Friday, June 29, 2012

Obesity and Florida Students


What is the problem?
The 2009 Florida Youth Risk Behavior Survey indicates that among high school students:
 Obesity
•10% were obese (students who were > 95th percentile for body mass index, by age and sex, based on reference data).
Unhealthy Dietary Behaviors
•78% ate fruits and vegetables less than five times per day during the 7 days before the survey. (1)
•67% ate fruit or drank 100% fruit juices less than two times per day during the 7 days before the survey.
•87% ate vegetables less than three times per day during the 7 days before the survey. (2)
•29% drank a can, bottle, or glass of soda or pop at least one time per day during the 7 days before the survey. (3)
Physical Inactivity
•19% did not participate in at least 60 minutes of physical activity on any day during the 7 days before the survey. (4)
•75% were physically active at least 60 minutes per day on less than 7 days during the 7 days before the survey. (4)
•56% did not attend physical education (PE) classes in an average week when they were in school.
•73% did not attend PE classes daily when they were in school.
•38% watched television 3 or more hours per day on an average school day.
•31% used computers 3 or more hours per day on an average school day. (5)
What are the solutions?
Better health education • More PE and physical activity programs • Healthier school environments
What is the status?
The 2010 Florida School Health Profiles indicates that among high schools:
Health Education
·         15% required students to take 2 or more health education courses.
·         68% had a health education curriculum that addresses all 8 national standards for health education.
·         74% taught 14 key nutrition and dietary behavior topics in a required course.
·         78% taught 12 key physical activity topics in a required course.
·         PE and Physical Activity
·         16% did not allow students to be exempted from taking a required PE course for certain reasons. (6)
·         73% offered opportunities for all students to participate in intramural activities or physical activity clubs.

School Environment
·         14% did not sell less nutritious foods and beverages anywhere outside the school food service program.
·         43% did not sell soda pop or fruit drinks that are not 100% juice from vending machines or at the school store, canteen, or snack bar.
·         29% always offered fruits or non-fried vegetables in vending machines and school stores, canteens, or snack bars, and during celebrations when foods and beverages are offered.
·         38% prohibited all forms of advertising and promotion of candy, fast food restaurants, or soft drinks in all locations. (7)
·         37% used the School Health Index or a similar self-assessment tool to assess their policies, activities, and programs in nutrition and physical activity.

1.         100% fruit juice, fruit, green salad, potatoes (excluding French fries, fried potatoes, or potato chips), carrots, or other vegetables.
2.         Green salad, potatoes (excluding French fries, fried potatoes, or potato chips), carrots, or other vegetables.
3.         Not including diet soda or diet pop.
4.         Doing any kind of physical activty that increased their heart rate and made them breathe hard some of the time.
5.         Played video or computer games or used a computer for something that was not school work.
6.         Enrollment in other courses, participation in school sports, participation in other school activities, participation in community sports activities, high physical fitness competency test score, participation in vocational training, and participation in community service activities.
7.         In school buildings; on school grounds, including on the outside of the school building, on playing fields, or other areas of the campus; on school buses or other vehicles used to transport students; and in school publications.

What is FLORIDA Doing About Obesity?


The table below is derived from the 2009 edition of F as in Fat, published by Trust for America’s Health. The summary below is intended for comparing a state’s activities as of 2008 with others and provides information on state-specific policies as well as the number of states implementing a particular policy. For more information on recommended policy strategies, go to: www.reversechildhoodobesity.org.

ECONOMIC INDICATORS
FL
National
Estimated adult obesity-attributable medical expenditures, 1998-2000 (in 2003 dollars)
$3,987 M
$75 Billion
OBESITY-RELATED STATE INITIATIVES
Snack and/or soda tax
YES
29 states + DC
Menu labeling law
NO
2 states
Complete the Streets policy
YES
9 states
OBESITY-RELATED SCHOOL STANDARDS
Nutritional standards for school meals and snacks that go beyond existing USDA requirements.
NO
19 states
Nutritional standards for competitive food products sold a la carte, in vending machines, school stores or at bake sales
NO
27 states
Limited access to competitive food
YES
28 states
BMI or health information collected
YES
21 states
CHILD CARE CENTER LICENSING REGULATIONS
Meals and snacks should follow meal requirements
NO
29 states
Meals and snacks should be consistent with Dietary Guidelines for Americans
NO
2 states
Have policy prohibiting or limiting foods of low nutritional value
NO
12 states
Have policy on vending machines
NO
4 states
Require vigorous or moderate physical activity
NO
8 states

The Obesity Epidemic and its Cost


More than one-third of U.S. adults (over 72 million people) and 17% of U.S. children are obese. During 1980–2008, obesity rates doubled for adults and tripled for children. During the past several decades, obesity rates for all population groups—regardless of age, sex, race, ethnicity, socioeconomic status, education level, or geographic region—have increased markedly. The U.S. Centers for Disease Control and Prevention released a new report in which they indicated that an estimated 42% of Americans will be obese by the year 2030.

 Obesity and Florida

In the fall 2003, Governor Jeb Bush formed the Governor's Task Force on the Obesity to make recommendations regarding the problem of overweight and obesity in Florida. In the executive summary for the task force’s final report, Zachariah P. Zachariah, M.D. Chair of the Task Force, states, "Obesity is second only to tobacco use as a threat to public health. Its implications include serious health consequences such as diabetes, coronary heart disease, high blood pressure, and certain cancers. A recent study published in The New England Journal of Medicine indicates that one out of four children who are overweight have early signs of type 2 diabetes. Additionally a recent study by the RAND Corporation, a research and development institution concludes that obesity is linked to higher rates of chronic health conditions than smoking, drinking or poverty."

That statement was made in 2004, and eight years later the increase in the rate of overweight and obesity Floridians has gone unabated. The recommendations of the task force can be found at: http://www.doh.state.fl.us/family/GTFOE/report.pdf
Financial Consequences of Obesity

Obesity takes a toll on physical health, but it also places a financial burden o the health care delivery system to treat increased illness as a result of obesity-related health challenges. Erik Finklestein, PH.D and others have estimated that as much as $75 billion dollars of our public health cost bill as attributable to obesity in 2003, about half of which was publically financed.

Obesity, its impact on medical cost in Florida and on state budget dollars is problematic in light of growing number of citizen eligible for and utilizing Medicaid. Since 2000 the percent of the entire state budget allocated to Medicaid has grown from 20.3% to 30.7% in 2012. The burden of obesity-related medical costs falls disproportionately on public health care in the U.S., draining resources from public programs like Medicare and Medicaid. Obesity accounted for 27 percent of the growth in real U.S. health care spending between 1987 and 2001.

In a unique study that departed from looking at historical costs of obesity, Kenneth E. Thorpe, Ph.D., and colleagues from Emory University developed an econometric model to estimate the growth of health care costs over time that are attributable to changes in obesity rates. This report provides projections of future health care costs directly attributable to obesity for each state and for the nation.
Major Findings
  • Obesity is growing faster than any previous public health issue our nation has faced. If current trends continue, 103 million American adults will be considered obese by 2018.
  • The U.S. is expected to spend $344 billion on health care costs attributable to obesity in 2018 if rates continue to increase at their current levels. Obesityrelated direct expenditures are expected to account for more than 21 percent of the nation’s direct health care spending in 2018.
  • If obesity levels were held at their current rates, the U.S. could save an estimated $820 per adult in health care costs by 2018 a savings of almost $200 billion dollars.
  • In the study the obesity level in Florida is projected to increase from 29.4% in 2008 to 35.8% in 2013 and  to 43.9%in 2018
  • Health care spending (millions of dollars) in Florida attributable to obesity and obesity-related diseases is projected to increase from $4,873 in 2008, to $9,389 in 2013, and to $25,804 in 2018
  • If obesity-attributable health caring spending remained constant the state of Florida could realize a medical care saving of $2.6 billion for 2013 and $15.7 billion for 2018