TFAH Statement on the Draft House Republican Obamacare Replacement Bill: Our Nation’s Health Will Suffer

Washington, D.C., February 24, 2017 – The below is a statement from John Auerbach, president and CEO, of Trust for America’s Health (TFAH).

“The draft House Republican Obamacare replacement bill—which would eliminate the Prevention and Public Health Fund—would threaten the health of American children, families and communities.

Thanks to the Prevention Fund, hundreds of thousands of Americans benefit from increased access to vaccines and other preventive health services. Quite simply, more people are getting and remaining healthy because of the Prevention Fund.

Yet, the proposed replacement bill would eliminate this important Fund and 12 percent of the U.S. Centers for Disease Control and Prevention’s (CDC) budget along with it.

And, without the Prevention Fund, states will lose substantial sums of money—totaling as much as $3 billion over the next 5 years—which fight growing epidemics and emerging diseases.

Every year, we spend $3 trillion on healthcare, yet millions suffer from chronic diseases and death rates among Blacks and other people of color remain too high. At the same time, death rates among white middle-aged Americans increased for the first time in decades, mainly due to preventable conditions.

Time and again research shows that the vast majority of these conditions—heart disease, diabetes and others—can be prevented by investing in addressing the root causes. Yet, the country has repeatedly failed to do so.

The nation cannot afford to trade away our single best investment in preventing disease, preparing for and responding to infectious disease outbreaks, reducing rates of chronic illness, and saving lives and money.

If this draft becomes law, our nation’s health will suffer—and it will be exponentially harder to fight growing epidemics, like the rise in prescription drug and heroin overdoses.”

 

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Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.

It Takes a Village: How Mancelona, Michigan Worked Together to Improve Health and Education

By Mike Swain, MPH, Community Health Coordinator, Health Department of Northwest Michigan

In the early 1990s, residents of Mancelona (a northern Michigan town) had limited access to healthcare, social services and higher education and there were sparse employment opportunities.

With the lowest per capita income in the immediate area, most families lived in poverty, and were underinsured, uninsured altogether or enrolled in Medicaid.

Some of the community’s youngest were hardest hit: the area had the state’s highest rates of youth physical and sexual abuse, teen pregnancies, drinking and drug use. And as could be expected, these health risks had a significant impact on academic performance – with behavior problems in the classroom, low grades, and high dropout rates. In the 1994-95 school year, 39 percent of Mancelona high schoolers dropped out and just 64 percent of the senior class graduated.

Terry McCleod, the Middle School Principal at the time, recognized the critical role of student health and wellness in academic success – and he led the charge for change in Mancelona.

First, he brought together a grassroots network of public and private service providers. Along with a three year grant from the W.K. Kellogg Foundation, they built Project S.H.A.R.E. (School Home Alliance for Restructured Education) to provide a comprehensive assessment and evaluation of the gaps and needs in Mancelona.

The results made it clear that any successful, lasting intervention would need to improve the environment and families by addressing the underlying, interconnected issues of poverty. The layout of the community’s schools—all three were essentially on the same campus—allowed for a unique solution: building a dedicated family resource center right next to school grounds. With thoughtful outreach, community advocates and the public health administration were engaged in the cause, and the land for this building was secured.

The group secured a grant from the Michigan Department of Health and Human Services (MDHHS) to fund the beginning of construction, with the Mancelona Family Resource Center (MFRC) officially opening in 1996.

MFRC housed health, social, daycare, educational, and economic services, offering a unique and comprehensive suite of services to support Mancelona’s students and their families. Staffing and programs were brought in with continued support from Project S.H.A.R.E., including the Michigan Works! Association – which resided in a dedicated wing of the MFRC.

Michigan Works! played a critical role in turning the tide of poverty by strengthening the employability of adults with workforce development services and mobilization of local businesses.

Still, quality healthcare was at the heart, with the local Health Department providing previously unattainable care, including a Dental Health Clinic, on site. Additionally, the MFRC team provided convenient and confidential, family planning, reproductive health services, and education. And working closely with the school, this innovative approach included the development of a dedicated class for pregnant mothers to help improve the health of future Mancelona generations.

Over time, partnerships and additional resources were added within the center, the school and the community. In 2001, Communities In Schools (CIS) began providing programs and services in Mancelona. Founded on the national CIS model, this non-profit organization provided new programs for before/after school activities, mentoring and tutoring.

The CIS team worked in collaboration with the MFRC, providing care coordination and referrals for students and their families. And, when the state of Michigan expanded school-linked health center qualification requirements to include areas with rural status, the MFRC leadership were among the first applicants in line. Mancelona was included with the first round of funded centers under this new qualification.

In 2006, with this additional funding, the Mancelona school-linked health center opened, called the Ironmen Health Center, was opened. The Center offered services to students aged 10-21 regardless of health insurance status. In addition, social work and behavioral health services were provided.

By blending and braiding different funding sources and bringing to bear all community resources to link families to important social services and interventions, the community is much improved.

In fact, rates of teen pregnancy, drug and tobacco use, and child abuse are all down. And, high school graduation is up—to 91 percent, a 42 percent increase from the inception of project.

The benefits of this innovative care model doesn’t stop there: 60 percent of the 2013 graduating class enrolled in college that fall. And nearly 100 percent of the 2015 seniors are making plans to pursue some form of higher education or technical skills training post-graduation. What was once and ending is now just the beginning of a story.

Here you can find a timeline and more information on the model, including details on the Women’s Resource Center, Communities in Schools and the Ironmen Health Center. 

 

Survey Finds 73 Percent Support Investments to Improve Health; Obesity, Future Health of Children Top Concerns

Washington, D.C., January 19, 2017 —A new national survey of registered voters has found that nearly three-quarters (73 percent) of Americans support increasing investments to improve the health of communities.  Support spans across party lines (57 percent of Republicans, 87 percent of Democrats and 70 percent of Independents) and regionally across the country (75 percent in the Northeast, 71 percent in the Central U.S., 72 percent in the South, and 75 percent in the West).  Women are the strongest proponents of supporting health improvement efforts (62 percent of Republican women, 87 percent of Democratic women and 80 percent of Independent women).

The survey, released today by the Robert Wood Johnson Foundation and the Trust for America’s Health, was conducted by Greenberg Quinlan Rosner Research, in consultation with Bellweather Research, on September 8-9, 2016 of a nationwide sample of 1302 registered voters across the country.

A majority (51 percent) believe that today’s children will be less healthy than previous generations when they reach adulthood.  The groups who hold this belief most strongly include: Republicans (55 percent); rural residents (60 percent); Southerners (57 percent); Independent women (62 percent); and Black women (68 percent).  Most registered voters with children under age 18, however, believe their own children are very healthy (92 percent give an 8-10 rating on a 10-point scale); this is the case for parents of all ideologies, incomes, education levels, and ethnicities.

Additionally, 64 percent believe that the number of health issues facing the country has grown in recent years. Obesity is the top health concern (41 percent), cancer ranked second (33 percent), followed by heart disease and stroke (14 percent) and diabetes and substance misuse (both at 11 percent).

Americans also rate their own health better than the health of the community where they live (66 percent rate their own health as 8-10 (very good) on a 10 point scale, but only 36 percent rank their community’s health as very good).  There are differences based on income, age, education and area of the country on how people rank their health.  For instance:

  • 73 percent of college-educated Whites rank their health as very good compared to 57 percent of Whites without college degrees; and
  • 72 percent of individuals with a household income above $50,000 per year rank their health as very good compared to 59 percent of those with incomes below $50,000.

A majority of American registered voters also strongly support (rating 8-10 out of a 10 point scale) a range of priorities and strategies for improving health, including:

  • 74 percent of people highly support providing enough time — during the school day and afterschool – for kids’ physical education, physical activity or community sports;
  • 74 percent also highly support creating partnerships among farmers, food suppliers and community health groups to bring fresh produce trucks or mobile markets to communities that lack access to grocery stores;
  • 65 percent highly support providing kids with more information on making healthy food choices and being physically active;
  • 63 percent highly support investing more in preventing obesity and chronic diseases like heart disease, diabetes and stroke;
  • 62 percent highly support increasing early childhood health programs, including home visit programs, mobile health screenings and treatment for diseases like asthma;
  • 61 percent highly support investing more in preventing the spread of infectious diseases like the Zika virus, bird flu and hepatitis;
  • 60 percent highly support treating substance use, including addiction to prescription painkillers and heroin, like a disease, not a crime;
  • 60 percent highly support planning for building more parks, walking and biking trails and other recreation areas for people to be physically active in all communities;
  • 60 percent highly support increasing access to safe and affordable housing and routinely testing for things that create health problems in homes, like lead in water and paint, carbon monoxide, and harmful chemicals in the air;
  • 59 percent highly support increasing incentives that encourage business owners to open grocery stores in communities that lack access to healthy food options; and
  • 58 percent highly support building local partnerships across businesses, health systems, schools and community organizations to address specific health problems in communities.

Methodology:  On behalf of the Robert Wood Johnson Foundation and the Trust for America’s Health, Greenberg Quinlan Rosner Research, in consultation with Bellwether Research, conducted a survey among 1,320 registered voters nationwide (1,019 weighted). The survey was conducted between September 8th and 19th, 2016. Voters were randomly selected from a list of registered voters and reached on a landline or cell phone depending on the number they designated on their voter registration. Interviews were conducted by live telephone interviewers; 50 percent were reached on a cell phone. Included in the sample were three oversamples: 100 Black voters, 100 Hispanic voters, and 100 White non-college voters. Upon completion of the survey, the results were weighted to bring the three oversamples into line with the racial and ethnic composition of registered voters nationwide. The data was weighted to reflect the total population of registered voters, taking into account regional and demographic characteristics according to known census estimates and voter file projections. The data are subject to a margin of error of +/- 3.1 percentage points.  Full survey and topline results are available upon request.

For more than 40 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are striving to build a national Culture of Health that will enable all to live longer, healthier lives now and for generations to come. For more information, visit www.rwjf.org. Follow the Foundation on Twitter atwww.rwjf.org/twitter or on Facebook at www.rwjf.org/facebook

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Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.

Majority of States Score 6 or Lower Out of 10 Indicators in Report on Health Emergency Preparedness

Washington, D.C., December 20, 2016 – In Ready or Not? Protecting the Public from Diseases, Disasters and Bioterrorism, 26 states and Washington, D.C. scored a six or lower on 10 key indicators of public health preparedness.

The report, issued by the Trust for America’s Health (TFAH), found that the nation is often caught off guard when a new threat arises, such a Zika or the Ebola outbreak or bioterrorist threat, which then requires diverting attention and resources away from other priorities.

In the report, Alaska and Idaho scored lowest at 3 out of 10, and Massachusetts scored the highest at 10 out of 10, with North Carolina and Washington State scoring 9’s.

“Health emergencies can quickly disrupt, derail and divert resources from other ongoing priorities and efforts from across the government,” said Rich Hamburg, interim president and CEO, TFAH.  “Many areas of progress that were made after 9/11 and the anthrax attacks to improve health security have been undercut.  We aren’t adequately maintaining a strong and steady defense, leaving us unnecessarily vulnerable when new threats arise.”

Ready or Not? examines the nation’s ability to respond to public health emergencies, tracks progress and vulnerabilities, and includes a review of state and federal public health preparedness policies.  Some key findings include:

  • 26 states increased or maintained funding for public health from Fiscal Year (FY) 2014-2015 to FY 2015-2016.
  • Just 10 states vaccinated at least half of their population (ages 6 months and older) against the seasonal flu during the 2015-2016 flu season (from July 2015 to May 2016).
  • 45 states and Washington, D.C. increased the speed of DNA fingerprinting using pulsed-field gel electrophoresis (PFGE) testing for all reported cases of Shiga toxin-producing E. coli O157, a measure of a state’s ability to detect foodborne outbreaks.
  • 10 states have a formal access program or a program in progress for getting private sector healthcare staff and supplies into restricted areas during a disaster.
  • 30 states and Washington, D.C. met or exceeded the overall national average score (6.7) of the National Health Security Preparedness Index™ (as of 2016).
  • 32 states and Washington, D.C. received a grade of C or above in States at Risk: America’s Preparedness Report Card, a national assessment of state-level preparedness for climate change-related threats – which have an impact on human health.

In addition, the report examined trends in public health preparedness over the last 15 years, finding successes and ongoing concerns.

  • One-third of funds for health security and half of funds for healthcare system preparedness have been cut:  Health emergency preparedness funding for states has been cut from $940 million in fiscal year (FY) 2002 to $660 million in FY 2016; and healthcare system preparedness funding for states has been cut by more than half since FY 2005 – down to $255 million.
  • Some major areas of accomplishment:  Improved emergency operations, communication and coordination; support for the Strategic National Stockpile and the ability to distribute medicines and vaccines during crises; major upgrades in public health labs and foodborne illness detection capabilities; and improvements in legal and liability protections during emergencies.
  • Some major ongoing gaps: Lack of a coordinated, interoperable, near real-time biosurveillance system; insufficient support for research and development of new medicines, vaccines and medical equipment to keep pace with modern threats; gaps in the ability of the healthcare system to care for a mass influx of patients during a major outbreak or attack; and cuts to the public health workforce across states.

The Ready or Not? report provides a series of recommendations that address many of the major gaps in emergency health preparedness, including:

  • Requiring strong, consistent baseline public health Foundational Capabilities in regions, states and communities—so that everyone is protected.
  • Ensuring stable, sufficient health emergency preparedness funding to maintain a standing set of foundational capabilities alongside a complementary Public Health Emergency Fund which would provide immediate surge funding during an emergency.
  • Improving federal leadership before, during and after disasters – including at the White House level.
  • Recruiting and training a next generation public health workforce with expert scientific abilities to harness and use technological advances along with critical thinking and management skills to serve as the Chief Health Strategist for a community.
  • Reconsidering health system preparedness for new threats and mass outbreaks by developing stronger coalitions and partnerships among providers, hospitals, insurance providers, pharmaceutical and health equipment businesses, emergency management, and public health agencies.
  • Prioritizing efforts to address one of the most serious threats to human health by expanding efforts to stop Superbugs and antibiotic resistance.
  • Improving rates of vaccinations for children and adults – which are one of the most effective public health tools against many infectious diseases.

Ready or Not? was released annually from 2003-2012, and more recently, TFAH has released Outbreaks: Protecting Americans from Infectious Diseases, from 2013-2015The report was supported by a grant from the Robert Wood Johnson Foundation (RWJF).

Score Summary: 

A full list of all of the indicators and scores and the full report are available on TFAH’s website.  For the state-by-state scoring, states received one point for achieving an indicator or zero points if they did not achieve the indicator.  Zero is the lowest possible overall score, 10 is the highest.  The data for the indicators are from publicly available sources or were provided from public officials.

10 out of 10: Massachusetts

9 out of 10: North Carolina and Washington

8 out of 10: California, Connecticut, Iowa, New Jersey, Tennessee and Virginia

7 out of 10: Colorado, Delaware, Florida, Indiana, Maryland, Michigan, New Hampshire, New Mexico, New York, North Dakota, Oregon, Rhode Island, South Carolina, Utah and Wisconsin

6 out of 10: Arizona, Arkansas, District of Columbia, Georgia, Hawaii, Illinois, Kansas, Kentucky, Louisiana, Maine, Minnesota, Mississippi, Montana, Nebraska, Ohio, Pennsylvania, Texas and Vermont

5 out of 10: Alabama, Missouri, Oklahoma, South Dakota and West Virginia

4 out of 10: Nevada and Wyoming

3 out of 10: Alaska and Idaho

 

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 Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.

Trust for America’s Health: Deeply Disappointed Congress Utilized the Prevention Fund as a 21st Century Cures Offset

Washington, D.C., December 7, 2016 – The below is a statement from Rich Hamburg, interim president and CEO, of Trust for America’s Health (TFAH) on the 21st Century Cures legislative package.

“TFAH is deeply disappointed Congress will utilize the Prevention and Public Health Fund as an offset for the legislative package known as 21st Century Cures. Cutting the Prevention Fund will limit the nation’s ability to improve health and quality of life and prevent disease.

While TFAH supports aspects of this legislative package, including the much-needed funds to address the opioid epidemic, we remain opposed to using the Prevention Fund to offset the cost of this legislation.

The Prevention Fund is inextricably tied to the nation’s future ability to reign in healthcare costs. This is the nation’s first and only substantial investment in moving from our current “sick care” system to a true preventive health system. The Prevention Fund should be dedicated to its intended purpose: helping all Americans stay healthy.

Despite the exponentially growing burden of largely preventable diseases, federal disease prevention and public health programs remain critically underfunded. Public health spending is still below pre-recession levels, having remained relatively flat for years. Today, more than 12 percent of the CDC budget is supplied through Prevention Fund investments, including the 317 immunization program, epidemiology and laboratory capacity grants and the entire Preventive Health and Health Services Block Grant program—all critical to preparing for and responding to public health emergencies.

The United States spends $3 trillion annually on healthcare without much to show for it: Millions of Americans suffer from chronic diseases, which are responsible for seven out of 10 deaths and $1.3 trillion in treatment costs and lost productivity every year.

And, two-thirds of Americans are overweight or obese and nearly 20 percent of Americans smoke. Obesity costs the country $147 billion and tobacco use leads to another $130 billion in healthcare spending each year.

Time and again research shows that the vast majority of these chronic diseases can be prevented by investing in addressing the root causes. Yet, the country has repeatedly failed to do so.

The nation cannot afford to trade away our single best investment in preventing disease, preparing for and responding to infectious disease outbreaks, reducing rates of chronic illness, and saving lives and money.”

 

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Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.

Obesity Rates Among Young Children from Low-Income Families Declined in 31 States

Robert Wood Johnson Foundation and Trust for America’s Health Highlight Signs of Progress Among WIC Participants, but Emphasize Obesity Rates Remain Too High

 

Washington, D.C., November 17, 2016 – Obesity rates showed a statistically significant decrease in 31 states and three territories and increased significantly in four states among 2- to 4-year-olds enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) from 2010 to 2014, according to a study published today in Morbidity and Mortality Weekly Report (MMWR) by the Centers for Disease Control and Prevention (CDC) and U.S. Department of Agriculture (USDA).

Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) released a new data visualization showing how state-by-state obesity rates have changed among 2- to 4-year-old WIC participants since 2000 and a series of maps highlighting states’ efforts to help promote nutrition and physical activity in early child care settings. 

“These data are encouraging because kids from lower-income families are especially vulnerable and often face higher risk for obesity,” said Donald F. Schwarz, MD, MPH, MBA, vice president, RWJF. “We must continue to track and analyze child obesity and the programs that aim to reduce rates, especially among our nation’s youngest kids. This is critical for informing efforts to address disparities and ensuring that all children—no matter who they are or where they live—have a healthy start from their very first days.” 

Utah had the lowest rate of 2- to 4-year-old WIC participants who were obese at 8.2 percent, while Virginia had the highest rate at 20.0 percent, according to today’s findings.

Additional data on obesity rates among young children:

WIC

  • 18 states have obesity rates at or above 15 percent among 2- to 4-year-old WIC participants (in 2014). In 2010, 26 states had a rate at or above 15 percent.
  • While obesity rates among this population have declined in recent years, they remain high – with a national average of 14.5 percent. The national average was 8.4 percent in 1992.

NHANES

  • These new data for young children from low-income families reflect the significant inequity in obesity and health related to income—the national obesity rate among 2- to 5-year-olds across all economic levels is 8.9 percent (from the National Health and Nutrition Examination Survey, 2014).

“It is heartening to see evidence of progress after decades of work,” said Rich Hamburg, interim president and CEO, TFAH. “However, this doesn’t mean we’ve accomplished our goal. We need to keep the momentum going to ensure young children and families have the support they need — through programs like WIC — that help improve access to healthy, affordable food, quality healthcare, home visiting programs and health and nutrition education programs.”

Last month, CDC released a new Early Care and Education State Indicator Report, tracking state policies that aim to prevent obesity in child care settings. Some key findings include:

  • 38 states and Washington, D.C. have Quality Rating and Improvement Systems (QRIS) for child care programs, and, of those, 29 have included obesity prevention in their state standards;
  • 41 states and Washington, D.C. offer online professional development training for early childhood education (ECE) providers that cover obesity prevention topics;
  • 42 states and Washington, D.C. include ECE settings in their comprehensive plans for addressing chronic disease or nutrition and physical activity; and
  • 28 states and Washington, D.C. encouraged enhanced nutrition standards in their Child and Adult Care Food Programs (CACFP) as of 2015.

In September 2016, RWJF and TFAH released State of Obesity 2016: Better Policies for a Healthier America, which included a detailed policy analysis of WIC and other related childhood nutrition and obesity prevention initiatives, noting that:

  • WIC provides benefits — direct food assistance as well as counseling and education support — to approximately 8 million low-income individuals, including around 2 million pregnant and post-partum women, 2 million infants and 4 million children under age 5;
  • For every dollar spent on pregnant women enrolled in the WIC program, up to $4.21 is saved in Medicaid spending;
  • Around 15 million U.S. children live in “food-insecure” households, where they have limited access to adequate food and nutrition due to cost, proximity and/or other resources; and
  • Food insecurity among families is particularly concentrated in different areas around the country — in 321 counties, the average food insecurity rate is 23 percent, while in the other 2,821 counties, the average rate is 15 percent. Fifty percent of the high food-insecurity counties are in rural areas, 26 percent are metropolitan and 90 percent are in the South.

The State of Obesity report includes recommended strategies and policies to help ensure all young children have the opportunity to maintain a healthy weight. Some key areas of emphasis include:

  • Ensuring access to quality healthcare and family home visiting programs for at-risk families, which includes supporting early screening for health, nutrition and social service needs and connecting families directly to programs and resources;
  • Nutrition assistance and education programs and healthy food financing initiatives to make healthy choices affordable and available for all families in all neighborhoods;
  • Active living initiatives in communities that support places that are convenient and safe to be physically active;
  • Supporting healthy nutrition and physical activity in all child care settings, including limiting screen time, eliminating sugar-sweetened beverages and implementing the updated standards from the Child and Adult Care Food Program and Child Care and Development Block Grant; and
  • Prioritizing early childhood education opportunities under the Every Student Succeeds Act (ESSA).

Data released today are from the WIC Participant and Program Characteristics Study (WIC PC) as reported in an analysis of the Morbidity and Mortality Weekly Review. WIC PC summarizes the demographic information of WIC participants and is based on measured height and weight data. Women, infants and children in families with incomes at or below 185 percent of the federal poverty level (FPL) who are at nutritional risk are eligible for the WIC program (FPL is $24,250 for a family of four); some participants become income eligible for WIC through participation in other programs based on income or other economic variables programs. Further analysis of the WIC program and changes in participation levels could provide additional evidence on the factors that helped contribute to the decline in obesity rates.

Follow the conversation at #StateofObesity.

Trust for America‘s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.

For more than 40 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are striving to build a national Culture of Health that will enable all to live longer, healthier lives now and for generations to come. For more information, visit www.rwjf.org. Follow the Foundation on Twitter at www.rwjf.org/twitter or on Facebook at www.rwjf.org/facebook. 

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2014 STATE-BY-STATE OBESITY RATES OF WIC PARTICIPANTS AGES 2-4

Based on an analysis of new state-by-state data from the WIC Participant and Program Characteristics Study (WIC PC), obesity rates for children ages 2-4 by state from highest to lowest were:

1. Virginia (20.0); 2. Alaska (19.1); 3. Delaware (17.2); 4. South Dakota (17.1); 5. Nebraska (16.9); 6. (tie) California (16.6) and Massachusetts (16.6); 8. Maryland (16.5); 9. West Virginia (16.4); 10. (tie) Alabama (16.3) and Rhode Island (16.3); 12. (tie) Connecticut (15.3) and 12. New Jersey (15.3); 14. Illinois (15.2); 15. (tie) Maine (15.1) and 15. New Hampshire (15.1); 17. (tie) North Carolina (15.0) and Oregon (15.0); 19. (tie) Tennessee (14.9) and Texas (14.9); 21. (tie) Iowa (14.7) and 21. Wisconsin (14.7); 23. Mississippi (14.5); 24. (tie) Arkansas (14.4) and North Dakota (14.4); 26. (tie) Indiana (14.3) and New York (14.3); 28. Vermont (14.1); 29. Oklahoma (13.8); 30. Washington (13.6); 31. Michigan (13.4); 32. (tie) Arizona (13.3) and Kentucky (13.3); 34. Louisiana (13.2); 35. Ohio (13.1); 36. (tie) District of Columbia (13.0) and Georgia (13.0) and Missouri (13.0); 39. Pennsylvania (12.9); 40. Kansas (12.8); 41. Florida (12.7); 42. (tie) Montana (12.5) and New Mexico (12.5); 44. Minnesota (12.3); 45. (tie) Nevada (12.0) and South Carolina (12.0); 47. Idaho (11.6); 48. Hawaii (10.3); 49. Wyoming (9.9); 50. Colorado (8.5); 51. Utah (8.2).

Note: 1 = Highest rate, 51 = lowest rate.

Special Issue Brief: Obesity Rates Among WIC Children

«state»’s Obesity Rate Among Young Children from Low-Income Families «delta_upper», is «rate_2014» Percent

Robert Wood Johnson Foundation and Trust for America’s Health Highlight Signs of Progress Among WIC Participants, but Emphasize Obesity Rates Remain Too High

Washington, D.C., November 17, 2016 —«state»’s obesity rate among young children from low-income families «delta_lower» and is «rate_2014» percent, according to a study published today in Morbidity and Mortality Weekly Report (MMWR) by the Centers for Disease Control and Prevention (CDC) and U.S. Department of Agriculture (USDA). «state»’s rate is «rank_upper».

Overall, obesity showed a statistically significant decrease in 31 states and three territories and increased significantly in four states (Nebraska, North Carolina, Ohio and West Virginia) among 2- to 4-year-olds enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) from 2010 to 2014.

Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) released a new data visualization showing how state-by-state obesity rates have changed among 2- to 4-year-old WIC participants since 2000 and a series of maps highlighting states’ efforts to help promote nutrition and physical activity in early child care settings.

Utah had the lowest rate of 2- to 4-year-old WIC participants who were obese at 8.2 percent, while Virginia had the highest rate at 20.0 percent, according to today’s findings.

Additional data on obesity rates among young children:

WIC

  • 18 states have obesity rates at or above 15 percent among 2- to 4-year-old WIC participants (in 2014). In 2010, 26 states had a rate at or above 15 percent.
  • While obesity rates among this population have declined in recent years, they remain high – with a national average of 14.5 percent. The national average was 8.4 percent in 1992.

NHANES

  • These new data for young children from low-income families reflect the significant inequity in obesity and health related to income-the national obesity rate among 2- to 5-year-olds across all economic levels is 8.9 percent (from the National Health and Nutrition Examination Survey, 2014).

“These data are encouraging because kids from lower-income families are especially vulnerable and often face higher risk for obesity,” said Donald F. Schwarz, MD, MPH, MBA, vice president, RWJF. “We must continue to track and analyze child obesity and the programs that aim to reduce rates, especially among our nation’s youngest kids. This is critical for informing efforts to address disparities and ensuring that all children-no matter who they are or where they live-have a healthy start from their very first days.”

“It is heartening to see evidence of progress after decades of work,” said Rich Hamburg, interim president and CEO, TFAH. “However, this doesn’t mean we’ve accomplished our goal. We need to keep the momentum going to ensure young children and families have the support they need — through programs like WIC — that help improve access to healthy, affordable food, quality healthcare, home visiting programs and health and nutrition education programs.”

Last month, CDC released a new Early Care and Education State Indicator Report, tracking state policies that aim to prevent obesity in child care settings. Some key findings include:

  • 38 states and Washington, D.C. have Quality Rating and Improvement Systems (QRIS) for child care programs, and, of those, 29 have included obesity prevention in their state standards;
  • 41 states and Washington, D.C. offer online professional development training for early childhood education (ECE) providers that cover obesity prevention topics;
  • 42 states and Washington, D.C. include ECE settings in their comprehensive plans for addressing chronic disease or nutrition and physical activity; and
  • 28 states and Washington, D.C. encouraged enhanced nutrition standards in their Child and Adult Care Food Programs (CACFP) as of 2015.

In September 2016, RWJF and TFAH released State of Obesity 2016: Better Policies for a Healthier America, which included a detailed policy analysis of WIC and other related childhood nutrition and obesity prevention initiatives, noting that:

  • WIC provides benefits – direct food assistance as well as counseling and education support – to approximately 8 million low-income individuals, including around 2 million pregnant and post-partum women, 2 million infants and 4 million children under age 5;
  • For every dollar spent on pregnant women enrolled in the WIC program, up to $4.21 is saved in Medicaid spending;
  • Around 15 million U.S. children live in “food-insecure” households, where they have limited access to adequate food and nutrition due to cost, proximity and/or other resources; and
  • Food insecurity among families is particularly concentrated in different areas around the country – in 321 counties, the average food insecurity rate is 23 percent, while in the other 2,821 counties, the average rate is 15 percent. Fifty percent of the high food-insecurity counties are in rural areas, 26 percent are metropolitan and 90 percent are in the South.

The State of Obesity report includes recommended strategies and policies to help ensure all young children have the opportunity to maintain a healthy weight. Some key areas of emphasis include:

  • Ensuring access to quality healthcare and family home visiting programs for at-risk families, which includes supporting early screening for health, nutrition and social service needs and connecting families directly to programs and resources;
  • Nutrition assistance and education programs and healthy food financing initiatives to make healthy choices affordable and available for all families in all neighborhoods;
  • Active living initiatives in communities that support places that are convenient and safe to be physically active;
  • Supporting healthy nutrition and physical activity in all child care settings, including limiting screen time, eliminating sugar-sweetened beverages and implementing the updated standards from the Child and Adult Care Food Program and Child Care and Development Block Grant; and
  • Prioritizing early childhood education opportunities under the Every Student Succeeds Act (ESSA).

Data released today are from the WIC Participant and Program Characteristics Study (WIC PC) as reported in an analysis of the Morbidity and Mortality Weekly Review. WIC PC summarizes the demographic information of WIC participants and is based on measured height and weight data. Women, infants and children in families with incomes at or below 185 percent of the federal poverty level (FPL) who are at nutritional risk are eligible for the WIC program (FPL is $24,250 for a family of four); some participants become income eligible for WIC through participation in other programs based on income or other economic variables programs. Further analysis of the WIC program and changes in participation levels could provide additional evidence on the factors that helped contribute to the decline in obesity rates.

Follow the conversation at #StateofObesity.

Trust for America‘s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority. For more information, visit www.healthyamericans.org.

For more than 40 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are striving to build a national Culture of Health that will enable all to live longer, healthier lives now and for generations to come. For more information, visit www.rwjf.org. Follow the Foundation on Twitter at www.rwjf.org/twitter or on Facebook at www.rwjf.org/facebook.


2014 «state»-BY-«state» OBESITY RATES OF WIC PARTICIPANTS AGES 2-4

Based on an analysis of new state-by-state data from the WIC Participant and Program Characteristics Study (WIC PC), obesity rates for children ages 2-4 by state from highest to lowest were:

1. Virginia (20.0); 2. Alaska (19.1); 3. Delaware (17.2); 4. South Dakota (17.1); 5. Nebraska (16.9); 6. (tie) California (16.6) and Massachusetts (16.6); 8. Maryland (16.5); 9. West Virginia (16.4); 10. (tie) Alabama (16.3) and Rhode Island (16.3); 12. (tie) Connecticut (15.3) and 12. New Jersey (15.3); 14. Illinois (15.2); 15. (tie) Maine (15.1) and 15. New Hampshire (15.1); 17. (tie) North Carolina (15.0) and Oregon (15.0); 19. (tie) Tennessee (14.9) and Texas (14.9); 21. (tie) Iowa (14.7) and 21. Wisconsin (14.7); 23. Mississippi (14.5); 24. (tie) Arkansas (14.4) and North Dakota (14.4); 26. (tie) Indiana (14.3) and New York (14.3); 28. Vermont (14.1); 29. Oklahoma (13.8); 30. Washington (13.6); 31. Michigan (13.4); 32. (tie) Arizona (13.3) and Kentucky (13.3); 34. Louisiana (13.2); 35. Ohio (13.1); 36. (tie) District of Columbia (13.0) and Georgia (13.0) and Missouri (13.0); 39. Pennsylvania (12.9); 40. Kansas (12.8); 41. Florida (12.7); 42. (tie) Montana (12.5) and New Mexico (12.5); 44. Minnesota (12.3); 45. (tie) Nevada (12.0) and South Carolina (12.0); 47. Idaho (11.6); 48. Hawaii (10.3); 49. Wyoming (9.9); 50. Colorado (8.5); 51. Utah (8.2).

Note: 1 = Highest rate, 51 = lowest rate.