With jangling Zumba skirts tied around their waists, a group of about 15 women stretched, danced and lifted weights while upbeat music echoed through the gym Wednesday morning at the Nogales Housing Authority gym on Western Avenue.
Led by volunteer Maria Quintana, this is one of many free or low-cost fitness classes offered in Santa Cruz County aimed at improving community health, including fighting obesity.
While the most recent data on obesity in the United States points to a growing problem, Santa Cruz County residents remain below both national and state averages in the measure, though not by much. And public health advocates say issues such as poverty, a lack of recreational opportunities and an abundance of processed foods pose big challenges to local waistlines.
“The availability of unhealthy food is ridiculous,” said Badria Bedri, a nutritionist in Nogales for the USDA’s program for Women, Infants and Children (WIC).
Obesity among U.S. adults has reached an all-time high of 38 percent, or more than one in three people, according to new studies by the Centers for Disease Control and Prevention released last week. Forty percent of women and 35 percent of men are now considered obese.
“The news is neither good nor surprising,” says an editorial published in the Journal of the American Medical Association last week. “Obesity threatens to reverse decades of improvements in mortality.”
In Santa Cruz County, 26 percent of adults are considered obese, according to recent data from the Arizona Department of Health Services. In Arizona overall, 28 percent of adults have a Body Mass Index (BMI) within the obese range. The state ranks 29th in the country for obesity.
BMI is a height-to-weight ratio used to measure obesity. Ratios between 18.5 and 24.9 is considered to be in the normal range, 25 to 29.9 is labeled overweight, and individuals with a BMI above 30 are deemed obese.
While BMI is not a perfect measure, as it only considers height and weight not taking into account factors such as muscle mass or natural body composition, it is the best and easiest way to monitor obesity, said Chris Bachelier, program director at the University of Arizona Nutrition Network extension in Santa Cruz County. And the increasing ratio of body weight to height among people in the United States is a major concern among health professionals.
Obesity is not a cause of death, but it is a significant risk factor for major killers such as diabetes, high blood pressure, asthma and cardiovascular disease, according to Gail Emrick, executive director of the Southeast Arizona Area Health Education Center (SEAHEC) in Nogales.
“In our community assessment, people considered being overweight the most important factor impacting community health,” she said of Santa Cruz County.
While the food culture and unhealthy eating contributed to obesity among Santa Cruz County residents, Emrick points to inactivity as one of the biggest challenges for the community.
“I think one of the most noticeable factors is the way our city is laid out,” she said. “If you look at literally the way our streets run – Mariposa, Grand Avenue – they are big, fast streets. Access to naturally occurring physical activity is hard to come by.”
Adding things like bike routes and walking paths would give more people access to exercise as part of their daily lives, Emrick said.
Additionally, economics play a big role in obesity, according to Bachelier.
“Some people say it’s the border, it’s the culture or whatever. Honestly, I think it is poverty,” she said. “When you look at it realistically, that when you go into a grocery store and grapes, even if they’re only 99 cents a pound but you can get five boxes of macaroni and cheese for a buck. You know, what are you going to do? I think that’s the choices some of these parents have to make.”
Focus on kids
Classes on nutrition and budgeting address the economics of eating healthy, but it’s hard to get adults to attend, partly because of time, Bachelier said. So addressing childhood obesity in Santa Cruz County has become a major focus since it’s easier to reach kids at school.
It’s also better to teach kids healthy habits when they are young than waiting until people are set in their ways, said Lourdes Jeong, who teaches nutrition and Jazzercise, a dance-based fitness program, to youth in Santa Cruz County.
“You’re not going to change the parents,” said Jeong. “It’s with the kids. It’s trying to change the kids now so that when they become adults it’s a healthier generation.”
Nationwide, childhood obesity is a significant issue, with 17 percent of U.S. youths under 18 falling into that category, and almost 6 percent considered extremely obese, according to a new study by the CDC.
Arizona has one of the highest rates of childhood obesity, ranked seventh among the 50 states. Nearly 20 percent of Arizona children ages 10-17 are considered obese, according to state data from the Trust for America’s Health and the Robert Wood Johnson Foundation.
In Santa Cruz County, 12 percent of children under age 18 qualified as obese in 2007, and 16 percent of children ages 2-5 were considered obese in a 2011 study, according to the ADHS. And as with adults, the numbers are increasing, the study showed.
But addressing childhood obesity can be a challenge. In some cases, families are sensitive to hearing that their children are overweight, Jeong said.
“It’s a requirement by the state, if something is wrong with the child the nurse is required to send a letter home – if they need glasses, a hearing test,” Bachelier said. “So if these kids are in the 96th percentile for BMI, they are overweight and obese, and there are health risks. So the schools were sending home letters and parents were getting offended.”
Some parents are in denial about their kids, Jeong said. But many others know what needs to be done and want to make positive changes for their children and themselves, according to Bedri, the WIC nutritionist who councils women who are overweight or have overweight children.
“Most of them do know. It’s not like I’m telling them something new,” Bedri said. And many of her clients are trying to make positive changes. But time is a major barrier for families trying to improve their eating habits and get more exercise. Plus, our habits of watching TV, playing video games and eating processed foods are ingrained into the culture today, she said.
But there are resources available to the community. There are an abundance of nutrition programs, free exercise classes and cardiovascular disease prevention classes that could help people address concerns about their weight, said Rosie Piper, health promotion manager at the Mariposa Community Health Center.
The challenge is getting people to show up, Bachelier said. People are busy and don’t find time to attend the classes, or they just don’t know about them.
“It’s a never-ending battle,” she said. “It’s hard for all of us to make that lifestyle change.”