[Excerpt of article by Belén Dumont, Published December 13, 2023]
CT Latino News’ series—Hartford Children’s Health: Equitable Access—explores responses to complex systemic and cultural barriers across Connecticut’s capital that impact the daily health of its youngest residents. About 28,000 children and youth live in Hartford, one of the state’s most diverse communities that continues to address a variety of longstanding health-related disparities.
HARTFORD—Weekday mornings are a flurry of packing backpacks and deciding on outfits for the day for most children. Across Connecticut—where about 327,000 guardians work hourly—parents also prepare for their own busy day and students caught up in the morning rush can get into the habit of skipping breakfast or grabbing something quickly to go.
Every day, about 28,000 Hartford children and youth make their way to and from school, the majority walking an average of 0.25 miles to their school bus stop or being driven to school by a guardian, according to Hartford Public Schools Superintendent Dr. Leslie Torres-Rodriguez. Laing recalls these busy school days when her two children walked to and from St. Joseph Cathedral School in Hartford.
“Some parents feel it’s safer to drive their kids to school…because of predators and safety concerns,” she explained in a phone call. “But you find that kids do not get the exercise they really should be getting from doing those kinds of brisk walks.”
An inconsistency of balanced meals and safe, enjoyable opportunities for regular exercise will weaken health, just like poor sleep quality and mental health can. These four areas of well-being, along with genetics, play significant roles in a person’s likelihood to develop obesity, which is prevalent in about 38% of adults across Hartford.
Our bodies respond and adapt to our daily habits, resulting in immediate as well as longer-term effects. So, we hear about the importance and pressure of having “healthy lifestyles.” Still, these discussions tend to ignore certain complexities and imply that we all have the same access to resources and that having certain lifestyles is always a choice.
“Hartford doesn’t really have a grocery store in the entire city,” said Dr. Melissa Santos, Division Head of Pediatric Psychology and Clinical Director of the Pediatric Obesity Center at Connecticut Children’s. “If you don’t have transportation, how are you purchasing fresh fruits, fresh vegetables… how are you getting it back home in a safe way? Where do your kids play? Do you have a built environment that allows for parks and green space? Or are you in a multi-family house where your kid can’t run or jump because you’re going to disturb the neighbors? We also know that obesity tends to be genetic. So, chances are other people in the family have obesity as well. So, then how do you help the whole family start to make changes?”
Hartford’s Rising Obesity Rates
In 2023, Hartford had one of the highest prevalences of obesity across Connecticut, which has an average obesity rate of 29%, according to DataHaven’s latest Hartford Equity Report. About 42% of the capital’s Latino population and 39% of its Black population have been diagnosed with obesity, compared to 28% of the white population.
Childhood obesity rates in Connecticut show similar racial and ethnic disparities. The Connecticut Department of Public Health reported that about one in five children from 5 to 17 years old across the state were diagnosed with obesity in 2020. About 30.8% of Connecticut children experiencing obesity identified as Hispanic, while 12.5% of children across the state with obesity were Non-Hispanic white, according to the study. There was no data available on non-Hispanic Black children.
ConnectiCare Nurse Karin Remicio has worked in the Hartford County community for nine years and has also seen a high prevalence of diabetes along with heart disease, strokes, and high blood pressure among patients. She emphasized factors like the high-cost of healthy foods, insufficient nutritional education, and culture that can heavily influence people’s health.
“Different cultures, Hispanic cultures too, might be a little more resistant to that [lifestyle] change because of those barriers, because of the parents working, because financially they can’t afford certain foods…” Remicio said of families’ struggle to be as physically active and nutritious as they would like.
Community members and healthcare providers have emphasized the role of culturally informed education in residents’ health. Hartford is home to one of the state’s largest communities of color, with Latinos making up 44% and Black residents representing 36% of the capital’s population.
“When I was growing up…it was more quantity. It was more just having food…our parents just wanted to make sure that we ate,” explained Remicio, who is originally from Lima, Peru. “But with my kids and this new generation, I think we’ve become more educated either through their schools, or our own careers, or our own experiences outside our family and within our family. So, now that we are raising our kids, it’s more quality instead of quantity.”
In Hartford, 35% of Latino residents, 31% of Black residents, and 17% of white residents experienced food insecurity, with the average rate of food insecurity across Greater Hartford at 13% and across Connecticut at 14%, according to 2021 data provided by DataHaven.
“When you have higher rates of food insecurity or you’re a parent who grew up in poverty or…with food insecurity, it’s really hard not to purchase in bulk. Because you’re gonna want to know that your pantries are full of food. You’re going to want to know that your child is never hungry,” Santos said. “Oftentimes, when kids will be like, ‘Mom, I’m hungry’, even when you know [they’re] not hungry, that breaks a parent’s heart. Particularly if you knew what it was like to go to bed hungry. You’re never going to let your child have that feeling you had.”
Hartford’s built environment is a shared concern among community members and local healthcare providers. In such urban areas with extensive communities of color, there’s a lack of easy access to grocery stores with fresh produce and healthy beverages and insufficient safe green spaces for families to play and walk across.
“We have a lot of families that come here from Puerto Rico and when we say ‘When did [weight concerns] become a thing?’ They’re like ‘as soon as we moved to Connecticut’,” Santos explained. “Because when we talk about Puerto Rico, there’s more walking, there’s a more natural kind of being outdoors…that built environment just isn’t [here].”
Santos pointed out that aside from diet and exercise, mental health is another, much less recognized and discussed, aspect of obesity. Research shows that obesity often comes with comorbid mental health conditions such as depression, anxiety, and suicide. This comorbidity is more present among youth of color—particularly Black children and adolescents—who may experience higher levels of psychological stress from racially motivated discrimination.
“We also have to take into account the whole child and understand that physical, emotional, and environment [factors] are all going to play together,” Santos explained. “I think the more that we focus on the social determinants of health of the built environment, access to care, and really change the conversation of obesity as a disease that needs to be respected and treated just like every other medical condition that goes a long way to help families.”