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State Actions on Childhood Overweight and Obesity– Update for 2005 By Amy Winterfeld, JD Program Principal Health Program National Conference of State Legislatures amy.winterfeld@ncsl.org. Obesity – Fast Facts. Obesity is epidemic in the U.S. and cost $117 billion in 2000.
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State Actions on Childhood Overweight and Obesity– Update for 2005 By Amy Winterfeld, JD Program Principal Health Program National Conference of State Legislatures amy.winterfeld@ncsl.org
Obesity – Fast Facts • Obesity is epidemic in the U.S. and cost $117 billion in 2000. • Obesity increased 60 percent among U.S. adults in the last 10 years. • 59 million U.S. adults are obese. • Obesity-associated chronic diseases – heart disease, some cancers, stroke, diabetes – are the 1st, 2nd, 3rd, & 6th leading U.S. causes of death.
Obesity & Children’s Health • 16 percent of U.S. children and adolescents age 6-19 are overweight (9 million children). • Since 1980, obesity has doubled for children and tripled for adolescents. • The number of children diagnosed with type 2 diabetes (formerly “adult onset diabetes”) has increased. • Other health consequences of obesity for children may include:
Obesity – Factors Driving Policy • Obesity-attributable U. S. medical expenses were estimated at $75 billion for 2003. • Taxpayers fund about half of this through Medicare and Medicaid. • Healthy eating and a physically active lifestyle can help children and adults achieve and maintain a healthy weight and may reduce or prevent obesity-related medical costs and chronic diseases.
State Medical Obesity Costs in Millions of Dollars Source: Obesity Research, Volume 12, No. 1, January 2004
Obesity – Legislative Responses • Nutrition Topics • Nutrition Standards in Schools • Nutrition Education • Measurement of Student Body Mass Index (Arkansas enacted in 2003) • Nutrition Menu Information for School Foods • Taxes on Foods or Beverages with Minimal Nutritional Value
Obesity – Legislative Responses • Physical Activity Topics • Physical Education or Physical Activity in Schools • Walkable communities - city planning, transportation • Safe routes to school • Partnerships with businesses to increase physical activity and healthy eating at workplaces
Obesity – Legislative Responses • General Obesity-Related Legislation • Diabetes Screening and Management • Insurance Coverage for Obesity Prevention and Treatment • School Wellness Policies • Obesity Task Forces, Commissions, or Studies • Raising Awareness • Limitations on Lawsuits Against the Food Industry
Nutrition Standards in Schools • 38 statesconsidered or enactedschool nutrition legislation in 2005. This includes: • 15states that enacted school nutrition legislation in 2005: AZ, AR, CO, IL, KS, KY, LA, ME, MD, NM, OK, RI, SC, TX and WV. In UT a resolution encouraging passed the legislature and was sent to the lieutenant governor. • 21 states that are considering or have considered school nutrition legislation in 2005: AL, AK, CA, HI, IN, IA, MA, MO, MS, MT, NE, NH, NJ, NY, NC, ND, OH, OR, PA,TN and VA. Information is updated periodically on the NCSL web site at: http://www.ncsl.org/programs/health/ChildhoodObesity-2005.htm
Nutrition Standards Enacted- 2005 • Comprehensive food and beverage guidelines that require healthy choices or restrict sale of competitive foods • AZ HB 2544, AR SB 965, CT SB1309, KS SB 154, KY SB 172, MD SB 473, NM HB 61, OK SB 265, SC HB 3499, WV HB 2816 • Encouraging school districts to adopt nutrition & wellness guidelines • CO SB 81, WV HB 2816 • Evaluation of nutrition services; celebrations allowed • TX SB 42 • Regulatory action on school nutrition standards • TX (2004), NJ (2005)
Body Mass Index (BMI) Legislation • 13 states considered or enacted BMI legislation in 2005 • Enacting BMI reporting – Tennessee, West Virginia • Legislation introduced - Alaska, Connecticut, Georgia, Iowa, Maine, New Jersey, New York, North Carolina, Oregon, South Carolina, and Texas • Considered repeal – Arkansas
Diabetes Legislation • School child screening • Enacted CA and IL – 2003 • Considered NY and PA - 2004 • Considered PA – 2005 • At-school treatment and training of school personnel in diabetes management • Passed both chambers of legislature – HI – 2005 • Considered TX – 2005; CA, IL, MA, NJ, PA, TN, VT, VA – 2004 • Diabetes awareness in schools • Enacted resolution - CA – 2005 (SCR 4)
Insurance Coverage – Obesity Prevention and Treatment • Insurance coverage option required – GA, IN, VA • States considering insurance coverage requirements or strengthening coverage requirements in 2005– CA, CT, GA, IN, MD, MO, MS, TN • Insurance coverage required – Maryland
Nutrition Content Information for School Foods Legislation • School nutrition information requirements considered 2005 • California, Illinois, Massachusetts, and New York • School nutrition information requirements enacted 2005 • Colorado, Kentucky, Maine, West Virginia
Nutrition Education in School Curriculum • School nutrition education requirements considered 2005 • Minnesota, New Mexico, New York, Oklahoma, Pennsylvania, Vermont, Virginia • School nutrition education requirements enacted 2005 • Colorado, Kansas, Illinois (for food stamp, TANF recipients - passed both legislative chambers), Maine, South Carolina, Texas and West Virginia
Physical Activity – Legislative Responses • Physical Education or Physical Activity in Schools • 48 states require P.E. in schools, but scope of requirement varies • 60% of states require schools to follow national or state P.E. guidelines. 80% require adapted or mainstream P.E. for IEP students. • IL requires daily P.E. for K-12, but exemptions allowed. AL requires daily P.E. for K-8.
Physical Activity – Legislative Responses • Physical Education or Physical Activity in Schools • 8 states enacted or strengthened P.E. or physical activity requirements in 2005: AZ, CO, CT, KS, KY, MT, SC, TX • 25 states introduced legislation to implement or strengthen P.E. or physical activity requirements in 2005: AL, AK, DE, GA, HI, IL, IN, IA, MA, MI, MS, MO, NE, NH, NM, NY, OH, OK, OR, PA, RI, TN, UT, VA.
Physical Activity – Legislative Responses • Walkable communities – through community planning and transportation projects that encourage walking. • Safe routes to school - CA, DE, FL, OR, TX have state laws as of 2003. • Legislative role models – CO legislators participate in 10,000 Steps to Better Health and created Colorado Walking Wednesday urging parents and children to walk to school; WI legislators resolved to Lose a Ton.
School Wellness Policy Legislation • Federal Child Nutrition and WIC Reauthorization Act of 2004 – Requires local school districts participating in the National School Lunch or Breakfast Programs to establish local wellness policies by the beginning of the 2006-2007 school year. • Statewide wellness policy legislation – considered in 2005 in CA, OH, TN. • Statewide wellness policy legislation – enacted in 2005 in CO, IL, RI.
Task Forces, Commissions, or Studies • Six states previously enacted obesity task forces, commissions, or studies – Arkansas, Maine, New York, Texas, Rhode Island, Washington • Legislation introduced for obesity task forces, commissions, or studies in 2005 – Kansas, New Mexico, North Carolina, Virginia, and West Virginia
Legislative Effort to Raise Awareness • California – A panoply of awareness raising efforts encouraged to increased physical activity and improve nutrition and wellness in all branches and levels of government, communities, schools, workplaces; healthy food options in restaurants, markets, and homes; and increased emphasis on health education and prevention of obesity and diabetes. • Maryland – Proposed November as “Obesity Awareness Month”
Snack Tax Legislation • Nebraska – Proposed sales tax on snack foods to create a fund for school facilities. • Texas – Proposed snack and sweets tax to fund childhood obesity prevention programs.
Additional Resources Links for NCSL and other resources on legislation and policy options to address childhood obesity are: • NCSL updated overview of childhood obesity policy options considered in 2005 at: http://www.ncsl.org/programs/health/childhoodobesity-2005.htm • NCSL overview of childhood obesity policy options considered in 2003-2004 at: http://www.ncsl.org/programs/health/childhoodobesity.htm • NCSL information on access to healthy foods in communities at: http://www.ncsl.org/programs/health/publicHealth/foodaccess/index.htm?CFID=614822&CFTOKEN=54359522 • Information about federal wellness policy requirements on the U.S. Department of Agriculture web site at: http://www.fns.usda.gov/tn/Healthy/wellnesspolicy.html
Thank you! NCSL Contact for Additional Childhood Obesity Policy Information: Amy Winterfeld Program Principal Health Program National Conference of State Legislatures 7700 East First Place Denver, Colorado 80230 amy.winterfeld@ncsl.org 303-364-7700, ext. 1544