obesity. why should we care?. what is obesity? obesity is considered 30 pounds overweight. today’s...
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Obesity.Obesity.
Why should we care?Why should we care?
What is Obesity?What is Obesity?Obesity is considered 30 pounds overweight.Obesity is considered 30 pounds overweight.
Today’s children weigh 10 pounds more than Today’s children weigh 10 pounds more than the children did 10 years ago.the children did 10 years ago.
Obesity Trends* Among U.S. Obesity Trends* Among U.S. Adults, BRFSS 1990 Adults, BRFSS 1990 (1)(1)
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
no data < 10% 10%-14%
Source: Behavioral Risk Factor Surveillance System, CDC
Obesity Trends* Among U.S. Obesity Trends* Among U.S. Adults, BRFSS 1991Adults, BRFSS 1991
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Source: Behavioral Risk Factor Surveillance System, CDC
no data < 10% 10%-14% 15%-19%
Obesity Trends* Among U.S. Obesity Trends* Among U.S. Adults, BRFSS 1992Adults, BRFSS 1992
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
no data < 10% 10%-14% 15%-19%
Source: Behavioral Risk Factor Surveillance System, CDC
Obesity Trends* Among U.S. Obesity Trends* Among U.S. Adults, BRFSS 1993Adults, BRFSS 1993
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
no data < 10% 10%-14% 15%-19%
Source: Behavioral Risk Factor Surveillance System, CDC
Obesity Trends* Among U.S. Obesity Trends* Among U.S. Adults, BRFSS 1994Adults, BRFSS 1994
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
no data < 10% 10%-14% 15%-19%
Source: Behavioral Risk Factor Surveillance System, CDC
Obesity Trends* Among U.S. Obesity Trends* Among U.S. Adults, BRFSS 1995Adults, BRFSS 1995
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
no data < 10% 10%-14% 15%-19%
Source: Behavioral Risk Factor Surveillance System, CDC
Obesity Trends* Among U.S. Obesity Trends* Among U.S. Adults, BRFSS 1996Adults, BRFSS 1996
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
no data < 10% 10%-14% 15%-19%
Source: Behavioral Risk Factor Surveillance System, CDC
Obesity Trends* Among U.S. Obesity Trends* Among U.S. Adults, BRFSS 1997Adults, BRFSS 1997
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
no data 10%-14% 15%-19%
Source: Behavioral Risk Factor Surveillance System, CDC
≥20%< 10%
Obesity Trends* Among U.S. Obesity Trends* Among U.S. Adults, BRFSS 1998Adults, BRFSS 1998
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
no data < 10% 10%-14% 15%-19%
Source: Behavioral Risk Factor Surveillance System, CDC
≥20%
Obesity Trends* Among U.S. Obesity Trends* Among U.S. Adults, BRFSS 1999Adults, BRFSS 1999
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
no data < 10% 10%-14% 15%-19%
Source: Behavioral Risk Factor Surveillance System, CDC
≥20%
Obesity Trends* Among U.S. Obesity Trends* Among U.S. Adults, BRFSS 2000Adults, BRFSS 2000
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
no data < 10% 10%-14% 15%-19%
Source: Behavioral Risk Factor Surveillance System, CDC
≥20%
Obesity Trends* Among U.S. Obesity Trends* Among U.S. Adults, BRFSS 2001Adults, BRFSS 2001
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
no data < 10% 10%-14% 15%-19%
Source: Behavioral Risk Factor Surveillance System, CDC
20%-24% ≥25%
Obesity Trends* Among U.S. Obesity Trends* Among U.S. Adults, BRFSS 2002Adults, BRFSS 2002
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
no data 10%-14% 15%-19%
Source: Behavioral Risk Factor Surveillance System, CDC
20%-24% ≥25%< 10%
Obesity Trends* Among U.S. Obesity Trends* Among U.S. Adults, BRFSS 2003Adults, BRFSS 2003
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
no data 15%-19%
Source: Behavioral Risk Factor Surveillance System, CDC
20%-24% ≥25%< 10% 10%-14%
Obesity Trends* Among U.S. Obesity Trends* Among U.S. Adults, BRFSS 2004Adults, BRFSS 2004
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
no data
Source: Behavioral Risk Factor Surveillance System, CDC
20%-24% ≥25%< 10% 10%-14% 15%-19%
Obesity Trends* Among U.S. Obesity Trends* Among U.S. Adults, BRFSS 2005Adults, BRFSS 2005
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
no data
Source: Behavioral Risk Factor Surveillance System, CDC
20%-24% 25%-29%< 10% 10%-14% 15%-19% ≥30%
Obesity Trends* Among U.S. Obesity Trends* Among U.S. Adults, BRFSS 2006Adults, BRFSS 2006
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
no data
Source: Behavioral Risk Factor Surveillance System, CDC
20%-24% 25%-29%< 10% 10%-14% 15%-19% ≥30%
Obesity Trends* Among U.S. Obesity Trends* Among U.S. Adults, BRFSS 2007Adults, BRFSS 2007
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
no data
Source: Behavioral Risk Factor Surveillance System, CDC
20%-24% 25%-29%< 10% 10%-14% 15%-19% ≥30%
Obesity Trends* Among U.S. Obesity Trends* Among U.S. Adults, BRFSS 2008Adults, BRFSS 2008
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
no data
Source: Behavioral Risk Factor Surveillance System, CDC
20%-24% 25%-29%< 10% 10%-14% 15%-19% ≥30%
Obesity Trends* Among U.S. Obesity Trends* Among U.S. Adults, BRFSS 2009Adults, BRFSS 2009
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
no data
Source: Behavioral Risk Factor Surveillance System, CDC
20%-24% 25%-29%< 10% 10%-14% 15%-19% ≥30%
Prevalence and Trends DataPrevalence and Trends Data
OBESITY RATES IN FLORIDA
In 1995 In 2011 In 2030 if we continue
In 2030 if BMI Decreases by 5%
23.3% 26.6% 58.6% 51.1%
Obesity-Related Health Care Costs in Florida
Potential Savings by 2020 if BMI is Reduced by 5%
(cumulative)
Potential Savings by 2030 if BMI is Reduced by 5%
(cumulative)
$12,541,000,000 $34,436,000,000
REDUCING THE AVERAGE BODY MASS INDEX (BMI) INFLORIDA BY 5% COULD LEAD TO HEALTH CARE SAVINGS OFMORE THAN $12 BILLION IN 10 YEARS AND $34 BILLION IN 20YEARS
Top Obesity Related Health Top Obesity Related Health ProblemsProblems
2010 # of Cases
Potential Cases
Avoided by 2020 if BMI is Reduced by
5% (cumulative)*
Potential Cost
Savings by2020, if BMI is Reduced
by 5%(cumulative)
Potential Cases
Avoided by2030 if BMI is Reduced by
5%(cumulative)
Potential CostSavings by
2030, if BMI is Reduced by
5%(cumulative)
Type 2 Diabetes 1,722,671 260,135* $4,459,000,000 501,976 $14,074,000,000
Obesity Related Cancers
352,183 24,965 $328,000,000 43,451 $656,000,000
Coronary HeartDisease &
Stroke
1,412,354 234,408 $5,913,000,000 465,385 $14,684,000,000
Hypertension 4,372,354 235,932 $827,000,000 401,924 $2,175,000,000
Arthritis 4,225,434 117,776 $1,013,000,000 218,399 $2,849,000,000
2010 baseline for potential cases, costs and savings* National Heart Forum provided the total cases and cases avoided per 100,000 people, and TFAH used the state’s 2011 census data to translate to the full population-based estimates.^Top obesity-related cancers include endometrial (uterine), esophageal, kidney, colon and post-menopausal breast cancer.
The Problem:The Problem:
And that’s risky and expensive.And that’s risky and expensive.
Chronic Diseases related to obesity is a leading cause of deathChronic Diseases related to obesity is a leading cause of death
Obesity related diseases costs the U.S. $270 billion a yearObesity related diseases costs the U.S. $270 billion a year
• We’re too sedentary• We don’t eat well
Financial Work Related Cost of ObesityFinancial Work Related Cost of Obesity
Indirect Costs:Indirect Costs: Value of Lost WorkValue of Lost Work Insurance Premiums and CompensationsInsurance Premiums and Compensations Lower WagesLower Wages
Obesity-related absenteeism costs employers as much Obesity-related absenteeism costs employers as much as as $6.4 billion $6.4 billion a yeara year
The annual cost of obesity-related loss of productivity is The annual cost of obesity-related loss of productivity is as much as as much as $30 billion $30 billion each year. each year. (Forbes 2013)(Forbes 2013)
Starts at ChildhoodStarts at Childhood Today, one in three American kids and Today, one in three American kids and
teens are overweight or obese, nearly teens are overweight or obese, nearly triple the rate in 1963. triple the rate in 1963.
Childhood obesity is now the No. 1 Childhood obesity is now the No. 1 health concern among parents in the health concern among parents in the United States, topping drug abuse and United States, topping drug abuse and smoking smoking
Source: Centers for Disease Control and Prevention
The Food EnvironmentThe Food Environment
Increased number of fast food Increased number of fast food establishments in the U.S. establishments in the U.S.
Lack of access to full service grocery Lack of access to full service grocery stores selling affordable healthful foodsstores selling affordable healthful foods
Less healthy food & beverage advertising Less healthy food & beverage advertising aimed at childrenaimed at children
Dietary BehaviorsDietary Behaviors
Increased consumption of sugar Increased consumption of sugar
sweetened beveragessweetened beverages
Continued low consumption of fruitsContinued low consumption of fruitsand vegetablesand vegetables
Factors of ObesityFactors of Obesity Hectic/busy schedulesHectic/busy schedules
turn to fast foodturn to fast food
Children watching more TV/video gamesChildren watching more TV/video games Less activeLess active Likely to consume more soda and junk foodLikely to consume more soda and junk food Parents and children forgot how to “play” Parents and children forgot how to “play”
Poor neighborhoods and lack of physical activityPoor neighborhoods and lack of physical activity May not have easy access to nutritional foodMay not have easy access to nutritional food May not be as safe for walking and playingMay not be as safe for walking and playing
Source: Stanford Prevention Research Center
Physical ActivityPhysical Activity 76.4% of adults in Pinellas County did not meet the weekly 76.4% of adults in Pinellas County did not meet the weekly
recommendation for leisure-time aerobic or muscle strengthening recommendation for leisure-time aerobic or muscle strengthening physical activity in the 30 days.physical activity in the 30 days.
74% of white adults in Pinellas County had not met the weekly 74% of white adults in Pinellas County had not met the weekly recommendation compared to 93% of blacks.recommendation compared to 93% of blacks.
22.4% of adults were sedentary overall, but it jumps to 35% for 22.4% of adults were sedentary overall, but it jumps to 35% for adults who made less than $25,000 adults who made less than $25,000
Even though a recent grant that ended, Communities Putting Even though a recent grant that ended, Communities Putting Prevention to Work, helped to increase opportunities for physical Prevention to Work, helped to increase opportunities for physical
activity, the data still shows significant disparities.activity, the data still shows significant disparities.
(Centers for Disease Control and Prevention BRFSS 2012)(Centers for Disease Control and Prevention BRFSS 2012)
Community Design & the Built Community Design & the Built EnvironmentEnvironment
Standardized Share of Mode for Trips to School:Standardized Share of Mode for Trips to School:National Personal Transportation SurveyNational Personal Transportation Survey
Car
Bus
Walk/bike
Public Transit
McDonald NC. Am J Prev Med 2007;32:509
0
10
20
30
40
50
60
1969 1977 1983 1990 1995 2001
Year
% o
f Tri
ps
Children Walking to SchoolChildren Walking to School1969 – 50%1969 – 50%Now – 14% Now – 14%
ChallengesChallenges Environmental factors beyond the control of individuals
contribute to increased obesity rates by reducing the likelihood of healthy eating and active living behaviors.
Environmental factors that influence physical activity behavior (26, 27):
Lack of infrastructure supporting active modes of transportation, i.e. sidewalks & bike facilities
Access to safe places to play and be active Access to public transit Mixed use & Transit Oriented Developments
WHY?WHY?Does the current environment Does the current environment inadvertently inadvertently encourageencourage this?this?
How can we incentivize How can we incentivize healthierhealthier behaviors?behaviors?
Pre-contemplation
“Never”
Contemplation
“Maybe”
Preparation
“Soon”
Action
“Now”
Maintenance
“Always”
Take Ownership.Take Ownership.
The obesity epidemic The obesity epidemic IS IS
everyone’s problem. everyone’s problem.
It will take It will take EVERYONEEVERYONE to solve it. to solve it.
What we What we DON’TDON’T need to do need to do
Tell people how to find fruits and Tell people how to find fruits and veggies near their home veggies near their home (They know how)(They know how)
Tell people parks are nearby Tell people parks are nearby (They know)(They know)
Tell them to get healthy Tell them to get healthy (They think they are fairly healthy)(They think they are fairly healthy)
Tell them exercise and physical Tell them exercise and physical activity are good for their healthactivity are good for their health(We all know this already)(We all know this already)
Thinking In Thinking In NewNew Ways Ways The choice to sustain good health must be supported by the The choice to sustain good health must be supported by the
environment we live in. environment we live in. Leaders must make decisions that impact the environment in Leaders must make decisions that impact the environment in
healthy ways. healthy ways. Leaders must make decisions in ways they have not thought Leaders must make decisions in ways they have not thought
of previously in community planning. of previously in community planning.
Employee Wellness PoliciesEmployee Wellness Policies Healthy Vending PoliciesHealthy Vending Policies Fitness ZonesFitness Zones Added bike racks Added bike racks Farmers Markets/Produce StandsFarmers Markets/Produce Stands
The Focus:The Focus: Change systems, infrastructure and policies so Change systems, infrastructure and policies so
they encourage – not discourage – healthy eating they encourage – not discourage – healthy eating and physical activity.and physical activity.
Broad leadership team that includes elected Broad leadership team that includes elected officials, non-profit organization and the private officials, non-profit organization and the private sector.sector.
Partner with local governments, transportation Partner with local governments, transportation authorities, schools, Early Childhood authorities, schools, Early Childhood programs/organizations, after school programs, programs/organizations, after school programs, local businesses, community and faith-based local businesses, community and faith-based groups in partnerships.groups in partnerships.
Making Healthy Living Easier
QUESTIONS?QUESTIONS?
Megan CarmichaelMegan CarmichaelHealthy Pinellas Program ManagerHealthy Pinellas Program Manager
Florida Department of Health - PinellasFlorida Department of Health - Pinellas
(727) 588-4040 x3118(727) 588-4040 x3118
Megan.Carmichael@flhealth.govMegan.Carmichael@flhealth.gov
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