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Evidence on the Impacts of Childhood Obesity Policy

Evidence on the Impacts of Childhood Obesity Policy. David Frisvold University of Iowa (Economics, Obesity Research and Educational Initiative, & Public Policy Center). Obesity in Perspective. 150 million adults are overweight or obese (78m are obese) in 2010

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Evidence on the Impacts of Childhood Obesity Policy

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  1. Evidence on the Impacts of Childhood Obesity Policy David Frisvold University of Iowa (Economics, Obesity Research and Educational Initiative, & Public Policy Center)

  2. Obesity in Perspective • 150 million adults are overweight or obese (78m are obese) in 2010 • 126 million adults voted in the 2012 presidential election • 63 million people attended church in a given weekend in 2010 • 23.5 million children are overweight or obese (12.5m are obese) in 2010 • The medical costs of obesity are $257 billion per year in 2010 $ • Sequestration reduced federal expenditures by $85 billion • Estimated costs from Hurricane Katrina are $148 billion • Consequences of high medical costs • Higher premiums for EPHI and higher taxes/reduction in benefits for Medicare and Medicaid • But the medical costs of obesity are due to costs as an adult • Does it makes sense to focus policy attention on children? • Obese children are highly likely to become obese adults • Difficult to reduce weight: <2% of obese adults were healthy weight 10 years later

  3. Overview of Public Policy Related to Obesity • Policies to reduce obesity • Improve diet through restrictions, taxes/subsidies, information, access • Increase physical activity through safe parks/built environment • Policies with an unintended consequence of contributing to obesity • Expansions of highways • School accountability/National School Lunch Program • This is not true for the SNAP program • Mixed results regarding cigarette taxes • Difficulties related to optimal policy design • Technological progress has contributed to the rise in obesity through cheaper food and more sedentary lifestyles • How to reduce obesity (and benefit society) without decreasing the benefits from technological progress

  4. Policies Targeting All Ages • Food pricing policies: Taxes on sugar-sweetened beverages • Existing taxes on soft drinks reduce consumption of soft drinks but not total calories (b/c of substitutes) • Adolescents are most responsive • Can be implemented as an excise tax or by excluding SSBs as a food under the exemptions to sales taxes • MD: Food from grocery stores is exempt from sales tax, soft drinks are not “food” • Information-based policies: Calorie posting requirements • Reductions in calories purchased in some settings • No evidence for children or whether restaurants change menu content • Montgomery County: chains with 20 or more locations are required to post calorie counts • Nationwide requirements through the ACA

  5. Policies Targeting All Ages • Access: Food deserts • Studies document correlations between food deserts and obesity • Subsidies to encourage new grocery stores have not been effective in reducing obesity • Built environment • Studies of housing voucher lotteries demonstrate that the neighborhood environment effects obesity • Limited success with specific policies; an area that needs more research

  6. Policies Targeting Children • K-12 School-based policies • Restrictions on vending machines • Reduce soft drink consumption during school but not overall • Physical education requirements • Reduce obesity in elementary school (minutes per week requirements) but not high school • 100 minutes of required PE => 40 minutes of time spent in PE => 3.2 pct. point decrease in obesity. • MD: schools are required to offer PE, but there is no minimum amount required • These laws are not effective (equivalent to not having a law) • School meals • Minor changes to the design of the cafeteria can improve diet • Research is ongoing about changes to the breakfast program (expanding access, universally-free) • MD: requires breakfast in elementary schools (but does permit waivers), Maryland Meals for Achievement (universal breakfast)

  7. Policies Targeting Children • Early childhood education policies • Child care regulations • Require physical activity, limit TV, dietary restrictions • Research is ongoing • Head Start • Some evidence of a lasting reduction in obesity • Attending Head Start for a full day reduces obesity by 25% • Shows the promise of a comprehensive change to the environment for disadvantaged young children

  8. Two Takeaways from the Research Literature • Comprehensive policies are more effective than narrowly focused policies • Comprehensive policies are more expensive to implement but are more cost effective • Limited effectiveness of narrowly targeted policies • Policies targeting younger ages are more effective • In combination, substantial changes to the environment of young children can decrease childhood obesity rates

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