States are failing when it comes to requiring child care operations to provide nutritious foods and exercise.
Kansas is no exception.
The Robert Wood Johnson Foundation, a national advocate for improving health, released a report this week that examined state regulations that require healthy eating or physical activity for child care centers and child care homes.
Nationally, about 75 percent of children between ages 3 and 6 are in some form of nonparental child care, and just over half are in a child center.
Health experts think these child care providers can play an important role in reversing the growing obesity rate among children.
About 25 percent of children between ages 2 and 5 are overweight or obese. In Kansas, about 13 percent of children between ages 2 and 4 are obese.
Regulations lack specifics
Researchers found that most states failed to have model regulations, so they had to look at less stringent and less specific standards. Still, most states performed at average or below-average levels.
The Robert Wood Johnson Foundation recently released a report that examined Kansas’ regulations regarding requirements for healthy eating and physical activity in day care centers and homes.
Here’s a breakdown on how the state fared:
• Day care centers — Received a C for healthy eating and B- for physical activity. It had eight of the 20 recommended regulations.
• Child care homes — Received a D for healthy eating and C- for physical activity. It had three of the 20 recommended regulations.
Here are some of the recommended regulations that the state does not have, according to the report:
• Children older than 2 are served reduced-fat milk.
• Sugar-sweetened beverages are not served.
• Foods of low nutritional value are served infrequently.
• Child care providers do not withhold active play time as punishment.
• Physical activity education is offered to child care providers.
• At least one provider joins children in active play.
Kansas was among 22 states that received an overall C. Only six states scored lower, with Idaho receiving the only F. The highest grade was a B and only two states — Georgia and Nevada — received it.
Most states, like Kansas, have weakly worded regulations that leave out specifics that could help children stay healthy.
For example, model regulations specify that children should get at least 60 minutes of physical activity per day. But according to the less stringent standards that experts used for the report, states were given credit even if they required some physical activity.
“These findings suggest that most states have a lot of room for improvement in regulations aimed at preventing obesity in young children,” said Sara Benjamin, who conducted the study as a research fellow at Harvard Medical School, in a news release. She now is an assistant professor at Duke University.
“This nation must do a better job at promoting healthy eating and regular physical activity in very young children, especially those in lower-income families who are at high risk for obesity.”
Addressing the issue
Dr. Jason Eberhart-Phillips, health director for the Kansas Department of Health and Environment, which regulates child care operations, agrees.
He said Kansas health officials are aware they need to improve state regulations and are reviewing them.
He hopes to have new regulations in place in 2010. But there are a few steps involved, such as a public hearing and legislative approval.
He said the goal is to make the regulations more specific in terms of nutrition and physical activity. For example, he said, they may eliminate sugar-sweetened beverages and require serving reduced-fat milk for children ages 2 and older.
“We are really good at addressing the acute risks that our precious, young children face in these child care environments around injuries and abuse and things that have these acute, bad outcomes,” Eberhart-Phillips said. “We are only just really starting to appreciate that it’s also neglect and abuse — but the effects are much slower and gradual and not as perceptible — to allow them to eat unhealthful food and to remain inactive for long periods of time.”
According to the report, Kansas had five more regulations for child care centers than child care homes. For example, child care centers are required to provide some physical activity daily and to provide shaded areas for outdoor play, but homes are not.
In Kansas, there are an estimated 105,000 children in child care, and about 58,000 are in a home setting.
Eberhart-Phillips said the new regulations will bring similar standards to all child care operations.
“There’s no reason why kids that are getting care in a home situation should have any less shot at a healthy life than kids who are in a center. Ideally, the standards will be very similar,” he said.
Already exceeding standards
In Douglas County, there are about 6,900 children in day care centers, preschools or day care homes.
Karen Flanders, child care licensing coordinator for the Lawrence-Douglas County Health Department, said most child care providers go well beyond what the state requires.
“Most of our providers are aware of the best practices,” she said. “Most go above the minimum standard.”
Flanders said the last time the state updated the regulations was in 1990.
“It’s way past due,” she said.
Flanders said childhood obesity is a problem that needs to be addressed in child care settings and at home.
“Parents have a big role in this, too,” she said. “Parents need to keep them exercising in the evenings and not let them go home and sit in front of the TV. Everybody has to be working on this.”
Flanders suggested that the city of Lawrence could pass even stricter regulations than the state. New York City, for example, recently enacted healthy eating and physical activity regulations that were more stringent than the state’s.
“I think it’s definitely something that we need to be looking at and working on as a community.”