Nolan VA Obesity

Obesity: States Working to Slow the Epidemic: 

Obesity: States Working to Slow the Epidemic Kathleen Nolan Health Division Director National Governors Association Center for Best Practices

Obesity Epidemic: 

Obesity Epidemic Rates of obesity have risen in every state and in every sub-group. In children In adults In minorities In elderly Increased obesity results in increases in diabetes, heart diseases, some cancer, and arthritis

Slide3: 

Source: Behavioral Risk Factor Surveillance System, CDC. 1996 2003 Obesity Trends* Among U.S. Adults BRFSS, 1991, 1996, 2003 No Data andlt;10% 10%-14% 15%-19% 20%-24%  25% (*BMI 30, or about 30 lbs overweight for 5’4' person)

Obesity in Children: 

Obesity in Children

If We Don’t Make Change: 

If We Don’t Make Change Overweight children often become overweight adults. The risk for developing diabetes for children born in 2000: Boys 32.8% Girls 38.5% Hispanic boys 45.4% Hispanic girls 52.5%

Virginia versus US: 

Virginia versus US Overall Virginia is far from the worst: 58.8% of VA’s adults are overweight (58.7%--US) 72% of adults report eating fewer than 5 servings of fruits/veggies a day (76%--US) Deaths due to diabetes and heart disease in VA are slightly lower than the national averages.

The National Costs of Obesity: 

The National Costs of Obesity It is estimated that overweight and obesity costs the United States as much as $117 billion dollars each year $61 billion in direct costs $56 billion for indirect costs Virginia annually spends an estimated $374 million (13.1%) of its Medicaid dollars on obesity related costs. Obese people cost 36% more for health svcs and 77% more for pharmaceuticals.

Why States Must Act: 

Why States Must Act Costs for health care rising Responsibility for public employees Private sector investment slowed or damaged Communities, Schools, health care providers, and agencies overburdened STRATEGIC ACTION REQUIRED ON ALL FRONTS

Ways to think of this issue: 

Ways to think of this issue The Individual needs to eat less and exercise more We in Government need to help them Focus on policy—make it easier for people to do this Focus on the environment Focus on support Focus on systems Focus on data

Opportunities for Prevention with Children: 

Opportunities for Prevention with Children Implementing enhanced Phys. Educ. Promoting breast-feeding Reducing television time Improving school-nutrition and nutrition education Increasing after-school programs and access to school facilities after hours

Opportunities for Prevention with All Virginians: 

Opportunities for Prevention with All Virginians Community/State-wide education campaigns Promoting the use of stairs in the workplace and in public spaces Support groups and tailored programs Disease management with a focus on weight control Provide opportunities in the community for physical activity

Arkansas: 

Arkansas Multi-pronged approach launched by Gov. Mike Huckabee Children in schools Medicaid population focus Adults in the workplace Aging citizens

AR Innovations with Children: 

AR Innovations with Children BMI assessment in schools Year 1 results: 345,000 students assessed throughout the state 38 percent were obese or overweight Demographic breakdown of obesity/overweight: 40 percent of African American children 46 percent of Hispanic children 36percent of white (non-Hispanic) children

AR Innovations with Medicaid Recipients: 

AR Innovations with Medicaid Recipients Offers comprehensive smoking cessation services Worked with major company in state to pilot a diabetes self-management course including weight control Developing a health risk assessment to identify people in need of intervention to prevent chronic diseases

AR Innovations with Adults: 

AR Innovations with Adults Developed a program with state employees Working closely with communities and private companies to promote worksite wellness programs with employees from public and private sector Exploring implementation of incentives for healthy behaviors for insurance costs.

AR Innovations for the Aging: 

AR Innovations for the Aging Gov. Huckabee is focusing on pilot programs to reach aging populations with healthy behavior education and messages. Identifying opportunities for improving nutrition among aging populations in the community.

Michigan’s Prescription for Health: 

Michigan’s Prescription for Health Gov. Jennifer Granholm appointed the nation’s first State Surgeon General Dr. Wisdom is charged with monitoring the health of Michiganders, and for promoting improved health. Serves as a convener for a broad number of stakeholders Developed a state-wide walking campaign

Florida: 

Florida Gov. Bush formed a task force on Obesity A list of recommendations were forwarded to the Governor, and served as a basis for several bills: Called for the creation of standards and guidelines for school nutrition and phys ed Created a wellness program for state employees

A few additional examples: 

A few additional examples Texas Dept of Ag requirements for school lunches CDC stairwell improvement project Promoting stairwell use with music, art, etc. California soda ban in schools No soft drink sales allowed on campuses (vending or a la carte)

So what can VA do: 

So what can VA do NGA’s Suggestions: Educate people on the reasons and the how’s to eat better and be active Improve phys educe. Strategize with partners from food and fitness industries Regulate access to junk foods and sodas in schools Consider coverage enhancements for health insurance recipients

Things VA can do: 

Things VA can do NGA’s Suggestions (cont’d): Gather economic impact and demographic data and use in setting priorities. Work with medical groups, charitable organizations, churches, and others to provide services for Virginians at high-risk for obesity. Partner with state and local agencies to promote healthy community design. Use the bully-pulpit at all levels. Challenge private sector efforts to mobilize response to obesity epidemic

Some other things to think about: 

Some other things to think about The evidence base: Guide to community preventive services Centers for Disease Control Other states and community connections Planning/strategy—breadth of issues Support communities/pilot projects Empowerment to eat less and exercise more