The Food Journal and Food, Nutrition & Science

An alliance between The Lempert Report and The Center for Food Integrity

The State-by-State Fight Against Obesity

The State-by-State Fight Against Obesity

Shoppers and Trends

January 27, 2013

More than one third of adults in the U.S. are obese. Childhood obesity rates in America have tripled over the past three decades. And in 2008, the medical costs associated with obesity from conditions including heart disease and type 2 diabetes was estimated at $147 billion.

These are all staggering numbers, to say the least, which is why well publicized, national programs to fight obesity – like First Lady Michelle Obama’s Let’s Move! campaign – are so important. But lesser known local obesity programs are starting to make their marks as well. State-run initiatives are tackling obesity on local and neighborhood levels, intervening where residents need it most.

California’s Project Lean works to advance nutrition and physical activity policy in school and communities in order to prevent obesity and its associated chronic diseases. Much of their efforts are in low resource, high need communities, with efforts centered around youth and parent empowerment, policy and environmental change strategies and community-based solutions.

There are five current projects operating under the Project Lean banner, each with it’s own central focus. Drew Johnson, acting deputy director, Center for Chronic Disease Prevention in the California Department of Public Health (CDPH), says it is this multi-pronged approach that is helping address different aspects of obesity prevention.

“The causes of overweight and obesity are complex and numerous, and occur at the social, economic, environmental, and individual levels. People make decisions in the context of their environment, and in California there are strong environmental forces that often make healthy choices difficult,” says Johnson.

Johnson says that CDPH recognizes that health inequities exist in communities and that specific racial and ethnic minorities experience higher rates of overweight and obesity because of certain social conditions. With this in mind, they focus much of their efforts in low-resource, high-need communities whose members are adversely impacted by such social conditions. And they work directly with communities and schools to implement strategies that will improve access to healthy foods and physical activity opportunities.

“We also work with state and local physical activity and nutrition leaders, key school and community organizations, school board members, youth, parents, and ‘promotoras’ (Latino communities’ health care providers) because stakeholder engagement is an essential component of obesity prevention and health promotion,” says Johnson.

CDPH has made considerable progress in schools and communities throughout California in the area of obesity prevention, and they’ve got the numbers to prove it. A large-scale evaluation study of the Latino Campaign reported a 37 percent increase in fruit and vegetable consumption, compared to Spanish speakers not exposed to the campaign. The findings also showed that the greater exposure to the Latino Campaign, the more fruit and vegetable consumption increased. And during 2012, a cluster randomized controlled study of Power Play! (a program that reaches 4th- and 5th-graders as they begin to make food and physical activity choices independently of their parents) conducted over 10 weeks in 44 schools showed a significantly greater change in fruit and vegetable consumption (¼ cup/day) among intervention children at follow-up compared to control students not receiving Power Play!

“Our efforts are centered around youth and parent empowerment approaches, environmental change strategies, and community-based solutions that improve nutrition and physical activity environments. We recognize that no one organization can address the issues surrounding obesity alone. It will take employers, health care insurers and providers, community organizations, schools and child care, the food and beverage industry, and other diverse organizations to come together in a shared, comprehensive, multi-sector collaboration that addresses all venues in which we live, work, and play,” adds Johnson.

Other state programs are gaining traction too. Eat Smart, Move More in North Carolina is a statewide movement that promotes increased opportunities for healthy eating and physical activity wherever people live, learn, earn, play and pray. Healthy Living/Happy Living in Texas is an after-school, family-based obesity program funded by multiple local philanthropic partners. The 10-week program targets overweight and obese children aged 6 to 11 years old and their parents/guardians, and focuses on providing tools for families to empower them to make healthy changes. And the list goes on.

Perhaps one of the more well known city programs is New York City’s recent ban of sugary drinks sold in containers larger than 16 ounces. One of NYC Mayor Bloomberg’s passion projects, the ban is an effort to combat the growing waistlines of New Yorkers, which is in turn contributing to an increase in diabetes and heart disease.

Additionally, there are programs that function on both the state as well as the national level. For example, Safe Routes to School (SRTS) programs work with parents, schools and community leaders at the local, state and federal levels to improve the health and well-being of children by enabling and encouraging them to walk and bicycle to school. In 1969 almost half of students in K-8 grades walked or biked to school, but by 2009 only 13% were doing so. Safe Routes is dedicated to addressing safety problems and bringing those numbers back up.

Nancy Pullen-Seufert, Associate Director at the National Center for Safe Routes to School, says that Safe Routes to School programs, bolstered by more than $1 billion in funding in the last federal transportation bill, are designed to improve safety and accessibility for school routes and in the process hopefully make walking to school a more appealing transportation choice.

Not only is the overall concept of walking and bicycling to school extremely successful – since 1997, every year they’ve hosted a National Walk to School Day they have broken their previous record in terms of participation – but it also serves as a way of bringing the community together, giving kids and parents a chance to socialize with each other and their peers while improving their health. The next National Walk to School Day is October 9th, 2013.

“Since so many of our communities have been built to make it easy to drive and hard to walk or bike, this is where the real challenge and opportunities of Safe Routes lies,” says Pullen-Seufert. “But like so many other things, Safe Routes is just one piece of the answer when it comes to tackling obesity. We have an understanding now about how the environment influences our behavior, when it comes to both how we eat and how we move, and we have to make changes to the built environment to encourage healthier behaviors.”