mass index screening

School based body
mass index screening:
The Arkansas
experience
Joseph
p W. Thompson,
p
, MD,, MPH
Surgeon General
State of Arkansas
Director, Arkansas Center for Health
Improvement / RWJF Center to Prevent
Childhood Obesity
Associate Professor
UAMS Colleges of Medicine and
Public Health
www.reversechildhoodobesity.org
2
Building Communities: RWJF Childhood Obesity Programs
Action
Advocacy
Evidence
Alliance for a Healthier
Generation, Healthy Schools
Communities Creating
g
Healthy Environments:
Active Living
g Research
Healthy Kids, Healthy
America (NGA Center for Best
Practices)
Faith-based Advocacy:
Galvanizing Communities to
End Childhood Obesity
Healthy Kids, Healthy
Communities
Leadership for Healthy
Communities: Advancing
Policies
o c es to Support
Suppo t Healthy
ea t y
Eating and Active Living
Pioneering
Pi
i
H
Healthier
l hi
Communities, YMCA of the
USA
Safe Routes to School (SRTS)
National Partnership
Mobilizing Health Care
Professionals as Community
L d
Leaders
in
i the
th Fight
Fi ht A
Against
i t
Childhood Obesity
National Policy and Legal
Analysis Network for
Childhood Obesity Prevention
Save the Children: Campaign
for Healthy Kids
3
African American
Collaborative Obesity
Research Network (AACORN)
Bridging the Gap
Food Marketing and Youth
Project, Rudd Center for Food
P li & Obesity
Policy
Ob i
Healthy Eating Research
Salud America! The RWJF
Research Network to Prevent
Obesity Among Latino
Children
Obesity Trends* Among U.S. Adults
BRFSS 1990,
BRFSS,
1990 1998,
1998 2007
(*BMI 30, or about 30 lbs. overweight for 5’4” person)
1998
1990
2007
N Data
No
D t
<10%
10%
10%–14%
10% 14%
15% 19%
15%–19%
20% 24%
20%–24%
Source: CDC Behavioral Risk Factor Surveillance System.
25% 29%
25%–29%
≥30%
Age-adjusted Percentage of U.S. Adults Who Were Obese or
Who Had Diagnosed Diabetes
1994
Obesity (BMI≥30)
Missing
Mi
i D
Data
t
14.0 - 17.9%
22.0 - 25.9%
14 0%
<14.0%
18.0 -21.9%
≥26.0%
Diabetes
Missing data
4.5 - 5.9%
7.5 - 8.9%
<4.5%
<4
5%
6.0 - 7.4%
≥9.0%
CDC’s Division of Diabetes Translation. National Diabetes Surveillance System
available at http://www.cdc.gov/diabetes/statistics
Age-adjusted Percentage of U.S. Adults Who Were Obese or
Who Had Diagnosed Diabetes
1995
Obesity (BMI≥30)
Missing
Mi
i D
Data
t
14.0 - 17.9%
22.0 - 25.9%
14 0%
<14.0%
18.0 -21.9%
≥26.0%
Diabetes
Missing data
4.5 - 5.9%
7.5 - 8.9%
<4.5%
<4
5%
6.0 - 7.4%
≥9.0%
CDC’s Division of Diabetes Translation. National Diabetes Surveillance System
available at http://www.cdc.gov/diabetes/statistics
Age-adjusted Percentage of U.S. Adults Who Were Obese or
Who Had Diagnosed Diabetes
1996
Obesity (BMI≥30)
Missing
Mi
i D
Data
t
14.0 - 17.9%
22.0 - 25.9%
14 0%
<14.0%
18.0 -21.9%
≥26.0%
Diabetes
Missing data
4.5 - 5.9%
7.5 - 8.9%
<4.5%
<4
5%
6.0 - 7.4%
≥9.0%
CDC’s Division of Diabetes Translation. National Diabetes Surveillance System
available at http://www.cdc.gov/diabetes/statistics
Age-adjusted Percentage of U.S. Adults Who Were Obese or
Who Had Diagnosed Diabetes
1997
Obesity (BMI≥30)
Missing
Mi
i D
Data
t
14.0 - 17.9%
22.0 - 25.9%
14 0%
<14.0%
18.0 -21.9%
≥26.0%
Diabetes
Missing data
4.5 - 5.9%
7.5 - 8.9%
<4.5%
<4
5%
6.0 - 7.4%
≥9.0%
CDC’s Division of Diabetes Translation. National Diabetes Surveillance System
available at http://www.cdc.gov/diabetes/statistics
Age-adjusted Percentage of U.S. Adults Who Were Obese or
Who Had Diagnosed Diabetes
1998
Obesity (BMI≥30)
Missing
Mi
i D
Data
t
14.0 - 17.9%
22.0 - 25.9%
14 0%
<14.0%
18.0 -21.9%
≥26.0%
Diabetes
Missing data
4.5 - 5.9%
7.5 - 8.9%
<4.5%
<4
5%
6.0 - 7.4%
≥9.0%
CDC’s Division of Diabetes Translation. National Diabetes Surveillance System
available at http://www.cdc.gov/diabetes/statistics
Age-adjusted Percentage of U.S. Adults Who Were Obese or
Who Had Diagnosed Diabetes
1999
Obesity (BMI≥30)
Missing
Mi
i D
Data
t
14.0 - 17.9%
22.0 - 25.9%
14 0%
<14.0%
18.0 -21.9%
≥26.0%
Diabetes
Missing data
4.5 - 5.9%
7.5 - 8.9%
<4.5%
<4
5%
6.0 - 7.4%
≥9.0%
CDC’s Division of Diabetes Translation. National Diabetes Surveillance System
available at http://www.cdc.gov/diabetes/statistics
Age-adjusted Percentage of U.S. Adults Who Were Obese or
Who Had Diagnosed Diabetes
2000
Obesity (BMI≥30)
Missing
Mi
i D
Data
t
14.0 - 17.9%
22.0 - 25.9%
14 0%
<14.0%
18.0 -21.9%
≥26.0%
Diabetes
Missing data
4.5 - 5.9%
7.5 - 8.9%
<4.5%
<4
5%
6.0 - 7.4%
≥9.0%
CDC’s Division of Diabetes Translation. National Diabetes Surveillance System
available at http://www.cdc.gov/diabetes/statistics
Age-adjusted Percentage of U.S. Adults Who Were Obese or
Who Had Diagnosed Diabetes
2001
Obesity (BMI≥30)
Missing
Mi
i D
Data
t
14.0 - 17.9%
22.0 - 25.9%
14 0%
<14.0%
18.0 -21.9%
≥26.0%
Diabetes
Missing data
4.5 - 5.9%
7.5 - 8.9%
<4.5%
<4
5%
6.0 - 7.4%
≥9.0%
CDC’s Division of Diabetes Translation. National Diabetes Surveillance System
available at http://www.cdc.gov/diabetes/statistics
Age-adjusted Percentage of U.S. Adults Who Were Obese or
Who Had Diagnosed Diabetes
2002
Obesity (BMI≥30)
Missing
Mi
i D
Data
t
14.0 - 17.9%
22.0 - 25.9%
14 0%
<14.0%
18.0 -21.9%
≥26.0%
Diabetes
Missing data
4.5 - 5.9%
7.5 - 8.9%
<4.5%
<4
5%
6.0 - 7.4%
≥9.0%
CDC’s Division of Diabetes Translation. National Diabetes Surveillance System
available at http://www.cdc.gov/diabetes/statistics
Age-adjusted Percentage of U.S. Adults Who Were Obese or
Who Had Diagnosed Diabetes
2003
Obesity (BMI≥30)
Missing
Mi
i D
Data
t
14.0 - 17.9%
22.0 - 25.9%
14 0%
<14.0%
18.0 -21.9%
≥26.0%
Diabetes
Missing data
4.5 - 5.9%
7.5 - 8.9%
<4.5%
<4
5%
6.0 - 7.4%
≥9.0%
CDC’s Division of Diabetes Translation. National Diabetes Surveillance System
available at http://www.cdc.gov/diabetes/statistics
Age-adjusted Percentage of U.S. Adults Who Were Obese or
Who Had Diagnosed Diabetes
2004
Obesity (BMI≥30)
Missing
Mi
i D
Data
t
14.0 - 17.9%
22.0 - 25.9%
14 0%
<14.0%
18.0 -21.9%
≥26.0%
Diabetes
Missing data
4.5 - 5.9%
7.5 - 8.9%
<4.5%
<4
5%
6.0 - 7.4%
≥9.0%
CDC’s Division of Diabetes Translation. National Diabetes Surveillance System
available at http://www.cdc.gov/diabetes/statistics
Age-adjusted Percentage of U.S. Adults Who Were Obese or
Who Had Diagnosed Diabetes
2005
Obesity (BMI≥30)
Missing
Mi
i D
Data
t
14.0 - 17.9%
22.0 - 25.9%
14 0%
<14.0%
18.0 -21.9%
≥26.0%
Diabetes
Missing data
4.5 - 5.9%
7.5 - 8.9%
<4.5%
<4
5%
6.0 - 7.4%
≥9.0%
CDC’s Division of Diabetes Translation. National Diabetes Surveillance System
available at http://www.cdc.gov/diabetes/statistics
Age-adjusted Percentage of U.S. Adults Who Were Obese or
Who Had Diagnosed Diabetes
2006
Obesity (BMI≥30)
Missing
Mi
i D
Data
t
14.0 - 17.9%
22.0 - 25.9%
14 0%
<14.0%
18.0 -21.9%
≥26.0%
Diabetes
Missing data
4.5 - 5.9%
7.5 - 8.9%
<4.5%
<4
5%
6.0 - 7.4%
≥9.0%
CDC’s Division of Diabetes Translation. National Diabetes Surveillance System
available at http://www.cdc.gov/diabetes/statistics
National Childhood Obesity Trends
Peercent Overrweight
25
20
15
10
US 12-19 yr
5
US 6-11 yr
0
1963-65
1971-74
1966 70
1966-70
1976 80
1976-80
1988-94
01-02
99 00 03-04
99-00
03 04
NHANES data sources: Ogden et al
al. Prevalence and Trends in Overweight Among US Children and
Adolescents, 1999-2000. JAMA 2002;288(14):1728-1732. Ogden et al. Prevalence of Overweight
and Obesity in the United States, 1999-2004. JAMA 2006;295(13):1549-1555.
Percentage of Children who are Obese
Aged 10–17 Years by State (2003)
Data for these maps were retrieved from the Child and Adolescent Health
Measurement Initiative, 2003 National Surveys of Children's Health, Data Resource
Center for Child and Adolescent Health website (accessed 10/03/08,
www.nschdata.org).
Robert Wood Johnson Foundation Center to Prevent Childhood Obesity
Percentage of Children who are Obese
Aged 10–17 Years by State (2007)
Data for these maps were retrieved from the Child and Adolescent Health
Measurement Initiative, 2007 National Surveys of Children's Health, Data Resource
Center for Child and Adolescent Health website (accessed 5/26/09,
www.nschdata.org).
Robert Wood Johnson Foundation Center to Prevent Childhood Obesity
Act 1220
A
1220: Arkansas
Ak
Child and
d
Adolescent Obesityy Initiative
84th General Assembly Act 1220 of 2003
An act to create a Child Health Advisory Committee; to
coordinate statewide efforts to combat childhood
obesity
b it and
d related
l t d illnesses;
ill
t improve
to
i
the
th health
h lth off
the next generation of Arkansans; and for other purposes.
Goals:
• Change
g the environment within which children g
go to
school and learn health habits everyday
• Engage the community to support parents and build a
system that encourages health
• Enhance awareness of child and adolescent obesity
to mobilize resources and establish support
structures
Act 1220 Requirements
1. Establishment of an Arkansas Child Health
Advisory Committee
2. Vending machine content and access changes
3 Physical
3.
Ph i l activity
ti it / education
d
ti
requirements
i
t
4. Requirement of professional education for all
cafeteria workers
5. Public disclosure of “pouring contracts”
6 Establishment of local parent ad
6.
advisory
isor
committees for all schools
7 Confidential child health report delivered
7.
annually to parents with body mass index (BMI)
assessment
Amending Act 1220 – Acts 201, 719, & 317
off 2007
• Periodicity of BMI assessments change to every
even year beginning in K thru 10th grade.
• Parents must p
provide a written refusal to keep
p
child from participating.
• ADH nurses responsible for quality assurance to
follow protocols.
• Adds 5 members to CHAC
CHAC.
• Broadens CHAC scope to all school health.
• Eliminates physical activity for all but K-5.
Legislation regarding BMI
Measurement
• Act 201 of 2007 Changes
g periodicity
p
y of BMI
screening to every 2 years starting in K
g 10th grade.
g
Parallels other screens –
through
vision, hearing and scoliosis
– Parents have written opt
p out capacity
p
y
– Report sent to parents in new Health Screen format
– Provides for enhances p
policies and procedures
p
to
secure privacy and uniformity in measurement
Legislation Regarding Physical
Activity
• Act 317 An act to increase class time by
y
limiting mandated PA activity time in
grades K-12
K 12 This bill provides for 60
minutes of PE weekly and 90 minutes of PA
weekly for K-5 only
only. No requirements for
Physical activity n grades 6-12.
Legislation Regarding the Child
Health Advisory committee
• Act 719 of 2007 Calls for CHAC’s expanded role
on Coordinated School health and adds new
membership
– CHAC will make recommendations concerning
g the
implementation of the Arkansas Coordinated School
Health Program – expansion beyond physical activity
and nutritional standards
– 5 new members added (for a total of 25) –
representation from
•
•
•
•
Office of Minority
y Affairs at DHHS
Arkansas School Boards Association
Arkansas Association of School Business Officials
Arkansas Association for Supervision and Curriculum
Deve.
• A Classroom teacher
AR Responses beyond Act 1220
• CDC School Health Initiative (DOE)
(
)
• School, community and faith-based efforts
• Development of first continuing medical
education p
program
g
for clinicians
• Regionalization of specialty care
• Elimination of fiscal barriers to
reimbursement (Medicaid / SCHIP)
• Increased awareness of physical activity
needs (Mini
(Mini-marathon)
marathon)
Arkansas Board of Education actions
• Vending machines restricted until 30
minutes
i t after
ft lunch
l
h in
i all
ll schools
h l
– 12-ounce maximum beverage size
– 50% healthy options required
• No competitive foods in cafeterias
• Cafeteria food service education
• Nutrition and health curriculum changes
• 30 minutes
i t per d
day physical
h i l activity
ti it (K-12
(K 12)
12
– 2007 change to accept activities (9-12 grades)
AR Health Care Environmental Response
• Local school, community and faith-based
initiatives
• Growth in farmers’ markets
• Development of first CME program for clinicians
• Regionalization of secondary and tertiary care
(e g Fitness Clinic at AR Children’s Hospital)
(e.g.,
• Elimination of fiscal barriers to reimbursement
(M di id / SCHIP)
(Medicaid
• Increased awareness of physical activity needs
(Mini-marathon)
• Changes
g to built environment – world’s longest
g
pedestrian bridge
Child Health Report (2004)
Source: Arkansas Center for Health Improvement, Little Rock, AR, 2004.
Spanish Child Health Report (2005)
EXAMPLE SCHOOL DISTRICT
EXAMPLE SCHOOL NAME
Address
City, AR, #####
May 16, 2005
Parent Name
«MailingAddress1»
«MailingCity», «MailingState» «Zip»
Estimados Padres:
Esta carta importante se refiere a la salud de Example Student. Por favor léala toda.
Muchos niños en Arkansas tienen problemas de salud debido a su peso. Recientemente, en la escuela de su niña, la
estatura y su peso fueron medidos. Las medidas de peso y estatura, así como la edad y el sexo se usaron para calcular
el percentil del índice de masa corporal (IMC). El IMC es una prueba inicial que sugiere si una persona tiene sobrepeso,
está al riesgo de sobrepeso, tiene peso apropiado o está baja de peso.
¿Por qué se midió el IMC en la escuela?
Las leyes del estado de Arkansas requieren que la escuela de su niña mida el IMC cada año y que se le envíe a usted un
Si un niña está pasada de peso
peso, usualmente se debe a que tiene un exceso de grasa corporal
corporal. Las niñas que tienen
reporte
sobre
b riesgo
los
l de resultados.
lt d de salud
E
Enque
llas
l pesod
de
A
Arkansas
k Las niñas ttambién
bié se practican
ti
pruebas
b iiniciales
i i l para b
buscar problemas
bl
exceso de grasa
corporalt tienen
más
tener problemas
las escuelas
niñas con un
apropiado.
que están pasados de peso o en riesgo de estar pasados de peso son mas propensos a ser adultos obesos o con
con lapuede
vista
yenfermedades
la audición
de diabetes,
los niños.
Medir
eldelIMC
de
sobrepeso. La obesidad
causar
tales como
alta presión,
problemas
corazón
así su
comoniña es otra manera de ayudarle a cuidar su salud. Acciones
otros problemas de salud. Las niñas bajas de peso también pueden tener problemas de salud.
que se tomen ahora pueden ayudar a disminuir el riesgo de desarrollar enfermedades serias cuando crezca su niña. Así
Raramente, la IMC de un niño puede estar alta (sobrepeso o al riesgo de sobrepeso) debido a que el niño sea muy
que, es importante medir el IMC cada año para ver si su niña está creciendo y desarrollando de una manera saludable.
muscular. Al ser muy muscular no aumentan los problemas de la salud en el niño. Solamente puede decir un doctor si la
IMC está alta a causa de mucha grasa corporal. Según la información en esta carta, seria bueno que hablara con el
doctor de su niña.
¿Es el peso de su niña un problema de salud?
El pasado
dla escuela?
3/1/05 su niña
3/1/05,
iñ ffue medida
did y pesada
d en
¿Por qué se midió
el IMC en
Las leyes del estado de Arkansas requieren que la escuela de su niña mida el IMC cada año y que se le envíe a usted un
la
escuela.
EXAMPLE
midió
4
pies
con
8
pulgadas
reporte sobre los resultados. En las escuelas de Arkansas también se practican pruebas iniciales para buscar problemas
con la vista y la audición de los niños. Medir el IMC de su niña es otra manera de ayudarle a cuidar su salud. Acciones
y pesó
libras,
lo que
le daenfermedades
un IMCserias
que
que se tomen ahora
pueden 137.4
ayudar a disminuir
el riesgo
de desarrollar
cuando crezca su niña. Así
que, es importante medir el IMC cada año para ver si su niña está creciendo y desarrollando de una manera saludable.
sugiere que ella pueda estar sobrepeso.
¿Es el peso de su niña un problema de salud?
El pasado 3/1/05, su niña fue medida y pesada en
la escuela. EXAMPLE midió 4 pies con 8 pulgadas
y pesó
ó 137.4
13 4 libras,
lib
llo que lle d
da un IMC que
sugiere que ella pueda estar sobrepeso.
El IMC de su Niña
¿Qué debe hacer usted?
Bajo de peso
Peso apropiado
En riesgo de
estar sobrepeso
Sobrepeso
El IMC de su Niña
Bajo de peso
Peso apropiado
En riesgo de
estar sobrepeso
Sobrepeso
La línea demuestra como el IMC de su niña se compara con el de otros niños en
las escuelas de Arkansas.
La línea demuestra como el IMC de su niña se compara con el de otros niños en
¿Qué debe hacer usted?
las escuelas de Arkansas.
Dado que el IMC de EXAMPLE sugiere que ella
está sobrepeso, seria bueno que hablara con el doctor de su niña. Por favor enséñele esta carta al doctor (EXAMPLE’s
BMI was 30.8 or 97.4 percentile). Su doctor verificara el IMC de su niña y se asegurara que las medidas que se tomaron
en la escuela son las correctas. Además, su doctor puede informarle acerca de una alimentación saludable y actividades
físicas para su niña. Por ejemplo, la Academia Americana de Pediatría es un grupo de médicos que atienden a niños y
sugieren
i
que su ffamilia
ili d
debe
b d
de:
 Ofrecer bocadillos saludables tales como frutas, verduras y otras comidas bajas en azúcar y sal.
 Beber menos sodas y tomar más agua, leche desgrasada o bebidas bajas en calorías.
 Limitar a dos horas diarias el tiempo viendo televisión o jugando videos.
 Hacer ejercicios con sus niños tales como corriendo, caminando o usando la bicicleta.
Los hábitos saludables empiezan a una edad temprana. Por favor, esté conciente que la alimentación y la actividad física
afectarán la salud y vida de su niña.
Gracias,
EXAMPLE SCHOOL NAME
Para mayor información, visite www.achi.net.
Source: Arkansas Center for Health Improvement, Little Rock, AR, 2005.
Percent by Gender and Ethnic Group (2005–2006)
Data source: ACHI. The Arkansas Assessment of Childhood and Adolescent Obesity—Tracking Progress (Year 3 Fall 2005–Spring 2006). Little
Rock, AR: ACHI; September 2006.
Percent at risk for overweight or overweight by
gender ethnicity,
gender,
ethnicity and grade (’05–’06)
(’05 ’06)
F
Females
l
Males
60%
60%
50%
50%
40%
40%
30%
30%
20%
20%
Hispanic
African American
White
10%
Hispanic
African American
White
10%
0%
0%
PK K
1
2
3
4
5
6
7
8
9 10 11 12
PK K
1
2
3
4
5
6
7
8
9 10 11 12
Source: ACHI. The Arkansas Assessment of Childhood and Adolescent Obesity—Tracking Progress (Year 3 Fall 2005–
Spring 2006). Little Rock, AR: ACHI; September 2006.
Percentage
of students
classified as
g
overweight
or at risk for
overweight
by Arkansas
public
school
district
(’05 ’06)
(’05–’06)
Source: ACHI. The Arkansas Assessment of Childhood and Adolescent Obesity—Tracking Progress (Year 3 Fall 2005–Spring
2006). Little Rock, AR: ACHI; September 2006.
National and Arkansas Childhood Obesity Trends
22.0
25
21.5
21.0
20
20.0
19.5
15
AR grades
d 7-12
7 12
AR grades K-6
20.5
AR grades K-6
AR grades 7-12
7 12
03-04 N=981
03-04 N=2,159
19.0
2004
2005
2006
2007
10
US 12-19
12 19 yr
5
US 6-11 yr
0
1963-65
1971-74
1966-70
1976-80
Avg N=150,881
Avg N=212,011
1988-94
01-02 04 06
99-00 03-04 05 07
NHANES data sources: Ogden et al. Prevalence and Trends in Overweight Among US Children and Adolescents,
1999-2000. JAMA 2002;288(14):1728-1732. Ogden et al. Prevalence of Overweight and Obesity in the United
States, 1999-2004. JAMA 2006;295(13):1549-1555.
Arkansas data source: Arkansas Center for Health Improvement, Little Rock, AR, September 2007.
UAMS College of Public Health
Evaluation of Act 1220 (2006)
• Parents’ awareness of obesity-related
obesity related health
problems increased (1/3 recognized problem > 2/3)
• 95% of parents read some or all of the Child Health
Report and 67% found the report helpful
• No feared consequences of BMI measurements
• Students reported purchasing more healthy drinks,
such as water and other unsweetened beverages
• Innovations in schools and communities across the
state – taste tests in cafeterias
cafeterias, curriculum changes
• Support of continued improvements to nutrition
standards in school cafeterias
Fay W. Boozman College of Public Health. Year Two Evaluation Arkansas Act 1220 of 2003 to Combat
Childhood Obesity. http://www.uams.edu/coph/reports/Act1220Eval.pdf. Accessed 27 March, 2006.
What iis the
Wh
h iimpact off obesity
b i
on children’s healthcare?
Average Annual Total Use by Age Group
10
–2%
21%
p=<.0001
8
8.7
8
7.2
8.9
8
8..4
9.2
9
9.4
4
9.0
9
6
8.7
8
Days of Serv
vice
3%
6%
p=.04
p
.04
2
0
All
Normal
5-9 yr
10-14 yr
15-19 yr
Overweight
Contact days of services for outpatient, inpatient, other place of service, and dental visits.
Significant p values for within-group t-test are shown.
Average Annual Total Cost by Age Group
$1,400
$1 200
$1,200
9%
$1,01
16
$1,166
$1,0
080
$934
4
$400
$945
5
$600
$1,1
101
$800
$1
1,310
–1%
$1,00
08
To
otal Cos
st
$1,000
29%
p=<.0001
8%
p=.02
$200
$0
All
Normal
5-9 yr
10-14 yr
Overweight
Total payments for outpatient, inpatient, pharmacy, and dental claims.
15-19 yr
Adult Average Annual Total Risk Cost
No Risks
$2,382
O
O+P
P
$3,441
$4,158
$3,169
Obese
$3,679
Physically
Inactive
$3 643
$3,643
C+O+P
C+O
$4 432
$4,432
$3,529
Daily Cigarette
Users
$3,081
C+P
$3,257
C
$2 690
$2,690
O =Obese
P =Physically
Inactive
C =Daily
Cigarette
Use
Annual Average Total* Costs Linked to Obesity
$4,500
Pharmacy
Medical
$3,000
Total difference
$1,238
$1,297 (54%)
$785
$1,500
$2,441
$1,597
$0
No Risk
Obese
*Includes medical (inpatient and outpatient) and pharmacy costs for 18-84 year old state employees.
$8,860
$
Average Annual Total* Costs Linked to Obesity
compared with No Risk by Age Group
$10,000
No Risk
$
$9,000
$5,391
$8,000
$2,000
$3,266
$2,409
1,991
$1
$2,160
$
$1,23
30
$3 000
$3,000
$1,38
82
$4,000
$1,857
$5 000
$5,000
$2,801
$6,000
$3,7
765
$7 000
$7,000
$4,338
$
Obese
$1,000
$0
18-24
25-34
35-44
45-54
55-64
65-74
*Includes medical (inpatient and outpatient) and pharmacy costs for state employees.
$4,522
$4
522
(104%)
What Next?
Immediate Opportunities
• Align education
education, health,
health and financing options to
support parents and communities in making change
– Update and expand school nutritional guidelines in
accordance with IOM recommendations - Child Nutrition
Act (Congressional reauthorization 2009)
– Incorporate financial coverage for childhood obesity SCHIP (reauthorization 2009)/Medicaid Rules & Regs
– “No
“N Child Left
L ft Behind”
B hi d” K-12
K 12 education
d
ti
reauthorization
th i ti
Consider personal physical performance goals
– Non
Non-motorized
motorized transportation investments –
Transportation (SAFETY-LU) reauthorization 2009
• Local and state investments in food access, built
environment, and multi-facet strategies for impact
• Consider Medicare
Medicare’s
s future financial risk to support
current prevention programs
www.reversechildhoodobesity.org
Robert Wood Johnson Foundation Center to Prevent Childhood Obesity
Contact information
• Joseph
p W. Thompson
p
MD,, MPH
• 501.526.2244
• [email protected]
thompsonjosephw@uams edu