Issue Category: Obesity/Chronic Disease

Improving Americans’ Nutrition Security Requires Legislative Action

Q&A with Dr. Hilary Seligman:

Hilary Seligman, M.D., MAS, is a professor at the University of California, San Francisco, with appointments in the Departments of Medicine, Epidemiology, and Biostatistics. Her research and advocacy work focuses on food insecurity, its health implications, and the needed policy responses.

 

TFAH: Food insecurity is obviously a serious problem in the United States. Can you also talk about the issue of nutrition insecurity and the relationship between the two?

Dr. Seligman: First, it’s important to recognize that the food-security construct always considered access to nutrition, not just calories. But, the sector’s new focus on nutrition security has helped emphasize the importance of providing not just food but food that meets people’s health and nutrition needs. The construct of nutrition security is also strongly related to issues of equity and the massive burden of early mortality in our country that is related to poor diets.


TFAH: Can food banks and charitable food networks address hunger and improve nutrition?

Dr. Seligman: Yes, of course they can, and they must. The charitable food system as a whole has made massive investment and progress in this area over the last decade. What I do want to call attention to though is that the same forces that make it difficult for individuals to afford and prepare healthy food make it difficult for the charitable food system to distribute healthy food. Healthy alternatives almost always cost more, they are often perishable, and they often require more preparation time which can be costly to provide. So, although there has been strong investment and tremendous progress at the system level, there is still a lot to be done. It will always be cheaper to distribute a box of mac and cheese than it will be to distribute a peach.


TFAH: You’ve been a leader in grassroots anti-hunger programs in the San Francisco area, programs like EatSF, a healthy food voucher program. Are these programs making a difference in food insecurity for San Francisco families and children?

Dr. Seligman: EatSF is one of a rapidly growing ecosystem of state and local food voucher programs and produce prescription programs in the U.S. These programs have functioned as a way for local leaders and health systems to say: We see we have this critical problem of nutrition insecurity in our community, this is not acceptable in the richest county in the U.S., and we are going to do something about it. I think that is amazing, and I am privileged to be a part of that movement. But, let’s be honest, the nutrition security problem in the U.S. is not going to be solved by small local programs. We need a systems-based approach. We need better policies to address nutrition security, and we need to rectify the way in which our current policies work better for white people than they do for people who are not white.


TFAH: Can you say more about that? How does current policy work better for white people than for people of color?

Dr. Seligman: SNAP program policies are a good example. In order for able bodied adults to receive SNAP benefits they have to be working. For a myriad of reasons, Black people are less likely to be able to secure employment. They are therefore less likely to be able to meet the work requirements that would allow them to enroll in SNAP, even if they are food insecure.


TFAH: You direct the National Clinician Scholars Program at the UCSF School of Medicine. The goal of the program is to train clinicians to be change-agents in order to improve their patients’ health. Are clinicians and the healthcare system doing enough to address the social determinants of health? Are they well-prepared to treat their patients who have obesity?

Dr. Seligman: Traditionally, healthcare in the U.S. has focused on treating, not preventing, disease in individuals. The evidence is very clear that this is the worst way to approach obesity: first to do it at the treatment stage (when obesity has already developed, rather than to prevent the onset of obesity) and second to do it by attempting to change people’s behaviors, rather than changing the environments that resulted in the onset of obesity to begin with. So, although I hate that we need to be having this discussion at all, we do. We do because the U.S. has completely failed at prevention efforts and at policy and environmental approaches to obesity prevention for decades. So now, what needs to be done? Obesity and poor diets are the biggest drivers of healthcare costs in the country— so the healthcare system has to get involved (whether it is traditionally in their wheelhouse or not), and the best way to do this is by addressing social determinants of health and food environments. It is not a comfortable fit for the healthcare system, but there really is no other choice. And because it is not a comfortable fit and requires a new way of thinking about healthcare and new kinds of engagement and policy change, we have to nurture the next generation of healthcare leaders to be able to tackle these really complicated problems.


TFAH: What are the links between public policy and obesity? What policy actions or changes would you like to see enacted?

Dr. Seligman: Oh, there are so many of them—dozens if not more are being discussed as potential approaches for the next Farm Bill. At the federal level alone, there are policy levers that Congress, USDA, and the FDA have authority over that could help reverse obesity trends. Let’s start with an enormous one: SNAP. Early in my career I worked on health literacy, and I was always challenged by the lack of existing infrastructure to reach people with effective health literacy interventions. Food insecurity is not like that. SNAP works. It reaches almost 50 million people in the U.S. annually. It is available in every county nationwide. It helps families to afford more nutritious food. So, we have the tools, we have the evidence, and we have the infrastructure to solve food insecurity in the U.S. What we lack is the political will. We need to expand SNAP eligibility to all the people who aren’t receiving the food they need but who are not currently eligible for benefits, and we need to raise benefit rates to allow for the purchase of healthy food. If these changes are made, it is very clear to me that they will have a substantial impact on obesity rates and on public health.


TFAH: There  were a number of waivers in federal food programs like SNAP, WIC, and school meals, during the COVID-19 pandemic to better reach individuals and families during the public health emergency. Are there any lessons we can learn from these policy changes?

Dr. Seligman: Yes! The predominant lesson is: these programs work. Food insecurity rates did not increase nearly as much as anticipated during the pandemic, although there were certainly vast disparities in how the pandemic impacted different communities. Why didn’t rates of food insecurity rise as much as anticipated? Because we had the will to do the things we knew—based on a tremendous amount of evidence— would make a difference. When we make it easier for people to enroll in SNAP, more people have access to benefits and food insecurity falls. When we provide money on debit cards to replace the meals not being served in schools, food insecurity falls. When stimulus checks were sent to people across the U.S. in response to the pandemic, low-income households reported that food was the first or second most covered item from the stimulus money.

The really optimistic lesson is that we know how to address hunger, nutrition security, and obesity prevention through good public policy. Now we just have to keep these programs in place as interest in the pandemic wanes.

Additional Resources:

Brief: Legislative Priorities for the 118th Congress

Report:  State of Obesity 2022

Priority Issue: Obesity /Chronic Disease

This interview was originally published as a part of TFAH’s 2022 State Of Obesity: Better Policies for a Healthier America report.

State of Obesity 2022 Congressional Briefing and Webinar

This briefing explores the findings from TFAH’s recent report, which found obesity rates continue to climb nationwide and within population groups. 19 states had adult obesity rates at 35% or higher, up from 16 states the previous year. These persistent increases underscore that obesity is caused by a combination of factors including societal, biological, genetic, and environmental, which are beyond personal choice. Addressing the obesity crisis will require attending to the economic and structural factors of where and how people live.

Panelists discussed the latest data on obesity and its impacts, promising approaches to ensure healthier communities, and offered policy recommendations that can help all American lead healthier lives.

Resources:

Trust for America’s Health

The White House:

 

 

Nation’s Obesity Epidemic is Growing: 19 States Have Adult Obesity Rates Above 35 Percent, Up From 16 States Last Year

Social and Economic Factors Are Key Drivers of Increasing Obesity Rates

(Washington, DC – September 27, 2022) – Four in ten American adults have obesity, and obesity rates continue to climb nationwide and within population groups, according to a report State of Obesity 2022: Better Policies for a Healthier America released today by Trust for America’s Health (TFAH). The report amplifies the importance of the White House Conference on Hunger, Nutrition and Health happening tomorrow. The Conference and the report are intended to spotlight the links between hunger, nutrition, and health, and diet-related diseases including obesity. In addition, they will drive policy action to address food insecurity and health disparities, factors often at the root of diet-related health issues.

The report finds that persistent increases in obesity rates across population groups underscores that obesity is caused by a combination of factors including societal, biological, genetic, and environmental, which are often beyond personal choice. The report’s authors conclude that addressing the obesity crisis will require attending to the economic and structural factors of where and how people live.

Based in part on newly released 2021 data from the Centers for Disease Control and Prevention’s Behavioral Risk Factors Surveillance System, and analysis by TFAH, the report tracks rates of overweight and obesity by age, race/ethnicity, and state of residence. Among the most striking findings are:

Nineteen states have adult obesity rates over 35 percent.  West Virginia, Kentucky, and Alabama have the highest rate of adult obesity at 40.6 percent, 40.3 percent, and 39.9 percent, respectively. The District of Columbia, Hawaii, and Colorado had the lowest adult obesity rates at 24.7 percent, 25 percent, and 25.1 percent respectively.

A decade ago, no state had an adult obesity rate at or above 35 percent.  (See state-by-state rate chart).

National data from the 2017-2020 National Health and Nutrition Examination Survey also included in the report show the following:

  • Nationally, 41.9 percent of adults have obesity.
  • Black adults had the highest level of adult obesity at 49.9 percent.
  • Hispanic adults had an obesity rate of 45.6 percent.
  • White adults had an obesity rate of 41.4 percent.
  • Asian adults had an obesity rate of 16.1 percent.
  • Rural parts of the country had higher rates of obesity than did urban and suburban areas.

Structural and social determinants are significantly influencing the rates of obesity among adults and youth.  Factors such as structural racism, discrimination, poverty, food insecurity, housing instability, and lack of access to quality healthcare are key drivers of the differences in obesity rates across racial and ethnic groups. These systemic barriers make it inappropriate to assign blame to individuals with obesity for their weight. The purpose of this report is to analyze conditions in people’s lives which make them more likely to develop obesity and recommend policies to address those conditions.

Obesity rates are also increasing among children and adolescents with nearly 20 percent of U.S. children ages 2 to 19 having obesity. These rates more than tripled since the mid-1970s and Black and Latino youth have substantially higher rates of obesity than do their white peers.

A special section of the report looks at the relationship between food insecurity and obesity. Food insecurity, defined as being uncertain of having or unable to acquire enough food because of insufficient money or resources, is driven by many of the same social and economic factors that drive obesity including poverty and living in communities with many fast-food establishments but limited or no access to healthy, affordable foods such as available in full-service supermarkets or farmers markets. Being food and nutrition insecure often means families must eat food that costs less but is also high in calories and low in nutritional value.

Obesity is multifactored and involves more than individual behavior

Social and economic factors including experiencing poverty and the impact of long-standing structural racism and health inequities are strongly associated with obesity and are at the root of higher rates of obesity in low-income communities that have fewer resources to support healthy eating and being physically active.

“The continued increase in rates of obesity across all population groups is alarming,” said J. Nadine Gracia, M.D., MSCE, President and CEO of Trust for America’s Health. “Policies and programs to reduce obesity need to be implemented at a systems level. We must advance policies that address the community, institutional, and structural factors that are barriers to healthy eating and physical activity and that exacerbate health inequities.”

Addressing obesity is critical because it is associated with a range of diseases including type 2 diabetes, heart disease, stroke, arthritis, sleep apnea, and some cancers. Obesity is estimated to increase U.S. healthcare spending by $170 billion annually (including billions by Medicare and Medicaid).

The report includes recommendations for policy actions that federal, state, and local policymakers and other stakeholders should take including:

  • Increase funding for the CDC’s National Center for Chronic Disease Prevention and Health Programs to prevent obesity and related chronic diseases. Funding increases need to be sufficient to put proven obesity prevention programs to work in every state and should prioritize those communities where the need is greatest to address health inequities.
  • Make healthy school meals for all students a permanent policy, extend COVID-19 flexibilities that expand nutrition access for students and their families, strengthen school nutrition standards, and increase students’ opportunities for physical activity during the school day.
  • Expand the CDC’s social determinants of health program to address the upstream, structural drivers of chronic disease.
  • Decrease food insecurity and improve the nutritional quality of available food by increasing funding for and participation in nutrition assistance programs such as the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and the Child and Adult Care Food Program.
  • End unhealthy food marketing to children by closing tax loopholes and eliminating business-cost deductions related to the advertising of unhealthy food and beverages to young people.
  • Impose excise taxes on sugary drinks and devote the revenue to local obesity prevention programs and to reduce health disparities.
  • Expand support for maternal and child health, including supporting breastfeeding.
  • Fund active transportation projects like pedestrian and biking paths in all communities and make local spaces more conducive to physical activity such as opening school recreational facilities to community groups outside of school hours.
  • Expand access to healthcare and require insurance coverage with no cost sharing for U.S. Preventive Task Force recommended obesity prevention programs.

Read the full report

 

La epidemia de obesidad de la nación está creciendo: 19 estados tienen tasas de obesidad en adultos superiores al 35 por ciento, frente a los 16 estados del año pasado

Factores sociales y económicos son impulsores clave del aumento de las tasas de obesidad

(Washington, DC – 27 de septiembre de 2022) – Cuatro de cada diez adultos estadounidenses tienen obesidad, y las tasas de obesidad continúan aumentando en todo el país y dentro de los grupos de población, según un informe State of Obesity 2022: Better Policies for a Healthier America publicado hoy por Trust for American Health (TFAH). El informe amplifica la importancia de que la Conferencia de la Casa Blanca sobre el Hambre, la Nutrición y la Salud (White House Conference on Hunger, Nutrition and Health) que se llevara cabo mañana. La Conferencia y el informe tienen como objetivo destacar los vínculos entre el hambre, la nutrición y la salud, y las enfermedades relacionadas con la dieta, incluida la obesidad. Además, impulsarán la acción política para abordar la inseguridad alimentaria y las disparidades en la salud, factores que a menudo son la raíz de los problemas de salud relacionados con la dieta.

El informe encuentra que los aumentos persistentes en las tasas de obesidad en los grupos de población subrayan que la obesidad es causada por una combinación de factores que incluyen factores sociales, biológicos, genéticos y ambientales, que a menudo están más allá de la elección personal. Los autores del informe concluyen que abordar la crisis de la obesidad requerirá prestar atención a los factores económicos y estructurales de dónde y cómo vive la gente.

Basado en parte en los datos recientemente publicados en el 2021 del Sistema de Vigilancia de Factores de Riesgo de Comportamiento de los Centros para el Control y la Prevención de Enfermedades y el análisis realizado por TFAH, el informe rastrea las tasas de sobrepeso y obesidad por edad, raza/etnicidad y estado de residencia. Entre los hallazgos más llamativos se encuentran:

Diecinueve estados tienen tasas de obesidad en adultos superiores al 35 por ciento. West Virginia, Kentucky y Alabama tienen la tasa más alta de obesidad en adultos con un 40,6 %, 40,3 % y 39,9 %, respectivamente. El Distrito de Columbia, Hawái y Colorado tenían las tasas más bajas de obesidad en adultos con 24,7 %, 25 % y 25,1 %, respectivamente.

Hace una década, ningún estado tenía una tasa de obesidad en adultos igual o superior al 35 por ciento. (Consulte el cuadro de tarifas estado por estado).

Los datos nacionales de la Encuesta Nacional de Examen de Salud y Nutrición 2017-2020 también incluidos en el informe muestran lo siguiente:

  •  A nivel nacional, el 41,9 por ciento de los adultos tienen obesidad.
  • Los adultos afroamericanos tenían el nivel más alto de obesidad en adultos con un 49,9 por ciento.
  • Los adultos hispanos tenían una tasa de obesidad del 45,6 por ciento.
  • Los adultos blancos tenían una tasa de obesidad del 41,4 por ciento.
  • Los adultos asiáticos tenían una tasa de obesidad del 16,1 por ciento.
  • Las zonas rurales del país tenían tasas más altas de obesidad que las zonas urbanas y suburbanas.

Los determinantes estructurales y sociales están influyendo significativamente en las tasas de obesidad entre adultos y jóvenes. Factores como el racismo estructural, la discriminación, la pobreza, la inseguridad alimentaria, la inestabilidad de la vivienda y la falta de acceso a una atención médica de calidad son factores clave de las diferencias en las tasas de obesidad entre los grupos raciales y étnicos. Estas barreras sistémicas hacen que sea inapropiado culpar a las personas con obesidad por su peso. El propósito de este informe es analizar las condiciones en la vida de las personas que las hacen más propensas a desarrollar obesidad y recomendar políticas para abordar esas condiciones.

Las tasas de obesidad también están aumentando entre los niños y adolescentes, con casi el 20 por ciento de los niños estadounidenses de 2 a 19 años que tienen obesidad. Estas tasas se triplicaron con creces desde mediados de la década de 1970 y los jóvenes negros y latinos tienen tasas de obesidad sustancialmente más altas que sus pares blancos.

Una sección especial del informe analiza la relación entre la inseguridad alimentaria y la obesidad. La inseguridad alimentaria, definida como la incertidumbre de tener o no poder adquirir suficientes alimentos debido a la insuficiencia de dinero o recursos, está impulsada por muchos de los mismos factores sociales y económicos que impulsan la obesidad, incluida la pobreza y vivir en comunidades con muchos establecimientos de comida rápida, pero con pocos recursos o ningún acceso a alimentos saludables y asequibles, como los disponibles en supermercados de servicio completo o mercados de agricultores. La inseguridad alimentaria y nutricional a menudo significa que las familias deben comer alimentos que cuestan menos pero que también tienen un alto contenido de calorías y un bajo valor nutricional.

La obesidad es multifactorial e involucra más que el comportamiento individual

Los factores sociales y económicos, incluida la experiencia de la pobreza y el impacto del racismo estructural de larga data y las desigualdades en salud, están fuertemente asociados con la obesidad y son la raíz de las tasas más altas de obesidad en comunidades de bajos ingresos que tienen menos recursos para apoyar una alimentación saludable y estar físicamente bien activo.

“El aumento continuo de las tasas de obesidad en todos los grupos de población es alarmante”, dijo J. Nadine Gracia, M.D., MSCE, presidenta y directora ejecutiva de Trust for America’s Health. “Las políticas y los programas para reducir la obesidad deben implementarse a nivel de sistemas. Debemos promover políticas que aborden los factores comunitarios, institucionales y estructurales que son barreras para la alimentación saludable y la actividad física y que exacerban las inequidades en salud”.

Abordar la obesidad es fundamental porque está asociada con una variedad de enfermedades que incluyen diabetes tipo 2, enfermedades cardíacas, derrames cerebrales, artritis, apnea del sueño y algunos tipos de cáncer. Se estima que la obesidad aumenta el gasto en atención médica en los Estados Unidos a más de $ 170 mil millones anuales (incluidos los miles de millones de Medicare y Medicaid).

El informe incluye recomendaciones para acciones de políticas que los legisladores federales, estatales y locales y otras partes interesadas deben tomar, incluyendo:

  • Aumentar la financiación del Centro Nacional para la Prevención de Enfermedades Crónicas y los Programas de Salud de los CDC para prevenir la obesidad y las enfermedades crónicas relacionadas. Los aumentos de fondos deben ser suficientes para poner en funcionamiento los programas probados de prevención de la obesidad en todos los estados y deben priorizar aquellas comunidades donde la necesidad es mayor para abordar las inequidades en salud.
  • Hacer que las comidas escolares saludables para todos los estudiantes sean una política permanente, extender las flexibilidades de COVID-19 que amplían el acceso a la nutrición para los estudiantes y sus familias, fortalecer los estándares de nutrición escolar y aumentar las oportunidades de actividad física de los estudiantes durante el día escolar.
  • Ampliar el programa de determinantes sociales de la salud de los CDC para abordar los impulsores estructurales de las enfermedades crónicas.
  • Disminuir la inseguridad alimentaria y mejorar la calidad nutricional de los alimentos disponibles al aumentar la financiación y la participación en programas de asistencia nutricional como el Programa de Asistencia Nutricional Suplementaria (SNAP), el Programa Especial de Nutrición Suplementaria para Mujeres, Bebés y Niños (WIC), y el Programa de Alimentación para el Cuidado de Niños y Adultos.
  • Poner fin a la comercialización de alimentos no saludables para los niños cerrando las lagunas fiscales y eliminando las deducciones de costos comerciales relacionadas con la publicidad de alimentos y bebidas no saludables para los jóvenes.
  • Imponer impuestos especiales sobre las bebidas azucaradas y dedicar los ingresos a los programas locales de prevención de la obesidad y para reducir las disparidades en la salud.
  • Ampliar el apoyo a la salud materno infantil, incluido el apoyo a la lactancia materna.
  • Financiar proyectos de transporte activo como senderos para peatones y ciclistas en todas las comunidades y hacer que los espacios locales sean más propicios para la actividad física, como abrir instalaciones recreativas escolares a grupos comunitarios fuera del horario escolar.
  • Ampliar el acceso a la atención médica y requerir cobertura de seguro sin costo compartido para los programas de prevención de la obesidad recomendados por el Grupo de trabajo preventivo de EE. UU.

Lea el informe completo.

Public Transit Access to Full-Service Grocery Stores Will Help Address Country’s Obesity Crisis

Trust for America’s Health’s (TFAH) report, The State of Obesity 2021: Better Policies for a Healthier America provides an annual analysis of national obesity and overweight trends. In 2020, 16 states had adult obesity rates at or above 35 percent, up from 12 states the previous year. These and other emerging data show that while obesity rates in the U.S. have been at epidemic proportion for years, the COVID-19 pandemic changed eating habits, put families at risk for food insecurity, and heightened stress, all worsening the countries’ decades long pattern of obesity.

Food Access

A major part of a person’s ability to maintain a healthy diet is being able to access and afford quality, nutritious food. This access requires that all communities have local grocery providers, like supermarkets, farmer’s markets, and/or community gardens. In addition to physical proximity, stores need to be accessible via driving, walking, biking, and public transportation.  Access to farmer’s markets or full-service grocery stores means that community members have the option to purchase fruits and vegetables, and less processed foods. Without such access, “food deserts” can develop – neighborhoods where grocery stores are largely inaccessible due to their distance or the lack of public transportation. Food desert communities often have fast food outlets or stores that sell processed, packaged foods with low nutritional value. A food environment with limited healthy options can contribute to the likelihood that a person or community struggles with chronic health issues related to diet like obesity, diabetes, hypertension, stroke, and cardiovascular disease.

Transportation and Food Access

The 2017-2018 National Health and Nutrition Examination Survey (NHANES) estimates the 42.4 percent of U.S. adults have obesity. According to the United States Department of Agriculture (USDA) 40 million Americans have poor access to food retailers. This lack of access is heavily concentrated in rural, low-income, and minority neighborhoods. Also contributing to the food deserts problem is that 2.1 million U.S. households do not own an automobile and live 20 miles from a supermarket, burdening mostly low-income and minority communities. According to the U.S. Centers for Disease Control and Prevention, providing public transit is a simple strategy that can improve people’s ability to receive medical care, purchase healthy food, and access opportunities for physical activity, but 45 percent of U.S. households do not have access to public transit and approximately 20 percent have transportation barriers that limit their ability to buy healthy foods. Poor transportation infrastructure is considered the largest and most pressing healthy foods access barrier in rural areas.

A study published in Preventing Chronic Disease evaluated a nationally representative sample of approximately 2,000 U.S. municipalities for their public transit infrastructure: availability of public transit, planning for food access in public transit, and availability of more individualized demand-responsive transit (DRT) as a public transit alternative. DRT offers smaller buses or vans for transportation without a fixed time schedule or route. The study used National Survey of Community-Based Policy and Environmental Supports for Healthy Eating and Active Living (CBS HEAL) data that evaluated municipal government policies and practices that encourage healthy eating and physical activity. It found that approximately one-third of municipalities did not have public transit, most commonly in municipalities that were rural, Southern, had a population of fewer than 2,500 people, had a median educational attainment of high school graduation or less, or had a population that was greater than 50 percent non-Hispanic white. Statistical significance was found for smaller population size, rural status, being in the Southern census region, and greater poverty prevalence relative to the availability of public transit. Approximately one-third of municipalities with public transit reported planning for food accessibility. It was reported more commonly among larger municipalities, urban municipalities, Western municipalities, municipalities with less than 50 percent non-Hispanic white people, and in municipalities that contained food deserts.

Community Examples to Improve Food Access

Although the study results did not find a strong, health-focused public transit infrastructure in many communities, often communities most in need of such services, there are some hopeful examples of community efforts to improve food access. They include the public Grocery Bus line in Austin, Texas that connects a low-income, Latino community that lacks adequate transportation options with supermarkets. It is a city-community-business collaborative that has now been integrated into the regular transit system. Similarly, the Dallas Area Rapid Transit (DART) GoLink program in Dallas, Texas provides transportation for essential needs, including food, that is an on-demand service and has been expanded in partnership with Uber. Community leaders have been able to distribute rider cards to residents and social workers, hoping to partner with community-based organizations, and anecdotally observed users benefit, like being able to purchase their full grocery list with the help of readily available and accessible transportation. As of February 2019, thirty-eight states, Puerto Rico, and the District of Columbia also authorize by statute, public-private transportation partnerships.

Policy Actions and Recommendations

In addition to the encouraged collaborations targeting food access and availability through public transit, TFAH makes additional policy recommendations to encourage healthy behaviors and mitigate obesity risk. These can be especially impactful in affected areas struggling with food insecurity.

  • Ensure free, healthy school meals for all students to increase childhood access to healthy foods.
  • Expand Supplemental Nutrition Assistance Program (SNAP) benefits and enhance access to the Special Supplemental Nutrition Program for Women, Infants and Children (WIC).
  • Increase funding to allow for the expansion of the Centers for Disease Control and Prevention’s (CDC) National Center for Chronic Disease Prevention and Health Promotion obesity prevention programs in all 50 states. This funding should include allocations for the CDC divisions of Nutrition, Physical Activity and Obesity and Racial and Ethnic Approaches to Community Health.
  • Ensure safe and convenient access to walking and biking trails, for leisure as well as school transportation. Furthermore, education agencies should prioritize integrating physical activity and movement regularly throughout the school day.
  • Disincentivize unhealthy food choices by closing tax loopholes and eliminating business-cost deductions related to the advertising of unhealthy food and beverages to children and by enacting sugary drink excise taxes where tax revenue is allocated to local efforts to reduce health and socioeconomic disparities.

Read TFAH’s State of Obesity: Policy Recommendations for a Healthier America 2021 report and recommendations.

TFAH Applauds Announcement of White House Conference on Hunger, Nutrition, and Health

(Washington, DC – May 4, 2022) – Trust for America’s Health (TFAH) applauds the Biden-Harris Administration’s announcement that it will hold a White House Conference on Hunger, Nutrition, and Health this coming September.  The conference, which was authorized and funded by Congress with bipartisan support, will be the second of its kind. The first, held in 1969, resulted in critical legislation to support Americans’ nutritional needs.

The conference will be held at a time the country is facing epidemic level numbers of diet-related health problems including obesity, diabetes, and heart disease. According to the Centers for Disease Control and Prevention (CDC), 6 in 10 Americans have a chronic disease, many associated with having obesity or being overweight.  Over 42 percent of all U.S. adults have obesity and social determinants, such as poverty and neighborhood resources, contribute to persistent disparities in obesity prevalence.  Furthermore, the COVID-19 pandemic and its related economic and social stressors led to an increase in food insecurity and weight gain for many American families. Food insecurity–being unable to access enough affordable, nutritious food–is related to obesity and other nutrition-based diseases.

“This conference will be an important opportunity to create an action plan to address America’s nutrition and hunger crisis,” said J. Nadine Gracia, MD, MSCE, President and CEO, Trust for America’s Health.  “A growing number of Americans are dealing with diet-related chronic health problems, and parts of the population – individuals and families who live in rural areas, people with lower income and many people of color – face even higher rates of diet-related diseases and food insecurity. The stark amount of preventable disease that is related to the nation’s current food system and food environment needs urgent attention. Addressing these issues will make our country healthier and more equitable.”

TFAH tracks the nation’s obesity crisis in its annual report, State of Obesity: Better Policies for a Healthier America  which includes recommendations for policy action in five broad areas:

  • Ensure access to healthy school meals for all children, which would decrease food insecurity, improve educational achievement, and decrease rates of diet-related disease. Nutrition standards of school meals and snacks should also be strengthened.
  • Expand access to nutrition support programs, such as the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and maintain eligibility and flexibility provisions created in response to the COVID-19 pandemic. In addition, nutrition support programs should expand voluntary pilots to evaluate innovative approaches to healthy eating, such as providing increased incentives for the purchase of fruits and vegetables.
  • Advance health equity by targeting obesity prevention programs in communities with high levels of individuals living with obesity and unhealthy excess weight, including expanding CDC’s obesity-prevention programs like the State Physical Activity and Nutrition program and the Racial and Ethnic Approaches to Community Health program.
  • Strengthen obesity prevention programs within the healthcare system by expanding access to healthcare coverage and requiring health insurers to cover obesity-related prevention services, such as the Childhood Obesity Research Demonstration program.
  • Call on the private sector to change marketing strategies that lead to poor nutritional choices and pursue pricing strategies that tax sugary drinks and eliminate business-cost deductions related to the advertising of unhealthy food to children.
  • Make physical activity safer and more accessible for everyone by providing funding for programs in the CDC’s Division on Nutrition, Physical Activity, and Obesity, which increase physical education in early care and education systems and create activity-friendly routes to everyday destinations.

 

TFAH Applauds USDA’s Announcement of New Standards Improving Nutrition in School Meals

Actions will Help Address Youth Obesity Crisis

(Washington, DC – February 7, 2022) – The U.S. Department of Agriculture’s recent announcement that the agency will update school meal nutrition standards will help ensure more nutritious school meals for millions of children and adolescents and is an important step toward reversing the nation’s alarming rates of childhood obesity.

The Department announced a stepwise approach, beginning in the next school year. Among the most critical changes are:

  • Beginning in the 2022-2023 school year, requiring that schools and child-care providers serving children ages six and older offer low-fat, flavored milk, nonfat flavored milk, or nonfat or low-fat unflavored milk.
  • Requiring that 80 percent of the grains served in school meals each week are rich in whole grains, beginning with the 2022-2023 school year.
  • Requiring a 10 percent decrease in weekly sodium levels in school meals starting with the 2023-2024 school year.
  • Beginning the process for more permanent nutrition standards for the 2024-2025 school year.

Importantly, these changes will return nutritional standards for school meals to 2012 levels, which have been found to have dramatically increased the quality of students’ nutrition.

Rising obesity rates are a serious problem among children and adolescents nationwide. According to the latest available data, nearly 20 percent (19.3 percent) of U.S. children ages 2 to 19 have obesity. These data more than tripled since the mid-1970s and Black and Latino youth have substantially higher rates of obesity than do their white peers. The racial and ethnic disparities in obesity underscore the need to address social determinants of health, including food insecurity, access to healthy and nutritious foods, poverty, and other systemic barriers to health.

“These changes in school meal nutrition standards are an important step toward addressing America’s childhood obesity crisis. Millions of U.S. children get a significant proportion of their daily food intake via meals served in school. Evidence shows that ensuring that those meals are high in nutritional value will improve children’s health and help with their school performance and readiness to learn,” said J. Nadine Gracia, M.D., MSCE, President and CEO of Trust for America’s Health.

Learn more about adult and childhood obesity trends and policies to address the obesity crisis in TFAH’s 2021 State of Obesity Report: Better Policies for a Healthier America.