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Hannah Geressu

University of Minnesota Master of Public Health (MPH) candidate

Just six months after being signed into law, Minnesota’s 'No Child Left Inside' program faced an unprecedented crisis: the coronavirus pandemic.

The program funds outdoor environmental, ecological, and other natural resource-based activities for Minnesota youth, particularly those with limited access to such opportunities.

With Governor Walz’s latest COVID-19 restrictions now in effect and winter just around the corner, No Child Left Inside faces the challenge of keeping outdoor youth programming afloat while adhering to social distancing guidelines.

Among the qualifying recipients of Minnesota’s 'No Child Left Inside' program's grant funding are Native American tribes. However, none of the 59 grants awarded in 2019 during Phase 1 of the program were allocated to a Native American tribe. This was a missed opportunity to address the issue of high obesity rates among Minnesota’s Native youth.

Native American adolescents ages 10 to 17 in Minnesota have higher rates of obesity compared to their peers of other races and ethnicities in the state. While the overall obesity rate for 10 to 17-year-olds in Minnesota is 9.9 percent, the obesity rate for Native Americans in this age group is more than twice as high. The 2019 Minnesota Student Survey found that, on average, 22 percent of Native American grade school adolescents report their weight status as obese.

The financial toll of obesity is substantial. Obese adolescents incur an estimated $19,000 in obesity-related medical costs over their lifetimes. This means that for Minnesota’s 10,632 Native youth – 22 percent of whom have obesity, according to the Student Survey results – lifetime medical costs due to obesity amount to over $44.4 million.

In addition to direct medical costs, obesity results in indirect costs such as days missed from work and higher insurance premiums paid by employers.

The problem of high obesity rates among Native American youth stems from centuries of marginalization and disenfranchisement. Forced removal of Native Americans from their ancestral lands led to the creation of Indian reservations, which often lack industrial diversity and job opportunities. Presently, 1 in 3 Native Americans lives in poverty, with a median income of $23,000.

Food insecurity also contributes to the problem of obesity in Native youth. Food insecurity is a condition in which households lack reliable access to affordable, nutritious food.

In Minnesota, the Red Lake Reservation qualifies as a food desert – a geographic area where residents live far from large grocery stores and other healthful food providers. Large portions of other tribal nations in Minnesota, including the White Earth, Leech Lake, Mille Lacs, and Bois Forte Reservations, are also food deserts. Food deserts lead to regular consumption of cheap, convenient, and unhealthy food, which puts food desert inhabitants at greater risk for obesity.

To maintain a healthy body weight, the CDC recommends that children ages 10 to 17 get at least 60 minutes of physical activity every day. Yet in 2019, only 16 percent of Minnesota’s Native adolescents reported that they met the CDC’s recommendation. This shortfall presents an opportunity for No Child Left Inside to encourage more Native youth to be active outdoors on a regular basis.

The 'No Child Left Inside' program should address the issue of Native youth obesity in Minnesota by awarding a set number of grants exclusively to Native American tribes. This would guarantee that some grants are available to tribal applicants, no matter how large the applicant pool. Clear communication with tribal leaders, residents, and groups regarding these exclusive grants would ensure that Native American tribes know such grants are available to them.

COVID-19 has forced millions of Americans to adapt to remote settings for work, school, social gatherings, and other everyday functions. No Child Left Inside must adapt as well.

A helpful example of adapted Native youth programming during COVID-19 is the Zuni Youth Enrichment Project (ZYEP) in New Mexico. ZYEP is a Native-led organization that aims to improve the health of kids belonging to the Zuni tribe. After the pandemic hit, ZYEP distributed physical activity kits in lieu of kicking off its spring basketball league. The kits were distributed through the Zuni Public School District’s free meal program, and included exercise materials such as jump ropes and health challenge guides for families.

Like ZYEP, the No Child Left Inside program should distribute physical activity kits as a temporary alternative to organized youth activities. The kits could include items like coats, mittens, boots, sleds, and ice fishing drills and rods, which would equip Minnesota kids for sustained outdoor activity through the winter. To ensure that Native youth benefit from these kits, coordination between No Child Left Inside administrators and Native youth organizations would be essential.

As Minnesota days grow colder and COVID-19 cases climb, No Child Left Inside must quickly adjust its program delivery to promote safe youth outdoorsmanship in the months to come.

Hannah Geressu is a graduate student at the University of Minnesota School of Public Health, studying Public Health Administration and Policy. She was born in Minneapolis, where she still resides. She is on Facebook (Hannah Geressu,) Instagram (Hannah Geressu,) and YouTube (Hannah in Health.)