childhood obesity grant recommendations report

What’s Inside:Executive Summary . . . . . . . . . . . . . . . . . 2

Community Indicators 6

Capacity Indicators 24

Needs AssessmentGeneral County Health Comparisons

Community Scorecard

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Recommendations . . . . . . . . . . . . . . . . . . 76

Bibliography . . . . . . . . . . . . . . . . . . . . . . 84

Marion and Vanderburgh NonprofitsMarion and Vanderburgh Issue Specific Nonprofits

Government & Private Sector Overview

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Capacity Scorecard

Introduction & Community Selection 4 . . .

Appendix . . . . . . . . . . . . . . . . . . . . . . . . . I

Executive Summary

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The issue of childhood obesity is a significant problem throughout the United States, especially in the State of Indiana. Roughly 14% of the childhood population in Indiana are obese according to the Robert Wood Johnson Foundation and the Centers for Disease Control and Prevention. To help combat the problem of childhood obesity in Indiana, specifically teenage obesity, the Robert Wood Johnson Foundation enlisted TheSix Consulting firm to conduct a community and capacity analysis of two Indiana counties - Marion County and Vanderburgh County. Vanderburgh County is home to the Evansville Metro Area which has received national media attention as the “Fattest City in America”. Marion County is the most populous county in the Indiana and includes with the state capital, Indianapolis.

To fully analyze the size and scope of organizations addressing childhood obesity, the group examined nonprofit organizations specalizing in Health, Recreation, Sports, Leisure, and Athletics, and Youth Development represented by NTEE categories E, N, and O. Through this analysis, a number a organizations were identified as possible partners for obesity prevention and mitigation in both communities. HealthNet Inc. and the Wellborn Baptist Foundation represented the two organizations with the greatest potential in the Health category. The Indianapolis Parks Foundation and Evansville Parks Foundation were identified as two possible partner organizations in the Recreation, Sports, Leisure, and Athletics category. Finally, the Boys & Girls Clubs of Indianapolis and Evansville also represented two possible partner organizations committed to addressing childhood obesity. The analysis of private entities reflected a greater capacity for partnership in Marion County, however, no specific private organization showed potential to partner organizations to address childhood obesity. When the group analyzed public sector capacity, it was readily apparent that the Evansville government took a leading role in addressing childhood obesity within the community. The Indianapolis and Marion County governments do not share this role.

Based on the analysis of the nonprofit, public, and private sectors, the group developed community and capacity indicator scorecards to determine which county had the greater health need and nonprofit, government, and private capacity to address the issue of child and teenage obesity in Indiana. The county received a score of “1’ or “0” based on a side-by-side comparison on each metric. If there was less than a 2% difference between any indicator for both counties, each received a score of “0”; if there was a greater than two percent difference between the two counties, the county with the higher percentage received a score of “1”. Appropriate data was per capitized to make a more even comparison. With scorecard results of 7-0 on the community scorecard and 11-2 on the capacity scorecard, Marion County clearly demonstrates greater need to address childhood obesity. Based on these scorecard results, Marion County has greater community need in areas of general health and obesity, including smoking and obesity rates, children in poverty and in single parent households, health food access, childhood obesity rates, and number of fast food restaurants, among others. Marion County also demonstrated higher capacity in the nonprofit, public, and private sectors to be able to combat childhood obesity in this community. Marion County has a greater number of nonprofit organizations, a higher percentage of people contributing to nonprofit organizations, and a greater number of organization and foundation assets and revenue.

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Following the selection of Marion County as the target of the Robert Wood Johnson Foundation grant, the group identified HealthNet Inc. as the partner organization to implement the grant. Because of its existing program of school-based clinics in four Indianapolis area high and middle schools, it was apparent that HealthNet has existing relationships with the target population - teens - that the Robert Wood Johnson Foundation seeks to impact. With an annual income of $52 million, $25 million in assets, and $48 million in expenses, HealthNet Inc. and its school-based clinic program is primed for expansion. Expansion of the school-based clinic program from an annual budget of $450 thousand to nearly $1 million annually will allow the school-based clinics to serve more students and community members, providing additional preventative health and nutrition training. Additionally, the grant will create a pilot program at KIPP Indianapolis Collegiate Preparatory to implement integrated preventative health and nutrition education in science, health, physical education, and other classes. Students will then use their newly acquired knowledge to make good health and nutrition choices to prevent and fight childhood obesity. They will also share this information and behaviors with their families. KIPP is the target for this pilot program because it serves the youngest students in the schools served by HealthNet Inc. The program will also include a focus on data collection to track and benchmark changes in obesity rates in HealthNet school-based clinics school and the rest of Marion County. The KIPP pilot program will also include data tracking of classroom visits by clinic staff, lessons focused on preventative health and nutrition, and access to healthy meals and snacks within the school. Finally, qualitative analysis will be essential to determine changes in mindsets and awareness of preventative health and nutrition techniques among students served by the school-based clinic and enhanced education program.

The funding disbursements of this grant will follow a five-year timeline split into two periods. In the first two years of the grant, RWJF will contribute $1 million to HealthNet efforts at KIPP. These activities include a preventative health teen clinic, integrating health training and education into the classroom, and improving healthy food choices in the school. In addition, $500,000 will be given to the four teen clinics in operation at schools around Marion County. Lastly, $500,000 will be given to HealthNet to improve data collection and reporting of program activities. Funding for the final two years of the grant cycle will be based on an evaluation conducted during the second year of the cycle. The last three years of the funding cycle will consist of $1 million to KIPP, $1 million to the four teen clinics, and $1 million to data collection.

With implementation of this grant program, TheSix and the Robert Wood Johnson Foundation hopes to decrease childhood obesity rates in schools with HealthNet Inc. school-based clinics, ideally expanding these programs throughout the entirety of Marion County. In addition to decreasing obesity rates among these student populations, the programs will also lead to changed mindsets and greater awareness of preventative health and nutrition techniques. Students acquiring this knowledge will share it with friends and family members to expand obesity prevention beyond the target populations. Evaluation of the program’s results will determine whether or not the partnership and program with the Robert Wood Johnson Foundation and HealthNet Inc. should continue.

Introduction

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At the request of the Robert Wood Johnson Foundation, TheSix Consulting Group began a process of thoroughly conducting research on the topic of childhood obesity. This final report concludes an extensive process with our recommendations to the Robert Wood Johnson Foundation while assessing childhood obesity in Marion and Vanderburgh Counties in the state of Indiana. In the preliminary report, TheSix delivered information that indicated that although efforts have been taken in both communities, there remains a large deficit in the education offered and action taken to prevent childhood obesity in these counties. In the interim report, TheSIx provided a capacity overview of the two counties, delivering a scorecard to better judge the counties against one another. FInally, TheSix delivered a narrowed group of possible organizations that the Robert Wood Johnson Foundation should look into for rewarding a possible grant towards combatting childhood obesity.

This final report contains a review of information contained in the first two reports, including new information that we feel is important to include. Among the new information contained is an expanded section on community selection, financial analysis of the nonprofit sector in each community, and expanded scorecards on the community and capacity of both communities, among other things. Section one will summarize the community indicators, with a scorecard found at the end of that section. Section two contains capacity indicator information, again ending in the appropriate scorecard. The report concludes with our organizational recommendation for the Robert Wood Johnson Foundation, including what actions we advise, why we advise those actions, an action plan, and what expectations we would have for the organization given the grant.

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Community SelectionWhen determining which two communities to study, we decided to choose two communities in Indiana. We chose Indiana because we all currently reside here and wanted to learn more about childhood obesity within our state. It was very easy to identify two communities in Indiana that would be viable candidates for funding from a foundation and quickly decided upon Vanderburgh County and Marion County.

Vanderburgh County, which contains much of the Evansville Metro Area, came to mind immediately due to its stigma as “America’s Fattest City.” A 2011 Gallup Poll ranked the Evansville Metro Area as the most obese in the country with an obesity rate of 37% (Gallup, 2011). Despite the self-reported nature of the survey and its emphasis on BMI measurements, the title of “America’s Fattest City” spread internationally with mentions in the United Kingdom’s DailyMail newspaper and a BBC Documentary (BBC, 2011). To compound the problem, Evansville is also known for being a test market for the restaurant and fast-food industry (Ragan, 2011).

The other community that made the most sense to study in comparison to Vanderburgh County was Marion County because it plays a central role in Indiana’s state policy. Due to the centrality of Marion County and the state’s capital being located within it, Marion County is a fertile ground for non-profit activity and growth. The county’s large metropolitan population also makes for an interesting comparison to Vanderburgh, which has a much smaller metropolitan population.

When determining which community had the greatest capacity for funding, we considered which county had more health related needs, such as smoking rates, physical inactivity rates and obesity rates. Through the community indicators scorecard we created, we determined that Marion County is the community that has a greater need. Even though Vanderburgh County has the stigma of being “The Fattest City In America,” the data collected actually showed that Marion County is much worse off when it comes to physical fitness and overall healthiness.

It was also important to consider capacity when deciding which community to chose for funding. According to the capacity scorecard, again Marion County had the greater need. There are simply more organizations in the Marion County community which have the capacity to take on funding from our foundation. Vanderburgh County, while having strong government programing which promoted fitness and healthy lifestyles, had very little to offer in the nonprofit sector. Very few organizations or entities existed which could shoulder a strong fight against childhood obesity. Due to both the greater health needs and a stronger capacity, we have chosen Marion County over Vanderburgh County as the community that we will take our funding to.

Community Indicators

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The Center for Disease Control defines overweight as “having excess body weight for a particular height from fat, muscle, bone, water, or a combination of these factors,” and obesity as “having excess body fat” (Center for Disease Control and Prevention, 2013). The National Institutes of Health recommends calculating overweight or obesity through using BMI or Body Mass Index. A BMI between 25 and 30 is considered Overweight. A BMI over 30 is considered Obese (National Institutes of Health, 2012). For children, BMI is calculated by how a child’s weight compares to weight for other children at a similar age. Children in the 95th percentile are considered obese and children between the 85th and 94th percentile are overweight. Children between the 5th and 85th percentile are considered to be normal weight (American Heart Association, 2011). About one in three American children and teens are overweight or obese. Since 1963, the rate of childhood obesity has tripled (American Heart Association, 2014). Obesity have doubled among children and nearly tripled among adolescents (Ogden CL, 2012). The American Heart Association found that childhood obesity is the top health concern among parents, ranking higher than both smoking and substance abuse (American Heart Association, 2011). Surgeon General Richard Carmona released a statement claiming that “[b]ecause of the increasing rates of obesity, unhealthy eating habits and physical inactivity, we may see the first generation that will be less healthy and have a shorter life expectancy than their parents” (Carmona). Children that are overweight have a 70-80% chance of staying overweight for the duration of their lives.

The National Health and Nutrition Examination Survey found that children aged 2-5 had an obesity rate of 12.1% of all children nationally. Children aged 6-11 had an obesity prevalence of 18% and adolescents aged 12-19 averaged 18% obese (CDC/NCHS, 2012). For adolescents, the highest area obesity was among male students (16.1%) rather than female (10%). Rates were highest among Afri-can American students (18%) when compared to His-panic students (14%) and Caucasian students (12%). (Centers For Disease Control and Prevention, 2012). From 1971-2008, the obesity rate of children ages 2-5 increased from 5% to 10%. The rate of children ages 6-11 increased from 4%-20% and for children ages 12-19 the rate increased from 6% to 18% (American Heart Association, 2011).

Overall, the reported rates of obesity may be lower than reported. A study presented at the 57th Annual Meeting of the American College of Sports Medicine compared heights/weights of children taken at an orthopedic with the heights/weights that parents reported. The study found parents overestimated boys heights and weights and underestimated girls heights and weights, resulting in large errors in computing BMI. The study found that obesity statistics could have resulted in about one in five obese children, or 21% of obese children, not being identified as obese in national studies (American College of Sports Medicine, 2013). Therefore, this report may be underreporting the overall scope of the problem of obesity. Regardless, the rates of childhood obesity have risen greatly and show no signs of halting.

Needs Assessment Overview

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Causes of Obesity

A number of factors contribute to childhood obesity. The American Heart Association cites growing portion sizes, poor nutrition, increased levels of eating out and moving less as the main sources of childhood obesity. The study found that around one in four children do not participate in any free-time physical activity. The organization also found that an average child spends four to five hours in front of the TV, computer screen or playing video games daily (American Heart Association, 2011). The National Heart, Lung, and Blood Institute found that genetics and family history contribute to rates of childhood obesity. A child is far more likely to be overweight if one, or both, parents are overweight or obese. Environmental impacts also can increase rates of obesity. A lack of sidewalks or safe places for recreation, busy work schedules, lack of access to healthy foods and increased food advertising can all impact rates of obesity in a community. They also emphasize the impacts of leading an inactive lifestyle (National Institutes of Health, 2012). The Harvard School of Public Health credits unhealthy diets, prenatal and postnatal influence and sedentary lifestyles as the main contributors to obesity (Harvard School of Public Health, 2013). The Center for Disease Control found that childhood obesity resulted from overconsumption of calories and a lack of physical activity (Centers for Disease Control and Prevention, 2013). Overall, a variety of sources can contribute to obesity in children.

“One in four children do not participate in any free-time physical activity”

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National Consequences of Obesity

Childhood obesity, particularly among adolescents creates a multitude of health-related problems. Obese teens are much more likely to become obese adults. One study found “that as BMI increased in adolescence the probability of obesity as an adult significantly increased as well. Obese male youths were 18 times more likely to become obese adults and obese female youths were 49 times more likely to become obese adults. About 70 percent of obese youths have at least one additional risk factor for cardiovascular disease, such as elevated total cholesterol, triglycerides, insulin or blood pressure” (Wang LY, 2008). Additionally, one in five teenagers in the US has abnormally high cholesterol levels, which can lead to heart disease. Other troubling diseases that can develop because of obesity include asthma, sleep-disordered breathing, Type II Diabetes, heart disease and stroke, neurological and psychiatric diseases, kidney disease, liver disease, arthritis and more (Robert Wood Johnson Foundation, 2014). Children that are overweight are subject to bullying, fatigue, and lower levels of academic achievement. Self-esteem issues also lead to more severe rates of psychological disorders, such as depression or severe anxiety (NYU Lagone Medical Center, 2013)

Childhood obesity carries heavy economic costs. Overall obesity in the United States costs an astounding $190 billion to national healthcare costs. Obese men add an extra $1,152 each year in medical spending while women add an extra $3,613 per year. Health spending costs related to obesity have now overtaken health costs associated with smoking (Ungar, 2012). Direct costs associated with obesity come with charges for outpatient and impatient health services, surgeries, tests and results and therapy from drugs. Indirect costs can include value in lost work (days missed, lost productivity, long term disabilities and premature death), insurance costs (obese individuals cause higher insurance premiums), and wages (studies have found that obesity is associated with lower income levels) (Harvard School of Public Health Obesity Prevention Source Web, 2013). The Society of Actuaries estimate that lost productivity costs employers $164 billion (Baugh, 2013). Some researchers found that if obesity trends continue, obesity costs could raise by $48 to $66 billion a year by 2030 (Wang CY, 2011).

Obesity also carries an environmental impact. A study from the University of Illinois found that the extra weight from vehicles carrying obese individuals is responsible for around one billion additional gallons of gasoline being burned each year (equal to 1% of the total gasoline usage), totaling $3.4 billion in costs (Begley, 2012).

Health Consequences

Economic Consequences

Environmental Consequences

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Obesity in Indiana

Indiana’s battle with obesity is well documented. A 2011 comprehensive study of Indiana obesity by the Indiana State Department of Health (ISDH) titled “The Burden of Obesity”, stated that the three most nationally used age ranges for tracking childhood obesity were 2-5 years, 10-17 years, and high school age students (Health, The Burden of Obesity ). For the purposes of this report, we will use these age ranges in our analysis.

Children ages 2 to 5 (CDC) 16% overweight 14% obese

Children ages 10 to 17 (Robert Wood Johnson Foundation, 2013) 14.3% obese

High school students (Robert Wood Johnson Foundation, 2013) 14.7% obese

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Recent Trends

Although Indiana ranks high in comparison to the rest of the nation in many obesity and overweight categories, the recent state data has shown little deviation from national trends.

Graph 1.1 displays data from 1999 to 2009, showing the percentage of Indiana children ages 2-5 who were obeseincreased from 12% to 14% while the national percentage rose from 13% to 15% (Health, The Burden of Obesity , p. 13).

The Indiana trends in other age groups are also close to the national trends in recent years. Graph 1.2 shows that in 2003, around 15% of Indiana youth ages 10-17 were considered obese. The change between 2003 and 2009 was not significant as the 2009 number remained at 15% (Health, The Burden of Obesity , p. 12). The national numbers also reflected a minimal change between 15% and 16% (Health, The Burden of Obesity , p. 12).

Graph 1.2 from “Burden of Obesity”


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Recent Trends

Graph 1.3 shows that of the three major age groups, Indiana’s high school students fair the worst in national obesity rankings (Robert Wood Johnson Foundation, 2013). In 2003, 12% of high school students in Indiana were obese. That number rose to 13% in 2009 while the nationally average stayed steady at 12% over that same period (Health, The Burden of Obesity ).


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Contributing Factors to Obesity

At the most basic level, childhood obesity results from two risk factors: lack of physical activity and poor nutrition (Overweight and Obesity). These two factors may result from personal choices and lifestyles but they can also be influenced by public policy related to obesity risk factors.

Physical ActivityA 2007 study by the National Initiative for Children’s Healthcare Quality (NICHQ) found that on 66.2% of Indianan children ages 6-17 participate in rigorous physical activity at least four times a week (Indiana State Fact Sheet). In comparison to the nation, Indiana actually fairs better than the national average of 64.2%. One major reason for a lack of physical activity is the increase of children’s “screen time” in our society. Screen time is defined by the NICHQ as including “TV, video games, computer games, etc” (Indiana State Fact Sheet). The NICHQ estimates that 11.9% of Indiana children ages 6-17 engage in 4 or more hours of screen time per day as compared to the national average of 10.8% (Indiana State Fact Sheet).

Graph 1.4 shows data from the Indiana State Department of Health has also published statistics showing healthy levels of activity among Indiana high school students. Nearly 41% of Indiana high school students meet national recommended levels of physical activity. In addition, the level of physical activity amongIndiana high school students is significantly higher than the national averages (Health, Burden of Obesity, p. 15).


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10

0

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From these statistics we can see that many Indiana children are exceeding national standards for physical activity in several age groups. One of the best ways to encourage physical activity is through school polices. A review of Indiana state school standards will show if the state is one of the drivers behind physical activity in children.

Physical Activity Policies in Indiana SchoolsThe Trust for America’s Health and the Robert Wood Johnson Foundation partnered to produce the “F as in Fat” yearly study that has often been cited in this report. The 2013 study compares five major school physical activity policies for each state (Robert Wood Johnson Foundation, 2013).

1. Physical Education Requirements Some physical education requirements for students.

2. Physical Activity Requirements Standards for the type and amount of physical activity required for students during the day outside of physical education class.

3. Shared Use Agreements Laws encouraging or requiring schools to enable facilities to be used by the community.

4. Safe Routes to School Supports sidewalks, bike paths, reduced speed zones and other policies that provide safe ways for students to get to school.

5. Complete Street Programs Complete Streets programs encourage physical activity through “green” transportation.

By this study’s evaluation, Indiana schools have policies comparable to or better than most states in categories 1-4, but not 5 (Robert Wood Johnson Foundation, 2013). It seems that Indiana is on par with national school policy standards fighting childhood obesity. Although there may be successes in this policy arena for the state, an evaluation of nutrition standards in schools paints a different picture.

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Nutritional Policies in Indiana SchoolsIndiana youth may participate in the prescribed amounts of healthy physical activity, but their nutritional habits may be of some concern. Indiana high school students consume the recommended amounts of fruits and vegetables at lower rates than the national average (Health, Burden of Obesity, p. 17).

Similar to the physical activity policies, Robert Wood Johnson identifies several nutrition policy categories contributing to childhood obesity (Robert Wood Johnson Foundation, 2013).

1. Nutritional Standards for Competitive Foods in Schools State standards for all foods and beverages sold in schools that are not part of the USDA school lunch program.

2. Limits on Competitive Foods in Schools Policies expanding on federal standards limiting the amount of competitive foods sold in schools.

3. Sugar-Sweetened Beverage Taxes Some states include soda on the list of items subject to sales tax.

4. Farm to School Programs Partnerships between schools and farms in the community to bring locally-sourced, healthy foods to kids in school.

At the state level, Indiana meets the national standards for “Nutritional Standards for Competitive Foods” and “Sugar Sweetened Beverage Taxes”, but not for the other two categories (Robert Wood Johnson Foundation, 2013).

In terms of state action on eliminating childhood obesity through public and school policy, Indiana is surprisingly active. Although these state standards are in place, it is quite possible that many localities and school districts have created their own contradicting policies. Tackling a problem as comprehensive as childhood obesity requires coordinated action from the statehouse down to local governments, school governing bodies, and nonprofits to make significant progress. A more locally focused analysis of childhood obesity in Marion County and Vanderburgh County will detail the problem in the two counties, as well as their efforts fighting it.

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Indiana Consequences of Obesity

It is no mystery that those who are overweight or obese as children have much higher risks of being obese as adults. Indiana overweight and obese adults constitute a large number of the Indiana population afflicted by high blood pressure, high cholesterol, heart attack, angina, coronary disease, and diabetes (Health, Burden of Obesity, p. 5). As chart 1.1 shows, according to the Indiana State Department of Health, Hoosiers who are overweight or obese are diagnosed with diabetes approximately seven times more than those who are not overweight or obese (Health, The Burden of Obesity , p. 5).

Health Consequences

As evidenced by the chart above, overweight and obese Indiana adults suffer from adverse health conditions at much higher rates than healthy individuals. Indiana children and adolescents also have increased risk of diabetes as over 75% of children and adolescents with type II diabetes are obese (Health, The Burden of Obesity , p. 6).

Chart 1.1 from “Burden of Obesity”

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Indiana Consequences of Obesity

Obesity also contributes significantly to the different causes of death in Indiana. As explained in chart 1.2, the three of the leading causes of death in Indiana, heart disease, cancer, and stroke, are related to obesity (Health, The Burden of Obesity, p. 6).

Chart 1.2 from “Burden of Obesity”

Economic ConsequencesIn addition to health consequences, obese and overweight individuals also bring increased economic costs in Indiana. An Obesity Research Journal study estimated 2009 obesity related medical costs in Indiana to total over 3.5 billion dollars (Justin G. Trogdon, 2012, p. 218). The Indiana State Department of Health also reports that spending on obesity-related illness treatments has increased at the alarming rate of 89% from 1998-2006 (Health, Burden of Obesity, p. 7). If comprehensive action is not taken to fight obesity in Indiana, these costs will continue to rise and be a significant drain on the Indiana economy.

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General County Health Comparison

Marion County and Vanderburgh County both have significant obstacles for leading healthy lifestyles. Citizens are less likely to lead healthy lifestyles in these counties, when compared to other counties in Indiana. The Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute collaborate to publish the County Health Ranking & Roadmaps. The County Health Rank-ing measures look at a variety of issues that impact health outside of the doctor’s office. Some of the factors included are “the rate of people dying before age 75, high school graduation rates, unemployment, limited access to healthy foods, air and water quality, income, and rates of smoking, obesity and teen births.” The ranking aims to measure the overall health for each county in all 50 states.

Marion County ranks 79th out of the 92 counties in Indiana. With an adult obesity rate of 30% and physical inactivity of 26%, the city ranks as one of the least healthy counties in Indiana. Factors contributing to unhealthy lifestyles include high rates of adult obesity (26% with a national benchmark of 13%), extremely high rates of adult smoking (26% of adults smoke, with a national benchmark of 13%), and very high rates of teenage births (60 per 1,000 teens with the national benchmark of 21) (County Health Rankings & Roadmaps, 2013).

Vanderburgh County ranks 72th out of the 92 counties in Indiana. Vanderburgh County has an adult obesity rate of 29% and rates of physical inactivity reach 28%. Factors contributing to unhealthy lifestyles include high rates of adult obesity (13% higher than the national benchmark of 13%), extremely high rates of adult smoking (26% of adults smoke, with a national benchmark of 13%), high percentages of children in single-parent households (39%), and a high school graduation rate of only 83% (Robert Wood Johnson Foundation, 2014).

A number of other factors are prevalent that lead to higher rates of childhood obesity. For instance, access to healthy food and grocery stores can impact rates of obesity. Marion County has 8.9 fast-food restaurants per 10,000 people and only 1.7 grocery stores per 10,000 people. Only 50% of zip codes in Marion County have access to a healthy food outlet (National Initiative for Children’s Healthcare Quality, 2010). Vanderburgh County has 1.7 grocery stores per 10,000 people and 9.6 fast-food markets per 10,000 people. Other factors contributing to obesity are rates of poverty. The percentage of low-income preschoolers that qualify as obese is 15%. The lowest rate of obesity for low-income preschoolers is in Hamilton County, with only 8.5% of low-income preschoolers qualifying as obese. The percentage of low-income preschoolers that are obese is 12.8%. (National Initiative for Children’s Healthcare Quality, 2010).

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Childhood Obesity Comparison

As mentioned earlier in the report, most estimates of rates of childhood obesity are likely to be underestimates. In addition, there are vast differentials in the quality and quantity of data available for these counties regarding childhood obesity. Below are the findings for rates of childhood obesity in Marion and Vanderburgh County. Vanderburgh County has made headlines with its high rate of adult obesity. The rates of childhood obesity in the county are equally as troubling. In the tri-state area, 62% of children are considered to have a normal weight, while 16% are overweight and 20% are obese. Focusing specifically on High School students, nearly 32% of students are overweight or obese. That rate has increased from 26% of students being classified as overweight or obese in 1999 (Tri-State Community Wellness Indicators, 2011).

The Centers for Disease Control and Prevention found that only 43% of high school age students in Vanderburgh County got the suggested 60 minutes per day for at least five days a week (Centers for Disease Control and Prevention, 2012).

Childhood obesity is very prevalent in Marion County. In Marion County, 22% of school children in Kindergarten through 12th grade met the CDC requirements for being overweight and another 18% were at risk of being overweight.

Combined, almost 40% of children in Marion County are in danger of leading unhealthy lifestyles and suffering the numerous consequences associated with childhood obesity. Of the 40% of Marion County residents aged 5-17 that are obese or at risk of being obese, 38% of the students are Caucasian, 42% of the students are African American, and 49% of the students of the students were Hispanic. Hispanic males were at the highest rate (52%) of being overweight or at risk of becoming overweight within all children demographics (Monroe County Health Department , 2008)

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Childhood Obesity Comparison

Demographic GroupRace & Gender White Male White Female Black Male Black Female Hispanic Male Hispanic Female Multiracial Male Multiracial Female Asian/Pac. Is. Male Asian/Pac Is. Female Amer. Indian Male Amer. Indian Female Unknown Male Unknown FemaleYears of Age 5 6 7 8 9 10 11 12 13 14 15 16 17 18

* Underweight: under 5th percentile; Normal: 5th less than 85th percentile; At risk: 85th less than 95th percentile; Overweight: 95th percentile and greater

Underweight

21111122531001

22211221111122

Normal

5963585547545758636852506668

6463626158565455545758596262

At Risk

1718181920211718161627151114

1717171718181920201819181717

Overweight

2218222531242423161320352417

1718192123252524242423212019

Students

21,79321,56717,18716,9323,7313,4861,8991,8875625689294

148201

2,6127,1968,0818,3118,2117,7957,8607,6717,5357,3036,0735,2644,2152,020

Percent of group by BMI category*

Table by Monroe County Health Department , 2008

Table 1.1: Marion County

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Data Problems

After exhausting sources while searching for childhood obesity rates in Marion County, only one source appeared to have accurate data-the Marion County Health Department. Not a single nonprofit, private organization, or scholarly paper has tracked or published rates of obesity in Marion County for children in all socioeconomic categories. In Vanderburgh County, only tri-state area exists, which does include the majority of Vanderburgh County, but certainly is not a perfect measurement of the problem. The foundation’s efforts were a substantive start to tracking obesity in adults, but a lack of data regarding childhood obesity at the county level is troubling. This gap in data could demonstrate a lack of awareness in the communites and the nonprofit sector about the dangers of childhood obesity. A more comprehensive review of the nonprofit sector will be required to see if the sector can put forth concrete solutions to reducing the high rates of childhood obesity in these counties.

Reference Appendix D for more information.

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Community Scorecard

Community Indicators Scorecard Methodology

Outside of the nonprofit sector, a number of health and outside factors impact the rate of childhood obesity in a community. The Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute collaborate to publish the County Health Ranking & Roadmaps. The County Health Ranking looks at a variety of issues that impact health outside of the doctor’s office. This report gave rates for important statistics, all of which have an impact on the rate of childhood obesity. Factors that were selected from the report and that were placed into the Community Indicators Scorecard were selected because of their direct impact on the rates of childhood obesity. Non-relevant factors were not included. State and National benchmarking data is provided with the County Health Ranking & Roadmap.

The report first gives the adult smoking rate. Scholars at Harvard found that higher rates of smoking led to higher rates of obesity (Harvard School of Public Health, 2013). It also gives the adult obesity rate and the rate of physical inactivity in the public, both of which have been linked to and are results of higher rates of childhood obesity (American Heart Association, 2011). The Robert Wood Johnson Foundation found that childhood obesity was much higher among teenage mothers and their children (Robert Wood Johnson Foundation, 2013). Another study found poverty to be a major indicator of both childhood and adult obesity. Individuals who lacked health insurance, did not graduate from high school, or were living in poverty were all at risk. Individuals with one or more of these factors in their lives were seventy percent more likely to be overweight or obese (Eric A. Finkelstein, 2003). Similar to the statistics for poverty and teenage birth, children living in households with a single parent were more likely to be obese or overweight (NYU Lagone Medical Center, 2013). Finally, the Harvard School of Public Health emphasizes the importance of environmental factors in childhood obesity. Access to healthy foods and recreation facilities play a major factor in the lifestyle of children (Harvard School of Public Health Obesity Prevention Source Web, 2013). The County Health Ranking also provides a Fast Food Restaurants per capita statistic, which provides an interesting juxtaposition to the access to healthy food statistics. Parks, miles of bike trails, and aquatic centers are public infrastructure that allows members of communities to get the recommended levels of exercise. Those metrics were all provided by the Parks and Recreation Department of each county.

The final statistic on the chart is the reported rates of childhood obesity. Keeping in mind that a recent study from the American College of Sports Medicine found that parents overestimated boys heights and weights and underestimated girls heights and weights, resulting in large errors in computing BMI. The study found that obesity statistics could have resulted in about one in five obese children, or 21% of obese children, not being identified as obese in national studies, the rates of obesity from the county are presented in their most recent form. The childhood obesity rate for Vanderburgh County comes from the Tri-State Community Wellness Indicators report from 2011 and the rate for Marion County comes from the Marion County Health Department (Tri-State Community Wellness Indicators, 2011) (Marion County Health Department, 2008). The National and State rate of childhood obesity comes from the National Council of State Legislatures. (National Council of State Legislatures, 2012).

Community Scorecard

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For tabulation, each community will be ranked by a variety of community health indicators. The community showing a higher level of need for each indicator will receive a score of “1.” The community with less need will receive a score of “0.” Lesser level of need is defined of having a lower level of each individual indicator (example: If Marion County has a smoking rate of 26% and Vanderburgh County a smoking rate of 20%, Vanderburgh County has need for this indicator and would receive a score of “0”).

If values are similar (within 2% for percentage comparisons), both cities will receive a score of “0.” For Per Capita comparisons, the difference will be determined by a number of people. The community showing a higher level of capacity will receive a score of “1.” The community with less capacity will receive a score of “0.” The scores will be deemed too close to differentiate if the values are within 2% of the per capita number used (For example, if the per capita is measured by #/10,000 residents, values within 200 individuals, or 2% of 10,000 residents, will be deemed too close to differentiate). In that case, both communities will receive a “0”.

Community Scorecard

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Table 1.2 Community IndicatorsCommunity

Indicators Marion County Score Vanderburgh County Score Indiana National

Adult Smoking Rate 26% 0 26% 0 24% 13% Adult Obesity Rate 30% 0 29% 0 30% 25% Physical Inactivity 26% 0 28% 0 27% 21%

Teen Birth Rate 60/1000

Residents 0 43/1000

Residents 0 41 21 Uninsured 20% 1 15% 0 17% 11% High School Graduation Rate 81% 0 83% 0 86% N/A Children in Single Parent Households 46% 1 39% 0 32% 20%

Children in Poverty 32% 1 22% 0 23% 14% Access to Recreational Facilities

10/100,000 Residents 0 13/100,000

Residents 0 9 16 Number of Parks per 10,000 persons 2.23 0 2.22 0 - - Number of Aquatic Centers per 10,000 persons

.22 1 .5 0 - -

Miles of Bike Trails 74 1 20 0 - - Limited Access to Healthy Foods 8% 1 4% 0 6% 1% Fast Food Restaurants

55% of all dining establishments. 1 51% of all dining

establishments. 0 50% 27% Rate of Childhood Obesity

22.0% 1 19.9% 0 - 15.3%

Overall Score Marion County 8 Vanderburgh County 0

Marion and Vanderburgh Nonprofits

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Capacity IndicatorsIn order to effectively identify potential organizations to fund, it is important to narrow our discussion to the specific group of nonprofits that the foundation could fund.

The National Taxonomy of Exempt Entities, a project of the Urban Institute, attempts to make sense of the vast scope of the nonprofit sector by dividing organizations into distinct categories (Urban Institute). There are 26 “Major Categories” within the NTEE classification system.

The Robert Wood Johnson Foundation funds organizations that work to improve the “…health and healthcare of all Americans” (Robert Wood Johnson Foundation). The foundation’s funding efforts are concentrated around two of the “Major Categories” of the NTEE system: “Health” and “Human Services”. Since our report will focus on combatting childhood obesity within Indianapolis and Evansville, the main NTEE category of interest is “Human Services”.

Within Human Services, two subcategories immediately identify themselves as relevant to our discussion: “Recreation & Sports” and “Youth Development”.

One of the main ways to reduce obesity in children is to offer outlets for physical activity. The “Recreation & Sports” subcategory includes organizations such as “Camps”, “Parks and Playgrounds”, and “Community Recreational Centers” (Urban Institute, NTEE). These organizations, as well as others in the “Recreation and Sports” category, will be relevant to our later discussion of funding opportunities.

“Youth Development” organizations also contribute to the fight against obesity by offering children opportunities to be involved in healthy extracurricular activities. This subcategory includes organizations such as “Boys & Girls Clubs” and “Youth Development Programs” (Urban Institute, NTEE).

Selected Field of Activity

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Number of Nonprofits by SubsectionTo begin evaluating the nonprofit fields of Marion and Vanderburgh County, the evaluation team used Guidestar, an information organization dedicated to nonprofit sector transparency. Abramson and McCarthy discuss the importance of informational organizations in the nonprofit sector. Information about nonprofit and foundation operations “enhances the accountability of nonprofits and foundations, informs the decision-making of grant makers and grant seekers, supports the work of researchers…and promotes public understanding of nonprofits” (McCarthy, 2012; McCarthy, 2012). Guidestar and the National Center for Charitable Statistics (NCCS) both provide valuable information regarding the size and scope of the nonprofit sector in Marion County and Vanderburgh County.

The number of tax-exempt organizations can be calculated using two main methods. First, the Internal Revenue Service categorizes organizations into more than 25 different classifications, the most common being a 501(c)(3) organization (donations to which are tax-deductible) (Board Source, 2012). Second, the National Center for Charitable Statistics uses the National Taxonomy of Exempt Entities (NTEE) in partnership with the IRS “to classify nonprofit organizations. It is also used by the Foundation Center to classify both grants and grant recipients (typically nonprofits or governments)” and it helps describe the type of individuals served by these organizations (National Center for Charitable Statistics, 2004).


As seen in graph 2.1, using the Advanced Search feature of Guidestar, organizations were searched by city and state (Indianapolis, Indiana and Evansville, Indiana). Guidestar does not offer searching by County or FIPS Code. No organization name, category, or NTEE code was specified. A search was then conducted to calculate the number of organizations in each IRS tax category (501(c)(1), 501(c)(2), 501(c)(3)…4947(a)(1)).

Shown in graph 2.3, an additional search was conducted to determine the numbers of organizations in each of the 26 National Taxonomy of Exempt Entities categories. Organizations were searched by city and state (Indianapolis, Indiana and Evansville, Indiana). Guidestar does not offer searching by County or FIPS Code. No organization name was specified. Only 501(c)(3) organizations were included in the search.

Methodolgy


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Chart 2.1: Number of Nonprofits by Tax CodeGuidestar

NCCS Chart 2.2: Number of Nonprofits by NTEE Code


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Chart 2.3: Number of Nonprofits by Tax CodeGuidestar

Marion and Vanderburgh NonprofitsOther Nonprofit Indicators

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Outside of the number of exempt organizations in each county, a number of other indicators can be compiled to reveal the size and scope of the nonprofit sector in Marion County and Vanderburgh County. The National Center for Charitable Statistics provides data on rates of household giving, religious organizations, and foundation activities.

Household GivingMethodologyTo gauge the level of household giving, table 2.1 reflects a Geographical Search conducted on the National Center for Charitable Statistics. In the Geographical Search, the data was collected from the State of Indiana. All areas of nonprofit activity were collected. Data was then analyzed at the County level (Marion County, FIPS Code 18097 and Vanderburgh County, FIPS Code 18053). All data was collected from the “Community Resources: Households and Organizations.” Data is from 2005.

Table 2.1: Household Giving

AnalysisTable 2.1 indicates that engaging citizens in the nonprofit sector shows higher levels of community involvement in the sector and higher levels of organizational impact. In addition to volunteering, community contributions “strongly define the character of many nonprofit organizations and reflects the willingness of individuals to voluntarily forgo their own consumption for the good of others” (Steuerle, 2006) While fees for goods and services make up the majority of money in the nonprofit sector, private contributions have been increasing. Most scholars note that household giving tends to increase with wealth levels. Therefore, giving levels in Marion County and Vanderburgh County may be impacted by their income levels.

The number of households in Marion County are much larger than Vanderburgh Count. Vanderburgh County reports 2.04% more households reporting contributions than Vanderburgh County. Marion County contains 5.44% more percent of households itemizing donations. The higher percentage of households itemizing donations in Marion County implies a higher base of households making substantial donations than Vanderburgh County.

Marion County Vanderburgh County

Indiana

Number of Households 418,716 82,322 5,620,048

Number of Households Itemizing Deductions

135,999 22,257 1,708,894

% of Households Itemizing 32.5% 27.0% 30.4%

% Reporting Contributions 82.3% 84.3% 83.7%


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Religious OrganizationsMethodologyTo gauge the level of religious organizations, a Geographical Search was conducted on the National Center for Charitable Statistics. In the Geographical Search, the data was collected from the State of Indiana. All areas of nonprofit activity were collected. Data was then analyzed at the County level (Marion County, FIPS Code 18097 and Vanderburgh County, FIPS Code 18053). All data was collected from the “Congregations and Other Religious Organizations” collection. Data is from 2013.

Table 2.2: Religious Organizations

Congregation Data Marion County Vanderburgh County Indiana

Number of Congregations 984 142 5,811

Number of Other Religious Organization

83 20 437

Total 1,067 162 6,248 Number of Congregations per 10,000 Persons

11.2 8.3 9.6

Number of Organizations per 10,000 Persons

12.1 9.4 10.3


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The Association of Religion Data Archives (ARDA) offers an additional source of analysis of the size and scope of the religious sector in Marion and Vanderburgh Counties. ARDA works to democratize data on religious institutions. The data below is taken from the 2010 County Membership Report. The report defines Congregational adherents to include all full members, their children, and others who regularly attend services. Congregation Data Marion County Vanderburgh County Number of Adherents 383,176 95,361 Number of Congregations 876 212

Number of Congregations Per 10,000 Persons

9.7 11.8

Adherent Total as Percentage of County Population

42.4% 53.1%

Tradition with the most adherents

Evangelical Protestant (143,339 Adherents)

Evangelical Protestant (41,066 Adherents)

Tradition with the second most adherents

Catholic (99,990 Adherents)

Catholic (29,097 Adherents)

Table 2.3: Religious Organizations


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AnalysisReligious organizations represent an important subsection of the nonprofit sector in Marion County and Vanderburgh County. Expanding upon their historic role in the nonprofit sector in the United States, religious organizations serve as core institutions of the sector. While little literature or academic research was pursued involving religious organizations until very recently, religious organizations account for approximately half of all philanthropic donations in the United States. Studies show that religious organizations encourage individuals in a community to think more about their responsibility to the poor and individuals will participate more in other community organizations. Scholars also caution that the number of reported religious organizations may is understated due to current tax law and the high level of diversity among religious organizations (Wuthnow, 2006). Furthermore, religious institutions carry over features from other organizations in the nonprofit sector. Kevin Robbins found that “modern charitable nonprofit organizations owe their inception and continued support to the public-spirited generosity of philanthropists who feel that contributions to the commonwealth are spiritual or moral imperatives…organized charity is driven by religious organizations” (Robbins, 2012).

While useful for understanding the size and scope of the nonprofit sector in these counties, a number of problems arise when analyzing religious institutions. Frunkin lists three key features of a nonprofit organization: they do not coerce participation, they operate without distributing profits to shareholders and they exist without simple and clear lines of ownership and accountability. The lack of accountability and ownership is especially apparent when analyzing the religious impact in a community (Frumkin, 2012). Because religious institutions are not required to file 990 or 990-EZ tax form to the IRS, like other organizations receiving nonprofit status, the data about the size and scope of religion in communities is often unreliable. Please note that data presented above may not represent all of the religious organizations present in the communities, due to the lack of reporting requirements. Many varieties exist when discussing the size of religion in a city. Also, data does not account for any religious activity in the informal sector, which could be substantial.

The two data sources give conflicting information about the number of congregations in each community. Also, the ARDA data does not list general religious organizations that do not qualify as a congregation. Overall, it appears that Marion County has more congregations. However, the citizens were much more likely to be adherent to a religious organization in Vanderburgh County rather than Marion County. The participation rate in these cities could reveal the engagement of citizens in other nonprofit organizations. Both communities have large groups of Evangelical Protestant and Catholic adherents. While the data may be lacking in completeness for the numbers, the data available indicates that religious organizations are substantial components of the nonprofit sector in both Marion County and Vanderburgh County.

Marion and Vanderburgh Nonrprofits

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Foundation ActivityMethodologyTo gauge the level of foundation activity, a Geographical Search was conducted on the National Center for Charitable Statistics. In the Geographical Search, the data was collected from the State of Indiana. All areas of nonprofit activity were collected. Data was then analyzed at the County level (Marion County, FIPS Code 18097 and Vanderburgh County, FIPS Code 18053). All data was collected from the “Private Foundation Activities.” Data is from 2011.

Table 2.3: Foundation Activity

AnalysisFoundations encourage redistribution of funds in a community, allowing money to go to programs that assist underserved parts of communities in a cost effective manner. Foundations in communities across the country have experienced dramatic expansion from the twentieth century to the turn of the century. Overall, foundations play important roles in supporting the operation of the nonprofit sector (Prewitt).

While Marion County nearly doubles the number of foundations in Vanderburgh County, Vanderburgh County contains 4.47 more organizations per 10,000 persons that Marion County. Looking at revenue, Marion County foundations contain nearly seven times as many total assets per 10,000 persons than the total assets per 10,000 persons in Vanderburgh County.

Foundation Data (Geographical Search)

Marion County Vanderburgh County Indiana

Number of Foundations 266 129 1,436

Total Assets (Fair Market Value) $9,242,958,708 $259,838,778 $12,176,166,479

Total Revenue $1,024,439,641 $23,739,197 $1,328,171,576 Contributions and Grants Made $380,779,372 $15,150,347 $618,185,640

Number of Organizations (per 10,000 persons)

3.0 7.5 2.7

Contributions and Grants (per 10,000)

$433 $93 102

Total Revenue (per 10,000 persons)

$1,166 $138 $218

Total Assets (per 10,000 persons) $10,517 $1,511 $2,002


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Marion County Photo © Indianapolis Junk Hauling

Vanderburgh County Photo © 2006 John Blair

Marion and Vanderburgh Nonrprofits

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Financial AnalysisIntroductionIn order to truly assess the size, scope, and operation of the nonprofit sector in these two communities, an overall financial analysis is necessary. Blackwood, Wing, and Pollak use assets, revenue, and expenses as the three main financial indicators in their publication “Facts and Figures from the Nonprofit Almanac 2008: Public Charities, Giving, and Volunteering” (Ott p. 12). The following section will also put these three indicators to use in order to further describe nonprofit activity in Vanderburgh and Marion counties.

Financial Indicator Marion County Vanderburgh

County Indiana

Total Revenue (Nonprofit Sector)

$11,171,277,627 $1,406,159,510 $31,179,813,433

Total Expenses $10,271,430,374 $1,300,990,058 $28,206,153,165

Total Assets $17,438,305,872 $2,067,447,851 $60,399,290,076

Total Revenue ($ per Capita)

$12,711 $8,179 $268

Total Expenses ($ per capita)

$11,687 $7,567

Total Assets ($ per capita)

$19,841 $12,025 $405

Total AGI ($ thousands) $20,141,388 $3,850,738 $264,893,743

Total Contributions ($ thousands)

$437,138 $79,960 $5,516,330

Contributions as a % of AGI 2.8% 2.1% 2.1%

Table 2.4: Overview of Financial Analysis

AnalysisMarion County holds $4,532 more in total revenue per capita than Vanderburgh County and $4,120 more in total expenses per capita than Vanderburgh County. Total assets per capita in Marion County outweigh Vanderburgh County by $7,816.

AssetsDefinitionThe Financial Accounting Standard defines asset as “probable future economic benefits obtained or controlled by a particular entity as a result of past transactions or events” (FASB). Assets provide a simple way to summarize the scope of the nonprofit sector and its subsectors. In 2005, the 1.4 million organizations filing a Form 990 reported $3.4 trillion in assets (Ott p.13). Of those organizations, 2005 public charities held $2 trillion in assets (Ott, p.13). Line 16 of the Balance Sheet section of the Form 990 lists “Total Assets” and is where the NCCS Business Master File draws its data (IRS). Some examples of assets that nonprofit organizations may hold could include real estate, vehicles, or buildings that contribute to the operations and mission of the organization.

MethodologyAn in-depth search in the National Center for Charitable Statistics Data Web was used to determine the level of organizational assets by NTEE Code. Using the report builder, the Business Master File (which is generated two times annually from IRS Data. Data is collected from all active organizations registered with the Internal Revenue Service, gross receipts, total assets, and the relevant tax period. Data comes from organizations’ latest Forms 990, 990-EZ or 990-PF) from the latest filing (BMF 12/2013 501c3). Due to the data collection methods of the National Center for Charitable Statistics, this data for total assets only represents approximately 1/3 of registered organizations filing Forms 990, 990-EZ, or 990-PF. The data does not represent any exempt organization classified as “Other” by the NCCS. Rather, the data focuses primarily on registered 501(c)(3) organizations. A two variable hierarchical report was generated for assets (Asset Code, separated into the categories displayed in the graph below) and NTEE Codes (NTEE major group “A-Z”). Data was filtered by FIPS Code 18097 (Marion County) and then a separate report was generated for FIPS Code 18163 (Vanderburgh County).


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Assets: Marion CountyChart 2.4: Marion County Assets

AnalysisWhen looking at the raw numbers in charts 2.4 and 2.5, Marion County not surprisingly has more organizations in each asset bracket than Vanderburgh County. Considering that the city of Indianapolis has nearly 7 times as many people as Evansville, the two main metropolitan areas in each county, Vanderburgh still shows a robust nonprofit sector. The distribution of organizations in each asset bracket is strikingly similar however. Both counties have their largest share of organizations in the $100,000-$499,999 category. In addition, Marion County slightly edges out Vanderburgh in the percentage of organizations with greater than $10 million and $50 million.

Chart 2.5: Marion County Assets by Percentage


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Assets: Vanderburgh CountyChart 2.6: Vanderburgh County Assets

AnalysisCharts 2.6 and 2.7 show that similar to Marion County, Vanderburgh also has their largest concentration of organizations with between $25,000 and $4,999,999 in assets. The asset category with the largest concentration of organizations was again $100,000 to $499,999 with 12.6% and the category with the smallest was $50 million or greater with 1.1%. The presence of the Wellborn Baptist Foundation in Vanderburgh County may also skew the overall financial averages for the county. With an annual income of $700 million, the Foundation far outpaces other organizations assets in Vanderburgh County, causing an effect on the overall financial results for the county.

Chart 2.7: Vanderburgh County Assets by Percentage


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ExpensesDefinitionNCCS draws “Expenses” from Line 17 of Part 1 of the Form 990. The line totals the organizations expenses by summing categories such as “grants and other assistance”, “benefits paid to members”, “payroll taxes”, “management”, “legal”, and other expenses (Form 990). Analyzing expenses provides a look into the day-to-day operations of the organization. Blackwood, Wing, and Pollak state that a majority of public charities report under $500,000 in expenses and our data is consistent with that claim (Ott p. 13). Our data also matches with the small percentage of organizations (4%) that report over $10 million in expenses, although those organizations will be important to our analysis (Ott p.13).

MethodologyAn in-depth search of the National Center for Charitable Statistics Data Web was used to determine the level of organizational expenses in Vanderburgh and Marion counties. Core Data Files were utilized through the Report Builder in order to generate a three-variable, hierarchical report. The Core Files include financial variables pulled from Form 990-series data and is updated annually; only organizations that are required to file are included. Core Public Charities 2011 (Core 2011 PC) was the data file used in order to generate this report. Core Public Charities 2011 includes 133 variables and 381,035 records. Data was filtered with three variables: FIPS code, EXPS (expenses), and NTEE1 (NTEE code).


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Chart 2.8: County Organization Comparison by Expenses

AnalysisBoth communities have a similar distribution of organizations in each of the revenue brackets. In general, as expenses increase, the number of organizations in the expense category decreases for both communities. However, each community shows a disproportionate number of organizations in the $1-$5 million category. Marion County has more organizations with $10 million or more in expenses than $5-$10 million. This speaks to the size of the organizations serving the Indianapolis Metro area such as large hospitals that would account for these abnormally high expenses.


Marion County Nonprofit Expenses

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Chart 2.9: Marion County Organizations by Expenses

Chart 2.10: Marion County Organizations with $100,000 or less in Expenses


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AnalysisChart 2.9 indicates the largest group of Marion County organizations in any expenses group fall in the $0-$100,000 bracket. The next largest group of organizations fall within the $100,000-$500,000 bracket. A breakdown of organizations in Marion County with $0-$100,000 in expenses by NTEE Code is shown in chart 2.10. This category is heavily dominated by “Education” organizations. Marion County is the most populated area in Indiana so it follows that schools will make up a large portion of the smaller organizations in the area. Chart 2.11 contains organizations with $10 million or more and is led by “Health” organizations. This category includes hospitals and Indianapolis has the largest hospitals in the state of Indiana.

Chart 2.11: Marion County Organizations with $10 Million or More in Expenses


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Vanderburgh County Nonprofit ExpensesChart 2.12: Vanderburgh Organizations by Expenses

Chart 2.13: Vanderburgh County Organizations with $100,000 or less in Expenses


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Chart 2.14: Vanderburgh Organizationswith $10 Million or More in Expenses

AnalysisVanderburgh has a similar organizational profile to Marion with the highest number of organizations falling in the $0-$100,000 category and the next highest number in the $100,000-$500,000 category. The smallest category of organizational expenses is again led by “Education” but followed closely by “Recreation, Sports, Leisure, and Athletics”. This does not necessarily mean Vanderburgh has more of these types of organizations than Marion county, but that those organizations are smaller by nature. This is again a function of the smaller population of Vanderburgh County.


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RevenueDefinitionNCCS draws “Total Revenue” from Line 12 of Part 1 of the Form 990. This line totals an organization’s revenue from the previous lines including categories such as “direct public support”, “government contributions”, “membership dues”, “program service revenue”, and other various forms of organizational income (IRS). An analysis of revenue may provide insight into the amount of current support an organization is receiving and also point to its overall financial health. In 2005, reporting organizations received $1.6 trillion in revenue while public charities received over $1.1 trillion (Ott, p. 13,14).

MethodologyAn in-depth search of the National Center for Charitable Statistics Data Web was used to determine the level of organizational revenue in Vanderburgh and Marion counties. Core Data Files were utilized through the Report Builder in order to generate a three-variable, hierarchical report. The Core Files include financial variables pulled from Form 990-series data and is updated annually; only organizations that are required to file are included. Core Public Charities 2011 (Core 2011 PC) was the data file used in order to generate this report. Core Public Charities 2011 includes 133 variables and 381,035 records. Data was filtered with three variables: FIPS code, TOTREV2 (total revenue), and NTEE1 (NTEE code).


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Chart 2.15: County Organization Comparison by Revenue

AnalysisThe distribution of organizations in each bracket of revenue shown above is nearly identical to the distribution of expenses shown in the preceding section. The largest group of organizations fall in the $0-$100,000 category and the next largest group fall in the $100,000-$500,000 category. Considering both expenses and revenues paints a clear picture of the two counties. Each has a significant number of smaller organizations that makes up the majority of the organizations in their community. Both communities have a large number of schools that fall in this category. As for the large organizations, both communities have large hospitals that have the largest operating budgets in the community respectively.


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Marion County Nonprofit RevenueChart 2.15: Marion Organizations by Revenue

Chart 2.16: Marion Organizations with $0-$100,000 in Revenue


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Chart 2.17: Marion Organizations with $10 million or More in Revenue

AnalysisAgain, as charts 2.15 through 2.17 indicate, most of the organizations operating in Marion County with less than $100,000 in revenue are “Education” organizations and most of the organizations with large operating revenues are “Health” organizations.


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Vanderburgh County Nonprofit RevenueChart 2.18: Vanderburgh Organizations by Revenue

Chart 2.19: Vanderburgh Organizations with $0-$100,000 in Revenue

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Chart 2.20: Vanderburgh Organizations with $10 Million or More in Revenue

AnalysisCharts 2.18 through 2.20 indicate that most of Vanderburgh’s are organizations operating with less than $100,000 in revenue are “Education” organizations and most of the organizations with large operating revenues are “Health” organizations.


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Overall Analysis of NonprofitsAt first glance, research shows an overwhelming capacity and resource rich environment in Marion County. This was to be expected considering Marion County is home to the State’s capitol and most populous city. The sheer volume of 501c organizations in Indianapolis dwarfs that of Evansville. Comparing 501c3’s alone (which make up the bulk of nonprofit organizations in either city), Indianapolis has almost 5000 more organizations than Evansville. The same applies when comparing these cities by NTEE code. The top 5 categories of NTEE code represented in either community are as follows:

Indianapolis:1. M – Public Safety, Disaster Preparedness, and Relief2. T – Philanthropy, Voluntarism, and Grantmaking3. A – Arts, Culture, and Humanities4. Q – International, Foreign Affairs, and National Security5. U – Science and Technology, Research Institutes

Evansville:1. T – Philanthropy, Voluntarism, and Grantmaking2. A – Arts, Culture, and Humanities3. M – Public Safety, Disaster Preparedness, and Relief4. Q – International, Foreign Affairs, and National Security5. U – Science and Technology, Research Institutes

Interestingly, the same 501c3 codes make the top five in both communities. The only difference is their relative position on the list. This may indicate similar objectives or needs in either community.

Given the differences in the two communities a fairer comparison should analyze the information in terms of percentages and per capita statistics. The number of households itemizing and reporting contributions, the number of religious organizations per 10,000 people, and total contributions as a percentage of AGI are relatively similar in both communities. Additionally, Vanderburgh has double the number of organizations per 10,000 persons while Marion County has about 10 times the total assets per 10,000 persons. Lastly, grant money contributions amount to a smaller percentage of total assets in Marion County than Evansville. These statistics could demonstrate a propensity for higher participation and philanthropic giving in Vanderburgh and a possible untapped environment for nonprofit programs dealing with childhood obesity.

Further analysis of other community aspects could help in better understanding the capacities and needs of each community.

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Issue Specific Nonprofit Overview

After exploring the state of nonprofit organizations within Marion and Vanderburgh Counties generally, focus now shifts to an analysis of nonprofit organizations specifically related to childhood obesity. After exploring the NTEE classification codes centered upon childhood obesity, the Health (E), Recreation, Sports, Leisure, and Athletics (N), and Youth Development (O) categories comprise the focus of continued evaluation. Health organizations provide necessary medical and nutritional expertise and resources to treat and prevent childhood obesity; Recreation, Sports, Leisure, and Athletics organizations comprise youth sports and recreation leagues which provide access to athletic activity that can prevent and fight childhood obesity; finally, Youth Development organizations provide programming to educate youth on healthy lifestyles and provide an opportunity to engage in these activities. However, the capacity these two counties have in each area differs greatly, as evidenced by the following data. Capacity is an essential component of the community scorecards as “the most basic dimension of civil society is its scale or capacity” (Salamon & Sokolowski, 2012).

MethodologyTo analyze these three NTEE major groups within Marion and Vanderburgh Counties, the National Center for Charitable Statistics (NCCS) Data Web was utilized. Using the Business Master Files from the IRS for 501(c)(3) organizations from December, 2013 exclusively, data on the number of 501(c)(3) organizations in Marion and Vanderburgh Counties, using Census FIPS Codes (18097 and 18163, respectively), NTEE major groups, and NTEE classification codes, was obtained. Additionally, average values for annual receipts, annual revenue, and end of year assets were obtained to help facilitate the comparison of these organizations within each county. These are important figures for analysis because each represents the charitable contributions received by organizations, a key indicator of organizational capacity (Salamon & Sokolowski, 2012).

Following the preliminary analysis using the NCCS Data Web to find the number of organizations and average financial figures for these three categories, Guidestar was utilized to provide additional contextual information regarding organizations found in each. To maximize the number of organizations found by Guidestar, simple searches using the terms, “Indianapolis” and “Evansville”, were used. We eliminated organizations classified as organizations other than 501(c)(3) public charities, as other entities are ineligible to receive foundation grants. Following these searches, the results were reviewed for organizations that fell within the target NTEE categories - E, N, and O - to evaluate those organizations more explicitly and to determine specific programmatic results. However, it is important to note that Guidestar records are not as exhaustive and up-to-date as the NCCS Data Web data records. As such, the number of organizations for each category may differ from the Guidestar to NCCS Data Web data. Additionally, Guidestar does not allow search by FIPS codes, which means that organizations are likely omitted because of the limitations of using only Indianapolis and Evansville search terms. However, we are confident that major organizations within each county in each of the three categories have been identified from both data sources. This is the case because Guidestar pulls information from filed IRS Form 990 reports (Abramson & McCarthy, 2012). Inactive 501(c)(3) organizations (organizations which have not filed Form 990 reports for three years) and small or


unincorporated nonprofits with annual revenues under $50,000 will not be included in Guidestar analysis because these organizations are not required to file Form 990 reports (Guidestar , 2005). As a result, Guidestar will report 501(c)(3) organizations that are active and have substantive revenues, eliminating small, inactive, and low-revenue organizations from consideration. Thus, though the Guidestar results might not be exhaustive, the results will likely include active organizations with fairly substantive revenues. This is important because in order to adequately address the problem of childhood obesity within Marion and Vanderburgh counties, it is necessary to look at active organizations with substantive revenue that have the capacity or could be expanded to address the obesity problem.

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OverviewBecause of the significant difference in population between these two counties and the fact that Marion County includes the state capital, it follows that the number of organizations in each of these three major NTEE categories differs greatly for both counties. Marion County has more than double the number of organizations in each of these categories than those found in Vanderburgh County. It is also apparent from the data that organizations in the Health category have a significant financial advantage over those in the Recreation and Youth Development categories. These differences are accounted for by the fact that hospitals and major regional healthcare systems are included in the Health category; many of these institutions have substantial endowments and receive funding not only from donors, but also from state and federal governments, patients, and insurance companies in the form of medical payments (Schlesinger, 2012). This funding variance accounts for a great deal of the difference in the average annual receipts, revenue, and total assets possessed by organizations in each of the three major categories. However, when examining per capita annual receipts, revenue, and total assets for the organizations in each county, Vanderburgh County actually has greater capacity in the Health and Youth Development categories than Marion. This is important to bear in mind during further evaluation of the two communities. Differences in per capita financial figures may also provide insight in individual giving patterns in each of these communities. Further evaluation of these giving patterns may provide insight in regards to whether or not the differences in per capita figures can be attributed to increased giving in Vanderburgh County as well (Martin, 2012). Additionally, the difference between the two counties in the Recreation, Sports, Leisure, and Athletics category is likely due to the presence of major national sports governing bodies in Marion County. These major governing bodies include the National Collegiate Athletic Association (NCAA), USA Gymnastics, and USA Track & Field.


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Childhood Obesity Related Organizations in Marion and Vanderburgh Counties

NTEE Major Category

Total Number of Organizations

Average Annual Receipts, Per Capita

Average Annual Revenue, Per Capita

Average End of Year Total Assets, Per Capita

Marion County Health (E) 140 $67.0 $61.5 $79.4 Recreation, Sports, Leisure, and Athletics (N)

190 $6.1 $5.5 $6.1

Youth Development (O)

119 $1.0 $0.6 $1.3

Vanderburgh County Health (E) 28 $250.8 $237.0 $309.3 Recreation, Sports, Leisure, and Athletics (N)

40 $0.5 $0.4 $0.8

Youth Development (O)

30 $1.4 $0.9 $3.8

*National Center for Charitable Statistics, 2014; STATS Indiana, 2013

Organizations in the Recreation, Sports, Leisure, and Athletics category include a variety of youth sports leagues in a number of activities, ranging from baseball and soccer to hockey and figure skating. These organizations have the second-highest average receipts, revenue, and assets for Marion County, likely reflecting the larger overall number of organizations and the larger population that they serve; they have the lowest average receipts, revenue, and assets in Vanderburgh County, likely reflecting the smaller, and more rural, population in the county which makes community sports leagues more challenging.

The Youth Development categories include traditionally visible organizations like the Boys & Girls Club, Boy Scouts, and Girl Scouts. These organizations also have the lowest average receipts, averages, and assets in Marion County, though they have the second highest in Vanderburgh County. However, as detailed later, these nonprofit organizations may have a significant capacity to impact healthy lifestyle activities for students in these communities.

Table 2.5: Childhood Obesity Related Organizations in Marion and Vanderburgh Counties

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HealthWhen evaluating the Health organizations in Marion and Vanderburgh Counties, it is apparent that these organizations possess a great deal of financial resources to achieve their missions; however, it is less obvious that they have a focus on combatting childhood obesity through their programs.

Marion County In Marion County, major hospitals and health networks comprise the majority of organizations in this category; a similar pattern is present in Vanderburgh County. Though all of these entities focus on healthcare provision and quality of life improvement for people in their communities, a thorough evaluation of their specific programs failed to yield specific results targeted at improving child nutrition and activity in youth populations, specifically teenagers. However, the presence of major foundations in support of these hospitals and health systems, like the Wellborn Baptist Foundation and the St. Vincent Hospital Foundation, indicates that there may be room for partnerships with other nonprofit and public entities in the community. However, the lack of specific childhood obesity programs sponsored by these hospitals and health networks leads to questions about whether or not they would entertain the possibility of creating, or partnering with, such programs. However, the average annual receipts, revenue, and total assets indicate that these health organizations have the fiscal capacity to deal with large influxes of grant money, including a $5 million grant over five years from the Robert Wood Johnson Foundation (RWJF) which is not the case with many of the organizations in the other two categories (Schlesinger, 2012).

The largest networks and affiliated hospitals in Marion County include St. Vincent Health and Indiana University (IU) Health and their respective subsidiaries. After evaluating these two large regional health and hospital systems, there were no specific programs centered on childhood obesity and its prevention; these efforts were included in larger health and quality of life services (Indiana University Health, 2014) (St. Vincent Health, 2014). So, in spite of their great financial assets, these entities do not readily appear as partners to expand an existing childhood obesity program. However, these two entities and their subsidiaries combine to reach millions of people in Marion County and surrounding areas.

When evaluating organizations in the major field of Health, one organization in particular presents itself as a possible partner for RWJF. HealthNet Inc. is a 501(c)(3) not-for-profit public charity that seeks to provide primary health care services to the medically underserved (HealthNet, 2014). One of their programs focuses on providing diet and nutrition education to develop healthy eating habits in these communities. Additionally, HealthNet sponsors school-based services which provide school-based clinics and nurses to provide primary, preventative, and educational services for students in four Marion County public schools, including diet and healthy eating habits training (HealthNet , 2014). The four schools include Arsenal Tech High School, Harshman Middle School, George Washington Community School, and KIPP Indianapolis College Preparatory School (HealthNet , 2014). HealthNet Inc’s work will be an area of continued explora-tion and research as the evaluation of partner organizations continues.


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Vanderburgh County Much like Marion County, Vanderburgh County is dominated by two health organizations and their subsidiaries. The St. Mary’s Medical system and its myriad partners are particularly visible in the county. Additionally, the Deaconess Clinic and its affiliated doctors play an outsized role financially in the Health category and in the region. However, once again, neither of these organizations and their affiliates have explicit childhood obesity programs in these communities.

NTEE Major Category: Health Care

Marion County Vanderburgh County Organization Name

Total Revenue Per Capita

Total Assets Per Capita

Organization Name



Community Health Network

$792.2 NA Deaconess Clinic

$307.1 $65.6

Community Health Network Inc.

$763.2 $1,615.9 Echo Community Healthcare

$34.7 $36.9

Community Hospitals of Indiana, Inc.

$171.8 $222.7 Rehabilitation Center, Inc.

$17.1 $43.6

Community Physicians of Indiana

$92.1 $31.5 St. Mary’s At Home Inc.

$32.5 $14.3

Eskenazi Health Foundation, Inc.

$52.1 $71.2 St. Mary’s Health Services

$71.7 $367.1

Fairbanks Memorial Hospital Inc.

$23.6 $25.5 St. Mary’s Hospital Memorial Foundation

$14.9 $47.4

HealthNet Inc.

$56.0 $27.1 St. Mary’s Medical Center Auxiliary

$0.92 $1.1

Indiana Behavioral Health Choices Inc.

$25.8 $8.1 St. Mary’s Medical Center of Evansville, Inc.

$2,519.9 $2,975.2

Table 2.6: Marion and Vanderburgh Health Related Organizational Revenue and Assets


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Indiana Heart Hospital LLC

$128.7 $224.3 St. Mary’s Ohio Valley Heartcare Inc.

$45.2 $17.6

Indiana University Health Arnett Inc.

$341.5 $263.4 Southwestern Behavioral Center

$79.4 $32.5

Indiana University Health Ball Memorial Hospital

$402.5 $324.3 Wellborn Baptist Foundation

$3,856.2 NA

Indiana University Health Care Associates, Inc.

$341.7 $74.2

Indiana University Health Inc.

$3,124.1 $4,739.9

IU Health Inc. $56.9 $30.1 IU Medical Group Foundation Inc.

$86.4 $99.9

Methodist Health Foundation

$14.9 $124.6

St. Vincent Health, Inc.

$155.2 $262.0

St. Vincent Hospital Foundation, Inc.

$15.9 $75.5

St. Vincent Hospital and Healthcare

$1,400.4 $1,508.2

St. Vincent New Hope Inc.

$23.8 $9.0

St. Vincent Seton Specialty Hospital Inc.

$74.0 $85.7

*Guidestar, 2014; STATS Indiana, 2013


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The Health category organization that presents the greatest potential to work with in the fight against childhood obesity is the Wellborn Baptist Foundation. The Wellborn Baptist Foundation provides a great deal of assistance to the Evansville community and the Evansville-Vanderburgh County school system to create and implement programs designed to address childhood obesity problems within the area, as detailed in the public and private sector section of this report. It is possible that a partnership between the RWJF and the Wellborn Baptist Foundation could expand these already existing programs and the fight against childhood obesity, particularly in the teen population.

Finally, it is important to note that the revenue and assets of Health organizations in Vanderburgh County are not as great as those in Marion County; this reality may make it difficult for some of these organizations to take on a major grant of $5 million over five years, at it may represent a significant portion of the their normal operating budget.

After a thorough evaluation of the Health category organizations in Marion and Vanderburgh counties, HealthNet Inc. and the Wellborn Baptist Foundation represent partner organizations with the greatest potential.

Recreation, Sports, Leisure, and Athletics

Most organizations in the Recreation, Sports, Leisure, and Athletics category represent community athletic leagues, especially youth sports leagues. As such, much of their income comes from user fees. Fee structures are generally derived based on the operational needs of the nonprofit as well as the willingness to pay of the consumer of the organization’s services (Salamon, 2006) (Slivinski, 2006). However, these organizations also represent opportunities for youth to become involved in a sport or other athletic activity, allowing them to remain active and practice healthy exercise in their everyday lives. Once again, youth sports organizations are greater in the more heavily populated Marion County; however, there are a number of youth sports organizations in Vanderburgh County as well. The size of this category of organizations also contributes to their overall receipts, revenue, and assets figures, meaning that these figures are higher for Marion than for Vanderburgh County, reflecting the differences in population and overall income.


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Marion County A number of organizations comprise the NTEE field of Recreation, Sports, Leisure, and Athletics, particularly community athletic leagues, especially ones that serve youth in particular. However, it is important to note that Marion County is unique in that at least three major amateur sports organizations have their national headquarters in Indianapolis. These organizations are USA Gymnastics, USA Track and Field, and the NCAA. The annual revenue of these organizations drives up the average revenue of the group because of their substantial yearly budgets. Most other organizations in this category have rather small annual revenues, typically less than $1 million.

Reviewing these particular organizations does not indicate any specific focus on preventing and eliminating childhood obesity; it is more related to the overall mission to provide access to sports that addresses this need.

It is interesting to note that the major national organizations in Marion County - USA Gymnastics, USA Track & Field, and the NCAA – do not have any organizational initiatives centered on childhood obesity.

As a result of the lack of programs focused on childhood obesity in the Recreation category within Marion County, it is unlikely that a partnership will be established with one of these organizations to address the issue.

Additionally, the low annual revenues of these organizations indicate potential organizational incapability to accept and utilize a grant the size of the RWJF’s $5 million grant over five years.

Vanderburgh County Much like in Marion County, many of the organizations in this category serve to provide a means to participate in these specific sports within Evansville and the larger Vanderburgh County communities. Similarly, many of these organizations are fee-based organizations with minimal annual revenues that only total in the thousands. Furthermore, many of these organizations do not exclusively serve youth, but may also serve adults interested in the same sports and activities. Because of these characteristics, these organizations do not seem to be prepared to accept a large grant of $5 million over five years and the acceptance of such a grant for childhood obesity programs may lead to mission drift within them. Mission drift can occur unintentionally and voluntarily within organizations; however, it is not the goal to cause mission drift within these community organizations by offering large sums of grant funds in exchange for adopting that mission (Chang, 2006).


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The presence of recreation organizations within these target communities is a positive indication of the possibility to engage in physical activity to prevent childhood obesity; however, they do not appear to be the best options for expand childhood obesity prevention and education programs within these communities.

However, one unique area of the Recreation category includes the Indianapolis Parks Foundation and the Evansville Parks Foundation. Both of these foundations are responsible for providing financial resources to support the parks in both of these cities, including the construction of new playgrounds and specific programs within the parks operated by these foundations. The Indianapolis Parks Foundation in particular has focused its programming around childhood obesity and improved health, fitness, and nutrition. Its “Be Healthy, Be Fit” program provides fitness and nutrition programming in parks and schools within Indianapolis (Indianapolis Parks Foundation, 2014). Additionally the Indianapolis Parks Foundation has consciously expanded the pools, basketball courts, and playground equipment available in their parks, particularly in high-need neighborhoods. The presence of these foundations in these communities is a particular area of continued evaluation to determine the best partner for the RWJF grant.

NTEE Major Category: Recreation, Sports, Leisure, and Athletics

Marion County Vanderburgh County Organization Name



Organization Name



Evans Indianapolis Track & Field Club

$0 $0 Evansville Area Tennis Patrons Foundation Inc.

$2.7 $16.3

Geist Half Marathon

$0.39 $0.1 Evansville Elite Soccer Club

$2.2 $0.4

Greater Indianapolis Regional League of Soccer Inc.

$0.03 $0.05 Evansville Junior Football League

$0.4 $1.9

Indiana High School Athletics Association

$11.1 $12.3 Evansville Junior Golf Association

$0.08 $0.02

Indianapolis Boxing Club

$0 $0 Evansville Little League Baseball

$0.3 $0.1

Table 2.7: Marion and Vanderburgh Recreation Organizational Revenue and Assets


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Indianapolis Junior Golf Foundation

$0.05 $0.2 Evansville Parks Foundation

$0.9 $1.9

Indianapolis Junior Tennis Development Fund

$0.1 $0.4 Evansville River City Volleyball

$0.5 $0.07

Indianapolis Parks Foundation

$4.1 $5.3 Evansville Sports Corporation

$2.1 $1.2

Indianapolis Rowing Center

$0.3 $0.2 Evansville Youth Football League

$0 $0

Indianapolis Skating Club Inc. Carmel Ice Skadium

$0.07 $0.2 Evansville Youth Hockey Association

$1.2 $0.3

Indianapolis South Stars Youth Hockey Association

$0.1 $0.02 Evansville Youth Soccer League

$0.2 $0.1

Indianapolis United Soccer Club

$0.2 $0.07 Greater Evansville Figure Skating Club Inc.

$0.3 $0.1

Indianapolis Youth Hockey Association

$0.2 $0.1 Greater Evansville Swimming

$0.2 $0.2

Junior Baseball Inc. of Indianapolis

$0 $0 North Evansville Youth Soccer Club

$0.6 $1.9

Little League Baseball Inc. of Indianapolis

$0.2 $0.2

National Collegiate Athletic Association

$906.0 $758.8


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National Junior Tennis League of Indianapolis

$0.2 $0.08

Pike Youth Soccer Club

$0.7 $0.2

Road Runners Club of America

$0.3 $0.1

United Soccer Alliance of Indiana/Pike Youth Soccer Club

$0.7 $0.2

USA Football $8.3 $9.7 USA Gymnastics

$19.4 $12.0

USA Track and Field

$19.0 $8.8

*Guidestar, 2014


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Youth DevelopmentThe third and final category of specific evaluation and analysis in Marion and Vanderburgh Counties are those focused on Youth Development. Youth Development organizations seek to facilitate the positive personal development of youth to be productive and healthy citizens. This is an area of tremendous potential to discover programming centered around childhood obesity and expand those programs.

Marion CountyThe Boys & Girls Club of Indianapolis has two programs that directly address childhood obesity, how to prevent it, and teach good nutrition and exercise habits. These programs include “SMART Girls” and “Triple Play”. “SMART Girls” is a small group program for girls which focuses on eating right and staying fit as they are educated about heath, fitness, prevention, education, and self-esteem enhancement (Boys & Girls Clubs of Indianapolis, 2014). “Triple Play” is a comprehensive national Boys and Girls Club of America program developed with the US Department of Health and Human Services to increase physical activity and good nutrition (Boys & Girls Club of Indianapolis, 2014). Because these programs are national programs, they also occur at the Boys and Girls Clubs of Evansville. However, these programs only reach those who are members of the respective club; expanding membership in the clubs and access to these specific programs is an area of continued research for possible expansion of programs to address childhood obesity in these communities.

The “Catch the Stars Foundation” supports programs encouraging fitness and provides resources to access to playgrounds, tennis courts, and basketball courts in Indianapolis. “Playworks Indiana” has a similar mission to expand playground access in Indiana, which it has done by building one new playground facility in Indianapolis.

Vanderburgh County Girl Scouts and Boys Scouts play a role in each of these counties; however, programming surrounding child-hood obesity is only tangentially related to the mission of these organizations and the acquisition of related badges. Further, there are no significant nonprofit organizations within the county that might serve as effective stewards in the fight against childhood obesity.


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NTEE Major Category: Youth Development Marion County Vanderburgh County

Organization Name

Total Revenue (in millions)

Total Assets (in millions)

Organization Name

Total Revenue (in millions)

Total Assets (in millions)

Boys & Girls Clubs of Indianapolis

$3.1 $3.4 Boys & Girls Club of Evansville

$4.5 $40.2

Boy Scouts of America Council

$11.0 $29.3 Boy Scouts of America Buffalo Trace Council 156

$7.2 $25.9

Camptown Inc.

$0.3 $0.4 Girl Scouts of Southwest Indiana

$7.2 $14.3

Catch the Stars Foundation

$0.2 $0.1 YWCA of Evansville

$6.1 $24.3

Girl Scouts of Central Indiana Inc.

$12.0 $15.8

Playworks Indiana

$30.0 $15.2

* Guidestar, 2014; STATS Indiana, 2013 AnalysisThough there are a number of organizations in the Health, Recreation, and Youth Development categories, not all of them share a mission devoted to combatting childhood obesity or the fiscal capacity to do so. However, a few organizations warrant additional evaluation and consideration as a partner organization for RWJF.

HealthNet Inc. and the Wellborn Baptist Foundation represent two health organizations that have a history of supporting efforts to address childhood obesity. Additionally, the Indianapolis and Evansville Park Foundations represent potential partners in the recreation category to increase access to parks and resources to encourage physical activity. Finally, the Boys and Girls Clubs of Indianapolis and Evansville possess programs that encourage healthy habits. The Catch the Stars Foundation and Playworks Indiana increase access to playground equipment and other programs which encourage physical activity in their communities. This step provides tremendous information to continue our analysis on behalf of RWJF.

Table 2.8: Marion and Vanderburgh Youth Development Organizational Revenue and Assets


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Government and Private Sector Overview

OverviewWhile the main scope of our research focuses on nonprofit organizations in the communities of Vanderburgh County and Marion County, it is also important to consider the public and private sectors as well. Once thought of as the independent sector, this pseudonym for the nonprofit sector is now less fitting as the lines between these three sectors (private, public and nonprofit) have become blurry as they often interact and intermingle with one another (Ott 2012). While we would like to think nonprofit organizations are not swayed by these two other sectors, they often are. Nonprofits are not independent from the government (in fact they often must rely on them for grants and funding) nor are they uninhibited by the pressures of the marketplace (Frumkin 2002). Therefore it is important to at least have a grasp on what the private and public sectors are doing in our two communities to combat childhood obesity.

MethodologyObtaining information on government and private sector programs related to childhood obesity proved difficult. Government operations and finances are, ideally, meant to be transparent but, realistically, this is not often the case. Program information is spread across various websites operated and administered by different departments. More often than not, these websites are primitive, in need of updating, and difficult to navigate. In the rare event these programs are funded directly by the government, expenditures are often recorded and concealed within general funds. While the GAO suggests standard practices regarding how to format and create budget documentation, few local governments abide by these standards.

Data on private programs and financial information is even harder to find. Unlike government, there is no presumption of transparency and, indeed, like any private corporation the financial data on these programs is non-existent. The programs, however, are more high profile and better covered in media sources than those of the government. This is possibly because of the partners involved (high profile professional sports teams) or because the corporate financiers have made efforts to publicize their charity to demonstrate community involvement and encourage community support of the business.

Initial research for government programs started with targeted searches on departmental websites including that of the Indianapolis Park and Recreation Department, Marion County Heath Department, the City of Indianapolis, Indianapolis Public Schools and Marion County Public Schools. Additional information was found through newspaper and nonprofit resources. Initial information on private programs was found primarily through proprietary websites and by searching news media websites.

The information on government programs is more than likely credible with claims often supported by news reports. Private sector information, however, was often limited to the program website themselves with little or no additional coverage from independent entities, as such the possible biased nature of the information warrants caution.

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GovernmentMarion county government programing for childhood obesity issues can be categorized into three major themes: education/research, recreational activity, and government/non-profit partnerships. Education, Research, and ResourcesMarion County has several online resource sites to provide citizens information on childhood obesity and strategies to prevent or alleviate the disease. The Indiana Healthy Weight Initiative seeks to promote good nutrition, regular physical activity, and healthy weight across the state (Indiana Healthy Weight Initiative). The program functions as a resource bank providing communities with legal and policy resources, national and local data on obesity, and helps highlight community successes. InShape Indiana similarly “motivates, educates, and connects Hoosiers to valuable resources” (INShape). The focus of this program is healthy nutrition, physical activity, and tobacco avoidance. Weight specific programs include “Ready, Set, Walk!,” “10 in 10 Challenge,” “Summer Fit,” and “InShape 150” (INShape). All these programs encourage physical activity and provide excel spreadsheets to help participants track their progress. These are statewide programs but are often referenced as partners by programs and organizations operating locally in Marion County.

Indianapolis has its own resource and outreach program known as “FitCity” (FitCity). FitCity is “dedicated to reducing childhood obesity, making Indianapolis and surrounding counties the healthiest place to live, work and grow” (FitCity). Targeted exclusively to children and their parents, FitCity encourages physical activity and healthy nutrition. The program provides tips, challenges, recipes, and a community events calendar as well as links to local, state and national resources for physical activity, nutrition, and obesity prevention.

Research is another main function of government activity. The Center for Pediatric Obesity and Diabetes Prevention Research at IUPUI has undertaken child obesity research with a mission to “[advance] the health of vulnerable populations [define] best practices for obesity/diabetes prevention among youth, and cost-effective translation of the research to the community” (Inside IUPUI). The Center for Pediatric Obesity and Diabetes Prevention Research was awarded the IUPUI Signature Centers Initiative funding in 2012. The award will provide substantial funding over 3-years for the center’s research and scholarly activity on child obesity.

Marion County

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School Initiated ProgramsSchool initiated programs make up the bulk of direct government child obesity intervention. These programs are often initiated by school districts individually or in conjunction with a non-profit partner. Funding assistance is often crucial for these programs. Assistance is often a mix of state and federal grants, community fund-raising efforts, and private grants.

Local public schools have partnered with various non-profit organizations in combating child obesity. In 2012, Indianapolis Public Schools (IPS) brought nine13sports’ 5-week “Bicycling for Change” program to 24 Indianapolis schools – targeting primarily grades 4-12 (Nine13Sports Program and IPS Partnership). IPS has also initiated two proprietary programs: “Steps Right Up” and “New Horizons Hikers” (Five Local Organizations). These programs each received $1000 dollar grants from United Heath Care in 2013.

MCS and IPS are both participants in the Indiana Safe Routes to School (SRTS) program. SRTS is based on the federal program designed to encourage walking and bicycling to and from school and to address national and state obesity trends (INDOT). The Indiana SRTS Program makes federal funding available for activities and infrastructure improvements related to SRTS objectives. Since 2005, 23.4 million dollars has been used to fund SRTS programs in Indiana, 7% of this has gone to schools in Marion County (INDOT).

Recreation and InfrastructureTransportation and recreational infrastructure improvements as well as the presence of recreational areas and activities are often developed or undertaken for a variety of reasons but their effect is, essentially, to encourage more active lifestyles and in doing so reduce some of the health effects of sedentary living, including childhood obesity.

On August 13, 2012 Indianapolis passed a Complete Streets ordinance. Complete Streets are designed to allow safe access for cyclists, pedestrians, personal vehicles, and public transportation (We Have A Complete Streets Ordinance). In essence, complete streets encourage citizens to walk or bike when they otherwise wouldn’t have by reducing the barriers to safety often confronted in a car-centric environment. “Children with low neighborhood amenities or those lacking neighborhood access to side-walks or walking paths, parks or playgrounds, or recreation or community centers had 20-45% higher odds of becoming obese or overweight compared to children who had access to these amenities” (White House Task Force). To this end, Indianapolis has committed to creating more than 200 miles of bike lanes across the City over the next 12 years (Bikeways). Additionally, the Parks and Recreation Department, in partnership with the Marion County Health Department, has instituted the “Indy in Motion” program, which organizes walking and aerobic classes in parks (Parks and Health).


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PrivateCCompared to private programs in Vanderburgh County, those in Marion County are more active in the fight against childhood obesity and more numerous. The programs sponsored by the professional sports teams are arguably the most publicly visible. The Indianapolis Colts have adopted the NFL PLAY 60 initiative, encouraging children to be physically active for at least 60 minutes a day (NFL Play 60). The Colts areimplementing a variety of PLAY 60 programming to engage children at school (PLAY 60 Super School Contest, FUEL UP to Play 60, Big Blue Football Camps), within their communities (Playground Build, PLAY 60 Fitness Grants, PLAY 60 Challenge, and Colts Fitness Camps) as well as online (NFLRush.com) (NFL Play 60). The Pacers likewise have a “Get Pacers Fit” initiative in partnership with Kroger offering health and nutrition programs (Community Relations Health). Boomer’s Boot Camp, NBA Fit Week, and the Pacers Summer Hoops Tour all encourage physical activity (Community Relations Health). Nutritional programming includes a healthy cooking segment, healthy shopping segment, and nutritional recipes. In 2012, the Indians presented their “Rowdie: Home Run for Health” program for the 4th year in a row, engaging 10,000 students in physical activity (Giving Back).

Another major source of activity undertaken by private programs is the provision of grants and funds to school, hospitals, non-profit groups, and communities. Several corporations provide grants to schools or non-profits dealing with childhood obesity. Wellpoint Inc. has given $5 million to “Triple Play” a Boys and Girls Club “comprehensive health and wellness program, developed in collaboration with the U.S department of Heath and Human Services” (Healthy Generations). Wellpoint Inc. similarly provides grant money to OASIS CATCH, which pairs seniors with children and encourages them to play games and learn about food in an effort to address adult sedentary habits and childhood obesity (Healthy Generations). In 2004, The Anthem Blue Cross and Blue Shield Foundation created the Learning Well grant for Marion County Schools. The grant provided $100,000 to establish “at least two school-based health clinics and to support programs that address childhood obesity and asthma” (Anthem Foundation). As mentioned, in 2013 United Health Care awarded $7,000 to Marion County organizations and programs addressing childhood obesity (Five Local Organizations). These included the Boys and Girls Club of Indianapolis, Indianapolis Public Schools, the William McKinley School’s “39 Steppers” program, and the George H Miller School’s “Wildcat Hiking Club” program (Five Local Organization). AnalysisWhile the private sector has a lot to offer in Marion County, the government arguably has the most clout in this issue. Public schools in particular provide the direct contact and educational capacity to successfully implement various programs. The above information demonstrates that whether through partnerships with private and non-profit entities, or through their own programs, public schools are the most active players in the fight against childhood obesity. Any grant decisions in Marion County should take this essential relationship into consideration.


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MethodologyInitial research into Evansville’s Government programs and private programs which target general fitness and wellness for the city’s citizens and their children began by looking at the city’s website. By looking at the Park and Recreation Department, the Health Department, and the Mayor’s Office pages we were able to find many city-sponsored programs. Further research was conducted by searching local newspapers and magazines’ websites to find information and articles about local fitness programs for the city.

GovernmentVanderburgh County Health Department programs:“Worksite Wellness” ProgramThe Vanderburgh County Health Department offers a health and wellness screening for employees or groups. It also offers a weight loss program, which can be instituted in a workplace. The types of screenings/services that are offered by the Vanderburgh County Health Department include: Health Risk Appraisals, Body Fat Testing, and Cholesterol and Blood Sugar Screenings.

“WEIGH DOWN!” ProgramThe Vanderburgh County Health Department offers a very popular free weight loss program. The program meets once a week for five weeks. Requirements for participating include residence in Vanderburgh County, ability to attend all sessions and a need to lose at least 20 pounds. Educational materials are distributed along with weekly confidential “weigh-ins.”

“Nutrition 101” ProgramThe Vanderburgh County Health Department offers an all ages program that focuses on the “My Plate” guide to be used for making healthy food choices. The “Food Groupies” program is used to educate the younger children. The programs are adapted to focus on specific areas of nutrition.

“Evansville In Motion” BookletThe Evansville In Motion booklet is a compilation of map routes for walkers and runners, including 23 new or updated maps. Locations were decided upon, measured and made into easy-to-read maps. Inspirational quotes and walking tips were researched and added to the bottom of each map in addition to other informational pages. The Vanderburgh County Health Department boasts that the Evansville In Motion‘booklet has received much positive feedback from members of our community as well as from other coun-ties.

Vanderburgh County

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Mayor’s Office programs:Energize Evansville Initiative The Energize Evansville Initiative works to incorporate health activities through out Evansville and help resident’s live more active lives. The program partners with over fifty local fitness experts, nutritionists, and other health consciences minds to help meet the initiative’s goals. Fitness In The Park is one of the major programs as a part of the initiative that promotes health events in local parks around the city.

Parks and Recreation Department:Services and ProgramsThe Sports Department (within the Parks and Recreation Department) offers adult recreational programs for Men’s, Women’s and Co-Ed teams for Basketball, Flag Football, Indoor Volleyball, Sand Volleyball, Soccer, and Softball. The Sports Department schedules and manages over 1,200 teams each year with an estimated 10,000 program participants for all leagues.

Fruits and Vegetables Evansville (FAVE) is a program designed to get Evansville residents to consume more health fruits and vegetables. Lead by USI community nutrition students, the program offers residents a chance to sample a variety of different fruits and vegetables. The program takes place weekly through March and April at the CK Newsome Community Center.

FacilitiesThe Evansville Parks and Recreation Department oversees 8 community parks, 21 neighborhood parks, 3 regional parks, 8 mini-parks, 7 golf courses, 9 aquatic centers, 2 nature preserves and 9 special facilities. All of which offer residents places to walk, jog, run, swim, hike and play.

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Evansville Vanderburgh School Corporation (EVSC) programs:Health and Wellness ProgramsThe EVSC has a Coordinated School Health Team that looks at the well being of the county’s children. With grants through many partnerships in the community, the EVSC provides services for health, physical education, nutrition, counseling, and community and family involvement.

Health Care Specialists in the schools provide families and students with support through the following programs:- Open Airways program for elementary students- Action plans for asthma, diabetes, seizures, hemophilia, and/or food allergies- Vision, hearing, and communicable disease screenings- School-based health clinics

EVSC School-Community Council: Healthy Outlook GrantThe EVSC School Community Council received a 3 year, $1.2 million, Carol M. White Physical Education Program Grant in 2007. The PEP grant has provided Evansville schools with the opportunity to have a PE Specialist who will work PE teachers and students on evidence based physical education programs. The programs take place during before-school hours, after-school hours, during the school day and during recess time. Students use equipment from SPARK programs, learn how to understand their workouts by using Polar Heart Rate Monitors, and create steps to a better lifestyle of healthier choices. A Wellness Coordinator was appointed at each school to help coordinate the nutrition education and collect data for evaluation. The in-depth evaluation system will be used to monitor program outcomes and successes. This evaluation system serves to measure the extent to which both short-term and long-term goals are being met. Site Councils comprised of community agencies, parents, school personnel, and the Healthy Outlook staff work to enhance communication and commitment, and to promote an environment of sustainability at each school.


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HEROES ProgramThe HEROES Program is a program supported by the Welborn Baptist Foundation that takes place in EVSC Schools. The HEROES model influences system level changes in schools to create an environment more conducive to healthy choices. Students participate in increased physical activity and receive more nutritious foods in schools. As of December 2012, there are 34 schools in the region participating in HEROES, the majority in Vanderburgh County.

The mission of the HEROES Program is to increase the number of childcare settings adopting nutritional guidelines. They focus on prevention and early intervention, including increasing the number of child care settings adopting nutritional guidelines and expansion of the Welborn Baptist Foundation HEROES program, (Healthy, Energetic, Outstanding, Enthusiastic Schools), for improved physical activity/nutrition in schools, based on the Coordinated School Health Model.

Evansville MPO – Bike Routes The City of Evansville has installed approximately 20 miles of urban, signed bike routes. These routes are shared routes, meaning the bicyclists and motorists share the travel lane. The City of Evansville will be working with the Department of Parks and Recreation to update a comprehensive bicycle and pedestrian connectivity plan in early 2014.

Indiana Healthy Weight InitiativeThe Indiana Healthy Weight Initiative is an initiative from The Indiana State Department of Health Division of Nutrition and Physical Activity whose mission is to enhance the health and quality of life of Hoosiers by promoting good nutrition, regular physical activity, and a healthy weight through policy, environment, and lifestyle change. Some of their key activities include:- Organizing and maintaining the Indiana Healthy Weight Initiative Task Force.- Implementing and evaluating Indiana’s Comprehensive Nutrition and Physical Activity Plan, 2010-2020.- Maintaining the Indiana Healthy Weight Initiative website and other resources to provide technical assistance and training for statewide partners.


PrivateWorkout CentersTristate Athletic Center Tri-State Athletic Club provides tennis, swimming, basketball players with lessons and training programs for children ages 4-18. They also offer a general fitness/work-out program for kids in that age range.

Bob’s GymAt Bob’s Gym children from the ages of 11-13 are eligible to take the Teen Weight Training course. This course enables them to use all aspects of their facilities, from the cardio machines to the weights. Children 10 and under have access to the basketball court and the swimming pool. There is also a Kid’s P.E. class at select location for younger children, which offers a “miniature workout.”

Youth Yoga SchoolYouth Yoga School is a camp geared toward kids ages 5 to 8 to teach them the basic of yoga. The classes are geared to be more active and engaging than a traditional yoga class for adults — to get the kids motivated to be physically active.

AnalysisVanderburgh County’s public sector support for combatting childhood obesity is quite impressive. It is arguably more impacting than the private and non-profit efforts combined. The Evansville Vanderburgh School Corporation is such a large part in the fight against childhood obesity in the community and their efforts have been noticed. Partnering with the Wellborn Foundation’s programs and numerous other programs makes it a useful and immediate resource for the community’s children.

The private sector has very little to offer as far as children’s fitness and wellness programs. A few gyms offer programs and there is a youth yoga program; otherwise our research has yielded no other private sectors impacts towards the fight against childhood obesity.


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Capacity Scorecard

Capacity Indicators Scorecard MethodologyIn addition to the community indicators, the scorecard below also lists a number of metrics used to assess the capacity of each nonprofit community to address childhood obesity issues. Capacity indicators include the scope of the overall nonprofit sector, household giving, religious organizations, foundation presence, and financial indicators such as assets and revenue.

The scope of the nonprofit sector in each community gives insight to the efforts of community members in addressing social issues (Gronbjerg, Paarlberg 684). The proportion of nonprofit organizations to people shows the amount of nonprofit work already being accomplished in each community. The two subsequent indicators, related to household giving, shows the community members engagement with the nonprofits in their community in addition to their ability to do so.

The next set of indicators relate to the prevalence of congregations and religious organizations in each community. Congregations and religious organizations are important pieces of the nonprofit puzzle and a large majority participate in some sort of “social service” such as providing food for those in need, distributing clothing, and performing home repair or maintenance (Chaves, 381). Foundations presence is next in the list of indicators. An active group of foundations in the community can contribute significantly to other nonprofit organizations ability to function through increased local funding streams. Finally, several financial indicators are listed in the scorecard. Going along with the “nonprofit scope” indicators listed earlier, the financial metrics can delve deeper into the nonprofit sectors ability to address issues in the community. County and State data was found using the same methodology described earlier in the report. National benchmarks are not available from this data set.

Data from the private sector was collected through the 2011 County Business Patterns from the United States Census Bureau. As explained earlier in the report, combatting childhood obesity is accomplished through a variety of types of organizations. The North American Industry Classification System categorizes businesses for “the purpose of collecting, analyzing, and publishing statistical data related to the U.S. business economy” (United States Census Bureau, 2012). Focusing on health care and social assistance (62-71), educational services (61-62), arts, entertainment, and recreation (71-72) will be analyzed for comparison purposes (Gronbjerg, January 27).

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Capacity Scorecard

Table 2.9: Capacity Scorecard for Marion and Vanderburgh Counties

For tabulation, each community will be ranked by a variety of organizational capacity indicators. The community showing a higher level of capacity for each indicator will receive a score of “1.” The community with less capacity will receive a score of “0.” Lesser level of capacity is defined as having a value for each indicator of a lesser value than the other community (example: If Marion County has 100 organizations per 10,000 persons and Vanderburgh County has 3 organizations per 10,000 persons, Vanderburgh County has less capacity for this indicator and would receive a score of “0”).

If values are similar (within 2% for percentage comparisons), both cities will receive a score of “0.” For Per Capita comparisons, the difference will be determined by a number of people. The community showing a higher level of capacity will receive a score of “1.” The community with less capacity will receive a score of “0.” The scores will be deemed too close to differentiate if the values are within 2% of the per capita number used (For example, if the per capita is measured by #/10,000 residents, values within 200 individuals, or 2% of 10,000 residents, will be deemed too close to differentiate). In that case, both communities will receive a “0”.

Capacity Indicators Marion County

Score Vanderburgh County

Score Indiana Number of Organizations (per 10,000 persons)

17.3 1 15.8 0 -

Number of Organizations Filing Annually

1,520 1 272 0 -

% of Households itemizing deductions

32.5% 1 27.0% 0 30.4%

% of households reporting contributions

82.3% 0 84.3% 0 83.7%

Contributions as a % of AGI

2.8% 0 2.1% 0 2.1%

Number of congregations per 10,000 persons

11.2 0 8.3 0 9.6

Number of Religious Organizations per 10,000 persons

12.1 0 9.4 0 10.3

Number of Foundations per 10,000 persons

3.0 0 7.5 0 2.7

Foundation assets per 10,000 persons

$10,517 1 $1,511 0 $2,002

Foundation contributions and grants per 10,000 persons

$433 1 $93 0 $102

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Organizational Assets per capita

$19,841 1 $12,025 0 Organizational revenue per capita

$12,711 1 $8,179 0

Budget of County Parks and Recreation Department (per 10,000 persons)

$223,453.9 0 $572,867.1 1

Paid Employees for Pay Period Including March 12: NAICS Category Health Care and Social Assistance (per 10,000 persons)

26.5 0 31.4 0

Annual Payroll ($1,000): NAICS Category Health Care and Social Assistance (per 10,000 persons)-

8.6% 0 10.6% 0

Total Establishments: NAICS Category Educational Services (per 10,000 persons)

$43,573.3 0 $42,368.6 0

Paid Employees for Pay Period Including March 12: NAICS Category Educational Services

3.4 0 3.6 0

Annual Payroll ($1,000): NAICS Category Educational Services (Per 10,000 persons)

1.4% 0 1.2% 0

Total Establishments: NAICS Category Arts, Entertainment, and Recreation (per 10,000 persons)

$4,150 1 $2,779.1 0

Paid Employees for Pay Period Including March 12: NAICS Category Arts, Entertainment, and Recreation

3.5 0 3.8 0

Annual Payroll ($1,000): NAICS Category Arts, Entertainment, and Recreation (per 10,000 persons)

.83% 0 .75% 0

Overall Score Marion County

9 Vanderburgh County

1

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Scorecard ComparisonRecommendationsOf the 15 indicators considered with the Community Indicators scorecard, Marion County showed a greater level of need in 7 of the indicators. However, 8 of the indicators were considered within the range of error and no community demonstrated a greater need in these communities. Factors that were similar included the smoking rate, adult obesity rate, the rates of physical inactivity, the teen birth rate, high school graduation rate, access to recreational facilities, and the number of parks per 10,000 persons. It is important to note that a number of these indicators and the final score could be compounded by outside variables (such as poverty rates, rates of diversity, size of the cities and more). However, most of the research will support that a resident of Marion County is much more likely to become a victim of an unhealthy lifestyle that will result in childhood obesity. Vanderburgh County did not have any indicators that were of a greater community health need, resulting in a needs score of 0. Both communities score poorly when compared to other counties in the State of Indiana, as shown through the state benchmark levels (added into the scorecard when the data was available).

The government, private, and nonprofit sectors of Marion County show greater capacity to address childhood obesity. Comparing the counties over 22 indicators, Marion County showed a higher level of capacity in 10 of the categories. Vanderburgh and Marion County were contained similar rates of the remaining 12 indicators. While Marion County is significantly larger in terms of population than Vanderburgh County, per-capatized data and looking at the percentages NAICS data allows for a more even comparison of the sectors. Benchmarks from the State of Indiana were included when available. The unique charitable, government, and private sectors of these communities make an interesting comparison. However, Marion County shows a greater potential for handling and administering a large infusion of funding from a national organization.

When moving forward with selecting an organization, the Robert Wood Johnson Foundation will need to consider both the needs of the community and the capacity of the nonprofit community to handle a high level infusion of funding.

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Recommended Organization and Actions

The organization recommended by TheSix following a thorough analysis of the Vanderburgh and Marion County communities is HealthNet Indianapolis, specifically its school-based clinics program. HealthNet Indianapolis currently sponsors four school-based clinics, including nurse provision, at three Indianpolis Public Schools (IPS) and one charter school. These locations include Arsenal Tech High School, HL Harshman Middle School, Washington Community High School, and KIPP Indianapolis College Preparatory School. Located in various parts of downtown Indianapolis, these four schools target the populations that RWJF seeks to impact with their grant funding and obesity program support. The table 3.1 details the minority and free and reduced price lunch populations as a percent of total students served in each school, in state report card grades and grade levels served in each. Percent minority and percent free and reduced price lunch eligible are often used as proxy measurements for poverty in schools. Poverty is often a leading indicator of obesity in child populations and lack of access to good nutrition and health education. As such, all four of these schools represent the target populations of the RWJF in obesity awareness and prevention strategies.

School Name Percent Minority

Percent Free And Reduced Price Lunch

Eligible

State Report Card Grade (A-F Scale)

Grade Levels Served

Arsenal Tech High School

77.5% 84.6% D 9-12

HL Harshman Middle School

78.1% 92.0% B

7-8

Washington Community High School

63.2% 76.4% D 9-12

KIPP Indianapolis College Preparatory

97.9% 92.6% C 5-8

*Indiana Department of Education, COMPASS, 2014

Table 3.1: Minority and Free and Reduced Price Lunch in HealthNet Program

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The school-based clinic services are wide reaching in these schools, providing a variety of health services, including obesity prevention and education. However, there is more that can be done to expand these services to the students and community members served by these clinics in order to address obesity within Marion County. Though HealthNet Indianapolis’ 2012 income was $52 million with $25 million in assets and $48 million in expenses, only $450 thousand goes to the school-based clinics program (Guidestar, 2014). A grant from RWFJ would expand resources to the school-based clinics program to substantially increase obesity prevention programming. Because all four of these schools reach teen populations, the grant will impact the population most often forgotten in the fight against childhood obesity: teens.

The grant program proposed to HealthNet Indianapolis from RWFJ has three distinct facets. The first is to expand existing obesity and health programming in these clinics through additional health and nutrition programming in the schools as well as an increased emphasis on obesity prevention during primary care visits to the clinics. The expansion of obesity-specific health programming will allow HealthNet to reach 3,500 students and their families in Marion County with specific action plans to prevent and reverse childhood obesity within the community.

The second facet of the program will be to launch a pilot program at KIPP Indianapolis College Preparatory. KIPP Indianapolis was selected because it reaches the youngest students of all four existing schools in the program. Early access to health and nutrition education is key to prevent childhood obesity in teens. Additionally, the school also represents the highest minority and free and reduced price lunch eligible students of the four existing schools in the program. The pilot program will focus on preventative health training and education. This pilot program will be directly linked to daily instruction through science, health, physical education, and other coursework and will allow students to practice the lessons they have learned during their free time and by providing healthier eating options. The program will wrap around the school day to students at home as they implement their integrated lessons and healthy eating habits with their families at home. The pilot program and the expansion of the school-based clinic programs lead to the third facet of the program.

The third and final facet of the grant program includes the capacity and resources to engage in data analysis and reporting on the impact of the KIPP pilot program and the expansion of existing school-based services. This part of the program may include hiring a new employee to focus on data collection and analysis of program results or the purchase of technical resources, support, and/or professional development to engage in this analysis. Specific analysis on the obesity rates within each school, especially in the KIPP pilot cohorts, at the beginning and end of each year of the five-year award is required. Additionally, qualitative evaluations using survey instruments to determine acquisition of healthy nutrition and health habits leading to the prevention of obesity are required. These survey instruments will be issued as pre- and post-assessments to determine the effect of HealthNet’s school-based clinic programming on student health and nutrition.

The following sections explain the theoretical basis of these program recommendations, the specifics of the grant proposal, and anticipated program outcomes as a result of these recommendations.

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Strengthening current activities, the creation of a pilot program, and collecting data all greatly benefit Marion County. These new programs will help promote health, create leverage by sharing evidence, and bring new perceptions of healthy lifestyles to the community (Robert Wood Johnson Foundation, 2014). Overall, this program is important for increasing community awareness of childhood obesity, providing preventative care to children who may not have outside access, tracking the trends in an accurate and complete manner, and reducing life-threatening health problems facing children who are overweight or obese.

The National Institutes of Health’s International Journal of Preventative Medicine found that levels of childhood obesity can be greatly decreased through prevention and sustainable interventions related to healthy nutrition practices and physical activity promotion. The school-based programs with the highest levels of success targeted early prevention of weight gain through increasing levels of physical activity and healthy diet education. The preventative nature of the services provided by Health-Net aligns with internationally proven methods. In addition, each student in the school will be required to participate in Health-Net’s programs. By requiring the participation of each student, the stigmatization of obese children will be reduced, because students who may be unhealthy are not singled out (Kanekar, 2012). At the national level, the United States Preventative Services Task Force found with a high level of certainty that moderate levels of screening and tracking childhood obesity would lead to moderate to high intensity results with interventions, such as the nutrition and physical components offered through the Health-Net program. By combining access to health services, preventative screenings, and a strong intervention plan, Health-Net’s plan meets the task forces’ recommendation on reducing obesity (US Preventative Services Task Force, 2010).

As discussed earlier in the report, data collected with childhood obesity is often an underestimate. Furthermore, little accurate data exists at the local level. While the data collection element of this grant will help with program evaluation and demonstrative effectiveness to the foundation, the collection moves beyond these positives. Having strong data collection at the local level will reduce overall healthcare costs, help shape future policy, track obesity trends in Marion County, and design preventative obesity solutions that will be able to lower rates of childhood obesity in Marion County (Matt Longjohn, 2010).

The pilot program component is also important and will help reduce the rates of childhood obesity in Marion County. The United States Agency for International Development found pilot programs related to health to find the most important and feasible innovations in health, especially in areas with high poverty levels. Pilot programs have the unique ability to gauge the environment of an area of need. It allows for organizations to adapt funding and scale-up in a sustainable manner. HealthNet can use the pilot program to gain a greater understanding of the need in Marion County, decide how to expand accordingly, and will help organizational planning sustainability (U.S. Agnecy for International Development, 2004).

Explanation of Recommended Actions

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The strongest results for reducing rates of childhood obesity occur with the support of community wide change. By choosing to launch this program in prominent and diverse schools across Marion County, Health Net’s program can work to build community wide coalitions for helping children’s health (Harvard School of Public Health, 2014). By focusing on school-based interventions, Health Net has a high probability of reaching the target audience of the intervention. Teenagers are especially vulnerable to facing further health problems as an adult if they do not change essential health habits. Because Health Net is taking a school approach, their projected level of success increases, rather than focusing on community based measures (L. Tarro, 2014).

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Action Plan

In order to achieve the recommended activities as described above, RWJF will fund HealthNet school-based clinic programs in the amount of $4 million over the next 5 years. Funding will be disbursed in two payouts. First, initial funding will be given for a 2 year period to provide an initial period of expansion and startup at an amount of money that the organization can reasonably handle given their current capacity . A “midterm evaluation” of the use of the grant funds will be conducted at the end of the second year. Finally, additional funding will be given for the last two years following a successful evaluation of HealthNet’s activities to fur-ther build on the gains and expanded capacity created during the first 2 years.

FundingFirst 2 Years1. $1 million in the first year as seed money to begin a pilot program at KIPP Indianapolis focusing on preven-tative health training and education One additional staff member will be hired to oversee the new program The program will install a health clinic similar to the 4 current clinics in operation The staff member will coordinate with school instructors to link coursework with the preventative health efforts of the clinic

2. $500,000 to the 4 teen clinics Current operating expenses are $450,000 per year for the 4 clinics operated by HealthNet This additional funding will cover operating expenses as well as allowing for expansion of obesity pre vention efforts during primary care visits3. $500,000 to improved data collection One new staff member will be hired to conduct data collection on the current operations of the teen clinics as well as the new KIPP program The duties of the staff member will include both collection and analysis of obesity data within the schools operating clinics Surveys of the students, issued as pre- and post-assessments, will provide insight into the effective ness of the programming on students’ choices and lifestyles Data will be used in the evaluation for additional funding as well as opportunities for funding outside of the scope of this grant

Evaluation at the end of the second yearHealthNet’s current capacity does not allow for the full five years of funding to be disbursed in the initial amount. In efforts to not overwhelm their organizational capacity, the first two years of activity will be evaluated to determine funding for the final two years. The newly hired staff member will head the data analysis efforts and should report findings in accordance with the requirements of RWJF. Program activities will be evaluated on the outcomes defined and detailed in the following section.

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Action Plan

Beginning of the 3rd year1. $1 million to KIPP After monitoring the growth of the initial pilot program, an additional $1 million will be given to ex pand program activities HealthNet will be given the discretion to expand program efforts based on the midterm evaluation results and in order to meet the requirements of the final evaluation2. $1 million to 4 teen clinics After monitoring the growth of the teen clinics, an additional $1 million will be given to expand pro gram activities HealthNet will be given the discretion to expand program efforts based on the midterm evaluation results and in order to meet the requirements of the final evaluation3. $1 million to data collection As previously mentioned, data collection and analysis will continue until the conclusion of the grant cycle in order to produce the final report for the final evaluation

Final EvaluationAt the conclusion of the grant cycle, a final evaluation will be conducted based on the outcomes defined and detailed in the “Outcomes” section. A final report will be produced by HealthNet to detail the activities carried out as a result of the grant funds. The final evaluation will serve as the basis for future funding opportunities from RWJF.

Evaluation PlanKIPP Program1. Track the number of classroom visits by the HealthNet staff 2. Track student participation in the health clinic3. Improvements in students’ healthy food choices4. Track the sale of healthy foods and snacks in the school

Existing Teen Clinics1. Track student participation in health clinics2. Track preventative health and obesity information available in health clinics3. Complete post-visit surveys with students and community members to determine if clinic staff provides access to obesity prevention and healthy nutrition and activity information

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Expected Results

HealthNet currently provides obesity prevention and education clinics in all four program schools. A grant from RWJF could substantially increase the number and efficacy of these clinics. Several measures can be used in evaluating the impact of RWJF funding in strengthening current activities and programs. Measuring participation and how well students internalize the information will indicate the popularity of the program, the exposure students receive, and their level of understanding. As current programs expand we would like to see clinic participation as a ratio of the student population increase. An Increased tendency for students to making healthier food choices while at school and at home, measured possibly by the consumption rate of healthy food, is also a hoped for outcome. Overall, there should be a noticeable and sustained reduction in negative health indicators.

The HealthNet Program is a great way to bring personalized fitness and action plans to elementary and middle school students. While current operations are commendable, program expansion is strongly recommended. Early access to health and nutrition education is important in preventing obesity in teens. As such, we hope to see health training and education programs truly affect the students at KIPP by reducing childhood obesity rates and instilling healthy habits that continue through their teenage years. If the program proves a success, we would like to see it expand to other schools in Marion County and serve as a model for schools throughout Indiana.

Collecting and tracking data on childhood obesity is paramount to properly track the success of programs and education. The difficulty in finding consistent obesity data, such as childhood obesity rates, in Indiana demonstrates an information gap that needs to be filled. Resources should be allocated to gather more data on the issue. With more data on childhood obesity, we can begin to get at the root of the problem and tailor future initiatives to better meet it. Additionally, long-term tracking of students of HealthNet programs as they progress through the school system could be invaluable at measuring the effectiveness of childhood educational programs. No substantial evaluation can be undertaken without complete and meaningful quantitative data.

Overall there should be a decrease in negative health indicators across the four current schools and the KIPP pilot. We hope to see healthier choices in the areas of meal and snack choices and fitness and activity choices. Finally, we would love to see continued efforts by schools to improve the health of their students. Through our HealthNet programing, we will strengthen the current activities, create a successful pilot program at the KIPP school and provide resources to gather stronger data and data reporting methods all in the hopes of promoting healthier children, healthier families, and a healthier community in Marion County.

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Health and Wellness. (n.d.). Retrieved March 20, 2014, from http://www.evscschools.com/evsc-offices/center-family-school-and-commu-nity-partnerships/health-and-wellness-0

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Levco, J. (2011, August 04). How does the ‘Fattest City in America’ turn things around? Ragan.com. Retrieved February 23, 2014, from http://www.ragan.com/Main/Articles/How_does_the_Fattest_City_in_Ameri-ca_turn_things_a_43404.aspx Juniors Tri-State Athletic Club. (n.d.). Retrieved March 20, 2014, from http://www.tristateathleticclub.com/tennis/juniors

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“Marion County Public Schools -- Health, Wellness, and Physical Educa-tion.” Marion County Public Schools. 2014. Web. 14 Mar. 2014. <http://www.marion.k12.fl.us/dept/che/>.

Martin, E. B. (2012). Individual Giving and Volunteering. In L. M. Sal-amon, The State of Nonprofit America (pp. 495-520). Washington, DC: Brookings Institution Press.

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Mendes, E. (2011, March 17). More Than 1 in 5 Adults Obese in Metro Areas Nationwide. More Than 1 in 5 Adults Obese in Metro Areas Nationwide. Retrieved February 23, 2014, from http://www.gallup.com/poll/146669/adults-obese-metro-areas-nationwide.aspx

Miles of Bike Trails: 74 (currently, more planned) (http://www.indy.gov/eGov/City/DPW/SustainIndy/Bikeways/Pages/BikewaysHome.aspx)

National Center for Charitable Statistics. (2004). National Taxonomy of Exempt Entities. Retrieved March 12, 2014, from NTEE Core Codes (NTEE-CC) Overview: http://nccs.urban.org/classification/NTEE.cfm

National Center for Chronic Disease Prevention and Health Promotion. (2013, August 9). Marion County, Indiana. Retrieved February 9, 2014, from National Healthy Worksite Program: http://www.cdc.gov/nation-alhealthyworksite/communities/marion-county.html

National Initiative for Children’s Healthcare Quality. (2010). Child Policy Research Center. Retrieved February 13, 2014, from Healthy Lifestyles in Marion County, Indiana : http://dl.dropboxusercontent.com/u/19550741/Indiana/IN_Marion_factsheet.pdfNational Initiative for Children’s Healthcare Quality. (2010). Child Policy Research Center. Retrieved February 13, 2014, from Healthy Life-styles in Vanderburgh County, Indiana: http://dl.dropboxusercontent.com/u/19550741/Indiana/IN_Vanderburgh_factsheet.pdf

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“Nine13Sports Program and IPS Partnership Encourages Biking for Health.” Indianapolis Public Schools IPS. Web. 15 Mar. 2014. <http://www.ips.k12.in.us/2013/01/29/nine13sports-program-and-ips-encour-ages-biking-for-health/>.

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Ogden CL, C. M. (2012). Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. Journal of the American Medical Association , 307 (5), 483-490.

Parks: 207 (http://www.indy.gov/eGov/City/DPR/Pages/Park-List.aspx)

Parks Budget: In 2011, $20,736,518 page 70 or budget (http://www.indy.gov/eGov/City/OFM/Finances/City/Pages/2013-Budget.aspx)

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Robert Wood Johnson Foundation . (2014). Our Mission . Retrieved February 12, 2014 , from www.rwjf.org: http://www.rwjf.org/en/about-rwjf/our-mission.html

Robert Wood Johnson Foundation. (2014). About RWJF. Retrieved February 12, 2014, from www.rwfj.org: http://www.rwjf.org/en/about-rwjf.html

Robert Wood Johnson Foundation. (2014). Our Work. Retrieved Febru-ary 12, 2014, from www.rwjf.org: http://www.rwjf.org/en/our-work.html

Robert Wood Johnson Foundation. (2013, May 15). RWJF Scholar finds link to late life weight gain in young moms. Retrieved March 15, 2014, from Teen Pregnancy Increases Obesity Risk: http://www.rwjf.org/en/about-rwjf/newsroom/newsroom-content/2013/05/teen-pregnancy-increases-obesity-risk.html

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Steinberg, The Nonprofit Sector: A Research Handbook (pp. 66-78) (pp. 89-116). London, England: Yale University Press.

T. (2013, January 09). BBC Documentary on Evansville’s Obe-sity Problem. 1061 KISS FM. Retrieved February 23, 2014, from http://1061evansville.com/bbc-documentary-on-evansvilles-obesity-problem/

The California Endowment . (2014, April 8). Health Happens in Schools . Retrieved April 20, 2014, from www.calendow.org: http://www.calen-dow.org/in_schools.aspx

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I

Foundation Summary

The Robert Wood Johnson Foundation (RWJF) is a 501(c)(3) non-operating foundation based in Princeton, New Jersey with a mission “to improve the health and health care of all Americans.” Founded by Robert Wood Johnson, the founder and former President of Johnson & Johnson, RWJF is the nation’s largest philanthropy devoted solely to public health. In order to achieve the Foundation’s overall mission of improving health and health care for all Americans, RWJF has a number of broad focus areas, including its Healthy Weight for All Children initiative. Started in 2007, the Healthy Weight for All Children initiative seeks to reverse the American childhood obesity epidemic by dedicating $500 million to fight it. As a result of its efforts, rising childhood obesity rates have abated and in some areas have decreased. However, RWJF recognizes that the fight against childhood obesity continues, particularly in rural communities and in those of color. To continue this trend reversal, RWJF seeks a partner organization in Indiana, a state with one of the highest obesity rates in the country, to alleviate the threat of childhood obesity in the populations it most effects. The partner organization will receive a five-year, $5 million grant to implement and expand a program that addresses and alleviates childhood obesity in a specific Indiana community. By engaging in a thorough analysis of impacted communities and the capacity therein, RWJF will identify a grantee able to substantively impact the threat of childhood obesity within their community to continue the mission of RWJF to reverse the childhood obesity epidemic specifically and to improve American health overall.

Appendix A

II

Foundation Selection Methodology

When considering the vast number of health-related foundations to partner with on this project, the goal was to ensure that the foundation is specifically invested in fighting childhood obesity. Additionally, the significance of the grant – up to $5 million over five years – required the selected foundation to have the capacity to make such a grant. To review the focus areas of major foundations funding health-related initiatives, the Foundation Center’s list of the top 25 foundations making health-related grants in the US was reviewed. The review specifically focused on whether or not child health, specifically childhood obesity, is a key program area of the foundation in question. After reviewing this list, the Robert Wood Johnson Foundation, the California Endowment, and the WK Kellogg Foundation leapt to the forefront as foundations focusing on childhood health, in particular, childhood obesity. Further evaluation of these three foundations provided additional insight into their foci within the realm of childhood health. It was at this stage where the Robert Wood Johnson Foundation appeared as the target foundation. In addition to its identification of childhood obesity as a specific program area, RWJF also notes that its grant funding focuses on local organizations, healthier policies, grants to researchers, and leadership for healthier communities. RWJF’s support of local organizations to address childhood obesity was particularly intriguing. Its designation of $500 million to address the childhood obesity epidemic in 2007 demonstrates the foundation’s capacity to provide a grant of the targeted amount. Finally, RWFJ partnered with the Trust for America’s Health on the landmark 2013 report, F as in Fat: How Obesity Threatens America’s Future, which provided an overview of the obesity threat throughout the United States and in the individual states (Trust for America’s Health, 2013). This report was particularly valuable to defining the obsesity problem nationally and in Indiana specifically.

In contrast, the California Endowment focuses its fight against childhood obesity on the role of schools. As such, the Endowment seeks to ensure that schools have access to healthier foods and beverages. Additionally, the Endowment works to add and maintain physical education opportunities in schools. Though these efforts are laudable, they are too specific for the purposes of this analysis. This report centers around childhood obesity prevention on a broader scale; finally, much of the California Endowment’s work occurs in California. This focus is too specific for this report, especially considering it centers upon Indiana.

The WK Kellogg Foundation also underwent final consideration and was eliminated. The Foundation focuses its efforts on ensuring kids are healthy; however, it does not focus on childhood obesity as much as it focuses on healthy beginnings for children through maternal health programs, access to healthy foods, and healthcare from the earliest stages of life. Though these programs are essential in preventing childhood obesity and are closely linked, the focus of this report is childhood obesity and its effects on teenagers. As such, the missions of the WK Kellogg Foundations and the TheSix Consulting Group do not match.

III

Foundation Selection Methodology

Additionally, during the preliminary review of nonprofit organizations and foundations in our targeted communities of Indianapolis-Marion County and Evansville-Vanderburgh County, a number of foundations sponsored by Indianapolis-based corporations were identified, including the Eli Lilly & Company Foundation, the WellPoint Foundation, the Simon Youth Foundation, the Finish Line Youth Foundation. The Indianapolis Colts and the Indiana Pacers professional football and professional basketball organizations are also particularly active in encouraging physical activity to fight childhood obesity. Though each of these foundations and organizations are particularly active in the fight against childhood obesity, the WellPoint Foundation’s efforts were particularly intriguing.

The Indianapolis Colts and Indiana Pacers’ programs were eliminated from consideration because they generally serve as program partners, providing direct resources and player participation, as opposed to grant funding for programs. As such, though their support is valued in Marion County and surrounding communities, it did make sense to select them as Foundation partners for this analysis.

Though the Eli Lilly & Company Foundation possesses tremendous financial resources, it does not address childhood obesity, which eliminated it from consideration. Instead, it focuses on educational and community improvement, both of which are vital goals but are too broad for this partnership. The Simon Youth Foundation focuses on education as well, providing scholarships and other financial resources to students in Indiana and elsewhere and promotes graduation and life skill acquisition. As such, the mission of the Simon Youth Foundation does not match the outcome of this report. The Finish Line Youth Foundation comes closer to the childhood obesity prevention goal through its programs than the others, though it still does not completely align. The Foundation aims to provide grants to youth athletic and camp programs that encourage physical activity. However, these grants are typically only $1,000 to $5,000 denominations, far lower than the target for this grant, eliminating the Finish Line Youth Foundation from consideration.

Sponsored by WellPoint, Inc., the WellPoint Foundation funds the Healthy Generations program, which includes a programmatic focus on childhood and elderly obesity. As part of this initiative, the WellPoint Foundation funds the Triple Play program sponsored by the Boys & Girls Clubs of America as well as OASIS’s CATCH (Coordinated Approach to Child Health) program. Though the financial support of these programs demonstrates the WellPoint Foundation’s commitment to fighting childhood obesity, the sponsorship of these national programs was not conducive to funding Indiana-specific programs. Because the WellPoint Foundation funds a program nationally which fights childhood obesity, it did not seem conducive to fund a similar program in the state when children already benefit from the Foundation’s support.

This further compelled the selection of the Robert Wood Johnson Foundation as the foundation most conducive to and supportive of childhood obesity reduction efforts in Indiana and aligns with the Foundation’s overall mission at the forefront of health-related activities in the United States.

IV

City Selection JustificationAppendix B

A 2011 Gallup Poll ranked the Evansville Metro Area as the most obese in the country with an obesity rate of 37% (Gallup, 2011). Despite the self-reported nature of the survey and its emphasis on BMI measurements, the title of “America’s Fattest City” spread internationally with mentionsin the United Kingdom’s DailyMail newspaper and a BBC Documentary (BBC, 2011). To compound the problem, Evansville is also known for being a test market for the restaurant and fast-food industry (Ragan, 2011). As a result, Evansville Mayor Lloyd Winnecke has made fighting obesity and changing the city’s image part of his political platform. Winnecke’s Energize Evansville initiative encourages “healthy activities throughout the city and help[s] residents live more active lives.” (Evansville Gov.) The Evansville Vanderburgh School Cooperation is also a big proponent of childhood fitness in the fight against childhood obesity. The “PE in the EVSC”initiative helped raise $12,000 to fight childhood obesity in Evansville. Marion County was chosen as a county of comparison because it plays a central role in state policy. The supply-side theory of non-profits argues that the sector expands and revolves around the resources and ideas that flow into it from its environment (Ott 25). In this sense, Marion County is a fertile ground for nonprofit activity and growth. It is home to the state capital, several large research and educational institutions, and a myriad of nonprofit groups that deal directly with obesity.

V

Changes in Indiana PopulationAppendix C

Map 4.1

Projected Population Change by County,2010-2050

VI

Changes in Indiana Population

Nationwide, the CDC has found adults in the age groups of 40-59 and those over 60 have a higher prevalence of obesity. As the baby boomer generation continues to age,as shown in graph 1.5 and 1.6, it will substantially change Indiana’s population demographics, health concerns, and associated public policy. By 2030 there will be a projected 70% increase in the number of individuals aged 65 and older – bringing the senior population up from 13% to 20% of the total state population.

Source: Indiana Business Research Center

Graph 4.1 Projected Share of Total Population by Age Group, 2010 to 2050

VII

Changes in Indiana Population

Source: Indiana Business Research Center

The Marion County Health Department (MCHD) has published an indicator “dashboard” allowing comparisons to be made between Indiana Counties and the state of Indiana as a whole (Marion County, 2014). Of the adult population age 18 and older in Marion County 30% are considered obese and 26% of adults report undertaking no leisure time physical activity. The same age demographic in Vanderburgh County has an obesity rate of 29% and an adult inactivity rate of 28%. These two counties have been chosen due to their similar projected demographic trends, health related statistics, and noted community concern regarding obesity.

Graph 4.2 Projected Population Change by Age Group, 2010 to 2030

VIII

Potential Limits with the DataAppendix D

As outlined in other parts of the report, there are many limits to the data explored in this report. This section will outline the limits of five different types of data.

A) Obesity Related Statistics To begin, there are varying definitions of obesity. The Center for Disease Control definition of obesity and overweight was applied to the majority of the report. However, at the State and Local levels, data collectors could have used different definitions. This may account for some variance in reported values explored in the report. Also, “childhood” carried a range of different values (all of which were noted in the report). The predominant definition was ages 0-18, but different segmentation occurred in different reports, which could vary the final outcome.

Second, finding accurate childhood obesity rates at the county level proved to be an extremely difficult task. After exhausting sources while searching for childhood obesity rates in Marion County, only one source ap-peared to have accurate data-the Marion County Health Department. In Vanderburgh County, only tri-state area exists, which does include the majority of Vanderburgh County, but certainly is not a perfect measure-ment of the problem. The lack of data at the county level made comparisons difficult, resulting in our final suggestion emphasizing data collection.

Finally, as explained in the introduction of the paper, the rates of obesity may be lower than reported. A study presented at the 57th Annual Meeting of the American College of Sports Medicine compared heights/weights of children taken at an orthopedic with the heights/weights that parents reported. The study found parents overestimated boys heights and weights and underestimated girls heights and weights, resulting in large errors in computing BMI. The study found that obesity statistics could have resulted in about one in five obese children, or 21% of obese children, not being identified as obese in national studies (American College of Sports Medicine, 2013). Therefore, this data may be underreporting the overall scope of the problem of obesity. Regardless, the rates of childhood obesity have risen greatly and show no signs of halting.

IX

Potential Limits to the Data

B) Religion Data Religious organizations represent an important subsection of the nonprofit sector in Marion County and Vanderburgh. A number of problems arise when analyzing religious institutions. Because religious institutions are not required to file 990 or 990-EZ tax form to the IRS, like other organizations receiving nonprofit status, the data about the size and scope of religion in communities is often unreliable. Please note that data presented in the report may not represent all of the religious organizations present in the communities, due to the lack of reporting requirement. Many varieties exist when discussing the size of religion in a city. Also, data does not account for any religious activity in the informal sector, which could be substantial.

The main data sources are the NCCS Geographical Search Data and the data collected from ARDA. These sources give conflicting values for the size and scope of the religious organizations in Marion and Vanderburgh counties. Also, the ARDA data does not list general religious organizations that do not qualify as a congregation.

C) GuideStarGuideStar serves nonprofit researchers and those curious about the nonprofit sector by providing primarily financial data pulled from IRS Form-990s. In 2012, GuideStar reported that they have “some level of data” for over 1.6 million organizations and “digitized data” for more than 300,000 public charities (2012 Annual Report). Digitized data consists of digital copies of Form-990s that GuideStar has entered electronically into their database (Guidestar, p. 1). GuideStar states that 300 fields per Form-990 are digitized and the numbers are accurate at the 99.9 percent level (Guidestar, 2014).

The two main parts of our report that utilize GuideStar data are the “Nonprofit Sector Overview” and the “Health Specific Overview” sections. One of the shortcomings of using GuideStar as a data resource, is that it does not allow filtering of results by county or by FIPS code. The other sections of this report using NCCS data were able to filter by FIPS as the report is a comparison between Marion and Vanderburgh counties, not Indianapolis and Evansville. GuideStar did prove more useful than NCCS when searching for individual organizations however. Once a large-scale search of all nonprofits in a geographical region was completed, GuideStar provides simple ways to select individual organizations from the list and gain financial data about them quickly and efficiently. This method proved useful in the “Health Specific Overview” section as the most relevant individual organizations were easily identifiable from lists generated by GuideStar.

X

D) Financial IndicatorsAssetsAssets for the relevant organizations in this report were gathered from the IRS Business Master File stored in the NCCS dataweb. NCCS describes “Asset Amount” as the total assets at the end of the year. These values were drawn directly from the Form-990 PART IV Line 59 Col. B and should accurately reflect the total assets of the organization (NCCS, 2006)

ExpensesExpenses were extracted from NCCS Core Data Files from the Core 2011 PC file. This file includes all public charities that filed a Form-990 in 2011. The Core Data Files should accurately reflect the expenses of reporting organizations as “EXPS” or Total Expenses is drawn from the Form-990 Part I Line 17 directly (NCCS, 2014).

Revenue Revenue was extracted from NCCS Core Data Files from the Core 2011 PC file. This file includes all public charities that filed a Form-990 in 2011. NCCS advises against using the BMF amount for “INCOME” as a substitute for Total Revenue as INCOME denotes a calculation of gross receipts and may not be accurate for every organization (NCCS, 2006). For this reason, our report utilized the Core Data files which extracts “Total Revenue” directly from PART I Line 12 (Total Revenue) on the forms themselves.

Potential Limits with the Data

XI

Additional Nonprofit ChartsAppendix E

Chart 4.1: Indianapolis Nonprofits by Guidestar

Chart 4.2: Evansville Nonprofits by Guidestar

XII

Additional Nonprofit Charts

Chart 4.3: Indianapolis Nonprofits by NCCS

Chart 4.4: Evansville Nonprofits by NCCS

XIII

Additional Nonprofit Charts

Chart 4.5: Indianapolis Nonprofits by Guidestar

Chart 4.6: Evansville Nonprofits by Guidestar

THESIXCONSULTING GROUP

childhood obesity grant recommendations report

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