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Integrating Care

Case Study: Consortium to Lower Obesity in Chicago Children

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The Consortium to Lower Obesity in Chicago Children (CLOCC) brought together organizations and individuals across sectors and neighborhoods to understand childhood obesity and design interventions. The CLOCC’s guiding principles are:

  • Social Ecology
  • Evidence-Based Decision Making
  • Community Engagement
  • Health Equity

In 2002, Dr. Katherine Kaufer Christoffel, a pediatrician at the Ann and Robert H. Lurie Children’s Hospital of Chicago, founded the CLOCC. Her vision for the consortium grew out of her daily clinical experience: seeing increasing numbers of obese patients in the nutrition clinic. She was well-versed in the clinical significance of this epidemic.

The CLOCC conducted the first citywide prevalence data for Chicago children (aged 3-7) entering school for the first time. The data showed that 24% of Chicago children were entering school already obese – two- and-a-half times the national average at that time. Politicians took note, introducing more than 40 related pieces of legislation. The CLOCC officially sponsored the passage of the 2004 Illinois stae bill that called for schools to collect data relating to obesity when performing annual student health examinations.

Early on, the CLOCC’s efforts focused on short-term, specific programs and interventions to start or keep individual children on a path to a healthy lifestyle. The CLOCC’s attention to individually-focused approaches, and the recognition that children and families needed sound information to make good decisions on nutrition and physical activity, led them to develop the 5-4-3-2-1-Go® healthy lifestyle message. Over time, CLOCC began to recognize the importance of making health easier by changing the environments within which children and families live, work, learn, and play. Known as Policy, Systems, and Environmental change (PSE) strategies, these approaches support communities with the goal of making healthy options the default options.

Today the CLOCC comprises more than 3,000 individuals representing over 1,200 organizations working on childhood obesity prevention in Chicago, across Illinois, throughout the nation, and beyond. Working together, CLOCC staff and partners have sought to increase individual and family knowledge about healthy lifestyle, strengthen organization and institutional practices to support healthy eating and physical activity, and improve environments so that health food and physical activity are widely available where people, and especially children, live, work, learn, and play.

Dr. Christofel, commenting on her own journey in obesity prevention says:

When I entered medical school I dedicated myself specifically to health and health promotion.

To be of help, I had to learn how families work, hour by hour, week by week, year by year. People trusted me to pry and spend time with them to learn about them. To cross the ocean that divided us. My attention gradually turned to problems related to primary calorie imbalance, both malnutrition and obesity, and this became my clinical focus for decades.

When evidence of the obesity epidemic showed up in my examining room, I saw that protecting kids from this scourge required approaches well beyond what can be offered in the clinic. This was clearly a very big mountain indeed, spanning many areas of life and unjustly affecting those most in need. I took its measure and concluded that what was needed was a very comprehensive approach, with a focus on primary prevention and so an emphasis on young children.

Some of the ideas that I have learned along the way that informed the design of the CLOCC include:

      • Partner with others who have complementary work preferences and skills.
      • Understand your limited perspective.
      • Remember that many things can’t be controlled.
      • Work in teams, which achieve the most and provide perspective.

As a result of the CLOCC’s work over five years from 2002-2007, Chicago achieved a statistically significant decrease in obesity among children entering school, from 24% to 22%.