在贫困, 主要是拉丁裔贝尔花园, 率 36% - 比任何其他城市高.

“他们就像两个不同的世界,” 说保罗·西蒙, 谁指使慢性病预防为县卫生局.

在年轻人肥胖开始在加利福尼亚州和全国各地的平整. 但形成鲜明的差异仍然存在, 冒充令人烦恼的障碍，进一步转变.

仅在洛杉矶县, 关于肥胖的成本 $12 十亿每年用于医疗和生产力损失, 根据一个 2006 report by the California Center for Public Health Advocacy.

The challenges are plain at the Bell Gardens Community Health Clinic, where physician Jacqueline Lopez, deals with the consequences: diabetes and heart disease. She delicately coaches families to pick healthful foods and break through cultural barriers. Many Latino parents, 她说, simply don’t recognize the risks of their children being overweight.

“There is a misperception that bigger children are healthier children,” 她说：. “I am trying to be sensitive, but really what we are talking about is these children are at risk of having a shortened life span.”

Arturo Gonzalez said his 13-year-old daughter’s doctor recently told him she is 30 pounds overweight and showing early signs of diabetes. “I am worried,” 他说：, watching his 5-year-old son play on a swing set in a Bell Gardens park. “We talk about the consequences of being overweight…. She listens, but it goes in one ear and out the other.”

Gonzalez said his children watch too much television, snack too much and complain when he makes them take walks. He has enrolled his daughter in an after-school program to cut down on TV time and snacking.

But he doesn’t think poverty is a culprit. “In Mexico, we were poor, but we weren’t overweight,” 他说：, recalling that children in his homeland drank water instead of soda and walked a lot.

Bell Gardens’ officials are trying to combat the problem. They recently declared obesity a “serious public health threat,” banned sodas from park vending machines and are discussing adding track and fitness equipment as part of a park renovation.

“We are trying policy-wise to make changes, but we can’t dictate what parents do in their homes,” said city recreation director Pam Wasserman. For parents on tight budgets, 她说：, healthful food isn’t always the least expensive option. “It is hard for us to compete with 10 tacos for $10.”

Lorena Hernandez said her family often chooses fast-food restaurants because they are cheap. At home, she cooks Mexican specialties, such as beans, 饭, tortillas and soups. Her husband has diabetes, but both she and her 6-year-old daughter, Leanne, are thin, so she doesn’t worry about what they eat. “We don’t really talk about it at home, honestly,” 她说：.

Bell Gardens falls at the opposite end from Manhattan Beach on many economic and demographic indexes.

关于 80% of Manhattan Beach’s 36,000 residents are white, and the median household income is $127,000. 只 3% of people are living in poverty and three-fourths of residents over 25 have college degrees. There was a single homicide and 48 other violent crimes in 2010, 根据美国联邦调查局.

There are relatively few fast-food restaurants and several upscale grocery stores emphasizing fresh foods, including Trader Joe’s, Whole Foods and Bristol Farms.

In Bell Gardens, 96% 的 44,000 residents are Latino, and median household income is less than one-third of Manhattan Beach’s. Nearly one in four residents lives in poverty and just 4% 那些 25 or older have a college degree. Crime is far more prevalent, with five homicides and 210 other violent crimes in 2010.

一 2009 survey by the Campaign for a Healthier Bell Gardens, started by a community clinic, 发现 141 convenience or fast-food restaurants within the city’s 2.4 平方英里. Many grocery shopping options are smaller corner stores, where fresh produce choices and availability tend to be limited.

Researchers have drawn strong links between obesity and such socioeconomic disparities. Families in low-income areas are less aware of the harm that beverages and foods sweetened with high-fructose corn syrup can cause, 博士说：. James Marks of the Robert Wood Johnson Foundation. And schools in low-income areas generally have fewer physical education programs and may offer less healthful options in school cafeteria lunches, 他说：.

“If people who want to make the healthy choices are unable to, they are not going to succeed,” Marks said.

County health officials have noted more obesity in communities with less parkland, where children can get out and exercise. Manhattan Beach, 例如, 有 5.7 acres of parkland per 1,000 居民, more than three times the ratio in Bell Gardens, 根据一个 2007 报告. And parks in poorer areas may be considered less safe and operate fewer hours, researchers say.

Health advocates are working with Bell Gardens’ city government, businesses and educators, as well as the county, to plant gardens, hold mini-farmers markets and take mobile health clinics to schools, encouraging the students to become advocates of better diets and more exercise. A major challenge is getting families to prepare healthful versions of traditional Latino dishes.

“We are nowhere near where we need to be,” said Lani Cupchoy, 谁是导演的健康改善活动. “我们真的不能说，我们有一个健康的城市, 但我们的道路上。”

曼哈顿海滩市市长尼古拉斯·泰尔指出，他的城市有天然的优势，鼓励健康的生活方式: 2英里开放的海滨. 居民骑自行车, 沿着海滩边的路径运行，或者去冲浪，在沙滩上打排球. “我们有这个惊人的海滩，它告诉人们到外面去,” 他说：.

曼哈顿海滩居民芭芭拉·丰塔纳, 46, 一名前职业排球运动员, 说，她的儿子 - 年龄 6 和 8 - 去冲浪趴板或骑自行车在周末和踢足球, 篮球和棒球等天. 不久前的一个下午, 他们踢一个球周围沙丘公园，她看着.

“这就是我喜欢我的孩子们在做,” 她说：. “Sitting at a computer or a TV isn’t my cup of tea.”

The differences extend indoors. At the Manhattan Beach Trader Joe’s, Chang, 39, filled her basket with fruit, bread, 蔬菜, eggs and yogurt. She generally avoids junk food, but lets the grandparents occasionally take the children out for ice cream or to McDonald’s.

“I’m not inspecting every single package,” 她说：. “But I try to eat wholesome foods.”