Child and Adult Obesity in Ohio: 2008 Ohio Family Health Survey Supporting Decision-Making Through Research: Finding

1. Child and Adult Obesity in Ohio: 2008 Ohio Family Health SurveySupporting Decision-Making Through Research: Findings from the 2008 Ohio Family Health Survey Leona Cuttler, M.D.* Lisa Simpson, MB, BCh, MPH^ JB Silvers, PhD* Andrew Gallan, PhD* Ann Nevar, MPA* Mendel Singer, PhD* *The Center for Child Health and Policy at Rainbow Babies & Children’s Hospital, Case Western Reserve Univ. ^Child Policy Research Center, CCHMC, Univ. of Cincinnati

3. …But what are the actual data?? ….. impact on health during childhood? and adulthood?

4. Does Childhood Obesity Really Have an Impact? Health during childhood

5. Does Childhood Obesity Really Have an Impact? Health during Adulthood Childhood obesity tends to persist into adulthood, and predisposes to: Diabetes Cardiovascular disease Cancer (colon, pancreas, breast, etc.) and much more

7. Childhood obesity increases the risk of adult heart disease

8. Adult obesity impacts health and costs

9. What is the current state of child and adult obesity in Ohio? Sponsored by: The Ohio Family Health Survey 2008 Funded by: State of Ohio Departments of Insurance, Job and Family Services, Health, and Mental Health Directed by: Ohio Colleges of Medicine Government Resource Center at The Ohio State University and the Health Policy Institute of Ohio

10. The Ohio Family Health Survey Telephone interviews: 50,092 households Adults: height, weight, health If child between 10-17 yrs in household: child’s height, weight, health (n= 6086) provided by adult (86% parents) Body Mass Index (BMI) calculated Classification of BMI: underweight, healthy, overweight, obese

11. Obesity: terminology Body Mass Index (BMI) is used to assess “fatness” “Overweight” refers to individuals who are above normal weight but not obese (children: BMI 85th-94th percentile; adults: BMI 25-29.9 kg/m²) “Obese” refers to individuals who are markedly above normal weight (children: BMI> 95th percentile; adults: BMI > 30 kg/m²)

12. How many Ohioans are overweight or obese?

13. Overweight and obesity in Ohio: children and adults Children: - 2003 NSCH (10-17 y): 30.5% (vs. 30.5% US) - 2008 OFHS (10-17 y): 35.6%

14. But prevalence of childhood obesity in Ohio is uneven across racial and demographic groups*

15. Gender: Overweight and obesity is more common in Ohio males than females - Children*

16. Gender: Overweight and obesity is more common in Ohio males than females - Adults*

17. Childhood Obesity in Ohio: Impact on Health*

18. Adult Obesity in Ohio: Impact on Health*

19. Obese Ohioans need more health services than those who are normal weight (P<.01) Special health care needs: Chronic medications: Emergency room visits Two or more: Hospitalizations Two or more:

20. Therefore, obesity is currently a major public health threat to Ohio: prevalence, impact on health, use of health resources What should we do about it? Do the data help identify policy directions?

21. Given the scope of the problem, policy is important to address obesity Start young Target parent + child Not focus on a single geographic region Multilevel approach: global + some subgroups Change perceptions of health, food, activity Develop policies for prevention + treatment Consider defining obesity as a chronic disease

22. 1. Start Young If we want to overcome obesity in Ohio, we have to target children because: Obesity starts very young, and becomes more prevalent with advancing age

23. OHIO:Obesity (BMI>95%ile) Across the Lifespan

24. 1. Start Young If we want to overcome obesity in Ohio, we have to target children because: Obesity starts very young, and becomes more prevalent with advancing age Obese children generally become obese adults

25. 2. Target Parents + Children Parent obesity is a strong independent predictor of childhood obesity

26. Parent obesity is linked to childhood obesity*

27. 2. Target Parents + Children Parent obesity is a strong independent predictor of childhood obesity Targeting parents includes focus on their educational attainment

28. Parent education is linked to childhood obesity*

29. 3. We should not focus on a single geographic region Obesity is not easily targeted geographically: Child and adult obesity is widespread in OH No specific region or type of region is dominant

30. Ohio: County-by-County Rates of Obesity

31. 4. Consider multilevel approach, recognizing demographic subgroups

32. In addition, other independent risk factors for childhood obesity Children: more likely to be obese 10-11 Years-Old (vs 16-17 years-old) 2.2-fold Adult is Obese (vs healthy weight) 1.7-fold Adult High School (vs 4 year college) 1.4-fold

33. Other policy recommendations Change perceptions of health, food, and activity Develop policies that address prevention and treatment Consider defining obesity as a chronic disease

34. Summary (1) In Ohio: 35.6 % of children and 65% of adults are overweight or obese Rates of obesity differ according to demographic factors (gender, race, income, insurance, and parent education) Obesity is associated with both - a substantial increase in diseases, and - marked increased use of health resources

35. Summary (2) The extent/impact of obesity suggest that policy interventions are needed. The data suggest: Start young Target parent + child Not focus on a single geographic region Multilevel approach: global + some subgroups Change perceptions of health, food, activity Develop policies for prevention + treatment Consider defining obesity as a chronic disease

36. Summary (3) Act now. When is the evidence enough? When the problem is big enough: Get data? Act on best available evidence? Re-evaluate? Modify

37. Thank you Thanks to Ohio Dept. of Job and Family Services, Ohio Dept. of Health, Ohio Dept. of Insurance, and Ohio Dept. of Mental Health, OSU-HPIO Thanks to Rainbow Board of Trustees Research team: Leona Cuttler, A. Gallan, Ann Nevar, JB Silvers, Mendel Singer, Lisa Simpson Reviewer team: Cynthia Burnell, James Gearheart, Lorin Ranbom, Barry Jamieson