Issue Category: Obesity/Chronic Disease

New National Adult Obesity Data Show Level Trend

Stabilization of Obesity Rates is Welcome News but More Investment in Prevention Policies and Programs is Needed

(Washington, DC – October 10, 2024) – Over the last two decades, obesity has increased across the country in both adults and children. Newly released National Health and Nutrition Examination Survey (NHANES) data from 2021–2023 find that 40.3 percent of adults had obesity, which is slightly lower than the previous data (2017–2020). This is tentatively positive news, as it suggests a possible stabilization of the overall adult obesity rates in the United States in recent years— though the rate is still much higher than prior decades.

Percent of Adults Ages 20 and Older with Obesity, 1999-2023


Source: NHANES

Obesity is a complex disease that is influenced by many factors beyond personal behavior. Reversing the nation’s obesity crisis requires sustained investment in multidimensional strategies and policies, that are tailored for population groups and regional differences. As TFAH’s September 2024 State of Obesity report explores, there are a number of evidence-based policies and programs that improve nutrition and support healthy eating, and help to reduce rates of obesity and chronic disease.

This includes important policy progress, like:

  • Improving nutritional quality of the food supply and diets by prohibiting trans fats in foods, instituting voluntary guidance to reduce sodium in commercial foods, and taxing sugar sweetened beverages to reduce added sugar consumption.
  • Empowering consumers through better labeling and education, like improved Nutrition Facts labels, new restaurant menu labeling, and family education programs.
  • Increasing nutritional quality and access in schools, institutions, and nutrition programs, including aligning child nutrition programs and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) with the Dietary Guidelines for Americans.

(See State of Obesity report pages 14–17 for more on these nutrition and food environment policies.)

Looking forward, we need to build on these initial steps to ensure that adult obesity rates continue to trend in the right direction, including critical policies like:

  • Increase federal resources for evidence-based, effective efforts that reduce obesity-related disparities and related conditions including funding for CDC’s chronic disease and obesity prevention programs, such as the State Physical Activity and Nutrition, Racial and Ethnic Approaches to Community Health, and Healthy Tribes
  • Decrease food and nutrition insecurity while improving the nutritional quality of available foods in every community by, among other activities, providing healthy school meals for all students and maintaining progress on the final 2024 school nutritional meal standards. In addition, Congress should expand access to nutrition support programs such as the Supplemental Nutrition Assistance Program (SNAP) and WIC, and increase the value of their benefits.
  • To help consumers make informed choices, the Food and Drug Administration should swiftly implement a front-of-package label that will help people more easily understand the nutrients of concern in packaged foods.

(See State of Obesity 2024 recommendations on pages 67–76 for additional measures policymakers should take to continue to make progress in efforts to help all Americans maintain a healthy weight.)

“It is welcome news that the latest NHANES data suggest the overall adult obesity rate in this country has not been increasing in recent years,” said J. Nadine Gracia, M.D., MSCE, President and CEO of Trust for America’s Health. “However, much more needs to be done to address this health crisis. This is a critical moment to increase our efforts: boost and sustain investment in proven obesity prevention policies and programs and build healthier communities where everyone has access to affordable, nutritious foods and safe places to engage in physical activity.”

The new NHANES report also highlights the link between obesity and socioeconomic status. Like previous years, the new data show clear differences in obesity prevalence by educational attainment, with lower obesity rates for adults with a bachelor’s degree (31.6 percent) than in adults with less education (high school diploma or less (44.6 percent) and those with some college (45.0 percent). This underscores the critical role of policies and programs that boost accessibility and affordability of healthy food for all Americans.

Notably, the newly released report does not include data by race/ethnicity, though we hope that will be released later this year. Previous years’ data have shown large differences in obesity prevalence and trends by race/ethnicity. Understanding trends across different racial/ethnic groups, and if disparities are increasing or decreasing, is essential for a complete picture and successful policy response.

See TFAH’s State of Obesity 2024: Better Policies for a Healthier America report for more information about obesity rates and solutions.

 

 

 

Nuevo informe: La obesidad adulta en EE. UU. alcanza niveles epidémicos

Las tasas de obesidad son predominantemente más elevadas en las comunidades que experimentan obstáculos para una alimentación sana y en las que tienen pocas oportunidades para la actividad física.

(Washington, DC – 12 de septiembre de 2024) – Según un informe publicado el día de hoy por Trust for America’s Health (TFAH, por sus siglas en inglés.) Las tasas de obesidad entre los adultos estadounidenses eran iguales o superiores al 35% en veintitrés estados en 2023, lo que representa un aumento de varias décadas en las tasas de estadounidenses que viven con obesidad. En 2012, ningún estado tenía una tasa de obesidad en adultos igual o superior al 35%.

El informe Estado de la obesidad 2024: Mejores políticas para una America más saludable, incluye el análisis de TFAH de los datos más recientes del Sistema de Vigilancia de Factores de Riesgo del Comportamientos (BRFSS) de los Centros para el Control y la Prevención de Enfermedades (CDC).  La obesidad y otras enfermedades relacionadas con la dieta se asocian a una serie de afecciones físicas y mentales, mayor mortalidad, mayores costos sanitarios y pérdidas de productividad.

Los estados con las tasas más altas de obesidad entre los adultos en 2023 fueron Virginia Occidental (41,2 por ciento), Misisipi (40,1 por ciento), Arkansas (40,0 por ciento), Luisiana (39,9 por ciento) y Alabama (39,2 por ciento). Entre 2022 y 2023, tres estados experimentaron aumentos estadísticamente significativos en sus tasas de obesidad adulta: Alaska, Arkansas y Oregón, mientras que ningún estado tuvo un descenso estadísticamente significativo. Entre 2018 y 2023, 28 estados experimentaron aumentos estadísticamente significativos en las tasas de obesidad adulta.

Los estados con niveles más bajos de obesidad adulta en 2023 fueron el Distrito de Columbia (23,5 por ciento), Colorado (24,9 por ciento), Hawai (26,1 por ciento), Massachusetts (27,4 por ciento) y California (27,7 por ciento).

A nivel nacional, más de cuatro de cada diez adultos estadounidenses padecen de obesidad. Aunque las tasas de obesidad han aumentado en todos los grupos de la población, los grupos con las tasas más altas son con frecuencia las poblaciones de color, ya que enfrentan obstáculos a nivel de estructura para lograr una alimentación sana, algunas de estas limitaciones incluyen, el costo, acceso a los alimentos, la falta de oportunidades y lugares para realizar actividad física. Los adultos negros y latinos y las personas que viven en comunidades rurales tienden a tener las tasas más altas de obesidad.

Las tasas de obesidad también están aumentando entre niños y adolescentes, casi el 20% de los niños y adolescentes estadounidenses entre 2 y 19 años padecen obesidad. Estas tasas se han más que triplicado desde mediados de la década de 1970, los jóvenes negros y latinos tienen tasas de obesidad sustancialmente más elevadas en comparación con sus pares blancos.

Una sección especial del informe analiza el entorno alimentario del país y los factores que afectan al consumo de alimentos, como las políticas alimentarias, la oferta, el suministro, el acceso y los precios, así como la influencia de la publicidad de alimentos en lo que la gente consume. La sección analiza las oportunidades que tienen los responsables políticos para hacer que el entorno alimentario sea más propicio para una alimentación sana, especialmente en las comunidades con bajos ingresos.

“El número de personas que viven con obesidad y las tasas de enfermedades relacionadas con la obesidad siguen aumentando, por lo que urge dar respuestas políticas a nivel sistémico”, ha declarado la Dra. J. Nadine Gracia, MSCE, presidenta y directora general de Trust for America’s Health. “La epidemia de la obesidad no se debe únicamente al comportamiento individual, sino que también influyen factores socioeconómicos y ambientales que escapan en gran medida al control de cualquier persona. Los responsables políticos deben actuar para hacer frente a esta creciente crisis sanitaria.”

Se necesitan medidas políticas

El informe incluye recomendaciones políticas basadas en pruebas para funcionarios federales, estatales y locales, así como para otras partes interesadas, como el sector sanitario y la industria alimentaria. Entre las medidas políticas recomendadas se incluyen:

Aumentar los recursos federales para lograr reducir las disparidades relacionadas con la obesidad y las afecciones relacionadas, otorgando financiamiento para los programas de prevención de enfermedades crónicas y obesidad de los CDC, incluidos los programas estatales de Actividad Física y Nutrición, Enfoques Raciales y Étnicos para la Salud Comunitaria y Tribus Saludables.

Disminuir la inseguridad alimentaria y nutricional para mejorar la calidad nutricional de los alimentos disponibles en cada comunidad, entre otras actividades, proporcionando comidas escolares saludables para todos los estudiantes y manteniendo el progreso en las normas finales de comidas nutricionales escolares de 2024. Además, el Congreso debe ampliar el acceso a los programas de apoyo a la nutrición como el Programa de Asistencia Nutricional Suplementaria (SNAP) y el Programa Especial de Nutrición Suplementaria para Mujeres, Bebés y Niños (WIC) y aumentar el valor de sus beneficios.

Ayudar a los consumidores a elegir con conocimiento de causa, la Administración de Alimentos y Medicamentos debe implantar rápidamente una etiqueta en la parte frontal del envase que ayude a comprender de manera sencilla los nutrientes de los alimentos envasados.

Eliminar los vacíos tributarios y las deducciones de costos empresariales por la publicidad de alimentos y bebidas poco saludables dirigida a los niños. También puede fomentarse la elección de alimentos y bebidas saludables imponiendo impuestos a las bebidas azucaradas.

Garantizar que todas las comunidades dispongan de un entorno que fomente el transporte activo, por ejemplo, ir a pie o en bicicleta a los destinos cotidianos y de lugares seguros para realizar actividades físicas, como parques y otros lugares para jugar dentro y fuera de casa.

Los legisladores, la atención médica y la salud pública, entre otras partes interesadas, deberían lograr que el acceso a la atención sanitaria este al alcance de todos, expandiendo Medicaid y ofreciendo un buen mercado de salud que sea asequible para todos. Medicaid, Medicare y otros programas deberían cubrir los servicios relacionados con la obesidad sin que el paciente tenga que compartir los costos.

El Congreso debe abordar las causas que producen las enfermedades crónicas e incentivar la colaboración multisectorial para abordar los factores sociales y componentes ambientales que afectan la condición de salud, la atención medica y las aseguradoras deben continuar expandiendo estrategias para evaluar y reembolsar las necesidades sociales relacionadas con la salud de los pacientes.

Lea el informe completo

 

Trust for America’s Health es una organización no partidista y sin ánimo de lucro dedicada a la investigación, la política y la defensa de la salud pública, que promueve una salud óptima para todas las personas y comunidades y hace de la prevención de enfermedades y lesiones una prioridad nacional. www.tfah.org

 

 

 

New Report: U.S. Rates of Obesity Among Adults at Epidemic Levels

Obesity Rates are Predominantly Highest in Communities Experiencing Barriers to Healthy Eating and Those with Few Opportunities for Physical Activity

(Washington, DC – September 12, 2024) – Obesity rates for U.S. adults were at or higher than 35 percent in twenty-three states in 2023, part of a multi-decade increase in the rates of Americans living with obesity, according to a report released today by Trust for America’s Health (TFAH). In 2012, no state had an adult obesity rate at or above the 35 percent level.

The report, State of Obesity 2024: Better Policies for a Healthier America includes TFAH’s analysis of the latest data from the Centers for Disease Control and Prevention’s (CDC) Behavioral Risk Factor Surveillance System.  Obesity and other diet-related diseases are associated with a range of physical and mental health conditions, higher mortality, higher healthcare costs, and productivity losses.

The states with the highest rates of obesity among adults in 2023 were West Virginia (41.2 percent), Mississippi (40.1 percent), Arkansas (40.0 percent), Louisiana (39.9 percent), and Alabama (39.2 percent). Between 2022 and 2023, three states experienced statistically significant increases in their adult obesity rates: Alaska, Arkansas, and Oregon, while no states had a statistically significant decline. Between 2018 and 2023, 28 states have experienced statistically significant increases in adult obesity rates.

States with lowest levels of adult obesity in 2023 were District of Columbia (23.5 percent), Colorado (24.9 percent), Hawaii (26.1 percent), Massachusetts (27.4 percent), and California (27.7 percent).

Nationally, over four in 10 U.S. adults have obesity. While obesity rates have increased for all population groups, groups with the highest rates, often populations of color, typically face structural barriers to healthy eating, including food cost and access, and a lack of opportunities and places to be physically active. Black and Latino adults and people living in rural communities tend to have the highest rates of obesity.

Obesity rates are also increasing among children and adolescents, with nearly 20 percent of U.S. children and adolescents, ages 2 to 19, having obesity. These rates have more than tripled since the mid-1970s, and Black and Latino youth have substantially higher rates of obesity compared to their white peers.

A special section within the report looks at the country’s food environment and factors that affect food consumption such as food policy, supply, access, and pricing, and the influence of food advertising on what people eat. The section discusses opportunities for policymakers to make the food environment more conducive to healthy eating, especially within low-income communities.

“As the number of people living with obesity, as well as the rates of obesity-related disease continue to rise, there’s an urgent need for systems level policy responses,” said J. Nadine Gracia, M.D., MSCE, President and CEO of Trust for America’s Health. “The obesity epidemic is not only about individual behavior; socioeconomic and environmental factors which are largely beyond any one person’s control have a significant role. Policymakers need to act to address this growing health crisis.”

Policy action is needed

The report includes evidence-based policy recommendations for federal, state, and local officials, as well as other stakeholders such as the healthcare sector and the food industry. Recommended policy actions include:

Increase federal resources for effective efforts that reduce obesity-related disparities and related conditions including funding for CDC’s chronic disease and obesity prevention programs, including State Physical Activity and Nutrition, Racial and Ethnic Approaches to Community Health, and Healthy Tribes programs.

Decrease food and nutrition insecurity while improving the nutritional quality of available foods in every community by, among other activities, providing healthy school meals for all students and maintaining progress on the final 2024 school nutritional meal standards. In addition, Congress should expand access to nutrition support programs such as the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and increase the value of their benefits.

To help consumers make informed choices, the Food and Drug Administration should swiftly implement a front-of-package label that will help people more easily understand the nutrients in packaged foods.

Eliminate tax loopholes and business cost deductions for the advertising of unhealthy foods and beverages to children. Healthy food and drink choices can also be encouraged by taxing sugar-sweetened beverages.

Ensure that every community has a built environment that encourages active transportation, e.g., walking and biking to everyday destinations, and safe places to be physically active including parks and other places for indoor and outside play.

Policymakers, healthcare, public health, and other stakeholders should close gaps in healthcare access by expanding Medicaid and by making marketplace coverage more affordable. Medicaid, Medicare, and other payers should cover obesity-related services without patient cost sharing.

Congress should address root causes of chronic diseases by incentivizing multi-sector collaborations to address social and nonmedical drivers of health and healthcare and insurers should continue to expand strategies to screen and reimburse for patients’ health-related social needs.

Read the full report

 

Trust for America’s Health is a nonprofit, nonpartisan public health research, policy, and advocacy organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority.  www.tfah.org

 

 

 

National Immunization Month Highlights Lifesaving Benefits of Vaccines

August 2024

National Immunization Awareness Month sponsored by the National Public Health Information Coalition (NPHIC) and observed every August, highlights the lifesaving benefits of vaccines. During the month, activities will raise awareness of the importance of vaccinating people of all ages against serious and sometimes deadly diseases. The awareness month also celebrates the successes of immunizations and educates Americans about vaccine safety and effectiveness.

According to a study by the Commonwealth Fund, from December 2020 through November 2022, COVID-19 vaccines prevented approximately 18.5 million hospitalizations and 3.2 million deaths in the U.S., but the lifesaving impact of vaccines extends far beyond COVID-19. Vaccines have dramatically reduced the spread of diseases like measles, polio, and whooping cough, protecting countless individuals and communities.

According to new data published this month by the CDC, among children born during 1994-2023, routine childhood vaccinations will have prevented about 508 million cases of illness, 32 million hospitalizations, and 1,129,000 deaths over the course of their lifetimes.

Unfortunately, numerous factors have led to a decline in vaccination rates in recent years including healthcare disruptions during the COVID-19 pandemic and the spread of misinformation about vaccine safety and effectiveness. In some cases, this has resulted in outbreaks of once-controlled diseases, including measles and to a lesser degree polio, jeopardizing the progress we have made.

According to the American Association of Immunologists, getting vaccinated protects against the spread of infectious diseases by helping our immune systems fight infection. Vaccines work by introducing a weakened or inactive form of a virus or bacteria to the body. This triggers the immune system to develop antibodies, creating a kind of shield against future infection. When a large portion of the population is vaccinated, it creates “herd” or community-level immunity, making it difficult for diseases to spread, even protecting those who haven’t been vaccinated themselves.

The public health benefits of vaccines include:

Disease Prevention: Vaccines are highly effective at preventing serious illnesses like measles, mumps, rubella, polio, diphtheria, tetanus, whooping cough, chickenpox, shingles, influenza, and pneumonia. These diseases can cause severe complications, hospitalization, and even death.

Reduced Healthcare Costs: Vaccines are a cost-effective way to prevent illness and its associated medical expenses. Vaccination programs save billions of dollars in healthcare costs each year.

Protection for Populations at Higher Risk: Vaccines are especially important for protecting those with developing immune systems (infants) or weakened immune systems, such as older adults and people with certain chronic illnesses.

Global Health Impact: Vaccination programs have had a significant impact on global health. They have helped to virtually eliminate smallpox and dramatically reduced the burden of other diseases worldwide.

To build on and sustain the health benefits of vaccines, TFAH’s 2024 Ready or Not: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism report includes a number of important recommended policy actions to strengthen the nation’s vaccine infrastructure:

  • Increased Funding: Congress should provide at least $1.1 billion per year to support vaccine infrastructure and delivery, including programs promoting equitable vaccine distribution.
  • Insurance Coverage: Congress and states should ensure first-dollar coverage for recommended vaccines under commercial insurance and for uninsured populations.
  • Minimizing Exemptions: States should minimize vaccine exemptions for schoolchildren, and healthcare facilities should increase vaccination rates of healthcare workers.
  • New Vaccine Development: Congress should create incentives for new-product discovery to prevent and fight resistant infections including therapeutics, diagnostics, and prevention products such as vaccines.
  • Strengthening Influenza Defenses: Congress should strengthen the pipeline of influenza vaccines, diagnostics, and therapeutics.
  • Countering Vaccine Misinformation:The spread of misinformation about vaccines can lead to vaccine hesitancy and lower vaccination rates. TFAH calls for promoting accurate information from trusted sources to increase vaccine confidence.

According to research published in The Lancet, since 1974, vaccination has prevented 154 million deaths worldwide. By ensuring equitable access to vaccines, promoting accurate information, and investing in research and education, we can continue to harness the power of vaccines and build a healthier future for all.

 

What If Congress Adequately Funded Public Health?

You know the old adage, ‘those that don’t learn from history are doomed to repeat it.’ Coming off the COVID-19 public health emergency that has thus far claimed the lives of 1.2 million Americans, there are discussions in Congress to significantly cut funding for public health initiatives to dangerously low levels – again. And it doesn’t have to be like this.

Why do we go through these bleak cycles when anchoring public health in policymaking is a win-win decision for everyone – from elected officials to individual constituents.

Federal public health funding is facing challenges on multiple fronts right now. Congress continues to negotiate appropriations bills for the 2024 fiscal year, which will have major implications for the next fiscal year and beyond. The current short-term funding agreement for Health and Human Services expires on March 22. If Congress passes another continuing resolution rather than new appropriations, it could trigger extreme, across-the-board cuts to non-defense spending.

First, continuing resolutions, which are short-term measures to fund the government at the previous year’s levels, negatively impact the systems we need to protect the nation’s health. And severe cuts triggered by failing to pass a long-term spending bill would be even more dangerous. TFAH has joined more 1,000 other organizations in urging Congress to pass a full-year funding bill using the bipartisan framework laid out in the Senate as a starting point for negotiations.

Secondly, the FY2024 bills proposed by the House and Senate for Labor, Health and Human Services, Education and Related Agencies – the main funding source for public health programs – are vastly different and neither addresses the chronic underfunding of public health. Congress has already rescinded hundreds of millions of dollars intended to shore up the public health workforce and readiness and response efforts. The Senate’s bill proposes a small cut to the Centers for Disease Control and Prevention (CDC), and the House version would cut about $1.6 billion from CDC’s budget. TFAH and partners have called for a $2.5 billion increase for CDC.

Finally, we continue to see proposals to cut the Prevention and Public Health Fund, a critical investment in programs ranging from immunizations to tobacco use prevention. If these proposals were to move forward, this would again push public health funding into the “bust” phase of a decades long “boom and bust” funding pattern.

The health, safety, and well-being of individuals and communities should be at the foundation of U.S. policy and be funded accordingly.

Imagine if we fully invested in the prevention of adverse childhood experiences, suicide, and substance misuse. Many communities would see suicide and overdose rates fall.

Imagine if we prevented the root causes of death, injury, and excess healthcare costs instead of spending trillions of dollars to treat preventable chronic conditions. Workers would be healthier and more productive, employers would face fewer financial burdens, and the nation would be more resilient and thriving.

Imagine if CDC, state, local, tribal, and territorial health departments had modern data systems instead of rudimentary spreadsheets to track the spread of diseases. This country could contain potential outbreaks in their earliest stages and save lives.

Much of our health and well-being is determined by economic, environmental, and societal factors. In the midst of a recent and troubling decrease in life expectancy, TFAH believes that investing in the foundations of public health and effective prevention programs is a critical and indispensable path forward to protecting and promoting the health of the nation.

 

 

 

 

TFAH’s President and CEO Dr. Gracia Discusses the Significance of Dr. Martin Luther King Jr. Day & National Day of Racial Healing

(Washington, DC – January 15, 2024) – This week TFAH’s President and CEO, Dr. J. Nadine Gracia and Director of Strategic Communications and Policy Research Rhea Farberman discussed the significance of two important observances, Dr. Martin Luther King Jr. Day and the National Day of Racial Healing. The conversation focused on the intersections between Dr. King’s mission to advance social justice and TFAH’s work to promote optimal health. Also discussed were the ways in which structural racism creates barriers to good health for many people of color and the policy actions needed to dismantle those barriers.

“What we know, especially in thinking about this in terms of Dr. Martin Luther King, Jr. Day and the National Day of Racial Healing, is that for too many people of color and communities of color there has been, over many decades, a disadvantage in terms of access to health promoting resources.”

“We have to act with a sense of urgency because the health, well-being and prosperity of our nation depends on it.  That’s the call that I believe Dr. King would challenge us to continue, to strive for and not relent.  That’s his legacy to us, to ensure that everyone us the opportunity to reach their full potential for health.”

Dr. J. Nadine Gracia
President and CEO
Trust for America’s Health

“Listen to the full conversation”