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

Who Opposed Obamacare - The Most Obesity States

The Supreme Court upheld the Affordable Care Act of 2010, otherwise known as Obamacare.  Judging from the polls, American public opinion appears to be very sharply divided over the legislation.  Some view it as socialism, others as the first success in a half-century of efforts to achieve a sensible national policy on health care.

Those who have the most to gain from President Obama’s health care legislation are those who have a pre-existing condition or are pre-disposed to illness, and that obviously applies to overweight and obesity Americans.  They are more likely to need medical care in the future, but can be charged higher rates if they try to buy private insurance, by virtue of their condition.  Or without a change in policy they can be excluded completely.  Each obese American currently incurs medical costs 42% higher than those of normal weight, that insurers can have been able to avoid that risk.

One of the interesting things about opposition to the ACA, was that some of the most obesity states voted against their own best interest. The chart below shows how Congressmen from each state voted on the Affordable Care Act on the vertical axis of Figure 1, with the state rates of obesity on the horizontal axis.   There is a statistically significant relationship.  But the relationship goes the other way:    states where more people are overweight, such as Mississippi, Alabama, South Carolina and Texas, are more likely to oppose Obamacare.   In those parts of the country where people are slimmer, such as New England, New York and Colorado, there is strong support for health care reform.  For every one percentage point increase in obesity, support for Obamacare declines by an estimated four percentage points on average.

      Figure 1:  States with higher obesity rates tend to oppose the Affordable Care Act 
   

Exercise and eating habits obviously relate to be overweight or obesity.  The states where residents get the most physical exercise are Minnesota, Utah, Oregon, Washington and Vermont; the states that get the least are Mississippi,  Tennessee,  Kentucky,  Lousiana and Alabama. And which states do data  data sources indicate has bad eating habits:  the five worst-ranking are Mississippi, Alabama, Missouri, Kansas and Oklahoma.

In addition to obesity, what the data reveal about how states rank on the overall health index.  The states that rank the best on an overall health index are Vermont, New Hampshire, Massachusetts, Minnesota, and Maine and Iowa.  The states where people are the least healthy overall are Louisiana, Mississippi, New Mexico, Nevada, Oklahoma and Texas.  The weight of the evidence is fairly clear: the states where people are most in need of help getting private insurance (and obesity related illness) are the states opposing the legislation that helps them do that.
 
It seems that the economists’ view of the world is wrong.  People are not voting in their self interest.
  
 Most people don’t know what Obama’s bill does.  Broadcast media has contribute to the view that it reduces personal responsibility for health care.  But the truth is the opposite.  In our current system, hospitals are required to treat patients who show up at the emergency entrance with a heart attack - even if their condition is partly their fault, due to habits of overeating and under-exercising.  This uncompensated care is passes on as a cost to insurers and other payors, and the rest of us end up footing the bill.   The universal mandate is designed to fix that, by making everyone pay for the health care they get (and perhaps even encouraging them to see a doctor who will advise them to adopt a healthy life style).  Establishing personal responsibility, not socialized medicine, is the reason why conservative think tanks proposed the idea of the universal mandate in the first place, and why Mitt Romney enacted it in Massachusettts.   But most people seem still unaware of this.