Community Action Partnership at 45: Keeping Our Promise

Why is Obesity Prevention an Important Anti-Poverty

Strategy

Dolores BarrettDirector of Partnerships and Services

Community Action Partnership of Orange County

September 4, 2009

Prevent

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, 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%

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 2002

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%

Obesity Trends* Among U.S. AdultsBRFSS, 2006

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends* Among U.S. AdultsBRFSS, 2007

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends* Among U.S. AdultsBRFSS, 2008

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

1999

Obesity Trends* Among U.S. AdultsBRFSS, 1990, 1999, 2008

(*BMI 30, or about 30 lbs. overweight for 5’4” person)

2008

1990

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

• In 1990, among states participating in the Behavioral Risk Factor Surveillance System, ten states had a prevalence of obesity less than 10% and no states had prevalence equal to or greater than 15%.

• By 1999, no state had prevalence less than 10%, eighteen states had a prevalence of obesity between 20-24%, and no state had prevalence equal to or greater than 25%.

• In 2008, only one state (Colorado) had a prevalence of obesity less than 20%. Thirty-two states had a prevalence equal to or greater than 25%; six of these states (Alabama, Mississippi, Oklahoma, South Carolina, Tennessee, and West Virginia ) had a prevalence of obesity equal to or greater than 30%.

Health Risks• Diabetes• Coronary Heart

Disease• Dyslipidemia (high

cholesterol, high triglycerides)

• Stroke• Gynecological

problems (abnormal menses, infertility)

• Hypertension (high blood pressure)

• Cancer (endometrial, breast, colon, pancreatic)

• Liver and Gallbladder Disease

• Sleep Apnea and respiratory disease

• Osteoarthritis

CostsObvious Costs

Costs in health care doubled in less than a decade to $147 billion (CDC)

Hidden Costs

Transportation and fuel costs

Insurance Premiums

Physical Environment

Health Disparities

• The proportion of adolescents from poor households who are overweight or obese is twice that of adolescents from middle- and high-income households. Obesity is especially prevalent among women with lower incomes and is more common among African American and Mexican American women than among white women.

Health Disparities• Compared with white youth, black and

Hispanic youth have higher prevalences of asthma, overweight, and type 2 diabetes.

• Among youth aged 10–19 years, American Indians have the highest prevalence of type 2 diabetes of any racial/ethnic group.

• In 2005, after adjusting for population age differences, Mexican-Americans were 1.7 times more likely to have diabetes than non-Hispanic whites

Health Disparities• In 2000, rates of death from diseases of

the heart were 29 percent higher among African American adults than among white adults, and death rates from stroke were 40 percent higher.

• During 2003-2004, 24% of non-Hispanic black females aged 2-19 years were overweight, compared with 15% of non-Hispanic white.

“Despite obesity having strong genetic determinants, the genetic composition of the population does not change rapidly. Therefore, the large increase (obesity)…must reflect major changes in non genetic factors.”

Hill & Towbridge, Childhood Obesity future directions and research priorities. Pediatrics 1998

Food/Calories – energy in

Physical Activity –energy out

Weight is a simple equation

Framing the Issue

The issue is not individual weight

loss.

PLACE MATTERS

Individual & Environment

Success –

Policy, Systems & Environmental Change

California D

reamin’

*Adapted from NC Energizers

Climb up a redwood tree.Climb up a Redwood Tree

Do a touchdown dance like a 49’er.

Swim like a fish in the Monterey Bay Aquarium

Wave and pose for your fans like an actor in L.A.

Surf the Pacific in the O.C.

Swing your golf club in Palm Springs

Sit down in your beach chair and enjoy the sunset on a San Diego Beach

If given enough time, people can walk anywhere.

WALKING

But why would they?

Unless…

… it was NICE

… … there were places were places to walk TO…to walk TO…

Dan Burden

… and getting there was safe and fun for all!

What’s What’s wrong with wrong with this this picture?picture?

…and this one?

Ready,Set,Go!

And this picture?

e

Can you

spot the

pedestrian?

OverbuiltOverbuilt Roads Roads……

Can our streets encourage walking?

Yes! How?• Scenery• Maintenance• Accommodation • Variety of Uses • Activity • Connectivity• Aesthetics & Beauty• Safety

Dan Burden

BeforeBefore

Dan Burden

After

PedestrianRefuge

Bike Lanes Bus Shelter

In-Pavement Warning Lights

Ped-Scale Lighting

Before

After

Cost Savings - ROI

Prevention is an Investment

$1 spent - $1 return in 1 year

$1 spent - $5.60 return in 5 years

$10 per person for prevention –

$16 billion saved annually in 5 years

ACHIEVE-Action Communities for Health, Innovation, and EnVironmental changE

CDC program that funds national organizations to work through local affiliates to advance local community leadership in the nation’s effort to prevent chronic disease and related risk factors.

ACHIEVE National Organizations

Community Funding National Association of Chronic Disease Directors

National Association of County and City Health Officials-NACCHO

National Recreation and Park AssociationYMCA of the USA

Translation and Dissemination– National Association of County and City Health Officials– Society for Public Health Education

Creating a National Movement

CHART – Community Health Assessment Response TeamLa Mirada: City Parks & Recreation, LA County Public Health, Nonprofit, Community Hospital, Community Action

CHANGE – Community Health Assessment aNd Group EvaluationCommunity, Worksite, School, Healthcare, and Community Organization/Institution

CAP – Community Action Plan3 Year plan to implement PSE change

Partnerships

Orange County Nutrition and Physical Activity Collaborative,

NuPAC• 10 Years

• Leadership roles, Chair, Chair of the Policy Committee, Leadership Team

• Multiple Events, Trainings

• List Serve – 250, Active Membership 75

• Orange County Obesity Prevention Plan

Kid Healthy, Steps to Healthy Living Campaign

• 6 years• Public Awareness Campaign – 7 Counties,

direct intervention for 100,000 children 2009

• Partners- ABC7, Kaiser Permanente, Power Play (CAPOC), CVS, Sav-On

• Power Play in OC provided over 100,000 nutrition education and physical activity lessons

Network for a Healthy California(Nutrition Network- 5 a Day)

• 9 years• Represented OC in state meetings of

regional collaboratives• 6 years contract -Power Play, Latino

campaign, California Assoc. of Food banks

• State and County Public Health• Nutrition and Physical Activity Education

and Health Promotion

Community Building Initiative

• 5 years

• Community Leadership Development

• Low Income Community driven Policy, Systems, Environmental Change

• 6 Communities

• Playground equipment, 25 streetlights, community input in street widening and development process, etc.

More Partnerships

• California Convergence

• Santa Ana Building Healthy Communities

Existing Movements

• Prevention – Gang, Drug and Alcohol, Teen Pregnancy, Tobacco, Violence

• Environment – Bike/Transportation, Slow Growth, Parks, Organic, Energy, Green

• Physical Activity – Sports, Professional & Recreational, PE, Parks, Recreation

• Food – Grocery Stores, Health food Industry, Agriculture, Food Industry

• Planning Departments

• Transportation Agencies

• Public Works• Traffic Engineers• Planning

Commissions• Developers• Smart Growth• Environmentalists• Farmers, Agriculture

• Public Health Department (Chronic Disease, Injury Prevention)

• Schools (PE Dept./Teachers, Food Service)

• Restaurants• Grocery Stores• Employers,

Businesses• Healthcare

What are your next steps?