The State of Obesity 2016

Better Policies for a Healthier America

State of Obesity is the 13th annual report produced by TFAH and the Robert Wood Johnson Foundation, with support by a grant from RWJF. This edition marks the first time in the past decade that any states have experienced decreases – aside from a decline in n Washington, D.C. in 2010. The report includes annual rates and rankings of adult obesity and obesity rate trends by ethnicity, region, age, gender, education and income.

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, according to The State of Obesity: Better Policies for a Healthier America, a report from TFAH and the Robert Wood Johnson Foundation (RWJF).

This marks the first time in the past decade that any states have experienced decreases – aside from a decline in n Washington, D.C. in 2010.

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 13th 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).

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.

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.
  • American Indian/Alaska Natives have an adult obesity rate of 42.3 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: 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).

In addition, recent national data show that childhood obesity rates have stabilized at 17 percent over the past decade. Rates are declining among 2- to 5-year-olds, stable among 6- to 11-year-olds, and increasing among 12- to 19-year-olds. There are significant racial and ethnic inequities, with rates higher among Latino (21.9 percent) and Black (19.5 percent) children than among White (14.7 percent) children.

Some other 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) (note: does not include sport/energy drinks, diet sodas or water with added sugars).
  • 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).
  • More than 29 million children live in “food deserts,” and more than 15 million children live in “food-insecure” households with not enough to eat and limited access to healthy food.
  • The federal government has provided more than $90 million via 44 Healthy Food Financing Initiative awards in 29 states since 2011, helping leverage more than $1 billion and create 2,500 jobs. Farm-to-School programs now serve more than 42 percent of schools and 23.6 million children.
  • 18 states and Washington, D.C. require a minimum amount of time that elementary students must participate in physical education; 14 states and Washington, D.C. require a minimum amount for middle schoolers; and six states require a minimum amount for high schoolers.

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.”