Obesity Prevention: A look at the legislative landscape

1. Obesity Prevention: A look at the legislative landscape Andrew Wapner, DO, FACOP, FAAP 2012 Public Policy Institute Preliminary Program

2. Learning Objectives The learner will be able to: • discuss the importance of addressing obesity prevention through evidence-based strategies to improve health through environmental change. • discuss the role of public health practitioners in improving opportunities for healthy living. • discuss current legislation to improve nutrition and increase physical activity in Ohio.

4. What Influences Our Behavior?

5. “Global Drivers & Local Environments” Swinburn, Lancet, 2011

6. Where Does Public Health Fit?

8. Legislation: What’s Out There? • Nutritional Standards • BMI & Student Fitness • Chronic disease management • Insurance coverage for CD prevention and management • Joint use agreements • Nutritional and physical education • Physical activity & Recess • School wellness Policies • Taxes & tax credits

9. 2010 US Childhood Obesity Legislation • 12 states and DC: school nutrition legislation • California and North Carolina included legislation to improve nutrition in early childhood or day care programs • 3 states: student fitness assessment/BMI screening • North Carolina also requires development of fitness assessment • At least 10 states and DC: Physical education or PA at school www.NCSL.org

10. 2010 US Childhood Obesity Legislation • Required insurance coverage for obesity evaluation and management as a child wellness service • Maryland • Joint use authorization and/or funding • Arkansas, California, North Carolina, Washington • Existing or newly enacted nutritional education schools requirements • California, Colorado, Indiana, Louisiana, Maine, Massachusetts, New Hampshire, Oklahoma, South Carolina, Texas, Vermont, West Virginia, Illinois, Minnesota and Mississippi • Tax exemption changes & new taxes/fees on specific foods • Colorado, DC, Mississippi, Tennessee and Washington www.NCSL.org

11. Ohio in 2010: Healthy Choices for Healthy Children • More than 70 partners from health care, public health, public and private sector • Bipartisan, bicameral • Focus on three main areas • Nutrition • Physical Activity • Body Mass Index Screening

12. HCHC—Nutrition • Limits sale of certain foods/beverages to students during school and at before- and after-school programs • Districts to adopt standards for beverage sales on school premises and report on compliance • Prohibits placement of vending machines in classrooms • Permits federal school breakfast program to be offered in the classroom

13. HCHC—Physical Activity (PA) • ODE administration of a PA pilot program for students to participate in at least 30 minutes of moderate to rigorous physical activity daily • Specifies new hires be licensed in physical education • Requires the one-half unit in health education to provide instruction in nutrition and the benefits of physical activity

14. HCHC—Body Mass Index Screening • Body mass index (BMI) screening programs for K, 3rd, 5th and 9th grades • Any school may request a waiver of BMI screening requirements stating an inability to comply

15. HCHC—Reporting & Administration • ODE annual compliance report with the BMI screening requirements • ODE report cards to include: • Student success in meeting physical education standards • Compliance with federal requirements for local wellness policies • Compliance with BMI requirements • Participation in PA pilot program

16. Take Home Points: • Healthy eating and active living requires consistent positive influences from multiple levels in our social networks, communities, organizations and environments • Policy is a critical tool that can help turn influences into opportunities for whole populations to lead healthful lives • Many options exist and Ohio is moving forward!

17. Andrew Wapner, DO Chronic Disease Medical Director Bureau of Healthy Ohio Ohio Department of Health 614-466-1337 Andrew.Wapner@odh.ohio.gov