This is the seventh in a series of articles about health care in Southwest Georgia, an area of the state that has great health needs and challenges, but also some innovative approaches to such problems. The series is the product of a collaboration between Georgia Health News and the health and medical journalism graduate program at UGA Grady College of Journalism and Mass Communication, a partnership made possible by the Ford Foundation and Grady College.
When Monika Griner took over as director of Colquitt County’s school nutrition program in 2004, a typical school lunch was pepperoni pizza with a side of French fries. And the fries counted as a vegetable.
Much has changed since then as officials and the public have become more aware of nutritional issues and childhood obesity.
The 2010 passage of federal legislation supported by the Obama administration increased spending on school meals, made them accessible to more children, and mandated that healthier, high-quality foods be served. Whole grains dominate the menu now, and all lunches must contain one fruit and one vegetable.
But despite these changes, many elementary school students in Colquitt County are overweight or obese and suffer from preventable health problems associated with poor diet. (Data show that more than 30 percent of third-graders in the county were obese, while adult obesity there is currently measured at 37 percent, much higher than the state average, according to County Healthy Rankings.)
“I don’t know how to fix what happens outside the school day,” says Griner. “We had room for improvement in school nutrition, I don’t deny it. But we’re not solely to blame for childhood obesity.”
Georgia is not the only place where the dramatic overhaul of what’s on the school lunch tray has failed to show immediate results. In 2009, the year before the Healthy, Hunger-Free Kids Act was passed, 18 percent of six- to 11-year-old children were obese nationwide, and that number was unchanged one year after the act went into effect. During the same three-year period, obesity rates for those 12 to 19 years old climbed from 18 percent to 21 percent.
Griner says many families rely on high-calorie, low-nutrient foods because they are on tight budgets, live some distance from large, well-stocked grocery stores and often lack the transportation to get to those stores. Thirty percent of Colquitt County residents live below the federal poverty level, which for a family of four means a yearly income of $24,250. More than 80 percent of the county’s children qualify for free meals at school.
This is Georgia’s agricultural belt, but it’s not a Garden of Eden where everyone simply lives off the land without effort. Many locals don’t have the property or resources to grow any food at all.
“People who have never been here think we’re all living on farms and that we shouldn’t have any problems with food access. But some of the kids in our schools, their school lunch is the only real meal they get,” says Griner, who grew up in Moultrie, the county seat.
In Georgia, Colquitt ranks 141 out of 159 in the latest county-by-county health rankings compiled by the Robert Wood Johnson Foundation and released this March. Only 18 counties in Georgia are less healthy than Colquitt, based on a formula that takes into account such factors as access to health care, environmental contamination, and individual behavior such as smoking and alcohol use.
This is Colquitt County’s lowest health ranking since 2011, when RWJF first began publishing data for every county in the United States.
This was not supposed to happen.
In 2009, the county received a community health grant from the CDC. Since then, local leaders, aided by University of Georgia experts, have struggled mightily to help families improve their health and increase well-being.
“For all our efforts, we’ve really seen no measurable success,” says Greg Coop, director of the Healthy Colquitt Coalition. “If you could measure awareness, I think you’d see results. But even if people are more aware, they’re not necessarily choosing, or maybe they’re not able, to use that information.”
The Healthy Colquitt Coalition is a private, non-profit group that has been aided by UGA’s Archway Partnership, a program that matches UGA resources with community needs. Together, the two have pioneered education programs for children and adults.
“Our goal is to help students be the change agents in their families,” says Archway representative Whitney Costin, who lives in Moultrie. “Twice a month, in a program called Action Pack, we visit five elementary schools with lessons on healthy choices, like substituting water for soda or getting up and moving around during the commercial breaks on TV. They all got water bottles a few weeks ago and really had fun with those.”
Colquitt elementary schools have joined Georgia Shape’s Power Up for 30 program, which promotes incorporating 30 minutes of activity during the school day to promote learning and better health. County schools also participate in FITNESSGRAM assessments as part of a state requirement.
Another crusader for healthy habits is Julie Faison, director of the STEM program at Odom Elementary in Moultrie. STEM (which stands for Science, Technology, Engineering and Mathematics) is a national effort to inspire K-12 students with a passion for the sciences. The curriculum emphasizes hands-on learning, and Faison has worked with her students to build a greenhouse that is now up and running.
“I had never really grown vegetables before,” says a fourth-grader involved in the program. “But I like it. It’s really fun.”
Despite the efforts of school nutritionists, community activists, academic researchers and classroom teachers, there’s no quick fix for obesity and related health problems. School nurses in Colquitt County see the consequences of poor nutrition and inadequate physical activity all too often.
“We definitely have students who have already acquired Type 2 diabetes in elementary school,” says director of nurses Suzanne Sumner. “It’s also not uncommon for us to see kids with high blood pressure.”
“Children have access to food — to calories — but not necessarily to healthy choices,” says Costin, the UGA Archway professional. There are some large grocery stores, and a new Publix is under construction in Moultrie, but such well-stocked establishments are not nearly as common as in Georgia’s affluent suburban areas. In parts of southwest Georgia, people rely on fast food restaurants and small stores with limited produce.
There aren’t many choices when a child is sick, either. Colquitt Regional Medical Center is a 99-bed general medical and surgical hospital that treats mostly adults. A child with diabetes might be taken to its emergency room in case of a crisis, but the closest pediatric endocrinologist is 90 minutes away, in Tallahassee, Florida.
Income and ZIP code have a lot to do with inequalities in Colquitt County.
“Unfortunately, I can look at a child’s address and tell you a lot about what their health status is likely to be,” says Healthy Colquitt Coalition director Greg Coop. “And that’s something that isn’t an easy fix. We know that people of lower incomes tend to be located in neighborhoods with less access to healthy choices. And I think this is what limits us in seeing significant results in our county. But I don’t think that means we should quit trying.”
Shelby Jarrett is a second-year Master’s student at Grady College of Journalism and Mass Communication. Excerpts of her journalistic, creative, and photography works can be found at https://sjarrett.wordpress.