overview of the national obesity epidemic. assuring the conditions for population health employers...

Overview of the National Overview of the National Obesity EpidemicObesity Epidemic

Assuring the Assuring the Conditions for Conditions for

PopulationPopulationHealthHealth

Employersand

Business

Academia

Governmental

Public Health

Infrastructure

The Media

Healthcare

delivery system

Community

Institute of Medicine, The Future of the Public’s Health in the 21st Century, 2003

The Public Health SystemThe Public Health System

Obesity Trends Among U.S. Adults between 1985 and 2005

Obesity Trends Among U.S. Adults between 1985 and 2005

Definitions:• Obesity: having a very high amount of body

fat in relation to lean body mass, or Body Mass Index (BMI) of 30 or higher for adults.

• Body Mass Index (BMI): a measure of weight in relation to height, specifically weight in kilograms divided by the square of his or her height in meters.

Definitions:• Obesity: having a very high amount of body

fat in relation to lean body mass, or Body Mass Index (BMI) of 30 or higher for adults.

• Body Mass Index (BMI): a measure of weight in relation to height, specifically weight in kilograms divided by the square of his or her height in meters.

Source: Behavioral Risk Factor Surveillance System, CDC.

Obesity Trends* Among U.S. AdultsBRFSS, 1985

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

No Data <10% 10%–14%

Source: Behavioral Risk Factor Surveillance System, CDC.

Obesity Trends* Among U.S. AdultsBRFSS, 1986

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

No Data <10% 10%–14%

Source: Behavioral Risk Factor Surveillance System, CDC.

Obesity Trends* Among U.S. AdultsBRFSS, 1987

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

No Data <10% 10%–14%

Source: Behavioral Risk Factor Surveillance System, CDC.

Obesity Trends* Among U.S. AdultsBRFSS, 1988

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

No Data <10% 10%–14%

Source: Behavioral Risk Factor Surveillance System, CDC.

Obesity Trends* Among U.S. AdultsBRFSS, 1989

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

No Data <10% 10%–14%

Source: Behavioral Risk Factor Surveillance System, CDC.

Obesity Trends* Among U.S. AdultsBRFSS, 1990

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

No Data <10% 10%–14%

Source: Behavioral Risk Factor Surveillance System, CDC.

Obesity Trends* Among U.S. AdultsBRFSS, 1991

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

Source: Behavioral Risk Factor Surveillance System, CDC.

Obesity Trends* Among U.S. AdultsBRFSS, 1992

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

Source: Behavioral Risk Factor Surveillance System, CDC.

Obesity Trends* Among U.S. AdultsBRFSS, 1993

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

Source: Behavioral Risk Factor Surveillance System, CDC.

Obesity Trends* Among U.S. AdultsBRFSS, 1994

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

Source: Behavioral Risk Factor Surveillance System, CDC.

Obesity Trends* Among U.S. AdultsBRFSS, 1995

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

Source: Behavioral Risk Factor Surveillance System, CDC.

Obesity Trends* Among U.S. AdultsBRFSS, 1996

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

Source: Behavioral Risk Factor Surveillance System, CDC.

Obesity Trends* Among U.S. AdultsBRFSS, 1997

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% ≥20%

Source: Behavioral Risk Factor Surveillance System, CDC.

Obesity Trends* Among U.S. AdultsBRFSS, 1998

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% ≥20%

Source: Behavioral Risk Factor Surveillance System, CDC.

Obesity Trends* Among U.S. AdultsBRFSS, 1999

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% ≥20%

Source: Behavioral Risk Factor Surveillance System, CDC.

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%

Source: Behavioral Risk Factor Surveillance System, CDC.

Obesity Trends* Among U.S. AdultsBRFSS, 2001

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Source: Behavioral Risk Factor Surveillance System, CDC.

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 2002

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Source: Behavioral Risk Factor Surveillance System, CDC.

Obesity Trends* Among U.S. AdultsBRFSS, 2003

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Source: Behavioral Risk Factor Surveillance System, CDC.

Obesity Trends* Among U.S. AdultsBRFSS, 2004

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Source: Behavioral Risk Factor Surveillance System, CDC.

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%

Now, the children…

What are the health consequences What are the health consequences for adults?*for adults?*

• Premature death• Type 2 diabetes• Heart disease• Stroke• Hypertension• Gallbladder disease• Osteoarthritis• Sleep apnea• Asthma

• Psychological disorders or difficulties

• Some cancers• Dyslipidemia• Complications of

pregnancy• Hirsuitism• Menstrual abnormalities• Stress incontinence• Increased surgical risk

* Adapted from “The Surgeon General’s Call to Action to Prevent Obesity and Decrease Overweight and Obesity” 2001

Source: Behavioral Risk Factor Surveillance System, CDC.

Source: Mokdad et al., Diabetes Care 2000;23:1278-83.

Diabetes Trends* Among Adults in the U.S.,(Includes Gestational Diabetes)

BRFSS 1990

No Data <4% 4%-6% 6%-8% 8%-10% >10%

Source: Behavioral Risk Factor Surveillance System, CDC.

Diabetes Trends* Among Adults in the U.S.,(Includes Gestational Diabetes)

BRFSS 1991-92

Source: Mokdad et al., Diabetes Care 2000;23:1278-83.

No Data <4% 4%-6% 6%-8% 8%-10% >10%

Source: Behavioral Risk Factor Surveillance System, CDC.

Diabetes Trends* Among Adults in the U.S.,(Includes Gestational Diabetes)

BRFSS 1993-94

Source: Mokdad et al., Diabetes Care 2000;23:1278-83.

No Data <4% 4%-6% 6%-8% 8%-10% >10%

Source: Behavioral Risk Factor Surveillance System, CDC.

Diabetes Trends* Among Adults in the U.S.,(Includes Gestational Diabetes)

BRFSS 1995-96

Source: Mokdad et al., Diabetes Care 2000;23:1278-83.

No Data <4% 4%-6% 6%-8% 8%-10% >10%

Source: Behavioral Risk Factor Surveillance System, CDC.

Diabetes Trends* Among Adults in the U.S.,(Includes Gestational Diabetes)

BRFSS 1995

Source: Mokdad et al., Diabetes Care 2000;23:1278-83.

No Data <4% 4%-6% 6%-8% 8%-10% >10%

Source: Behavioral Risk Factor Surveillance System, CDC.

Diabetes Trends* Among Adults in the U.S.,(Includes Gestational Diabetes)

BRFSS 1997-98

Source: Mokdad et al., Diabetes Care 2000;23:1278-83.

No Data <4% 4%-6% 6%-8% 8%-10% >10%

Source: Behavioral Risk Factor Surveillance System, CDC.

Diabetes Trends* Among Adults in the U.S.,(Includes Gestational Diabetes)

BRFSS 1999

Source: Mokdad et al., Diabetes Care 2001;24:412.

No Data <4% 4%-6% 6%-8% 8%-10% >10%

Source: Behavioral Risk Factor Surveillance System, CDC.

Diabetes Trends* Among Adults in the U.S.,(Includes Gestational Diabetes)

BRFSS 2000

Source: Mokdad et al., J Am Med Assoc 2001;286:10.

No Data <4% 4%-6% 6%-8% 8%-10% >10%

Source: Behavioral Risk Factor Surveillance System, CDC.

Diabetes Trends* Among Adults in the U.S.,(Includes Gestational Diabetes)

BRFSS 2001

Source: Mokdad et al., J Am Med Assoc 2001;286:10.

No Data <4% 4%-6% 6%-8% 8%-10% >10%

Costs of Obesity: LocalCosts of Obesity: Local

• NIH: Below based on 2001 data- likely to be MUCH higher now.

• Total costs (2001): $117 billion– Direct medical costs: $61 billion

• Estimated at $92 billion for 2002

– Indirect costs: $56 billion

http://win.niddk.nih.gov/statistics/index.htm#econ

Costs of Obesity: LocalCosts of Obesity: Local

• CDC: Based on financial data from 1998 and BRFSS data from 1998-2000*

Total Medicaid Medicaid-Obesity related

NYS: 2000 $23.2 billion $3.6 billion 2006 $35.7 billion $5.4 billion

Onondaga: 2000 $366 million $55.7 million 2006 $565 million $86.1 million**

*Finkelstein, EA, Fiebelkorn, IC, Wang, G. State-level estimates of annual medical expenditures attributable to obesity. Obesity Research 2004;12(1):18–24.** Extrapolated from estimated 2000 % costs related to obesity

IOM RECOMMENDATIONS:IOM RECOMMENDATIONS:

Recommendations for the Federal Government, Industry and Media, Health-Care Professionals, Community and Nonprofit Organizations as well as Parents and Families

Recommendations for State/Local Governments and for Education Authorities/Schools

Source: Preventing Childhood Obesity: Health in the Balance, Institute of Medicine, Sept. 2004

IOM RECOMMENDATIONS: State and IOM RECOMMENDATIONS: State and Local GovernmentsLocal Governments

• Work with communities to support partnerships and networks that expand the availability of and access to healthful foods

• Expand and promote opportunities for physical activity in the community

Source: Preventing Childhood Obesity: Health in the Balance, Institute of Medicine, Sept. 2004

IOM RECOMMENDATIONS: State and IOM RECOMMENDATIONS: State and Local GovernmentsLocal Governments

• Provide leadership and sustained commitment- establish a task force, commit adequate resources

• Evaluate policies and programs• Monitor progress and conduct research• Disseminate promising practices

Source: Progress in Preventing Childhood Obesity: How Do We Measure Up?, Institute of Medicine, Sept. 2006

Grants:Grants:

• April 2005: “Healthy Children, Healthy Futures”– Wellness initiative for schools in Cayuga,

Cortland, Herkimer, Madison, Oneida, Onondaga, Oswego

• Eat Well, Play Hard: Sept 2006- funded for additional five years

A day in the life of public health…