Mind and Body/Opinion

Does Rhode Island have an eating disorder?

Or, was a recent provocative column by the Globe’s Dan McGowan about the prevalence of overweight kids in RI perhaps a projection?

Image courtesy of RI KIDS COUNT, file image

A map displaying the incidence of children who were obese or overweight, taken from a 2019 issue brief produced by Rhode Island KIDS COUNT.

By Richard Asinof
Posted 5/23/22
A provocative column by Globe columnist Dan McGowan appeared to “fat shame” kids in Rhode Island, in ConvergenceRI’s opinion.
Is it appropriate to call a Governor “boring” as a criticism about his apparent popularity in the polls? What data exist for correlation of endocrine disruptors and microplastics found in food and the incidence of chronic diseases in Rhode Island’s kids? Do any of the popular restaurants in Rhode Island offer cooking classes for young mothers/fathers, with free daycare?
There have been a number of clinical studies that have shown that providing pregnant women with a source of free fresh fruits and vegetables have improved the health outcomes for their children. In Flint, Mich., Dr. Mona Hannah-Attisha, a pediatrician, has pioneered providing her patients with a “prescription” for food at the local coop located in the same building where her office is. Beyond focusing on exercise regimens, the ability for young mothers and their children to access nutrition food would seem to be a necessary component of any program to address obesity in children in Rhode Island, based on the evidence.

PROVIDENCE – Talented Boston Globe columnist Dan McGowan has the gift of the gab. Time and again, McGowan has displayed his prodigious skills in moderating conversations on Facebook and in facilitating in-person debates between political candidates.

In his daily RHODE MAP email newsletter, McGowan has often served as a popular signpost to dish out the latest political gossip in Rhode Island.

In a recent column, published on May 18, “R.I. Gov. McKee isn’t cooked yet. But he’s in desperate need of a reset,” McGowan opined that the biggest challenge facing Gov. Dan McKee in his re-election bid was his need to overcome the fact that: “He’s boring.”

And, as a dedicated Little League baseball coach, McGowan often shares on Twitter the wisdom he has acquired in shepherding youngsters along the base paths of life, in a 21st- century version of Art Linkletter’s “Kids say the darndest things.”

For sure, McGowan does not shy away from advocating on behalf of his own favorite choices of preferred food groups – “Things I love: baseball, steak, chocolate cake,” according to his Twitter profile.

McGowan recently used one of his favorites – chocolate cake from Gregg’s – to be the metric to demonstrate how much money candidates had raised so far in pursuit of elected office in 2022.

“Here’s a look at how much chocolate cake from Gregg’s [$10.54 a slice on DoorDash] the people who want to be your governor or mayor of Providence could be buying to actually win over voters,” McGowan wrote, in a May 3, 2022, column, “Forget yard signs. Here’s how much [emoji of a cake] RI politicians can buy,” illustrated with photo of a slice of Gregg’s six-layer Death by Chocolate cake, taken from Gregg’s Facebook page.

Without a doubt, it was a clever device: to imagine that investing in slices of chocolate cake to deliver to prospective voters would be a better bet than investment in yard signs.

But there was nothing very clever or funny, in ConvergenceRI’s opinion, about McGowan’s more recent column, “Rhode Island’s child obesity problem.” The column, published on May 17, began: “There’s no polite way to say this: Too many Rhode Island children are overweight, and not the adorable, pinch-your-cheeks-because-you-look-like-a-chipmunk kind of chubby. We’re talking Del’s-on Del’s-on-Del’s-on-milkshake fat.”

The illustration [a stock photo from Shutterstock] that appeared with the column was viewed by many critics as a pejorative image of a chubby young white female adolescent, sitting on a couch, eating candy, a remote at the ready, with the caption: “Experts say being sedentary and not eating healthy foods both contribute to the high number of overweight children in Rhode Island.”

McGowan then went on to cite numbers from the latest Rhode Island KIDS COUNT Factbook: “More than one in three children in Rhode Island – 35 percent – are overweight or obese, according to data published by the Rhode Island KIDS COUNT, the state’s leading child advocacy group.”

The data around obesity was one of the five data facts pulled out by McGowan in a story about the release of the 28th annual Rhode Island KIDS COUNT Factbook in his RHODE MAP email blast sent out on Monday, May 16.

Under the heading, “Many kids are overweight or obese,” McGowan wrote: “Rhode Island ranks No. 35 in the country ([and worst in New England] for the percent of children between ages 10 and 17 who are overweight or obese, at 34 percent.”

The news item continued: “In Central Falls, 52 percent of children between ages 2 and 17 are considered overweight or obese, followed by Woonsocket at 48 percent. The fear among doctors is that being overweight as a child could lead to lifelong health complications.”

Was it “fat-shaming?”
McGowan’s column drew an angry response from many public health practitioners, including a Twitter thread from Liz Gledhill, who wrote: “Poverty isn’t a choice children make …and access to fresh food, organized sports and regular [health care] is a privilege often not afford[able] to the poor. RI should feel shame about its systems that perpetuate obesity, not its children who suffer from it.”

Other critics of the column took exception to what they said was McGowan’s apparent belief that it was a matter of personal responsibility when it came to changing the trends around obesity that could be overcome by exercise and fitness programs.

McGowan suggested that the state should invest in developing outdoor exercise programs to promote physical fitness, suggesting that Providence College basketball coach Ed Cooley might be recruited to lead a new initiative targeting urban kids.

Does that suggestion ring a bell? Such an idea sounded remarkably similar to the 2010 initiative promoted by former First Lady Michelle Obama, called “Let’s Move,” focused on physical exercise and good nutrition. What a difference a decade makes.

The argument about “personal responsibility,” of course, also sounded somewhat similar to the arguments that have been made by some anti-vaxxers regarding the spread of the coronavirus – that somehow people who were most likely to catch COVID were overweight, had diabetes, and had not taken good care of their own health.

In search of a conversation
ConvergenceRI had reached out to McGowan to inquire if the columnist would be willing to sit down and talk in a formal interview, a request that has been pending for more than two years. McGowan declined, saying, “I’ve got a lot on my plate [emphasis added] right now, so I’m going to pass.”

One of the areas of conversation that ConvergenceRI had wanted to talk about with McGowan was to have a more in-depth discussion around youth obesity rates in Rhode Island, because ConvergenceRI had been covering the story since the summer of 2018, four years ago, and then again in the spring of 2019, with the publication of an issue brief by Rhode Island KIDS COUNT. [See link below to ConvergenceRI story, “Capturing the data on childhood obesity in RI.”]

As ConvergeneRI had reported in the 2019 story: The new issue brief, entitled “Childhood Overweight and Obesity: New Data for Rhode Island,” represented the efforts of a statewide coalition of providers, insurers, community advocates and agencies to bridge that gap. It found that some 35 percent of Rhode Island children, ages 2 to 17, based upon data from 2016, were overweight or obese, a takeaway that captured the weighty dimensions of the problem.

Note that in 2019, the level of overweight or obese children in Rhode Island was 35 percent [emphasis added]; in the 2022 Rhode Island KIDS COUNT Factbook, the number of overweight or obese kids was also 35 percent [emphasis added], showing that the trend had apparently remained roughly the same during the last three years.

In 2019, a panel discussion followed the presentation of the data brief, which featured Ellen Amore, from the Center for Health Data and Analysis at the R.I. Department of Health; Dr. Patrick Vivier, from the Hassenfeld Institute for Child Health Innovation; and Karin Wetherill, from the Rhode Island Healthy Schools Coalition.

During the conversation that ensued, ConvergenceRI realized that he had covered a preliminary report on the data brief that had been presented to the State Innovation Model steering committee, in August of 2018. [See link below to ConvergenceRI story, “Mining the golden ore of clinical data.”]

As ConvergenceRI had reported in the 2019 story: ConvergenceRI directed his ‘upstream” question to Vivier, who had done extensive mapping and analysis of lead data and its correlation with asthma, asking: In a similar manner to the work done on lead and asthma, could the high incidence of obesity in Rhode Island perhaps be correlated with potential contamination of drinking water by PFAs, the chemical produced in the manufacture of Teflon? A study conducted in Cincinnati with pregnant women and their children had found [apparent] correlation with childhood obesity and the toxic chemical, and Joseph Braun, an epidemiologist at the School of Public Health at Brown, had been involved in that study.

Vivier, despite the complexity of the question, welcomed the inquiry. The work on lead, he explained, had created a comprehensive dataset that allowed health researchers to pursue active interventions. The new dataset on obesity in Rhode Island, Vivier continued, was the first step in getting to that next level of analysis and potential environmental links. Vivier also praised the work being done by Braun.

No one questions that obesity in Rhode Island has emerged as a chronic issue. The problem, however, as illustrated by McGowan’s column, is that solutions may require a more place-based, holistic approach, looking at the prevalence of food deserts and food swamps, the availability of more nutritious foods in school lunches, more, better physical exercise programs, and a better understanding of the underlying issues of environmental contamination of endocrine disruptors. Can we talk?

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