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City of Boise Approves Healthy Child Care Ordinance

By Dr. David C. Pate, News and Community
November 11, 2014

Editor’s note: What follows is Dr. Pate’s testimony delivered before the Boise City Council in mid-September in support of the city’s healthy child care initiatives.

The Boise Healthy Child Care Ordinance was approved Sept. 30 and became effective Oct. 1, with implementation of some components to take effect through 2015. 

The city has posted a schedule of effective dates and under information at

Nationally and locally, we have a problem that is going to make the healthcare cost crisis of today pale in comparison to what families and businesses will face in the upcoming decades.

That problem is childhood obesity.

We are now seeing high blood pressure, high cholesterol, diabetes, and musculoskeletal problems in children, and we will see more strokes and heart problems at younger and younger ages. We now know that these children also can be at higher risk, merely because of their obesity, for at least nine different cancers.

Even as St. Luke’s works to keep patients well and out of the hospital to reduce healthcare spending, that will only put a dent in the healthcare spending that will be associated in treating expensive, high-risk conditions in patients in the prime of their lives that we previously did not see until later in life.

It’s also likely that the resultant, greater number of obese young adults will perpetuate this cycle of increasing childhood obesity as they, in turn, have children.

Nationally, 14.9 percent of children entering kindergarten today are overweight, and another 12.4 percent are obese. That is more than one in four kindergarten children – at an average age of 5.6 years! And those nearly 15 percent of children who are overweight but not obese are four times as likely as normal-weight children to become obese over the next nine years.

St. Luke’s has designed treatment programs for childhood obesity, but this is analogous to fighting a forest fire with hand-held fire extinguishers.

It is far more cost-effective to prevent obesity from the very start of life than to try to cure it later. St. Luke’s simply cannot do this alone.

We now are learning more and more that the determinants of childhood obesity appear in the first years of life when the child cannot make the decisions and yet will have to live with the consequences, perhaps for the rest of life.

The ordinance proposed by Councilman TJ Thomson is a huge start at helping to prevent childhood obesity. While much more is needed, Boise has the opportunity to be a leader in developing healthy communities, and no measure will have more impact than stemming the tide of childhood obesity.

St. Luke’s wholeheartedly embraces and supports Councilman Thompson’s healthy initiatives, and we are indebted to him for his leadership in this critical area of public health.

About The Author

David C. Pate, M.D., J.D., previously served as president and CEO of St. Luke's Health System, based in Boise, Idaho. Dr. Pate joined the System in 2009 and retired in 2020. He received his medical degree from Baylor College of Medicine in Houston and his law degree from the University of Houston Law Center.