As many of us in the public health field know, there are foods on the market that don’t facilitate good health. The South Bronx has the highest rate of childhood obesity in the City. Packaged and fast foods are ubiquitous in many neighborhoods, and residents may find themselves in the difficult position of finding cheap, healthy food on a consistent basis. The solution seems simple: children and adults should eat better food and exercise more. But what if the issue of childhood obesity is more complex than that?

As an article published at VICE magazine  might indicate from the author’s personal experience (and is supported in quite a few studies), eating habits are established early in childhood. Children learn how, when, and how much to eat from their parents, and often when parents are strapped for cash, they tend to purchase what is cheapest. In an environment where parents do not have much material means, and are engaging with learning curves in their children’s development and behavior, food has many more uses than just nourishment.

In fact, resources like this one from the University of Rochester Medical Center advise parents not to use food as a reward or a punishment for their children, a common practice. This is often because the rewards tend to be sugary, high-calorie treats, punishments tend to be healthier foods or no food, and they may inadvertently cause their children to develop destructive or dysfunctional relationships with foods of all types. Parents may be struggling with what affordable foods to feed their children who have health conditions. Many parents without material means tend to use less healthy foods as a nice treat, an indulgence when they otherwise cannot afford much else to give to their children, and as many of us know from experience, junk food makes kids happy.

So what does all this mean for the public health issue of childhood obesity? Childhood habits start early – and so should interventionists. It is much more difficult to unlearn behaviors as adults that we have kept since we were children. Food is as much a part of cultural and social practices as it exists to nourish. Families share meals together, parents feed their kids foods for many purposes, and in developing interventions, public health practitioners should consider all of these factors to work together with people and meet them where they are in order to create effective interventions.