[date] [name] [organization] using the state indicator report on fruits and vegetables, 2009 state...
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[Date]
[NAME]
[ORGANIZATION]
Using the State Indicator Report on Fruits and Vegetables, 2009
State Indicator Report on Fruits and Vegetables, 2009
Information provided by:Division of Nutrition, Physical Activity & Obesity (DNPAO)National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and Prevention (CDC)
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Presentation Outline
• Background Why fruits and vegetables Development of Report
• Describe purpose of State Indicator Report on Fruits and Vegetables, 2009
• Present key components and data Behavioral indicators Policy and environmental indicators
• Describe application of the Indicator Report – Call to Action
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Why focus on Fruits and Vegetables?
Fruits and vegetables (F&V), as part of a healthy diet, are important for:
• Optimal child growth
• Weight management
F&V have a protective role in:
• Diabetes
• Heart disease
• Stroke
• Some cancers
• Hypertension
Source: http://www.health.gov/DietaryGuidelines/dga2005/document/
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State Indicator Report on Fruits and Vegetables, 2009 can be used:
• As a surveillance tool, part of state’s surveillance plan
• Identify current successes & opportunities for growth and improvement in environmental and policy supports for making F&V more available and affordable within the state
• Provide data for advocacy for change
State Indicator Report on Fruits and Vegetables
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Story, M., K. M. Kaphingst, et al. (2008). "Creating healthy food and eating environments: policy and environmental approaches." Annual Rev Public Health 29: 253-72, Figure 1.
Approaches for increasing supportive environments for F&V
Socioecological (SE) Model
• Physical environment
•Schools
•Communities
• Macro-level environments
•Policy actions
•Land use
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State Indicator Report on Fruits and Vegetables
Reports information for each state on two categories of indicators.
• Reports information for each state on two categories of indicators.
• The behavioral indicators profile the extent to which a state’s population is meeting Healthy People 2010 Fruit and Vegetable objectives.
• The policy and environmental indicators measure elements of supportive policies and environments for F&V consumption.
• The indicators show where a state has been successful in supporting the F&V target area and where more work is needed.
• CDC plans publish to regularly throughout decade
• Inform, Influence, and Monitor Change 6
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• [Insert state indicators, or data to augment Indicator Report information]
State Indicator Report on Fruits and Vegetables
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Development of the State Indicator Report on Fruits and Vegetables
Criteria for inclusion of an indicator included:
• Promising area within the physical and macro-level environments of socioecological model approach for F&V
• Data measurable and available for most states, e.g. BRFSS as the adult dietary data source
• Data from reputable source
• Transparent methodology in obtaining information
CDC received feedback from partners
• ASTPHND, State F&V Nutrition Coordinators
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State Indicator Report on Fruits and Vegetables
Behavioral Indicators are derived from Healthy People 2010 Fruit objective and Vegetable objective
Monitor the objectives and their targets in our state
• Increase the proportion of residents in the state consuming fruit at least two times per day (objective 19-5, target 75% of residents in the state)
• Increase the proportion of residents in the state consuming vegetables at least three times per day (objective 19-6, target 50% of residents in the state)
Source: http://www.healthypeople.gov/Document/HTML/Volume2/19Nutrition.htm
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Behavioral Indicators
Adult fruit and vegetable consumption
• Proportion of adult residents in the state consuming fruit at least two times per day (objective 19-5, target 75% of residents in the state)
• Proportion of adults residents in the state consuming vegetables at least three times per day (objective 19-6, target 50% of residents in the state)
• Proportion of adult residents in the state consuming fruit at least two times per day and consuming vegetables at least three times per day (both objectives)
• State source for monitoring Healthy People 2010 Fruit and Vegetable Objectives – Behavioral Risk Factor Surveillance System (BRFSS 2007, Odd year data collection)
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Behavioral Indicators
Youth fruit and vegetable consumption• Proportion of adolescent residents in the state consuming fruit
at least two times per day (objective 19-5, target 75% of residents in the state)
• Proportion of adolescent residents in the state consuming vegetables at least three times per day (objective 19-6, target 50% of residents in the state)
• Proportion of adolescent residents in the state consuming fruit at least two times per day and consuming vegetables at least three times per day (both objectives)
• Source: Youth Risk Behavior Surveillance System (YRBSS 2007, odd year data collection, grades 9-12)
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Summary of Behavioral Indicators Among Adults
[State] Fruit and Vegetable Daily Frequency
32.827.4
14.0
0
25
50
75
100
≥ 2 Fruit ≥ 3 Vegetable ≥ 2 Fruit & ≥ 3Vegetable
Pre
vale
nce
US National
State Percentage
Note: Change your state percentage!• Double-click on the graph to open the datasheet. If that doesn't bring up the datasheet, right click on the plot area (white background), and select “datasheet”). • Type your state name in the cell entitled “State Percentage”.• Replace the "100"s in the state data with your actual state data. • Do not change the HP2010 numbers as these are providing a reference to the HP2010 objectives.• Close out of the datasheet. The bar chart should now reflect your state data.•Delete this text box (but not the slide number box)!
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Summary of Behavioral Indicators Among Adolescents
[State] Fruit and Vegetable Daily Frequency
32.2
13.2 9.5
0
25
50
75
100
≥ 2 Fruit ≥ 3 Vegetable ≥ 2 Fruit & ≥ 3Vegetable
Pre
va
len
ce
US National
State Percentage
Note: Change your state percentage!• Double-click on the graph to open the datasheet. If that doesn't bring up the datasheet, right click on the plot area (white background), and select “datasheet”). • Type your state name in the cell entitled “State Percentage”.• Replace the "100"s in the state data with your actual state data. • Do not change the HP2010 numbers as these are providing a reference to the HP2010 objectives.• Close out of the datasheet. The bar chart should now reflect your state data.•Delete this text box (but not the slide number box)!
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State Indicator Report on Fruits and Vegetables
Policy and environmental indicators
• Represent three different types of strategies to support F&V:
Availability of healthier food retail in communities
Availability of healthier foods & nutrition services in schools
Food systems support
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Policy and environmental indicators
Availability of Healthier Food Retail in Communities
• % of census tracts that have healthier food retailers located within the tract or within 1/2 mile of tract boundaries
Supermarkets, larger grocery stores, fruit and vegetable markets, warehouse clubs
• Policy for healthier food retail, 2001-2009 [y/n] Policies that support building of new food outlets; renovations of
existing outlets; increases in & promotion of healthier foods Financial incentives (e.g. grants, loans, tax credits) Technical assistance
• Sources: Commercial retail establishment data – Dun & Bradstreet November 2007; US Census Bureau 2000; Legislative databases (DNPAO 2001-2008, NCSL 2004-2009)
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Availability of Healthier Food Retail in Communities (cont)
• Farmers markets per 100,000 state residents
• % of farmers markets that accept electronic benefits transfer (EBT)
• % of farmers markets that accept WIC Farmers Market Nutrition Program coupons
• Source: USDA Agricultural Marketing Services 2009; U.S. Census Bureau 2008
Policy and environmental indicators
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Summary of policy and environmental indicators
• Availability of healthier food retail in communities % census tracts
Nationally: 72%
Range across states: 56% – 84%
[STATE]: X%
8 states have supportive state-level policies for healthier food retail
[STATE]: [Yes/No]
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Summary of policy and environmental indicators
• Availability of healthier food retail in communities (cont) Farmers market availability
Nationally: 1.7 / 100,000 Range across states: 0.2 – 10.5 / 100,000 [STATE]: X/100,000
% Farmers markets that accept EBT Nationally: 7.6% Range across states: 0-50%
[STATE]: X%
% Farmers markets that accept WIC FMNP
Nationally: 28.2% Range across states: 0-94%
[STATE]: X%18
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Policy and environmental indicators
Availability of Healthier Foods and Nutrition Services in Schools
• % of middle and high schools that offer fruits (not juice) and non-fried vegetables as competitive foods
Fruits (not juice) & non-fried vegetables are offered to middle and high school students when other food is offered or sold
• Policy for Farm to School, 2001-2009 [y/n] Legislative policies that support any component of a Farm to School
program (e.g. school or district procurement of local produce, school gardens, staff training)
• Sources: CDC School Health Profiles survey 2008; legislative databases (DNPAO 2001-2008, NCSL 2004-2009)
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Summary of policy and environmental indicators
• Availability of healthier foods and nutrition services in schools % of middle and high schools that offer fruits (not juice) and non-fried
vegetables as competitive foods
Average percentage across participating states: 21%
Range across participating states: 0-39%
[STATE]: X%
21 states have state-level policies for Farm to School
[STATE]: [Yes/No]
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Policy and environmental indicators
Food System Support
• % of cropland acreage harvested for fruits and vegetables
Of the total land in the state that is harvested for crops, the % that is used for fruits and vegetables
• State-level Food Policy Council [y/n]
• Number of local Food Policy Councils
• Sources: USDA NASS 2007; Community Food Security Coalition 2009
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Summary of policy and environmental indicators
• Food system support % of cropland harvested for fruits and vegetables
Nationally: 2.5%
Range across states: 0-42.9%
[STATE]: X%
20 states have state-level Food Policy Councils
[STATE]: [Yes/No]
59 local Food Policy Councils across the country
Range across states: 0-14
[STATE]: X local councils22
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• Incorporate into state plan Surveillance Priority strategies
• Advocate for improvement
• Evaluate progress over time
• Identify success stories
• Broaden community support for F&V
• Strengthen policy action and support
State Indicator Report on Fruits and Vegetables – Call to Action
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Availability of Healthier Food Retail – Potential Action Steps
• Provide financial and nonfinancial incentives to food retailers1,2
• Provide support for farmers markets to purchase wireless electronic benefit transfer (EBT) devices – SNAP & WIC2
• Engage in outreach and education to residents of lower-income neighborhoods and SNAP and WIC recipients in communities where farmers markets, stands, and other venues accept benefits2
• Improve zoning and transportation policies – retail accessibility2
1Keener D, 20092 IOM, 2009
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Availability of Healthier Food Retail – Resources
• Policy Link tool for improving access to healthy food in underserved communities: http://www.policylink.org/site/c.lkIXLbMNJrE/b.5137405/k.6042/Healthy_Food_Retailing.htm
• Planning for Healthy Places provides Model General Plan Language to Protect and Expand Farmers Markets: http://www.healthyplanning.org/modelpolicies.html
• Leadership for Healthy Communities Action Strategies Toolkit is a guide to create healthy communities and prevent childhood obesity: http://www.rwjf.org/files/research/20090508lhcactionstrategiestoolkit.pdf
• The National Policy & Legal Analysis Network to Prevent Childhood Obesity (NPLAN) provides model policies, fact sheets, toolkits, on various topics related to obesity and public health: http://nplanonline.org/
State Indicator Report on Fruits and Vegetables – Call to Action
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Availability of Healthier Foods and Nutrition Services in Schools – Potential Action Steps
• Establish nutrition standards for competitive foods as part of school wellness policies.3
• Monitor and evaluate the implementation and enforcement of nutrition standards.3
• Support Farm-to-School initiatives.1
1Keener D, 20093 IOM, 2007
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Availability of Healthier Foods and Nutrition Services in Schools – Resources
• National Farm to School: http://www.farmtoschool.org/
• Council of State Governments, School Wellness Policies, Legislator Policy Brief: www.healthystates.csg.org/NR/rdonlyres/C87EB28D-B2F6-4399-B1BD-BC5617940019/0/SchoolWellnessPoliciesFINAL.pdf
• CDC resource on Local Wellness Policy Tools & Resources for school setting: http://www.cdc.gov/HealthyYouth/healthtopics/wellness.htm
State Indicator Report on Fruits and Vegetables – Call to Action
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Food System Support – Potential Action Steps
• Organize a Food Policy Council or Coalition.1
• Adopt supportive policies for production, distribution, or procurement from local farms.1
State Indicator Report on Fruits and Vegetables – Call to Action
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1 Keener D, 2009.
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Food System Support – Resources
• Building local food systems: A planning guide. Center for Popular Research, Education and Policy and New York Sustainable Agriculture Working Group, 2006. http://www.nysawg.org/pdf/Local_Food_Planning_Guide_v2.pdf
• The North American Food Policy Council site: http://www.foodsecurity.org/FPC/
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Action References1. Keener, D., Goodman, K., Lowry, A., Zaro, S., & Kettel Khan, L.
(2009). Recommended community strategies and measurements to prevent obesity in the United States: Implementation and measurement guide. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. http://www.cdc.gov/obesity/downloads/community_strategies_guide.pdf
2. IOM (Institute of Medicine). 2009. Local Government Actions to Prevent Childhood Obesity. Washington, DC: The National Academies Press. http://www.iom.edu/Object.File/Master/72/800/local%20govts%20obesity%20report%20brief%20FINAL%20for%20web.pdf
3. IOM (Institute of Medicine). 2007. Nutrition Standards for Foods in Schools: Leading the Way Toward Healthier Youth. Washington, DC: The National Academies Press. http://www.iom.edu/CMS/3788/30181/42502.aspx
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• General Resources State Indicator Report on Fruits and Vegetables, 2009
http://www.fruitsandveggiesmatter.gov/indicatorreport National and state by state data, data sources,
references Maps National Action Guide
CDC Division of Nutrition, Physical Activity, and Obesity website
http://www.cdc.gov/nccdphp/dnpao/ CDC is part of the National Fruit and Vegetable Program (
http://www.fruitsandveggiesmatter.gov) Goal: increase F&V consumption for improved public
health Tools, recipes, and other resources
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• [STATE] Resources [Add applicable state resources here]
• [STATE] Partners [Add applicable state partners here]
• Create awareness among… [Add applicable groups]
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State Indicator Report on Fruits and Vegetables – Next Steps
• Discussion of next steps
• [Fill in points for discussion]
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The State Indicator Report on Fruits and Vegetables, 2009 http://www.fruitsandveggiesmatter.gov/indicatorreport
Division of Nutrition, Physical Activity, and Obesity
http://www.cdc.gov/nccdphp/dnpao/index.html
[STATE] Contact Information
[NAME]
[e-mail]
[phone]
CDC Contact Information
• Technical assistance
• Feedback and general questions
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