OBESITY IN MISSOURI: IMPLICATIONS FOR HEALTH / FOOD POLICY

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1 1 OBESITY IN MISSOURI: IMPLICATIONS FOR HEALTH / FOOD POLICY Venkata Garikapaty, PhD, MPH Chief, Office of Epidemiology Missouri Department of Health and Senior Services 10/26/2017 Missouri Council for Activity and Nutrition (MOCAN)

2 Outline of the Presentation Prevalence of obesity among adults, adolescents, and children in Missouri Diet related illness for Missourians diabetes, hypertension, heart disease, high cholesterol Health care costs and behaviors associated with obesity

3 Child and teen obesity spreading across the globe 3 Boys Girls The highest rates of obesity are shown in red, followed by orange and yellow. Green and blue means fewer than 5% of the young population is obese Source: October 11, 2017,

4 4 Obesity among all US adults reaches alltime high CNN, October 13, 2017 In , the prevalence of obesity was 39.8% in adults and 18.5% in youth. The prevalence of obesity was higher among middle-aged adults (42.8%) than among younger adults (35.7%). Prevalence of obesity was higher among youth aged 6 11 years (18.4%) and adolescents aged years (20.6%) compared with children aged 2 5 years (13.9%). Prevalence of obesity was higher among non-hispanic black and Hispanic adults than among non-hispanic white and non-hispanic Asian adults. Similar pattern among youth. No significant changes between and Source: National Health and Nutrition Examination Survey (NHANES)

5 5 Prevalence of obesity among Missouri adults, 2016 Source: Behavioral Risk Factor Surveillance System (BRFSS) Missouri, % 10

6 6 Trends in Obesity Prevalence, US vs MO, Source: Behavioral Risk Factor Surveillance System (BRFSS),

7 7 Regional distribution of obesity, Missouri, 2015 Source: Behavioral Risk Factor Surveillance System (BRFSS),

8 8 Trends in obesity prevalence by race, MO, Source: Behavioral Risk Factor Surveillance System (BRFSS),

9 9 Obesity Rate: Missouri WIC Participants, Ages 2-4, 2014 Missouri, % 35 Source: Special Supplemental Program for Women, Infants and Children (WIC), USDA

10 Prevalence of Obesity among WIC Children (2-4 years) in Missouri, Source: MO DHSS WIC Child MICA,

11 11 Percent of Children Aged 2-5 Years in WIC with a BMI >=85th percentile, MO, Source: MO DHSS WIC Child MICA,

12 12 Prevalence of obesity among high school students, Missouri, 2015 Source: Youth Risk Behavioral Surveillance System (YRBS) Missouri, % 8

13 13 Obesity among middle and high school students in Missouri, Source: Youth Risk Behavioral Surveillance System (YRBS)

14 14 Overweight among middle and high school students in Missouri, Source: Youth Risk Behavioral Surveillance System (YRBS)

15 15 Overweight and obesity among Missouri high school students by race/ethnicity, 2013 and 2015 Source: Youth Risk Behavioral Surveillance System (YRBS)

16 16 Prevalence of overweight & obesity among children (10-17 years), Missouri, 2016 Source: National Survey of Children's Health Missouri, % 35

17 Pre-pregnancy Obesity, %-25% 30%-35% 35%-40%

18 18 Diet Related Illness Diabetes, Hypertension, High Cholesterol, Heart Disease and Obesity Related Cancer

19 19 Prevalence of Diabetes among Missouri adults, 2016 Source: Behavioral Risk Factor Surveillance System (BRFSS) Missouri, % 10

20 20 Trends in diabetes prevalence, MO and US, Source: Behavioral Risk Factor Surveillance System (BRFSS), MO DHSS

21 21 Regional / racial distribution of diabetes, Missouri, 2016 Missouri White, non-hispanic Black, non-hispanic Source: Behavioral Risk Factor Surveillance System (BRFSS), MO DHSS

22 22 Prevalence of hypertension among Missouri adults, 2015 Source: Behavioral Risk Factor Surveillance System (BRFSS) Missouri, % 23

23 23 Regional / racial distribution of hypertension, Missouri, 2015 Source: Behavioral Risk Factor Surveillance System (BRFSS), MO DHSS

24 24 Prevalence of heart disease among Missouri adults, 2016 Source: Behavioral Risk Factor Surveillance System (BRFSS), MO DHSS

25 25 Heart Disease Death Rate per 100,000, 35+years, Source:

26 26 Prevalence of high cholesterol among Missouri adults, 2015 Source: Behavioral Risk Factor Surveillance System (BRFSS), MO DHSS

27 Obesity related cancers October 6, Overweight and obesity are associated with increased risk of at least 13 different types of cancer 40% of all cancers diagnosed associated with overweight and obesity - 55% in women and 24% in men Non-Hispanic blacks and non-hispanic whites had higher cancer incidence rates compared with other racial and ethnic groups. Black males and American Indian/Alaska Native males had higher incidence rates than white males. Cancers associated with overweight and obesity, excluding colorectal cancer, increased 7% between 2005 and Cancers associated with overweight and obesity, excluding colorectal cancer, increased among adults younger than age 75. Source:

28 Top 10 Causes of Death, USA, 1900 vs 2010 Source: Jones DS, et al. N Engl J Med :

29 Life style behaviors related to obesity Risk Behaviors Diet Fruit and vegetable consumption Sugar-added drinks or non-diet soda consumption Physical activity Meet physical activity recommendations Physical inactivity Screen time

30 30 Percent of Adults Consuming Fruits and Vegetables Less than Once Daily (2011) Nationally, 37.7 percent of adults consume fruits less than one time a day, and 22.6 consume vegetables less than one time a day State Fruits Vegetables 1 Mississippi 50.8% 32.3% 2 Oklahoma 50.2% 26.8% 3 Arkansas 47.5% 28.6% 4 West Virginia 47.2% 26.2% 5 Louisiana 46.7% 32.5% 6 Tennessee 46.3% 25.4% 7 Kentucky 45.9% 25.2% 8 South Carolina 44.4% 27.3% 9 Missouri 43.9% 25.2% 10 Alabama 43.8% 24.3% In 2015: Consumed vegetables less than once daily = 23.3% Consumed fruits less than once daily = 44.4% Source: Behavioral Risk Factor Surveillance System (BRFSS), 2011

31 Sugar-sweetened beverage (SSB) consumption among Missouri students, Source: Youth Risk Behavior Surveillance System (YRBS)

32 32 Spending on food away from home

33 33 Physical Inactivity among Missouri adults, 2016 Source: Behavioral Risk Factor Surveillance System (BRFSS) Missouri, % 17

34 34 Regional distribution of physical inactivity among Missouri adults, 2016 Source: Behavioral Risk Factor Surveillance System (BRFSS), MO DHSS

35 35 Physical activity among middle and high school students in Missouri, Source: Youth Risk Behavior Surveillance System (YRBS)

36 Physical Education among Middle and High School Students, Missouri, Source: Youth Risk Behavior Surveillance System (YRBS)

37 TV viewing 3+hours per day on an average school day, Missouri, Source: Youth Risk Behavior Surveillance System (YRBS)

38 Screen time 3+ Hours per Day in an Average School Day, Missouri, Source: Youth Risk Behavior Surveillance System (YRBS)

39 39 Missouri s Population by Age-Sex Group as a Percentage of Total Population Source:

40 Percent of seniors age 65 and older, Missouri, 2010 and Source:

41 County Health Rankings 41 Annually since 2010, the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation have produced the County Health Rankings, a population health checkup for the nation s over 3,000 counties.

42 County health rankings, Missouri, Health Factors Health Outcomes

43 Different years same counties 43 Source: County Health Rankings,

44 Health care costs associated with obesity 44 Obesity accounts for 21 percent of U.S. health care costs ($147 billion to nearly $210 billion per year) Childhood obesity alone is responsible for $14 billion in direct medical costs. As a person's BMI increases, so do the number of sick days, medical claims and healthcare costs Per capita healthcare costs for severely or morbidly obese adults (BMI >40) are 81 percent higher than for healthy weight adults Too Fat to Fight: Military Threatened by Childhood Obesity, The Gazette, Colorado Springs, Colo. 15 Oct 2017

45 45

46 Missouri s Obesity prevention efforts 46 Healthy Eating / Active Living Program (HEAL) Missouri Livable Streets Project Professional development and technical assistance to childcare providers on policies and practices for physical activity Supported professional development opportunities on implementing comprehensive school physical activity programs to school physical education teachers and other stakeholders through collaboration with the Missouri Association for Health, Physical Education, Recreation and Dance (MOAHPERD)

47 47 Missouri s Obesity prevention efforts Implemented a youth initiative pilot in an effort to engage and empower youth to get more involved in their community efforts to improve physical activity and nutrition. Partnered with Children s Mercy to provide training to the MCH program s district nurse consultants and the HEAL staff to enable them to provide direct technical assistance and support to the LPHAs implementing Fit-Tastic 12345! The School Health Program developed Resource Guide: School Nurse Interventions to Promote Healthy Weight and disseminated the material through professional development opportunities such as pre-conference sessions. olnurseinterventionstopromotehealthyweight.pdf

48 48 Source:

49 Acknowledgements Dr. Jiaqing Li Dr. Kyle Waller Dr. Noaman Kayani Katie Long Supriya Nelluri Pat Simmons

50 50 THANK YOU! Contact Information:

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