Issue Category: School Nutrition

COVID-19 School Closures Put 30 Million Children at Risk of Hunger

Many States with High COVID-19 Infection Rates Also Have Highest School-Meal Programs Participation Rates

(Washington, DC – July 16, 2020) – As COVID-19 infection rates continue to increase in states across the country, many of those jurisdictions are facing the complex dilemma of high infections rates complicating school re-openings and thereby limiting students’ access to school-based meal programs. Among the states with spiking infection rates and a high percentage of students participating in school-based meal programs are Arizona, Florida, Louisiana, Mississippi and South Carolina.

In March schools across the country began closing to stop the spread of the COVID-19 virus. In response, and recognizing the important source of nutrition school-based meals were to millions of American children, the U.S. Department of Agriculture’s Food and Nutrition Service began approving nationwide waivers to provide school systems flexibility in how meals were provided to students.  For example, these waivers enable schools to serve meals in non-congregate settings and outside of standard mealtimes, serve afterschool snacks and meals outside of structured environments, and waive requirements that students be present when meals are picked up.

Over half of all students in elementary and secondary schools across the country depend on the National School Lunch Program, and 12.5 million of those students also participate in the School Breakfast Program. As the COVID-19 pandemic closed schools this spring, these students were placed at risk of not having enough to eat.

A new policy brief, Beyond School Walls: How Federal, State and Local Entities are Adapting Policies to Ensure Student Access to Healthy Meals During the COVID-19 Pandemic, released today by Trust for America’s Health, reviews steps the federal and state governments have taken to ensure students’ access to healthy meals when schools are closed and what needs to be done to ensure continued meal access as all school systems face uncertainties about how to safely reopen for the 2020-2021 school year.

“School meal programs are the most important source of nutritious food for millions of American children. To the degree possible, school systems, with financial and regulatory relief from the federal government,  should continue to be innovative about how to deliver meals to students and should strive to meet or exceed federal nutrition standards for these meals despite product shortages created by the pandemic,” said Adam Lustig, Project Manager at Trust for America’s Health and the brief’s author.

Due to the economic impact the pandemic has had on millions of American families and the numerous uncertainties about how to safely re-open schools, the currently in place program waivers should be extended through the summer and may need to be kept in place during the 2020–2021 school year, the brief says.

Many of the states hardest hit by COVID also have highest school meal programs participation rates

States with some of the highest rates of COVID-19 infections also have high percentages of students who depend on school meals for much of their nutrition. States in which both COVID-19 infection rates are above national medians and school meals program enrollment is high include Arizona, Florida, Georgia, Louisiana, Mississippi, and South Carolina.

States in which more than half of students are enrolled in school-meals programs are:

Percentage of students enrolled in school meal programs

D.C.                                        76.4%

Mississippi                           75.0%

New Mexico                         71.4%

South Carolina                    67.0%

Arkansas                              63.6%

Louisiana                             63.0%

Oklahoma                            62.5%

Georgia                                62.0%

Nevada                                60.8%

Kentucky                             58.7%

California                            58.1%

Florida                                 58.1%

Arizona                                57.0%

Missouri                              52.7%

New York                            52.6%

Illinois                                 50.2%

Alabama                              51.6%

Oregon                                 50.5%

Hunger, poor nutrition and food insecurity can increase a child’s risk of developing a range of physical, mental, behavioral, emotional, and learning problems. Hungry children also get sick more often and are more likely to be hospitalized. Maintaining children’s access to nutritious meals despite school closures not only ensure they do not go hungry, but also promotes children’s health.

“State and federal guidelines waivers have allowed school systems to provide meals to students during the pandemic response, keeping them in place this summer and into the 2020-2021 school year will be the difference between kids who have enough to eat and kids who go hungry,” Lustig said.

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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. Twitter:@HealthyAmerica1

When Two Health Risks Merge – Rising Obesity Rates Put More Americans at Risk for Serious Health Impacts of the Novel Coronavirus

High obesity rates in communities of color may be one of a number of factors leading to severe COVID-19 impacts in those communities

(Washington, DC – May 6, 2020) – New data drawn from the National Health and Nutrition Examination Survey (NHANES) found that 42.4 percent of U.S. adults age 20 and older have obesity. That rate was up nearly three percentage points from the previous NHANES survey taken in 2015-2016 when 39.6 percent of the nation’s adults had obesity. After remaining relatively stable in the 2000s, these new data represent the third consecutive NHANES survey that found increases in the nation’s adult obesity rate of 2.8, 1.9 and 2.8 percentage points respectively.

The latest survey also showed a continuing pattern of higher rates of obesity in Black and Latino communities than in the White population. Among adults, the prevalence of both obesity and severe obesity was highest in Black adults compared with other races/ethnicities.

Rates of Obesity – U.S. Adults by Race:

  • Blacks – 49.6%
  • Latinos – 44.8%
  • Whites – 42.2%

Rates of Obesity – U.S. Adults by Race and Gender

  • Black Women – 56.9%
  • Black Men – 41.1%
  • Latina Women – 43.7%
  • Latino Men – 45.7%
  • White Women – 39.8 %
  • White Men – 44.7 %

Childhood obesity is also increasing across the country. Having obesity as a child puts you at a higher risk of having obesity as an adult.


Having obesity puts people at higher risk for severe COVID-19 impact
It is well-established that obesity is associated with serious health risks.  The risk of diabetes is closely associated with obesity. In addition, people with obesity have higher levels of pre-existing respiratory and cardiac disease which puts them at higher risk for serious impacts if infected by the novel coronavirus.  In a study in review for publication, researchers at New York University found that obesity is one of three of the most common risk factors for COVID-19 hospitalizations.

The COVID-19 crisis is disproportionately causing severe illness and taking the lives of Black Americans. As of April, of COVID-19 positive tests where the patient’s race/ethnicity was known, 28.5 percent were Black. Blacks make-up 13.4 percent of the U.S. population.  Additional examples include Milwaukee County, Wisconsin, Blacks are 28 percent of the county’s population but as of early April were 73 percent of its coronavirus deaths. In Michigan, Blacks are 14 percent of the state’s population and 41 percent of the state’s coronavirus deaths. In Chicago, Blacks are 23 percent of the city’s residents and 58 percent of its coronavirus deaths.

The social, economic, and environmental conditions that lead to higher rates of obesity and other chronic diseases in communities of color are tied to factors that also elevate the risk of COVID-19 related hospitalizations and death.  Factors such as lack of economic opportunities, for example in the form of good jobs with living wages, contribute to obesity by making it more difficult to afford healthier foods or have access to stores that sell affordable healthy produce.  Additional conditions in many communities of color that contribute COVID-19 infections, hospitalizations and deaths are living in multigenerational households, working in public-facing jobs that elevate COVID-19 risk (such as work in home health care, grocery stores, delivery services and the public transit system) and less access to healthcare.

“Numerous factors are leading to the tragic overrepresentation of people of color in the nation’s COVID-19 deaths, among them the number of people of color working on the frontlines as essential workers, where telework or physical distancing is not possible,” said Dr. J. Nadine Gracia, Trust for America’s Health’s Executive Vice President and Chief Operating Officer. “In addition, high levels of chronic disease within communities of color, such as diabetes and heart disease, are contributing to higher levels of COVID-19 deaths”.

The nation’s obesity crisis and the COVID-19 pandemic will continue to interact in additional ways. For example, food insecurity is associated with obesity. An additional contributing factor is lack of physical activity. Unfortunately, COVID-19 will increase both of those concerns as millions of families are currently food insecure due to job loss and many places to exercise such as gyms, community centers and parks are closed.

“The COVID-19 crisis has illuminated systemic and structural inequities that impact the health and well-being of people of color,” Dr. Gracia said. “The factors associated with maintaining a healthy weight are another example of the ways in which where people live, the neighborhood resources available, and the economic opportunities afforded to them drive their health, and are now driving their degree of health risk due to COVID-19.”

While federal and state leaders are immediately focused on protecting lives during the current crisis, investing in programs to stem the rise in the country’s obesity rates will not only improve Americans’ health, it will also make the country more resilient during future health emergencies.

Some of the federal policy actions TFAH recommends to reverse the country’s rising obesity rates are:

  • Congress should fully fund CDC’s Division of Nutrition, Physical Activity and Obesity’s SPAN (State Physical Activity and Nutrition program) grants for all 50 states and the District of Columbia. Current CDC funding only supports 16 states out of 50 approved applications.
  • Congress should increase funding for CDC’s Racial and Ethnic Approaches to Community Health (REACH) program which works with community organizations to deliver effective local and culturally appropriate obesity prevention programs in communities that bear a disproportionate burden of chronic disease. Current funding only supports 31 grantees out of 261 approved applications.
  • Build capacity for CDC and public health departments to work with other sectors (such as housing and transportation) to address social determinants of health, the nonmedical factors that affect communities’ health status including rates of obesity.
  • Without decreasing access or benefit levels, ensure that anti-hunger and nutrition-assistance programs, like the Supplemental Nutrition Assistance Program (SNAP), Special Supplemental Nutrition Program for Women, Infants and Children (WIC) follow the Dietary Guidelines for Americans and make access to nutritious food a core program tenet.
  • Expand the WIC program to age 6 for children and for two years postpartum for mothers. Fully fund the WIC Breastfeeding Peer Counseling Program.
  • Increase the price of sugary drinks through excise taxes and use the revenue to address health and socioeconomic disparities. Increasing the price of surgery drinks has been shown to decrease their consumption.
  • Enforce existing laws that direct most health insurers to cover obesity-related preventive services at no-cost sharing to patients. Comprehensive pediatric weight management programs and services should also be covered by Medicaid.
  • Encourage safe physical activity by funding Complete Streets, Vision Zero and other pedestrian safety initiatives through federal transportation and infrastructure funding.
  • In schools, strengthen and expand school nutrition programs beyond federal standards to include universal meals and flexible breakfasts, eliminate all unhealthy food marketing to students, support physical education programs in all schools and expand programs that ensure students can safely walk or ride bicycles to and from school.

See TFAH’s State of Obesity: Better Policies for a Healthier America 2019 for additional recommendations on how to stem the country’s obesity crisis. https://www.tfah.org/report-details/stateofobesity20

 

 

 

New Report Shows Hamstrung COVID-19 Response was Years in the Making

Funding for public health preparedness and response programs lost ground in FY 2020 and over the past decade.

(Washington, DC – April 16, 2020) – Chronic underfunding of the nation’s public health and emergency preparedness systems has made the nation vulnerable to health security risks, including the novel coronavirus pandemic, according to a new report released today by Trust for America’s Health.

The report, The Impact of Chronic Underfunding on America’s Public Health System: Trends, Risks, and Recommendations, 2020, examines federal, state, and local public health funding trends and recommends investments and policy actions to build a stronger system, prioritize prevention, and effectively address twenty-first-century health risks.

“COVID-19 has shined a harsh spotlight on the country’s lack of preparedness for dealing with threats to Americans’ well-being,” said John Auerbach, President and CEO of Trust for America’s Health. “Years of cutting funding for public health and emergency preparedness programs has left the nation with a smaller-than-necessary public health workforce, limited testing capacity, an insufficient national stockpile, and archaic disease tracking systems – in summary, twentieth-century tools for dealing with twenty-first-century challenges.”

Mixed Picture for CDC FY 2020 Funding

The U.S. Centers for Disease Control and Prevention (CDC) is the nation’s leading public health agency. The CDC’s overall budget for FY 2020 is $7.92 billion – a $645 million increase, 9 percent over FY 2019 CDC funding, 7 percent in inflation-adjusted dollars. The largest FY 2020 increase was a onetime investment in buildings and facilities (+$225 million). Other increases included funding for the Ending HIV initiative (+$140 million) and small increases for suicide and chronic disease prevention programs.

Emergency Preparedness Funding Down This Year and For Over a Decade

Funding for CDC’s public health preparedness and response programs decreased between the FY 2019 and FY 2020 budgets – down from $858 million in FY 2019 to $850 million in FY 2020.  CDC’s program funding for emergency preparedness in FY 2020 ($7.92 billion) is less than it was in FY 2011 ($7.99 billion in FY 2020 dollars), after adjusting for inflation.

Funding for state and local public health emergency preparedness and response programs has also been reduced, by approximately one-third since 2003. And, of critical concern now, funding for the Hospital Preparedness Program, the only federal source of funding to help the healthcare delivery system prepare for and respond to emergencies, has been cut by half since 2003.

Federal action to enact three supplemental funding packages to support the COVID-19 pandemic response was critical. But they are short-term adjustments that do not strengthen the core, long-term capacity of the public health system, according to the report’s authors.  Sustained annual funding increases are needed to ensure that our health security systems and public health infrastructure are up to the task of protecting all communities.

The nation’s habitual neglect of public health, except during emergencies, is a longstanding problem. “Emergencies that threaten Americans’ health and well-being are becoming more frequent and more severe. These include wildfires and flooding, the opioid crisis, the increase in obesity and chronic illness, and this year a measles outbreak, serious lung injuries due to vaping, and the worst pandemic in a century. We must begin making year-in and year-out investments in public health,” Auerbach said.

In addition to supporting federal activities, federal monies are also the primary source of funding for most state and local public health programs. During FY 2018, 55 percent of states’ public health expenditures, on average, were funded from federal sources. Therefore, federal spending cuts have a serious trickle-down effect on state and local programs. Between FY 2016 and FY 2018, state expenditures of federal monies for public health activities decreased from $16.3 billion to $12.8 billion.   On top of federal cuts, some states have also reduced public health funding.  More than 20 percent of states (eleven) cut their public health funding between 2018 and 2019.

These funding cuts have led to significant workforce reductions in state and local public health departments. In 2017, 51 percent of large local public health departments reported job losses.  Some of the positions lost were frontline public health staff who would have been mobilized to combat the COVID-19 pandemic.

The report includes 28 policy recommendations to improve the country’s emergency preparedness in four priority areas:

  • increased funding to strengthen the public health infrastructure and workforce, including modernizing data systems and surveillance capacities.
  • improving emergency preparedness, including preparation for weather-related events and infectious disease outbreaks.
  • safeguarding and improving Americans’ health by investing in chronic disease prevention and the prevention of substance misuse and suicide.
  • addressing the social determinants of health and advancing health equity.

The report also endorses the call by more than 100 public health organizations for Congress to increase CDC’s budget by 22 percent by FY 2022.

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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. Twitter: @healthyamerica1

The State of Obesity 2019 Congressional Briefing: Better Policies for a Healthier America

On November 18th, 2019, Trust for America’s Health held a briefing for congressional staff and partners that reviewed the latest obesity rates and trends, the role of public health and other stakeholders in preventing, treating and responding to obesity and its comorbidities, highlighted promising approaches to ensure healthy communities, and offered evidence-based policy recommendations that could help all Americans lead healthier lives.

Briefing speakers included:

  • John Auerbach, MBA, President and CEO, Trust for America’s Health
  • Devita Davison, Executive Director, FoodLab Detroit
  • Martha Halko, MS, RD, LD, Deputy Director of Prevention & Wellness, Cuyahoga County (Ohio) Board of Health
  • Ruth Petersen, MD, MPH, Director, Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control & Prevention (CDC)

Briefing materials:

  • Panelists biographies
  • Presentation slides
  • CDC Division of Nutrition, Physical Activity, and Obesity At A Glance fact sheet
  • CDC Division of Nutrition, Physical Activity, and Obesity’s Work in Healthcare Settings to Reduce Childhood Obesity fact sheet
  • TFAH’s State of Obesity 2019 Report
  • TFAH’s State of Obesity 2019 report fact sheet
  • Robert Wood Johnson Foundation’s (RWJF) 2019 Obesity Report

For more information, please contact Daphne Delgado, TFAH Senior Government Relations Manager at [email protected]

 

Produce Rx: Using Prescriptions to Improve Affordability of Healthy Foods

Healthy eating among families and communities promotes optimal health and well-being. However, approximately three-fourths of Americans do not consume the recommended amounts of healthy foods, such as fruits and vegetables, set by the 2015-2020 Dietary Guidelines for Americans.

A healthy daily diet is linked to reduced risk for obesity, diabetes, hypertension, and other preventable chronic illnesses. But, despite efforts to promote healthy eating, communities across the U.S. continue to face barriers to accessing healthy foods.

Produce Rx

In 2012, DC Greens, a food justice non-profit located in Washington, DC, launched a pilot program called Produce Rx which began as a small-scale partnership between health care clinics and local farmer’s markets. The vision, like that of similar efforts across the country, was to increase patients’ access to fresh produce and empower them to make healthier food choices in order to manage and improve their health.

A sample prescription a doctor might provide for Produce Rx.

As part of the program, patients facing food insecurity and living with diet-related chronic disease enrolled in a six-month group nutrition class at a local health clinic, where they received monthly nutrition education and seasonal recipe demonstrations and had a check-in with a healthcare provider. Additionally, they received a “prescription” in the form of a voucher from the healthcare provider to purchase fresh produce from their local farmer’s market.

Community members who participated in the Produce Rx program showed significant improvements in health outcomes, such as lower BMI among 50 percent of the participants. In addition, 85 percent of the program participants reported improved patient-provider relationships.

Expansion and Growth

In March 2019, DC Greens, with funding support from the DC Department of Health and AmeriHealth Caritas, the largest Medicaid managed care organization in the District with more than 100,000 members, established a new partnership with Giant Food – the only grocery store located in D.C.’s Ward 8. The Ward 8 neighborhood has some of the highest income, educational, health, and racial and ethnic disparities among all of the District’s 8 wards – creating an opportunity to support D.C. residents with the greatest need through a new expanded model of the Produce Rx program.

D.C.’s Ward 8 is known as a “food desert” due to the limited number of retailers selling fresh, affordable produce, and the fact that the community faces disproportionate rates of people with diet-related chronic conditions. Moreover, Ward 8 has the highest rates of death due to diabetes and heart disease within the city.

“There is a myth that people living in poverty don’t want healthy food. We know this isn’t true,” says Lauren Shweder Biel, Executive Director of DC Greens. “people simply lack the resources to get the healthy foods that they want and that they need. With Produce Rx, we’ve been able to give patients a way to follow their doctors’ medical advice.”

“Giant Food is excited about the positive impact the Produce Rx program has had at our Alabama Avenue store,” said Ira Kress, interim President at Giant Food. ” As a food retailer, with roots in Washington, D.C. dating back 83 years, we recognize the important role we can play in the access to healthy foods and health education in our community, and this program has been a natural fit.”

With the new partnership Produce Rx participants will have access to fresh fruit and vegetables year-round. The program will expand its services to 500 AmeriHealth Medicaid participants who will receive a $20 voucher every week to purchase produce at their neighborhood Giant.

Produce Rx patient Adrienne Dove exchanges her prescription for a voucher for produce from Giant Food Pharmacy Manager Adaoma Chinweuba.

“AmeriHealth Caritas DC is committed to helping our members, especially those with chronic health conditions, improve their overall health by adding more fruits and vegetables to their daily diet,” said Keith Maccannon, Director of Community Relations and Outreach at AmeriHealth Caritas DC. “Collaboration with community-based organizations and businesses like DC Greens and Giant Food are a key component of our strategy in this area.”

Participants in this program will also have access to personal-level nutrition education at their health clinic and through Giant’s in-store nutritionist and AmeriHealth’s nutrition and wellness programs.

“Pairing nutrition education with produce access is essential for helping our customers unlock the power of produce,” said Jillian Griffith, Giant Food in-store nutritionist. “It is one thing to be instructed by a medical provider to eat more fruits and vegetables, but it’s another to have an in-store nutritionist available to share plant-based recipe ideas or new produce pairings for traditional family favorites. I am so grateful for the opportunity to teach Produce Rx participants the role food plays in their overall health while empowering them with the “produce tools” needed to meet dietary recommendations.”

Through these services, Produce Rx is making healthy food options more affordable and accessible for both individuals and their families.

“The program has impacted me and my family because we found we are eating healthier, losing more weight, and needing less medication than we used to,” said Adrienne Dove, a participant in the program. “I count my spending to make sure I don’t go over on food, but now I can buy healthier options, like spinach and broccoli, that my son wants to try, from the grocery store right around the corner.”

Next Steps

This next iteration of Produce Rx will run for a year, allowing DC Greens to conduct a robust evaluation of its effectiveness by measuring key behavior changes, health outcomes, and tracking health care costs among program participants. Currently, DC Greens administers Produce Rx but with this evaluation they hope to build the case for scalable and sustainable investments in these programs by the healthcare system.

(From left to right) Kevin O’Donnell (Giant Food District Pharmacy Manager), Adaoma Chinweuba (Giant Food Pharmacy Manager), Adrienne Dove (Produce Rx Patient) Samir Balile (Giant Food Clinical Programs Specialist).

“We are working to integrate ‘food as medicine’ as a key component of clinical care, but we know that the only way to truly scale a program like this is to prove a return on investment for the healthcare system,” says Biel. “With AmeriHealth Caritas and DC Health at our side, we believe this program is poised to demonstrate the impact that ‘food as medicine’ can have on individual health and patient utilization of the healthcare system.”

More Investment in Policies and Programs to Support Food Access and Healthy Choices is Needed

Continued investments in local, state, and federal policies and programs are critical for improving nutrition and health, especially among low-income and underserved communities that face limited access to affordable, fresh produce. More research is needed to definitively demonstrate the impact that DC Greens Produce Rx and other innovative programs are having on health and healthcare services usage. But the preliminary findings are promising.

“With the obesity crisis getting worse, we need to have a comprehensive and multi-faceted approach to changing the conditions that make it difficult for people to eat a healthful diet. Such an approach includes initiatives like DC Produce Rx with its focus on reducing the financial barriers to accessing healthy foods as well as providing culturally and linguistically tailored educational information,” said John Auerbach, President and CEO of Trust for America’s Health.

From community-based programs that test new strategies like Produce Rx to federal programs such as the Supplemental Nutrition Assistance Program for Woman, Infants, and Children (WIC) access to nutritious, affordable foods can help communities live healthier lives. As the nation experiences growing rates of obesity and other chronic diseases, it’s important for policymakers to continue supporting innovative solutions that address the root causes of preventable disease.

U.S. Obesity Rates at Historic Highs – Nine States Reach Adult Obesity Rates of 35 Percent or More

 Report Calls for Sugary Drink Taxes, Expanded SNAP and WIC Nutrition Support Programs and a built environment that encourages physical activity to Help Address Health Crisis

(Washington, DC – September 12, 2019) – Nine U.S. states had adult obesity rates above 35 percent in 2018, up from seven states at that level in 2017, an historic level of obesity in the U.S., according to the 16th annual State of Obesity: Better Policies for a Healthier America report released today by the Trust for America’s Health (TFAH).

The report based in part on newly released data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System (BRFSS), and analysis by TFAH, provides an annual snapshot of obesity rates nationwide.  The State of Obesity series and this report were made possible by funding from the Robert Wood Johnson Foundation.

Obesity has serious health consequences including increased risk for type 2 diabetes, high blood pressure, stroke and many types of cancers. Obesity is estimated to increase national healthcare spending by $149 billion annually (about half of which is paid for by Medicare and Medicaid) and being overweight or obese is the most common reason young adults are ineligible for military service.

Obesity rates vary considerably between states with Mississippi and West Virginia having the highest level of adult obesity in the nation at 39.5 percent and Colorado having the lowest rate at 23.0 percent.

For the first time, adult obesity rates were above 35 percent in nine states in 2018: Alabama, Arkansas, Iowa, Kentucky, Louisiana, Mississippi, Missouri, North Dakota and West Virginia.

As recently as 2012, no state had an adult obesity rate over 35 percent and within the last five years (2013 and 2018) 33 states had statistically significant increases in their rates of adult obesity.

“These latest data shout that our national obesity crisis is getting worse,” said John Auerbach, President and CEO of Trust for America’s Health. “They tell us that almost 50 years into the upward curve of obesity rates we haven’t yet found the right mix of programs to stop the epidemic.   Isolated programs and calls for life-style changes aren’t enough.  Instead, our report highlights the fundamental changes that are needed in the social and economic conditions that make it challenging for people to eat healthy foods and get sufficient exercise.”


Differential Impact Amongst Minority Populations

The report highlights that obesity levels are closely tied to social and economic conditions and that individuals with lower incomes are more at risk. People of color, who are more likely to live in neighborhoods with few options for healthy foods and physical activity, and, are the target of widespread marketing of unhealthy foods, are at elevated risk.

As of 2015-2016, the latest available data, nearly half of Latino (47 percent) and Black adults (46.8) had obesity while adult obesity rates among White and Asian adults were 37.9 percent and 12.7 percent respectively.  Incidence of childhood obesity was highest amongst Latino children at 25.8 percent while 22 percent of Black children had obesity, 14 percent of White children had obesity and 11 percent of Asian children had obesity.


What Could Work?

While the obesity rates are alarming, there are new data offering the promise of policies that combat the epidemic, namely promoting healthier food for children through revamped WIC food packages and fostering behavior change through taxes on sugary drinks.

  • Obesity rates for children enrolled in WIC (Special Supplemental Nutrition Program for Women, Infants and Children) continue to decline, from 15.9 percent in 2010 to 13.9 percent in 2016. In 2009, the USDA updated WIC food packages to more closely meet recommended national dietary guidelines including the addition of more fruits, vegetables and whole grains and reduced fat levels in milk and infant formula. A Los Angeles County study published this year found that 4-year-olds who had received the revised WIC food package since birth had reduced risk for obesity.
  • A number of U.S. cities and the Navajo Nation have passed local taxes on sugary drinks that are showing promise as a means to change consumers’ beverage habits. Studies of a 1-cent per ounce tax in Berkeley, California and a 1.5 cent per ounce tax in Philadelphia, Pennsylvania found that the consumption of sugary drinks decreased significantly after the tax was imposed.

“Policies such as these are proving effective in changing behavior. But, no single solution – however promising – is sufficient.  Obesity is a complex problem and will need multi-sector, multi-factor solutions,” said TFAH’s Auerbach.

“Creating the conditions that allow people to more easily make healthy choices is central to preventing obesity, as is prioritizing investment in those communities most affected by the crisis,” Auerbach said.


Recommendations for Policy Action

The report includes 31 recommendations for policy action by federal, state and local government, across several sectors, designed to improve access to nutritious foods and provide safe opportunities for physical activity, while minimizing harmful marketing and advertising tactics.

Among the report’s recommendations for policies to address the obesity crisis are:

  • Expand the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) to age 6 for children and for two years postpartum for mothers and fully fund the WIC breastfeeding Peer Counseling Program.
  • Increase the price of sugary drinks through excise taxes and use the revenue to address health and socioeconomic disparities.
  • Ensure that CDC has enough funding to grant every state appropriate funding to implement evidence-based obesity prevention strategies (currently, CDC only has enough funding to work with 16 states).
  • Make it more difficult to market unhealthy food to children by ending federal tax loopholes and business costs deductions related to the advertising of such foods to young audiences.
  • Fully fund the Student Support and Academic Enrichment program and other federal programs that support student physical education.
  • Encourage safe physical activity by funding Safe Routes to Schools (SRTS), Complete Streets, Vision Zero and other pedestrian safety initiatives through federal transportation and infrastructure funding.
  • Ensure that anti-hunger and nutrition-assistance programs, like the Supplemental Nutrition Assistance Program (SNAP), WIC, and others follow the Dietary Guidelines for Americans and make access to nutritious food a core program tenet.
  • Strengthen and expand school nutrition programs beyond federal standards to include universal meals, flexible breakfasts and eliminate all unhealthy food marketing to students.
  • Enforce existing laws that direct most health insurers to cover obesity-related preventive services at no-cost sharing to patients.
  • Cover evidence-based comprehensive pediatric weight management programs and services in Medicaid.

 

State by State rates of adult obesity – highest to lowest

Tie: Mississippi and West Virginia (39.5%), 3. Arkansas (37.1%), 4. Louisiana (36.8%), 5. Kentucky (36.6%), 6. Alabama (36.2%), 7. Iowa (35.3%), 8. North Dakota (35.1%), 9. Missouri, (35.0%),  10. – Tie: Oklahoma and Texas (34.8%), 12. – Tie: Kansas and Tennessee (34.4%), 14. South Carolina (34.3 %), 15. – Tie: Indiana and Nebraska (34.1%), 17. Ohio (34.0%), 18. Delaware (33.5%), 19 – Tie: Michigan, North Carolina (33.0), 21. Georgia (32.5%), 22. New Mexico (32.3%), 23. Wisconsin (32.0%), 24. Illinois (31.8%), 25. – Tie: Maryland and Pennsylvania (30.9%), 27. Florida (30.7%), 28 – Tie: Maine and Virginia (30.4%), 30. Tie: Minnesota and South Dakota (30.1%), 32. Oregon (29.9 %), 33. New Hampshire (29.6%), 34. Three-way Tie: Alaska, Arizona and Nevada (29.5%), 37. Wyoming (29.0%), 38. Washington (28.7%), 39. Idaho (28.4%), 40. Utah (27.8%), 41. Rhode Island (27.7%), 42. New York (27.6%), 43. Vermont (27.5%), 44. Connecticut (27.4%), 45. Montana (26.9%), 46. California (25.8%), 47. – Tie: Massachusetts and New Jersey (25.7%), 49. Hawaii (24.9%), 50. District of Columbia (24.7%), 51. Colorado (23.0%).

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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. Twitter: @healthyamerica1

 

 

 

 

Tasas de obesidad en Estados Unidos con altos récords históricos

Nueve estados alcanzan tasas de obesidad en adultos superiores al 35 por ciento

El Reporte demanda por Impuestos para las Bebidas Azucaradas, Programas Ampliados de Apoyo Nutricional SNAP y WIC y un entorno que fomente la actividad física para ayudar a abordar la crisis de salud

(Washington, DC) – 12 de septiembre de 2019 – Nueve estados de EE. UU. Tenían tasas de obesidad en adultos superiores al 35 por ciento en 2018, en comparación con siete estados en ese nivel en 2017, un nivel histórico de obesidad en los EE. UU., Según el 16 ° Estado anual de Obesidad: mejores políticas para un informe más saludable de América publicado hoy por el Trust for America’s Health (TFAH).

El informe basado en parte en datos recientemente publicados del Sistema de Vigilancia del Factor de Riesgo del Comportamiento (BRFSS, por su sigla en ingles) de los Centros para el Control y la Prevención de Enfermedades, y el análisis realizado por TFAH, proporciona las tasas de obesidad anuales en todo el país. La serie El estado de la obesidad y este informe fueron posibles gracias a el financiamiento de la Fundación Robert Wood Johnson.

La obesidad tiene graves consecuencias para la salud, incluido un mayor riesgo de diabetes tipo 2, presión arterial alta, accidente cerebrovascular y muchos tipos de cáncer. Se estima que la obesidad aumenta el gasto nacional en atención médica en $ 149 billones anuales (aproximadamente la mitad de lo cual es pagado por Medicare y Medicaid) y el sobrepeso y la obesidad es la razón más común por la que los adultos jóvenes no son elegibles para el servicio militar.

Las tasas de obesidad varían considerablemente entre los estados, con Mississippi y West Virginia con el nivel más alto de obesidad en adultos en la nación con 39.5 por ciento y Colorado con la tasa más baja con 23.0 por ciento.

Por primera vez, las tasas de obesidad en adultos superaron el 35 por ciento en nueve estados en 2018: Alabama, Arkansas, Iowa, Kentucky, Louisiana, Mississippi, Missouri, Dakota del Norte y Virginia Occidental.

No muy lejos atrás en el 2012, ningún estado tenía una tasa de obesidad en adultos superior al 35 por ciento y en los últimos cinco años (2013 y 2018) 33 estados tuvieron incrementos estadísticamente significativos en sus tasas de obesidad en adultos.

“Estos últimos datos indican que nuestra crisis nacional de obesidad está empeorando”, dijo John Auerbach, presidente y director ejecutivo de Trust for America’s Health. “Nos dicen que casi 50 años después de la curva ascendente de las tasas de obesidad todavía no hemos encontrado la combinación correcta de programas para detener la epidemia”. Los programas aislados y los llamados a cambios en el estilo de vida no son suficientes. En cambio, nuestro informe destaca los cambios fundamentales que se necesitan en las condiciones sociales y económicas que hacen que sea difícil para las personas comer alimentos saludables y hacer suficiente ejercicio “.

Impacto diferencial entre las poblaciones minoritarias

El informe destaca que los niveles de obesidad están estrechamente vinculados a las condiciones socioeconómicas. Las personas con ingresos más bajos están más en riesgo. Las comunidades de color, que tienen más probabilidades de vivir en vecindarios con pocas opciones de alimentos saludables y actividad física, y que a menudo son el objetivo de una comercialización generalizada de alimentos poco saludables, también tienen un riesgo elevado.

A partir de 2015-2016, casi la mitad de los adultos latinos (47 por ciento) y los adultos negros (46.8) tenían obesidad, mientras que las tasas de obesidad entre adultos blancos y asiáticos fueron de 37.9 por ciento y 12.7 por ciento respectivamente. La incidencia de obesidad también fue más alta entre los niños latinos con un 25.8 por ciento, mientras que el 22 por ciento de los niños negros tienen obesidad, el 14 por ciento de los niños blancos tienen obesidad y el 11 por ciento de los niños asiáticos tienen obesidad.

¿Qué podría funcionar?

Si bien las tasas de obesidad son alarmantes, hay nuevos datos que ofrecen la promesa de políticas que combaten la obesidad, como promover alimentos más saludables para los niños a través de paquetes de alimentos renovados de WIC y fomentar el cambio de comportamiento a través de impuestos sobre las bebidas azucaradas.

  • Las tasas de obesidad para los niños inscritos en WIC (Programa Especial de Nutrición Suplementaria para Mujeres, Bebés y Niños) continúa disminuyendo, de 15.9 por ciento en 2010 a 13.9 por ciento en 2016. En 2009, el Departamento de Agricultura de los Estados Unidos (USDA, por su siglas en inglés) actualizó los paquetes de alimentos de WIC para cumplir más estrechamente con las recomendaciones nacionales. pautas dietéticas que incluyen la adición de más frutas, verduras y granos integrales y niveles reducidos de grasa en la leche y la fórmula infantil. Un estudio del condado de Los Ángeles publicado este año encontró que los niños de 4 años que habían recibido el paquete de alimentos WIC revisado desde su nacimiento habían reducido los riegos de padecer obesidad.
  • Varias ciudades de EE. UU. Y la Nación Navajo han aprobado impuestos locales sobre las bebidas azucaradas que se muestran prometedoras como un medio para cambiar los hábitos de bebidas de los consumidores. Los estudios de un impuesto de 1 centavo por onza en Berkeley, California y un impuesto de 1,5 centavos por onza en Filadelfia, Pensilvania, encontraron que el consumo de bebidas azucaradas disminuyó significativamente después de la imposición del impuesto.

“Políticas como estas están demostrando ser efectivas para cambiar el comportamiento. Pero, ninguna solución única, por prometedora que sea, es suficiente. La obesidad es un problema complejo y necesitará soluciones multisectoriales y multifactoriales “, dijo Auerbach de TFAH.

“Crear las condiciones que permitan a las personas tomar decisiones saludables con mayor facilidad es fundamental para prevenir la obesidad, al igual que priorizar la inversión en las comunidades más afectadas por la crisis”, dijo Auerbach.

Recomendaciones para la acción política

El informe incluye 31 recomendaciones para la acción política del gobierno federal, estatal y local, en varios sectores, diseñado para mejorar el acceso a alimentos nutritivos y proporcionar oportunidades seguras para la actividad física, al tiempo que minimiza las tácticas perjudiciales de marketing y publicidad.

Entre las recomendaciones del informe para las políticas para abordar la crisis de obesidad están:

  • Ampliar el Programa Especial de Nutrición Suplementaria para Mujeres, Bebés y Niños (WIC) a los 6 años para niños y durante dos años después del parto para las madres y financiar completamente el Programa de Orientación de Pares de WIC para la lactancia materna.
  • Aumentar el precio de las bebidas azucaradas mediante impuestos especiales y utilizar los ingresos para abordar las disparidades socioeconómicas y de salud.
  • Asegurarse de que los CDC tengan los recursos suficientes para otorgar a cada estado fondos apropiados para implementar estrategias de prevención de la obesidad basadas en evidencia (actualmente, los CDC solo tienen fondos suficientes para trabajar con 16 estados).
  • Hacer que sea más difícil comercializar alimentos no saludables para los niños al poner fin a los vacíos fiscales federales y las deducciones de costos comerciales relacionados con la publicidad de dichos alimentos para el público joven.
  • Financiar completamente el programa de Apoyo al Estudiante y Enriquecimiento Académico y otros programas federales que apoyan la educación física del estudiante.
  • Fomentar la actividad física segura mediante la financiación de Rutas Seguras a las Escuelas (SRTS), Complete Streets, Vision Zero y otras iniciativas de seguridad para peatones a través de fondos federales de infraestructura y transporte.
  • Asegurar de que los programas contra el hambre y la asistencia nutricional, como el Programa de Nutrición Suplementaria (SNAP), WIC y otros, sigan las Pautas dietéticas para estadounidenses y hagan del acceso a alimentos nutritivos un principio básico del programa.
  • Fortalecer y expandir los programas de nutrición escolar más allá de los estándares federales para incluir comidas universales, desayunos flexibles y eliminar todo el mercadeo de alimentos poco saludables para los estudiantes.
  • Hacer cumplir las leyes existentes que ordenan a la mayoría de las aseguradoras de salud que cubran los servicios preventivos relacionados con la obesidad sin costo compartido para los pacientes.
  • Cubrir el manejo del programa integral del peso pediátrico basado en evidencia y servicios en Medicaid.

Tasas de obesidad adulta por estado, de mayor a menor:

1. (Empatados): Mississippi and Virginia Occidental (39.5%), Arkansas (37.1%), 4. Louisiana (36.8%), 5. Kentucky (36.6%), 6. Alabama (36.2%), 7. Iowa (35.3%), 8. Dakota del Norte (35.1%), 9. Missouri, (35.0%), 10. – Empatados: Oklahoma and Texas (34.8%), 12. – Empatados: Kansas and Tennessee (34.4%), 14.  Carolina del Sur (34.3 %), 15. – : Indiana and Nebraska (34.1%), 17. Ohio (34.0%), 18. Delaware (33.5%), 19 – Empatados: Michigan, Carolina del Norte (33.0), 21. Georgia (32.5%), 22. Nuevo Mexico (32.3%), 23. Wisconsin (32.0%), 24. Illinois (31.8%), 25. – Empatados: Maryland and Pennsylvania (30.9%), 27. Florida (30.7%), 28 – Empatados: Maine and Virginia (30.4%), 30. Empatados: Minnesota and Dakota del Sur (30.1%), 32. Oregon (29.9 %), 33. New Hampshire (29.6%), 34. Empatados: Alaska, Arizona and Nevada (29.5%), 37. Wyoming (29.0%), 38. Washington (28.7%), 39. Idaho (28.4%), 40. Utah (27.8%), 41. Rhode Island (27.7%), 42. Nueva York (27.6%), 43. Vermont (27.5%), 44. Connecticut (27.4%), 45. Montana (26.9%), 46. California (25.8%), 47. – Empatados: Massachusetts and Nueva Jersey (25.7%), 49. Hawaii (24.9%), 50. Districto de Columbia (24.7%), 51. Colorado (23.0%).

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Trust for America’s Health es una organización sin fines de lucro y no partidista que promueve la salud óptima para cada persona y comunidad y hace de la prevención de enfermedades una prioridad nacional. WWW.tfah.org