The report attributes many of the causes of childhood obesity to social determinants of health.

“We historically had really focused on healthy eating and physical activity,” said Jamie Bussel, a senior program officer for the foundation. “Those are really, really important. But as important is whether or not that child has a safe place to call home. Does mom or dad or that care provider have a stable income? Is there reliable transportation? Is there access to high quality health care, access to healthy food? So all of those factors influence the child and the family’s opportunities to live well, be healthy, and be at a healthy weight.”

Experts say many of those factors were exacerbated by the pandemic. Families that were already dealing with financial challenges were increasingly burdened in every aspect of their lives — housing, education, health care, food insecurity, and job security.

Dr. Stephanie Tanner Walsh, a pediatrician at Crozer Health in Chester, Pennsylvania, said the pandemic has had a deep impact on families in her community, which has a history of high poverty and food insecurity.

“Our school district was hit very hard, and most of these kids were out of school from March 2020 to September 2021, and the majority of those children were receiving school meals. Their parents often had jobs that did not allow them to telework, and child care centers were shut down, so these kids were left to their own devices for food while also having their usual recreational activities taken away,” she said.

The Robert Wood Johnson Foundation report also names structural racism as a contributor to childhood obesity and health care inequality, as it affects housing, school options, and access to health care and food.

“If we don’t get at this sort of fundamental kind of structural racism, we’re not going to make progress on health equity in America,” said Bussel. “And we’re certainly not going to make progress on addressing childhood obesity.”

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