Therefore, in developing a strategy to reverse the obesity epidemic in America, a comprehensive "health in all policies" approach must be implemented. A roadmap to reverse obesity will not only tackle health and nutrition issues, but also focus on the underlying social and environmental factors that contribute to this public health problem. Decades of scientific research have revealed that our health habits and environments -- the choices people make regarding tobacco use, alcohol, food, and exercise, and the communities in which they live with their transportation systems, workplaces, grocery stores, and schools -- all impact health.
Thus, a broad range of strategies are needed to address the individual, social and environmental factors and their interactions that affect people's health-related behaviors. At the national level, several initiatives have been launched to address these fundamental issues. The Affordable Care Act has mandated inclusion of menu labeling in restaurants and on vending machines, the Healthy Hunger-Free Kids Act has set nutrition standards for foods served in schools and child care facilities, and the increase in the number of Baby Friendly hospitals has expanded efforts to promote breastfeeding .
Furthermore, First Lady Michelle Obama's Let's Move Campaign is mobilizing all sectors of society to get involved in reversing childhood obesity rates within a generation. As part of this initiative, the Child Care State Challenge is encouraging the adoption of voluntary standards for physical activity, limits on screen time, healthy beverages, and promoting the availability of healthy foods in child care settings.
At the community level, new affordable housing neighborhoods like Greenbridge, Washington located in King County near Seattle are being designed and built as models for creating an environment that promotes healthy diets and active lifestyles for their residents. In this predominantly immigrant community where more than 15 languages are spoken, more than 54 percent of adults are overweight or obese, and more than 85 percent of adolescents in grades 8, 10, and 12 do not meet the physical activity recommendations set by the federal government .
Supported by Healthy Kids, Healthy Communities HKHC , a national program funded by the Robert Wood Johnson Foundation that promotes community-based solutions, Greenbridge focuses on shaping the environment to encourage healthy behaviors among families, with special attention to children who are at the highest risk. Thus far, a comprehensive set of measures has been put in place to foster the development of a healthier community.
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In addition to an elementary school, a Head Start program, and a Boy and Girls Club, this new affordable housing initiative offers community gardens to grow fresh fruits and vegetables, a library, as well as play areas, parks, and walking paths. A food bank, a public health clinic, and a community center that provides free exercise classes are located just a few blocks away. This integrative approach has turned a troubled neighborhood into a welcoming place to live.
Obesity and poverty: a new public health challenge
This new community emphasizes the importance of cultivating a nurturing environment for youth, especially as children and adolescents constitute over a quarter of the neighborhood's population. Initiatives like this one that involve not only individuals but the entire family and community provide a model for how to improve the health of cities across our nation.
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Targeting only one aspect of the problem will not be effective in fighting the obesity epidemic, since many of its causes stem from broad social and environmental factors. Moreover, to effectively confront the disproportionate impact of obesity on low income populations, the social determinants of health -- including the significant disparities that poorer people experience -- must be addressed.
Communities are the cornerstone for preventive interventions that increase the accessibility of fresh foods and physical activity, implement policies to reduce the marketing of unhealthy foods to children and adults, and help make healthy nutritional choices easier and affordable. In this regard, public-private partnerships are critical in bringing families, businesses, health care organizations, government and other stakeholders together to reverse the impact of obesity in our country.
Margaret Mead once said, "Never doubt that a small group of thoughtful, committed citizens can change the world.
Indeed, it is the only thing that ever has. While the path to reversing the obesity epidemic in America is challenging, by working together, we can ensure a healthier future for all Americans. Rear Admiral Susan Blumenthal, M. Blumenthal served for more than 20 years in senior health leadership positions in the Federal government in the Administrations of four U. Admiral Blumenthal has received numerous awards including honorary doctorates and has been decorated with the highest medals of the US Public Health Service for her pioneering leadership and significant contributions to advancing health in the United States and worldwide.
Jean Guo is an undergraduate student at Stanford University who is currently studying in Paris.
The Health Risks of Obesity
National Center for Health Statistics. Prevalence of Obesity in the United States, Gortmaker, and Martin Brown.
Story, and Melissa C. For more articles by Susan Blumenthal, M. For more healthy living health news, click here. Poverty is also a significant health threat: The increase in chronic conditions for people living in poverty is approximately 58 percent. Figure 2 shows health care expenditures for obese individuals, current smokers, past smokers, heavy drinkers, and people who have aged from 30 to 50, as compared with a baseline of normal-weight individuals of the same age and sex with similar social demographics. The bars on the left show expenditures for such health services as inpatient care and visits to the doctor's office; the bars on the right show expenditures for medication both prescription and over-the-counter.
Obese individuals spend more on both services and medication than daily smokers and heavy drinkers.
[PDF] Obesity and Poverty: A New Public Health Challenge - Semantic Scholar
For example, obese individuals spend approximately 36 percent more than the general baseline population on health services, compared with a 21 percent increase for daily smokers and a 14 percent increase for heavy drinkers. Obese individuals spend 77 percent more on medications. Only aging has a greater effect — and only on expenditures for medications.
Not only does obesity have more negative health consequences than smoking, drinking, or poverty, it also affects more people. Approximately 23 percent of Americans are obese. An additional 36 percent are overweight. By contrast, only 6 percent are heavy drinkers, 19 percent are daily smokers, and 14 percent live in poverty. Obesity rates are increasing dramatically. These rates used to be fairly stable: Between and , there was only a minor increase in the number of Americans who were overweight or obese.
Let's take on childhood obesity
Since , however, not only has the percentage increased, but much of the increase is concentrated in the "obese" category, which grew by 60 percent between and Because this increase is relatively recent, its full impact is not known. Some chronic conditions take years to develop. Current research may, if anything, understate the public health consequences of obesity.
The past 20 years have witnessed a significant lifestyle change: Americans are exercising less while maintaining at least the same caloric intake.
Desk jobs, an increase in the number of hours devoted to television watching, and car-friendly and pedestrian- and bike-hostile urban environments are some of the environmental changes that have combined to discourage physical activity. These changes affect other industrialized countries, too.
For example, over the past 20 years, Great Britain and Germany have experienced obesity growth rates similar to those in the United States. But because they started from lower levels, obesity in those countries has not yet become an epidemic-level threat to public health. The dangers of both smoking and heavy drinking have been on the national health agenda for years. A variety of measures, such as increased education, access control including smoking bans in many buildings nationwide , taxation, better enforcement of laws relating to minors, curbs on advertising, and increased clinical attention, have resulted in decreased rates for both smoking and drinking.
RAND's findings suggest that weight reduction should be an urgent public health priority. The prevalence of obesity, and its strong association with chronic conditions, indicate that weight reduction would mitigate the effects of obesity on the occurrence of specific diseases and would significantly improve quality of life. RAND research briefs present policy-oriented summaries of individual published, peer-reviewed documents or of a body of published work.
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