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Working Together to Address Obesity Maternal and Child Health Bureau Federal/State Partnership Meeting October 17, 2007. LuAnn Heinen Director, Institute on the Costs and Health Effects of Obesity National Business Group on Health. Institute on the Costs & Health Effects of Obesity.
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Working Together to Address ObesityMaternal and Child Health BureauFederal/State Partnership MeetingOctober 17, 2007 LuAnn Heinen Director, Institute on the Costs and Health Effects of Obesity National Business Group on Health
Institute on the Costs & Health Effects of Obesity • Build the business case • Promote environmental changes at work • Reach families– especially children • Redesign benefits • Communicate the value of change to employers and employees
Obesity is Weighing Us Down • More than a quarter of US health costs are related to physical inactivity, overweight and obesity • 27% of the increase in health spending between 1987 and 2001 was attributable to obesity • Between 1979 and 1999, obesity-associated hospital costs for children (6-17 years) more than tripled Source: F as in Fat, Trust for America’s Health, 2007
Medical and Absenteeism Expenditures Attributable toExcess Overweight and Obesity Source: Finkelstein EA, Fiebelkorn IC, Wang G. The costs of obesity among full-time employees. Am J Health Promotion 2005;20(1):45-51
The obesity epidemic has been likened to a “massive tsunami headed to the shoreline…”
Disparities • Rate of death from heart disease 31% higher among blacks than whites and 49% higher among men than women • Rates of death from stroke 43% higher among blacks than whites • Each year, about 40,000 more women than men have a stroke • Geographic variation • Rural access issues
Unhealthier, Earlier • Approximately 177,000 children and teens under age 20 have diabetes • 2 million adolescents (1 in every 6 overweight adolescents) have pre-diabetes • Obese children as young as 6 may be on their way to heart disease (stiffer arteries and other risk factors as evidence) • Emotional health concerns– poor body image, low self-esteem, symptoms of depression
Health habits of Americans: Are we doing all we can to maintain health? • Control weight (normal range): 40% healthy BMI • Eat right: 23% eat at least 5 fruits and vegetables each day • Be physically active: 22% active at least 30 minutes per day, at least 5 days per week • Do not smoke: 75% nonsmokers But…only 3% follow all 4 health habits Source: April 25, 2005 Archives of Internal Medicine analysis of BRFSS survey data
Common Goals Public health and private sector seek to: • increase the health and productivity of Americans • avoid unnecessary costs, reduce trend Unhealthy lifestyles are harming America’s competitiveness, readiness, wealth/economic security, productivity and opportunity Productivity impact = disability, absenteeism, presenteeism (lower productivity even when on the job) Lifestyle-related health costs account for an estimated 50% of health care expenditures
Explaining the Decrease in U.S. Deaths from Coronary Disease, 1980-2000New England Journal of Medicine, June 7, 2007 Conclusion: “Approximately half the decline in U.S. deaths from coronary heart disease from 1980 through 2000 may be attributable to reductions in major risk factors and approximately half to evidence-based medical therapies.” However, “increases in the body-mass index accounted for about 26,000 additional deaths in 2000, and increases in the prevalence of diabetes for about 33,500 additional deaths.”
Employees are at work for 35% of working hours • Stable group environments can support long-term changes • Employers have financial incentive to improve employee health • Employers and employees benefit Source: Michael O’Donnell, Editor in Chief, AJHP
What Are Employers Doing? Large employers have a key role • Clinical Preventive Services • Worksite Health Promotion • Environmental Changes
A Purchaser's Guide to Clinical Preventive Services: Moving Science into Coverage
Worksite Health Promotion Programs • Visible leadership role & employee involvement • Health assessments/population and individual reporting • Behavior change & counseling interventions • Evaluation and continuous improvement
Fast Food does not have to Equal Fat FoodLife on the run can include a healthy diet
Previous Best Employers for Healthy Lifestyles Winners • Aetna • Bath Iron Works, A General Dynamics Company • Cisco Systems • Dell, Inc. • Florida Power & Light • Hannaford Brothers Company • IBM • Johnson & Johnson • Kellogg Company • Medtronic, Inc. • Motorola, Inc. • Pitney Bowes • Texas Instruments, Inc. • Union Pacific Railroad
Leading Examples • IBM rebate programs to support healthy lifestyles • J&J nutritionally dense whole foods initiative • FPL Group healthy food subsidies • General Mills physical activity promotion • HEB, Hannaford diverse workforce approaches
Fostering Partnerships • Childhood obesity • Nutrition education • Healthy weight initiatives • Physical activity • Breastfeeding • Prenatal information