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Overview of the National Obesity Epidemic. Health care delivery system. Community. Assuring the Conditions for Population Health. Governmental Public Health Infrastructure. Employers and Business. Academia. The Media. The Public Health System.
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Health care delivery system Community Assuring the Conditions for Population Health Governmental Public Health Infrastructure Employers and Business Academia The Media The Public Health System Institute of Medicine, The Future of the Public’s Health in the 21st Century, 2003
Obesity Trends Among U.S. Adults between 1985 and 2005 • Definitions: • Obesity: having a very high amount of body fat in relation to lean body mass, or Body Mass Index (BMI) of 30 or higher for adults. • Body Mass Index (BMI): a measure of weight in relation to height, specifically weight in kilograms divided by the square of his or her height in meters.
Obesity Trends* Among U.S. AdultsBRFSS, 1985 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14%
Obesity Trends* Among U.S. AdultsBRFSS, 1986 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14%
Obesity Trends* Among U.S. AdultsBRFSS, 1987 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14%
Obesity Trends* Among U.S. AdultsBRFSS, 1988 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14%
Obesity Trends* Among U.S. AdultsBRFSS, 1989 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14%
Obesity Trends* Among U.S. AdultsBRFSS, 1990 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14%
Obesity Trends* Among U.S. AdultsBRFSS, 1991 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. AdultsBRFSS, 1992 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. AdultsBRFSS, 1993 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. AdultsBRFSS, 1994 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. AdultsBRFSS, 1995 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. AdultsBRFSS, 1996 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. AdultsBRFSS, 1997 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%
Obesity Trends* Among U.S. AdultsBRFSS, 1998 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%
Obesity Trends* Among U.S. AdultsBRFSS, 1999 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%
Obesity Trends* Among U.S. AdultsBRFSS, 2000 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%
Obesity Trends* Among U.S. AdultsBRFSS, 2001 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Obesity Trends* Among U.S. AdultsBRFSS, 2002 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Obesity Trends* Among U.S. AdultsBRFSS, 2003 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Obesity Trends* Among U.S. AdultsBRFSS, 2004 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Obesity Trends* Among U.S. AdultsBRFSS, 2005 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Premature death Type 2 diabetes Heart disease Stroke Hypertension Gallbladder disease Osteoarthritis Sleep apnea Asthma Psychological disorders or difficulties Some cancers Dyslipidemia Complications of pregnancy Hirsuitism Menstrual abnormalities Stress incontinence Increased surgical risk What are the health consequences for adults?* * Adapted from “The Surgeon General’s Call to Action to Prevent Obesity and Decrease Overweight and Obesity” 2001
No Data <4% 4%-6% 6%-8% 8%-10% >10% Diabetes Trends* Among Adults in the U.S.,(Includes Gestational Diabetes)BRFSS 1990 Source: Mokdad et al., Diabetes Care 2000;23:1278-83.
No Data <4% 4%-6% 6%-8% 8%-10% >10% Diabetes Trends* Among Adults in the U.S.,(Includes Gestational Diabetes)BRFSS 1991-92 Source: Mokdad et al., Diabetes Care 2000;23:1278-83.
No Data <4% 4%-6% 6%-8% 8%-10% >10% Diabetes Trends* Among Adults in the U.S.,(Includes Gestational Diabetes)BRFSS 1993-94 Source: Mokdad et al., Diabetes Care 2000;23:1278-83.
No Data <4% 4%-6% 6%-8% 8%-10% >10% Diabetes Trends* Among Adults in the U.S.,(Includes Gestational Diabetes)BRFSS 1995-96 Source: Mokdad et al., Diabetes Care 2000;23:1278-83.
No Data <4% 4%-6% 6%-8% 8%-10% >10% Diabetes Trends* Among Adults in the U.S.,(Includes Gestational Diabetes)BRFSS 1995 Source: Mokdad et al., Diabetes Care 2000;23:1278-83.
No Data <4% 4%-6% 6%-8% 8%-10% >10% Diabetes Trends* Among Adults in the U.S.,(Includes Gestational Diabetes)BRFSS 1997-98 Source: Mokdad et al., Diabetes Care 2000;23:1278-83.
No Data <4% 4%-6% 6%-8% 8%-10% >10% Diabetes Trends* Among Adults in the U.S.,(Includes Gestational Diabetes)BRFSS 1999 Source: Mokdad et al., Diabetes Care 2001;24:412.
No Data <4% 4%-6% 6%-8% 8%-10% >10% Diabetes Trends* Among Adults in the U.S.,(Includes Gestational Diabetes)BRFSS 2000 Source: Mokdad et al., J Am Med Assoc 2001;286:10.
No Data <4% 4%-6% 6%-8% 8%-10% >10% Diabetes Trends* Among Adults in the U.S.,(Includes Gestational Diabetes)BRFSS 2001 Source: Mokdad et al., J Am Med Assoc 2001;286:10.
Costs of Obesity: Local • NIH: Below based on 2001 data- likely to be MUCH higher now. • Total costs (2001): $117 billion • Direct medical costs: $61 billion • Estimated at $92 billion for 2002 • Indirect costs: $56 billion http://win.niddk.nih.gov/statistics/index.htm#econ
Costs of Obesity: Local • CDC: Based on financial data from 1998 and BRFSS data from 1998-2000* Total MedicaidMedicaid-Obesity related NYS: 2000 $23.2 billion $3.6 billion 2006 $35.7 billion $5.4 billion Onondaga: 2000 $366 million $55.7 million 2006 $565 million $86.1 million** *Finkelstein, EA, Fiebelkorn, IC, Wang, G. State-level estimates of annual medical expenditures attributable to obesity. Obesity Research 2004;12(1):18–24.** Extrapolated from estimated 2000 % costs related to obesity
IOM RECOMMENDATIONS: Recommendations for the Federal Government, Industry and Media, Health-Care Professionals, Community and Nonprofit Organizations as well as Parents and Families Recommendations for State/Local Governments and for Education Authorities/Schools Source: Preventing Childhood Obesity: Health in the Balance, Institute of Medicine, Sept. 2004
IOM RECOMMENDATIONS: State and Local Governments • Work with communities to support partnerships and networks that expand the availability of and access to healthful foods • Expand and promote opportunities for physical activity in the community Source: Preventing Childhood Obesity: Health in the Balance, Institute of Medicine, Sept. 2004
IOM RECOMMENDATIONS: State and Local Governments • Provide leadership and sustained commitment- establish a task force, commit adequate resources • Evaluate policies and programs • Monitor progress and conduct research • Disseminate promising practices Source: Progress in Preventing Childhood Obesity: How Do We Measure Up?, Institute of Medicine, Sept. 2006
Grants: • April 2005: “Healthy Children, Healthy Futures” • Wellness initiative for schools in Cayuga, Cortland, Herkimer, Madison, Oneida, Onondaga, Oswego • Eat Well, Play Hard: Sept 2006- funded for additional five years