ANNOUNCER: THIS IS NEED TO KNOW WITH …JEFF GREENFIELD…MARIA HINOJOSA … RAY SUAREZ … AND THIS WEEK… SCOTT SIMON.
SCOTT SIMON [narration]: ON THIS EDITION…NEW YORK CITY TAKES ON OBESITY AND DIABETES.
People haven’t changed, people’s genes haven’t changed, what’s happened is the world has changed.
SCOTT SIMON [narration]: BUT, SHOULD THE GOVERNMENT DECIDE WHAT AND HOW MUCH YOU SHOULD EAT …. AND DRINK?
ROSS HAMMOND: There’s need for action at the federal level but there’s even stronger need for action at the local and community level.
SCOTT SIMON [narration]: AND, FROM AMERICAN VOICES…
HAILE JOHNSTON: We saw an opportunity to actually reestablish some of these relationships, connecting small sustainable family farms, with communities
SCOTT SIMON [narration]: NEXT ON NEED TO KNOW.
SCOTT SIMON: Welcome to Need to Know. And thanks for joining us. Now that Paul Ryan has been named Mitt Romney’s running mate, there is a growing consensus that this fall’s presidential election may come down to a fundamental question — what is the role of government? How big should it be? How active should it be? Is it the problem or the solution? Those questions have spilled over into the public health debate here in New York City about how to curb obesity and diabetes.
You probably heard that Mayor Michael Bloomberg’s administration has proposed banning super-sized servings of soda and other sugar sweetened drinks – a plan that has met fierce resistance by those who think the government is overstepping its bounds. No matter what you think about that, there is no debate about the serious damage and enormous costs associated with obesity and diabetes. The problem is especially acute in areas like the Bronx, the poorest of New York City’s five boroughs. Need to Know’s Sarah Schenck went there recently and reports now on one young girl whose health is already in jeopardy.
DOCTOR TOLENTINO: There is a little bit of darkening around her neck. A lot of the patients actually come in here and the parents saying the teacher told me that the neck is dirty. And it has nothing to do with hygiene.
SARAH SCHENCK [narration]: WHEN CARLA ELLIS WENT TO THE DOCTOR RECENTLY WITH HER MOM, SHE GOT POTENTIALLY CATASTROPHIC NEWS.
DOCTOR TALENTINO: Your body is not using insulin the way it should use it and this is where people can get into trouble and sort of start having symptoms of diabetes.
SARAH SCHENCK [narration]: THAT MEANS THIS 10-YEAR-OLD GIRL COULD CONTRACT A DISEASE THAT HAS STRICKEN SEVERAL FAMILY MEMBERS AND LED TO ONE RELATIVE’S LEG AMPUTATION AND DEATH.
CARLA ELLIS: I was scared, I was really, really scared. I was like oh my God, I can’t believe this is happening to me.
It was overwhelming and I didn’t want her to see the emotion, but it’s a scary thing, because this thing is in my family. I’m sorry. And I really need to stop this cycle.
SARAH SCHENCK [narration]: CARLA’S SITUATION WAS VIRTUALLY UNHEARD OF TWENTY YEARS AGO. NOW IT’S FRIGHTENINGLY COMMON, PARTICULARLY IN LOW-INCOME, PREDOMINANTLY MINORITY, INNER CITY NEIGHBORHOODS – LIKE HERSIN THE BRONX.
DR. ALAN SHAPIRO:What the predictions are for kids growing up in this community is that one out of every two children are going to have diabetes sometime in their adulthood. Nationwide, one in three children are at risk for diabetes in adulthood. That’s horrifying.
SARAH SCHENCK [narration]: IT’S HORRIFYING, SAYS DR. ALAN SHAPIRO OF THE CHILDREN’S HEALTH FUND AND THE CHILDREN’S HOSPITAL AT MONTEFIORE IN THE SOUTH BRONX, BECAUSE DIABETES CAN CAUSE CARDIOVASCULAR DISEASE, BLINDNESS, AMPUTATION AND KIDNEY FAILURE – ALL PROBLEMS THAT WRECK LIVES AND ARE ENORMOUSLY EXPENSIVE TO TREAT.
DR. ALAN SHAPIRO: The cost to society and the cost to them as an individual, it is impossible to exaggerate how serious that is.
SARAH SCHENCK [narration]: IN THE FACE OF THESE MOUNTING COSTS, THE NEW YORK CITY HEALTH DEPARTMENT HAS LAUNCHED AN AGGRESSIVE AD WAR AGAINST SUGAR CONSUMPTION MEANT TO SHOCK CHILDREN LIKE CARLA.
THE GOAL IS TO GET KIDS TO CHANGE WHAT THEY EAT AND ESPECIALLY WHAT THEY DRINK BEFORE THEY BECOME OBESE. THE THINKING IS IF THEY DON’T BECOME OBESE, THEY MIGHT NOT BECOME DIABETIC.
NYC SUGAR AD: Fifty pounds of sugar from just one soda a day.
THOMAS FARLEY:Right now, 40 percent of our children in New York City are overweight or obese.
SARAH SCHENCK [narration]: THOMAS FARLEY IS COMMISSIONER OF THE NEW YORK CITY HEALTH DEPARTMENT.
THOMAS FARLEY:We are very concerned about the immediate impact and even more so about the long-term impact.
DR. ALAN SHAPIRO: Prevention is a lot easier than having to intervene once obesity is set in. We know that obese children have a much greater likelihood to be obese adults.
SARAH SCHENCK [narration]: CARLA HAS BEEN BATTLING WEIGHT ISSUES SINCE INFANCY. BY THE TIME SHE WAS IN FIRST GRADE, SHE WAS ALREADY 50 POUNDS OVERWEIGHT. EARLIER THIS YEAR, THE 10-YEAR-OLD WEIGHED NEARLY 170 POUNDS.
DOREEN ELLIS: One day she came home from school and you know, and she was like ‘Mommy I’m the biggest person in the class,’ it was overwhelming for me because at first I had to let her know that she is beautiful no matter what size she is.
SARAH SCHENCK [narration]: CARLA SEEMS TO HAVE GOTTEN HER MOM’S MESSAGE. SHE SEEMS HAPPY AND WELL-ADJUSTED ABOUT HER SIZE. MANY PEOPLE ON BOTH SIDES OF HER FAMILY ARE BIG.
CARLA ELLIS: Hi. I’m Carla and I’m 10 years old.
DELIJAH: And I’m Delijah and I’m 11.
CARLA ELLIS: You really think this is our sizes? This is how it really is.
SARAH SCHENCK [narration]: BUT OBESITY MAY HAVE COMPLICATED HER LIFE IN OTHER WAYS.
SARAH SCHENCK: Carla, how old were you when you got your first bra?
CARLA ELLIS: I was six years old. Just when other people saw it, they didn’t really– they were shocked.
SARAH SCHENCK [narration]: ALTHOUGH SHE’S ONLY 10, CARLA LOOKS A LOT OLDER. THAT MAY BE BECAUSE FAT PRODUCES ESTROGEN AND CAN TRIGGER EARLY ON-SET PUBERTY.
DOREEN ELLIS: She was 8 going onto 9 but she — her body was developing and the hormones and everything else was telling them listen I’m a 12 years old, not a eight years old. So, it was moving faster than mentally she was ready for.
SARAH SCHENCK: How was that for you as a parent?
DOREEN ELLIS: Scary, because again, um, I, this is my baby and she was moving too fast.
SARAH SCHENCK [narration]: CARLA’S SURROUNDINGS HAVE PROBABLY CONTRIBUTED TO HER OBESITY.
SHE WAS RAISED BY HER MOM AND DAD IN THE SOUTH BRONX, A POOR NEIGHBORHOOD WHERE HEALTHY FOOD IS HARD TO COME BY AND CHEAP HIGHLY PROCESSED FOODS ARE UBIQUITOUS. AREAS LIKE THESE ARE SOMETIMES CALLED ‘FOOD DESERTS’.
SARAH SCHENCK: What’s your number one obstacle to healthy eating?
DOREEN ELLIS: Not enough Money. Not too many healthy choices that’s…quick.
A lot of us want run to the nearest corner and it’s cheaper, they go to McDonald’s they got 2 for 5 Big Macs.
DR. ALAN SHAPIRO: No one wants to be obese. It’s not a matter of not making the right choices, it’s really a matter of access. It’s modern life, it’s modern life living in an inner city without access to all of the healthy choices that middle class suburban life has.
SARAH SCHENCK [narration]: SOME KIDS IN CRIME-RIDDEN NEIGHBORHOODS ACTUALLY SEE BEING HEAVY AS A WAY TO PROTECT THEMSELVES ON THE STREET. OTHERS EXERCISE LESS AND EAT MORE BECAUSE THEY’RE STUCK AT HOME.
DR. ALAN SHAPIRO: When the sun goes down at 4:30 in the South Bronx, you know, there’s not a lot of opportunity outside to play around.
UNHEALTHY EATING IN DOREEN’S FAMILY HAS BEEN GOING ON FOR GENERATIONS. ALTHOUGH SHE DOESN’T HAVE DIABETES, SHE’S ALWAYS STRUGGLED WITH HER WEIGHT. HER OWN MOM NEVER TAUGHT HER TO PREPARE HEALTHY MEALS SO SHE DIDN’T MAKE THEM FOR CARLA EITHER.
DOREEN ELLIS: I see the trend of diabetes and high blood pressure. So it’s gotta be where it has to stop somewhere. And I’m hoping that right here could be where we can branch a new branch off of the tree. So when my grandkids and I’m a great grandmother, everybody’s eating right.
SARAH SCHENCK [narration]: WITH CARLA ALREADY SHOWING EARLY SYMPTOMS OF DIABETES, DOREEN KNOWS THE STAKES ARE HIGH.
DOREEN ELLIS: Our number one goal for me and Carla is to overcome that obstacle, named diabetes. Yes.
SARAH SCHENCK [narration]: CARLA’S TAKEN THE LEAD. SHE ENROLLED IN A HEALTH AND FITNESS CLASS, THROUGH THE CHILDREN’S HEALTH FUND AND MONTEFIORE HOSPITAL, AND IS LEARNING ABOUT NUTRITION, COOKING, AND EXERCISE.
CARLA ELLIS: We learn different things to eat healthy. We’ve been active.
CARLA ELLIS: Saturated fat is zero percent, sodium is three percent, that’s awesome.
SARAH SCHENCK [narration]: CARLA AND OTHER KIDS HERE ARE LEARNING TO UNDERSTAND FOOD LABELS THAT CAN OFTEN BE CONFUSING.
SANDRA AREVALO: So, if you don’t know how to read the labels and what to look for, you’re gonna just look at the front and say, you know, it’s good. It’s calcium, it’s vitamin D, it tastes good, it’s whole grain. They uncover the truth on the pretty face.
SARAH SCHENCK [narration]: REGISTERED DIETICIAN SANDRA AREVALO RUNS THE CLASS FOR KIDS IN THE COMMUNITY. SHE SAYS ABOUT A QUARTER OF HER PATIENTS LOSE WEIGHT AND KEEP IT OFF. CARLA HOPES TO BECOME ONE OF THEM.
SANDRA AREVALO: Her strength is her personality. She is very determined, when she wants something she goes for it. She spoke to every nurse that she could in order to actually make it to my office and they called me and they were like, ‘no she wants to see you really.’
CARLA ELLIS: I had to realize that I had to stop. It wasn’t stop eating, stop eating the way I was. It was stop eating the things I was eating. So that was pretty- that was also one of the worst things I ever had to go through, not stopping, it’s just facing that challenge.
CARLA ELLIS: If I’m eating, like if they have cheeseburgers and French fries. I eat half of my cheeseburger and I eat two French fries and I give them away. I don’t eat all of it. When I go up to class and if I’m still hungry, I drink water.
SARAH SCHENCK [narration]: NEW YORK CITY’S HEALTH DEPARTMENT HAS ALSO TAKEN STEPS TO ENCOURAGE HEALTHIER EATING.
We’ve put calorie labels on fast food menu boards. And we’ve introduced these health bucks, which are vouchers for people who are on food stamps to be able to use at farmers markets.
SARAH SCHENCK [narration]: ACCORDING TO THE HEALTH COMMISSIONER, CITY SCHOOLS HAVE REPLACED FULL FAT MILK WITH LOW FAT MILK, ELIMINATED DEEP FRIED FOODS AND SUGARY DRINKS, AND INCREASED THE AVAILABILITY OF WATER. HE SAYS WHEN KIDS DRINK MORE WATER THEY CONSUME FEWER CALORIES.
THOMAS FARLEY: People should be able to choose what they want but we want to make it so the default choice is healthier so we don’t all pay for it by getting sick years down the line.
CARLA ELLIS: Saturated fat is zero.
SARAH SCHENCK [narration]: NOWADAYS, WHEN CARLA GOES FOOD SHOPPING WITH HER MOM, THE PUPIL HAS BECOME THE INSTRUCTOR.
DOREEN ELLIS: I know this is your favorite.
CARLA ELLIS: Ahhh. Wait, we need to read the food labels.
DOREEN ELLIS: For the Dorito Cool Ranch, if you only get 12 chips, that’s the…
CARLA ELLIS: …serving.
DOREEN ELLIS: Ok, so you’re telling me you can only eat as a healthy is 12 chipss.
CARLA ELLIS: Yes.
DOREEN ELLIS: You think you can do that?
DOREEN ELLIS: We got the greens, we got this, let’s go get the rice and the meat.
CARLA ELLIS: Wait! With our vegetables, we need different colors. Because different colors equal different nutrients and vitamins. So we have green and orange, and here goes our red.
CARLA ELLIS: I take everything I learn and I give it to these people right here, and they’ll take it and they will probably send it on. And it is like a cold it will keep spreading and spreading and spreading.
SARAH SCHENCK [narration]: THIS REMARKABLY ARTICULATE 10 YEAR OLD GIRL NOW WANTS TO SPREAD HER MESSAGE ABOUT GOOD NUTRITION BY MAKING HER OWN VIDEOS.
CARLA ELLIS: This is the CeeCee show. This is the one I did in my new camera, so here it goes. Welcome to the Cee Cee show! And today for you guys, we have some healthy tips.
SARAH SCHENCK [narration]: EVEN HER DAD HAS BECOME A BELIEVER — AND A FOLLOWER.
DOREEN ELLIS: You know, I think it’s Carla that kind of got him more in the kitchen than anything. I enjoy sitting back watching them, you know, cook. And I’m the taster, the taste tester.
CARLA ELLIS: Just to know: I am a daddy’s girl. I love my daddy.
CARLA ELLIS: Dear God, thank you for this food. In Jesus name, amen.
DOREEN ELLIS: Amen.
CARLA ELLIS: Mm hm. It tastes really good, with mustard.
DOREEN ELLIS: You know, sometimes I’m feeling low, you know, she give me the self esteem to get up and say ‘ Oh Mommy, we can do this.’
DOREEN ELLIS: You’re never too old to learn something new from your kids.
DOREEN ELLIS: Little by little. Things don’t come overnight. You know, just like this little walk right here. Believe me it’s doing more for me then it’s doing for you.
DOREEN ELLIS: The nutrition, the health fitness, it helped me and it helped save my baby. It’s an educational thing all around because she really have taught me.
DOCTOR TOLENTINO: So, this is Carla, right? Carla you came and saw me in February, February 9th you’re weighing 169 lbs right? And you came back in Feb 23rd, 164. March 162, May 161. And today, June 28th you weigh 156. High five. That is great Carla. You are doing a wonderful job.”
CARLA ELLIS: I won! Ha ha. I won. Thanks Dad!
SCOTT SIMON: Joining me now to discuss if public policy can play a role in combating obesity is Ross Hammond. He is a senior fellow at the Brookings Institution, and is on the editorial board of the journal Childhood Obesity. He joins us from Washington DC.
INTERVIEW WITH ROSS HAMMOND
SCOTT SIMON [narration]: THIS WEEK ONLINE, TAKE PART IN OUR WEEKLY POLL. THE TOPIC: THE GOVERNMENT’S ROLE IN REGULATING THE THINGS YOU EAT…AND DRINK. LET US KNOW WHAT YOU THINK AND WHY. VISIT PBS.ORG/NEED TO KNOW.
SCOTT SIMON: Finally, we turn to American Voices – featuring diverse voices and diverse points of view. This week , we hear from Haile Johnston, founder of Philadelphia’s “Common Market”. He talks about the importance of increasing access to healthy, local foods in our nation’s lower-income neighborhoods through business-oriented solutions
HAILE JOHNSTON: Common Market is a nonprofit, local food distribution company, and we got started basically in response to the struggles that a lot of communities were having, accessing good food. Part of the vision of Common Market was actually to make local and sustainably grown food more affordable and accessible to all. It is an exciting time in a lot of ways, because there’s a lot of creativity and innovation happening around re-envisioning what the food system looks like, and re-envisioning regional economies. One of the reasons why you see natural foods and organic foods in the market being far more expensive is the system for getting that food into the marketplace is relatively inefficient in many cases. When we started out, the distribution that used to connect farmers and communities was gone. These relationships that used to nourish both sides of the food chain no longer existed. So, we saw an opportunity to actually reestablish some of these relationships through distribution, connecting small sustainable family farms, with communities. We have relationships with nearly 100 farms in the Delaware Valley region. We sell directly to hospitals, schools, elder care facilities. Colleges and universities. Retailers. So, everything from small specialty retailers to food cooperatives. To larger supermarkets that have been the beneficiaries of the fresh food financing initiative, to build supermarkets in food deserts. And we’re actually trying to demonstrate to the business community that neighborhoods like ours– low income communities in urban areas, as well as in rural areas, are not communities that should be ignored. That there actually is a business case to be made for bringing product– bringing good, sustainably grown– healthy product– to communities like ours. In the last year, we sold to over 100 schools. So, we were the farm-to-school supplier for about 65 public schools in our region as well as about 20 private schools. And a number of colleges and universities. And we’ve experienced pretty tremendous growth in the four short years that we’ve been in business. We’ve been growing at about 80% a year. This year, we’ll sell about $1.7 million of food. And we’ve been growing so fast that we’ve outgrown our facility where we’re located. Where I see great opportunity is actually for, again, reestablishing—re-establishing these relationships between rural producing communities and urban consumers in ways that are mutually beneficial.
SCOTT SIMON: That’s it for this edition of Need to Know. For more, including our weekly poll, visit us online at PBS.org/Need to Know. And for continuing election coverage from other PBS programs please visit PBS.org/election 2012. Next week, Jeff Greenfield reports from Ohio – maybe the most important swing state this year. You’ll hear from key officials, delegates and voters. We’ll see you then.