Discover, Innovate, Scale: A Systems Approach for Childhood Health and Wellness

  • Article
  • August 4, 2016

It’s no secret that we are grappling with a childhood obesity epidemic. While recent reports suggest childhood obesity levels are stabilizing, and even declining in certain populations, overall rates remain unacceptably high. Furthermore, disparities persist along racial, ethnic, socio-economic and geographic lines. Although there are no simple solutions, a comprehensive multi-sector approach may be able to address this complex issue.

A systems approach to addressing childhood obesity recognizes that the factors influencing obesity are interactive and interdependent. Strategies must simultaneously address the culture, societal norms, community assets and practices at home that influence a child’s ability to make healthy choices and, ultimately, their weight.

Shape Up Somerville

From 2002 to 2005, I led a community-wide effort to address childhood obesity in Somerville, Massachusetts. Shape Up Somerville brought to bear a multi-level, multi-sector, multi-system package of interventions that made simultaneous changes to every part of a child’s day. We engaged members of local government, health care providers, representatives from the media and the school community and parents in making comprehensive changes to the school, out-of-school-time and home environments.  

Our goal was to reduce over-consumption and increase energy expenditure to encourage healthy growth and development. As a result of the intervention, fewer children in the community were overweight or obese compared to children in the control communities, and we saw promising changes in key behavior patterns, like decreased sugary beverage consumption, decreased screen time and increased participation in physical activities. Somerville has become a model community for employing a systems approach to childhood obesity helping decrease the risk of childhood obesity.


Having achieved success with this approach, I wondered whether a similar strategy could be employed to reach a substantial portion of the tens of millions of children between the ages of 5 and 12 in the United States. 

In 2009, Peter Dolan, Chairman of Tufts University Board of Trustees, my colleague Dr. Miriam Nelson and I launched ChildObesity180. Housed at Tufts University Friedman School, ChildObesity180 combines the rigor of science with the innovation of business to rapidly scale evidence-based solutions.

We assembled a group of high-level leaders from academia, government, non-profits and the private sector to review dozens of recommendations and narrow in on areas for intervention. We then built a portfolio of impactful initiatives:

  • Healthy Kids Out of School promotes healthy habits in volunteer-led out-of-school-time programs like Boy and Girl Scouts, 4-H, and youth sports.
  • Active Schools Acceleration Project brings quality physical activity to schools with Billion Mile Race.
  • Eating Well Matters @ Restaurants works to reduce children’s excess calorie consumption in restaurants.
  • The Breakfast Initiative researched and promoted novel approaches to boosting school breakfast participation.

Each of these initiatives is working to influence the complex systems that shape children’s environments and behaviors. Working in concert, we are making significant strides to reverse childhood obesity and to close the disparities gap.