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Community Action Partnership at 45: Keeping Our Promise
Why is Obesity Prevention an Important Anti-Poverty
Strategy
Dolores BarrettDirector of Partnerships and Services
Community Action Partnership of Orange County
September 4, 2009
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Prevent
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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, 1986
(*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, 1987
(*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, 1988
(*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, 1989
(*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, 1991
(*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, 1992
(*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, 1993
(*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, 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, 1996
(*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, 1997
(*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, 1998
(*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, 1999
(*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, 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, 2001
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
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(*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%
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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%
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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%
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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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Obesity Trends* Among U.S. AdultsBRFSS, 2006
(*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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Obesity Trends* Among U.S. AdultsBRFSS, 2007
(*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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Obesity Trends* Among U.S. AdultsBRFSS, 2008
(*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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1999
Obesity Trends* Among U.S. AdultsBRFSS, 1990, 1999, 2008
(*BMI 30, or about 30 lbs. overweight for 5’4” person)
2008
1990
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
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• In 1990, among states participating in the Behavioral Risk Factor Surveillance System, ten states had a prevalence of obesity less than 10% and no states had prevalence equal to or greater than 15%.
• By 1999, no state had prevalence less than 10%, eighteen states had a prevalence of obesity between 20-24%, and no state had prevalence equal to or greater than 25%.
• In 2008, only one state (Colorado) had a prevalence of obesity less than 20%. Thirty-two states had a prevalence equal to or greater than 25%; six of these states (Alabama, Mississippi, Oklahoma, South Carolina, Tennessee, and West Virginia ) had a prevalence of obesity equal to or greater than 30%.
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Health Risks• Diabetes• Coronary Heart
Disease• Dyslipidemia (high
cholesterol, high triglycerides)
• Stroke• Gynecological
problems (abnormal menses, infertility)
• Hypertension (high blood pressure)
• Cancer (endometrial, breast, colon, pancreatic)
• Liver and Gallbladder Disease
• Sleep Apnea and respiratory disease
• Osteoarthritis
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CostsObvious Costs
Costs in health care doubled in less than a decade to $147 billion (CDC)
Hidden Costs
Transportation and fuel costs
Insurance Premiums
Physical Environment
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Health Disparities
• The proportion of adolescents from poor households who are overweight or obese is twice that of adolescents from middle- and high-income households. Obesity is especially prevalent among women with lower incomes and is more common among African American and Mexican American women than among white women.
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Health Disparities• Compared with white youth, black and
Hispanic youth have higher prevalences of asthma, overweight, and type 2 diabetes.
• Among youth aged 10–19 years, American Indians have the highest prevalence of type 2 diabetes of any racial/ethnic group.
• In 2005, after adjusting for population age differences, Mexican-Americans were 1.7 times more likely to have diabetes than non-Hispanic whites
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Health Disparities• In 2000, rates of death from diseases of
the heart were 29 percent higher among African American adults than among white adults, and death rates from stroke were 40 percent higher.
• During 2003-2004, 24% of non-Hispanic black females aged 2-19 years were overweight, compared with 15% of non-Hispanic white.
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“Despite obesity having strong genetic determinants, the genetic composition of the population does not change rapidly. Therefore, the large increase (obesity)…must reflect major changes in non genetic factors.”
Hill & Towbridge, Childhood Obesity future directions and research priorities. Pediatrics 1998
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Food/Calories – energy in
Physical Activity –energy out
Weight is a simple equation
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Framing the Issue
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The issue is not individual weight
loss.
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PLACE MATTERS
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Individual & Environment
Success –
Policy, Systems & Environmental Change
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California D
reamin’
*Adapted from NC Energizers
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Climb up a redwood tree.Climb up a Redwood Tree
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Do a touchdown dance like a 49’er.
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Swim like a fish in the Monterey Bay Aquarium
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Wave and pose for your fans like an actor in L.A.
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Surf the Pacific in the O.C.
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Swing your golf club in Palm Springs
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Sit down in your beach chair and enjoy the sunset on a San Diego Beach
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If given enough time, people can walk anywhere.
WALKING
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But why would they?
Unless…
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… it was NICE
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… … there were places were places to walk TO…to walk TO…
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Dan Burden
… and getting there was safe and fun for all!
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What’s What’s wrong with wrong with this this picture?picture?
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…and this one?
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Ready,Set,Go!
And this picture?
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e
Can you
spot the
pedestrian?
OverbuiltOverbuilt Roads Roads……
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Can our streets encourage walking?
Yes! How?• Scenery• Maintenance• Accommodation • Variety of Uses • Activity • Connectivity• Aesthetics & Beauty• Safety
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Dan Burden
BeforeBefore
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Dan Burden
After
PedestrianRefuge
Bike Lanes Bus Shelter
In-Pavement Warning Lights
Ped-Scale Lighting
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Before
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After
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Cost Savings - ROI
Prevention is an Investment
$1 spent - $1 return in 1 year
$1 spent - $5.60 return in 5 years
$10 per person for prevention –
$16 billion saved annually in 5 years
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ACHIEVE-Action Communities for Health, Innovation, and EnVironmental changE
CDC program that funds national organizations to work through local affiliates to advance local community leadership in the nation’s effort to prevent chronic disease and related risk factors.
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ACHIEVE National Organizations
Community Funding National Association of Chronic Disease Directors
National Association of County and City Health Officials-NACCHO
National Recreation and Park AssociationYMCA of the USA
Translation and Dissemination– National Association of County and City Health Officials– Society for Public Health Education
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Creating a National Movement
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CHART – Community Health Assessment Response TeamLa Mirada: City Parks & Recreation, LA County Public Health, Nonprofit, Community Hospital, Community Action
CHANGE – Community Health Assessment aNd Group EvaluationCommunity, Worksite, School, Healthcare, and Community Organization/Institution
CAP – Community Action Plan3 Year plan to implement PSE change
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Partnerships
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Orange County Nutrition and Physical Activity Collaborative,
NuPAC• 10 Years
• Leadership roles, Chair, Chair of the Policy Committee, Leadership Team
• Multiple Events, Trainings
• List Serve – 250, Active Membership 75
• Orange County Obesity Prevention Plan
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Kid Healthy, Steps to Healthy Living Campaign
• 6 years• Public Awareness Campaign – 7 Counties,
direct intervention for 100,000 children 2009
• Partners- ABC7, Kaiser Permanente, Power Play (CAPOC), CVS, Sav-On
• Power Play in OC provided over 100,000 nutrition education and physical activity lessons
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Network for a Healthy California(Nutrition Network- 5 a Day)
• 9 years• Represented OC in state meetings of
regional collaboratives• 6 years contract -Power Play, Latino
campaign, California Assoc. of Food banks
• State and County Public Health• Nutrition and Physical Activity Education
and Health Promotion
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Community Building Initiative
• 5 years
• Community Leadership Development
• Low Income Community driven Policy, Systems, Environmental Change
• 6 Communities
• Playground equipment, 25 streetlights, community input in street widening and development process, etc.
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More Partnerships
• California Convergence
• Santa Ana Building Healthy Communities
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Existing Movements
• Prevention – Gang, Drug and Alcohol, Teen Pregnancy, Tobacco, Violence
• Environment – Bike/Transportation, Slow Growth, Parks, Organic, Energy, Green
• Physical Activity – Sports, Professional & Recreational, PE, Parks, Recreation
• Food – Grocery Stores, Health food Industry, Agriculture, Food Industry
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• Planning Departments
• Transportation Agencies
• Public Works• Traffic Engineers• Planning
Commissions• Developers• Smart Growth• Environmentalists• Farmers, Agriculture
• Public Health Department (Chronic Disease, Injury Prevention)
• Schools (PE Dept./Teachers, Food Service)
• Restaurants• Grocery Stores• Employers,
Businesses• Healthcare
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What are your next steps?
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