By Joseph A. Curtatone

(The opinions and views expressed in the commentaries of The Somerville Times belong solely to the authors of those commentaries and do not reflect the views or opinions of The Somerville Times, its staff or publishers)

On Monday this week, State Auditor Suzanne Bump chose Somerville as the place where she announced the findings of her office’s audit of Massachusetts’s programs and initiatives that address childhood obesity. Auditor Bump wanted to announce the findings here because some of the recommendations—from SNAP sales at farmers’ markets to getting kids active before, during and after school—are initiatives that we’ve already undertaken as part of Shape Up Somerville. The success of Shape Up Somerville’s pilot program in 2002 and our accomplishments since have taught us an important lesson that is echoed in the now-released state audit: Combating childhood obesity is an adaptive challenge, not a technical challenge.

What does an “adaptive” challenge mean? It means that battling this major public health threat isn’t necessarily about setting rules in place—banning this or that, telling you how to live. Instead, it means that we need to understand how the policies we enact shape the environment we live in, which in turn influences how we live and the choices we’re able to make. For instance, outdated urban planning that treated Somerville as a cut-through for cars instead of neighborhoods led to the construction of I-93 and McGrath Highway, and the removal of almost 20 rail and trolley stops that served our community. Those highways made already scant open space in a densely populated city that much more rare, cut off neighborhoods from one another and made our community less walkable and bikeable. This string of failed policies reshaped our environment and the choices available to the people in our community, contributing to rising childhood obesity rates.

But it’s not as simple as passing an edict ordering people to eat healthier foods and walk more. While government can champion healthy living as a core civic value and take action in the public policy areas where it has direct control, we do not and cannot control everything. Ultimately it comes down to options. If we want to make healthy living more likely, we can’t ask people to upend their lives. People are busy: working, making time to shop for groceries, going to the bank, picking up kids from soccer practice, and so forth. If we want to ask people to make the choice of healthy living, we have to make the healthy choice the easy choice.

We also have to make it an easy choice for everyone. A top-down, one-size-fits-all program won’t work anywhere, but especially not in a community as diverse as Somerville. This is especially true with regard to helping working class families. At Somerville High School, 68 percent of the students are eligible for free or reduced lunch. Those with greater means can afford to make healthier choices, but a family with one or two working parents who are supporting their family with a more limited income might find that a healthier diet is both a financially difficult choice, and less accessible due to time constraints. Healthy choices need to be accessible to everyone, regardless of socioeconomic status.

That means a successful program that shapes the environment, making the healthy choice the easy choice, also needs to be community-based, with the support of both private and public partners. Shape Up Somerville’s pilot in 2002, under Dr. Christina Economos from Tufts University, demonstrated this successful approach. Schools, city government, community organizations, church groups and local businesses all joined in—we had more than 350 community partners—and the two-year results of the pilot study had 1st-3rd graders in Somerville gaining two pounds less compared to control communities used in the study. Somerville children had decreased prevalence and increased remission of being overweight—not weight loss, but a healthy growth in weight for a young, still growing child.

Since the conclusion of the pilot program, we’ve expanded Shape Up Somerville community-wide while staying true to the idea of making the healthy choice the easy choice by shaping the environment we live, work and play in. Schools both offer healthier food options—and educate families, students and staff about healthier diets—and have policies and programs that get kids active before, during and after school. We’re making the whole city more walkable and bikeable, building and renovating parks while including community garden space, and through programs like our Open Streets Initiative. Access to healthy foods has expanded through each of our four supermarket chains accepting the EBT/SNAP program, our community garden program, the first urban agriculture ordinance in Massachusetts, and our Mobile Farmers’ Market bringing affordable produce to two public house developments and a senior activity center.

It all adds up to a comprehensive, sustainable approach that benefits everyone that lives, visits and works in Somerville, and why First Lady Michelle Obama’s “Let’s Move!” is rooted in the Shape Up Somerville pilot study. Still, we cannot rest on our laurels, and the state audit holds lessons for cities and the state on how we can lead on this public health issue. People make health choices within context of their environment, not a vacuum, and if we’re going to continue making progress in battling the obesity epidemic that leads to higher health care costs and lost productivity, we can’t order people to make healthy choices. We need to make the healthy choice the easy choice.