Issue Category: Obesity/Chronic Disease

Cultivating Health for Success

Cultivating Health for Success (CHS) established in 2010, focuses on the inclusion of safe, affordable, and supportive housing to reduce unplanned care, improve adherence to recommended treatment, and improve health care cost and outcomes as well as quality of life for participants in greater Pittsburgh. CHS serves adults with one or more chronic illnesses and those with a history of at least one year of above average use of unplanned care, such as crisis services, Emergency Department visits, and the homeless. To deliver services, CHS partners with the Allegheny County Department of Human Services, Metro Family Practice, Community Human Services, UPMC for You, and the Community Care Behavioral Health Organization. Since CHS’s inception, per-member per-month (PMPM) medical costs have decreased 11.5 percent, the average PMPM for unplanned care has decreased by 19.2 percent, and the average prescription PMPM increased by 5.2 percent for participants with a meaningful tenure in the program. CHS is funded by UMPC for You contributions. To read more about this innovative program, see this brief summary [link].

Reducing Teen Substance Misuse: What Really Works

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Washington, D.C., November 19, 2015– In a new report, Reducing Teen Substance Misuse: What Really Works, «intro_text»

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The report’s analysis of the most recent drug overdose death rates among 12- to 25-year-olds found:

  • Current rates were highest in West Virginia (12.6 per 100,000 youth) – which were more than five times higher than the lowest rates in North Dakota (2.2 per 100,000).
  • Males are 2.5 times as likely to overdose as females (10.4 vs. 4.1 per 100,000). The rate in «state» for males was «male» «per_label» and «female» for females.
  • In 1999-2001, no state had a youth drug overdose death rate above 6.1 per 100,000. By 2011-13, 33 states were above 6.1 per 100,000. In the past 12 years:
    • Rates have more than doubled in 18 states (Alabama, Arizona, California, Colorado, Connecticut, Georgia, Hawaii, Idaho, Illinois, Kentucky, Nebraska, Nevada, New Jersey, New Mexico, North Carolina, Oregon, South Carolina and Tennessee);
    • Rates have more than tripled in twelve states (Arkansas, Delaware, Indiana, Iowa, Michigan, Minnesota, Missouri, New Hampshire, New York, Oklahoma, Utah and West Virginia); and
    • Rates have more than quadrupled in five states (Kansas, Montana, Ohio, Wisconsin and Wyoming).

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No. Indicator «state» Number of States Receiving Points
A “Y” means the state received a point for that indicator
1 Support Academic Achievement: State has at least an 80 percent high school graduation rate (2012-2013).
Source: U.S. Department of Education, ED Data Express, Regulatory Adjusted Cohort Graduation Rates, 2013-2014.		 «metric1» 35
2 Preventing Bullying: State has comprehensive bullying prevention laws.
Source: American Academy of Pediatrics.		 «metric2» 21
3 Preventing Smoking: State has smoke-free laws that prohibit smoking in public places, including restaurants and bars.
Source: Campaign for Tobacco-Free Kids.		 «metric3» 30 and Washington, D.C.
4 Preventing Underage Alcohol Sales: State has liability (dram shop) laws holding establishments accountable for selling alcohol to underage or obviously intoxicated individuals.
Source: National Conference of State Legislatures and NOLO.		 «metric4» 37 and Washington, D.C.
5 Screening, Brief Intervention and Referral to Treatment Support: State has billing codes for Screening, Brief Intervention and Referral for Treatment (SBIRT) in their medical health (Medicaid or private insurance) programs.
Source: Institute for Research Education & Training in Addictions and Community Catalyst.		 «metric5» 32 and Washington, D.C.
6 Mental Health Funding: State increased funding for mental health services for Fiscal Year 2015.
Source: National Alliance on Mental Illness.		 «metric6» 29 and Washington, D.C.
7 Depression Treatment: State has rates of treatment for teens with major depressive episodes above the National percentage of 38.1 percent (2009-2013).
Source: SAMHSA, Behavioral Health Barometer: United States, 2014. 		«metric7» 30 and Washington, D.C.
8 Good Samaritan Laws: State has laws in place to provide some immunity from criminal charges or mitigation of sentencing of seeking help for an overdose.
Source: Network for Public Health Law.		 «metric8» 31 and Washington, D.C.
9 Treatment and Recovery Support for Prescription Drug Misuse: State provides Medicaid coverage for all three FDA-approved medications for the treatment of painkiller dependence.
Source: American Society of Addiction Medicine.		 «metric9» 30 and Washington, D.C.
10 Sentencing Reform: State has taken action to roll back “one-size-fits-all” sentences for nonviolent drug offenses.
Sources: The Vera Institute of Justice for 2000-2013 laws. For 2014 updates, The Sentencing Project, National Conference of State Legislatures and additional legislative scans for states meeting the thresholds set by the Vera Institute review.		 «metric10» 31 and Washington, D.C.
Total «score_upper»

“More than 90 percent of adults who develop a substance use disorder began using before they were 18,” said Jeffrey Levi, PhD, executive director of TFAH. “Achieving any major reduction in substance misuse will require a reboot in our approach – starting with a greater emphasis on preventing use before it starts, intervening and providing support earlier and viewing treatment and recovery as a long-term commitment.”

The increase in youth drug overdose deaths is largely tied to increases in prescription drug misuse and the related doubling in heroin use by 18- to 25-year-olds in the past 10 years – 45 percent of people who use heroin are also addicted to prescription painkillers.

In addition, youth marijuana rates have increased by nearly 6 percent since 2008 and more than 13 percent of high school students report using e-cigarettes. Youth from affluent families and/or neighborhoods report more frequent substance and alcohol use than lower-income teens – often related to having more resources available to access alcohol and drugs.

“The case for a prevention-first and continuum-of-care approach is supported by more than 40 years of research, but the science hasn’t been implemented on a wide scale in the real world,” said Alexa Eggleston, senior program officer, domestic programs, Conrad N. Hilton Foundation. “It’s time to bring innovations to scale and invest in more proactive and sustained approaches that promote positive protective factors, like safe, stable families, homes, schools and communities and intervene early to address youth substance use before addiction develops.”

Reducing Teen Substance Misuse identified a set of research-based approaches and recommendations to modernize the nation’s strategy to prevent and reduce substance use and support a full continuum-of-care, including:

  • Putting prevention first, using evidence-based approaches across communities and in schools. Each state should have an end-to-end network of experts and resources to support the effective community-based selection, adoption, implementation and evaluation of evidence-based programs;
  • Strategically investing in evidence-based programs that show the strongest results in reducing risk factors for substance misuse, poor academic performance, bullying, depression, violence, suicide, unsafe sexual behaviors and other problems that often emerge during teen years and young adulthood;
  • Integrating school-based and wider community efforts, via multisector collaboration – and effectively collecting data to assess community needs, better select programs that match with those needs and improve accountability. Schools cannot and should not be expected to solve the problem on their own;
  • Renewing efforts to gain support for the adoption and implementation of evidence-based and sustained school-based programs – moving beyond decades of ineffective approaches;
  • Incorporating SBIRT as a routine practice in middle and high schools and healthcare settings – along with other regular health screenings – even brief counseling and interventions can have a positive impact; and
  • Increasing funding support for sustained and ongoing mental health and substance use treatment and recovery.

The report provides additional research-based recommendations for preventing and reducing youth substance misuse. It was supported by a grant from the Conrad N. Hilton Foundation and is available on TFAH’s website at www.healthyamericans.org.

Score Summary:

A full list of all of the indicators and scores, listed below, is available along with the full report on TFAH’s web site at www.healthyamericans.org.  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.

  • 10 out of 10: Minnesota and New Jersey
  • 9 out of 10: California, Connecticut, Maine, Maryland, New Mexico, New York and Vermont
  • 8 out of 10: Delaware, District of Columbia, Massachusetts, New Hampshire, Ohio, Oregon, Virginia, Washington and Wisconsin
  • 7 out of 10: Colorado, Iowa, North Carolina and Pennsylvania
  • 6 out of 10: Alabama, Illinois, Missouri, Rhode Island and Utah
  • 5 out of 10: Arkansas, Florida, Hawaii, Kansas, Kentucky, Michigan, Montana, North Dakota and Oklahoma
  • 4 out of 10: Alaska, Arizona, Georgia, Indiana, Nebraska, Nevada, South Carolina, South Dakota, Tennessee, Texas and West Virginia
  • 3 out of 10: Idaho, Louisiana, Mississippi and Wyoming

State-by-state Youth Drug Overdose Death Rankings:

Note: Rates include drug overdose deaths, for 2011-2013, a three-year average, for 12- to 25-year-olds. 1 = Highest rate of drug overdose fatalities, 51 = lowest rate of drug overdose fatalities. States with statistically significant (p<0.05) increases since 2005-2007 are noted with an asterisk (*), while states with a statistically significant decrease are noted with two asterisks (**).

1. West Virginia (12.6); 2. New Mexico (12.5); 3. Utah (12.1); 4. Pennsylvania (11.8); 5. Nevada (11.6); 6. New Jersey (10.7*); 7. Kentucky (10.5); 8. (tie) Arizona (10.2*) and Colorado (10.2*) and Delaware (10.2*); 11. Wyoming (9.8*); 12. Indiana (9.6); 13. Missouri (9.5*); 14. Oklahoma (9.4); 15. New Hampshire (9.3); 16. Ohio (9.1*); 17. Wisconsin (8.8*); 18. Maryland (8.5); 19. Arkansas (8.4); 20. Connecticut (8.3); 21. Illinois (8.2*); 22. Michigan (8.1*); 23. Massachusetts (7.8); 24. Alaska (7.2); 25. North Carolina (7.1); 26. (tie) Montana (7.0) and Tennessee (7.0**) and Vermont (7.0); 29. (tie) New York (6.9*) and Washington (6.9); 31. Oregon (6.5); 32. (tie) Alabama (6.2) and Louisiana (6.2**); 34. (tie) Rhode Island (6.0) and Texas (6.0); 36. (tie) Kansas (5.9) and Virginia (5.9); 38. (tie) Idaho (5.8) and South Carolina (5.8); 40. (tie) Florida (5.7**) and Minnesota (5.7*); 42. Georgia (5.2); 43. California (4.9*); 44. Maine (4.7**); 45. Hawaii (4.6); 46. Iowa (4.3); 47. (tie) Mississippi (3.7**) and Nebraska (3.7); 49. South Dakota (3.3); 50. North Dakota (2.2).

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. www.healthyamericans.org

Increasing Access to Breastfeeding Friendly Hospitals: The Iowa Experience

By Jane Stockton, Community Health Consultant, Bureau of Nutrition and Health Promotion, Iowa Department of Public Health & Catherine Lillehoj, Ph.D. Research Analyst, Iowa Department of Public Health

The Iowa Department of Public Health (IDPH) has a long tradition of striving to improve the health and wellness of all residents. Because breastfeeding is a key strategy to preventing obesity among children and youth, IDPH has worked for the past several years to increase rates of breastfeeding initiation and duration.

Five years ago, Iowa ranked 31 out of 53 states and territories on a national survey, the Maternity Practices in Infant Nutrition and Care (mPINC). When we looked a little deeper, we realized that the rural nature of our state made maternal nutrition and care somewhat difficult.

For instance, 89 percent of Iowa counties are considered rural, with hospitals in rural counties having a higher proportion of Medicaid births (40 to 60 percent of births). Sadly, these hospitals often don’t have the necessary resources to truly improve breastfeeding education and provide the appropriate technical assistance. In general, rural hospitals experience unique barriers due to distance between hospitals, patients and other facilities, plus staff are often not dedicated to working in maternity care units.

To get over these hurdles, IDPH targeted hospitals in rural counties with significant numbers of Medicaid births. One of the preliminary activities to improve breastfeeding was to meet with key hospital partners (e.g., OB managers, Chief Nursing Officers, Directors of Nursing, Educators). Along with key partners, hospital policies related to breastfeeding were reviewed and results of the mPINC survey were discussed. Following these initial meetings, 53 hospitals voluntarily completed a pre-assessment using a self-appraisal tool. Subsequently, the IDPH hosted a training, called 6 Steps 4 Success, which we developed specifically to address the Ten Steps to Successful Breastfeeding, a set of evidence-based practices that have been shown to increase breastfeeding initiation and duration.

After receiving technical assistance, resources and staff education, 37 of the 53 hospitals completed a post-assessment. The majority of the hospitals implemented at least three of the Ten Steps and the most widely adopted policy, encouraging breastfeeding on demand, was implemented by 83 percent of the hospitals. After attending the 6 Steps 4 Success training, one nurse stated, “This gave me a lot to think about. I have changed my position and going to change my ideas, way I promote breastfeeding.” Hospitals frequently express their gratitude for the technical assistance and education being brought to them in their rural setting, rather than having to go to the larger cities for these services.

To further enhance statewide breastfeeding initiatives, efforts for the past two years have focused on improving maternity practice in four or five hospitals each year that meet three criteria: rural location, Medicaid birth rate higher than statewide average and an mPINC score of less than the statewide composite score. Using their mPINC survey data, hospitals are given assistance in reviewing the results, determining where the greatest opportunities for improvement are, and developing an improvement plan to address at least two of the dimensions of care. Over the course of one year, hospitals are offered:

  1. Technical assistance related to breastfeeding policy – telephone, face-to-face, electronic messaging;
  2. Resources – desk references such as Hale’s Medications and Mother’s Milk, Continuity of care in Breastfeeding: Best Practices in the Maternity setting; model breastfeeding policy, and a Self Attachment video;
  3. Educational opportunities – funding to send one staff nurse to Certified Lactation Counselor (or comparable) training, Breastfeeding Education for Iowa Communities, a four hour training developed by the Iowa Breastfeeding Coalition, and/or 6 Steps 4 Success training; and
  4. Networking opportunities – Iowa’s Annual Breastfeeding Conference and networking call for all participating hospitals.

The most recent data indicate all participating hospitals demonstrated improvement in several areas including: Labor and delivery practice (an improvement ranging from 3 to 230 percent), Staff Training (63 percent improvement), Breastfeeding Assistance (18 percent improvement), and Structural and Organizational Aspects of Care (94 percent improvement). In addition, staff who became Certified Lactation Counselors are now educating other nurses in their hospital.

To truly make these activities pervasive and sustainable, the IDPH knew it was important to collaborate with key partners with valuable expertise, including:

  • University of Iowa Statewide Perinatal Team – Breastfeeding Guidelines were written and incorporated into the Guidelines for Perinatal Services published by IDPH and distributed by the University of Iowa’s Perinatal Care Program. The Guidelines for Perinatal Services provides the framework to be used in defining and evaluating the level of perinatal services being offered by hospitals.
  • Iowa Breastfeeding Coalition – Breastfeeding Education for Iowa Communities, a four hour training curriculum, is being presented to healthcare communities throughout the state. The training curriculum, based on WIC’s Grow and Glow curriculum, was written as a collaborative effort by IDPH staff and ICBLC members of the coalition.

Over the past five years Iowa hospitals have gone from understanding what the term “Baby Friendly” meant and about the significance of the Ten Steps to Successful Breastfeeding, to having one hospital designated as Baby Friendly and many other hospitals in the process of achieving that designation

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References

Lillehoj, C. & Dobson, B. (2012). Implementation of the Baby-Friendly Hospital Initiative Steps in Iowa Hospitals. http://authorservices.wiley.com/bauthor/onlineLibraryTPS.asp?DOI=10.1111/j.1552-6909.2012.01411.x&ArticleID=1043603.

New Report Finds 23 of 25 States with Highest Rates of Obesity are in the South and Midwest

Obesity rates at or above 30 percent in 42 states for Blacks, 30 states for Latinos, 13 states for Whites

Washington, D.C., September 21, 2015 – U.S. adult obesity rates remained mostly steady―but high―this past year, increasing in Kansas, Minnesota, New Mexico, Ohio and Utah and remaining stable in the rest, according to The State of Obesity: Better Policies for a Healthier America, a report from the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF).

Arkansas had the highest adult obesity rate at 35.9 percent, while Colorado had the lowest at 21.3 percent. The 12th annual report found that rates of obesity now exceed 35 percent in three states (Arkansas, West Virginia and Mississippi), are at or above 30 percent in 22 states and are not below 21 percent in any. In 1980, no state had a rate above 15 percent, and in 1991, no state had a rate above 20. Now, nationally, more than 30 percent of adults, nearly 17 percent of 2 to 19 year olds and more than 8 percent of children ages 2 to 5 are obese.

Obesity puts some 78 million Americans at an increased risk for a range of health problems, including heart disease, diabetes and cancer.

“Efforts to prevent and reduce obesity over the past decade have made a difference. Stabilizing rates is an accomplishment. However, given the continued high rates, it isn’t time to celebrate,” said Jeffrey Levi, PhD, executive director of TFAH. “We’ve learned that if we invest in effective programs, we can see signs of progress. But, we still haven’t invested enough to really tip the scales yet.”

Other key findings from The State of Obesity include:

  • Obesity rates differ by region, age and race/ethnicity.
  • 7 of the 10 states with the highest rates are in the South and 23 of the 25 states with the highest rates of obesity are in the South and Midwest.
  • 9 of the 10 states with the highest rates of diabetes are in the South. Diabetes rates increased in eight states – Colorado, Hawaii, Kansas, Massachusetts, Missouri, Montana, Ohio and Pennsylvania.
  • American Indian/Alaska Natives have the highest adult obesity rate, 54 percent, of any racial or ethnic group.
  • Nationally, obesity rates are 38 percent higher among Blacks than Whites; and more than 26 percent higher among Latinos than Whites. (Obesity rates for Blacks: 47.8 percent; Latinos: 42.5 percent; and Whites: 32.6 percent.)
  • Adult obesity rates are at or above 40 percent for Blacks in 14 states.
  • Adult obesity rates are at or above 30 percent in: 42 states for Blacks; 30 states for Latinos; and 13 states for Whites.
  • Obesity rates are 26 percent higher among middle-age adults than among younger adults― rates rise from 30 percent of 20- to 39- year olds to nearly 40 percent of 40- to 59-year-olds.
  • More than 6 percent of adults are severely obese – more than a 125 percent increase in the past two decades. Around 5 percent of children are already severely obese by the ages of 6 to 11.
  • Among children and teens (2 to 19 years old), 22.5 percent of Latinos, more than 20 percent of Blacks and 14.1 percent of Whites are obese.
  • Prevention among children is key. It is easier and more effective to prevent overweight and obesity in children, by helping every child maintain a healthy weight, than it is to reverse trends later. The biggest dividends are gained by starting in early childhood, promoting good nutrition and physical activity so children enter kindergarten at a healthy weight.
  • Healthy communities can help people lead healthy lives. Small changes that make it easier and more affordable to buy healthy foods and beverages and be physically active can lead to big differences. The U.S. Centers for Disease Control and Prevention, The New York Academy of Medicine, and other experts have identified a range of policies and programs (e.g., improving school nutrition, physical activity and lifestyle interventions, health screenings, walking programs) that can help create healthier communities. Lower-income communities often face higher hurdles, and need more targeted efforts.

“In order to build a national Culture of Health, we must help all children, no matter who they are or where they live, grow up at a healthy weight,” said Risa Lavizzo-Mourey, president and CEO of RWJF. “We know that when we take comprehensive steps to help families be more active and eat healthier foods, we can see progress. Now we must extend those efforts and that progress to every community in the country.”

The State of Obesity also reviews key programs that can help prevent and address obesity by improving nutrition in schools, child care and food assistance; increasing physical activity before, during and after school; expanding healthcare coverage for preventing and treating obesity; making healthy affordable food and safe places to be active more accessible in neighborhoods, such as through Complete Streets and healthy food financing initiatives; increasing healthy food options via public-private partnerships; and creating and sustaining policies that help all children maintain a healthy weight and adults be as healthy as possible, no matter their weight.

This is the 12th annual edition of The State of Obesity (formerly known as the F as in Fat report series) report. The full report, with state rankings in all categories and updated interactive maps, charts and graphs, is available at http://stateofobesity.org. Follow the conversation at #StateofObesity.

2014 STATE-BY-STATE ADULT OBESITY RATE

Based on an analysis of new state-by-state data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance Survey, adult obesity rates by state from highest to lowest were:

Note: 1 = Highest rate of adult obesity, 51 = lowest rate of adult obesity.

1. Arkansas (35.9); 2. West Virginia (35.7); 3. Mississippi (35.5); 4. Louisiana (34.9); 5. Alabama (33.5); 6. Oklahoma (33.0); 7. Indiana (32.7); 8. Ohio (32.6); 9. North Dakota (32.2); 10. South Carolina (32.1); 11. Texas (31.9); 12. Kentucky (31.6); 13. Kansas (31.3); 14. (tie) Tennessee (31.2) and Wisconsin (31.2); 16. Iowa (30.9); 17. (tie) Delaware (30.7) and Michigan (30.7); 19. Georgia (30.5); 20. (tie) Missouri (30.2) and Nebraska (30.2) and Pennsylvania (30.2); 23. South Dakota (29.8); 24. (tie) Alaska (29.7) and North Carolina (29.7); 26. Maryland (29.6); 27. Wyoming (29.5); 28. Illinois (29.3); 29. (tie) Arizona (28.9) and Idaho (28.9); 31. Virginia (28.5); 32. New Mexico (28.4); 33. Maine (28.2); 34. Oregon (27.9); 35. Nevada (27.7); 36. Minnesota (27.6); 37. New Hampshire (27.4); 38. Washington (27.3); 39. (tie) New York (27.0) and Rhode Island (27.0); 41. New Jersey (26.9); 42. Montana (26.4); 43. Connecticut (26.3); 44. Florida (26.2); 45. Utah (25.7); 46. Vermont (24.8); 47. California (24.7); 48. Massachusetts (23.3); 49. Hawaii (22.1); 50. District of Columbia (21.7); 51. Colorado (21.3).

 

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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. 

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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The State of Obesity 2015

New Report: «state» has the «rank_upper» Adult Obesity Rate in Nation

Rates Increased in Five States

Washington, D.C., September 21, 2015 – At «rate» percent, «state» now has the «rank_lower» adult obesity rate in the nation, according to The State of Obesity: Better Policies for a Healthier America, a report from the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF).

Across the country, rates increased in five states (Kansas, Minnesota, New Mexico, Ohio and Utah) and remained stable in the rest.

Rates of obesity are above 35 percent for the first time ever in three states (Arkansas, West Virginia and Mississippi), are at or above 30 percent in 22 states and are not below 21 percent in any. Arkansas had the highest rate of obesity at 35.9 percent, while Colorado had the lowest at 21.3 percent. In 1980, no state had a rate above 15 percent, and in 1991, no state had a rate above 20.

The State of Obesity finds that significant geographic, income, racial and ethnic disparities persist, with obesity rates highest in the South and among Blacks, Latinos and lower-income, less-educated Americans. Obesity puts some 78 million Americans at an increased risk for a range of health problems, including heart disease, diabetes and cancer.

“Efforts to prevent and reduce obesity over the past decade have made a difference. Stabilizing rates is an accomplishment. However, given the continued high rates, it isn’t time to celebrate,” said Jeffrey Levi, PhD, executive director of TFAH. “We’ve learned that if we invest in effective programs, we can see signs of progress. But, we still haven’t invested enough to really tip the scales yet.”

Other key findings from The State of Obesity include:

  • Obesity rates differ by region, age and race/ethnicity:

    • 7 of the 10 states with the highest rates are in the South and 23 of the 25 states with the highest rates of obesity are in the South and Midwest.
    • 9 of the 10 states with the highest rates of diabetes are in the South. Diabetes rates increased in eight states – Colorado, Hawaii, Kansas, Massachusetts, Missouri, Montana, Ohio and Pennsylvania.
    • American Indian/Alaska Natives have the highest adult obesity rate, 54 percent, of any racial or ethnic group.
    • Nationally, obesity rates are 38 percent higher among Blacks than Whites; and more than 26 percent higher among Latinos than Whites.
    • Nationally, obesity rates are 47.8 percent for Blacks («black_rate»); 42.5 percent for Latinos («latino_rate» percent in «state»); and 32.6 percent for Whites («white_rate» percent in «state»).
    • Adult obesity rates are at or above 40 percent for Blacks in 14 states.
    • Adult obesity rates are at or above 30 percent in: 42 states for Blacks; 30 states for Latinos; and 13 states for Whites.
    • Obesity rates are 26 percent higher among middle-age adults than among younger adults―increasing from 30 percent of 20- to 39- year olds to nearly 40 percent of 40- to 59-year-olds.
    • More than 6 percent of adults are severely obese — more than a 125 percent increase in the past two decades. Around 5 percent of children are already severely obese by the ages of 6 to 11.
    • Among children and teens ages 2 to 19, 22.5 percent of Latinos, more than 20 percent of Blacks and 14.1 percent of Whites are obese.

  • Prevention among children is key.

    It is easier and more effective to prevent overweight and obesity in children, by helping every child maintain a healthy weight, than it is to reverse trends later. The biggest dividends are gained by starting in early childhood, promoting good nutrition and physical activity so children enter kindergarten at a healthy weight.

  • Healthy communities can help people lead healthy lives.

    Small changes that make it easier and more affordable to buy healthy foods and beverages and be physically active can lead to big differences. The U.S. Centers for Disease Control and Prevention, The New York Academy of Medicine, and other experts have identified a range of policies and programs (e.g., improving school nutrition, physical activity and lifestyle interventions, health screenings, walking programs) that can help create healthier communities. Lower-income communities often face higher hurdles, and need more targeted efforts.

“In order to build a national Culture of Health, we must help all children, no matter who they are or where they live, grow up at a healthy weight,” said Risa Lavizzo-Mourey, president and CEO of RWJF. “We know that when we take comprehensive steps to help families be more active and eat healthier foods, we can see progress. Now we must extend those efforts and that progress to every community in the country.”

The State of Obesity also reviews key programs that can help prevent and address obesity by improving nutrition in schools, child care and food assistance; increasing physical activity before, during and after school; expanding healthcare coverage for preventing and treating obesity; making healthy affordable food and safe places to be active more accessible in neighborhoods, such as through Complete Streets and healthy food financing initiatives; increasing healthy food options via public-private partnerships; and creating and sustaining policies that help all children maintain a healthy weight and adults be as healthy as possible, no matter their weight.

This is the 12th annual edition of The State of Obesity (formerly known as the F as in Fat report series) report. The full report, with state rankings in all categories and updated interactive maps, charts and graphs, is available at http://stateofobesity.org. Follow the conversation at #StateofObesity.

2014 State-by-State Adult Obesity Rates

Based on an analysis of new state-by-state data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance Survey, adult obesity rates by state from highest to lowest were:

Note: 1 = Highest rate of adult obesity, 51 = lowest rate of adult obesity.

1. Arkansas (35.9); 2. West Virginia (35.7); 3. Mississippi (35.5); 4. Louisiana (34.9); 5. Alabama (33.5); 6. Oklahoma (33.0); 7. Indiana (32.7); 8. Ohio (32.6); 9. North Dakota (32.2); 10. South Carolina (32.1); 11. Texas (31.9); 12. Kentucky (31.6); 13. Kansas (31.3); 14. (tie) Tennessee (31.2) and Wisconsin (31.2); 16. Iowa (30.9); 17. (tie) Delaware (30.7) and Michigan (30.7); 19. Georgia (30.5); 20. (tie) Missouri (30.2) and Nebraska (30.2) and Pennsylvania (30.2); 23. South Dakota (29.8); 24. (tie) Alaska (29.7) and North Carolina (29.7); 26. Maryland (29.6); 27. Wyoming (29.5); 28. Illinois (29.3); 29. (tie) Arizona (28.9) and Idaho (28.9); 31. Virginia (28.5); 32. New Mexico (28.4); 33. Maine (28.2); 34. Oregon (27.9); 35. Nevada (27.7); 36. Minnesota (27.6); 37. New Hampshire (27.4); 38. Washington (27.3); 39. (tie) New York (27.0) and Rhode Island (27.0); 41. New Jersey (26.9); 42. Montana (26.4); 43. Connecticut (26.3); 44. Florida (26.2); 45. Utah (25.7); 46. Vermont (24.8); 47. California (24.7); 48. Massachusetts (23.3); 49. Hawaii (22.1); 50. District of Columbia (21.7); 51. Colorado (21.3).

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.

New Report Finds Adult Obesity Rates Increased in Six States

Rates Higher in South, and Among Blacks, Latinos and Low-Income Americans

September 4, 2014

Washington, D.C., September 4, 2014 –  Adult obesity rates remained high overall, increased in six states in the past year, and did not decrease in any, according to The State of Obesity: Better Policies for a Healthier America, a report from the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF).

The annual report found that adult obesity rates increased in Alaska, Delaware, Idaho, New Jersey, Tennessee and Wyoming.  Rates of obesity now exceed 35 percent for the first time in two states, are at or above 30 percent in 20 states and are not below 21 percent in any.  Mississippi and West Virginia tied for having the highest adult obesity rate in the United States at 35.1 percent, while Colorado had the lowest at 21.3 percent.

Findings reveal that significant geographic, income, racial, and ethnic disparities persist, with obesity rates highest in the South and among Blacks, Latinos and lower-income, less-educated Americans. The report also found that more than one in ten children become obese as early as ages 2 to 5.

“Obesity in America is at a critical juncture. Obesity rates are unacceptably high, and the disparities in rates are profoundly troubling,” said Jeffrey Levi, PhD, executive director of TFAH.  “We need to intensify prevention efforts starting in early childhood, and do a better job of implementing effective policies and programs in all communities – so every American has the greatest opportunity to have a healthy weight and live a healthy life.”

Other key findings from The State of Obesity include:

After decades of rising obesity rates among adults, the rate of increase is beginning to slow, but rates remain far too high and disparities persist.   

In 2005, the obesity rate increased in every state but one; this past year, only six states experienced an increase. In last year’s report, only one state, Arkansas, experienced an increase in its adult obesity rate.

Obesity rates remain higher among Black and Latino communities than among Whites:

  • Adult obesity rates for Blacks are at or above 40 percent in 11 states, 35 percent in 29 states and 30 percent in 41 states.
  • Rates of adult obesity among Latinos exceeded 35 percent in five states and 30 percent in 23 states.
  • Among Whites, adult obesity rates topped 30 percent in 10 states.

Nine out of the 10 states with the highest obesity rates are in the South.

Baby Boomers (45-to 64-year-olds)* have the highest obesity rates of any age group – topping 35 percent in 17 states and 30 percent in 41 states.

More than 33 percent of adults 18 and older who earn less than $15,000 per year are obese, compared with 25.4 percent who earn at least $50,000 per year.

More than 6 percent of adults are severely** obese; the number of severely obese adults has quadrupled in the past 30 years.

The national childhood obesity rate has leveled off, and rates have declined in some places and among some groups, but disparities persist and severe obesity may be on the rise.

As of 2011-2012:

  • Nearly one out of three children and teens ages 2 to 19 is overweight or obese, and national obesity rates among this age group have remained stable for 10 years.
  • More than 1 in 10 children become obese between the ages of 2 to 5; and 5 percent of 6- to 11-year-olds are severely obese.
  • Racial and ethnic disparities emerge in childhood (ages 2-19):  The obesity rates are 22.4 percent among Hispanics, 20.2 percent among Blacks and 14.1 percent among Whites.

Between 2008 and 2011, 18 states and one U.S. territory experienced a decline in obesity rates among preschoolers from low-income families.

“While adult rates are stabilizing in many states, these data suggest that our overall progress in reversing America’s obesity epidemic is uneven and fragile,” said Risa Lavizzo-Mourey, MD, RWJF president and CEO. “A growing number of cities and states have reported decreases in obesity among children, showing that when we make comprehensive changes to policies and community environments, we can build a Culture of Health that makes healthy choices the easy and obvious choices for kids and adults alike. Going forward, we must spread what works to prevent obesity to every state and region, with special focus on those communities where rates remain the highest.”

The State of Obesity reviews existing policies and issues high-priority recommendations for making affordable healthy foods and safe places for physical activity available to all Americans, such as focusing on healthy food financing, improving nutrition and activity in schools and child care settings, limiting the marketing of unhealthy foods to kids, and improving the built environment to support increased physical activity.  In addition, for this year’s report, TFAH and RWJF partnered with the NAACP, Salud America! The RWJF Research Network to Prevent Obesity Among Latino Children, and Greenberg Quinlan Rosner Research to identify more effective strategies for implementing obesity-prevention policies in Black and Latino communities.

Recommendations, which were based on a series of in-depth interviews with public health experts in Black and Latino communities around the country, included:

  • Expanding access to affordable healthy foods and opportunities for physical activity by increasing resources for programs, connecting obesity-prevention initiatives with other ongoing community programs, and other approaches;
  • Providing education and addressing cultural differences to both improve people’s knowledge about nutrition and physical activity and make initiatives more relevant to their daily lives; and
  • Making sustainability, community input, involvement and shared leadership top priorities of obesity-prevention initiatives from the outset.

The State of Obesity (formerly known as the F as in Fat report series) is the 11th annual report produced by TFAH and RWJF, with support by a grant from RWJF. The full report, with state rankings in all categories and new interactive maps, is available at http://stateofobesity.org. Follow the conversation at #StateofObesity.

* (45-64 Year Olds, includes most Baby Boomers, who range from 49-67 year olds)

Adult obesity = Body Mass Index of 30 or more; **Severe obesity in adults = BMI of 40 or more. 

Childhood obesity = BMI at or above the 95th percentile for children of same age/sex; Severe obesity in children = BMI greater than 120 percent of 95th percentile for children of same age/sex

2013 STATE-BY-STATE ADULT OBESITY RATES

Based on an analysis of new state-by-state data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance Survey, adult obesity rates by state from highest to lowest were:

Note: 1 = Highest rate of adult obesity, 51 = lowest rate of adult obesity.

1. (tie) Mississippi and West Virginia (35.1%); 3. Arkansas (34.6%); 4. Tennessee (33.7%); 5. Kentucky (33.2%); 6. Louisiana (33.1%); 7. Oklahoma (32.5%); 8. Alabama (32.4%); 9. Indiana (31.8%); 10. South Carolina (31.7%); 11. Michigan (31.5%); 12. Iowa (31.3%); 13. Delaware (31.1%); 14. North Dakota (31%); 15. Texas (30.9%); 16. (tie) Missouri and Ohio (30.4%); 18. Georgia (30.3%); 19. (tie) Kansas and Pennsylvania (30%); 21. South Dakota (29.9%); 22. Wisconsin (29.8%); 23. (tie) Idaho and Nebraska (29.6%); 25. (tie) Illinois and North Carolina (29.4%); 27. Maine (28.9%); 28. Alaska (28.4%); 29. Maryland (28.3%); 30. Wyoming (27.8%); 31. Rhode Island (27.3%); 32. (tie) Virginia and Washington (27.2%); 34. Arizona (26.8%); 35. New Hampshire (26.7%); 36. Oregon (26.5%); 37. (tie) Florida and New Mexico (26.4%); 39. New Jersey (26.3%); 40. Nevada (26.2%); 41. Minnesota (25.5%); 42. New York (25.4%); 43. Connecticut (25.0%); 44. Vermont (24.7%); 45. Montana (24.6%); 46. (tie) California and Utah (24.1%); 48. Massachusetts (23.6%); 49. Washington, D.C. (22.9%) 50. Hawaii (21.8%); 51. Colorado (21.3%).

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 the health and health care of all Americans. We are striving to build a national Culture of Health that will enable all Americans 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.

The State of Obesity: Better Policies for a Healthier America

New Report: «state» has the «ob_rank_cap» Adult Obesity Rate in Nation

Rates Increased in Only Six States Since Last Year – «increase» «state»

Washington, D.C., September 4, 2014 – «state» now has the «ob_rank_lower» adult obesity rate in the nation, according to The State of Obesity: Better Policies for a Healthier America, a report from the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF).

The annual report found that «state»’s adult obesity rate is «ob_percent» percent and rates only increased in six states in the past year – (Alaska, Delaware, Idaho, New Jersey, Tennessee and Wyoming) – and did not decrease in any. Rates of obesity are above 35 percent for the first time ever in two states (Mississippi and West Virginia), are at or exceed 30 percent in 20 states and are not below 21 percent in any.

National findings reveal that significant geographic, income, racial and ethnic disparities persist, with obesity rates highest in the South and among Blacks, Latinos and lower-income, less-educated Americans. The report also found that more than one in ten children become obese as early as ages 2 to 5.

Other key findings from The State of Obesity include:

After decades of rising obesity rates among adults, the rate of increase is beginning to slow, but rates remain far too high and disparities persist.

  • In 2005, the obesity rate increased in every state but one; this past year, only six states experienced an increase. In last year’s report, only one state, Arkansas, experienced an increase in its adult obesity rate.
  • Obesity rates remain higher among Black and Latino communities than among Whites:
    • Adult obesity rates for Blacks in «state» were «black». Overall, rates are at or above 40 percent in 11 states, 35 percent in 29 states and 30 percent in 41 states.
    • Rates of adult obesity among Latinos in «state» were «hispanic» percent. Overall, rates exceeded 35 percent in five states and 30 percent in 23 states.
    • Among Whites, adult obesity rates were «white» percent in «state». Overall, rates topped 30 percent in 10 states.
  • Nine out of the 10 states with the highest obesity rates are in the South.
  • Baby Boomers (45-to 64-year-olds)* have the highest obesity rates of any age group – and «boomer_rate» percent of Baby Boomers in «state» are obese. Nationally, rates topped 35 percent in 17 states and 30 percent in 40 states.
  • More than 33 percent of adults 18 and older who earn less than $15,000 per year are obese, compared with 25.4 percent who earn at least $50,000 per year.
  • More than 6 percent of adults are severely** obese; the number of severely obese adults has quadrupled in the past 30 years.

“Obesity in America is at a critical juncture. Obesity rates are unacceptably high, and the disparities in rates are profoundly troubling,” said Jeffrey Levi, PhD, executive director of TFAH. “We need to intensify prevention efforts starting in early childhood and do a better job of implementing effective policies and programs in all communities – so every American has the greatest opportunity to have a healthy weight and live a healthy life.”

The national childhood obesity rate has leveled off, and rates have declined in some places and among some groups, but disparities persist and severe obesity may be on the rise.

  • As of 2011-2012:
    • Nearly one out of three children and teens ages 2 to 19 is overweight or obese, and national obesity rates among this age group have remained stable for 10 years.
    • More than 1 in 10 children become obese between the ages of 2 to 5; and 5 percent of 6- to 11-year-olds are severely obese.
    • Racial and ethnic disparities emerge in childhood (ages 2-19): The obesity rates are 22.4 percent among Hispanics, 20.2 percent among Blacks and 14.1 percent among Whites.
  • Between 2008 and 2011, 18 states«wic» and one U.S. territory experienced a decline in obesity rates among preschoolers from low-income families.

“While adult rates are stabilizing in many states, these data suggest that our overall progress in reversing America’s obesity epidemic is uneven and fragile,” said Risa Lavizzo-Mourey, MD, RWJF president and CEO. “A growing number of cities and states have reported decreases in obesity among children, showing that when we make comprehensive changes to policies and community environments, we can build a Culture of Health that makes healthy choices the easy and obvious choices for kids and adults alike. Going forward, we must spread what works to prevent obesity to every state and region, with special focus on those communities where rates remain the highest.”

The State of Obesity reviews existing policies and issues high-priority recommendations for making affordable healthy foods and safe places for physical activity available to all Americans, such as focusing on healthy food financing, improving nutrition and activity in schools and child care settings, limiting the marketing of unhealthy foods to kids, and improving the built environment to support increased physical activity. In addition, for this year’s report, TFAH and RWJF partnered with the NAACP, Salud America! The RWJF Research Network to Prevent Obesity Among Latino Children, and Greenberg Quinlan Rosner Research to identify more effective strategies for implementing obesity-prevention policies in Black and Latino communities.

Recommendations, which were based on a series of in-depth interviews with public health experts in Black and Latino communities around the country, included:

  • Expanding access to affordable healthy foods and opportunities for physical activity by increasing resources for programs, connecting obesity-prevention initiatives with other ongoing community programs, and other approaches;
  • Providing education and addressing cultural differences to both improve people’s knowledge about nutrition and physical activity and make initiatives more relevant to their daily lives; and
  • Making sustainability, community input, involvement and shared leadership top priorities of obesity-prevention initiatives from the outset.

The State of Obesity (formerly known as the F as in Fat report series) is the 11th annual report produced by TFAH and RWJF, with support by a grant from RWJF. The full report, with state rankings in all categories and new interactive maps, is available at http://stateofobesity.org. Follow the conversation at #StateofObesity.

 

* (45-64 Year Olds, includes most Baby Boomers, who range from 49-67 year olds)

Adult obesity = Body Mass Index of 30 or more; **Severe obesity in adults = BMI of 40 or more. Childhood obesity = BMI at or above the 95th percentile for children of same age/sex; Severe obesity in children = BMI greater than 120 percent of 95th percentile for children of same age/sex.

2013 STATE-BY-STATE ADULT OBESITY RATES

Based on an analysis of new state-by-state data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance Survey, adult obesity rates by state from highest to lowest were:

Note: 1 = Highest rate of adult obesity, 51 = lowest rate of adult obesity.

1. (tie) Mississippi and West Virginia (35.1%); 3. Arkansas (34.6%); 4. Tennessee (33.7%); 5. Kentucky (33.2%); 6. Louisiana (33.1%); 7. Oklahoma (32.5%); 8. Alabama (32.4%); 9. Indiana (31.8%); 10. South Carolina (31.7%); 11. Michigan (31.5%); 12. Iowa (31.3%); 13. Delaware (31.1%); 14. North Dakota (31%); 15. Texas (30.9%); 16. (tie) Missouri and Ohio (30.4%); 18. Georgia (30.3%); 19. (tie) Kansas and Pennsylvania (30%); 21. South Dakota (29.9%); 22. Wisconsin (29.8%); 23. (tie) Idaho and Nebraska (29.6%); 25. (tie) Illinois and North Carolina (29.4%); 27. Maine (28.9%); 28. Alaska (28.4%); 29. Maryland (28.3%); 30. Wyoming (27.8%); 31. Rhode Island (27.3%); 32. (tie) Virginia and Washington (27.2%); 34. Arizona (26.8%); 35. New Hampshire (26.7%); 36. Oregon (26.5%); 37. (tie) Florida and New Mexico (26.4%); 39. New Jersey (26.3%); 40. Nevada (26.2%); 41. Minnesota (25.5%); 42. New York (25.4%); 43. Connecticut (25.0%); 44. Vermont (24.7%); 45. Montana (24.6%); 46. (tie) California and Utah (24.1%); 48. Massachusetts (23.6%); 49. Washington, D.C. (22.9%) 50. Hawaii (21.8%); 51. Colorado (21.3%).

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 the health and health care of all Americans. We are striving to build a national Culture of Health that will enable all Americans 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.