An Examination of the Programs and Initiatives for Addressing Childhood Obesity and Promoting Nutrition Standards
September 26, 2014 · Programs and Initiatives for Addressing Childhood Obesity and Promoting Nutrition Standards · Read the full official report (PDF) ↗
Published September 26, 2014 Audit covers July 1, 2009 – June 30, 2013 Under Suzanne M. Bump · 2011–2023
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“Although the Commonwealth, through its state agencies and public schools, has taken significant measures to address the problem of childhood obesity, OSA believes that more can be done, including expanding community-based recreational opportunities for children and standardizing PE time within public schools to meet national standards.”
Read the plain-English breakdown
This is a state performance audit looking at Massachusetts programs meant to reduce childhood obesity and improve nutrition and wellness.
“This audit concerns the programs and initiatives for addressing childhood obesity and promoting nutrition standards in the Commonwealth.”
The Auditor reviewed these programs because childhood obesity is a growing public health problem, and the state had laws, grants, and programs aimed at addressing it.
“In accordance with Chapter 11, Section 12, of the General Laws, the Office of the State Auditor (OSA) conducted a performance audit that examined the Commonwealth’s efforts to address childhood obesity and promote improved nutrition and wellness for children and adults.”
Childhood obesity can lead to serious health problems for children and higher healthcare costs for everyone.
“Childhood obesity has placed thousands of children at higher risk of serious physical health problems such as type 2 diabetes, cardiovascular disease, and asthma, as well as psychological issues including depression.”
For ordinary residents, this affects school meals, children’s exercise time, access to healthy food, community recreation, and future public healthcare costs.
“Based on these facts, the Commonwealth and its citizenry need to continue to work collaboratively to combat childhood obesity to reduce the incidence of serious health issues for children as well as the related healthcare costs.”
The audit found that schools generally followed nutrition and BMI requirements and DPH handled federal funds properly, but PE time was uneven and farmers’ market SNAP access still faced barriers.
“In large part, during our audit period, public schools complied with state requirements regarding the implementation of school nutrition regulations, BMI screening, and PE requirements.”
The Auditor recommended that state agencies keep improving oversight, remove barriers to SNAP use at farmers’ markets, and consider stronger rules and funding for physical activity.
“DPH should continue to collaborate with local, state, and federal entities to develop, implement, monitor, and support programs designed to combat obesity and improve the health and wellness of the Commonwealth’s citizenry.”
The report is significant because Massachusetts children had high rates of overweight and obesity, while school exercise requirements were weak compared with national recommendations.
“Specifically, 31% of the Commonwealth’s children aged 10 through 17 years are overweight or obese.”
BMI is a height-and-weight measure used to screen whether a child may be underweight, healthy weight, overweight, or obese compared with children of the same age and sex.
“BMI testing is a method of determining whether a child has a healthy weight compared to other children of the same age and sex.”
6 figure(s) pending source verification - not shown
What the Auditor checked
- Partially Determine whether public schools complied with laws and regulations on nutrition, physical education, and body mass index testing of certain schoolchildren.
- Complied Determine whether Mass in Motion funds were used in accordance with grant terms and conditions.
What the Auditor found
Why it matters: Incomplete BMI reporting and inconsistent physical education reduce oversight of childhood obesity trends and leave students below recommended physical activity levels.
Standard: 105 CMR 200.500; Chapter 71, Section 3, of the General Laws; national physical education guidelines from the Surgeon General and NASPE ( 105 CMR 200.500; Chapter 71, Section 3, of the General Laws; 105 CMR 225 )
3 recommendations
- DPH should collaborate with certain local school districts to ensure that they comply with 105 CMR 200.500 by reporting BMI aggregate data to DPH, adopting BMI administration policies, and giving children’s guardians the opportunity to opt out of the BMI program on behalf of their children.agency: agreed
- DPH should reconsider its policy requiring school nurses to notify physicians of student BMI measurements through students’ guardians.agency: agreed
- The Legislature should consider amending Chapter 71, Section 3, of the General Laws to ensure consistent durations of PE throughout the Commonwealth’s public schools.
Agency response & Auditor reply
Agency: "DPH appreciates this recommendation and agrees with the importance of collaborating with local school districts."
Auditor: "Based on their responses, DPH is taking measures to address our concerns in this area, and DESE will review potential legislation concerning standardized PE time in public schools."
Why it matters: Federal grant funds supported local community efforts to improve wellness, fitness, nutrition, and obesity prevention.
Standard: Federal grant terms and conditions for Community Transformation Grants and Childhood Obesity Research Demonstration grants ( Affordable Care Act’s Prevention and Public Health Fund )
1 recommendation
- DPH should continue to collaborate with local, state, and federal entities to develop, implement, monitor, and support programs designed to combat obesity and improve the health and wellness of the Commonwealth’s citizenry.
Agency response & Auditor reply
Agency: "DPH appreciates the recognition of its important and collaborative work focused on healthy eating and active living."
Why it matters: Failure to address staffing, accounting, and transaction-fee barriers could limit low-income families’ access to healthy local foods and impede expansion of SNAP sales at farmers’ markets.
Standard: USDA funding restrictions for farmers’ market EBT-compatible POS terminals
1 recommendation
- MDAR should continue working with USDA to resolve any barriers to SNAP participation at farmers’ markets.
Agency response & Auditor reply
Agency: "USDA has made clear that funds can only be used for the purchase of the equipment and any monthly connection fees associated with that equipment."
Auditor: "We encourage MDAR to continue its ongoing dialogue with USDA regarding any future farmers’ market funding in order to help ensure the success of the program."