By Stephanie Innes

Tucson, Arizona | Published: 01.17.2010

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A University of Arizona program that targets a serious obesity problem among people living along the Arizona/Mexico border has received $3.9 million from the federal government.

Many factors are contributing to high rates of obesity in Arizona border communities, including poverty, a lack of nutrition education and issues such as the location of fast-food outlets and grocery stores, said Lisa Staten, who directs the Canyon Ranch Center for Community Health Promotion at the UA's Mel and Enid Zuckerman College of Public Health.

The center has received funding from the U.S. Centers for Disease Control and Prevention since 1998. The $3.9 million from the CDC will allow the center to continue its work in promoting healthy habits among obese populations in border communities for the next five years, Staten said this week.

"Obesity, diabetes and cardiovascular disease are the top three preventable chronic diseases affecting Hispanic and American Indian populations living in border communities," she said. "When you think of chronic disease prevention, everybody thinks of individuals — what should a person do to be healthier? They need to eat better, be more active. Absolutely, that's true, but there are so many things around the environment that are barriers to doing that."

The center leads walking clubs in border communities called Pasos Adelante (Steps Forward). When Yuma residents in the program encountered city sprinklers during their 5 a.m. walks, center officials helped them lobby the city to change the sprinkler times — and it worked.

In another case, residents in a neighborhood in the San Luis/Somerton area near Yuma complained there were no parks where they could walk. The residents, in partnership with a community-health worker, showed up at a public meeting and demanded a place to walk. The result was a block grant to build a park.

"We're really focusing on what can be done on a bigger level," Staten said.

The Star interviewed Staten about her work to combat obesity and its related chronic diseases. Here are excerpts:

We do work across the border counties. A lot of our projects focus on Hispanic populations. We're also working to increase partnerships with the Tohono O'odham and Pascua Yaqui. ...

Our work on diabetes prevention and control started in the 1990s when several school nurses in Douglas said that something was going on — all of a sudden they were having to deal with kids on insulin. It was a huge increase in kids with diabetes. We call it type 2 diabetes now — it's no longer adult-onset diabetes because so many kids are getting it.

Socioeconomics are a big piece. There may be some genetic factors involved, too. ... There are so many factors that it's just amazing.

In the 1960s and '70s there was a big push to have P.E. in schools. In a lot of schools, that has gone away.

The way kids eat now is very different from what we ate in the '60s.

If you look at where schools were built before the 1980s, land use is different. Schools used to be built in the middle of a neighborhood and most kids could ride their bikes, walk, that kind of thing. Now they tend to be located on busier streets, and farther away. Schools used to be within a mile of people's homes. Now they are five, 10 miles away. Schools are bigger. What happens is, it's not really safe for kids to ride their bikes to school.

In the 1950s, kids drank a lot of milk. Now soda has surpassed milk. With milk you get calcium and other nutrients. With soda, it is empty calories. There is no positive nutrient value to it. Soda is really one of my pet peeves.

How do you hope to address chronic-disease prevention?

We're doing a national survey of community-health workers to get a feel for where the nation is so we can see, at the end of our project, if our local folks are doing more advocacy. At the end we want to have a training and support model that we can say, "Here is what you can do in your communities."

The biggest barrier is probably that we have folks who are dealing with so many personal issues that to be thinking about chronic disease — it is not the first thing they are going to think about.

When the community identifies a problem, we've worked with community-health workers to help identify solutions at a bigger level. For example, part of the curriculum is to promote lower-fat milk consumption. That seems pretty basic. But we learned it was not in their stores. ... We contacted the milk distributor and they said 98 percent of the milk they distributed in these communities was whole milk, because that's what was selling. They said if people started asking for it, they would carry it. And now they are carrying it.

Some of the communities have started farmers markets. Some convenience stores are starting to carry fresh produce.

I think the awareness (in Arizona border communities) is definitely higher about fitness, eating healthy and being active.