1. The State of Obesity Better Policies for a Healthier America Jack Rayburn, MPH Senior Government Relations Manager Human Services and Public Safety Policy Committee September 19, 2014 @jjrayburn #StateOfObesity

2. Overview  Adult rates remain high overall, including increases in six states  Significant disparities persist  We’ve seen some progress, particularly with children; however it is uneven and fragile  Future progress will require we examine what is working and bring these efforts to scale nationwide.

3. Adult Obesity (2013)

4. Adult Obesity Trends in 2013  Rates increased in six states Alaska, Delaware, Idaho, New Jersey, Tennessee, Wyoming  Adult obesity (BMI > 30) now exceeds 35% in two states In 1990, only one state exceeded 20%  More than 6% of adults are now severely obese Classified as a BMI of 40 or more Roughly 100 pounds over ideal body weight This rate has quadruped in the past 30 years.

5. Obesity Threatens Our Youth  Childhood obesity rates have tripled since 1980  However, national rates have roughly stabilized over the past 10 years

6. Disparities Persist in 2013  Report contains a special focus this year on racial and ethnic disparities in the epidemic.

7. Disparities Persist in 2013  In fact, the state of the epidemic in 2013 is partially driven by growing disparities:

8. Disparities Persist in 2013  Slightly different disparities among children

9. Racial and Ethnic Disparities  Rates for adult women vary widely among different racial and ethnic groups.

10. Socioeconomic Disparities  33% of adults who earn less than $15,000 per year were obese, versus 25.4% of those who earned at least $50,000 a year.

11. Systems and Environments Contribute

12. Physical Inactivity  State physical activity/inactivity rankings seem to track well with their obesity ranking.

13. Differences Among Age Groups

14. Why are we still concerned?  Despite signs of stabilizing, rates are dangerously high  Obesity increases the risk for dozens of health comorbidities Including type 2 diabetes, various types of cancer, cardiovascular disease, arthritis, etc.  Baby Boomers coming on to Medicare will further exacerbate our long-term fiscal outlook

15. Co-Morbidities  Type-2 diabetes rates have doubled in the past 20 years One-in-three adults will have diabetes by 2050.

16. Yet why are we still concerned? (cont’d)  Obesity carries national security risks. It has negative implications for education, agricultural, transportation sector.  Public health and prevention funding remains inadequate. CDC funding has seesawed but has experienced a net cut ($6.85 billion for FY2014 vs. $7.31 billion in FY2005). 33 states and DC have cut their public health budgets from FY11-12 to FY12-13

17. Yet why are we still concerned? (cont’d)

18. Bringing Initial Steps to Scale  Obesity prevention should be considered a major priority for reducing related health care spending and overall health care costs Community-based, comprehensive approaches (like CDC chronic disease prevention programs) seem to work best.  ROI is critical.

19. Bringing Initial Steps to Scale  Addressing primary risk factors Poor Nutrition Inadequate Physical Activity  Broad, sustainable funding of evidence-based interventions, environmental, and systems changes Investments in Partnerships to Improve Community Health—will not reach all Americans Expanded diabetes and heart disease funding  Connecting all Americans to preventive services and a variety of treatments

20. Areas of Focus  Physical Activity Before, During, and After School  School Foods and Beverages  Healthy Affordable Foods  Food and Beverage Marketing  Farm Bill and Nutrition Policy  Prevention Inside and Outside the Doctor’s Office  Early Care and Education  Transportation Policy  Menu Labeling

21. For Further Information  The full text of The State of Obesity and many other interactive features are available at: http://www.StateofObesity.org  Please contact Jack Rayburn, Senior Government Relations Manager, jrayburn@tfah.org if you have any further questionsjrayburn@tfah.org