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The Dual Public Health Crises of Hunger & Obesity

The Dual Public Health Crises of Hunger & Obesity. Ending Hunger in Oregon: 2012 Food Security Summit Corvallis, OR. January 19, 2011 Alejandro Queral , Northwest Health Foundation Laurie Trieger, Lane Coalition for Healthy Active Youth (LCHAY).

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The Dual Public Health Crises of Hunger & Obesity

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  1. The Dual Public Health Crises of Hunger & Obesity Ending Hunger in Oregon: 2012 Food Security Summit Corvallis, OR. January 19, 2011 Alejandro Queral, Northwest Health Foundation Laurie Trieger, Lane Coalition for Healthy Active Youth (LCHAY)

  2. At least 50% of our health is determined by socio-economic and environmental factors. • Health behaviors heavily influenced by social and economic environment. • Therefore, to have greatest impact on health outcomes, focus should be on factors that most affect health.

  3. Public health: population-based approach

  4. The Obesity Epidemic • In the US • Among children

  5. Obesity Trends Among U.S. Adults* BRFSS, 1990 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

  6. Obesity Trends Among U.S. Adults* BRFSS, 1991 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19

  7. Obesity Trends Among U.S. Adults* BRFSS, 1992 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

  8. Obesity Trends Among U.S. Adults* BRFSS, 1993 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

  9. Obesity Trends Among U.S. Adults* BRFSS, 1994 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

  10. Obesity Trends Among U.S. Adults* BRFSS, 1995 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

  11. Obesity Trends Among U.S. Adults* BRFSS, 1996 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

  12. Obesity Trends Among U.S. Adults* BRFSS, 1997 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24%

  13. Obesity Trends Among U.S. Adults* BRFSS, 1998 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24%

  14. Obesity Trends Among U.S. Adults* BRFSS, 1999 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24%

  15. Obesity Trends Among U.S. Adults* BRFSS, 2000 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24%

  16. Obesity Trends Among U.S. Adults* BRFSS, 2001 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29%

  17. Obesity Trends Among U.S. Adults* BRFSS, 2002 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29%

  18. Obesity Trends Among U.S. Adults* BRFSS, 2003 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29%

  19. Obesity Trends Among U.S. Adults* BRFSS, 2004 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29%

  20. Obesity Trends Among U.S. Adults* BRFSS, 2005 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

  21. Obesity Trends Among U.S. Adults* BRFSS, 2006 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

  22. Obesity Trends Among U.S. Adults* BRFSS, 2007 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

  23. Obesity Trends Among U.S. Adults* BRFSS, 2008 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

  24. Obesity Trends Among U.S. Adults* BRFSS, 2009 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

  25. Obesity Trends* Among U.S. AdultsBRFSS, 2010 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

  26. Obesity Trends* Among U.S. AdultsBRFSS,1990, 2000, 2010 (*BMI 30, or about 30 lbs. overweight for 5’4” person) 2000 1990 2010 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

  27. Lane County , OR. Childhood Obesity Incidence The sample (n = 10,853) represents students from 56% of the school districts in Lane County. LCHAY BMI data collection project, 2005-06. G. Moreno, PhD,CNS and T. Brooks, MD LCHAY weighed and measured ¼ of all Lane County K-8th Graders 37% at risk, overweight/obese

  28. Leading Causes of PreventableDeath in the U.S. JAMA, March 10, 2004 Vol 291, No.10

  29. Hunger and Obesity; common root causes

  30. Both hunger and obesity can be consequences of low income coupled with lack of access to enough nutritious food.

  31. Food Access & Choices

  32. Food Access & Choices

  33. Low income women more likely to be obese – is food insecurity a driver? Research: higher prevalence of obesity among food insecure women. Research: children born to mothers who consumed an unhealthy diet during pregnancy have an increased risk of type 2 diabetes (a significant contributing factor to heart disease and cancer) later in life.

  34. Obesity as a major driver of rising health care costs • ™ In Oregon, estimated medical costs related to obesity among adults were $781 million for 2003, representing 5.7% of Oregon’s total health care bill. • ™ For Oregon, Medicare obesity-attributable medical expenditures were estimated at $145 million, representing 6% of Medicare costs. • ™ $180 million of obesity-related care was financed by Medicaid, representing 8.8% of Medicaid costs in Oregon. • Source: Finkelstein E, Fiebelkorn I, Wang G. State-level estimates of annual medical expenditures attributable • to obesity. Obesity Research. 2004;12:18-24.

  35. Obesity as a major driver of rising health care costs • Rising rates of obesity  rise in clinical incidence and prevalence of key chronic diseases (diabetes, hypertension, hyperlipidemia, pulmonary disease and co-morbid depression. • Higher rate of disease prevalence accounts for about 1/3 of the rise in health care spending between 1998 and 2005. • In other words, the rise of obesity accounted for nearly 34 percent of the real per capita growth in health care spending • Source: Thorpe, K and K. Galactionova. The Impact of Obesity on Rising Medical Spending in Oregon from 1998 to 2005. Study commissioned by Northwest Health Foundation. 6 April 2009.

  36. Poor health as driver of food insecurity Over 6,000 Oregonians receiving food boxes surveyed: 25% cited “High medical costs” as reason for needing food box 15% responded they are “Too sick to work” 41% of emergency food box recipients indicated they have medical debt SOURCE: Oregon Food Bank, Profiles of Hunger & Poverty in Oregon, 2012 Hunger Factors Assessment Survey

  37. Shared solutions Using policy and environment change to address hunger and obesity

  38. "Give a man a fish and he will eat for a day. Teach a man to fish and he will eat for the rest of his life.“ -Chinese Proverb

  39. What Will Turn the Tide? Despite positive changes in emergency food system and federal nutrition programs over past 10 years; we still have rising rates of both hunger and obesity. Why…? …and what can be done?

  40. What key policy priorities can address food insecurity and obesity? • We know that: • Poverty is a factor in both food insecurity and female obesity. • Children of obese females more likely to become obese themselves. • Children born to females who either grew up or gestated in a poor nutritional environment are more likely to develop chronic disease (like Type II diabetes).

  41. Questions to Consider • We’ve always had poverty, but the obesity epidemic is relatively recent. What is different about now, versus one generation (and more) ago? • There are great projects happening across Oregon that improve access to more nutritious foods, especially fresh fruits & veg. What can be done to drive up demand for “a different way of eating”? • How does/can the emergency food distribution system serve as a tool for prevention of diet related diseases? • What policy approaches can (positively) impact both hunger & obesity? • What can we learn from the success of the WIC Program, with its laser-focus on both a specific vulnerable population and on prescriptive food items- that might transfer to other existing programs; or help create new policies or programs? • Basic, nutritious foods are affordable (think: rice & beans & cabbage). But there are reasons why we do not consume these foods. Discuss the social, cultural, or other influences on our food choices. In other words- what is available, promoted, and consumed; and how is that so?

  42. Thank You Alejandro Queral Northwest Health Foundation 971-230-1288 aqueral@nwhf.org Laurie Trieger Lane Coalition for Healthy Active Youth 541.682.4306 laurie@lchay.org Nancy Becker Oregon’s Public Health Institute 503.422.2482 nancy@orphi.org

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