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The Burden Of The Burden Of ObesityObesity
Alison Patrick, MPH, RD, LDCuyahoga County Board of Health
For the first time in two centuries,
the current generation of
children in America may live shorter lives than
their parents.
Childhood Obesity - Childhood Obesity - DefinedDefined
• Calculated using a child’s weight and heighto Weigh status is then determined using age and sex
specific percentile for BMI rather than using the adult BMI categories
• Childhood overweight: At or above the 85th percentile and lower than the 95th percentile for children of the same age and sex
• Childhood obesity: At or above the 95th percentile for children of the same age and sex
Childhood Obesity: Childhood Obesity: The Good NewsThe Good News
• Nationally, the percentage of American children who are obese has not increased in the past decade
Childhood Obesity:Childhood Obesity:The Bad NewsThe Bad News
• There has been no decrease in the percentage of American children who are obese
Childhood Obesity: Childhood Obesity: DisparitiesDisparities
Early Childhood Early Childhood ObesityObesity
• 10% of infants and toddlers have high weight-for-length
• 1 in 7 low-income preschool-aged children is obese
2009-2011 County Obesity Prevalence Among Low-Income Children Aged 2 to 4 Years
Chronic Disease Chronic Disease ImplicationsImplications
• Children who are obese are more than twice as likely to die before the age of 55
• 70% of obese youth have at least one risk factor for cardiovascular diseaseo 39% of obese children have two or more risk factors
• Children who are obese after the age of 6 are 50% more likely to be obese as adults
• Chronic disease accounts for 75% of health care spending in the US
2012 F as in Fat ReportTrust for America’s Health
Economic Cost of Economic Cost of ObesityObesity
• Obesity related medical careo $160 billion per year (2010 estimate)
• Indirect cost of obesity in Americao $450 billion per year (2011 estimate)
• $140 billion on incremental food costs, plus-sized clothing, and weight loss products and programs
• $160 billion on medications, surgeries, and doctor visits
• $130 billion on absenteeism, decreased productivity, and short-term disability
• $20 billion on increase use of fuel, electricity, etc.
OHIO: Obesity (BMI>95%tile) OHIO: Obesity (BMI>95%tile)
Across the LifespanAcross the Lifespan
<5% 5-9.9% 10-14.9% 15-19.9% 20-24.9% 25-29.9% >30%
2-5 yr. olds 10-17 yr. olds Adults
Pediatric Nutrition Surveillance System (PedNSS), CDC, and ODH 2006Ohio Family Health Survey (OFHS), ODJFS/ODH/ODI/ODMH, 2008
Does Place Matter?Does Place Matter?
Where you live, work, pray, and play impact our health
FactFact
The choices we make are shaped by the choices we
have
Prevalence of obesity in Cleveland neighborhoods, 2005-2009Source: Behavioral Risk Factor Surveillance System (BRFSS)Cleveland neighborhood clusters(W) West Riverside, Puritas-Longmead, Kamms Corner, and Jefferson(NW) Northwest Edgewater, Cudell, Detroit-Shoreway, Ohio City/Near West Side, andTremont(S/SW) South/Southwest:West Boulevard, Stockyards, Clark-Fulton, Brooklyn-Center, and OldBrooklyn(E) East: Downtown, Central, Goodrich-Kirtland Park, St. Clair-Superior, Fairfax, Hough, and University(NE) Northeast: Glenville, Forest Hills, North and South Collinwood,and Euclid-Green(EC) EasternCorridor:Industrial Valley, North Broadway, Kinsman,Woodland Hills and Buckeye-Shaker(SE) Southeast: South Broadway, Union-Miles, Corlett,Mt. Pleasant, and Lee-Miles
Hough 64.0
Lyndhurst 88.5
Life Expectancy: 80.3High School grads: 98.1%Unemployment: 3.4%Poverty: 3.3%Home ownership: 92.6%Non-white: 22.90%
Life Expectancy: 74.5High School grads: 82.9% Unemployment: 9.2%Poverty: 17.2%Home ownership: 56.3% Non-white: 46.1%
Life Expectancy: 65High School grads: 68.2%Unemployment: 18.7%Poverty: 37.4%Home ownership: 33.60%Non-white: 95.4%
Cuyahoga CountyCuyahoga CountyYouth Risk Behavior Youth Risk Behavior
SurveySurvey
•2011 High School Surveyo 12,749 student responses
•Nutritiono 22.6% of students met the recommendation for fruit and vegetable
intakeo 22.8% of students are drinking at least one soda per dayo Only 32.7% of students eat breakfast dailyo 75% of students report eating fast food one day per week
Youth Risk Behavior Youth Risk Behavior SurveySurvey
• Physical Activityo Only 43.8% of students met the recommended levels of physical
activityo 34.3% of students watch three of more hours of television dailyo 27.2% of students play video games three or more hours daily
• Weight Statuso 16.6% of students are overweighto 13.3% of students are obese
Early Childhood Early Childhood Obesity:Obesity:
Taking Action Taking Action
A Policy ApproachA Policy Approach
• All children have these things in common:
o The need for healthy food optionso The need for adequate time for physical
activityo Health and child care providers that monitor
health and growth, are mindful of healthy patterns, and can advise and assist parents in addressing issues
A Policy ApproachA Policy Approach
• Goal: To establish policies that are not only universal in addressing the health of young children, but that are also feasible across different settings and account for the potential negative social and economic factors that exist in communities
Breastfeeding PolicyBreastfeeding Policy
• Adults working with infants and families should promote and support exclusive breastfeeding for 6 months, and continuation of breastfeeding through one year of age, along with the introduction of age appropriate foods
10 Steps to Breastfeeding-10 Steps to Breastfeeding-Friendly Child Care CentersFriendly Child Care Centers• Designate an individual or group who is responsible for development and
implementation of the ten steps.• Establish a supportive breastfeeding policy and require all staff be aware of and
follow the policy.• Establish a supportive worksite policy for staff members who are breastfeeding.• Train all staff so that they are able to carry out breastfeeding promotion and support
activities.• Create a culturally appropriate breastfeeding-friendly environment.• Inform expectant and new families and visitors about your center’s breastfeeding-
friendly policies.• Stimulate participatory learning experiences with the children, related to
breastfeeding.• Provide a comfortable place for mothers to breastfeed or pump their milk in privacy,
if desired.• Educate families and staff that a mother may breastfeed her child wherever they
have a legal right to be. Establish and maintain connections with local breastfeeding coalition or community breastfeeding resources.
• Maintain an updated resource file of community breastfeeding services and resources kept in an accessible area for families
Nutrition PolicyNutrition Policy• Require that all meals, snacks, and beverages
served be consistent with the USDA Child and Adult Food Care program meal patternso Pattern is consistent with the Dietary Guidelines for Americans
• Ensure safe drinking water be both available and accessible to children
Nutrition Policy – Nutrition Policy – Food AccessFood Access
• Promote and refer individuals to food assistance programso Promote use of farmers market incentive
programs
• Farm to Preschool
• School Gardening
Energy Dense Foods and Sugar Sweetened Energy Dense Foods and Sugar Sweetened
BeveragesBeverages
• Limit or eliminate consumption during day
• Avoid use as reward in classroomo Limit use and consumption for classroom parties
• Fundraisers
Physical ActivityPhysical Activity• Establish physical activity policy to ensure
infants, toddlers, and preschool children have opportunities for physical activity throughout the day
• Policy should also ensure that the facility built environment supports the promotion of physical activity
• Policy should also support professional development opportunities for staff related to physical activity
Physical Activity PolicyPhysical Activity Policy• Opportunities to move freely
o Withholding physical activity should not be used as a punishment
• Infants, toddlers, and preschoolers should be allowed to move freelyo Policy needs to limit the use of equipment that restricts
movement • Infant equipment should be used only for its intended
purpose
Screen Time PolicyScreen Time Policy• Limit screen time for ages 2-5
o Less than 30 minutes per day for children in half-day programs
o Less than 1 hour per day for children in full-day programs
