Issue Category: Obesity/Chronic Disease

The State of Obesity 2018

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Report emphasizes urgent need to increase evidence-based obesity prevention programs to prevent disease and potentially save billions in healthcare spending

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Findings include:

  • Adult obesity rates vary considerably from state to state, with a high of 38.1 percent in West Virginia and a low of 22.6 percent in Colorado. No state had a statistically significant improvement in its obesity rate over the past year.
  • Adult obesity rates are at or above 35 percent in seven states; for the first time in Iowa and Oklahoma, and at least the second time in Alabama, Arkansas, Louisiana, Mississippi, and West Virginia.
  • Six states — Iowa, Massachusetts, Ohio, Oklahoma, Rhode Island, and South Carolina — saw their adult obesity rates increase significantly between 2016 and 2017.
  • Adult obesity rates are between 30 and 35 percent in 22 states and 19 states have adult obesity rates between 25 and 30 percent.
  • Over the past five years (2012 – 2017), 31 states had statistically significant increases in their obesity rate and no state had a statistically significant decrease in its obesity rate.
  • There continue to be striking racial and ethnic disparities in obesity rates. In 31 states, the adult obesity rate among Blacks is at or above 35 percent.  Latino adults have obesity at a rate at or above 35 percent in eight states.  White adults have obesity rates at or above 35 percent in one state. Nationally, the adult obesity rates for Latinos, Blacks and Whites are 47.0 percent, 46.8 percent and 37.9 percent respectively.

State by State rates of obesity among adults: 1 = highest rate of obesity, 51 = lowest rate

  1. West Virginia (38.1%), 2. Mississippi (37.3%), 3. Oklahoma (36.5%), 4. Iowa (36.4%), 5. Alabama (36.3%), 6. Louisiana (36.2%), 7. Arkansas (35.0%), 8. Kentucky (34.3%), 9. Alaska (34.2 %), 10. South Carolina (34.1%), 11. Ohio (33.8%), 12. Indiana (33.6%), 13. North Dakota (33.2%), 14. Texas (33.0%), 15. Tie Tennessee and Nebraska (32.8%), 17. Missouri (32.5%), 18. Kansas (32.4%), 19. Michigan (32.3%), 20. North Carolina (32.1%), 21. Wisconsin (32.0%), 22. South Dakota (31.9%), 23. Delaware (31.8%), 24. Tie Pennsylvania and Georgia (31.6%), 26. Maryland (31.3%), 27. Illinois (31.1%), 28. Virginia (30.1%), 29. Rhode Island (30.0%), 30. Arizona (29.5%), 31. Oregon (29.4%), 32. Idaho (29.3%), 33. Maine (29.1%), 34. Wyoming (28.8%), 35. Tie Minnesota, Florida and New Mexico (28.4%), 38. New Hampshire (28.1%), 39. Washington (27.7%), 40. Vermont (27.6%), 41. New Jersey (27.3%), 42. Connecticut (26.9%), 43. Nevada (26.7%), 44. Massachusetts (25.9%), 45. New York (25.7%), 46. Tie Montana and Utah (25.3%), 48. California (25.1%), 49. Hawaii (23.8 %), 50. District of Columbia (23.0%), 51. Colorado (22.6 %).

NOTE to reporters: See full report at TFAH.org/ObesityReport2018 and StateofObesity.org for state-by-state obesity rates, data interactives, priority policy summaries, and briefs for all 50 states.

“Obesity is a complex and often intractable problem and America’s obesity epidemic continues to have serious health and cost consequences for individuals, their families and our nation,” said John Auerbach, president and CEO of Trust for America’s Health. “The good news is that there is growing evidence that certain prevention programs can reverse these trends.  But we won’t see meaningful declines in state and national obesity rates until they are implemented throughout the nation and receive sustained support.”

Obesity is a problem in virtually every city and town, and every income and social sector.  But its impact is most serious in communities where conditions make access to healthy foods and regular physical activity more difficult, such as lower income and rural areas, including many communities of color.

The national costs of obesity are enormous.  Obesity drives an estimated $149 billion annually in directly related healthcare spending, and an additional $66 billion annually in lowered economic productivity. Also, one in three young adults is ineligible for military service, owing to being overweight, posing a national security vulnerability.

Evidence-based programs, policies and practices to reverse the obesity trend are known but need widespread implementation.

“Obesity is a major challenge in nearly every state and our role as public health leaders is to ensure we’re doing everything we can to address it,” said John Wiesman, president of the Association of State and Territorial Health Officials (ASTHO) and secretary of health at the Washington State Department of Health. “Our goal at the state level is to work across sectors to advocate for and implement evidence-based policies that encourage active healthy living and support healthy and safe communities that provide access to healthy foods, physical activity, and clinical preventive services.”

Recommendations

The report offers 40 recommendations for federal, state and local policymakers; the restaurant and food industries; and the healthcare system, including:

  • Support and expand policies and programs aimed at addressing obesity at the federal, state and community levels, including programs in the Centers for Disease Control and Prevention’s (CDC) Division of Nutrition, Physical Activity and Obesity, and community health programs like the Racial and Ethnic Approaches for Community Health program (REACH), and programs that focus on school health in CDC’s Division of Population Health.
  • Maintain and strengthen essential nutrition supports for low-income children, families and individuals through programs — like the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) in the U.S. Department of Agriculture (USDA) and expand programs and pilots to make healthy food more available and affordable through the program.
  • Maintain nutrition standards for school meals that were in effect prior to USDA’s interim final rule from November 2017, as well as current nutrition standards for school snacks.
  • States should ensure that all students receive at least 60 minutes of physical education or activity during each school day.
  • Medicare should encourage eligible beneficiaries to enroll in obesity counseling as a covered benefit, and, evaluate its use and effectiveness. Health plans, medical schools, continuing medical education, and public health departments should raise awareness about the need and availability of these services.
  • Food and beverage companies should eliminate children’s exposure to advertising and marketing of unhealthy products.
  • Hospitals should no longer sell or serve sugary drinks on their campuses; they should also improve the nutritional quality of meals and promote breastfeeding.

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Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority.  www.tfah.org

TFAH Applauds Passage of Senate Farm Bill

(Washington, D.C., June 29, 2018) – John Auerbach, president and CEO, of Trust for America’s Health (TFAH) today made the following statement regarding Senate passage of “Farm Bill” legislation (the Agriculture Improvement Act – Senate amendment to H.R. 2) to reauthorize key federal agricultural and nutrition programs.

“The Trust for America’s Health is pleased the U.S. Senate has completed work on Farm Bill legislation that will support and promote good nutrition and improved health outcomes. By rejecting the approach taken by the House, the Senate bill largely protects and strengthens the Supplemental Nutrition Assistance Program (SNAP), which serves as a critical lifeline to millions of American children and families that otherwise lack the means to access adequate nourishment and make healthy food choices.

In addition to increases in funding to the Food Insecurity Nutrition Incentive Pilot, the Senate bill includes a Harvesting Health pilot that would help to further promote linkages between health care providers and anti-hunger and nutrition improvement activities.

According to TFAH’s State of Obesity report, roughly two out of every three adults or one out of every three children is either obese or overweight. Obesity remains both a significant public health crisis and a national security issue-being overweight or obese is the leading cause of medical disqualifications for military service, with nearly one-quarter of applicants being rejected for exceeding the weight or body fat standards. Additionally, obesity translates to higher health care costs and poor quality of life.

Many efforts are underway that encourage SNAP recipients to make healthy food choices; for example, incentive programs to use SNAP benefits at farmers’ markets. Such efforts, combined with other prevention programs and policies, have been shown to be effective. We must now continue to invest in and scale such approaches to help Americans eat healthier. SNAP and other Farm Bill programs will be critical to turning the tide against this longstanding health problem.

TFAH looks forward to continuing to work with Congress through the conference process as it develops a final Farm Bill that will lead us in the right direction, towards improving the health and prosperity of all Americans.”

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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.

Separating parents and children at US border is inhumane and sets the stage for a public health crisis

(Washington, D.C., June 15, 2018) — “The Trump administration’s policy of separating parents and children at the U.S.-Mexico border will have a dire impact on their health, both now and into the future.

“As public health professionals we know that children living without their parents face immediate and long-term health consequences. Risks include the acute mental trauma of separation, the loss of critical health information that only parents would know about their children’s health status, and in the case of breastfeeding children, the significant loss of maternal child bonding essential for normal development. Parents’ health would also be affected by this unjust separation.

“More alarming is the interruption of these children’s chance at achieving a stable childhood. Decades of public health research have shown that family structure, stability and environment are key social determinants of a child’s and a community’s health.

“Furthermore, this practice places children at heightened risk of experiencing adverse childhood events and trauma, which research has definitively linked to poorer long-term health. Negative outcomes associated with adverse childhood events include some of society’s most intractable health issues: alcoholism, substance misuse, depression, suicide, poor physical health and obesity.

“There is no law requiring the separation of parents and children at the border. This policy violates fundamental human rights. We urge the administration to immediately stop the practice of separating immigrant children and parents and ensure those who have been separated are rapidly reunited, to ensure the health and well-being of these children.”

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APHA champions the health of all people and all communities. We strengthen the public health profession. We speak out for public health issues and policies backed by science. We are the only organization influence federal policy, has a nearly 150-year perspective and brings together members from all fields of public health. Visit us at www.apha.org.


Trust for America’s Health is a non-profit, non-partisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority.  Twitter: @HealthyAmerica1

Obesity/Chronic Disease

Obesity is one of the nation’s most pressing health problems and is related to the growing number of Americans living with a chronic disease such as heart disease, hypertension, and diabetes. TFAH’s State of Obesity: Better Policies for a Healthier America report found that four in ten American adults have obesity, and those rates continue to climb nationwide and within population groups.

Leading Public Health Groups: Using the Prevention Fund to help fund CHIP: A Serious Mistake

Statement from Trust for America’s Health, American Public Health Association, National Association of County and City Health Officials, Prevention Institute, and Public Health Institute

December 22, 2017

Washington, D.C., December 22, 2017 –It is a serious mistake to cut $750 million from the Prevention and Public Health Fund to provide very short-term funding for the Children’s Health Insurance Program (CHIP) and community health centers. The below is a statement from the American Public Health Association, National Association of County and City Health Officials, Prevention Institute, Public Health Institute, and Trust for America’s Health:

“The Prevention Fund supports critical public health activities—including lead poisoning surveillance, vaccination initiatives and other programs—in every state and community across the country. Cutting this significant funding source would leave communities without the vital resources needed to keep children and families happy, healthy and safe.

It is even more alarming and contradictory that this cut will be used to provide very short-term funding for CHIP and community health centers. Our organizations are united in support of CHIP and community health centers, which are vital to improving children’s health. But losing the Prevention Fund would just create another hole in the public health support children need.

The Prevention Fund is supported strongly by national, state and local groups alike—indeed to-date 1,142 have joined the Prevention Fund supporter’s list. They know the value of the $630 million annually that goes directly to states and communities to prevent illness and disease.

A strong public health system makes the difference between health and illness, safety and injury, life and death.

We urge Congress to oppose any and all future cuts to the Prevention Fund and to begin the long-overdue process of increasing support to CHIP, community health centers, CDC and other public health agencies so today’s children can be our healthiest and happiest generation.”

John Auerbach, President & CEO, Trust for America’s Health

Georges C. Benjamin, MD, Executive Director, American Public Health Association

Larry Cohen, Executive Director, Prevention Institute

Laura Hanen, MPP, Interim Executive Director and Chief of Government Affairs, National Association of County and City Health Officials

Mary A. Pittman, President & CEO, Public Health Institute

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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. www.healthyamericans.org

The American Public Health Association champions the health of all people and all communities. We strengthen the public health profession. We speak out for public health issues and policies backed by science. We are the only organization that combines a 145-year perspective, a broad-based member community and the ability to influence federal policy to improve the public’s health. Visit us at www.apha.org.

The National Association of County and City Health Officials (NACCHO) represents the nation’s nearly 3,000 local governmental health departments. These city, county, metropolitan, district, and tribal departments work every day to protect and promote health and well-being for all people in their communities. For more information about NACCHO, please visit www.naccho.org.

The Public Health Institute, an independent nonprofit organization, is dedicated to promoting health, well-being and quality of life for people throughout California, across the nation and around the world.

Prevention Institute is an Oakland, California-based nonprofit research, policy, and action center that works nationally to promote prevention, health, and equity by fostering community and policy change so that all people live in healthy, safe environments.

National Youth Obesity Rate Holds Steady, New Data Show

Three out of 10 youth ages 10 to 17 are overweight or obese

Princeton, N.J., September 19, 2017—Roughly three out of 10 young people in the United States, 31.2 percent, are overweight or obese, according to the newest available data. Seven states—Alabama, Florida, Mississippi, North Dakota, Rhode Island, Tennessee, and West Virginia—have rates of overweight and obesity that exceed 35 percent. Only one state, Utah, has a rate under 20 percent.

The 2016 state-by-state rates for children and adolescents ages 10 to 17 were recently released on the Data Resource Center for Child and Adolescent Health (DRC) website (www.childhealthdata.org) and are reported at stateofobesity.org/children1017. This is the first update to this national data set since 2011-12.

The release of these new youth data follow the recent publication of the annual State of Obesity report by the Robert Wood Johnson Foundation (RWJF) and Trust for America’s Health (TFAH), which includes state-by-state adult obesity rates. Together, the two data sets show that obesity rates may be levelling off, but that progress could be eroded if policies are weakened or programs are cut.

At the time of the State of Obesity release in August, the leaders of RWJF and TFAH shared their perspectives:

Richard Besser, president and CEO of RWJF:

“Obesity rates are still far too high, but the progress we’ve seen in recent years is real and it’s encouraging. That progress could be easily undermined if leaders and policymakers at all levels don’t continue to prioritize efforts that help all Americans lead healthier lives.”

John Auerbach, president and CEO of TFAH:

“It’s clear that the progress we’ve made in fighting obesity is fragile—and that we’re at a critical juncture where continuation of the policies that show promise and increased support and resources could truly help bend the rising tide of obesity rates. We’re far from out of the woods when it comes to obesity. But we have many reasons to be optimistic thanks to parents, educators, business owners, health officials, and other local leaders. Our nation’s policymakers must follow their example to build a culture of health.”

To accelerate progress in addressing obesity, RWJF and TFAH urge policymakers to:

  • Invest in prevention at the federal, state and local levels, including full funding for the Centers for Disease Control and Prevention and the Prevention and Public Health Fund.
  • Prioritize early childhood policies and programs, including support for Head Start and the Child and Adult Care Food Program.
  • Maintain progress on school-based policies and programs, including full implementation of current nutrition standards for school foods.
  • Invest in community-based policies and programs, including nutrition assistance programs such as the Supplemental Nutrition Assistance Program (SNAP), and transportation, housing, and community development policies and programs that support physical activity.
  • Fully implement menu labeling rules and the updated Nutrition Facts label.
  • Expand healthcare coverage and care, including continued Medicare and Medicaid coverage of the full range of obesity prevention, treatment, and management services.

The stateofobesity.org site provides a new feature examining relevant policies at the state level and an interactive feature reporting on the latest obesity rates by state. The DRC website, www.childhealthdata.org, enables visitors to examine youth obesity rates by race/ethnicity, household income, and other demographic factors, as well as other relevant variables, such as physical activity rates.

About the new youth data

The new overweight and obesity rates among 10- to 17-year-olds are from the 2016 edition of the National Survey of Children’s Health (NSCH). The Maternal and Child Health Bureau (MCHB) funds and directs the NSCH, and develops survey content in collaboration with a national technical expert panel and the U.S. Census Bureau, which then conducts the survey. The NSCH uses parent reports of a child’s or adolescent’s height and weight to calculate body mass index.

The NSCH methods and sample size changed between 2011-12 and 2016, meaning it is not advisable to directly compare results across years. But the data do indicate a consistent stabilization in national and state rates of childhood overweight and obesity over the last decade. The NSCH is planned as an annual survey going forward, so these and other trends can be evaluated.

The Child and Adolescent Health Measurement Initiative (CAHMI) at the Johns Hopkins Bloomberg School of Public Health partners with MCHB in the design of the NSCH and analyzes and publishes state by state findings on its Data Resource Center for Child and Adolescent Health website, which is where the data reported here were obtained. RWJF and TFAH worked with CAHMI to announce the latest obesity rate data.

Overweight and Obesity Rate Among Youth Ages 10-17 by State, 2016

1.       Tennessee

37.7

18.          Georgia

32.2

35.      Minnesota

27.7

2.       North Dakota

37.1

19.          Michigan

32

36.      Colorado

27.2

3.       Mississippi

37

20.          New York

31.8

37.      Virginia

27.2

4.       Florida

36.6

21.          New Jersey

31.7

38.      Wyoming

27.1

5.       Rhode Island

36.3

22.          Pennsylvania

31.7

39.      Illinois

27

6.       Alabama

35.5

23.          South Dakota

31.4

40.      Arizona

26.9

7.       West Virginia

35.1

24.          California

31.2

41.      Massachusetts

26.6

8.       Louisiana

34

25.          Delaware

30.9

42.      Alaska

26.3

9.       Arkansas

33.9

26.          Kansas

30.9

43.      Idaho

26

10.   Indiana

33.9

27.       North Carolina

30.9

44.      Hawaii

25.5

11.   District of Columbia

33.8

28.          Nevada

30.5

45.      Washington

25.5

12.   Oklahoma

33.8

29.          Connecticut

30.2

46.      New Mexico

24.9

13.   Maryland

33.6

30.          Iowa

29.9

47.      New Hampshire

23.8

14.   Kentucky

33.5

31.          Wisconsin

29.5

48.      Montana

23.2

15.   Texas

33.3

32.          Missouri

29.4

49.      Vermont

22.2

16.   Ohio

33.1

33.          Nebraska

29.2

50.      Oregon

20.3

17.   South Carolina

32.9

34.          Maine

28.2

51.      Utah

19.2

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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.