Communities Putting Prevention to Work

Transcription

1 Communities Putting Prevention to Work Applying research to practice brought to you by the Department of Health and Human Services

2 Making the healthy choice the easy choice by changing policy, systems, and the environment 2

3 CDC Framework for Preventing Obesity Policy Home and Family School Community Work Site Healthcare Genetics Psychosocial Other Personal Factors Food Beverage Intake Energy In Social Norms and Values Sectors of Influence Behavioral Settings Individual Factors Energy Balance Physical Activity Energy Out Food and Beverage Industry Agriculture Education Media Government Public Health Systems Healthcare Industry Business and Workers Land Use and Transportation Leisure and Recreation Draft last revised, March 24, 2005

4 Teams Schools and Child Care: UA Nutrition, Extension, United Way Neighborhoods: PRONeighborhoods Worksites: YMCA Hlth, Soc Svc and Faith: Carondelet Food systems: Comm. Food Bank Built Environment: UA Drachman Institute Media: PCHD Evaluation: UA COPH Policy: UA COPH 4

5 Policy Team 1. Research policy issues that arise from other teams 2. Healthy Restaurants 3. Community education re-framing obesity 4. Advocacy 5

6 High risk target areas: Ajo Doolen/Fruitvale, Dodge/Flower, Blenman-Elm Garden District Flowing Wells Marana Pasqua Yaqui Sahuarita Sells/San Xavier South Park/Las Vistas, Pueblo Gardens South Tucson Summit View Sunnyside/Elvira Tucson High Vail 6 Wakefield

7 The problem We are growing fatter

8 Adult Weight Trends in the us 80% 70% 60% 50% 40% 30% 20% 10% 0% Overweight Obese Extremely Obese

9 60% of Pima County adults are overweight or obese Six in ten Obese 29% Overwt 31% Normal 40%

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11 Trends in Child Obesity 20% 15% 10% 5% 0%

12 Why should we care?

13 HEALTH 44% of Americans had at least 1 chronic disease in 2005 Coronary heart disease Type 2 diabetes Cancers (endometrial, breast, and colon) Hypertension (high blood pressure) Cholesterol issues Stroke Liver and Gallbladder disease Sleep apnea and respiratory problems Osteoarthritis Gynecological problems (abnormal menses, infertility)

14 CHILD HEALTH Lower life expectancy for the first time in 200 years! Cardiovascular disease risk Diabetes risk Psychosocial Risk Stigmatization Low self-esteem Impacts academic and social functioning

15 HEALTH CARE COSTS That s $147 billion! $500 per year for every man, 9.1% of all health care costs are attributed to obesity woman and child in the US

16 JOBS absenteeism sick leave disability injuries decreased productivity Total nonmedical employee costs average $1,627 per obese person in the US.

17 NATIONAL DEFENSE 27% of young adults deemed too fat to fight. Hundreds of otherwise qualified military recruits are turned away each year The military discharges 1,200 enlistees each year because of weight issues

18 The Causes What is making Americans fat?

19 Energy In What we eat and drink Energy Out 15-30% related to physical activity All things being equal, individuals are responsible for their energy in / energy out balance

20 Choices??

21 Human brains are wired to crave carbohydrates and fat Are all things equal? What was adaptive in prehistory is mal- adaptive in modern times

22 What do I have time for? What s convenient? What can I afford? What does my family want? What s available?

23 Attitudes play a role But some things that are out of our control make the right choice the difficult one.

24 Why can t the healthy choice be the easy choice?

25 Food choices IS IT EASY TO MAKE THE HEALTHY CHOICE?

26 What s available? Fresh food deserts Fast food gluts 26

27 EATING OUT: What can I afford? Calorie for calorie, junk food costs less than fruits and vegetables. McChicken: 360 Double Cheeseburger: 440 Fries: 380 Side Salad: 20 Soft drink: Hot Apple Pies: 250 Hot fudge Sundae: 330 Sausage BB: 300 Snack Fruit/Yogurt: 160

28 What do I have time for?

29 What does my family want? Food industry spends $89 per capita CDC spends $1.20 per capita

30 What s available?

31 COST Low calorie foods: $18.16 per 1000 Kcal High calorie foods: $1.76 per 100 kcal * 370 common foods and beverages studied Milk $3.19/ gallon Punch $1.29/ gallon

32 Physical activity choices Active Transport: is it easy?

33 WHAT S AVAILABLE? Tucson: A bike- Friendly town?

34 Is it safe? TPD reports 7 Pedestrian deaths 80 pedestrian injuries 2 bicycle traffic deaths 113 bicycle traffic injuries in the first 9 months of 2010

35 Is there someplace to go?

36 Few expend many calories getting to work

37 Physical activity choices Exercise for exercise sake: is it easy?

38 WHAT S AVAILABLE? No place to play

39 WHAT S AVAILABLE? DANGER! Wide streets encourage speeding No sidewalks, no street lights

40 IS IT CONVENIENT? How do you get from here to there?

41 WHAT S AVAILABLE? Why don t I do it?

42 WHAT CAN I AFFORD? WHAT S CONVENIENT? What does my family want? What do I have time for?

43 The Problem American society has become 'obesogenic,' characterized by environments that promote increased food intake, non-healthful foods, and physical inactivity. The Solution While we can t (and shouldn t) regulate what people eat or how much they should exercise, we must promote wise choices in hopes of preventing consequences for which we will all have to pay.

44 How can communities promote wise choices? Prioritize healthy living using the same tools that created the problem in the first place

45 zoning High density Mixed use Allow groceries in neighborhoods Create walkable/bikable destinations Bring fresh foods into neighborhoods

46 Transportation Complete Streets Street diets Bike lanes and boulevards Sidewalks planning Traffic calming Make it safe for all types of transport.

47 Accommodate bikes

48 Cyclovia!

49 Joint use agreements School grounds can be open to the public during non-school hours.

50 Plan for shade Rainwater harvesting created these shady spaces

51 Promote local agriculture Utilize government owned properties for community gardens Create incentives in vendor licensing requirements for locally grown foods Purchase locally grown foods

52 Recognize and promote healthy restaurants Ensure that consumers have the information they need to make a healthy choice

53 Is this a big government intrusion? The tools of government have fueled the development of the obesogenic environment We can t afford to continue in this direction. We owe it to the next generation.

54 Local government tools Urban Planning Ordinances and Regulations Transportation Planning Zoning Create local destinations Complete streets that accommodate bikes and pedestrians as well as cars. Create shade Utilize school grounds as parks Promote local agriculture and increase access to fresh fruits and vegetables Recognize healthy restaurants

55 Health Health care costs Jobs and productivity = Policy, systems, and environmental change Military readiness Clean environment Economic development

56 What you can do Learn more Speak up! Provide public input for: General Plan Updates Transportation Planning Zoning decisions Ordinances Sign up to receive information about opportunities

57 Questions? Follow-up? CPPW Policy Team UA College of Public Health Activate Tucson: CPPW: Brought to you by the Department of Health and Human Services