current status, future impact and community solutions critical issues facing today’s youth: a...
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Current Status, Future Impact and Community Solutions
Critical Issues Facing Today’s Youth:
A Forum on Childhood Obesity
April 5, 2007
Lea Susan Ojamaa, MPH
Community Liaison Coordinator
Division of Health Promotion and Disease Prevention
MA Department of Public Health
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Obesity Trends* Among U.S. AdultsBRFSS, 1985
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14%
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Obesity Trends* Among U.S. AdultsBRFSS, 1990
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14%
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Obesity Trends* Among U.S. AdultsBRFSS, 1995
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
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Obesity Trends* Among U.S. AdultsBRFSS, 2000
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
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Obesity Trends* Among U.S. AdultsBRFSS, 2005
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
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Overweight and Obesity in Massachusetts Adults
56% of adults are overweight or obese
21% of adults are obese
2005 BRFSS, MDPH
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Overweight and Obesity in Massachusetts Children and Youth
More than one third of children aged 2 to 5 years that participate in the WIC program are either at risk (17%) or already overweight (16.6%)
2003 MA PedNSS, MDPH
27% of all high school students are either at risk for overweight (16%) or definitely overweight (11%) on the basis of their Body Mass Index. This is significantly higher than the 23% found in 1999, when height and weight questions were first included in the YRBS
2005 MYRBS, MDOE
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Chronic Disease in Massachusetts Adults
10% are living with asthma; 14% have had asthma during their lifetime
9% have heart disease
6% have been diagnosed with diabetes; it is estimated that an additional 2% remain undiagnosed
3% have had a stroke2005 BRFSS, MDPH
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Burden - Health Care Costs
In 2003, hospitalization charges for heart disease and stroke were $1.66 billion
Estimated direct costs of overweight and obesity in 2003 were $1.8 billion
Hospitalization charges for diabetes averaged $490 million a year from 1996-1999
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Burden - MA Lives Lost in 2004
Heart disease was the leading cause of death, accounting for 25.3% of all deaths (13,792 lives)
Cancer claimed 13,312 lives, accounting for 24.5% of all deaths
3,252 people died from a stroke (6% of all deaths)
Diabetes was the 8th leading cause of death, accounting for 2.4% of all deaths (1,327), when counted as either an underlying or contributing cause (diabetes-related), diabetes was associated with 3,987 or 7.3% of all deaths
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Modifiable Risk Factors
Nutrition
Activity patterns
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Nutrition and Physical Activity in Massachusetts Adults
29% eat the recommended five or more servings of fruits and vegetables a day
53% get regular physical activity
2005 BRFSS, MDPH
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Nutrition and Physical Activity in Massachusetts Youth
10% eat the recommended five or more servings of fruits and vegetables a day
63% engage in vigorous physical activity for 20 minutes at least three times per week
25% engage in moderate physical activity at least five times per week
59% attend a PE class one or more times in average school week
33% of students watch three or more hours of television on an average school day
2005 MYRBS, MDOE
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Most Common Approaches to Health Behavior Change
Trying to change individual behavior directly through:
Education
Awareness
Early Intervention
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What’s Wrong With This Approach?
Knowledge alone does not alter behavior
Individual behavior is determined to a large extent by social environment
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“ It is unreasonable to expect that people will change their behavior easily when so many forces in the social, cultural, and physical environment conspire against such change.”
Institute of Medicine
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Socio-Ecological Framework
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Individual vs. Environmental
Individual approaches focus on helping people develop the knowledge, attitudes, and skills they need to change their behavior
Environmental approaches focus on creating an environment that makes it easier for people to engage in healthy behavior
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Public Health and the Built Environment
Obesity
Diabetes
Asthma
Heart Disease and stroke
Cancer
Injuries
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Impact of Sprawl on Health
Air and water pollution
Car crashes
Pedestrian injuries
Physical activity
Social cohesion/social capital
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What Communities Can Do
Areas of FocusActive Living
• Recreation and Open Space
• Walking and Bicycling
• Safety
Healthy Eating
Disease Prevention and Emergency Care
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Community Initiatives - Active Living
Maintain and promote greenspace/conservation land by, in part, preventing over development
Connect neighborhoods, schools, stores and parks with walking/biking trails and sidewalks
Establish a sidewalk committee to assess walkability of community, accessibility for use by all residents, and maintenance needs
Assess municipality to identify potential locations and support for shared use paths
Add bike lanes and proper signage to key roads
Develop walk-to-school programs, utilizing the “safe routes to school” model where appropriate
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Community Initiatives - Pedestrian Safety
Separate pedestrians from vehicles through signaling, refuge islands, wide sidewalks and bike paths
Make pedestrians more visible by improving lighting and utilizing raised intersections
Utilize traffic calming measures to reduce vehicle speeds
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Community Initiatives - Healthy Eating
Attract grocery stores to under-served areas
Improve transportation options to grocery stores and other large food outlets
Establish farmers’ markets and/or community gardens
Increase use of locally grown foods in schools
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Role for Public Health
Collaborate with other disciplines Transportation
Planning
Engineering
Smart Growth coalitions
Public Health brings Data
Effective strategies
Skills in reaching the public and policy makers
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Contact Information
Lea Susan Ojamaa, Community Liaison Coordinator
617-994-9843 [email protected]
Lynda Graham-Meho, Community Liaison, Northeast Region
978-851-7261 x4067 [email protected]