1. Prevalence of Self-Reported Obesity Among U.S. Adults by State and Territory Definitions  Obesity: Body Mass Index (BMI) of 30 or higher.  Body Mass Index (BMI): A measure of an adult’s weight in relation to his or her height, calculated by using the adult’s weight in kilograms divided by the square of his or her height in meters.

2. Prevalence of Self-Reported Obesity Among U.S. Adults by State and Territory Source of the Data  The data were collected through the Behavioral Risk Factor Surveillance System (BRFSS), an ongoing, state-based, telephone interview survey conducted by state health departments with assistance from CDC.  Height and weight data used in the BMI calculations were self-reported.

3. Mississippi Heart Disease  MS has highest death rate from CV disease in US  Heart Disease is #1 killer in MS  Stroke is #5 killer in MS  Deaths from heart disease  7,542 from heart disease in 2010  1,520 from stroke in 2010 American Heart Association

4. Prevalence of Self-Reported Obesity Among U.S. Adults by State and Territory BRFSS Methodological Changes Started in 2011  New sampling frame that included both landline and cell phone households.  New weighting methodology used to provide a closer match between the sample and the population.

5. Prevalence of Self-Reported Obesity Among U.S. Adults by State and Territory Exclusion Criteria Used Beginning with 2011 BRFSS Data Records with the following were excluded:  Height: <3 feet or ≥8 feet  Weight: <50 pounds or ≥650 pounds  BMI: <12 kg/m 2 or ≥100 kg/m 2  Pregnant women

6. Source: Behavioral Risk Factor Surveillance System, CDC. Prevalence* of Self-Reported Obesity Among U.S. Adults by State and Territory, BRFSS, 2011 *Prevalence estimates reflect BRFSS methodological changes started in 2011. These estimates should not be compared to prevalence estimates before 2011. 15%–<20% 20%–<25% 25%–<30% 30%–<35% ≥35% CA MT ID NV UT AZ NM WY WA OR CO NE ND SD TX OK KS IA MN AR MO LA MI IN KY IL OH TN MS AL WI PA WV SC VA NC GA FL NY VT ME HI AK PR GUAM NH MA RI CT NJ DE MD DC

7. Source: Behavioral Risk Factor Surveillance System, CDC. 15%–<20% 20%–<25% 25%–<30% 30%–<35% ≥35% Prevalence* of Self-Reported Obesity Among U.S. Adults by State and Territory, BRFSS, 2012 *Prevalence estimates reflect BRFSS methodological changes started in 2011. These estimates should not be compared to prevalence estimates before 2011. CA MT ID NV UT AZ NM WY WA OR CO NE ND SD TX OK KS IA MN AR MO LA MI IN KY IL OH TN MS AL WI PA WV SC VA NC GA FL NY VT ME HI AK NH MA RI CT NJ DE MD DC PR GUAM

8. Source: Behavioral Risk Factor Surveillance System, CDC. 15%–<20% 20%–<25% 25%–<30% 30%–<35% ≥35% Prevalence* of Self-Reported Obesity Among U.S. Adults by State and Territory, BRFSS, 2013 *Prevalence estimates reflect BRFSS methodological changes started in 2011. These estimates should not be compared to prevalence estimates before 2011. CA MT ID NV UT AZ NM WY WA OR CO NE ND SD TX OK KS IA MN AR MO LA MI IN KY IL OH TN MS AL WI PA WV SC VA NC GA FL NY VT ME HI AK NH MA RI CT NJ DE MD DC PR GUAM

9. Prevalence* of Self-Reported Obesity Among U.S. Adults by State and Territory, BRFSS, 2013 Source: Behavioral Risk Factor Surveillance System, CDC. *Prevalence estimates reflect BRFSS methodological changes started in 2011. These estimates should not be compared to prevalence estimates before 2011. StatePrevalenceConfidence Interval Alabama32.4(30.8, 34.1) Alaska28.4(26.5, 30.4) Arizona26.8(24.3, 29.4) Arkansas34.6(32.7, 36.6) California24.1(23.0, 25.3) Colorado21.3(20.4, 22.2) Connecticut25.0(23.5, 26.4) Delaware31.1(29.3, 32.8) District of Columbia22.9(21.0, 24.8) Florida26.4(25.3, 27.4) Georgia30.3(28.9, 31.8) Guam27.0(24.4, 29.8) Hawaii21.8(20.4, 23.2) Idaho29.6(27.8, 31.4) Illinois29.4(27.7, 31.2) Indiana31.8(30.6, 33.1) Iowa31.3(29.9, 32.7) Kansas30.0(29.2, 30.7) Kentucky33.2(31.8, 34.6) Louisiana33.1(31.1, 35.2) Maine28.9(27.5, 30.2) Maryland28.3(27.0, 29.5) Massachusetts23.6(22.5, 24.8) Michigan31.5(30.4, 32.6) Minnesota25.5(24.1, 26.8) Mississippi35.1(33.5, 36.8) StatePrevalenceConfidence Interval Missouri30.4(28.8, 32.1) Montana24.6(23.4, 25.8) Nebraska29.6(28.4, 30.7) Nevada26.2(24.0, 28.6) New Hampshire26.7(25.3, 28.3) New Jersey26.3(25.1, 27.5) New Mexico26.4(25.1, 27.7) New York25.4(24.2, 26.6) North Carolina29.4(28.1, 30.7) North Dakota31.0(29.5, 32.5) Ohio30.4(29.2, 31.6) Oklahoma32.5(31.2, 33.9) Oregon26.5(24.9, 28.1) Pennsylvania30.0(28.9, 31.2) Puerto Rico27.9(26.4, 29.5) Rhode Island27.3(25.8, 28.8) South Carolina31.7(30.5, 33.1) South Dakota29.9(28.0, 31.8) Tennessee33.7(31.9, 35.5) Texas30.9(29.5, 32.3) Utah24.1(23.2, 25.1) Vermont24.7(23.4, 26.1) Virginia27.2(25.9, 28.5) Washington27.2(26.0, 28.3) West Virginia35.1(33.6, 36.6) Wisconsin29.8(28.0, 31.6) Wyoming27.8(26.2, 29.5)

10. Prevalence* of Self-Reported Obesity Among U.S. Adults by State and Territory, BRFSS, 2013 Summary  No state had a prevalence of obesity less than 20%.  7 states and the District of Columbia had a prevalence of obesity between 20% and <25%.  23 states had a prevalence of obesity between 25% and <30%.  18 states had a prevalence of obesity between 30% and <35%.  2 states (Mississippi and West Virginia) had a prevalence of obesity of 35% or greater.  The prevalence of obesity was 27.0% in Guam and 27.9% in Puerto Rico. + http://www.cdc.gov/obesity/data/prevalence-maps.html *Prevalence estimates reflect BRFSS methodological changes started in 2011. These estimates should not be compared to prevalence estimates before 2011. + Guam and Puerto Rico were the only US territories with obesity data available on the 2013 BRFSS.

11. Obesity in MS  35.1% Highest Adult Obesity in the Nation “Heaviest state in the Nation”  MOST IMPORTANT THREAT TO THE HEALTH OF MISSISSIPPIANS (MCOR)  OBESITY IT KILLING MISSISSIPPI: 1 of 3 Adults and increasing  Predisposes us to host of chronic diseases  Hypertension, heart disease, stroke, kidney disease, diabetes and cancer

12. OBESITY IS HURTING MS ECONOMY  An Obese Person generates 40% more in medical cost/yr  2006 MS spent $925 million on health care directly related to OBESITY  Trend at that rate will result in direct health care cost of $3.9 billion by 2018 Obese adults miss more work than lean adults impacting productivity. Obesity hurts MS business competitiveness Mississippi Center for Obesity Research

13. OBESITY is harming MS children  Highest rate of childhood obesity in the Nation  NEARLY HALF OF MS CHILDREN ARE OVERWEIGHT OR OBESE  Children as young as 8 years old are being treated for Type 2 Diabetes and High Cholesterol  Phenomenon UNHEARD of a Decade ago! MS Center for Obesity Research

14. Result of this trend among MS children  FROM MS CENTER FOR OBESITY RESEARCH WEBSITE  “THE IDEA THAT OUR CHILDREN WILL BE SICKER, AND DIE YOUNGER THAN THEIR PARENTS IS UNACCEPTABLE” MS Center for Obesity Research

15. DIABETES  Diabetes costs US about $245 Billion/Yr  About 10% of national health care spending  $175 billion in direct medical cost  $69 billion in reduced worker ability  PROJECTION: pre-diabetes, diabetes and complications will cost 3.35 Trillion dollars over this decade Diabetes Foundation of Mississippi

16. The Burden of Diabetes on Mississippi  2012 12.5% MS adult population reported having diabetes(national average 9.0% (MSHD 2012)  Estimated 373,000 adults in MS have diabetes BUT  Only 280,000 know they have it !!!

17. Diabetes is 6 th leading cause of death is MS  In 1990, 440 death certificates listed diabetes as underlying cause of death  By 2012, 1039 death certificates listed diabetes as underlying cause of death  1 of 10 with Type 2 DM have other serious health problems associated with the disease i.e heart disease, eye damage, kidney disease, foot problems that can lead to amputations Diabetes Foundation of Mississippi

19. Heart Disease Facts  Heart disease is the leading cause of death for both men and women. More than half of the deaths due to heart disease in 2009 were in men. 1  About 610,000 Americans die from heart disease each year—that’s 1 in every 4 deaths. 1  Coronary heart disease is the most common type of heart disease, killing more than 370,000 people annually. 1 1. Kochanek KD, Xu JQ, Murphy SL, Miniño AM, Kung HC. Deaths: final data for 2009[PDF-2M]. National vital statistics reports. 2011;60(3).

20. Heart Disease Facts (cont.)  In the United States, someone has a heart attack every 43 seconds. Each minute, someone in the United States dies from a heart disease-related event. 2  Heart disease is the leading cause of death for people of most racial/ethnic groups in the United States, including African Americans, Hispanics, and whites. For Asian Americans or Pacific Islanders and American Indians or Alaska Natives, heart disease is second only to cancer. 3  Coronary heart disease alone costs the United States $108.9 billion each year. 4 This total includes the cost of health care services, medications, and lost productivity. 2. Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics—2012 update: a report from the American Heart Association http://www.cdc.gov/Other/disclaimer.html. Circulation. 2012;125(1):e2–220.3. Heron M. Deaths: Leading causes for 2008[PDF-2.7M]. National vital statistics reports.2012;60(6).4. Heidenriech PA, Trogdon JG, Khavjou OA, Butler J, Dracup K, Ezekowitz MD, et al. Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association. Circulation. 2011;123(8):933–44.

21. Risk Factors High blood pressure, high LDL cholesterol, and smoking are key heart disease risk factors for heart disease. About half of Americans (49%) have at least one of these three risk factors. 5 Several other medical conditions and lifestyle choices can also put people at a higher risk for heart disease, including:  Diabetes  Overweight and obesity  Poor diet  Physical inactivity  Excessive alcohol use 5. CDC. Million Hearts™: strategies to reduce the prevalence of leading cardiovascular disease risk factors. United States, 2011. MMWR 2011;60(36):1248–51.