School of Public Health leading multi-state initiative to reduce childhood obesity along the U.S.-Mexico border

Joe Sharkey, Ph.D., M.P.H, has spent nearly a decade trying to improve the lives of children and families living along the U.S.-Mexico border.

Now, Sharkey plans to take his work to a new level with the help of a five-year, $4.9 million grant from the U.S. Department of Agriculture (USDA).

Sharkey will lead a team from Texas, New Mexico and Arizona who plan to implement a family-centered approach to reducing the incidence of childhood obesity along the border through research, education and extension. Levels of childhood obesity in this area are reaching “epidemic proportions,” according to studies conducted by the United States-México Border Health Commission.

“The burden of obesity disproportionately affects marginalized populations, such as children of Mexican heritage who reside in impoverished communities along the U.S.-Mexico border,” said Sharkey, who is professor of health promotion and community health sciences in the Texas A&M Health Science Center School of Public Health and founding director of the Program for Research and Outreach-Engagement on Nutrition and Health Disparities.

The program will focus on areas with the least amount of resources, such as the more than 2,300 colonias scattered along the Texas-Mexico border from El Paso to Brownsville. Colonias are unregulated neighborhoods that have sprung up in former agricultural areas that have exhausted their usefulness for growing crops. Families living in these areas have limited access to affordable, healthy foods and physical activity opportunities. Public health officials trying to improve the quality of life in these areas face numerous barriers such as language, level of education, poverty, inaccessibility, and trust of outsiders. The program will focus on Hidalgo County (Texas), Luna and Otero counties (New Mexico), and Santa Cruz County (Arizona).

“Obesity is a very complex issue in these areas,” Sharkey said. “It can be hard to be physically active when it is 100 degrees outside, there are dogs running loose and there are gangs. Parents may be keeping their kids inside the house because it is safer. You can’t just take a program from somewhere else and drop it in there.” As a result, the team will focus on addressing environmental context and culture of the areas.

Sharkey and other members of the research team plan to develop and test a promotora-driven model called Salud Para Usted y Su Familia (Health for You and Your Family). Promotoras are members of the community who are trusted by residents, serve as a cultural bridge, and have special training in outreach and health education. Sharkey said he was encouraged to start the program by promotoras themselves.

“We have been doing research along the border for years,” Sharkey said. “They wanted to know how we can change things.”

Working with these promotoras, Sharkey and his team plan to develop a program to improve individual and family behavior in three key areas: nutrition, physical activity and “screen time.”

“Positive behavior changes in children are not sustainable if the family system and home environment remains unchanged,” Sharkey said. He wants to develop a program that will enable residents to maintain their cultural traditions, but do so in a healthier way. For example, this might involve using olive oil in tortillas instead of lard.

The new program builds on variety of other programs Sharkey has developed in South Texas since 2007. His first project along the border involved driving every road in Hidalgo County to map its food resources. More recently, he has done several studies looking at hunger rates among children and the elderly who live in the colonias.

Sharkey said improving the health of families living along the U.S.-Mexico border is important because these communities are typical of many new immigrant communities springing up throughout the country, including in states such as North Carolina, Tennessee, Kentucky, Iowa, Colorado, Oregon and Oklahoma.

“If you look at the demographics, populations of Mexican origin will be the largest minority group in the United States, if they are not so already,” Sharkey said. “We hope this project will help us learn how to improve the health of this population, whether it is through individual behavior or environmental changes.”

Partners on the project include New Mexico State University (Jill McDonald, Ph.D.), the Mariposa Community Health Center in Nogales, Ariz. (Susan Kunz, M.P.H.), Texas A&M AgriLife Extension Service (Sharon Robinson, Ph.D.), and Baylor University (M. Renee Umstattd Meyer, Ph.D.). The USDA awarded the grant through the Childhood Obesity Prevention Challenge Area, a program of the Agriculture and Food Research Initiative sponsored by the National Institute of Food and Agriculture.