Obesity/Chronic Disease Archives - Page 12 of 16

The State of Obesity 2016

New Report Finds «state»’s Obesity Rate is «rate» Percent, «rank_upper»

Rates Decreased in Four States: Minnesota, Montana, New York and Ohio

Washington, D.C., September 1, 2016 — The adult obesity rate in «state» is «rate» percent, giving them the «rank_lower» rate, according to The State of Obesity: Better Policies for a Healthier America, a report from the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF).

U.S. adult obesity rates decreased in four states (Minnesota, Montana, New York and Ohio), increased in two (Kansas and Kentucky) and remained stable in the rest, between 2014 and 2015. This marks the first time in the past decade that any states have experienced decreases – aside from a decline in Washington, D.C. in 2010.

Despite these modest gains, obesity continued to put millions of Americans at increased risk for a range of chronic diseases, such as diabetes and heart disease, and costs the country between $147 billion and $210 billion each year.

In 2015, Louisiana has the highest adult obesity rate at 36.2 percent and Colorado has the lowest at 20.2 percent. While rates remained steady for most states, they are still high across the board. The 13^th annual report found that rates of obesity now exceed 35 percent in four states, are at or above 30 percent in 25 states and are above 20 percent in all states. In 1991, no state had a rate above 20 percent. The analyses are based on the U.S. Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System (BRFSS).

The State of Obesity also found that:

9 of the 11 states with the highest obesity rates are in the South and 22 of the 25 states with the highest rates of obesity are in the South and Midwest.
10 of the 12 states with the highest rates of diabetes are in the South-and rates of diabetes increased in three states (Louisiana, Mississippi and Oregon). «state»’s diabetes rate is «diabetes_rate» percent, «diabetes_rank».
American Indian/Alaska Natives have an adult obesity rate of 42.3 percent.
Adult obesity rates for Blacks are «black_rate» in «state»«black_rank» and at or above 40 percent for Blacks in 14 states.
Adult obesity rates for Latinos are «latino_rate» percent in «state», the «latino_rank» rate.
Adult obesity rates for Whites are «white_rate» percent in «state», the «white_rank» rate, and at or above 25 percent for Whites in 39 states.
Nationally, adult obesity rates are at or above 30 percent in: 40 states and Washington, D.C. for Blacks; 29 states for Latinos; and 16 states for Whites.

There is some evidence that the rate of increase has been slowing over the past decade. For instance, in 2005, 49 states experienced an increase; in 2008, 37 states did; in 2010, 28 states did; in 2011, 16 states did; in 2012, only one state did; and in 2014, only two states did. (Note: the methodology for BRFSS changed in 2011).

“Obesity remains one of the most significant epidemics our country has faced, contributing to millions of preventable illnesses and billions of dollars in avoidable healthcare costs,” said Richard Hamburg, interim president and CEO, TFAH. “These new data suggest that we are making some progress but there’s more yet to do. Across the country, we need to fully adopt the high-impact strategies recommended by numerous experts. Improving nutrition and increasing activity in early childhood, making healthy choices easier in people’s daily lives and targeting the startling inequities are all key approaches we need to ramp up.”

Some other key findings from the report include:

The number of high school students who drink one or more soda a day has dropped by nearly 40 percent since 2007, to around one in five (20.4 percent) in 2015 (note: does not include sport/energy drinks, diet sodas, or water with added sugars). «soda_text»
The number of high school students who report playing video or computer games three or more hours a day has increased more than 88 percent since 2003 (from 22.1 to 41.7 percent). «video_games_tv»
More than 29 million children live in “food deserts,” and more than 15 million U.S. children-including «food_insecure_rate» in «state»-live in “food-insecure” households – having limited access to adequate food and nutrition due to cost, proximity and/or other reasons.
The federal government has awarded more than $90 million via 44 Healthy Food Financing Initiative financial assistance awards in 29 states«hffi» since 2011 – helping leverage more than $1 billion and create 2,500 jobs.
18 states«elem_pe» and Washington, D.C. set a minimum amount of time that elementary students must participate in physical education; 14 states«ms_pe» and Washington, D.C. set a minimum amount for middle schools; and six states«hs_pe» set a minimum amount for high schools.

The report also includes a set of priority policy recommendations to accelerate progress in addressing obesity:

Invest in Obesity Prevention: Providing adequate funding for the Prevention and Public Health Fund and for the Centers for Disease Control and Prevention’s National Center for Chronic Disease Prevention and Health Promotion/Division of Nutrition, Physical Activity, and Obesity would increase support to state and local health departments.
Focus on Early Childhood Policies and Programs: Supporting better health among young children through healthier meals, physical activity, limiting screen time and connecting families to community services through Head Start; prioritizing early childhood education opportunities under the Every Student Succeeds Act (ESSA); and implementing the updated nutrition standards covering the Child and Adult Care Food Program.
School-Based Policies and Programs: Continuing implementation of the final “Smart Snacks” rule for improved nutrition for snacks and beverages sold in schools; eliminating in-school marketing of foods that do not meet Smart Snacks nutrition standards; and leveraging opportunities to support health, physical education and activity under ESSA.
Community-Based Policies and Programs: Prioritizing health in transportation planning to help communities ensure residents have access to walking, biking, and other forms of active transportation and promoting innovative strategies, such as tax credits, zoning incentives, grants, low-interest loans and public-private partnerships to increase access to healthy, affordable foods.
Health, Healthcare and Obesity: Covering the full range of obesity prevention, treatment and management services under all public and private health plans, including nutrition counseling, medications and behavioral health consultation, along with encouraging an uptake in services for all eligible beneficiaries.

“This year’s State of Obesity report is an urgent call to action for government, industry, healthcare, schools, child care and families around the country to join in the effort to provide a brighter, healthier future for our children. It focuses on important lessons and signs of progress, but those efforts must be significantly scaled to see a bigger turn around,” said Risa Lavizzo-Mourey, president and CEO of RWJF. “Together, we can build an inclusive Culture of Health and ensure that all children and families live healthy lives.”

The State of Obesity report (formerly known as F as in Fat), with state rankings and interactive maps, charts and graphs, is available at http://stateofobesity.org. Follow the conversation at #StateofObesity.

2015 STATE-BY-STATE ADULT OBESITY RATES

Based on an analysis of new state-by-state data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System, adult obesity rates by state from highest to lowest were:

Note: 1 = Highest rate of adult obesity, 51 = lowest rate of adult obesity.

1. Louisiana (36.2); 2. (tie) Alabama (35.6), Mississippi (35.6) and West Virginia (35.6); 5. Kentucky (34.6); 6. Arkansas (34.5); 7. Kansas (34.2); 8. Oklahoma (33.9); 9. Tennessee (33.8); 10. (tie) Missouri (32.4) and Texas (32.4); 12. Iowa (32.1); 13. South Carolina (31.7); 14. Nebraska (31.4); 15. Indiana (31.3); 16. Michigan (31.2); 17. North Dakota (31.0); 18. Illinois (30.8); 19. (tie) Georgia (30.7) and Wisconsin (30.7); 21. South Dakota (30.4); 22. (tie) North Carolina (30.1) and Oregon (30.1); 24. (tie) Maine (30.0) and Pennsylvania (30.0); 26. (tie) Alaska (29.8) and Ohio (29.8); 28. Delaware (29.7); 29. Virginia (29.2); 30. Wyoming (29.0); 31. Maryland (28.9); 32. New Mexico (28.8); 33. Idaho (28.6); 34. Arizona (28.4); 35. Florida (26.8); 36. Nevada (26.7); 37. Washington (26.4); 38. New Hampshire (26.3); 39. Minnesota (26.1); 40. Rhode Island (26.0); 41. New Jersey (25.6); 42. Connecticut (25.3); 43. Vermont (25.1); 44. New York (25.0); 45. Utah (24.5); 46. Massachusetts (24.3); 47. California (24.2); 48. Montana (23.6); 49. Hawaii (22.7); 50. District of Columbia (22.1); 51. Colorado (20.2).

Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority. For more information, visit www.healthyamericans.org.

For more than 40 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are striving to build a national Culture of Health that will enable all to live longer, healthier lives now and for generations to come. For more information, visit www.rwjf.org. Follow the Foundation on Twitter at www.rwjf.org/twitter or on Facebook at www.rwjf.org/facebook.

Trust for America’s Health Statement on Bipartisan Senate Agriculture Committee Compromise on Child Nutrition Reauthorization

Washington, D.C., January 19, 2016 – The following is a statement from Richard Hamburg, interim president and CEO of the Trust for America’s Health (TFAH), on the bipartisan compromise legislation introduced earlier this week by Senate Agriculture Committee Chairman Pat Roberts (R-KS) and Ranking Member Debbie Stabenow (D-MI).

“The Improving Child Nutrition Integrity and Access Act of 2016 is an important step toward ensuring healthier nutrition for all of the nation’s children. We applaud the committee leadership and staff for their hard work in achieving a compromise that will build on the important accomplishments that were made in the Healthy, Hunger-Free Kids Act of 2010.

Around 15.5 million children experience food insecurity each year, with their access to adequate food and nutrition limited due to cost, proximity and/or other resources. At the same time, 17 percent of children are obese. There’s clearly still a lot of work to do to ensure this generation of children receive the support they need to thrive. In our annual State of Obesity report, TFAH highlights programs and policies at the U.S. Department of Agriculture, U.S. Department of Health and Human Services and in states and localities that can help ensure all children have the chance to grow up with good nutrition. We know what works – but we need to keep moving forward and increasing support to realize the promise of these efforts.

This bill advances some important improvements by increasing investments in school kitchen equipment, Farm-to-School programs and other programs that help feed kids outside of traditional school settings. Unfortunately, there are some provisions in the bill that are not ideal and deviate from the evidence-base, such as not requiring 100 percent whole grains in school meals. But, on balance, the bill represents continued progress in the right direction.

We urge members of Congress to move forward with markup and embrace the spirit of compromise embodied in this legislation. TFAH stands ready to work with policymakers and partners to help ensure reauthorization legislation is best able to support our children, their families and schools.”

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Get Healthy Philly

“Get Healthy Philly” is an initiative of the Philadelphia Department of Public Health that brings together government agencies, community-based organizations, academia, and the private sector to address obesity and smoking in Philadelphia. The organization is making great strides toward a healthy Philly through actions including: designating nearly 12,000 acres of new smoke-free spaces; passing a $2 per pack tax increase on cigarettes; establishing school nutrition standards; menu labeling; and working with food retailers to promote healthy food sales. Accomplishments over the past four years include a 15 percent reduction in smoking among adults, a 30 percent reduction in smoking among youth, and a 5 percent reduction in childhood obesity. The initiative is supported by local, state, and federal funding, including the Centers for Disease Control and Prevention through the Prevention and Public Health Fund and the Pennsylvania Department of Health. To read more about this innovative program, see this brief summary [link].

District of Columbia Healthy Communities Collaborative

DC Healthy Communities Collaborative—a collaborative of community health leaders and organizations—formed in 2012 to assess and address the community health needs in the Washington, D.C. area. The Collaborative works in four key areas identified as community health needs in the D.C. area: asthma, obesity, sexual health, and substance abuse/mental health. To date, the Collaborative has conducted a community health assessment identifying health needs within the D.C. area and produced a community health improvement plan with strategies to address the aforementioned health needs. D.C. Healthy Communities Collaborative is funded by member contributions. To read more about this innovative program, see this brief summary [link].

Dignity Health’s Community Health Investments

For more than 20 years, Dignity Health, a health care provider in multiple states, has been investing in the health of the communities it serves through community benefit programs and community economic initiatives, including grants and low-interest loans to nonprofits addressing community needs. Investments are targeted to populations with disproportionate unmet health needs as identified through the community health needs assessment and a Community Need Index developed by Dignity Health. Since 1990, Dignity Health has awarded more than $51 million in areas such as prevention, HIV/AIDS services, behavioral health services, and improving access to care. The Dignity Health Community Investment Program has had a total loan volume of $143 million, benefiting the community-based health programs of California, Nevada, and Arizona including: providing affordable housing for seniors; access to shelters for the homeless discharged from community hospitals; and healthy food projects. To read more about this innovative program, see this brief summary [link].

Cultivating Health for Success

Cultivating Health for Success (CHS) established in 2010, focuses on the inclusion of safe, affordable, and supportive housing to reduce unplanned care, improve adherence to recommended treatment, and improve health care cost and outcomes as well as quality of life for participants in greater Pittsburgh. CHS serves adults with one or more chronic illnesses and those with a history of at least one year of above average use of unplanned care, such as crisis services, Emergency Department visits, and the homeless. To deliver services, CHS partners with the Allegheny County Department of Human Services, Metro Family Practice, Community Human Services, UPMC for You, and the Community Care Behavioral Health Organization. Since CHS’s inception, per-member per-month (PMPM) medical costs have decreased 11.5 percent, the average PMPM for unplanned care has decreased by 19.2 percent, and the average prescription PMPM increased by 5.2 percent for participants with a meaningful tenure in the program. CHS is funded by UMPC for You contributions. To read more about this innovative program, see this brief summary [link].

Reducing Teen Substance Misuse: What Really Works

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Washington, D.C., November 19, 2015– In a new report, Reducing Teen Substance Misuse: What Really Works, «intro_text»

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The report’s analysis of the most recent drug overdose death rates among 12- to 25-year-olds found:

Current rates were highest in West Virginia (12.6 per 100,000 youth) – which were more than five times higher than the lowest rates in North Dakota (2.2 per 100,000).
Males are 2.5 times as likely to overdose as females (10.4 vs. 4.1 per 100,000). The rate in «state» for males was «male» «per_label» and «female» for females.
In 1999-2001, no state had a youth drug overdose death rate above 6.1 per 100,000. By 2011-13, 33 states were above 6.1 per 100,000. In the past 12 years:
- Rates have more than doubled in 18 states (Alabama, Arizona, California, Colorado, Connecticut, Georgia, Hawaii, Idaho, Illinois, Kentucky, Nebraska, Nevada, New Jersey, New Mexico, North Carolina, Oregon, South Carolina and Tennessee);
- Rates have more than tripled in twelve states (Arkansas, Delaware, Indiana, Iowa, Michigan, Minnesota, Missouri, New Hampshire, New York, Oklahoma, Utah and West Virginia); and
- Rates have more than quadrupled in five states (Kansas, Montana, Ohio, Wisconsin and Wyoming).

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No.	Indicator	«state»	Number of States Receiving Points
A “Y” means the state received a point for that indicator
1	Support Academic Achievement: State has at least an 80 percent high school graduation rate (2012-2013). Source: U.S. Department of Education, ED Data Express, Regulatory Adjusted Cohort Graduation Rates, 2013-2014.	«metric1»	35
2	Preventing Bullying: State has comprehensive bullying prevention laws. Source: American Academy of Pediatrics.	«metric2»	21
3	Preventing Smoking: State has smoke-free laws that prohibit smoking in public places, including restaurants and bars. Source: Campaign for Tobacco-Free Kids.	«metric3»	30 and Washington, D.C.
4	Preventing Underage Alcohol Sales: State has liability (dram shop) laws holding establishments accountable for selling alcohol to underage or obviously intoxicated individuals. Source: National Conference of State Legislatures and NOLO.	«metric4»	37 and Washington, D.C.
5	Screening, Brief Intervention and Referral to Treatment Support: State has billing codes for Screening, Brief Intervention and Referral for Treatment (SBIRT) in their medical health (Medicaid or private insurance) programs. Source: Institute for Research Education & Training in Addictions and Community Catalyst.	«metric5»	32 and Washington, D.C.
6	Mental Health Funding: State increased funding for mental health services for Fiscal Year 2015. Source: National Alliance on Mental Illness.	«metric6»	29 and Washington, D.C.
7	Depression Treatment: State has rates of treatment for teens with major depressive episodes above the National percentage of 38.1 percent (2009-2013). Source: SAMHSA, Behavioral Health Barometer: United States, 2014.	«metric7»	30 and Washington, D.C.
8	Good Samaritan Laws: State has laws in place to provide some immunity from criminal charges or mitigation of sentencing of seeking help for an overdose. Source: Network for Public Health Law.	«metric8»	31 and Washington, D.C.
9	Treatment and Recovery Support for Prescription Drug Misuse: State provides Medicaid coverage for all three FDA-approved medications for the treatment of painkiller dependence. Source: American Society of Addiction Medicine.	«metric9»	30 and Washington, D.C.
10	Sentencing Reform: State has taken action to roll back “one-size-fits-all” sentences for nonviolent drug offenses. Sources: The Vera Institute of Justice for 2000-2013 laws. For 2014 updates, The Sentencing Project, National Conference of State Legislatures and additional legislative scans for states meeting the thresholds set by the Vera Institute review.	«metric10»	31 and Washington, D.C.
Total		«score_upper»

“More than 90 percent of adults who develop a substance use disorder began using before they were 18,” said Jeffrey Levi, PhD, executive director of TFAH. “Achieving any major reduction in substance misuse will require a reboot in our approach – starting with a greater emphasis on preventing use before it starts, intervening and providing support earlier and viewing treatment and recovery as a long-term commitment.”

The increase in youth drug overdose deaths is largely tied to increases in prescription drug misuse and the related doubling in heroin use by 18- to 25-year-olds in the past 10 years – 45 percent of people who use heroin are also addicted to prescription painkillers.

In addition, youth marijuana rates have increased by nearly 6 percent since 2008 and more than 13 percent of high school students report using e-cigarettes. Youth from affluent families and/or neighborhoods report more frequent substance and alcohol use than lower-income teens – often related to having more resources available to access alcohol and drugs.

“The case for a prevention-first and continuum-of-care approach is supported by more than 40 years of research, but the science hasn’t been implemented on a wide scale in the real world,” said Alexa Eggleston, senior program officer, domestic programs, Conrad N. Hilton Foundation. “It’s time to bring innovations to scale and invest in more proactive and sustained approaches that promote positive protective factors, like safe, stable families, homes, schools and communities and intervene early to address youth substance use before addiction develops.”

Reducing Teen Substance Misuse identified a set of research-based approaches and recommendations to modernize the nation’s strategy to prevent and reduce substance use and support a full continuum-of-care, including:

Putting prevention first, using evidence-based approaches across communities and in schools. Each state should have an end-to-end network of experts and resources to support the effective community-based selection, adoption, implementation and evaluation of evidence-based programs;
Strategically investing in evidence-based programs that show the strongest results in reducing risk factors for substance misuse, poor academic performance, bullying, depression, violence, suicide, unsafe sexual behaviors and other problems that often emerge during teen years and young adulthood;
Integrating school-based and wider community efforts, via multisector collaboration – and effectively collecting data to assess community needs, better select programs that match with those needs and improve accountability. Schools cannot and should not be expected to solve the problem on their own;
Renewing efforts to gain support for the adoption and implementation of evidence-based and sustained school-based programs – moving beyond decades of ineffective approaches;
Incorporating SBIRT as a routine practice in middle and high schools and healthcare settings – along with other regular health screenings – even brief counseling and interventions can have a positive impact; and
Increasing funding support for sustained and ongoing mental health and substance use treatment and recovery.

The report provides additional research-based recommendations for preventing and reducing youth substance misuse. It was supported by a grant from the Conrad N. Hilton Foundation and is available on TFAH’s website at www.healthyamericans.org.

Score Summary:

A full list of all of the indicators and scores, listed below, is available along with the full report on TFAH’s web site at www.healthyamericans.org. For the state-by-state scoring, states received one point for achieving an indicator or zero points if they did not achieve the indicator. Zero is the lowest possible overall score, 10 is the highest.

10 out of 10: Minnesota and New Jersey
9 out of 10: California, Connecticut, Maine, Maryland, New Mexico, New York and Vermont
8 out of 10: Delaware, District of Columbia, Massachusetts, New Hampshire, Ohio, Oregon, Virginia, Washington and Wisconsin
7 out of 10: Colorado, Iowa, North Carolina and Pennsylvania
6 out of 10: Alabama, Illinois, Missouri, Rhode Island and Utah
5 out of 10: Arkansas, Florida, Hawaii, Kansas, Kentucky, Michigan, Montana, North Dakota and Oklahoma
4 out of 10: Alaska, Arizona, Georgia, Indiana, Nebraska, Nevada, South Carolina, South Dakota, Tennessee, Texas and West Virginia
3 out of 10: Idaho, Louisiana, Mississippi and Wyoming

State-by-state Youth Drug Overdose Death Rankings:

Note: Rates include drug overdose deaths, for 2011-2013, a three-year average, for 12- to 25-year-olds. 1 = Highest rate of drug overdose fatalities, 51 = lowest rate of drug overdose fatalities. States with statistically significant (p<0.05) increases since 2005-2007 are noted with an asterisk (*), while states with a statistically significant decrease are noted with two asterisks (**).

1. West Virginia (12.6); 2. New Mexico (12.5); 3. Utah (12.1); 4. Pennsylvania (11.8); 5. Nevada (11.6); 6. New Jersey (10.7*); 7. Kentucky (10.5); 8. (tie) Arizona (10.2*) and Colorado (10.2*) and Delaware (10.2*); 11. Wyoming (9.8*); 12. Indiana (9.6); 13. Missouri (9.5*); 14. Oklahoma (9.4); 15. New Hampshire (9.3); 16. Ohio (9.1*); 17. Wisconsin (8.8*); 18. Maryland (8.5); 19. Arkansas (8.4); 20. Connecticut (8.3); 21. Illinois (8.2*); 22. Michigan (8.1*); 23. Massachusetts (7.8); 24. Alaska (7.2); 25. North Carolina (7.1); 26. (tie) Montana (7.0) and Tennessee (7.0**) and Vermont (7.0); 29. (tie) New York (6.9*) and Washington (6.9); 31. Oregon (6.5); 32. (tie) Alabama (6.2) and Louisiana (6.2**); 34. (tie) Rhode Island (6.0) and Texas (6.0); 36. (tie) Kansas (5.9) and Virginia (5.9); 38. (tie) Idaho (5.8) and South Carolina (5.8); 40. (tie) Florida (5.7**) and Minnesota (5.7*); 42. Georgia (5.2); 43. California (4.9*); 44. Maine (4.7**); 45. Hawaii (4.6); 46. Iowa (4.3); 47. (tie) Mississippi (3.7**) and Nebraska (3.7); 49. South Dakota (3.3); 50. North Dakota (2.2).

Increasing Access to Breastfeeding Friendly Hospitals: The Iowa Experience

By Jane Stockton, Community Health Consultant, Bureau of Nutrition and Health Promotion, Iowa Department of Public Health & Catherine Lillehoj, Ph.D. Research Analyst, Iowa Department of Public Health

The Iowa Department of Public Health (IDPH) has a long tradition of striving to improve the health and wellness of all residents. Because breastfeeding is a key strategy to preventing obesity among children and youth, IDPH has worked for the past several years to increase rates of breastfeeding initiation and duration.

Five years ago, Iowa ranked 31 out of 53 states and territories on a national survey, the Maternity Practices in Infant Nutrition and Care (mPINC). When we looked a little deeper, we realized that the rural nature of our state made maternal nutrition and care somewhat difficult.

For instance, 89 percent of Iowa counties are considered rural, with hospitals in rural counties having a higher proportion of Medicaid births (40 to 60 percent of births). Sadly, these hospitals often don’t have the necessary resources to truly improve breastfeeding education and provide the appropriate technical assistance. In general, rural hospitals experience unique barriers due to distance between hospitals, patients and other facilities, plus staff are often not dedicated to working in maternity care units.

To get over these hurdles, IDPH targeted hospitals in rural counties with significant numbers of Medicaid births. One of the preliminary activities to improve breastfeeding was to meet with key hospital partners (e.g., OB managers, Chief Nursing Officers, Directors of Nursing, Educators). Along with key partners, hospital policies related to breastfeeding were reviewed and results of the mPINC survey were discussed. Following these initial meetings, 53 hospitals voluntarily completed a pre-assessment using a self-appraisal tool. Subsequently, the IDPH hosted a training, called 6 Steps 4 Success, which we developed specifically to address the Ten Steps to Successful Breastfeeding, a set of evidence-based practices that have been shown to increase breastfeeding initiation and duration.

After receiving technical assistance, resources and staff education, 37 of the 53 hospitals completed a post-assessment. The majority of the hospitals implemented at least three of the Ten Steps and the most widely adopted policy, encouraging breastfeeding on demand, was implemented by 83 percent of the hospitals. After attending the 6 Steps 4 Success training, one nurse stated, “This gave me a lot to think about. I have changed my position and going to change my ideas, way I promote breastfeeding.” Hospitals frequently express their gratitude for the technical assistance and education being brought to them in their rural setting, rather than having to go to the larger cities for these services.

To further enhance statewide breastfeeding initiatives, efforts for the past two years have focused on improving maternity practice in four or five hospitals each year that meet three criteria: rural location, Medicaid birth rate higher than statewide average and an mPINC score of less than the statewide composite score. Using their mPINC survey data, hospitals are given assistance in reviewing the results, determining where the greatest opportunities for improvement are, and developing an improvement plan to address at least two of the dimensions of care. Over the course of one year, hospitals are offered:

Technical assistance related to breastfeeding policy – telephone, face-to-face, electronic messaging;
Resources – desk references such as Hale’s Medications and Mother’s Milk, Continuity of care in Breastfeeding: Best Practices in the Maternity setting; model breastfeeding policy, and a Self Attachment video;
Educational opportunities – funding to send one staff nurse to Certified Lactation Counselor (or comparable) training, Breastfeeding Education for Iowa Communities, a four hour training developed by the Iowa Breastfeeding Coalition, and/or 6 Steps 4 Success training; and
Networking opportunities – Iowa’s Annual Breastfeeding Conference and networking call for all participating hospitals.

The most recent data indicate all participating hospitals demonstrated improvement in several areas including: Labor and delivery practice (an improvement ranging from 3 to 230 percent), Staff Training (63 percent improvement), Breastfeeding Assistance (18 percent improvement), and Structural and Organizational Aspects of Care (94 percent improvement). In addition, staff who became Certified Lactation Counselors are now educating other nurses in their hospital.

To truly make these activities pervasive and sustainable, the IDPH knew it was important to collaborate with key partners with valuable expertise, including:

University of Iowa Statewide Perinatal Team – Breastfeeding Guidelines were written and incorporated into the Guidelines for Perinatal Services published by IDPH and distributed by the University of Iowa’s Perinatal Care Program. The Guidelines for Perinatal Services provides the framework to be used in defining and evaluating the level of perinatal services being offered by hospitals.
Iowa Breastfeeding Coalition – Breastfeeding Education for Iowa Communities, a four hour training curriculum, is being presented to healthcare communities throughout the state. The training curriculum, based on WIC’s Grow and Glow curriculum, was written as a collaborative effort by IDPH staff and ICBLC members of the coalition.

Over the past five years Iowa hospitals have gone from understanding what the term “Baby Friendly” meant and about the significance of the Ten Steps to Successful Breastfeeding, to having one hospital designated as Baby Friendly and many other hospitals in the process of achieving that designation

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References

Lillehoj, C. & Dobson, B. (2012). Implementation of the Baby-Friendly Hospital Initiative Steps in Iowa Hospitals. http://authorservices.wiley.com/bauthor/onlineLibraryTPS.asp?DOI=10.1111/j.1552-6909.2012.01411.x&ArticleID=1043603.

New Report Finds 23 of 25 States with Highest Rates of Obesity are in the South and Midwest

Obesity rates at or above 30 percent in 42 states for Blacks, 30 states for Latinos, 13 states for Whites

Washington, D.C., September 21, 2015 – U.S. adult obesity rates remained mostly steady―but high―this past year, increasing in Kansas, Minnesota, New Mexico, Ohio and Utah and remaining stable in the rest, according to The State of Obesity: Better Policies for a Healthier America, a report from the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF).

Arkansas had the highest adult obesity rate at 35.9 percent, while Colorado had the lowest at 21.3 percent. The 12th annual report found that rates of obesity now exceed 35 percent in three states (Arkansas, West Virginia and Mississippi), are at or above 30 percent in 22 states and are not below 21 percent in any. In 1980, no state had a rate above 15 percent, and in 1991, no state had a rate above 20. Now, nationally, more than 30 percent of adults, nearly 17 percent of 2 to 19 year olds and more than 8 percent of children ages 2 to 5 are obese.

Obesity puts some 78 million Americans at an increased risk for a range of health problems, including heart disease, diabetes and cancer.

“Efforts to prevent and reduce obesity over the past decade have made a difference. Stabilizing rates is an accomplishment. However, given the continued high rates, it isn’t time to celebrate,” said Jeffrey Levi, PhD, executive director of TFAH. “We’ve learned that if we invest in effective programs, we can see signs of progress. But, we still haven’t invested enough to really tip the scales yet.”

Other key findings from The State of Obesity include:

Obesity rates differ by region, age and race/ethnicity.
7 of the 10 states with the highest rates are in the South and 23 of the 25 states with the highest rates of obesity are in the South and Midwest.
9 of the 10 states with the highest rates of diabetes are in the South. Diabetes rates increased in eight states – Colorado, Hawaii, Kansas, Massachusetts, Missouri, Montana, Ohio and Pennsylvania.
American Indian/Alaska Natives have the highest adult obesity rate, 54 percent, of any racial or ethnic group.
Nationally, obesity rates are 38 percent higher among Blacks than Whites; and more than 26 percent higher among Latinos than Whites. (Obesity rates for Blacks: 47.8 percent; Latinos: 42.5 percent; and Whites: 32.6 percent.)
Adult obesity rates are at or above 40 percent for Blacks in 14 states.
Adult obesity rates are at or above 30 percent in: 42 states for Blacks; 30 states for Latinos; and 13 states for Whites.
Obesity rates are 26 percent higher among middle-age adults than among younger adults― rates rise from 30 percent of 20- to 39- year olds to nearly 40 percent of 40- to 59-year-olds.
More than 6 percent of adults are severely obese – more than a 125 percent increase in the past two decades. Around 5 percent of children are already severely obese by the ages of 6 to 11.
Among children and teens (2 to 19 years old), 22.5 percent of Latinos, more than 20 percent of Blacks and 14.1 percent of Whites are obese.
Prevention among children is key. It is easier and more effective to prevent overweight and obesity in children, by helping every child maintain a healthy weight, than it is to reverse trends later. The biggest dividends are gained by starting in early childhood, promoting good nutrition and physical activity so children enter kindergarten at a healthy weight.
Healthy communities can help people lead healthy lives. Small changes that make it easier and more affordable to buy healthy foods and beverages and be physically active can lead to big differences. The U.S. Centers for Disease Control and Prevention, The New York Academy of Medicine, and other experts have identified a range of policies and programs (e.g., improving school nutrition, physical activity and lifestyle interventions, health screenings, walking programs) that can help create healthier communities. Lower-income communities often face higher hurdles, and need more targeted efforts.

“In order to build a national Culture of Health, we must help all children, no matter who they are or where they live, grow up at a healthy weight,” said Risa Lavizzo-Mourey, president and CEO of RWJF. “We know that when we take comprehensive steps to help families be more active and eat healthier foods, we can see progress. Now we must extend those efforts and that progress to every community in the country.”

The State of Obesity also reviews key programs that can help prevent and address obesity by improving nutrition in schools, child care and food assistance; increasing physical activity before, during and after school; expanding healthcare coverage for preventing and treating obesity; making healthy affordable food and safe places to be active more accessible in neighborhoods, such as through Complete Streets and healthy food financing initiatives; increasing healthy food options via public-private partnerships; and creating and sustaining policies that help all children maintain a healthy weight and adults be as healthy as possible, no matter their weight.

This is the 12^th annual edition of The State of Obesity (formerly known as the F as in Fat report series) report. The full report, with state rankings in all categories and updated interactive maps, charts and graphs, is available at http://stateofobesity.org. Follow the conversation at #StateofObesity.

2014 STATE-BY-STATE ADULT OBESITY RATE

Based on an analysis of new state-by-state data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance Survey, adult obesity rates by state from highest to lowest were:

Note: 1 = Highest rate of adult obesity, 51 = lowest rate of adult obesity.

1. Arkansas (35.9); 2. West Virginia (35.7); 3. Mississippi (35.5); 4. Louisiana (34.9); 5. Alabama (33.5); 6. Oklahoma (33.0); 7. Indiana (32.7); 8. Ohio (32.6); 9. North Dakota (32.2); 10. South Carolina (32.1); 11. Texas (31.9); 12. Kentucky (31.6); 13. Kansas (31.3); 14. (tie) Tennessee (31.2) and Wisconsin (31.2); 16. Iowa (30.9); 17. (tie) Delaware (30.7) and Michigan (30.7); 19. Georgia (30.5); 20. (tie) Missouri (30.2) and Nebraska (30.2) and Pennsylvania (30.2); 23. South Dakota (29.8); 24. (tie) Alaska (29.7) and North Carolina (29.7); 26. Maryland (29.6); 27. Wyoming (29.5); 28. Illinois (29.3); 29. (tie) Arizona (28.9) and Idaho (28.9); 31. Virginia (28.5); 32. New Mexico (28.4); 33. Maine (28.2); 34. Oregon (27.9); 35. Nevada (27.7); 36. Minnesota (27.6); 37. New Hampshire (27.4); 38. Washington (27.3); 39. (tie) New York (27.0) and Rhode Island (27.0); 41. New Jersey (26.9); 42. Montana (26.4); 43. Connecticut (26.3); 44. Florida (26.2); 45. Utah (25.7); 46. Vermont (24.8); 47. California (24.7); 48. Massachusetts (23.3); 49. Hawaii (22.1); 50. District of Columbia (21.7); 51. Colorado (21.3).

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Trust for America‘s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.

For more than 40 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are striving to build a national Culture of Health that will enable all to live longer, healthier lives now and for generations to come. For more information, visit www.rwjf.org. Follow the Foundation on Twitter at www.rwjf.org/twitter or on Facebook at www.rwjf.org/facebook.

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