Transcript Technology and Preparedness: Can Public Health

F as in Fat, 2008: Why Obesity
Policies are Failing in America
Jeffrey Levi, PhD
Executive Director
Trust for America’s Health
September 17, 2008
Key Findings: F as in Fat, 2008
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Adult obesity rates rose for a second consecutive
year in 24 states and for a third consecutive year in
19 states, with no states experiencing a decrease.
More than 25 percent of adults are obese in 28 states,
an increase from 19 states last year.
More than 20 percent of adults are obese in every
state except Colorado.
Rates of type 2 diabetes grew in 26 states last year.
Seven of the top 10 states with the highest obesity
rates are also in the top 10 for highest poverty rates.
Key Findings: F as in Fat, 2008
Rank
State
Percentage of Adult Obesity
(Based on 2005-2007 combined data)
1
Mississippi
31.7% (+/- 1.0)
2
West Virginia
30.6% (+/- 1.1)
3
Alabama
30.1% (+/- 1.2)
4
Louisiana
29.5% (+/- 1.0)
5
South Carolina
29.2% (+/- 0.8)
6
Tennessee
29.0% (+/- 1.2)
7
Kentucky
28.4% (+/- 1.0)
8 (tie)
Oklahoma
28.1% (+/- 0.8)
8 (tie)
Arkansas
28.1% (+/- 0.9)
10
Michigan
27.7% (+/- 0.8)
Factors Contributing to Obesity Rates
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Inadequate Physical Activity
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For adults, physical inactivity rates range from 15.7%
(Minnesota) to 31.8% (Mississippi), with the majority of
states not demonstrating any statistically significant
change in their rates of physical inactivity.
All 50 states and DC have laws related to physical
education and physical activity in schools; only 13 include
enforceability language.
30 years ago, nearly half of American children walked or
biked to school; today, less than one in five either walk or
bike to school.
Factors Contributing to Obesity Rates
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Nutrition
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Higher caloric intake and higher caloric density of foods
influence obesity rates – adults consumed approximately
300 more calories daily in 2002 than they did in 1985.
The Dietary Guidelines for Americans were updated in
2005, but the USDA school meal program has yet to adopt
them. Standards for foods sold outside the school meal
program are outdated.
Rising food costs are putting an economic strain on
Americans, making it more difficult for schools and
families to purchase costlier, more nutritious fruits and
vegetables.
Factors Contributing to Obesity Rates
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Barriers in the Built Environment
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Lack of access to grocery stores and other venues that sell
healthy foods can inhibit healthy eating.
Communities without well-lighted sidewalks, bicycle
paths, trails, parks and other recreational sites may
discourage physical activity.
Health Coverage
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Ten states do not include specific coverage for nutrition
assessment and counseling for obese and overweight
children in their Medicaid programs.
Twenty states explicitly do not cover nutrition assessment
and consultation for obese adults under Medicaid.
Recommendation: National Strategy to
Combat Obesity
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We recommend the development of a comprehensive,
realistic plan that involves every department and agency of
the federal government, state and local governments,
businesses, communities, schools, families, and individuals.
It would outline roles and responsibilities and set national
goals so that agencies, businesses, families and communities
can implement policies, programs and practices in their
purview that aim to curtail obesity levels.
The National Strategy for Pandemic Influenza Planning can
serve as a model for this approach.
Recommendation: Increase Funding for
Obesity Prevention
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Many chronic disease prevention programs
have been flat-funded for the past few years.
Without additional funding, CDC’s chronic
disease prevention programs cannot expand to
all 50 states and in some cases have had to
decrease the number of grantees due to
insufficient funding.
Recommendation: Increase Funding for
Obesity Prevention
Chronic Disease Prevention, Health Promotion and Genomics
Dollars in Thousands)
$1,000,000
$899,628
$800,000
$789,972
$818,171
FY2003
FY2004
$833,574
$824,762
$833,827
$805,321
FY2006
FY2007
FY2008
FY2009
$600,000
$400,000
$200,000
$0
FY2005
Recommendation: Increase Funding for
Obesity Prevention
Nutrition, Physical Activity and Obesity
Dollars in Thousands)
$60,000
$40,000
$39,289
$41,930
$41,280
$40,590
$42,191
$42,018
FY2005
FY2006
FY2007
FY2008
FY2009
$34,149
$20,000
$0
FY2003
FY2004
Prevention for a Healthier America:
Financial Return on Investment?
With a Strategic Investment in Proven Community-Based Prevention
Programs to Increase Physical Activity and Good Nutrition and
Prevent Smoking and Other Tobacco Use
INVESTMENT:
$10 per person per year
HEATH CARE
COST NET
SAVINGS:
RETURN ON
INVESTMENT
(ROI):
$16 Billion annually
within 5 years
$5.60 for every $1