The American Academy of Pediatrics believes advertising “may contribute significantly” to childhood and adolescent obesity, as well as to their consumption of tobacco and alcohol.

Hearing that, I added “advertising” to my list of words beginning with the letter “a” that describe how we’re hurting the health of children. Besides “advertising,” they include access, appetite and apathy.

The AAP policy statement, which appeared in the December issue of the journal Pediatrics, focuses on advertising. It bulges with factoids about the money spent on the 3,000-plus ads viewed daily by the average child on television, on the Internet, on billboards and in magazines.

There’s $11.2 billion a year to promote cigarettes, $5.7 billion for alcohol, $2 billion for food products. That’s a couple of billion more than the pharmaceutical industry spent on drug and medicine research and development in 2003.

Of special concern to us at Kansas Action for Children is the AAP policy statement’s mention that more than 200 school districts nationwide have signed exclusive contracts with soft drink companies.

Also disturbing is that advertisers “have slowly but steadily infiltrated school systems around the country. The ‘3Rs’ have now become the ‘4 Rs,’ with the fourth being ‘retail.'”

We didn’t need that. More and more of our children are overweight. Nationally, on average, 31 percent of kids 10 to 17 are overweight or obese. In Kansas, the number is 30 percent.

If “advertising” is one of the primary barriers to children’s health, then access is, too. Ninety percent of our high school students in Kansas have access to a vending machine. The average number of machines in each school? Five.

We think that’s something that should worry school boards from Kansas City to Kanorado. Access is a problem because, frankly, advertising is so persuasive.

Several studies, according to the AAP policy statement, document “that young children request more junk food (defined as foods with high-caloric density but very low nutrient density) after viewing commercials.” In one study, “the amount of TV viewed per week correlated with requests for specific food and with caloric intake.”

Advertising plus access, in other words, increases appetite – my third “a.”

The fourth is apathy.

One source of apathy may be a failure to understand that vending machines are not simply a complement to whatever food is offered in the lunch room. They compete with balanced meals available to schools through lunch programs administered by the U.S. Department of Agriculture.

Another source of apathy is a mistaken belief that obesity is somebody else’s kid’s problem – or no problem at all. But medical costs incurred by obesity aren’t restricted to individuals. Among other things, they impact everyone’s health insurance costs.

Many defenses, of course, are offered for advertising and vending machine access. But what defense for apathy can exist when we are the world’s bulkiest nation?

The fact that Australia seems to be gaining ground on us provides little comfort. I hope school boards agree and think again about the gains and losses from vending machines.