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F as in Fat: How Obesity Threatens America's Future

F as in Fat: How Obesity Threatens America's Future

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SEPTEMBER 2012
P
REVENTING
E
PIDEMICS
.P
ROTECTING
P
EOPLE
.
ISSUE REPORT
2012
F as in Fat:
HOW OBESITY THREATENS AMERICAS FUTURE
EMBARGOED UNTIL TUESDAY, SEPTEMBER 18, 2012 AT 10 AM
 
TFAH BOARD OF DIRECTORS
Gail Christopher, DN
President of the Board, TFAH Vice President—Program Strategy 
 WK Kellogg Foundation
Cynthia M. Harris, PhD, DABT
Vice President of the Board, TFAH  Director and Professor 
Institute of Public Health, Florida A&MUniversity 
Theodore Spencer
Secretary of the Board, TFAH Senior Advocate, Climate Center.
Natural Resources Defense Council
Robert T. Harris, MD
Treasurer of the Board, TFAH  Former Chief Medical Officer and Senior Vice President for Healthcare 
BlueCross BlueShield of North Carolina
David Fleming, MD
 Director of Public Health 
Seattle King County, Washington
 Arthur Garson, Jr., MD, MPH
 Director, Center for Health Policy, University Professor,And Professor of Public Health Services 
University of Virginia
 John Gates, JD
 Founder, Operator and Manager 
Nashoba Brook Bakery 
 Alonzo Plough, MA, MPH, PhD
 Director, Emergency Preparedness and Response Program 
Los Angeles County Department of Public Health
Eduardo Sanchez, MD, MPH
Chief Medical Officer 
Blue Cross Blue Shield of Texas
 Jane Silver, MPH
President 
Irene Diamond Fund
REPORT AUTHORS
 Jeffrey Levi, PhD.
 Executive Director 
Trust for America’s Health and
Associate Professor in the Department of Health Policy 
The George Washington University School of Public Health and Health Services
Laura M. Segal, MA 
 Director of Public Affairs 
Trust for America’s Health
Rebecca St. Laurent, JD
Health Policy Research Manager 
Trust for America’s Health
 Albert Lang 
Communications Manager 
Trust for America’s Health
 Jack Rayburn
Government Relations Representative 
Trust for America’s Health
CONTRIBUTORS
Kathryn Thomas, MJ
Senior Communications Officer 
Robert Wood Johnson Foundation
Laura C. Leviton, PhD.
Special Advisor for Evaluation 
Robert Wood Johnson Foundation
Tina J. Kauh, PhD.
Research and Evaluation Program Officer 
Robert Wood Johnson Foundation
Chuck Alexander, MA 
Senior Vice President, and Director, Public Health Team 
Burness Communications
Elizabeth Wenk, MA 
Vice President 
Burness Communications
Elizabeth Goodman, MS
Senior Associate 
Burness Communications
 Adam Zimmerman
Associate 
Burness Communications
PEER REVIEWERS
Scott Kahn, MD, MPH
Co-Director 
George Washington University Weight Management Center;
and Faculty 
Department of Health Policy of theGeorge Washington University School of Public Health and Health Services
Monica Vinluan, JD
Project Director, Healthier Communities Initiatives 
The Y 
 ACKNOWLEDGEMENTS
T
RUST
 
FOR 
MERICA 
S
H
EALTH
 
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 
.
 
3
Introduction
The following is a letter from Risa Lavizzo-Mourey, MD, MBA, president and CEO of the Robert Wood Johnson Foundation, and Jeff Levi, PhD, executive director of Trust for America’s Health.
T
he future health of the United States is at a crossroads, due in large part tothe obesity epidemic. Each year, the Trust for America’s Health (TFAH)and the Robert Wood Johnson Foundation (RWJF) issue
 F as in Fat: How Obesity Threatens America’s Future 
to examine strategies for addressing the obesity crisis. Inthis ninth edition of the report, TFAH and RWJF also commissioned a new study tolook at how obesity could impact the future health and wealth of our nation.
This new analysis provides a picture of two pos-sible futures for the health of Americans overthe next 20 years:
If obesity rates continue on their current tra- jectory, it’s estimated that:
Obesity rates for adults could reach or ex-ceed 44 percent in every state and exceed60 percent in 13 states;
The number of new cases of type 2 diabe-tes, coronary heart disease and stroke, hy-pertension and arthritis could increase 10times between 2010 and 2020 — and thendouble again by 2030; and
Obesity-related health care costs could in-crease by more than 10 percent in 43 statesand by more than 20 percent in nine states.
But, if we could lower obesity trends by reduc-ing body mass indices (BMIs) by only 5 per-cent in each state, we could spare millions of  Americans from serious health problems andsave billions of dollars in health spending —between 6.5 percent and 7.8 percent in costsin almost every state.
1
  As this year’s report details, we have seen impor-tant inroads made toward preventing and reduc-ing obesity around the country, especially amongchildren. We know that real changes are possible.But we also have found that efforts will need tobe intensified if we are going to achieve a majorreduction in obesity and related health problems.The promising results we see in some cities andstates pave the way for more intensive efforts.Multiple studies and reports have demonstratedthat the cities and states that took an early andcomprehensive approach to preventing obesity have demonstrated progress toward reversingthe epidemic. For instance, in California, over-all rates of overweight and obesity among fifth-,seventh- and ninth-graders decreased by 1.1 per-cent from 2005 to 2010, and, in New York City,obesity in grades K-8 decreased 5.5 percent from2006-07 to 2010-11.
2, 3
In Mississippi, combinedrates of overweight and obesity among all pub-lic elementary school students dropped from 43percent in 2005 to 37.3 percent in 2011.
4
  While these cases showed that pockets of prog-ress are possible, they also showed that chil-dren who face the biggest obstacles to healthy choices and are at greatest risk for obesity, suchas children in lower-income families and Blackand Hispanic children, did not share equally inprogress. That’s why a study released just thismonth tells the best story of all.New data from Philadelphia show the city re-duced obesity rates in ways that also helped toclose the disparities gap. In addition to achiev-ing an overall decline in obesity rates amongpublic school students (from 21.5 percent of allpublic school students in the 2006-2007 school year to 20.5 percent in the 2009-2010 school year), the city made the largest improvementsamong Black male and Hispanic female stu-dents. For Black male students, rates declinedfrom 20.66 percent to 19.08 percent, and ratesfor Hispanic female students declined from22.26 percent to 20.61 percent within the sametimeframe. We need to learn from the City of Brotherly Love and spread the actions and poli-cies that work so all children can enjoy the ben-efits of better health.These pockets of progress around the country are showing the positive impact that many poli-cies and programs are having — but they needto be taken to scale. Fortunately, we know a lot about what it will take to bend the obesity curvein America.

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