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Weight of the Nation - what is our response?

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Have you been following the CDC Weight of the Nation 2012 forum in Washington DC?  Looking forward to the HBO special next week?  The conference and movie kick off a number of activities designed to engage us all to act against the obesity pandemic. 

Obesity is a public health crisis: two-thirds of adults and one-third of children are overweight or obese.  The staggering human toll of obesity-related chronic disease and disability, and an annual cost of $190.2 billion for treating obesity-related illness, underscore the urgent need to strengthen prevention efforts in the United States.

This morning, The Institute of Medicine (IOM) released its long-awaited report on catalysts that could speed progress in obesity prevention. On their own, accomplishing any one of these might help speed up progress in preventing obesity, but together, their effects will be reinforced, amplified, and maximized.

The five essential areas of focus are:

  • Integrate physical activity every day in every way
  • Market what matters for a healthy life
  • Make healthy foods and beverages available everywhere
  • Activate employers and health care professionals
  • Strengthen schools as the heart of health

Over the next few days we will be highlighting the different recommendations the IOM laid out.  Join R2R to highlight some of the important work you have undertaken to in these areas to redress the obesity pandemic.  Which best practices, initiatives, programs and partnerships have you taken on in your lab, your state, your coalition? Please share your story with us and help others in this essential work!

Obesity: Complex, but Conquerable.


Margaret - thanks for

Margaret - thanks for starting this discussion!  I attended the screening hosted by NIH on part 1 (consequences) and I'm looking forward to watching parts 2-4 this weekend.  In addition to airing the specials on their network and web site, HBO (in conjunction with NIH, CDC, IOM, Kaiser Permanente, and the Michael & Susan Dell Foundation) developed 40,000 screening toolkits that they are currently distributing free of charge.  The kits include copies of the films, bonus short videos, and extensive discussion guides.  They also provide social media tools to help direct and promote community events.  Click here to request a screening kit.  

And why stop there?  The Weight of the Nation screening and facilitated discussions would be the perfect "kick-off" to the Eat Healthy ● Be Active Community Workshops.  HHS's Office of Disease Prevention and Health Promotion (ODPHP) has developed six one-hour workshops based on the Dietary Guidelines for Americans, 2010 and 2008 Physical Activity Guidelines for Americans. Each workshop includes a lesson plan, learning objectives, talking points, hands-on activities, and handouts. The workshops are designed for community educators, health promoters, dietitians/nutritionists, cooperative extension agents, and others to teach to adults in a wide variety of community settings.

What do you think of these resources?  Like Margaret, I'm also interested to hear your stories about the work you're doing around the five essential areas of focus...what has worked in your community?

Kaiser Permanente is devoting

Kaiser Permanente is devoting considerable resources to address the obesity epidemic in the communities they serve and around the Nation.  They are committed to helping Americans THRIVE!

I was fortunate to

I was fortunate to participate in a community health center screening of Weight of the Nation last week.  A rich discussion about the barriers to and possibilities of implementing the IOM recommendations followed.

Of note (to me) was a discussion of Joint Use (sometimes called Shared Use) agreements.  A joint use/shared use agreement is a formal agreement between two separate government entities—often a school district and a city or county—setting forth the terms and conditions for the shared use of public property. 

Many communities lack safe, adequate places for children and their families to exercise and play. Schools might have a variety of recreational facilities, but many districts close their property to the public after school hours because of concerns about costs, vandalism, security, maintenance, and liability in the event of injury.

Comprehensive cancer coalitions have worked to support and implement Shared Use agreements across the country.  In her Featured Partner piece, Dr. Jennifer Redmond of the Kentucky Cancer Consortium spoke about how such agreements are a part of KY’s primary prevention efforts around obesity.

Interested in learning more? Active Living Research recently released a resource which summarizes research on community access to school recreation facilities outside of school hours as well as challenges associated with shared use of school facilities.  The research brief also presents recommendations and opportunities for policymakers at the state and local levels.

Are any of you involved with or considering Shared/Joint use agreements? What have been your experiences?

Shared/Joint use agreements

Shared/Joint use agreements make a ton of sense - otherwise all that great space and equipment just sits there benefiting NO ONE.  It's so nice to see that more government entities (or other organizations) are coming together to leverage these spaces and improve the health of their communities.  Good stuff.  

Some other pretty cool partnerships are going on in the food and nutrition arena as well. The IOM just released a new report, "Building Public-Private Partnerships in Food and Nutrition-Workshop Summary." The report summarizes a workshop that was held in November 2011 to better understand how to build multisectoral food and nutrition partnerships that achieve meaningful public health results.  Discussions and presentation addressed the benefits and risks of engaging in public-private collaboration, highlighted a wide range of existing public-private partnership and their keys to success, and provided guidance and tools for moving forward.

It you are thinking about entering into a partnership of this nature and wonder where to start (and what works) this might be worth a read.  You can access the full report at

Whether it's through joint use agreements that promote sharing fitness facilities and equipment or effective public-private partnerships that promote healthy food and nutrition, one thing is clear - we're all this together, so we need to find effective ways to work together to solve the problem.  

We would love hear your success stories that highlight where these strategies are working - please consider sharing yours!

Those working on "upstream"

Those working on "upstream" approaches, such as shared use agreements and local food poilcies may find a recent toolkit toolkit for local food policy councils of particua;r use and interest. Good Laws, Good Food: Putting Local Food Policy to Work for Our Communities will help food policy councils identify critical needs in their local food system and successfully work to address them. 

The toolkit provides step-by-step analyses of seven areas of law, policy, and planning that food policy councils, nonprofit organizations, and government entities may encounter in their efforts to enact change in their local food system. Sections of the toolkit include topics such as “School Food and Nutrition Education,” “Land Use Regulations,” and “Consumer Access.”

It also provides examples of innovative ways that cities have used legal and policy tools to improve the impacts of their local food systems on health, the environment, and the economy. Some of the local food policy solutions highlighted in the toolkit include Seattle’s zoning code, which requires at least one community garden for every 2,500 households and Washington, DC’s Healthy Schools Act, which requires every school to serve universal free breakfast, ensuring that all children start the day with a healthy meal. 

Good Laws, Good Food: Putting Local Food Policy to Work for Our Communities, is available for download at:

Two resources have recently

Two resources have recently be released which will be of use to practitioners planning and implementing obesity-prevention efforts in their communities.

The first are the new 2011 State Adult Obesity Maps based on the new BRFSS data:  

These maps illustrate that in 2011, rates of adult obesity remain high, with state estimates ranging from 20.7 percent in Colorado to 34.9 percent in Mississippi. No state had a prevalence of adult obesity less than 20 percent, and 12 states (Alabama, Arkansas, Indiana, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Oklahoma, South Carolina, Texas, and West Virginia) had a prevalence of 30 percent or more. The South had the highest prevalence of adult obesity (29.5 percent), followed by the Midwest (29 percent), the Northeast (25.3 percent) and the West (24.3 percent).

There are some considerations that you should be aware of in using these maps. In 2011, several updates occurred with the BRFSS (Behavioral Risk Factor Surveillance Survey) that impact estimates of state-level adult obesity prevalence. First, there was an overall change in the BRFSS methodology --- for the first time BRFSS now incorporates data from cell-phone only households and introduced a new data weighting process (no pun intended). These changes in methodology were made to ensure that the sample better represents the population in each state.  Second, to generate more accurate estimates of obesity prevalence, small changes were made to the criteria used to determine which respondents are included in the data analysis.  While these changes are important from the long term, it means that the 2011 maps should not be compared with previous state maps.

We are all concerned that obesity rates are climbing, but as Weight of the Nation indicates, it is essential that we all work together to implement evidence-based strategies to combat this pandemic.

To this end, the Tri-Affiliate Obesity Prevention Workgroup released a four-page primer titled “The Role of State Public Health in Obesity Prevention.”  Aimed at public health professionals, their colleagues in obesity prevention, government officials and others interested in the role of government in obesity prevention, the primer provides an overview of public health principles and explains the role of state public health in obesity prevention.  Also, the document outlines why preventing obesity matters and what state health agencies can and are doing to make a difference.

What measures are being implemented in your state and coalition? Do you have particular thoughts as to how we as cancer control practitioners can better work together to align our skills to stem the obesity epidemic and improve public health?  What is your response?

I was intrigued to read new

I was intrigued to read new CDC study published online today in the Journal of Public Health.  The study found that of young people who visited fast food or chain restaurants in the U.S. in 2010, girls and youth who were obese were more likely to use calorie information (or menu labeling) given in the restaurants to inform their food choices.  Girls were 80% more likely to use calorie information when available than boys. Obese youth were 70% more likely to use calorie information when available than those who were at a healthy weight.

The study also found that young people who ate less frequently at fast food or chain restaurants (once a week or less) were 50% more likely to use the calorie information when available than young people who ate more frequently at these places (twice or more each week).

This research is based on data from the 2010 YouthStyles and HealthStyles mail surveys. The study sample consisted of 721 youth, ages 9 to 18 years. The study excluded youth who never eat at fast food or chain restaurants (about 8%) or who said they never noticed calorie information (about 20%).

This is good news for those working to implement and support menu labeling requirements.