Overweight children outside of the metro Edmonton region tend to be larger than their city counterparts and pediatric weight management services must be designed to optimize access to health services in rural areas, according to a new University of Alberta study.
The study, Referrals for Pediatric Weight Management: the Importance of Proximity, looked at 555 physician referrals to Alberta Health Service’s Pediatric Centre for Weight and Health in Edmonton. The centre works with children between the ages of eight and 17 who have a body mass index (BMI) greater than the 85th percentile.
The study, which looked at referrals to the centre within a 600-kilometre radius around Edmonton, showed evidence that limiting access to weight management care can have a negative impact on the health and well-being of obese children and youth. It also found clear rural-urban inequities regarding health care access and treatment outcomes.
Geoff Ball and Kathryn Ambler of the U of A’s Faculty of Medicine, Department of Pediatrics, who also work at the Centre for Weight and Health, were lead authors of the study.
Ambler said there might be several reasons why overweight kids in rural areas tend to be larger than overweight kids in the city.
“Maybe there are less opportunities to access the same sorts of things that kids in the cities can get to in terms of recreational facilities, health specialists, in terms of the types of things that are focused on in schools, what things kids are doing in their extracurricular time,” Ambler said.
A total of 464 referrals came from the Edmonton Census Metropolitan Area (ECMA), which includes St. Albert.
On the local level, efforts to encourage kids to be more active and live healthier lifestyles have included more daily physical education in schools and having principals work directly with school councils to develop healthier cafeteria items and vending machine options.
“When you create an overall approach to personal wellness and the lifestyle associated with person wellness, then everybody gets motivated and it becomes a part of what you actually do,” said David Keohane, superintendent of the Greater St. Albert Catholic School Board.
In addition to letting the Canada Food Guide take centre stage in cafeteria menu planning and lessons on health, Keohane said schools have also expanded physical education programs to focus more on personal fitness and wellbeing.
“You’ll see that weight programs have become much more pervasive in our schools than they used to be 10 to 15 years ago,” he noted.
Several schools in St. Albert are part of the Ever Active Schools program, which encourages social and physical environments that are supportive of healthy, active school communities.
“We’re trying to take everybody, so in our school K to 9, and we involve them in all different types of activities and extracurricular programs outside of school,” said Kris Horb, physical education lead teacher at Elmer S. Gish Elementary and Junior High School, which has the Ever Active Schools designation.
Activities include skiing, a pumpkin pull, the Gish Heritage Classic and next week, skating at the Kinex Arena.
“This is all over and above our regular sports,” said Horb.
As an Ever Active School, Elmer S. Gish must draft up a game plan that includes what activities are planned and how they involve both the school and the community.
The plans are submitted every so often to Ever Active Schools (EAS), which is a special project of the Health and Physical Education Council of the Alberta Teachers' Association.
“There is education that goes with every activity that you’re doing so you’re educating the kids as to why we’re living a healthy, active lifestyle,” Horb said.
Ambler said health care services for overweight youth in rural areas must be flexible in order to meet clients where they are, in terms of their needs.
“There is really currently no gold standard about what we should be doing to provide care for children and families who are struggling with weight issues,” she said.
“In terms of what support is actually needed in any place, it depends on what is available to be provided in the first place. So it’s no good in saying we need to support families to join sports teams if they can’t get into a gymnasium or into an arena.”