ASTPHND State TeleconferenceHealthy Weight Indicator Report Card
June 1, 2010
This information is distributed solely for the purpose of pre dissemination public comment under applicable information quality guidelines. It has not been formally disseminated by the Centers for Disease Control and Prevention. It does not represent and should not be construed to represent any agency determination or policy.
Obesity Prevention and Control BranchDivision of Nutrition, Physical Activity & Obesity
NCCDPHP, CDC
State Indicator Report on Healthy Weight for Youth
United States, 2010
Contributors
Report Card
Steve Onufrak Kelly Pattillo
Beverly Kingsley Ashleigh May
Holly Wethington
Data Advisors
Liping Pan Sohyun Park
Karen Dalenius DASH
Advisory Members
Heidi Blanck Bettylou Sherry
Meredith Reynolds Terry O’Toole
Tina Lankford Marilyn Batan
State Indicator Report on Healthy Weight for Youth
•General overview
•Draft outcome indicators
•Draft environmental and policy indicators
•Next steps
State Indicator Report on Healthy Weight for Youth
Division of Nutrition, Physical Activity and Obesity
• Primary Target Areas– Physical Activity, Fruit & Vegetable,
Breastfeeding– Sugar Sweetened Beverages– Television Viewing – Energy Density
• Environment and Policy
Division of Nutrition, Physical Activity and Obesity
• Primary Target Areas– Physical Activity, Fruit & Vegetable,
Breastfeeding– Sugar Sweetened Beverages– Television Viewing – Energy Density
• Environment and Policy
• Draft Outcome Indicators– Children Healthy Weight Prevalence – Soft Drink Consumption – Television/Screen Time
• Draft Environmental and Policy Indicators
State Indicator Report on Healthy Weight for Youth
Comprehensive Approach for Preventing and Addressing Childhood Obesity
(IOM, 2007)
• Draft Environmental and Policy Indicators– School Environment and Policy– Home Environment– Childcare Environment and Policy
State Indicator Report on Healthy Weight for Youth
• School Environment and Policy– School Competitive Food Environment– School Neighborhood Retail Environment– School Physical Activity Availability and
Participation
State Indicator Report on Healthy Weight for Youth
• Home Environment– Television in Bedroom– Meals Eaten with Family
State Indicator Report on Healthy Weight for Youth
• Childcare Environment and Policy– Childcare Nutrition and Physical Activity
Regulations
State Indicator Report on Healthy Weight for Youth
• Other Reports– “F as in Fat 2009” Robert Wood Johnson Report
http://healthyamericans.org/reports/obesity2009/– “Child Obesity State Report Cards” - National Survey of
Children’s Healthhttp://nschdata.org/Content/07ObesityReportCards.aspx
– “State Fact Sheets” – Youth Risk Behavior Surveillance System and School Health Profileshttp://www.cdc.gov/HealthyYouth/obesity/facts.htm
State Indicator Report on Healthy Weight for Youth
• How is this report different?– More in-depth focus on youth: early
childhood through adolescence– Home environment– Soft drink consumption and availability in
schools/on campus– Retail food environment
State Indicator Report on Healthy Weight for Youth
• Healthy Weight Report indicators can be used to:– Monitor progress and celebrate state successes. – Identify opportunities for growth and improvement in
environmental and policy supports that make promoting healthy weight more feasible at the state level.
– Report to be released regularly
State Indicator Report on Healthy Weight for Youth
• Criteria for Inclusion:– Highlighted in multiple expert
recommendations and reports: e.g., IOM, DNPAO Guidance Documents
– Data measurable, available for most states– Data available from reputable
sources: .gov, .org, .edu; transparent methodology in obtaining information
State Indicator Report on Healthy Weight for Youth
Things to consider during today’s call:• Indicator
– Is it the right concept?
• Data source– Additional sources meeting inclusion criteria?
• Metric– Is this a helpful way to represent the data?
• Usefulness and feasibility in your state
State Indicator Report on Healthy Weight for Youth
Draft Outcome Indicators
State Indicator Report on Healthy Weight for Youth
Healthy WeightOutcome Indicators
Prevalence of Healthy Weight
Percent of children ages 2-5 with BMI percentile ≥5th and <85th
Pediatric Nutrition Surveillance System (PedNSS), 2009
State BMI percentile ≥5th
and <85th, 2009 PedNSS
Alabama 71.1%* (95% CI)
Alaska ┼
Arizona 69.4%* (95% CI)
Arkansas 70.2%* (95% CI)
California 66.7%* (95% CI)
Colorado 76.2%* (95% CI)
Connecticut 68.8%* (95% CI)
*Data shown are from 2008 PedNSS; estimates represent prevalence of underweight and healthy weight and are for illustration only
┼ Data not available
Healthy WeightOutcome Indicators
Prevalence of Healthy Weight
Percent of children ages 6-12 with BMI percentile ≥5th and <85th
National Survey of Children’s Health (NSCH), 2007
State BMI Percentile≥5th
and <85th, 2007 NSCH
Alabama 63.9%* (95% CI)
Alaska 66.1%* (95% CI)
Arizona 69.4%* (95% CI)
Arkansas 62.5%* (95% CI)
California 69.5%* (95% CI)
Colorado 72.8%* (95% CI)
Connecticut 74.3%* (95% CI)
*Data shown are from 2007 NSCH; estimates represent prevalence of underweight and healthy weight and are for illustration only
Healthy WeightOutcome Indicators
Prevalence of Healthy Weight
Percent of high school students with BMI percentile ≥5th and <85th
Youth Risk Behavior Surveillance System (YRBSS), 2009
State BMI Percentile ≥5th and <85th, 2009
YRBSS
Alabama 67.4%* (95% CI)
Alaska 72.7%* (95% CI)
Arizona 74.1%* (95% CI)
Arkansas 70.3%* (95% CI)
California ┼
Colorado 79.9%* (95% CI)
Connecticut 74.4%* (95% CI)*Data shown are from 2005 or 2007 YRBSS; estimates are for illustration only and do not account for underweight prevalence
┼ Data not available
Sugar Sweetened BeverageOutcome Indicators
Soft Drink Consumption
Median soft drink consumption for high school students
Youth Risk Behavior Surveillance System (YRBSS)
State Median Soft Drink
Consumption, 2009 YRBSS
Alabama *
Alaska *
Arizona *
Arkansas *
California *
Colorado *
Connecticut *
*Data currently not available
TelevisionOutcome Indicators
Television Viewing
% of children ages 2-5 meeting American Academy of Pediatrics recommendations of ≤2 hours of
TV per day
National Survey of Children’s Health (NSCH), 2007
State % Children Ages 2-5 Meeting AAP
Recommendations
Alabama 67.9% (95% CI)
Alaska 75.8% (95% CI)
Arizona 66.7% (95% CI)
Arkansas 67.4% (95% CI)
California 77.8% (95% CI)
Colorado 82.3% (95% CI)
Connecticut 70.9% (95% CI)
TelevisionOutcome Indicators
Television Viewing
% of children ages 6-10 meeting American Academy of Pediatrics recommendations of ≤2 hours of
TV per day
National Survey of Children’s Health (NSCH), 2007
State % Children Ages 6-10 Meeting AAP Recommendations
Alabama 71.1%* (95% CI)
Alaska 79.6%* (95% CI)
Arizona 76.9%* (95% CI)
Arkansas 73.2%* (95% CI)
California 77.9%* (95% CI)
Colorado 83.5%* (95% CI)
Connecticut 81.7%* (95% CI)
*Data shown are from 2007 NSCH; estimates indicate % of children 6-17 meeting AAP recommendations and are for illustration only
TelevisionOutcome Indicators
Television Viewing
% of middle school students meeting American Academy of Pediatrics recommendations of ≤2 hours of
TV per day
Youth Risk Behavior Surveillance System (YRBSS), 2009
State % Middle School Students Meeting
AAP Recommendations
Alabama 61.6%* (95% CI)
Alaska 77.0%* (95% CI)
Arizona 71.8%* (95% CI)
Arkansas 65.7%* (95% CI)
California ┼
Colorado 73.2%* (95% CI)
Connecticut 69.9%* (95% CI)
*Data shown are from 2005 or 2007 YRBS; estimates reflect % of middle and high school students watching 3 hours or less of television each day and are for illustration only
┼ Data not available
TelevisionOutcome Indicators
Television Viewing
% of high school students meeting American Academy of Pediatrics recommendations of ≤2 hours of
TV per day
Youth Risk Behavior Surveillance System (YRBSS), 2009
State % High School Students Meeting
AAP Recommendations
Alabama 61.6%* (95% CI)
Alaska 77.0%* (95% CI)
Arizona 71.8%* (95% CI)
Arkansas 65.7%* (95% CI)
California ┼
Colorado 73.2%* (95% CI)
Connecticut 69.9%* (95% CI)
*Data shown are from 2005 or 2007 YRBS; estimates reflect % of middle and high school students watching 3 hours or less of television each day and are for illustration only
┼ Data not available
Draft Environmental and Policy Indicators
State Indicator Report on Healthy Weight for Youth
School Environment and PolicySugar Sweetened Beverages
% middle and high schools in which sugar sweetened beverages
(including sports drinks and juice drinks that are not 100% juice) are
not available
School Health Profiles (Principal Questionnaire), 2008
State % Schools Where SSBs Were Not
Available
Alabama 68.3%* (95% CI)
Alaska 66.0%* (95% CI)
Arizona 81.0%* (95% CI)
Arkansas 52.3%* (95% CI)
California ┼
Colorado ┼
Connecticut 92.8%* (95% CI)
*Estimates reflect % of middle and high schools where soda and fruit drinks (not 100% juice) were not available and are for illustration only; sports drinks are not included in this calculation
┼ Data not available
School Environment and PolicyHigh Energy Density Snacks
% middle and high schools in which candy, salty snacks, ice cream, and
cookies/baked goods are not available
School Health Profiles (Principal Questionnaire), 2008
State % Schools Where High Energy
Density Snacks Were Not Available
Alabama 73.9%* (95% CI)
Alaska 63.6%* (95% CI)
Arizona 71.7%* (95% CI)
Arkansas 70.8%* (95% CI)
California ┼
Colorado ┼
Connecticut 80.4%* (95% CI)
*Estimates reflect % of middle and high schools where candy or salty snacks were not available, and are for illustration only
┼ Data not available
School Environment and Policy
Data compilation in process
Question
Is this a useful and meaningful indicator?
Retail Food Environment Index in 1 Mile Radius Surrounding Schools
Derived from GIS Analysis of Homeland Security Retail Database
School Environment and Policy
Physical Activity Opportunities
% middle and high schools in which intramural sports or physical activity
clubs are available to all students
School Health Profiles (Principal Questionnaire), 2008
State % Middle and High Schools Offering Intramural Sports
or PA Clubs
Alabama 57.4%
Alaska 83.3%
Arizona 71.2%
Arkansas 54.5%
California 79.7%
Colorado 72.3%
Connecticut 74.6%
School Environment and Policy
Data compilation in process
Question
Is this a useful and meaningful indicator?
Sports Participation
% of children participating on a sport team or taking sports lessons during
the past 12 months
National Survey of Children’s Health (NSCH), 2007
Home Environment
Family Meals Eaten Together
% of families that eat together as a family most (≥4) days of the
week
National Survey of Children’s Health (NSCH), 2007
State % Families Sharing Meal Together Most Days of the Week
Alabama 44.2*%
Alaska 50.2*%
Arizona 50.0*%
Arkansas 46.7*%
California 49.7*%
Colorado 44.7*%
Connecticut 40.3*%
*Estimates indicate % of children 6-17 eating meals together every day during week preceding survey and are for illustration only
Home EnvironmentTelevision in Bedroom
% of children meeting American Academy of Pediatrics
recommendations of no TV in bedroom
National Survey of Children’s Health (NSCH), 2007
State % Children Without TV in Bedroom
Alabama 32.3%
Alaska 67.0%
Arizona 52.7%
Arkansas 34.1%
California 53.6%
Colorado 63.4%
Connecticut 57.1%
Childcare Environment and PolicyRecommended* Childcare Nutrition Regulations
•Foods of low nutritional value served infrequently
•Sugar sweetened beverages not served
•Children older than two years served reduced fat milk
•Drinking water available for children to serve themselves throughout day
•Nutrition education offered to child care providers
•Juice limited to 4-6 ounces per day for children over age one
•Child care providers do not use food as a reward / punishment
•Nutrition education offered to children
•Child care provider sits with children at table and eats same meals and snacks
•Providers encourage, but do not force, children to eat *Report: Preventing Obesity In The Child Care Setting: Evaluating State Regulations
http://cfm.mc.duke.edu/modules/cfm_ehs_resrch/index.php?id=6
Childcare Environment and PolicyChildcare Nutrition Policy
# of recommended* nutrition regulations (out of 10 total) currently enacted in both home childcare and
childcare center settings
*Source: Preventing Obesity In The Child Care Setting: Evaluating State Regulations
http://cfm.mc.duke.edu/modules/cfm_ehs_resrch/index.php?id=6
State # of Recommended Childcare Nutrition
Policies Enacted
Alabama 1
Alaska 2
Arizona 2
Arkansas 2
California 2
Colorado 4
Connecticut 1
Childcare Environment and PolicyRecommended* Physical Activity Regulations
•Children are provided with 60 minutes of physical activity per day
•TV/video/computer time limited to once per week and ≤ 30 minutes each time
•Child care providers do not withhold active play time as punishment
•Special needs children provided active play opportunities while other children are physically active
•Children provided outdoor active play time at least two times per day
•Physical activity education offered to child care providers ≥ 1 time per year
•At least one provider joins children in active play at least one time per day
•Shaded area provided during outdoor play
•Children not seated for periods > 30 minutes except when sleeping or eating
•Physical activity education is offered to children at least three times per year *Report: Preventing Obesity In The Child Care Setting: Evaluating State Regulations
http://cfm.mc.duke.edu/modules/cfm_ehs_resrch/index.php?id=6
Childcare Environment and PolicyChildcare Physical Activity Policy
# of recommended* physical activity regulations (out of 10 total) currently enacted in both home childcare and
childcare center settings
*Source: Preventing Obesity In The Child Care Setting: Evaluating State Regulations
http://cfm.mc.duke.edu/modules/cfm_ehs_resrch/index.php?id=6
State # of Recommended Childcare PA
Policies Enacted
Alabama 3
Alaska 5
Arizona 3
Arkansas 2
California 0
Colorado 5
Connecticut 0
• MAPPS Focal Areas to Consider– Access (e.g., neighborhood retail environment)– Price (e.g., school competitive food environment)– Social support (e.g., family meals)– Media– Point of decision information
State Indicator Report on Healthy Weight for Youth
• Next Steps– Post-call feedback from you
• Additional Indicators?• Addressing Disparities?• Errors and Omissions?• General Comments?
State Indicator Report on Healthy Weight for Youth
Send comments to: [email protected]
by June 23rd
This information is distributed solely for the purpose of pre dissemination public comment under applicable information quality guidelines. It has not been formally disseminated by the Centers for Disease Control and Prevention. It does not represent and should not be construed to represent any agency determination or policy.
State Indicator Report on Healthy Weight for Youth