Perceptions of Childhood Obesity among Rural Parents, Teachers, and School Administrators

By Tripp, Paula J.; Choi, Jin Young | Journal of Family and Consumer Sciences, Fall 2014 | Go to article overview

Perceptions of Childhood Obesity among Rural Parents, Teachers, and School Administrators


Tripp, Paula J., Choi, Jin Young, Journal of Family and Consumer Sciences


As one of the 10 leading causes of death in the United States, obesity and its related health problems have a significant impact on the economy and the healthcare system (Finkelstein, Trogdon, Cohen, & Dietz, 2009; U.S. Department of Health and Human Services, 2001). The prevalence of childhood obesity in the U.S. has increased more than three times during the last 30 years. About 17% of children and adolescents aged 2-19 years are now obese (Ogden & Carroll, 2010).

Childhood obesity is related to (a) higher risks of physical health problems (e.g., type 2 diabetes, cardiovascular disease, and gallbladder disease); (b) social and psychological problems (e.g., stigmatization, poor self-esteem, depression, anxiety); and, (c) low academic performance, as well as (d) overweight/obesity and chronic diseases in adulthood (American Academy of Child & Adolescent Psychiatry, 2011; Freedman, Zuguo, Srinivasan, Berenson, & Dietz, 2007). The early onset of obesity-related diseases influences life expectancy, placing today's children at risk of being the first generation that has a shorter life span than their parents (Olshansky et ah, 2005). Reversing the growing childhood obesity epidemic is a high-priority public health issue in the U.S. (White House Task Force on Childhood Obesity, 2010).

Although the incidence of childhood obesity has increased among all social groups, the social inequalities in childhood obesity have widened {Singh, Siahpush, & Kogan, 2010). Children living in rural areas, in particular, have a higher risk of obesity than their urban counterparts (Liu et al., 2007). Their higher risk might be related to ruralspecific sociodemographic and environmental characteristics (Choi & Pate, 2012). Rural residents tend to have limited incomes, less independent access to a vehicle, a lack of public transportation, and less access to affordable healthy foods (Bustillos, Sharkey, Anding, & McIntosh., 2009; Liese, Weis, Pluto, Smith, & Lawson, 2007; Sharkey, 2009). Rural areas also tend to have fewer available recreation and fitness facilities, yet more convenience stores, which offer lower availability and higher cost for healthy foods than supermarkets and grocery stores (Choi, 2012; Liese et al., 2007). Moreover, rural children are more likely to live in families with low income and without supervision (U.S. Department of Health and Human Services, 2005), which may lead to the consumption of unhealthy foods and to lack of physical activity. Children in rural Texas, for example, compared to their urban counterparts, are less likely to participate in after-school sports, more likely to spend greater amounts of time using electronic entertainment media, and less likely to eat meals together as a family; all of these factors equate to higher risk for overweight and obesity (Liu et al., 2007).

Food choices and eating behaviors, as well as physical activities, are shaped early in life, primarily in the home and school environments (Birch & Fisher, 1998; Hsiao-Liang & Contento, 2014; Nagel et al., 2009). However, many factors can affect this phenomenon. Not surprisingly, parents, school teachers, and administrators' decisions to build a healthy school environment and practice a healthy life style at home might be affected by their perceptions and the cost-benefit analysis of associated behaviors and situations (Carroll-Scott et al., 2013; Institute of Medicine [US] Committee on Prevention of Obesity in Children and Youth, 2005; Timperio, Salmon, Telford, & Crawford, 2005).

Another factor that shapes this phenomenon is parents' predisposition to report different definitions of overweight and obese in relation to their children than standards used on growth charts (Jain et al., 2001; Rietmeijer-Mentink, Paulis, van Middelkoop, Bindels, & van der Wouden, 2013). For an already overweight or obese child, this misperception could influence parental actions related to healthy choices (Remmers et al. …

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