September 22, 2014

Obesity report finds no improvement for Arkansas, almost no bright spots for other states either

2014 State of Obesity Report: Better Policies for a Healthier AmericaIn its latest annual report on obesity, released this month, the Robert Wood Johnson Foundation has little good news to report. More than two-thirds of U.S. adults are overweight or obese, although the rate of increase appears to be stabilizing. The average American adult is 24 pounds heavier today than in 1960.

According to the report findings (based on 2013 telephone survey results), Arkansas is again ranked 3rd nationally for its adult obesity rate, the same as last year, with 34.6% of all adults obese. Arkansas has the highest percentage (69.9%) of overweight or obese adults. Minorities fare the worst: 32% of whites are obese, whereas 34.3% of Latinos and 42.2% of blacks are obese.

In 2001, the Robert Wood Johnson Foundation issued its first call to action to the nation to address the obesity epidemic and has done so every year since. This year’s report, RWJ State of Obesity 2014: Better Policies for a Healthier America, provides more in-depth information on policies and interventions that are working to prevent and reduce obesity, as well as a greater focus on disparities among vulnerable populations.

As in past years, the new report shines a light on the associated health and economic burdens of obesity. Diabetes rates have tripled in the past 20 years, and 75% of hypertension cases and 33% of cancer deaths are linked to obesity. If the current trajectory in obesity rates continues, by 2030 the associated costs in health care and lost productivity for the country could top $600 billion annually.

Besides dire warnings and disheartening statistics, the report devotes considerable attention to policies and programs that are making a difference in the battle of the bulge. If adopted more widely, these strategies have the potential to vastly improve the health of our nation and save billions of dollars. The recommendations touch on new approaches to patient care; relevant provisions in the Farm Bill and Affordable Care Act; strategies to increase access to healthy, affordable foods such as financing to bring grocery stores to food deserts; effective measures and insights into obesity in minority populations; and updates on marketing, nutrition standards, and other facets of the fight against early childhood obesity.

Arkansas’ rates for adult diabetes, physical inactivity, and hypertension all trended upward in the past year, but the rate of physical inactivity among adults was the only change that was statistically significant. Findings for Arkansas high school students also showed worsening trends for obesity, overweight, and inactivity. The report did not provide new data on younger children.

Arkansas now ranks 7th nationally for its adult diabetes rate (was 10th in 2013), 7th for adult hypertension (was 8th in 2013), and 3rd for physical inactivity among adults (was 1st in 2013).

Besides Arkansas, 39 other states showed statistically significant worsening rates for physical inactivity among adults. Of the 50 states and the District of Columbia, 32 had non-significant increases in the rate of adult overweight and obesity, 14 had non-significant decreases in the rate, two had significant increases in the rate, and only one state, Minnesota, had a statistically significant improvement in the rate. In fact, that was the only statistically significant improvement on any health indicator across the states addressed in the report.

The Fay W. Boozman College of Public Health (COPH) at the University of Arkansas for Medical Sciences has played a role in efforts to combat childhood obesity that garnered national attention. COPH Dean Jim Raczynski, Ph.D. was the principal investigator for the evaluation of the state-legislated measure of children’s body mass index (BMI) and related efforts to make changes in the school environment to reduce obesity. That project was funded by the RWJ Foundation over more than 10 years.

“The work that has been done by COPH faculty and staff in evaluating Act 1220 of 2003, designed to combat childhood obesity though school physical activity and nutrition policies, suggests that schools can have a positive impact on childhood obesity levels,” Dr. Raczynski said. “However, to be effective, those efforts in the schools must be “intensified and broadened to cover the gamut of both nutrition and physical activity to effect broad-scale changes to decrease child obesity rates.” In addition, “strategies need to be developed to work with parents so that they are able to make changes in the home to complement the efforts in the schools.”

According to COPH epidemiologist Martha Phillips, Ph.D., MPH, MBA, there is strong evidence that well-designed interventions can help adults lose weight and prevent weight gain. COPH researchers have conducted a number of community-based weight loss programs that have proven effective.

“COPH faculty have also conducted research on weight loss programs through using trained community health workers, lay leaders in churches and even web-based counseling approaches to allow both greater access to the programs and reduce the costs of delivering them,” Dr. Phillips said. “However, additional research is needed on alternative approaches, such as telephone counseling, and on the cost-effectiveness of these methods.”

To address these issues for both children and adults, the COPH is developing a Center for the Study of Obesity.

“The mission of the Center would be to answer important research questions in Arkansas related to approaches to reduce obesity and then help disseminate cost-effective, evidence-based methods,” Dr. Raczynski said.