OBESITY IN HISPANIC YOUTH: POLICY MUST CONSIDER SOCIOCULTURAL UNIQUENESS

Abstract

Childhood obesity is heavily documented as a public health crisis in the United States. Today, more than one-third of American youth can be medically classified as overweight or obese. Of those children, a disproportionately high number are Hispanic. There is a clear need for childhood obesity policy interventions with above average effectiveness in this expanding ethnic group, but the vast majority of the interventions implemented to date have not generated significant or lasting decreases in the levels of Hispanic childhood obesity. This thesis starts with the question: why? I hypothesize that these policies chronically fail to reach Hispanic youth because they are not attentive to the sociocultural uniqueness of this population. Importantly, the robust professional discourse on the childhood obesity epidemic recognizes the nature of the problem as hugely complex. Given the high levels of Hispanic childhood obesity in the United States, a branch of the professional pursuit of knowledge focuses just on how the epidemiology of Hispanic childhood obesity departs from the epidemiology of general population childhood obesity. In this thesis, though, I argue that the richness of the professional discourse does not translate into the realm of public opinion. The information that does survive the filter of the public opinion process has been woven into two dominant “frames” of the childhood obesity problem: a “personal responsibility” frame and a “social responsibility” frame. Each public opinion frame represents a narrow “understanding” of the problem, includes a judgment about who or what is responsible for this epidemic, and influences the design of contemporary childhood obesity policies. Notably, neither of these frames closely appreciates the sociocultural distinctiveness of Hispanic youth; rather, the childhood obesity policies derived from both frames are usually “one size fits all.” An independent case study of Hispanic childhood obesity in New Jersey, anchored by analysis of the New Jersey Childhood Obesity Study (2009-2010), yields three claims of special interest to this thesis. First, the design of this Study, which was commissioned to contribute to New Jersey’s pre-existing policy endeavor, validates the enormous influence of the dominant public opinion frames of childhood obesity on related policy endeavors. Second, the evidence marshaled from Hispanic respondents of this Study confirms that the two dominant public opinion frames capture, in fact, real forces contributing to Hispanic childhood obesity. Respondents acknowledged both unhealthy behaviors (the foundation of the “personal responsibility” frame), and environmental barriers to good health (the foundation of the “social responsibility” frame). And yet, third, there exists in this data a fundamental “disconnect.” Hispanic respondents’ positive perceptions of their children’s weight, the quality of nutrition and levels of exercise their children receive, are inconsistent, from a medical standpoint, with the more objective data about these children’s behaviors and lifestyles described by the same respondents. By bringing to bear a class of childhood obesity scholarship lost in the public opinion process, I reach the conclusion that this conceptual “disconnect” illuminates a unique, sociocultural conceptualization of “health” and a “healthy weight” operating in the Hispanic population, particularly among those still acculturating to America’s “medicalized” society. Going forward, childhood obesity policies aiming to reach Hispanic youth and their families must be rendered more culturally relevant, and more attentive to the unique challenge of a bicultural lifestyle faced by many Hispanics.