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18 Community Organizing for Obesity Prevention in Humboldt Park, Chicago The Challenges and Successes of Coalition Building across Two Organizing Traditions ADAM B. BECKER KATHERINE KAUFER CHRISTOFFEL JOSÉ E. LÓPEZ JOSÉ LUIS RODRÍGUEZ 329 As described in chapter 17, community coalitions are particularly useful in confronting complex public health problems that require intervention at multiple levels of social organization (e.g., family, community, institution). Childhood obesity is arguably one of the most complex public health problems of our time— and one of the most critical. Some predict that because of obesity and its sequelae, the current generation of children will be the first with a shorter life expectancy than that of the generation before it (Olshansky et al. 2005). At its core, obesity is the result of a caloric imbalance—consuming more calories through diet than the number of calories expended through physical activity. While on the surface, this imbalance may seem to be an individual-level problem that can be solved by supporting individuals to eat less and exercise more, further examination finds risk factors across multiple levels: family, institutions, communities , and society at large. Because the problem is so complex, a coalition-based approach is ideally suited to addressing it. Very few, if any, organizations have the capacity and expertise to identify and address factors at all these levels. Some organizations may specialize in assisting individuals through health education, nutrition, and activity programming. Others may focus on environmental change to increase access to healthy food and safe opportunities for physical activity in communities. Still others may have expertise in advocacy and public policy to address, for example, food and transportation systems across municipalities or at the state or federal levels. A coalition can combine and coordinate the resources and efforts of individual organizations with expertise across these spheres of influence such that obesity is addressed at multiple levels. In addition to the complexity of obesity, significant disparities in obesity prevalence exist among communities (Freedman 2011). Communities of color and low-income communities experience higher rates than those of white or economically advantaged communities. Coalitions that originate in or focus on these hardest-hit communities are an essential element of efforts to reduce disparities. However, obesity is not the only public health problem faced by low-income communities of color in the United States. To assess the utility of coalitions in addressing childhood obesity, a number of questions need to be answered. What are the opportunities and challenges for forming a community-based coalition to focus on a single public health problem in a community that is focused on a broader range of health and social issues? What processes are most helpful when public health–focused organizations come together with community-focused organizations to tackle such issues? What are the limitations of such processes? And how can these relationships and the efforts that emerge from them be sustained over time—especially when resources are limited? This chapter explores some of these issues through the experience of Community Organizing for Obesity Prevention in Humboldt Park (CO-OP HP), in Chicago. CO-OP HP is a multisector coalition of diverse organizations focused on the health and well-being of the predominantly Puerto Rican sections of the Humboldt Park and West Town neighborhoods (referred to hereafter as Humboldt Park) in the city. After a brief description of the problem and the history and primary activities of CO-OP HP, we turn to the primary questions posed above. We discuss these questions with an analysis of CO-OP HP’s experiences through an application of the community coalition action theory, described in chapter 17. The Public Health Scope of Childhood Obesity Childhood obesity rates in the United States have increased dramatically over the past four decades, from about 5 percent of children ages two to nineteen years old in the early 1970s to 14–18 percent in the early 2000s (Lavizzo-Mourey and Robert Wood Johnson Foundation 2009). While there is evidence that these rates have begun leveling off at approximately 17 percent for all children, this represents almost one in five children already obese, and rates among boys in the highest percentiles of body mass index appear to remain on the rise (Ogden et al. 2010). This situation predicts a large and ongoing burden of ill health for these children throughout their lives, and for society as well. Childhood obesity, caused by overnutrition, inactivity, or both, results in myriad health problems. Overweight and obese children are significantly more likely to...


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