Transcript Slide 1
Community Action Partnership at 45: Keeping Our Promise
Why is Obesity Prevention an Important Anti-Poverty Strategy
Dolores Barrett Director of Partnerships and Services Community Action Partnership of Orange County September 4, 2009
Prevent
Obesity Trends* Among U.S. Adults BRFSS, 1985
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%
Obesity Trends* Among U.S. Adults BRFSS, 1986
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%
Obesity Trends* Among U.S. Adults
person)
BRFSS, 1987
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” No Data <10% 10%–14%
Obesity Trends* Among U.S. Adults BRFSS, 1988
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%
Obesity Trends* Among U.S. Adults BRFSS, 1989
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%
Obesity Trends* Among U.S. Adults BRFSS, 1990
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%
Obesity Trends* Among U.S. Adults BRFSS, 1991
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. Adults BRFSS, 1992
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. Adults BRFSS, 1993
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. Adults BRFSS, 1995
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. Adults BRFSS, 1996
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. Adults BRFSS, 1997
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%
Obesity Trends* Among U.S. Adults BRFSS, 1998
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%
Obesity Trends* Among U.S. Adults BRFSS, 1999
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%
Obesity Trends* Among U.S. Adults BRFSS, 2000
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%
Obesity Trends* Among U.S. Adults BRFSS, 2001
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Obesity Trends* Among U.S. Adults BRFSS, 2002 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Obesity Trends* Among U.S. Adults BRFSS, 2003
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Obesity Trends* Among U.S. Adults BRFSS, 2004
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Obesity Trends* Among U.S. Adults BRFSS, 2005
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Obesity Trends* Among U.S. Adults BRFSS, 2006
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Obesity Trends* Among U.S. Adults BRFSS, 2007
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Obesity Trends* Among U.S. Adults BRFSS, 2008
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Obesity Trends* Among U.S. Adults BRFSS, 1990, 1999, 2008 (*BMI
30, or about 30 lbs. overweight for 5’4” person) 1990 1999 2008 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
• In 1990, among states participating in the Behavioral Risk Factor Surveillance System, ten
states had a prevalence of obesity less than 10% and no states had prevalence equal to or greater than 15%.
• By 1999, no state had prevalence less than 10%, eighteen states had a prevalence of obesity between 20-24%, and no state had
prevalence equal to or greater than 25%.
• In 2008, only one state (Colorado) had a
prevalence of obesity less than 20%.
Thirty-two states had a prevalence equal to
or greater than 25%; six of these states (Alabama, Mississippi, Oklahoma, South Carolina, Tennessee, and West Virginia ) had a prevalence of obesity equal to or greater than 30%.
Health Risks
• Diabetes • Coronary Heart Disease • Dyslipidemia (high cholesterol, high triglycerides) • Stroke • Gynecological problems (abnormal menses, infertility) • Hypertension (high blood pressure) • Cancer (endometrial, breast, colon, pancreatic) • Liver and Gallbladder Disease • Sleep Apnea and respiratory disease • Osteoarthritis
Costs
Obvious Costs Costs in health care doubled in less than a decade to
$147 billion
(CDC) Hidden Costs Transportation and fuel costs Insurance Premiums Physical Environment
Health Disparities
• The proportion of adolescents from poor households who are overweight or obese is twice that of adolescents from middle and high-income households. Obesity is especially prevalent among women with lower incomes and is more common among African American and Mexican American women than among white women.
Health Disparities
• Compared with white youth, black and Hispanic youth have higher prevalences of asthma, overweight, and type 2 diabetes. • Among youth aged 10–19 years, American Indians have the highest prevalence of type 2 diabetes of any racial/ethnic group. • In 2005, after adjusting for population age differences, Mexican-Americans were 1.7 times more likely to have diabetes than non-Hispanic whites
Health Disparities
• In 2000, rates of death from diseases of the heart were 29 percent higher among African American adults than among white adults, and death rates from stroke were 40 percent higher.
• During 2003-2004, 24% of non-Hispanic black females aged 2-19 years were overweight, compared with 15% of non Hispanic white.
“Despite obesity having strong genetic determinants, the genetic composition of the population does not change rapidly. Therefore, the large increase (obesity)…must reflect major changes in non genetic factors.”
Hill & Towbridge, Childhood Obesity future directions and research priorities.
Pediatrics 1998
Food/Calories – energy in Weight is a simple equation Physical Activity – energy out
Framing the Issue
The issue is not individual weight loss.
PLACE MATTERS
Individual
& Environment
Success
–
Policy, Systems & Environmental Change
*Adapted from NC Energizers
Climb up a redwood tree.
Climb up a Redwood Tree
Do a touchdown dance like a 49’er
.
Wave and pose for your fans like an actor in L.A.
Swing your golf club in Palm Springs
Sit down in your beach chair and enjoy the sunset on a San Diego Beach
WALKING
If given enough time, people can walk
anywhere
.
But why would they?
Unless…
… it was NICE
… there were places to walk TO…
Dan Burden
… and getting there was safe and fun for all!
What’s wrong with this picture?
…and this one?
And this picture?
e
Can our streets encourage walking?
Yes! How?
• Scenery • Maintenance • Accommodation • Variety of Uses • Activity • Connectivity • Aesthetics & Beauty • Safety
Before
Dan Burden
After
Dan Burden
Bike Lanes Pedestrian Refuge In-Pavement Warning Lights Ped-Scale Lighting Bus Shelter
Before
After
Cost Savings - ROI
Prevention is an Investment $1 spent - $1 return in 1 year $1 spent - $5.60 return in 5 years $10 per person for prevention – $16 billion saved annually in 5 years
ACHIEVE
-Action Communities for Health, Innovation, and EnVironmental changE
CDC program that funds national organizations to work through local affiliates to advance local community leadership in the nation’s effort to prevent chronic disease and related risk factors.
ACHIEVE National Organizations
Community Funding
National Association of Chronic Disease Directors National Association of County and City Health Officials-NACCHO National Recreation and Park Association YMCA of the USA
Translation and Dissemination
– National Association of County and City Health Officials – Society for Public Health Education
Creating a National Movement
CHART
– Community Health Assessment Response Team La Mirada: City Parks & Recreation, LA County Public Health, Nonprofit, Community Hospital, Community Action
CHANGE
– Community Health Assessment aNd Group Evaluation Community, Worksite, School, Healthcare, and Community Organization/Institution
CAP
– Community Action Plan 3 Year plan to implement PSE change
Partnerships
Orange County Nutrition and Physical Activity Collaborative, NuPAC
• 10 Years • Leadership roles, Chair, Chair of the Policy Committee, Leadership Team • Multiple Events, Trainings • List Serve – 250, Active Membership 75 • Orange County Obesity Prevention Plan
Kid Healthy, Steps to Healthy Living Campaign
• 6 years • Public Awareness Campaign – 7 Counties, direct intervention for 100,000 children 2009 • Partners- ABC7, Kaiser Permanente, Power Play (CAPOC), CVS, Sav-On • Power Play in OC provided over 100,000 nutrition education and physical activity lessons
Network for a Healthy California (Nutrition Network- 5 a Day)
• 9 years • Represented OC in state meetings of regional collaboratives • 6 years contract -Power Play, Latino campaign, California Assoc. of Food banks • State and County Public Health • Nutrition and Physical Activity Education and Health Promotion
Community Building Initiative
• 5 years • Community Leadership Development • Low Income Community driven Policy, Systems, Environmental Change • 6 Communities • Playground equipment, 25 streetlights, community input in street widening and development process, etc.
More Partnerships
• California Convergence • Santa Ana Building Healthy Communities
Existing Movements
• Prevention – Gang, Drug and Alcohol, Teen Pregnancy, Tobacco,
Violence
• Environment – Bike/Transportation, Slow Growth, Parks, Organic, Energy,
Green
• Physical Activity – Sports, Professional & Recreational, PE, Parks, Recreation • Food – Grocery Stores, Health food Industry, Agriculture, Food Industry
• Planning Departments • Transportation Agencies • Public Works • Traffic Engineers • Planning Commissions • Developers • Smart Growth • Environmentalists • Farmers, Agriculture • Public Health Department (Chronic Disease, Injury Prevention) • Schools (PE Dept./Teachers, Food Service) • Restaurants • Grocery Stores • Employers, Businesses • Healthcare