Posts Tagged ‘obesity’

Farm Bill Provides Public Health Intervention Options

April 1st, 2014

farmbillThe passage of the Farm Bill  (the  Agricultural Act of 2014)  includes some changes and reforms to the Supplemental Nutrition Assistance Program (SNAP or food stamps) and the Commodity Supplemental Food Program.  In Arizona, SNAP benefits help put healthy food on the table for more than one million people each month, with more than half of the benefits going to children and teens.

The new Farm Bill promotes healthier options by requiring SNAP retailers to provide healthy choices.  When fully implemented, any store that accepts SNAP must offer at least seven foods in each of the USDA’s four categories of staple foods.  The law also provides grant programs to encourage people that receive SNAP benefits to buy more fruits and vegetables, provide funding for loan programs for healthy food retailers, and create opportunities for schools to add different kinds of vegetables as part of school menus.

In terms of education funding for SNAP… we’ll be able to promote physical activity in addition to nutrition education. This is great news because the combination of healthier foods and physical activity are powerful tools in fighting the obesity epidemic.  And it fits so well with our Winnable Battle to promote nutrition and physical activity to reduce obesity.  Many studies show there’s a link between obesity and low-income families, so adding nutritional criteria to SNAP is a significant improvement on the status quo and a positive springboard for improving health outcomes moving forward.

Obesity Drops Among Preschoolers

March 5th, 2014

The latest CDC obesity data published in this week’s Journal of the American Medical Association found a significant decline in obesity among kids aged 2 to 5. Obesity prevalence for this age group declined by 43% in the last 8 years (from 14% in 2004 to 8% in 2012.  While the precise reasons for the decline in obesity aren’t clear, many child care centers have started to improve their nutrition and physical activity standards over the past few years (like our (EMPOWER Program).  In addition, CDCs data shows a decrease in consumption of sugar-sweetened beverages among kids in recent years. Another possible factor might be the improvement in breastfeeding rates- which helps stave off obesity. 


Arizona’s First Ever State Health Assessment

February 13th, 2014

Today we published Arizona’s first ever comprehensive State Health Assessment. The objective of the State Health Assessment is to give Arizona’s public health and health care systems a clear tool to help drive future decision-making and resource allocation as we collectively design and implement evidence-based interventions to improve health and wellness outcomes across Arizona.  

The Assessment uses Arizona-specific data to assess the state of the public’s health in Arizona and has been a collaborative effort among all of the health departments in each AZ county as well as the ADHS.  The 15 priority health issues in the Report are obesity, tobacco use, substance abuse, healthcare associated infections, suicides, teen pregnancy, creating healthy communities, behavioral health services, diabetes, heart disease, other chronic diseases (cancer, respiratory disease, asthma), accidents and injuries, oral health, access to well care, and access to health insurance. 

Each public health indicator is summarized for its significance and scope, trending, and comparative analysis against national data.  The report also provides in-depth analysis for a number of indicators in each of Arizona’s 126 Community Health Analysis Areas. 

Please take time to look at the State Health Assessment and the county level community health assessments.  After you’re done, we’d appreciate hearing from you through the survey monkey as we take the next giant step to create Arizona’s first State Health Improvement Plan.

Encouraging WIC Outcome Measures

February 4th, 2014

There’s increasing evidence that whether a person will have a healthy weight as an adult is influenced by nutrition and physical activity in the first 5 years of life.  In fact, a new study this week in the New England Journal of Medicine suggests that overweight 5-year-olds are 4 x more likely to become obese later in life. 

That makes our Women Infant and Children program a critical leverage point in turning the tide on obesity.  WIC focuses on the nutritional and overall health of families with kids aged 0-5.  Back in 2009 we moved to a healthier food package, and we’ve ramped up our nutrition assessment and education activities with evidence based practices.  This week we got some encouraging performance measures in from WIC suggesting that our efforts are paying off.     

Our initiatives have resulted in a decrease in overweight 2-5 year old WIC participants from 14% in 2011 to 13.3% in 2013.   Likewise, obese WIC participants 2-5 years old decreased from 13.2% in 2011 to 12.4% in 2013.  The percent of WIC moms who breastfed at least 6 months also increased from 25.7% in 2011 to 27.1% in 2013.  Congratulations and keep up the good work.

6.4 Trillion Calories

January 21st, 2014

Can you picture 6.4 trillion calories? That’s the number of fewer calories sold by 16 major food companies in the last 5 years.  The companies include names like Campbell’s Soup and the Coca-Cola Company. All are part of the Healthy Weight Commitment Foundation and have pledged to remove calories from their products as a public health intervention. 

A study published last week found that the Healthy Weight Commitment Foundation companies beat their pledged calorie reduction goal by 400% over the last 5 years.   This decrease translates to a reduction of 78 calories per person per day in the U.S.  Since the obesity epidemic is thought to be a result of just an extra 150 calories a day per person- this news shows we’re heading in the right direction. This study also shows how important the food industry is as a partner in our work to decrease the burden of obesity. 

Check out just some of the actions we’re taking to decrease obesity as part of our Strategic Plan to impact “Winnable Battles” here in Arizona.

Guide to Community Prevention Services

October 22nd, 2013

Every so often- you run into a resource guide that stands above the rest.  I discovered one of those awhile back called the Guide to Community Preventive Services – and it’s a free resource to help you choose programs and policies to improve health and prevent disease in communities.  The easy-to-read resource guide answers questions like: 1) Which program and policy interventions have been proven effective; 2) Are there effective interventions that are right for my community; and 3) What might effective interventions cost and what’s the return on investment?  

There are modules on different public health topics- and the evidence-based information is printed in colorful, easy-to-read formats.  Subjects include much of our core strategic plan activities in health and wellness including: Adolescent Health; Alcohol; Asthma; Birth Defects; Cancer; Cardiovascular Disease; Diabetes; Emergency Preparedness; Health Communication; Health Equity; HIV/AIDS,STD’s, Pregnancy; Mental Health; Motor Vehicle Injury; Nutrition; Obesity; Oral Health; Physical Activity; Social Environment; Tobacco Use; Vaccines; Violence; and Worksites.  Learn more about The Community Guide, collaborators involved in its development and dissemination, and methods used to conduct the systematic reviews.

Coming Attraction: AZ’s 1st State Health Assessment

August 23rd, 2013

Publication of Arizona’s very first State Health Assessment is just around the corner  The 2013 Arizona State Health Assessment will use AZ quantitative and qualitative data to assess the public health status of the state.  The end product will be a comprehensive summary of the 15 leading health issues that have the greatest impact in Arizona. 

Over 10,000 community members participated across the state in helping provide valuable input.  Our county health departments did the heavy lifting and engaged the public and their local partners to develop county level community health assessments. Primary data was collected through local community participation in surveys, focus groups and strategy meetings to establish local priorities and really capture the community’s concerns.  Secondary data from public data banks such as hospital discharge data, Behavioral Risk Factor Surveillance System, and the disease registries was also part of the analysis. 

The State Health Assessment uses a combination of the Community Health Status Indicator Project and the Healthy People 2020 Mobilize, Assess, Plan, Implement, Track Models. The 15 leading health issues identified in the Assessment were compiled from county and state priority rankings. Each indicator is summarized for its significance and scope, trending over the past few years, and comparative analysis against national data.  

The 15 priority health issues that’ll be identified in the Report are (in no particular order): obesity, tobacco use, substance abuse, healthcare associated infections, suicides, teen pregnancy, creating healthy communities, behavioral health services, diabetes, heart disease, other chronic diseases (cancer, respiratory disease, asthma), accidents and injuries, oral health, access to well care, and access to health insurance. 

The State Health Assessment will provide the starting point for our first ever State Health Improvement Plan in 2014… which will outline actionable and specific strategies, tactics and interventions for improving population health.  The Improvement Plan will provide a roadmap for Arizona policy makers at the state, county and local level as well as our partners in the private sector to take serious concrete steps to improve population health outcomes while reducing health care costs in AZ.

Childhood Obesity: Turning the Tide?

August 15th, 2013

We finally got some better news from the childhood obesity public health front this week.  Tuesday’s CDC Morbidity and Mortality Weekly Report found that childhood obesity rates are stabilizing or decreasing slightly across the country.  In fact, 19 states had a significant downward trend in obesity prevalence among low-income preschoolers.  There was no change in Arizona- but that’s better than going up.  The study looked at kids between 2 and 4 years old that participate in WIC, Early and Periodic Screening, Diagnosis and Treatment program, and the Maternal and Child Health programs between 2008–2011 and found a downward trend in obesity- for the first time that I can remember in my career. 

Where do we go from here?  Basically, we need to continue to press ahead and implement evidence-based best practices – as turning the tide on childhood obesity will be a long term effort.  Here are a few AZ specific examples: 

  • We’ll continue to work with many county health departments on the implementation of the Health in Arizona Policy Initiative.  This initiative focuses on school health, worksite wellness, healthy community design, procurement of healthy foods (like having healthy alternatives in vending machines), preventive clinical care, and inclusion of children with special health care needs.
  • The CDC recently awarded us a new public health prevention grant.  Like the Health in Arizona Policy Initiative, the goal is to make healthy living easier by supporting healthy environments in workplaces, schools, early childhood education/child care, and in the community.  Arizona was one of 32 states to be awarded enhanced funding; in total, ADHS will receive $2M per year for five years.   Activities are expected to begin rolling out by October. 
  • State and local partners can continue to help communities to conduct needs assessments, Health Impact Assessments, action plans, and initiatives aimed at increasing healthy eating and active living by using tools like the Arizona Health in Policy and Practice Resources and the Urban Land Institute’s Community Plan, both of which help local officials to focus on a holistic approach to land use planning, zoning, transportation, economic development, real estate development and finance. 
  • We’ll continue to support School Health Advisory Councils which help schools to identify and incorporate best practices for obesity prevention including standards that promote healthy eating and physical activity, like focusing on serving fruits and vegetables, limiting sugary beverages, and providing more opportunities for physical activity, and reducing screen time- like our nationally-recognized Empower program does. 
  • Our public health system will continue to assist local businesses, communities, and local elected by educating them about the importance of and tools to provide opportunities for physical activity, healthy food availability, and improving access to safe, free drinking water in public places.  Maryvale on the Move is a good example of this kind of approach. 
  • We can also continue to help community groups improve access to local play spaces & increase opportunities for physical activity by helping decision-makers to provide easier access to safe recreational facilities by passing laws like ARS 33-1551   which addresses liability concerns of schools when opening outdoor facilities to the public outside of the school day- making it easier for schools to open playgrounds to the public so children have more places to play and be physically active.

Our Newest Decision-making Tool

June 24th, 2013

The core of our decision-making as an agency relies on evidence.  Evidence can be scientific like surveillance or research or it can be administrative or financial.  Whichever way you slice it- the key is to get good reliable information so that our teams can make effective decisions as we execute our mission.  

One of the tools that the statewide public health system relies upon is called the Behavioral Risk Factor Survey.  It’s conducted throughout the year in AZ and examines the self-reported habits of thousands of people from across the state. The report contains key data on lifestyle risk factors contributing to the leading causes of death and chronic diseases- and measures the public health system’s progress on smoking, overweight, high blood pressure, exercise, flu/pneumonia vaccination, cholesterol, seat belt use, fruit/vegetable consumption and other risk factors. 

These data give us some of the tools we need to set priorities and craft intervention strategies. Judy Bass was the point person for this year’s report.   Well done Judy!


Obesity Declared a Disease

June 21st, 2013

The American Medical Association voted to recognize obesity as a disease this week.  This is an important change… because the term “disease” in the managed care world means that that prevention and treatment is more medically necessary, justifying reimbursement for necessary interventions. 

If obesity isn’t a disease then I don’t know what is.  Obesity has gone from being a public health nuisance to a public health disaster in the last 20 years.  In Arizona, the percentage of obese adults has nearly doubled in the last 15 years- from about 13% in 1995 to more than 25% in 2010.  It’s overwhelming the country both in health care costs and productivity. We spend about $150B annually on health care costs related to obesity… and it increases the risk of heart disease and type 2 diabetes. Type 2 diabetes leads to devastating health problems including blindness, the loss of limbs and an early death. 

As a public health system, we’ve got to start pulling folks out at the top of the waterfall rather than fishing them out at the bottom. While the change by the AMA is a positive step forward, some doctors might need the nudge of calling this a disease so that they’ll actually put together a treatment and prevention management plan together for their patients. This is where our work becomes even more important.  

Reducing obesity is a Winnable Battle both nationally and in Arizona.  We have lots of resources to help you and your family eat healthier meals and become more active. Check out the Arizona Nutrition Network’s Champions for Change for simple ways to eat better. Find more ideas for healthy eating and active living at, where you can sign up for healthy recipes that are emailed every week.