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Promoting Community-based Obesity Prevention

Promoting Community-based Obesity Prevention. Surgeon General’s Call to Action to Prevent & Decrease Overweight & Obesity. “Overweight and obesity may soon cause as much preventable disease and death as cigarette smoking.

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Promoting Community-based Obesity Prevention

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  1. Promoting Community-based Obesity Prevention

  2. Surgeon General’s Call to Action to Prevent & Decrease Overweight & Obesity “Overweight and obesity may soon cause as much preventable disease and death as cigarette smoking. People tend to think of overweight and obesity as strictly a personal matter, but there is much that communities can and should do to address these problems.” US Surgeon General David Satcher, MD, PhD

  3. Surgeon General’s Call to Action to Prevent & Decrease Overweight & Obesity “Communities can help when it comes to health promotion and disease prevention. When there are no safe places for children to play, or for adults to walk, jog, or ride a bike, that’s a community responsibility. When school lunchrooms or workplace cafeterias don’t offer healthy and appealing food choices, that is a community responsibility. And when we don’t require daily physical education in our schools, that is also a community responsibility.”

  4. Building Healthier Communities • By community, we mean a group of people who share a common place, experience, or interest. Such as those in the same town, ethnic and/or religious community. • Community health refers to the well-being of everyone in a community. It asks the question, “How healthy are all of the children of the community? Older adults? The poor? • Collaborative partnerships are alliances that are used to improve the health of a community. They encourage people to get involved and make a difference.

  5. Who Should Be Involved? • For example, a community partnership to promote child health might include representatives from: • The media • The business community • Area schools • Civic and community organizations • Youth organizations • Local government • Health organizations • The Faith community • Financial institutions

  6. You are an important collaborative partner in Obesity Prevention! In a healthy community, working together for the good of the community is a constant part of everyone’s lives.

  7. What is Obesity? • Obesity -having a very high amount of body fat in relation to lean body mass, or in adults, a Body Mass Index (BMI) of 30 or higher. • Overweight -increased body weight in relation to height, when compared to some standard (BMI over 25). • Body Mass Index (BMI) -a measure of weight in relation to height.

  8. What is BMI? • A screening tool to identify: • Overweight • At risk for overweight • Underweight • BMI-for-Age in children correlates • with health risks in adulthood • Elevated insulin levels • Cardiovascular disease • High blood pressure

  9. Calculate your BMI • To calculate your body mass index (BMI) • Multiply your weight (in pounds) by 700 and divide by your height (in inches) squared (Weight x 700/height2) • A BMI of 20-25 is associated with the lowest health risk.

  10. BMI Categories for Adults Source: NIH Evidence Report on Overweight & Obesity, 1998

  11. Overweightin Children in Texas • Overweight – Body Mass Index equal to or greater than the 95th percentile is overweight in standard reference tables based on age and gender • Norms for BMI: NCHS/CDC, http://www.cdc.gov/growthcharts/

  12. For Children, BMI Differs by Age BMI BMI Boys: 2 to 20 years Example: 95th Percentile Tracking Age BMI 2 yrs 19.3 4 yrs 17.8 9 yrs 21.0 13 yrs 25.1 http://www.cdc.gov/nccdphp/dnpa/bmi/bmi-for-age.htm BMI BMI Source: CDC Growth Chart Slides

  13. What does the 95th percentile look like? • For a girl: • 4th grade, 9 ½ years old, 48 inches (4’) • 85th percentile = 64 lbs. • 95th percentile = 73 lbs. • 8th grade, 13 ½ years old, 60 inches (5’) • 85th percentile = 118 lbs. • 95th percentile = 137 lbs. • 11th grade, 16 ½ years old, 66 inches (5’ 6”) • 85th percentile = 154 lbs. • 95th percentile = 181 lbs.

  14. Causes of Obesity • Genetic Factors • Environmental Factors • Psychological factors • Other causes

  15. Some facts about the health status of adults and children in the U.S.

  16. Trends in Adult Obesity in Texas • Between 1990 and 2002, the prevalence of overweight and obesity in Texas adults rose from 42.9% to 63% • In Texas, obesity is more pronounced among low-income adults, while overweight is more prevalent among high-income adults.

  17. Adult Trends - The Facts • Obesity is highest among African Americans (42%) and Hispanics (30%) • Prevalence of obesity and overweight combined in Texas is higher among men (69%) than women (55%) and among people 45-64 years of age (70%)

  18. Actual Causes of Death, 2000 Tobacco 435,000 * 400,000 Poor diet/Lack of exercise Alcohol 85,000 Infectious Agents 75,000 Pollutants/Toxins 55,000 * number of deaths Motor Vehicles Crashes 43,000 Firearms 29,000 Sexual Behavior 20,000 Illicit Drug Use 17,000 Percentage of all deaths Source: Mokdad AH, Marks JS, Stroup DF, and Gerberding JL. Actual Causes of death in the United States, 2000. (JAMA 2004;291:1238-45)

  19. No Data <10% 10%–14% 15%–19% Obesity Trends* Among U.S. AdultsBRFSS, 1995 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

  20. No Data <10% 10%–14% 15%–19% Obesity Trends* Among U.S. AdultsBRFSS, 1996 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

  21. No Data <10% 10%–14% 15%–19% ≥20 Obesity Trends* Among U.S. AdultsBRFSS,1997 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

  22. No Data <10% 10%–14% 15%–19% ≥20 Obesity Trends* Among U.S. AdultsBRFSS, 1998 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

  23. No Data <10% 10%–14% 15%–19% ≥20 Obesity Trends* Among U.S. AdultsBRFSS, 1999 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

  24. No Data <10% 10%–14% 15%–19% ≥20 Obesity Trends* Among U.S. AdultsBRFSS, 2000 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

  25. Obesity Trends* Among U.S. AdultsBRFSS, 2001 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

  26. Obesity Trends* Among U.S. AdultsBRFSS, 2002 (*BMI 30, or ~ 30 lbs overweight for 5’4” person) (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman) No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Source: Behavioral Risk Factor Surveillance System, CDC

  27. School-aged Children Trends • Nationally the prevalence of overweight and obesity has doubled in the last 20 years and is highest among minorities and males. • SPAN study indicates that the prevalence of child and adolescent overweight may be increasing at a rate similar to that of the adult population!

  28. Prevalence of Overweight in Texas School Children • Combined male and female findings by grade: • 4th grade – 22.4% • 8th grade – 19.2% • 11th grade – 15.5% TDH Innovation Grant, University of Texas Health Science Center – School of Public Health – Houston

  29. Prevalence of Overweight in Texas School Children • Overweight prevalence highest among: • Hispanic boys 29.5%-32.6% • 4th grade Hispanic girls 26.7% • 4th grade African American girls 30.8% • 8th grade African American girls 23.1% • Overweight prevalence lowest among: • 11th grade White/other girls 5.5% TDH Innovation Grant, University of Texas Health Science Center – School of Public Health – Houston

  30. Map of Public Health Regions in Texas

  31. 11th Grade Prevalence of Overweight* by Public Health Region in Texas, 2000-2002 *Overweight is > 95th Percentile for BMI by Age/Sex

  32. 8th Grade Prevalence of Overweight* by Public Health Region in Texas, 2000-2002 *Overweight is > 95th Percentile for BMI by Age/Sex

  33. 4th Grade Prevalence of Overweight* by Public Health Region in Texas, 2000-2002 *Overweight is > 95th Percentile for BMI by Age/Sex

  34. The Harsh Reality • One Texas school-aged child out of three is overweight or obese. • CDC projected that the lifetime risk of developing diabetes for children born in 2000 was more than 30% for males and 40% for females. • A child who is overweight at age 12 has a 75% chance of being overweight as an adult. • Two out of three Texas adults are overweight or obese. • In 2001, one out of every 200 Texans went to the hospital because of a problem linked to being overweight or obese.

  35. Increased Cost Burden • $117 billion spent in 2001 according to Surgeon General report • A significant portion of the increased costs of obesity are passed on to the American public adding an average of $732 to the mean yearly medical bills of all Americans.

  36. The Cost of Adult Overweight & Obesity in Texas • Estimated $10.4 billion in 2001 • Includes $4.2 billion for health care • An additional $6.2 billion impact from lost productivity due to illness, disability, and premature death. • Total cost estimates range in value from $8.8 billion to $14.2 billion, depending on the underlying assumptions. Texas Dept. of Health - Preliminary Analysis, Jan. 2004

  37. Mortality Rate Associated with Obesity • Obese individuals have a 50 to 100% increased risk of death from all causes, compared with normal-weight individuals. • Most of the increased risk is due to cardiovascular causes.

  38. Health Consequences of Obesity for Children • Depression/low self-esteem • Asthma • High blood pressure • Type 2 diabetes • Sleep apnea • Progression to adult obesity • Other disorders (i.e. PCOS, fatty liver)

  39. Most Logical Approach is PREVENTION

  40. Health Benefits of Obesity Prevention for the General Population • Reduced development of chronic diseases • Improved nutrition reducing gastro-intestinal problems and osteoporosis as well as CVD, diabetes and cancer • Improved fitness • Improved academic performance

  41. Best prevention approach is:TARGET CHILDREN and THEIR FAMILIES

  42. Four Goals of the Strategic Plan for the Prevention of Obesity in Texas • Build awareness of the problem • Mobilize families, schools, & communities • Advocate for a supportive environment • Monitor progress

  43. Strategic Plan for the Prevention of Obesity in Texas is intended as a SPRINGBOARD for ACTION

  44. Thought for the Day If an answer to this obesity epidemic is not found soon, for the first time in at least a century, the present generation of children will not live as long as their parents.

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