State Category: Montana

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

 

Half of States Scored 5 or Lower Out of 10 Indicators in Report on Health Emergency Preparedness

Report Finds Funding to Support Base Level of Preparedness Cut More than Half Since 2002

 

Washington, D.C., December 19, 2017 – In Ready or Not? Protecting the Public’s Health from Diseases, Disasters and Bioterrorism, 25 states scored a 5 or lower on 10 key indicators of public health preparedness. Alaska scored lowest at 2 out of 10, and Massachusetts and Rhode Island scored the highest at 9 out of 10.

The report, issued today by the Trust for America’s Health (TFAH), found the country does not invest enough to maintain strong, basic core capabilities for health security readiness and, instead, is in a continued state of inefficiently reacting with federal emergency supplemental funding packages each time a disaster strikes.

According to Ready or Not?, federal funding to support the base level of preparedness has been cut by more than half since 2002, which has eroded advancements and reduced the country’s capabilities.

“While we’ve seen great public health preparedness advances, often at the state and community level, progress is continually stilted, halted and uneven,” said John Auerbach, president and CEO of TFAH.  “As a nation, we—year after year—fail to fully support public health and preparedness. If we don’t improve our baseline funding and capabilities, we’ll continue to be caught completely off-guard when hurricanes, wildfires and infectious disease outbreaks hit.”

Ready or Not? features six expert commentaries from public health officials who share perspectives on and experiences from the historic hurricanes, wildfires and other events of 2017, including from California, Florida, Louisiana and Texas.

The report also examines the nation’s ability to respond to public health emergencies, tracks progress and vulnerabilities, and includes a review of state and federal public health preparedness policies. Some key findings include:

  • Just 19 states and Washington, D.C. increased or maintained funding for public health from Fiscal Year (FY) 2015-2016 to FY 2016-2017.
  • The primary source for state and local preparedness for health emergencies has been cut by about one-third (from $940 million in FY 2002 to $667 million in FY 2017) and hospital emergency preparedness funds have been cut in half ($514 million in FY 2003 to $254 million in FY 2017).
  • In 20 states and Washington, D.C. 70 percent or more of hospitals reported meeting Antibiotic Stewardship Program core elements in 2016.
  • Just 20 states vaccinated at least half of their population (ages 6 months and older) for the seasonal flu from Fall 2016 to Spring 2017—and no state was above 56 percent.
  • 47 state labs and Washington, D.C. provided biosafety training and/or provided information about biosafety training courses (July 1, 2016 to June 30, 2017).

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

  • Communities should maintain a key set of foundational capabilities and focus on performance outcomes in exchange for increased flexibility and reduced bureaucracy.
  • Ensuring stable, sufficient health emergency preparedness funding to maintain a standing set of core capabilities so they are ready when needed. In addition, a complementary Public Health Emergency Fund is needed to provide immediate surge funding for specific action for major emerging threats.
  • Strengthening and maintaining consistent support for global health security as an effective strategy for preventing and controlling health crises. Germs know no borders.
  • Innovating and modernizing infrastructure needs – including a more focused investment strategy to support science and technology upgrades that leverage recent breakthroughs and hold the promise of transforming the nation’s ability to promptly detect and contain disease outbreaks and respond to other health emergencies.
  • Recruiting and training a next generation public health workforce with expert scientific abilities to harness and use technological advances along with critical thinking and management skills to serve as Chief Health Strategist for a community.
  • Reconsidering health system preparedness for new threats and mass outbreaks.  Develop stronger coalitions and partnerships among providers, hospitals and healthcare facilities, insurance providers, pharmaceutical and health equipment businesses, emergency management and public health agencies.
  • Preventing the negative health consequences of climate change and weather-related threats. It is essential to build the capacity to anticipate, plan for and respond to climate-related events.
  • Prioritizing efforts to address one of the most serious threats to human health by expanding efforts to stop superbugs and antibiotic resistance. 
  • Improving rates of vaccinations for children and adults – which are one of the most effective public health tools against many infectious diseases.
  • Supporting a culture of resilience so all communities are better prepared to cope with and recover from emergencies, particularly focusing on those who are most vulnerable.   Sometimes the aftermath of an emergency situation may be more harmful than the initial event.  This must also include support for local organizations and small businesses to prepare for and to respond to emergencies.

The report was supported by a grant from the Robert Wood Johnson Foundation (RWJF).

Score Summary: 

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

9 out of 10: Massachusetts and Rhode Island

8 out of 10: Delaware, North Carolina and Virginia

7 out of 10: Arizona, Colorado, Connecticut, Hawaii, Minnesota, New York, Oregon and Washington

6 out of 10: California, District of Columbia, Florida, Illinois, Maryland, Nebraska, New Jersey, North Dakota, South Carolina, South Dakota, Utah, Vermont and West Virginia

5 out of 10: Georgia, Idaho, Maine, Mississippi, Montana and Tennessee

4 out of 10: Alabama, Arkansas, Iowa, Louisiana, Missouri, New Hampshire, Oklahoma and Pennsylvania

3 out of 10: Indiana, Kansas, Kentucky, Michigan, Nevada, New Mexico, Ohio, Texas, Wisconsin and Wyoming

2 out of 10: Alaska

 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.

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New Report Finds Adult Obesity Rates Decreased in Four States

Obesity Rates Remain High: 25 States have Adult Obesity Rates above 30 Percent

 

Washington, D.C., September 1, 2016 – U.S. adult obesity rates decreased in four states (Minnesota, Montana, New York and Ohio), increased in two (Kansas and Kentucky) and remained stable in the rest, between 2014 and 2015, according to The State of Obesity: Better Policies for a Healthier America, a report from the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF). This marks the first time in the past decade that any states have experienced decreases – aside from a decline in Washington, D.C. in 2010.

Despite these modest gains, obesity continued to put millions of Americans at increased risk for a range of chronic diseases, such as diabetes and heart disease, and costs the country between $147 billion and $210 billion each year.

In 2015, Louisiana has the highest adult obesity rate at 36.2 percent and Colorado has the lowest at 20.2 percent. While rates remained steady for most states, they are still high across the board. The 13th annual report found that rates of obesity now exceed 35 percent in four states, are at or above 30 percent in 25 states and are above 20 percent in all states. In 1991, no state had a rate above 20 percent.  The analyses are based on the U.S. Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System (BRFSS).

The State of Obesity also found that:

  • 9 of the 11 states with the highest obesity rates are in the South and 22 of the 25 states with the highest rates of obesity are in the South and Midwest.
  • 10 of the 12 states with the highest rates of diabetes are in the South.
  • American Indian/Alaska Natives have an adult obesity rate of 42.3 percent.
  • Adult obesity rates are at or above 40 percent for Blacks in 14 states.
  • Adult obesity rates are at or above 30 percent in: 40 states and Washington, D.C. for Blacks; 29 states for Latinos; and 16 states for Whites.

There is some evidence that the rate of increase has been slowing over the past decade.  For instance, in 2005, 49 states experienced an increase; in 2008, 37 states did; in 2010, 28 states did; in 2011, 16 states did; in 2012, only one state did; and in 2014, only two states did. (Note: the methodology for BRFSS changed in 2011).

In addition, recent national data show that childhood obesity rates have stabilized at 17 percent over the past decade. Rates are declining among 2- to 5-year-olds, stable among 6- to 11-year-olds, and increasing among 12- to 19-year-olds. There are significant racial and ethnic inequities, with rates higher among Latino (21.9 percent) and Black (19.5 percent) children than among White (14.7 percent) children.

“Obesity remains one of the most significant epidemics our country has faced, contributing to millions of preventable illnesses and billions of dollars in avoidable healthcare costs,” said Richard Hamburg, interim president and CEO, TFAH. “These new data suggest that we are making some progress but there’s more yet to do. Across the country, we need to fully adopt the high-impact strategies recommended by numerous experts. Improving nutrition and increasing activity in early childhood, making healthy choices easier in people’s daily lives and targeting the startling inequities are all key approaches we need to ramp up.”

Some other findings from the report include:

  • The number of high school students who drink one or more soda a day has dropped by nearly 40 percent since 2007, to around one in five (20.4 percent) (note: does not include sport/energy drinks, diet sodas or water with added sugars).
  • The number of high school students who report playing video or computer games three or more hours a day has increased more than 88 percent since 2003 (from 22.1 to 41.7 percent).
  • More than 29 million children live in “food deserts,” and more than 15 million children live in “food-insecure” households with not enough to eat and limited access to healthy food.
  • The federal government has provided more than $90 million via 44 Healthy Food Financing Initiative awards in 29 states since 2011, helping leverage more than $1 billion and create 2,500 jobs.
  • Farm-to-School programs now serve more than 42 percent of schools and 23.6 million children.
  • 18 states and Washington, D.C. require a minimum amount of time that elementary students must participate in physical education; 14 states and Washington, D.C. require a minimum amount for middle schoolers; and six states require a minimum amount for high schoolers.

The report also includes a set of priority policy recommendations to accelerate progress in addressing obesity:

  • Invest in Obesity Prevention: Providing adequate funding for the Prevention and Public Health Fund and for the Centers for Disease Control and Prevention’s National Center for Chronic Disease Prevention and Health Promotion/Division of Nutrition, Physical Activity, and Obesity would increase support to state and local health departments.
  • Focus on Early Childhood Policies and Programs: Supporting better health among young children through healthier meals, physical activity, limiting screen time and connecting families to community services through Head Start; prioritizing early childhood education opportunities under the Every Student Succeeds Act (ESSA); and implementing the updated nutrition standards covering the Child and Adult Care Food Program.
  • School-Based Policies and Programs: Continuing implementation of the final “Smart Snacks” rule for improved nutrition for snacks and beverages sold in schools; eliminating in-school marketing of foods that do not meet Smart Snacks nutrition standards; and leveraging opportunities to support health, physical education and activity under ESSA.
  • Community-Based Policies and Programs: Prioritizing health in transportation planning to help communities ensure residents have access to walking, biking, and other forms of active transportation and promoting innovative strategies, such as tax credits, zoning incentives, grants, low-interest loans and public-private partnerships to increase access to healthy, affordable foods.
  • Health, Healthcare and Obesity: Covering the full range of obesity prevention, treatment and management services under all public and private health plans, including nutrition counseling, medications and behavioral health consultation, along with encouraging an uptake in services for all eligible beneficiaries.

“This year’s State of Obesity report is an urgent call to action for government, industry, healthcare, schools, child care and families around the country to join in the effort to provide a brighter, healthier future for our children. It focuses on important lessons and signs of progress, but those efforts must be significantly scaled to see a bigger turn around,” said Risa Lavizzo-Mourey, president and CEO of RWJF. “Together, we can build an inclusive Culture of Health and ensure that all children and families live healthy lives.”

The State of Obesity report (formerly known as F as in Fat), with state rankings and interactive maps, charts and graphs, is available at http://stateofobesity.org. Follow the conversation at #StateofObesity.

2015 STATE-BY-STATE ADULT OBESITY RATES

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

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

1. Louisiana (36.2); 2. (tie) Alabama (35.6), Mississippi (35.6) and West Virginia (35.6); 5. Kentucky (34.6); 6. Arkansas (34.5); 7. Kansas (34.2); 8. Oklahoma (33.9); 9. Tennessee (33.8); 10. (tie) Missouri (32.4) and Texas (32.4); 12. Iowa (32.1); 13. South Carolina (31.7); 14. Nebraska (31.4); 15. Indiana (31.3); 16. Michigan (31.2); 17. North Dakota (31.0); 18. Illinois (30.8); 19. (tie) Georgia (30.7) and Wisconsin (30.7); 21. South Dakota (30.4); 22. (tie) North Carolina (30.1) and Oregon (30.1); 24. (tie) Maine (30.0) and Pennsylvania (30.0); 26. (tie) Alaska (29.8) and Ohio (29.8); 28. Delaware (29.7); 29. Virginia (29.2); 30. Wyoming (29.0); 31. Maryland (28.9); 32. New Mexico (28.8); 33. Idaho (28.6); 34. Arizona (28.4); 35. Florida (26.8); 36. Nevada (26.7); 37. Washington (26.4); 38. New Hampshire (26.3); 39. Minnesota (26.1); 40. Rhode Island (26.0); 41. New Jersey (25.6); 42. Connecticut (25.3); 43. Vermont (25.1); 44. New York (25.0); 45. Utah (24.5); 46. Massachusetts (24.3); 47. California (24.2); 48. Montana (23.6); 49. Hawaii (22.7); 50. District of Columbia (22.1); 51. Colorado (20.2).

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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. 

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A Menu Approach to Public Health: Empowering People to Take Responsibility for their Health Choices

By Tracy Neary, Director of Mission Outreach and Community Benefit, St. Vincent Healthcare

 

For nearly twenty years, St. Vincent Healthcare, a care site operated by the Sisters of Charity of Leavenworth Health System (SCL Health System), the Billings Health Clinic and RiverStone Health, our local health department, have been working together to address complex community wide health issues by adopting intervention strategies identified through a recurring CHNA.

A significant early collaboration came in 1994 when the CHNA showed access to prescription medications was a major issue for our community. We created a medication assistance program (MAP) that helped patients who couldn’t afford prescriptions obtain them.

Last year, MAP advocates, funded in part by St. Vincent Healthcare, assisted approximately 1,200 people with accessing medication worth more than four million dollars. What began as a single access point has expanded to a dozen locations across our community.

The initial collaboration, which began in the early 1990s, between the three organizations became more formal with a Memorandum of Understanding in 2001 to create “The Alliance”. Chief executives of our two competing hospitals and the public health department committed organizational expertise in planning, communication, advocacy, community benefit and clinical services to help lead community efforts to improve health.

Through a CHNA, we found there was a significant need for mental health services, as hospital emergency departments were being inundated with people who didn’t really need medical care but were admitted because of a mental health crisis. Knowing that emergency rooms are not typically the best place for mental health interventions, we created a joint partnership with the two hospitals to build the Community Crisis Center (CCC), the first licensed out-patient crisis management program in Montana.

Now, the CCC is staffed 24 hours per day, seven days per week with a combination of registered nurses, licensed mental health therapists, and mental health technicians. During an outpatient visit, clients are stabilized and assessed to facilitate the development of a crisis management plan.

The CCC has successfully reduced inappropriate utilization of local emergency departments, decreased the number of short-term inpatient hospital admissions, and has been a driving force in reducing the inmate population at the Yellowstone County Detention Facility.

Additionally, the CCC offers crisis intervention training to law enforcement officers in the region. Officers learn how to recognize mental health distress and de-escalate individuals rather than interacting with people in a way that escalates anxiety. Law enforcement officers credit the training with helping them more effectively respond to situations involving individuals with mental health disorders, especially those in suicidal situations.

One of our crisis intervention program officers, off duty at the time, was driving across a bridge and a man was on it threatening suicide. The officer was able to talk the person down without anyone getting hurt.

This is one example of how a community program has a wide-reaching public health benefit. Instead of the individual hurting himself and/or others, no one was hurt and the appropriate part of our community’s medical system (the mental health portion versus an emergency department) was involved.

In 2005, RiverStone Health underwent an assessment of the public health system’s performance in the 10 Essential Public Health Services established by CDC. The assessment was conducted using the National Public Health Performance Standards Program (NPHPSP), also established by the CDC. A key outcome of that assessment was an understanding of the need to perform a community health assessment and develop a community plan. The Alliance then sponsored the 2006 CHNA where childhood and adult obesity, heart disease, diabetes, nutritional intake, unintentional injury, and chronic depression were identified areas of weakness. Physical activity, nutrition, and well-being were selected as the areas of improvement because of their inter-connectedness and their collective benefit on our community’s health. The results moved us to thinking about longer term population health improvements through policy, system and environmental change strategies. We began by creating an operational work plan, “The PITCH.” The Plan to Improve the Community’s Health (PITCH) focuses on physical activity, nutrition, and well-being. PITCH is intended to increase awareness and knowledge of, as well as access to, healthier lifestyles in Yellowstone County.

This plan was developed with a broad variety of community stakeholders who participate in achieving the identified goals as part of a broad coalition. With the support of the Robert Wood Johnson Foundation, one of the most impactful early Health Impact Assessments (HIA) we completed was with our city/county master growth plan. Results of the HIA led to the adoption of a new health section within the plan in 2008, which set the foundation for later success in adopting a complete streets policy for Billings. This accomplishment was supported in large part by our work with Action Communities for Health, Innovation, and EnVironmental ChangE (ACHIEVE).

As one of the ten original participants in the Healthy Weight Collaborative, a project of the National Initiative for Children’s Healthcare Quality (NICHQ) and HRSA, we partnered with primary care providers to better document body mass index (BMI) in medical records and, if a BMI was too high, offer a patient-directed healthy weight plan. The efforts have created new collaboration between providers and community organizations.

The partnership has also launched an effort into the worksite by developing physical activity and nutrition guidelines. We found that it is important to create a menu approach of evidenced-based practices that have been shown to increase physical activity (i.e., promoting use of stairwells, on-site exercise classes, etc.). The menu option allows businesses to pick and choose which policies are appropriate in their environment and also empowers employers. A similar project, the “Healthy By Design” (HBD)  endorsement, was developed as a way of promoting events in Billings that are designed with health in mind. This endorsement is done through an application process and each application is reviewed and evaluated by a team of experts. There are five criteria: safety; nutrition; physical activity; prevention and wellness; and environmental stewardship.

As we look to the future and our interconnected health system, we see a community that is Healthy By Design with active people working to improve their own health and the health of those around them. It is a dream we plan to realize by continuing our work to identify unmet health needs and leading efforts to coordinate a community based response. We recognize the critical importance of key stakeholders in economic development, private business, city government, education, strategic planners in addition to traditional health partners. Our website, www.healthybydesginyellowstone.org includes our CHNA, work plans, accomplishments and a variety of tools we have developed to achieve our vision.