The State of Obesity 2015 Better Policies for a Healthier America

The State of Obesity 2015 Better Policies for a Healthier America

The State of Obesity 2016 Better Policies for a Healthier America Southern Obesity Summit November 14, 2016 Richard Hamburg Interim President and CEO Overview For first time, documented decreases in adult rates Significant disparities persist Prevention is key - It is easier to prevent in children than reverse trends later. Future progress will require we examine which state programs are working and bring these efforts to scale nationwide. Adult Obesity Rates (2015) States With The Highest Obesity Rates 9 of the 10 states with the highest rates of adult obesity are in

the South. The South and Obesity State Obesity Rate State Ranking Diabetes Rate State Ranking Hypertension Rate State Ranking Physical Inactivity State Ranking AL 35.6% 2 13.5% 3 40.4% 3 31.9% 5

AR 34.5% 6 12.6% 7 39.3% 4 34.2% 2 FL 26.8% 35 11.3% 15

33.5% 16 26.2% 24 GA 30.7% 19 11.3% 15 36.2% 9 27.3% 15 KY

34.6% 5 13.4% 4 39.0% 6 32.5% 4 LA 36.2% 1 12.7% 5 39.3%

4 31.9% 5 MS 35.6% 2 14.7% 1 42.4% 2 36.8% 1 MO 32.4%

10 11.5% 10 34.1% 14 27.0% 17 NM 28.8% 32 11.5% 10 30.0% 33

22.6% 36 NC 30.1% 22 10.7% 18 35.2% 11 26.2% 24 OK 33.9% 8

11.7% 9 36.2% 9 33.2% 3 SC 31.7% 13 11.8% 8 37.8% 8 26.7%

20 TN 33.8% 9 12.7% 5 38.5% 7 30.4% 8 TX 32.4% 10 11.4%

13 29.5% 40 29.5% 9 VA 29.2% 29 10.3% 22 33.2% 17 25.1% 29

WV 35.6% 2 14.5% 2 42.7% 1 30.8% 7 Persisting Disparities in 2015 data States with highest rates are in the South and Midwest Highest obesity rates are among Black adults (48.4%) Black woman are twice as likely to be severely obese as white

women Childhood Obesity Trends Over the last decade, childhood obesity rates have remained around 17% Being overweight or obese puts children at higher risk for health problems such as heart disease, hypertension, diabetes, stroke, cancer, asthma and osteoarthritis during childhood and as they age Diabetes and Obesity Type 2 Diabetes rates nearly doubled in the past 20 years 10 of the 12 states with highest type 2 diabetes rates are in the South Hypertension and Obesity The top 10 states with the highest rates of hypertension are in the South Poor Health, Increased Care Spending

Current rates put 78 million Americans at increased risk of health problems Cardiovascular disease, diabetes, cancer, arthritis and many more Obese adults spend 42 percent more on direct healthcare costs Income, Education Effects More than 33% of adults who earn less than $15,000 per year are obese 33% of adults who dont finish high school are obese Compared with 24.6 percent of those who earn at least $50,000. Versus obesity rate of 21.5 percent of those who finish college or technical college

Protective effect of education extends to their children Low Income Students in the South 51 % of U.S. public school students are from low income families and are eligible for free or reduced-price meals. 57 % of students in the South are low-income. 13 of 15 Southern states have rates above 50 %. Why are we still concerned?

Despite signs of stabilizing, rates are dangerously high Obesity increases the risk for dozens of health comorbidities Baby Boomers coming on to Medicare will further exacerbate our long-term fiscal outlook Obesity carries national security risks. It has negative implications for the education, agricultural, and transportation sectors. Public health and prevention funding remains inadequate. Total federal funding for CDC chronic disease prevention activities is about $1.2 billion. Bringing Initial Steps to Scale Obesity prevention should be considered a major priority for reducing related health care spending and overall health care costs Community-based,

comprehensive approaches (like CDC chronic disease prevention programs) seem to work best. ROI is critical. Bringing Initial Steps to Scale Addressing primary risk factors Broad, sustainable funding of evidence-based interventions, environmental, and systems changes Poor Nutrition Inadequate Physical Activity Investments in Partnerships to Improve Community Healthwill not reach all Americans. Funding is in danger for FY 2017. Expanded diabetes and heart disease funding

Connecting all Americans to preventive services and a variety of treatments Overall Policy Recommendations Invest in Obesity Prevention Focus on Childhood Policies and Programs School-based Policies and Programs Community-Based Policies and Programs Health, Healthcare and Obesity Systematic Federal Review 2016 report reviews federal policies and programs in

four key areas and offers recommendations: Early Childhood School Aged Children and Teens Community Programs Healthcare and Health Policies Early Childhood Successes U.S. Department of Agriculture issued updated nutrition standards for the Child and Adult Care Food Program Head Start standards revised WIC clinics in all 50 states provide nutritious foods, nutrition education, breastfeeding promotion and other support services to

participants, at no charge. School-Aged Children and Teen Successes The Every Student Succeeds Act (ESSA) creates a Student Support and Academic Enrichment Grant Program Safe Routes to Schools programs operate in all 50 states, benefiting close to 15,000 schools. Taylor, TX: Public meetings key to sidewalk project success Baton Rouge, Louisiana: Walk This Way Community Program Successes

REACH (Racial and Ethnic Approaches to Community Health) awards 49 grants for culturally-tailored, evidence-based strategies to reduce health inequities at the community level. USDA final rule, July 2016 Led 11 states, and Washington D.C to establish policies addressing marketing of unhealthy foods. NM Presbyterian Healthcare Service (Bernalillo County) AR University of Arkansas for Medical Sciences (Benton and Washington Counties) TN Meharry Medical College (City of Nashville) (AL, MS, OK, WV) Food and Drug Administration updated the Nutrition Fact Panel National Diabetes Prevention Program (DPP)

Year-long program offered by over 625 organizations, nationally Combines medical care with health coaches and group counseling DPP has cut participants risk of type 2 diabetes by 58% CMS supports DPP among 10,000 Medicare beneficiaries with prediabetes National Diabetes Prevention Program - ROI The Y-USA received a CMS Health Care Innovation Grant to test DPP (2013)

From 1996-2001 DPP was a clinical trial (1996-2001) End-of-Study follow up showed diabetes incidence reduced by 58% in the intervention group compared to placebo March, 2016 CMS Certifies DPP as saving $2,650 per participant in the first 5 quarters of the program Healthcare and Health Policy Successes The 2014 Farm Bill established a permanent federal Healthy Food Financing Initiative at USDA, authorized at $125 million. 29 states have received grants to help eliminate food deserts (AL, FL, KY, NM, NC, SC, TN, TX,VA, WV) 29 States have legislation that requires BMI screening or other weight-related assessments (AL, AR, FL, KY, LA, MO, MS, NC,

NM, OK, SC, TN, TX, WV) Progress at the State Level Many states have physical education requirements for students - 18 states require schools to provide physical activity or recess during the school day. (AR, KY, LA, MS, MO, NC, OK, SC, TN, TX, VA, WV) 36 States have laws supporting shared use of facilities. (AL, AR, GA, KY, LA, MS, MO, NM, NC, OK, TN, TX) 40 States have enacted farm-to-school programs Medicaid Coverage for Obesity Prevention

Nutrition States covering one of more service - AL, AR, FL, NC, SC, WV States covering no services - GA, KY, LA, MS, MO, NM, OK, TX, VA States covering all nutritional consults - KY, LA, OK, NM States covering at least one consult service - NC, SC, VA, WV States covering no consult services - AL, AR, FL, GA, MS, MO, TX Disease Management States covering at least one consult service OK, SC, TX, WV States covering no consult services AL, AR, FL, GA, KY, LA, MS, MO, NM, NC, VA Medicaid Coverage for Obesity cont.

Behavioral Consultation Pharmaceuticals States covering all behavioral consults - LA, OK, TX, VA States covering at least one consult service KY, NM, NC, SC States covering no consult services - AL, AR, FL, GA, MS, MO, WV States covering obesity drugs AR, VA States covering only lipase inhibitors AL, LA, SC States covering no obesity drugs FL, GA, KY, MS, MO, NM, NC, OK, TN, TX, WV Bariatric Surgery States covering bariatric surgery AL, AR, FL, GA, KY, LA, MO, NM, NC, OK,

SC, TN, TX, VA, WV States not covering bariatric surgery - MS Signs of Progress Cherokee County, SC Seminole County, FL Making healthy choices accessible, affordable and the norm Innovative partnerships contributing to a Community of Health Granville and Vance Counties, NC Combining many small-scale efforts to collectively make a

difference For Further Information The full text of The State of Obesity and many other interactive features are available at: Please contact Rich Hamburg, Interim President and CEO, [email protected] if you have any further questions

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