Issue Category: School Nutrition

Racial and Ethnic Approaches to Community Health (REACH) Program’s 25th Anniversary

Trust for America’s Health hosted a virtual Congressional briefing and national webinar honoring the 25th anniversary of the Centers for Disease Control and Prevention (CDC) Racial and Ethnic Approaches to Community Health (REACH) program. REACH aims to improve health, prevent chronic diseases, and reduce health disparities among racial and ethnic populations with the highest risk, or burden of chronic disease. Since 1999, the program has empowered communities to develop and share effective solutions, fostering a healthier future for all.

A panel of subject matter experts discussed the history, achievements, and future of the REACH program.

Nutrition Support Programs are Vital to Preventing Food and Nutrition Insecurity and Reducing Chronic Disease – Congress Must Act to Support Them

As of early November 2023, draft appropriation bills by both the House of Representatives and the Senate do not adequately fund the WIC nutrition support program, threatening to break a nearly 30-year, bipartisan commitment to ensure all participants can access the program without waitlists.

(Washington, DC – 11/20/23) – Access to nutritious food is critical to preventing many chronic diseases and is particularly important to keep young children on track with their growth and developmental needs. In 2022, an estimated 12.8 percent of U.S. households experienced food and or nutrition insecurity sometime during the year.
As Trust for America’s Health’s (TFAH) State of Obesity report series has demonstrated, food insecurity is a risk factor for obesity and other nutrition-related chronic diseases. Progress on addressing these critical public health issues is in jeopardy if Congress does not provide funding for federal nutrition support programs during the current fiscal year.
One of the key federal nutrition programs supporting the specific nutritional needs of young children, infants, and birthing people is the Special Supplemental Nutrition Program for Women, Infants, and Children, or WIC. Created in 1972, the WIC program is a short-term, public health intervention program designed to strengthen lifetime nutrition and health behaviors within households with low-incomes. The WIC program provides nutrition benefits tailored to support a young child’s development. Over time, the program, including its food packages, has aligned with new science about the key nutrients infants and children need. These changes have had a significant impact. Studies show that the 2007 benefit update helped improve beneficiaries’ diets and decreased rates of obesity among enrolled toddlers ages 2-4.

The WIC program also adapted to challenges created by the COVID-19 pandemic by implementing new flexibilities, such as allowing WIC agencies to remotely load benefits cards. In 2021, Congress also increased the monthly benefit available to families to purchase more fruits and vegetables from $9 to $26 for children, and from $11 to $47 for pregnant and postpartum participants. These changes modernized the program and in turn increased participation; important because WIC has long had lower participation rates in comparison to the number of eligible families.

Today, nearly seven million parents and children under five years old depend on the WIC program, and participation is expected to grow due to increased program flexibilities. To keep up with increased demand, additional program funding is needed. As of early November 2023, draft appropriation bills by both the House of Representatives and the Senate do not adequately fund the WIC program, which threatens to break a nearly 30-year, bipartisan commitment to ensure all participants can access WIC without waitlists. Increasing food costs, make action to grow the WIC program critically important as families are struggling to afford healthy meals and may be forced to turn to cheaper but less nutritious alternatives.

Critical public health programs like WIC not only provide nutritious foods to families in the short term, but also help prevent diet-related diseases. Trust for America’s Health urges Congress to increase funding in the Fiscal Year (FY) 2024 budget for the WIC program to ensure pregnant and postpartum birthing people and their young children have the nutrition they need to enjoy good

New Report: Rates of Adult Obesity Continue to Climb, Particularly in Communities Experiencing Barriers to Healthy Eating and Few Opportunities for Physical Activity

20th Annual Report Finds 22 States Have Adult Obesity Levels Above 35 Percent

(Washington, DC – September 21, 2023) – The number of adults in the United States with obesity continues to climb according to a new report, State of Obesity 2023: Better Policies for a Healthier America, released today. The report, the 20th annual edition produced by Trust for America’s Health (TFAH), examines the root causes of the nation’s rising obesity rates, and makes policy recommendations to address them.

According to TFAH’s analysis of the latest data from the Centers for Disease Control and Prevention’s (CDC) Behavioral Risk Factor Surveillance System, in 2022, 22 states had an adult obesity rate at or above 35 percent, up from 19 states the prior year. A decade ago, no state had an adult obesity rate at or above the 35 percent level.

West Virginia (41%), Louisiana (40.1%), Oklahoma (40.0%), and Mississippi (39.5%) have the highest rates of adult obesity. The District of Columbia (24.3%), Colorado (25.0%), and Hawaii (25.9%) have the lowest adult obesity rates.

Over the past two decades obesity rates have climbed for all population groups with certain populations of color experiencing the highest rates, often due to structural barriers to healthy eating and a lack of opportunities and places to be physically active.

Data summarized in the report from the 2017 – 2020 National Health and Nutrition Examination Survey (NHANES) tracks obesity trends nationally and within populations groups. Nationally, 41.9 percent of adults have obesity. Black and Latino adults and people living in rural communities tend to have the highest rates of obesity.

  • Black adults have the highest level of adult obesity at 49.9 percent.
  • Hispanic adults have an obesity rate of 45.6 percent.
  • White adults have an obesity rate of 41.4 percent.
  • Rural areas of the country have higher rates of obesity than urban and suburban areas.

Obesity rates are also increasing among children and adolescents with nearly 20 percent of U.S. children ages 2 to 19 having obesity according to 2017–2020 NHANES data. These rates have more than tripled since the mid-1970s, and Black and Latino youth have substantially higher rates of obesity than do their white peers.

An Evolving Understanding of Obesity

Since TFAH’s initial report, published in 2004, the national adult obesity rate has increased by 37 percent and the national youth obesity rate increased by 42 percent. The widespread increases show that obesity is a society-wide, population-level issue, i.e., one rooted in societal and environmental factors that are often beyond individual choice. TFAH concludes that solving the nation’s obesity crisis will require addressing the economic and structural factors that impact where people live and their access to employment, transportation, healthcare, affordable and healthy food, and places to be physically active.

Over the past 20 years, important strides have been made in understanding that obesity is a disease and how to prevent it, including the role that social determinants of health and health inequities play in driving obesity rates. Furthermore, many obesity-related policies and programs that have been implemented, such as increased access to and benefits within nutrition support programs, have a proven record of success but need increased investment to reach more people and communities.

“It’s critical to recognize that obesity is a multifactored disease involving much more than individual behavior,” says J. Nadine Gracia, M.D., MSCE, President and CEO of Trust for America’s Health.  “In order to stem the decades long trend of increasing obesity rates we have to acknowledge that the obesity crisis is rooted in economic, health, and environmental inequities.  Ensuring all people and communities have equitable opportunity and access to healthy food and physical activity is fundamental to addressing this crisis.”

Addressing obesity is critical because it is associated with a range of diseases, including type 2 diabetes, heart disease, stroke, arthritis, sleep apnea, and some cancers. Obesity is estimated to increase U.S. healthcare spending by $170 billion annually (including billions by Medicare and Medicaid).

Recommended Policy Steps to Address the Obesity Crisis

The report includes recommendations for policy actions that should be taken by federal, state, and local officials and other stakeholders within five issue areas:

  • Advance health equity by strategically dedicating federal resources to efforts that reduce obesity-related disparities and related conditions, including by increasing funding for CDC’s chronic disease and obesity prevention programs.
  • Decrease nutrition insecurity while improving nutritional quality of available food. Actions steps include guaranteeing healthy school meals for every student, increasing access to the Supplemental Nutrition Assistance Program (SNAP) and other nutrition support programs, and implementing a mandatory front-of-package labeling system on food packaging to help consumers make informed choices.
  • Change the marketing and pricing strategies that lead to health disparities, including closing tax loopholes and eliminating business-cost deductions for advertising unhealthy food to children.
  • Make physical activity and the built environment safer and more accessible for everyone. Action steps include increasing federal education funding to support health and physical education in schools and investing in active transportation projects like pedestrian and bike paths.
  • Work within the healthcare system to reduce disparities and close gaps in clinical-to-social service referrals by increasing access to health insurance through expanding Medicaid, making marketplace insurance more affordable, and expanding healthcare screenings for social needs.

 

Read the full report

Increases in Drug Overdose Death Rates Were Up Before COVID-19 and Are Continuing to Rise During the Pandemic

Trust for America’s Health and Well Being Trust Call for Renewed Focus on Preventing Deaths of Despair

DISTRICT OF COLUMBIA & OAKLAND, CA – Dec. 23, 2020 – According to data released this week by the National Center for Health Statistics, in 2019 age-adjusted drug overdose deaths increased slightly over the prior year.  Coupled with data released last week by the CDC showing increases in drug overdose deaths in early 2020, these reports demonstrate the continuing upward trajectory of drug deaths in the U.S, a trend that is being compounded by the COVID-19 pandemic.

The age-adjusted rate of drug overdose during 2019 was 21.6 per 100,000 deaths, up from the 2018 rate of 20.7 per 100,000. In 2019, 70,630 people died due to drug overdose in the United States.

Between 1999 and 2019 the rate of drug overdose deaths increased for all groups aged 15 and older, with people aged 35-44 experiencing the highest single year increase in 2019.  While rates of drug overdose deaths involving heroin, natural and semisynthetic opioids, and methadone decreased between 2018 and 2019 the rate of overdose deaths involving synthetic opioids other than methadone continued to increase.

2018 data showing only minor progress after decades of worsening trends, provisional drug overdose data showing an 18% increase over the last 12 months, and the recent CDC Health Alert Network notice on early 2020 increases in fatal drug overdoses driven by synthetic opioids all underscore the continued impact of the deaths of despair crisis and how the COVID-19 pandemic has further diminished the mental health and well-being of many Americans.

“These 2019 overdose rates and the outlook for 2020 are extremely alarming and the result of insufficient prioritization and investment in the well-being and health of Americans for decades,” said John Auerbach, President and CEO of the Trust for America’s Health. “As we work to recover from the COVID-19 pandemic, we must take a comprehensive approach that includes policies and programs that help Americans currently struggling and target upstream root causes, like childhood trauma, poverty and discrimination in order to help change the trajectory of alcohol, drug, and suicide deaths in the upcoming decades.”

Over the last five years, Trust for America’s Health (TFAH) and Well Being Trust (WBT) have released a series of reports on “deaths of despair” called Pain in the Nation: The Drug, Alcohol and Suicides Epidemics and the Need for a National Resilience Strategy, which include data analysis and recommendations for evidence-based policies and programs that federal, state, and local officials.

“If leaders don’t act now to stymie America’s mental health and addiction crises, next year’s data will easily surpass the astounding numbers we’re seeing today,” said Dr. Benjamin F. Miller, PsyD, Chief Strategy Officer at Well Being Trust. “Overdose deaths can be prevented if individuals who are struggling are able to access the appropriate services and supports – and with greater demonstrated success if the care individuals receive is rooted in their immediate communities.”

 

Drug Overdose Deaths, 1999-2019 (Rates age-adjusted)

Year Deaths Deaths per 100,000
1999 16,849 6.1
2000 17,415 6.2
2001 19,394 6.8
2002 23,518 8.2
2003 25,785 8.9
2004 27,424 9.4
2005 29,813 10.1
2006 34,425 11.5
2007 36,010 11.9
2008 36,450 11.9
2009 37,004 11.9
2010 38,329 12.3
2011 41,340 13.2
2012 41,502 13.1
2013 43,982 13.8
2014 47,055 14.7
2015 52,404 16.3
2016 63,632 19.8
2017 70,237 21.7
2018 67,367 20.7
2019 70,630 21.6

 Sources:
CDC – NCHS – National Center for Health Statistics
https://emergency.cdc.gov/han/2020/han00438.asp
https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm

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About Trust for America’s Health
Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority. Twitter: @HealthyAmerica1

 

About Well Being Trust
Well Being Trust is a national foundation dedicated to advancing the mental, social, and spiritual health of the nation. Created to include participation from organizations across sectors and perspectives, Well Being Trust is committed to innovating and addressing the most critical mental health challenges facing America, and to transforming individual and community well-being. www.wellbeingtrust.org Twitter: @WellBeingTrust

 

Policymakers and Health Systems Must Earn Trust within Communities of Color and Tribal Nations to Ensure COVID-19 Vaccine Receptivity, Say Health and Public Health Leaders

Policy brief calls for building vaccine acceptance in communities of color and tribal communities through data transparency, tailored communications via trusted messengers, ensuring ease of vaccine access and no out-of-pocket costs

(Washington, DC – Dec. 21, 2020) – A woeful history of maltreatment of communities of color and tribal nations by government and the health sector, coupled with present day marginalization of these communities by the healthcare system, are the root of vaccine distrust among those groups, according to a policy brief, Building Trust in and Access to a COVID-19 Vaccine Among People of Color and Tribal Nations released today by Trust for America’s Health (TFAH) and co-authors the National Medical Association (NMA) and UnidosUS.

This historic maltreatment, coupled with current day structural racism, has played out in COVID-19’s disproportionate impact on communities of color and tribal communities. These factors also make ensuring vaccine receptivity and access within those communities challenging and of critical importance to protecting lives and ending the pandemic.

In October 2020, TFAH, NMA and UnidosUS hosted a policy convening with 40 leading health equity, healthcare, civil rights, and public health organizations. The purpose of the convening was to advise policymakers on the barriers to vaccine receptivity within communities of color and tribal communities and how to overcome those barriers.

“Earning trust within communities of color and tribal communities will be critical to the successful administration of the COVID-19 vaccine. Doing so will require prioritizing equity, ensuring that leaders from those communities have authentic opportunities to impact vaccine distribution and administration planning, and, the resources to fully participate in supporting vaccine outreach, education and delivery in their communities,” said Dr. J. Nadine Gracia, Executive Vice President and COO of Trust for America’s Health.

The convening created recommendations for policy actions that should be taken immediately within six key areas:

Ensure the scientific fidelity of the vaccine development process.

  • HHS and vaccine developers should release all available vaccine data at frequent and regular intervals to improve transparency and increase confidence in the vaccine evaluation process. Leadership at FDA and HHS must commit to advancing any vaccine only after it has been validated based on established federal and scientific protocols. Programs to monitor for adverse events must also be in place and transparent. Any perception of bypassing safety measures or withholding information could derail a successful vaccination effort.
  • FDA should engage health and public health professional societies, particularly those representing healthcare providers of color, local public health officials, as well as other stakeholders with a role in vaccination, and allow these groups to validate all available data, review the vaccine development and approval process, and issue regular updates on data to their patients, members, and the public.

 Equip trusted community organizations and networks within communities of color and tribal nations to participate in vaccination planning, education, delivery and administration.  Ensure their meaningful engagement and participation by providing funding.

  • Congress should fund CDC and its state, local, tribal, and territorial partners to provide training, support, and financial resources for community-based organizations to join in vaccination planning and implementation, including community outreach, training of providers, and participation in vaccination clinics. State, local, tribal, and territorial authorities should authentically engage and immediately begin vaccination planning with community-based organizations, community health workers/promotores de salud, faith leaders, educators, civic and tribal leaders, and other trusted organizations outside the clinical healthcare setting as key, funded partners.

Provide communities the information they need to understand the vaccine, make informed decisions, and deliver messages through trusted messengers and pathways.

  • Congress should provide at least $500 million to CDC for outreach, communication, and educational efforts to reach priority populations in order to increase vaccine confidence and combat misinformation. All communications must be culturally and linguistically appropriate and tailored as much as possible to reach diverse populations as well as generations within groups.
  • FDA and CDC should initiate early engagement with diverse national organizations and provide funding and guidance for state, local, tribal, and territorial planners to help shape messaging and engage locally with healthcare providers in communities of color and tribal communities, such as nurses, pharmacists, promotores de salud, community health workers, and others to ensure they have the information they need to feel comfortable recommending the vaccine to their patients. Congress and HHS should provide funding for training and engagement of trusted non-healthcare communicators to help shape messaging and to train informal networks, civic and lay leaders, and other trusted community leaders and community-based organizations to answer questions and encourage vaccination.
  • All messaging about the vaccine must be appropriate for all levels of health literacy. Communication should be realistic and clear about timelines and priority groups (and the rationale for these decisions), vaccine effectiveness, types of vaccines, the number of doses, costs, and the need for ongoing public health protections. Planners must provide information that meets people where they are (e.g., barber shops, bodegas, grocery stores, places of worship, etc.) and ensure that trusted messengers in those places have the information they need to be credible and authentic spokespeople.

 

Ensure that it is as easy as possible for people to be vaccinated. Vaccines must be delivered in community settings that are trusted, safe and accessible.

  • We urge the administration and Congress to appropriate the resources necessary to expand and strengthen federal, state, local, territorial, and tribal capacity for a timely, comprehensive, and equitable COVID-19 vaccination planning, communications, distribution, and administration campaign, including funding to support vaccine distribution at the local level and by community-based organizations.
  • Congress and HHS should allocate funding to increase access to vaccination services to ensure that people seeking to be vaccinated do not experience undue increased exposure to the virus as they travel to, move through, and return home from vaccination sites. Flexibility in funding is needed to enable transport of people to vaccination sites, increase accessibility to people without cars, and promote safety and minimize exposure at vaccination locations. Funding should also be provided to health and community-based agencies to assist those for whom transportation or childcare costs are an obstacle to receipt of the vaccine.
  • Planners should ensure that vaccination sites are located in areas that have borne a disproportionate burden of COVID-19, especially leveraging community-based organizations such as Federally Qualified Health Centers, community health centers, rural health centers, schools and places of worship. Mobile services will be particularly important in rural areas. Planners should prioritize congregate living facilities, such as long-term care, prisons, and homeless shelters. In addition, some families, displaced by the COVID economic fallout, may be living with relatives. Planners should ensure vaccination sites have services that meet the Americans with Disabilities Act (ADA) and HHS Office for Civil Rights (OCR) standards for disability and language access.
  • Federal state, local, tribal, and territorial officials must guarantee and communicate with the public that immigration status is not a factor in people’s ability to receive the vaccine and that immigration status is not collected or reported by vaccination sites/providers. Similarly, the presence of law enforcement officers or military personnel could be a deterrent for vaccination at locations, so planners should consider other means of securing sites.
  • In the initial phase, as communities vaccinate healthcare workers, planners must be sure to prioritize home health, long-term care, and other non-hospital-based healthcare workers, who are more likely to be people of color. Other essential workers that comprise large numbers of workers who are people of color and should be treated as within the vaccination priority groups are the food service industry, farmworkers and public transportation employees.

Ensure complete coverage of the costs associated with the vaccine incurred by individuals, providers of the vaccine, and state/local/tribal/territorial governments responsible for administering the vaccine and communicating with their communities about it.

  • Congress, the Centers for Medicare and Medicaid Services, and private payers must guarantee that people receiving the vaccine have zero out-of-pocket costs for the vaccine, related health care visits, or any adverse events related to the vaccine, regardless of their health insurance status.
  • HHS, with emergency funding from Congress, should provide funding so that state, local, tribal, and territorial governments do not bear any cost of vaccine communication efforts, working with their communities, organizing sites, training their staff, and providing personal protective equipment (PPE).

 Congress must provide additional funding and require disaggregated data collection and reporting by age, race, ethnicity, gender identity, primary language, disability status, and other demographic factors on vaccine trust and acceptance, access, vaccination rates, adverse experiences, and ongoing health outcomes.

  • CDC, and state, local, tribal, and territorial authorities should include leaders from communities of color and tribal communities and to plan on-going data collection on vaccination efforts, interpret data, add cultural context, share data with communities, and determine implications and next steps.
  • CDC, and state, local, tribal, and territorial authorities should use these data to inform ongoing prioritization of vaccine distribution and rapidly address gaps in vaccination that may arise among subpopulations by race, ethnicity, neighborhood, or housing setting.

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Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority. Twitter: @healthyamerica1

 

Healthy People 2030

(Washington, D.C. – September 30, 2020)

On August 18, 2020, the U.S. Department of Health and Human Services (HHS) released Healthy People 2030 – the 5th iteration of the nation’s 10-year plan that sets data-driven objectives and targets to improve health and well-being in the United States. Updated every decennial since 1980, Healthy People 2030 builds on the knowledge gained and lessons learned to address the nation’s most critical public health priorities and challenges.

Healthy People 2030 includes 355 objectives in alignment with five overreaching goals. These goals include:

  • Attain healthy, thriving lives and well-being free of preventable disease, disability, injury, and premature death.
  • Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all.
  • Create social, physical, and economic environments that promote attaining the full potential for health and well-being for all.
  • Promote healthy development, healthy behaviors, and well-being across all life stages.
  • Engage leadership, key constituents, and the public across multiple sectors to take action and design policies that improve the health and well-being of all.

Healthy People 2030 also includes prioritizing 10-year measurable targets for objectives related to the social determinants of health – which include economic stability, education, health care access, neighborhoods and the built environment, and social and community environments. For example, related to economic stability and food insecurity, HHS wants to reduce household food insecurity by 5 percent over the next 10 years (11.1 percent of households were food insecure in 2018).

“Healthy People 2030 aligns with many of Trust for America’s Health’s priorities around health conditions such as diabetes and obesity; health behaviors such as vaccination and drug and alcohol use; population-level health for groups such as older adults; systems such as public health infrastructure and preparedness for emerging public health threats like COVID-19; and the social determinants of health,” said John Auerbach, President, and CEO at Trust for America’s Health.

“It provides a framework of measurable objectives to evaluate the change that needs to occur to achieve optimal health and well-being for every person and community. COVID-19 is the most current example that demonstrates the longstanding disproportionate health and economic impacts faced by Black, Indigenous, and people of color along with other marginalized communities. Together, public health must work with multiple sectors to advance equitable policies that address these social and economic disparities, and work towards achieving the goals of Healthy People 2030.”

For more information, visit Healthy People 2030.

La tasa de obesidad en adultos de EE. UU. Supera el 42 por ciento; el más alto jamás registrado

Tener obesidad es un factor de riesgo de consecuencias graves durante el COVID; La pandemia podría aumentar los niveles de obesidad en el futuro debido al aumento de la inseguridad alimentaria.

(Washington, DC – September 17, 2020) – La tasa de obesidad en adultos de los Estados Unidos superó la marca del 40 por ciento por primera vez, situándose en 42,4 por ciento, según el reporte  State of Obesity: Better Policies for a Healthier America, publicado hoy por Trust for America’s Health (TFAH). La tasa nacional de obesidad en adultos ha aumentado en un 26 por ciento desde el 2008.

El informe, basado en parte en los datos recientemente publicados en el 2019 del Sistema de Vigilancia de Factores de Riesgo del Comportamiento (BFRSS) de los Centros para el Control y la Prevención de Enfermedades (BFRSS) y el análisis de TFAH, proporciona anualmente las tasas de sobrepeso y obesidad en todo el país, incluso por edad, raza y estados de residencia.

Las tendencias demográficas y las condiciones de vida de las personas tienen un gran impacto en su capacidad para mantener un peso saludable. Generalmente, los datos muestran que cuanto más gana una persona, es menos probable que tenga obesidad. Las personas con menos educación también tienen más probabilidades de tener obesidad. Las comunidades rurales tienen tasas más altas de obesidad y obesidad severa que las áreas suburbanas y metropolitanas.

Factores socioeconómicos como la pobreza y la discriminación han contribuido a tasas más altas de obesidad entre ciertas poblaciones raciales y étnicas. Los adultos afroamericanos tienen el nivel más alto de obesidad adulta a nivel nacional con un 49,6 por ciento; esa tasa es impulsada en gran parte por una tasa de obesidad adulta entre las mujeres negras del 56,9 por ciento. Los adultos latinos tienen una tasa de obesidad del 44,8 por ciento. La tasa de obesidad para los adultos blancos es del 42,2 por ciento. Los adultos asiáticos tienen una tasa de obesidad general del 17,4 por ciento.

La obesidad y su impacto en la salud, incluidos los riesgos de COVID-19

La obesidad tiene serias consecuencias para la salud, incluyendo un mayor riesgo de diabetes tipo 2, presión arterial alta, aturdimiento y muchos tipos de cánceres. Se estima que la obesidad aumenta el gasto en atención médica en $ 149 mil millones al año (aproximadamente la mitad de los cuales son pagados por Medicare y Medicaid) y el sobrepeso y la obesidad es la razón más común por la que los adultos jóvenes no son elegibles para el servicio militar. Las preocupaciones sobre el impacto de la obesidad han adquirido nuevas dimensiones este año, ya que tener obesidad es una de las condiciones de salud subyacentes asociadas con las consecuencias más graves de la infección por el COVID, incluidas la hospitalización y la muerte. Estos nuevos datos significan que el 42 por ciento de todos los estadounidenses tienen un mayor riesgo de sufrir impactos graves, posiblemente fatales, en la salud por el COVID-19 debido a su peso y las condiciones de salud relacionadas con la obesidad.

“Para resolver la crisis de obesidad del país será necesario abordar las condiciones de la vida de las personas que conducen a la inseguridad alimentaria y crean obstáculos para tener mejores opciones de alimentos saludables y la actividad física segura. Esas condiciones incluyen pobreza, desempleo, viviendas segregadas y discriminación racial ”, dijo John Auerbach, presidente y director ejecutivo de Trust for America’s Health. “La pandemia de este año ha demostrado que estas afecciones no solo aumentan el riesgo de obesidad y enfermedades crónicas, sino que también aumentan el riesgo de los resultados más graves del COVID”.

La obesidad infantil también va en aumento

Las tasas de obesidad infantil también están aumentando según los últimos datos que muestran que el 19,3 por ciento de los jóvenes estadounidenses, de 2 a 19 años, tienen obesidad. A mediados de la década de 1970, el 5,5 por ciento de los jóvenes tenía obesidad. Tener sobrepeso u obesidad en la juventud los pone en mayor riesgo de tener obesidad y los riesgos para la salud relacionados en la edad adulta. Además, los niños presentan un inicio más temprano de lo que solían considerarse afecciones adultas, como la hipertensión y el colesterol alto.

Doce estados tienen tasas de obesidad en adultos superiores al 35 por ciento

Las tasas de obesidad varían considerablemente entre los estados y regiones del país. Mississippi tiene la tasa de obesidad adulta más alta del país con un 40,8 por ciento y Colorado tiene la más baja con un 23,8 por ciento. Doce estados tienen tasas de adultos superiores al 35 por ciento, son: Alabama, Arkansas, Indiana, Kansas, Kentucky, Luisiana, Michigan, Mississippi, Oklahoma, Carolina del Sur, Tennessee y Virginia Occidental. Recientemente en el 2012, ningún estado tenía una tasa de obesidad en adultos superior al 35 por ciento; en el 2000 ningún estado tenía una tasa de obesidad en adultos superior al 25 por ciento.

Inseguridad alimentaria y su relación con la obesidad

El informe incluye una sección especial sobre la inseguridad alimentaria y su relación con la obesidad. La inseguridad alimentaria está relacionada con dietas de menor calidad y con niveles más altos de obesidad en muchos grupos de población. La inseguridad alimentaria está estrechamente vinculada a las condiciones económicas. Hubo niveles más altos de inseguridad alimentaria durante la crisis financiera del 2008-2009 y los primeros datos indican un gran aumento en el número de familias estadounidenses que están experimentando inseguridad alimentaria debido a la crisis del COVID-19. Según los datos de la encuesta de la Oficina del Censo de los Estados Unidos, el 25 por ciento de todos los encuestados y el 30 por ciento de los encuestados con niños informaron haber experimentado inseguridad alimentaria entre abril y junio de este año.

Resolver la crisis de la obesidad requerirá iniciativas multisectoriales y cambios de política

El informe incluye recomendaciones sobre la mejor manera de abordar la crisis de la obesidad basada en dos principios: 1) la necesidad de un enfoque multisectorial y multidisciplinario y 2) un enfoque en los grupos de población que se ven afectados de manera desproporcionada por la crisis de la obesidad.

Las recomendaciones incluyen:

  • Debido a que la emergencia de salud pública del COVID-19 continúa vigente, continuar con las exenciones de políticas de nutrición del Departamento de Agricultura (USDA) y expandir las comidas escolares sin costo para todos los estudiantes inscritos durante todo el año escolar 2020-2021.
  • Aumentar los fondos para permitir la expansión de los programas críticos de prevención de la obesidad de los CDC, incluido el Programa Estatal de Actividad Física y Nutrición y el programa Enfoques Raciales y Étnicos para la Salud Comunitaria.
  • Ampliar los beneficios en el Programa de Asistencia de Nutrición Suplementaria (SNAP, anteriormente conocido como “cupones de alimentos”) al aumentar los niveles máximos de beneficios, extender Pandemic-EBT (P-EBT) para estudiantes y niños, duplicar las inversiones en SNAP-Ed y encontrar formas voluntarias de mejorar la calidad de la dieta sin perjudicar el acceso o los niveles de beneficios.
  • Incentivar las empresas y el uso de la tierra pública para aumentar las opciones de alimentos saludables y lugares seguros para hacer actividad física.
  • Desincentivar las opciones de alimentos poco saludables cerrando los vacios fiscales y eliminando las deducciones de costos comerciales relacionadas con la publicidad de alimentos y bebidas poco saludables para los niños y promulgando impuestos a las bebidas azucaradas donde los ingresos fiscales se asignan a los esfuerzos locales para reducir las disparidades socioeconómicas y de salud.
  • Alentar a Medicaid a cubrir los programas pediátricos de control de peso para todos los beneficiarios elegibles.

 

El texto completo del informe está disponible

La Fundación Robert Wood Johnson proporcionó apoyo para la serie de Informes sobre el estado de la obesidad. Las opiniones expresadas en este informe no reflejan necesariamente la opinión de la Fundación.

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Trust for America’s Health es una organización no partidista sin fines de lucro que promueve una salud óptima para cada persona y comunidad y hace de la prevención de enfermedades y lesiones una prioridad nacional.

U.S. Adult Obesity Rate Tops 42 Percent; Highest Ever Recorded

Having obesity is a risk factor for serious COVID consequences; pandemic could increase future levels of obesity due to increased food insecurity

(Washington, DC – September 17, 2020) – The U.S. adult obesity rate passed the 40 percent mark for the first time, standing at 42.4 percent, according to State of Obesity: Better Policies for a Healthier America released today by Trust for America’s Health (TFAH).  The national adult obesity rate has increased by 26 percent since 2008.

The report, based in part on newly released 2019 data from the Centers for Disease Control and Prevention’s Behavioral Risk Factors Surveillance System (BFRSS) and analysis by TFAH, provides an annual snapshot of rates of overweight and obesity nationwide including by age, race and state of residence.

Demographic trends and the conditions in people’s lives have a large impact on their ability to maintain a healthy weight.  Generally, the data show that the more a person earns the less likely they are to have obesity.  Individuals with less education were also more likely to have obesity. Rural communities have higher rates of obesity and severe obesity than do suburban and metro areas.

Socioeconomic factors such as poverty and discrimination have contributed to higher rates of obesity among certain racial and ethnic populations.  Black adults have the highest level of adult obesity nationally at 49.6 percent; that rate is driven in large part by an adult obesity rate among Black women of 56.9 percent.  Latinx adults have an obesity rate of 44.8 percent.  The obesity rates for white adults is 42.2 percent.  Asian adults have an overall 17.4 percent obesity rate.

Obesity and its impact on health including COVID-19 risks

Obesity has serious health consequences including increased risk for type 2 diabetes, high blood pressure, stroke and many types of cancers. Obesity is estimated to increase healthcare spending by $149 billion annually (about half of which is paid for by Medicare and Medicaid) and being overweight or having obesity is the most common reason young adults are ineligible for military service. Concerns about the impact of obesity have taken on new dimensions this year as having obesity is one of the underlying health conditions associated with the most serious consequences of COVID infection, including hospitalization and death. These new data mean that 42 percent of all Americans are at increased risk of serious, possibly fatal, health impacts from COVID-19 due to their weight and health conditions related to obesity.

“Solving the country’s obesity crisis will require addressing the conditions in people’s lives that lead to food insecurity and create obstacles to healthy food options and safe physical activity.  Those conditions include poverty, unemployment, segregated housing and racial discrimination,” said John Auerbach, President and CEO of Trust for America’s Health. “This year’s pandemic has shown that these conditions don’t only increase the risk of obesity and chronic illnesses, they also increase the risk of the most serious COVID outcomes.”

Childhood obesity also on the rise

Rates of childhood obesity are also increasing with the latest data showing that 19.3 percent of U.S. young people, ages 2 to 19, have obesity. In the mid-1970s, 5.5 percent of young people had obesity.  Being overweight or having obesity as a young person puts them at higher risk for having obesity and its related health risks as an adult. Furthermore, children are exhibiting earlier onset of what used to be considered adult conditions, including hypertension and high cholesterol.

Twelve states have adult obesity rates above 35 percent

Obesity rates vary considerably between states and regions of the country.  Mississippi has the highest adult obesity rate in the country at 40.8 percent and Colorado has the lowest at 23.8 percent.  Twelve states have adult rates above 35 percent, they are: Alabama, Arkansas, Indiana, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Oklahoma, South Carolina, Tennessee and West Virginia.  As recently as 2012, no state had an adult obesity rate above 35 percent; in 2000 no state had an adult obesity rate above 25 percent.

Food insecurity and its relationship to obesity

The report includes a special section on food insecurity and its relationship to obesity. Food insecurity is linked to lower quality diets and tracks with higher levels of obesity in many population groups. Food insecurity is closely linked to economic conditions. There were higher levels of food insecurity during the 2008-2009 financial crisis and early data indicate a large increase in the number of American families experiencing food insecurity due to the COVID-19 crisis. According to U.S. Census Bureau survey data, 25 percent of all respondents and 30 percent of respondents with children, reported experiencing food insecurity between April and June of this year.

Solving the obesity crisis will require multi-sector initiatives and policy change

The report includes recommendations on how best to address the obesity crisis grounded in two principles: 1) the need for a multi-sector, multi-disciplinary approach, and 2) a focus on those population groups that are disproportionately impacted by the obesity crisis.

Recommendations include:

  • While the COVID-19 public health emergency continues to be in place, continue USDA nutrition policy waivers and expand no-cost school meals to all enrolled students for the entire 2020-2021 school year.
  • Increase funding to allow for the expansion of critical CDC obesity-prevention programs including the State Physical Activity and Nutrition Program and the Racial and Ethnic Approaches to Community Health program.
  • Expand benefits in the Supplemental Nutrition Assistance Program (SNAP, formerly known as “food stamps”) by raising maximum benefit levels, extending Pandemic-EBT (P-EBT) for students and children, doubling investments in SNAP-Ed, and finding innovative, voluntary ways to improve diet quality without harming access or benefit levels.
  • Incentivize businesses and public land use to increase access to healthy food options and safe places to be physically active.
  • Disincentivize unhealthy food choices by closing tax loopholes and eliminating business-cost deductions related to the advertising of unhealthy food and beverages to children and by enacting sugary drink taxes where tax revenue is allocated to local efforts to reduce health and socioeconomic disparities.
  • Encourage Medicaid to cover pediatric weight-management programs for all eligible beneficiaries.

 

 

Report Full Text

 

Support for the State of Obesity report series was provided by the Robert Wood Johnson Foundation. The views expressed in this report do not necessarily reflect the view of the Foundation.

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