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In response to skyrocketing rates of childhood obesity, state and federal policymakers have developed public school-based programs to fight “America’s pandemic obesity problem.” These programs have focused on promoting “healthy” lifestyles without attempting to explore the cultural or political factors that underlie childhood obesity. One such program was the cornerstone of former Arkansas Governor and Republican presidential contender Mike Huckabee’s Health Arkansas Initiative, Arkansas’ Act 1220 of 2003. The “BMI Initiative” (repealed in 2007) required annual school reporting of Body Mass Index scores. This paper examines BMI Initiative data and the creation of rural foodways—now considered traditionally African American and Southern in the Arkansas Delta—to demonstrate how African American views and behaviors conflict with dominant medical and political definitions of health. Policies that have arisen from public health constructions of obesity allow the politicization of body image for a culturally specific, hegemonic ideal of beauty that ultimately devalues Southern African American women and allows structural inequalities in health care to be effectively ignored. G A T E S , N O L A N , S C H N E I D E R 20 Rates of obesity in America have reached unprecedented levels with as much as 65 percent of the adult population and 16 percent of children and adolescents now classified as overweight or obese (CDC 2006a). Obesity is pathologized by the medical community and the media and constructed as a primary global risk, effectively relegating obesity-related disease to the status of secondary risk. Not only do state and federal government groups support studies of obesity, but weight loss has become an American obsession. Popular television programs such as Oprah and Dr. Phil constantly feature discussions about the dangers of fat in American diets and about nutritional supplements and body surgical techniques that seem to offer solutions. Efforts from the $30-billion-a-year diet industry, however, focus not so much on health benefits from weight loss (substantiated mostly through reductions in diabetes) but emphasize improvements in self-confidence and good looks. The federal government provides nutritional guidelines and promotes physical activity, and the aims of public policy have followed suit, creating a rhetoric of individual responsibility in the war on fat. In an attempt to curb what is increasingly referred to as “America’s pandemic obesity problem” (Tillotson 2004), state and federal policymakers are beginning to focus their attention on the role of nutrition education and physical activity in public schools. Public school students in Arkansas, Florida, Tennessee, Illinois, Pennsylvania, Texas, California, Delaware, Missouri, and West Virginia all have some sort of BMI testing (Wickline 2007, 2-B). However, instead of understanding obesity as a behavioral pathology, this paper views overweight as a normal biological and behavioral response to obesogenic conditions, as well as a socially constructed category closely tied to socioeconomic status (SES), environment, and ethnic identity. No matter how well intended, policies that promote a single culturally determined vision of a healthy lifestyle will not be sufficient to create effective change in providing for the health and well-being of public school students and their communities. P O L I T I C S O F T R A D I T I O N A L F O O D WA Y S 21 The terms overweight and obese refer generally to weights considered unhealthy, at which the likelihood for developing certain diseases and health conditions, such as hypertension, heart problems, failing hips and knees, and diabetes, is increased. While more accurate methods of determining body fat percentage exist, Body Mass Index, calculated from an individual’s height and weight, is the measurement used most often in studies, since it is easy to calculate. An adult with a BMI falling between 25 and 29.9 is considered overweight, while an adult with a BMI of 30 or above is considered obese. The formula for categorizing BMI in children and adolescents differs slightly, placing individuals within specific percentiles referring to the relative position of the child’s BMI number among children of the same gender and age. A child is considered “at risk for overweight” with a BMI falling between the 85th and 95th percentile, and “overweight” with a BMI equal to or greater than the 95th percentile (CDC 2006b). BMI statistics can be alarming, but it may not be the weight Americans sustain that causes long-term health problems as much as Americans’ lack of exercise and balanced eating. Diet plans are largely unsustainable, and yo-yo dieting apparently causes increased rates of mortality. With an overweight/obese rate of 63.1 percent, Arkansas ranks as the sixth fattest state in the nation (Levi, Segal, and Juliano 2006). In 2003, Arkansas became the first state to require all of its K-12 public school students to have an annual BMI assessment (Act 1220). The bill also set forth general rules regarding nutrition and physical activity aimed at providing “students with the skills, opportunities and encouragement to adopt healthy lifestyles.” Among the key provisions of Act 1220 were the following requirements: “annually report each student’s BMI to his or her parents and provide families with information about the importance of nutrition and physical activity, bar student access to food and beverage vending machines in G A T E S , N O L A N , S C H N E I D E R 22 elementary schools, and disclose food and beverage contract agreements, including revenues and expenditures.” In addition, a Child Health Advisory Committee was created and, based upon the committee’s recommendations, schools were subsequently also required, among other provisions, to “improve access to healthy foods in cafeterias, limit access to competitive foods (such as vended snacks and beverages) and ensure that products offered meet strict nutrition standards” (Act 1220 of 2003). Headed by the Arkansas Center for Health Improvement, the Body Mass Index Initiative has resulted in a BMI database for approximately 97 percent of Arkansas’ public school students. According to the nationally published results of the third-year study, “analysis of the BMI assessments reveals that the progression of the childhood obesity epidemic in Arkansas has been halted” (ACHI 2006b). This conclusion, however, seemed premature to the members of the 2007 General Assembly that replaced the Huckabee initiative with Act 201. This new act will require BMI measurements to be taken less frequently and will make it clear to parents that they have the right to refuse to have their children tested. Between 2003 and 2006, the overall BMI of Arkansas schoolchildren dropped from 38.1 percent to 37.5 percent—a decrease of only 0.6 percent. The largest drop in BMI, from 38.0 percent to 37.5 percent occurred from 2005 to 2006 (ACHI 2006b). By 2007, data seemed to indicate that the weight of children was either leveling off or increasing slightly. Furthermore, 80,000 Arkansas public school children were not tested, either because they refused to participate in the study or were absent from school when measurements were made. In year one of the study, 10 percent of those whose BMI could not be measured were listed as “child refused to be measured”; in years two and three, this reason accounted for 17 percent and 19 percent, respectively, of those who could not be measured. “Parent refused” was listed as between 21 P O L I T I C S O F T R A D I T I O N A L F O O D WA Y S 23 percent and 24 percent during the three years of the study. An Arkansas Delta school nurse was quoted as saying that those who opted out were “usually the ones that need it” (Peacock 2006). Figures reported for the 2006-2007 school year showed that more than 50 percent of the students in four school districts (Bearden, PalestineWheatley, the KIPP Delta College Prepatory School in Helena-West Helena, and Strong-Huttig) were overweight (Wickline 2007, B-1). All of these school districts are in eastern Arkansas. Upon closer examination of year-to-year data, it appears that the only groups that made (slight) progress were Caucasian males and females and Hispanic females. The two groups with the highest overweight/obese percentages, Hispanic males and African American females, saw little change. The percentage of Hispanic males classified as overweight/obese actually rose from 50 percent to 51 percent from 2004 to 2005, and then dropped back to 50 percent by 2006, while the percentage of African American females classified as overweight/ obese remained at a relatively constant rate of 44 percent throughout all three years of the study. By the twelfth grade, all groups except African American females reached approximately the same population percentage of individuals classified as overweight/obese. All male subgroups’ rates leveled off at 36 percent to 40 percent; Hispanic and Caucasian female rates declined to almost exactly 30 percent, while African American female rates jumped to approximately 45 percent (ACHI 2006a). Arkansas State Surgeon General Joe Thompson acknowledged that the rate of valid assessments had declined from 85 percent in 2005-2006 to 77 percent in 2006-2007 (Wickline 2007, B1). With an overweight/obese population of approximately 64 percent concentrated mainly in the rural South, African American women nationwide are at a much higher risk for obesity than any other subgroup (Baturka, Hornsby, and Schorling 2000; Peralta G A T E S , N O L A N , S C H N E I D E R 24 2003). Statistically, all of the following populations are most at risk for becoming overweight or obese: African Americans, females, those of low socio-economic status, residents of areas of ethnic segregation, residents of the rural South, and those with low levels of education (CDC 2006b; Chang 2006). According to the BMI Initiative data, rates o

Southern foodways and culture [electronic resource] : local considerations and beyond