State Category: West Virginia

Tasas de obesidad en Estados Unidos con altos récords históricos

Nueve estados alcanzan tasas de obesidad en adultos superiores al 35 por ciento

El Reporte demanda por Impuestos para las Bebidas Azucaradas, Programas Ampliados de Apoyo Nutricional SNAP y WIC y un entorno que fomente la actividad física para ayudar a abordar la crisis de salud

(Washington, DC) – 12 de septiembre de 2019 – Nueve estados de EE. UU. Tenían tasas de obesidad en adultos superiores al 35 por ciento en 2018, en comparación con siete estados en ese nivel en 2017, un nivel histórico de obesidad en los EE. UU., Según el 16 ° Estado anual de Obesidad: mejores políticas para un informe más saludable de América publicado hoy por el Trust for America’s Health (TFAH).

El informe basado en parte en datos recientemente publicados del Sistema de Vigilancia del Factor de Riesgo del Comportamiento (BRFSS, por su sigla en ingles) de los Centros para el Control y la Prevención de Enfermedades, y el análisis realizado por TFAH, proporciona las tasas de obesidad anuales en todo el país. La serie El estado de la obesidad y este informe fueron posibles gracias a el financiamiento de la Fundación Robert Wood Johnson.

La obesidad tiene graves consecuencias para la salud, incluido un mayor riesgo de diabetes tipo 2, presión arterial alta, accidente cerebrovascular y muchos tipos de cáncer. Se estima que la obesidad aumenta el gasto nacional en atención médica en $ 149 billones anuales (aproximadamente la mitad de lo cual es pagado 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 tasas de obesidad varían considerablemente entre los estados, con Mississippi y West Virginia con el nivel más alto de obesidad en adultos en la nación con 39.5 por ciento y Colorado con la tasa más baja con 23.0 por ciento.

Por primera vez, las tasas de obesidad en adultos superaron el 35 por ciento en nueve estados en 2018: Alabama, Arkansas, Iowa, Kentucky, Louisiana, Mississippi, Missouri, Dakota del Norte y Virginia Occidental.

No muy lejos atrás en el 2012, ningún estado tenía una tasa de obesidad en adultos superior al 35 por ciento y en los últimos cinco años (2013 y 2018) 33 estados tuvieron incrementos estadísticamente significativos en sus tasas de obesidad en adultos.

“Estos últimos datos indican que nuestra crisis nacional de obesidad está empeorando”, dijo John Auerbach, presidente y director ejecutivo de Trust for America’s Health. “Nos dicen que casi 50 años después de la curva ascendente de las tasas de obesidad todavía no hemos encontrado la combinación correcta de programas para detener la epidemia”. Los programas aislados y los llamados a cambios en el estilo de vida no son suficientes. En cambio, nuestro informe destaca los cambios fundamentales que se necesitan en las condiciones sociales y económicas que hacen que sea difícil para las personas comer alimentos saludables y hacer suficiente ejercicio “.

Impacto diferencial entre las poblaciones minoritarias

El informe destaca que los niveles de obesidad están estrechamente vinculados a las condiciones socioeconómicas. Las personas con ingresos más bajos están más en riesgo. Las comunidades de color, que tienen más probabilidades de vivir en vecindarios con pocas opciones de alimentos saludables y actividad física, y que a menudo son el objetivo de una comercialización generalizada de alimentos poco saludables, también tienen un riesgo elevado.

A partir de 2015-2016, casi la mitad de los adultos latinos (47 por ciento) y los adultos negros (46.8) tenían obesidad, mientras que las tasas de obesidad entre adultos blancos y asiáticos fueron de 37.9 por ciento y 12.7 por ciento respectivamente. La incidencia de obesidad también fue más alta entre los niños latinos con un 25.8 por ciento, mientras que el 22 por ciento de los niños negros tienen obesidad, el 14 por ciento de los niños blancos tienen obesidad y el 11 por ciento de los niños asiáticos tienen obesidad.

¿Qué podría funcionar?

Si bien las tasas de obesidad son alarmantes, hay nuevos datos que ofrecen la promesa de políticas que combaten la obesidad, como promover alimentos más saludables para los niños a través de paquetes de alimentos renovados de WIC y fomentar el cambio de comportamiento a través de impuestos sobre las bebidas azucaradas.

  • Las tasas de obesidad para los niños inscritos en WIC (Programa Especial de Nutrición Suplementaria para Mujeres, Bebés y Niños) continúa disminuyendo, de 15.9 por ciento en 2010 a 13.9 por ciento en 2016. En 2009, el Departamento de Agricultura de los Estados Unidos (USDA, por su siglas en inglés) actualizó los paquetes de alimentos de WIC para cumplir más estrechamente con las recomendaciones nacionales. pautas dietéticas que incluyen la adición de más frutas, verduras y granos integrales y niveles reducidos de grasa en la leche y la fórmula infantil. Un estudio del condado de Los Ángeles publicado este año encontró que los niños de 4 años que habían recibido el paquete de alimentos WIC revisado desde su nacimiento habían reducido los riegos de padecer obesidad.
  • Varias ciudades de EE. UU. Y la Nación Navajo han aprobado impuestos locales sobre las bebidas azucaradas que se muestran prometedoras como un medio para cambiar los hábitos de bebidas de los consumidores. Los estudios de un impuesto de 1 centavo por onza en Berkeley, California y un impuesto de 1,5 centavos por onza en Filadelfia, Pensilvania, encontraron que el consumo de bebidas azucaradas disminuyó significativamente después de la imposición del impuesto.

“Políticas como estas están demostrando ser efectivas para cambiar el comportamiento. Pero, ninguna solución única, por prometedora que sea, es suficiente. La obesidad es un problema complejo y necesitará soluciones multisectoriales y multifactoriales “, dijo Auerbach de TFAH.

“Crear las condiciones que permitan a las personas tomar decisiones saludables con mayor facilidad es fundamental para prevenir la obesidad, al igual que priorizar la inversión en las comunidades más afectadas por la crisis”, dijo Auerbach.

Recomendaciones para la acción política

El informe incluye 31 recomendaciones para la acción política del gobierno federal, estatal y local, en varios sectores, diseñado para mejorar el acceso a alimentos nutritivos y proporcionar oportunidades seguras para la actividad física, al tiempo que minimiza las tácticas perjudiciales de marketing y publicidad.

Entre las recomendaciones del informe para las políticas para abordar la crisis de obesidad están:

  • Ampliar el Programa Especial de Nutrición Suplementaria para Mujeres, Bebés y Niños (WIC) a los 6 años para niños y durante dos años después del parto para las madres y financiar completamente el Programa de Orientación de Pares de WIC para la lactancia materna.
  • Aumentar el precio de las bebidas azucaradas mediante impuestos especiales y utilizar los ingresos para abordar las disparidades socioeconómicas y de salud.
  • Asegurarse de que los CDC tengan los recursos suficientes para otorgar a cada estado fondos apropiados para implementar estrategias de prevención de la obesidad basadas en evidencia (actualmente, los CDC solo tienen fondos suficientes para trabajar con 16 estados).
  • Hacer que sea más difícil comercializar alimentos no saludables para los niños al poner fin a los vacíos fiscales federales y las deducciones de costos comerciales relacionados con la publicidad de dichos alimentos para el público joven.
  • Financiar completamente el programa de Apoyo al Estudiante y Enriquecimiento Académico y otros programas federales que apoyan la educación física del estudiante.
  • Fomentar la actividad física segura mediante la financiación de Rutas Seguras a las Escuelas (SRTS), Complete Streets, Vision Zero y otras iniciativas de seguridad para peatones a través de fondos federales de infraestructura y transporte.
  • Asegurar de que los programas contra el hambre y la asistencia nutricional, como el Programa de Nutrición Suplementaria (SNAP), WIC y otros, sigan las Pautas dietéticas para estadounidenses y hagan del acceso a alimentos nutritivos un principio básico del programa.
  • Fortalecer y expandir los programas de nutrición escolar más allá de los estándares federales para incluir comidas universales, desayunos flexibles y eliminar todo el mercadeo de alimentos poco saludables para los estudiantes.
  • Hacer cumplir las leyes existentes que ordenan a la mayoría de las aseguradoras de salud que cubran los servicios preventivos relacionados con la obesidad sin costo compartido para los pacientes.
  • Cubrir el manejo del programa integral del peso pediátrico basado en evidencia y servicios en Medicaid.

Tasas de obesidad adulta por estado, de mayor a menor:

1. (Empatados): Mississippi and Virginia Occidental (39.5%), Arkansas (37.1%), 4. Louisiana (36.8%), 5. Kentucky (36.6%), 6. Alabama (36.2%), 7. Iowa (35.3%), 8. Dakota del Norte (35.1%), 9. Missouri, (35.0%), 10. – Empatados: Oklahoma and Texas (34.8%), 12. – Empatados: Kansas and Tennessee (34.4%), 14.  Carolina del Sur (34.3 %), 15. – : Indiana and Nebraska (34.1%), 17. Ohio (34.0%), 18. Delaware (33.5%), 19 – Empatados: Michigan, Carolina del Norte (33.0), 21. Georgia (32.5%), 22. Nuevo Mexico (32.3%), 23. Wisconsin (32.0%), 24. Illinois (31.8%), 25. – Empatados: Maryland and Pennsylvania (30.9%), 27. Florida (30.7%), 28 – Empatados: Maine and Virginia (30.4%), 30. Empatados: Minnesota and Dakota del Sur (30.1%), 32. Oregon (29.9 %), 33. New Hampshire (29.6%), 34. Empatados: Alaska, Arizona and Nevada (29.5%), 37. Wyoming (29.0%), 38. Washington (28.7%), 39. Idaho (28.4%), 40. Utah (27.8%), 41. Rhode Island (27.7%), 42. Nueva York (27.6%), 43. Vermont (27.5%), 44. Connecticut (27.4%), 45. Montana (26.9%), 46. California (25.8%), 47. – Empatados: Massachusetts and Nueva Jersey (25.7%), 49. Hawaii (24.9%), 50. Districto de Columbia (24.7%), 51. Colorado (23.0%).

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

 

Half of States Scored 5 or Lower Out of 10 Indicators in Report on Health Emergency Preparedness

Report Finds Funding to Support Base Level of Preparedness Cut More than Half Since 2002

 

Washington, D.C., December 19, 2017 – In Ready or Not? Protecting the Public’s Health from Diseases, Disasters and Bioterrorism, 25 states scored a 5 or lower on 10 key indicators of public health preparedness. Alaska scored lowest at 2 out of 10, and Massachusetts and Rhode Island scored the highest at 9 out of 10.

The report, issued today by the Trust for America’s Health (TFAH), found the country does not invest enough to maintain strong, basic core capabilities for health security readiness and, instead, is in a continued state of inefficiently reacting with federal emergency supplemental funding packages each time a disaster strikes.

According to Ready or Not?, federal funding to support the base level of preparedness has been cut by more than half since 2002, which has eroded advancements and reduced the country’s capabilities.

“While we’ve seen great public health preparedness advances, often at the state and community level, progress is continually stilted, halted and uneven,” said John Auerbach, president and CEO of TFAH.  “As a nation, we—year after year—fail to fully support public health and preparedness. If we don’t improve our baseline funding and capabilities, we’ll continue to be caught completely off-guard when hurricanes, wildfires and infectious disease outbreaks hit.”

Ready or Not? features six expert commentaries from public health officials who share perspectives on and experiences from the historic hurricanes, wildfires and other events of 2017, including from California, Florida, Louisiana and Texas.

The report also examines the nation’s ability to respond to public health emergencies, tracks progress and vulnerabilities, and includes a review of state and federal public health preparedness policies. Some key findings include:

  • Just 19 states and Washington, D.C. increased or maintained funding for public health from Fiscal Year (FY) 2015-2016 to FY 2016-2017.
  • The primary source for state and local preparedness for health emergencies has been cut by about one-third (from $940 million in FY 2002 to $667 million in FY 2017) and hospital emergency preparedness funds have been cut in half ($514 million in FY 2003 to $254 million in FY 2017).
  • In 20 states and Washington, D.C. 70 percent or more of hospitals reported meeting Antibiotic Stewardship Program core elements in 2016.
  • Just 20 states vaccinated at least half of their population (ages 6 months and older) for the seasonal flu from Fall 2016 to Spring 2017—and no state was above 56 percent.
  • 47 state labs and Washington, D.C. provided biosafety training and/or provided information about biosafety training courses (July 1, 2016 to June 30, 2017).

The Ready or Not? report provides a series of recommendations that address many of the major gaps in emergency health preparedness, including:

  • Communities should maintain a key set of foundational capabilities and focus on performance outcomes in exchange for increased flexibility and reduced bureaucracy.
  • Ensuring stable, sufficient health emergency preparedness funding to maintain a standing set of core capabilities so they are ready when needed. In addition, a complementary Public Health Emergency Fund is needed to provide immediate surge funding for specific action for major emerging threats.
  • Strengthening and maintaining consistent support for global health security as an effective strategy for preventing and controlling health crises. Germs know no borders.
  • Innovating and modernizing infrastructure needs – including a more focused investment strategy to support science and technology upgrades that leverage recent breakthroughs and hold the promise of transforming the nation’s ability to promptly detect and contain disease outbreaks and respond to other health emergencies.
  • Recruiting and training a next generation public health workforce with expert scientific abilities to harness and use technological advances along with critical thinking and management skills to serve as Chief Health Strategist for a community.
  • Reconsidering health system preparedness for new threats and mass outbreaks.  Develop stronger coalitions and partnerships among providers, hospitals and healthcare facilities, insurance providers, pharmaceutical and health equipment businesses, emergency management and public health agencies.
  • Preventing the negative health consequences of climate change and weather-related threats. It is essential to build the capacity to anticipate, plan for and respond to climate-related events.
  • Prioritizing efforts to address one of the most serious threats to human health by expanding efforts to stop superbugs and antibiotic resistance. 
  • Improving rates of vaccinations for children and adults – which are one of the most effective public health tools against many infectious diseases.
  • Supporting a culture of resilience so all communities are better prepared to cope with and recover from emergencies, particularly focusing on those who are most vulnerable.   Sometimes the aftermath of an emergency situation may be more harmful than the initial event.  This must also include support for local organizations and small businesses to prepare for and to respond to emergencies.

The report was supported by a grant from the Robert Wood Johnson Foundation (RWJF).

Score Summary: 

A full list of all of the indicators and scores and the full report are available on TFAH’s website.  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.  The data for the indicators are from publicly available sources or were provided from public officials.

9 out of 10: Massachusetts and Rhode Island

8 out of 10: Delaware, North Carolina and Virginia

7 out of 10: Arizona, Colorado, Connecticut, Hawaii, Minnesota, New York, Oregon and Washington

6 out of 10: California, District of Columbia, Florida, Illinois, Maryland, Nebraska, New Jersey, North Dakota, South Carolina, South Dakota, Utah, Vermont and West Virginia

5 out of 10: Georgia, Idaho, Maine, Mississippi, Montana and Tennessee

4 out of 10: Alabama, Arkansas, Iowa, Louisiana, Missouri, New Hampshire, Oklahoma and Pennsylvania

3 out of 10: Indiana, Kansas, Kentucky, Michigan, Nevada, New Mexico, Ohio, Texas, Wisconsin and Wyoming

2 out of 10: Alaska

 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.

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West Virginia Has Highest Obesity Rate Among US Adults

August 31, 2017
by John Raby
Associated Press WVA (In U.S. News & World Report)

The report released Thursday by the Trust for America’s Health and the Robert Wood Johnson Foundation analyzed figures from the Centers for Disease Control and Prevention and found West Virginia had an obesity rate of 37.7 percent. Mississippi was second at 37.3 percent and Alabama and Arkansas were tied for third at 35.7 percent.

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Local Health Officials: Chief Health Strategists Transforming Communities

By Rahul Gupta, Health Officer and Executive Director, Kanawha-Charleston Health Department

 

Just like the rest of the country, West Virginia and Kanawha County has been battling the obesity epidemic for decades. Across the state, there have been a myriad of physical activity, nutrition and other initiatives focused on helping people get to and remain at a healthy weight.

However, when these obesity prevention programs came in, there was a huge problem with sustainability so after a few years a program would lose funding and disappear. Quickly, residents saw these programs as fads or simply flashes in the pan. A lot of communities around the state felt kind of used, they were put into a program and researched and when the grant was up, the program was gone and, with it, the support, incentives and staffing. There was nothing built into the infrastructure of the community so there was no capacity left to sustain the process.

Clearly, as obesity rates and chronic conditions like diabetes continue to increase, this incremental, start and stop approach has failed. Realizing this early on, our community created an independent Health Coalition in Kanawha County that included the local hospitals, K-12 education systems, higher education, business and other people who had a stake and roots in our community. While health and wellbeing is a personal responsibility, it is the local, state and national government’s job to provide easy outlets for citizens to reach their goals.

The founding idea of the coalition was that if there are challenges facing the community, they will be brought to the coalition and they will be solved and resources will be dedicated by partner agencies.

As the coalition’s benefits to the community became apparent, it was obvious that the state needed more of these county-level coalitions across West Virginia.

Transforming Communities

When the CTG program was launched in May, 2011, we saw this as an opportunity to obtain the kind of resources and support that could stand up programs and capacity which would then remain in place after grant dollars disappeared.

The CTGs made it even easier to bring stakeholders and institutions to a common table to talk about health. At the outset, we had over 100 organizations interested in being part of transforming the state and local communities.

As we learned our lesson from past grants and programs, we weren’t going to let everyone get their piece of the CTG pie and go home in a silo. We wanted to ensure that each community worked with each other as well as across the traditional silos, so efforts were complimentary, not duplicative. It became evident that the best conduit for the grant money and ideas to flow was through Local Health Departments (LHDs). Our plan was to position the LHDs from all 55 counties as wellness or healthy living hubs for their communities. They would work with the local and state Departments of Education, West Virginia’s Universities and the Osteopathic School to ensure plans would work and were research driven and connected to clinical settings.

While it might not seem like a huge shift, this was a culture change in how resources and grants were distributed across the state. Instead of each LHD getting their money and going home, it was clear the funding was to build capacity, i.e., the resources and ability to do things — sort of how it’s better to teach a man to fish than simply give him a fish. LHDs were also the natural lead because they were trusted voices in the community and, quite simply, they weren’t going anywhere. Every day, in each community across West Virginia (and across the nation, for that matter) local health employees serve to carry out and accomplish the basic public health needs of their jurisdictions.

As a result, our communities are safer, healthier and protected from deadly diseases. Once we had the framework in place, we went back to communities to understand their needs.

Every three years, our county coalition conducts a needs assessment, which includes telephone surveys, focus groups, and key informant surveys.

A community forum, which is open to the public, is held to prioritize the top three health concerns in the county. Once identified, work groups are formed to address these health concerns over the next three years within the county after which the process recommences with a new needs assessment. Examples of health concerns that our community has asked to address in the past have included high rates of tobacco use including second hand smoke, poor nutritional standard, lack of physical activity and prevalence of substance abuse.

While we haven’t been able to create a statewide Comprehensive Clean Indoor Air Regulation (CIAR), that hasn’t stopped LHDs like Kanawha-Charleston Health Department (KCHD) from creating their own ordinances and enforcing them — it’s great to enact a policy, but the enforcement has to be just as good 

In Kanawha County, our Sanitarians conduct close to 5,000 inspections annually to ensure our CIAR ordinance is enforced and we have a near 100 percent compliance rate. To build support in our community for the ordinance, we took not only a policy approach (discussing the medical benefits of clean air), but also a social/media approach, business approach (showing that it would not hurt bars or restaurants but actually could increase business), and a science and research approach (we demonstrated a 37 percent reduction in heart attack related hospital admission rate in presence of CIAR over eight years — published in CDC’s Preventing Chronic Diseases, July 2011 issue). Every facet of our community became advocates for clean air for different reasons — a one-time tobacco-reliant community transformed into one with clean air.

Meanwhile, at a state level, we continue to work toward enacting a statewide comprehensive law. While it has happened incrementally, the capacity and know-how is there across the state. In fact, our local ordinance has been utilized by the state’s Division of Personnel to implement a state employee policy against second hand smoke. Consequently, the state government, without legislation, has adopted a comprehensive clean indoor air regulation for all state employees, which reaches and benefits thousands of West Virginians.

In addition, in doing our needs assessment, it became clear that people simply didn’t have access to safe places to work out and play. There was a huge barrier on the environmental side in our community: there were no sidewalks and the areas with the largest populations had no options for physical activity. We needed to connect those who wanted to work out with safe places to do so.

In Kanawha County, we built a Physical Activity Sites Google Map (http://www.kchdwv.org/Home/Health-Promotion.aspx). It includes a Google map of all physical activity opportunities in the County as well as tools such as walk score, Everytrail and Gmaps pedometer which can be used on mobile devices. The map empowers people to seek out nearby physical activity outlets. We hope to replicate this model in other counties across the state through CTG.

In addition, we’re looking to improve nutrition and physical activity in school and after-school settings, by, most notably:

  • Farm-to-School Initiatives: We have developed blueprints and guides for county Food Service Directors and farmers, giving them the capacity and knowledge to stand up their own  sustainable programs.
  • Child and Day Care Center Nutrition Programs: We implemented the “Be Choosy, Be Healthy” program, which educates and empowers children to choose healthy lifestyles. We have also expanded the “I am Moving, I am Learning” curriculum, which increases physical activity and promotes healthy food choices.

Lastly, our state is supporting the development of community coordinated care systems that link and build referral networks between the clinical system and community-based lifestyle programs that can help people overcome disease and disability and manage their health. We’ve linked clinicians with programs like Dining with Diabetes, Patient Centered Medical Home pilot initiatives, the National Diabetes Program and Chronic Disease Self-Management Program.

We want programs to be complimentary to clinical practice. If a physician is seeing 30 patients a day that need diabetes/weight loss resources, we need to provide these clinicians with the capacity and information to direct their patients to a referral network outside the doctor’s office. This approach is both time and cost effective and has the potential for healthier outcomes for patients.

West Virginia has worked long and hard to reverse the obesity epidemic. We’ve learned what doesn’t work and we’re beginning to transform our state, community by community. It’s become clear that we need to provide people with the resources to create their own programs and that positioning LHDs as chief health strategists will ensure capacity is maintained and programs continue if grant funding disappears. By ensuring that education, health, commerce and other key stakeholders are responsible for setting and enforcing policy, the entire community truly has a stake in the health and wellbeing of everyone.

Access a PDF of the story here.