CDC Division of Nutrition, Physical Activity and Obesity Activities

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CDC Division of Nutrition, Physical Activity and
Obesity Activities

• ASNNA Annual Meeting
• February 16, 2010
• Christa Essig, MPH
• Division of Nutrition, Physical Activity and
  Obesity
• Centers for Disease Control and Prevention
• FNCS/USDA Detail
• The findings and conclusions herein are those of
  the author(s)
• and do not necessarily represent the official
  position of
• the Centers for Disease Control and Prevention

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Obesity negatively impacts the nations economy

• Medical costs associated with obesity for the
  United States have risen to
• 147 billion in 2008 dollars.
• Finkelstein et al., 2009

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Division of Adult and Community Health

• Action Institutes and Training
• Tools for Community Action
• Community Health Resources Database
• Community Health Assessment and Group Evaluation
  (CHANGE) Tool
• Action Guides
• Evaluation and Innovation
• Program Monitoring and Evaluation
• Program Success Stories
• Journal Articles on Program Successes
• http//www.cdc.gov/healthycommunitiesprogram/

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Division of Adolescent and School Health
http//www.cdc.gov/HealthyYouth/about/index.htm
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Division of Nutrition, Physical Activity and
Obesity
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DNPAO Goals

• Increase health-related physical activity through
  population-based approaches.
• Improve those aspects of dietary quality most
  related to population burden of chronic disease
  and unhealthy child development.
• Decrease prevalence of obesity through prevention
  of excess weight gain and maintenance of healthy
  weight loss.

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Activities SupportPrinciple Target Areas

• Environments/policies that foster
• - Physical activity
• - Consumption of fruits and vegetables
• - Breastfeeding
• Environments/policies that discourage
• - Television viewing
• - Consumption of sugar-sweetened beverages
• - Consumption of high-energy dense foods
• (high calorie/low nutrient foods)

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Strategies to Support Behavior Targets

• To Decrease Consumption of High Energy Dense
  Diets
• Apply nutrition standards in childcare, school,
  and workplace settings
• Promote menu labeling in states and communities
  
• Support interventions for retail food in
  underserved areas
• To Decrease Consumption of Sugar-Sweetened
  Beverages
• Ensure ready access to safe and palatable
  (quality) drinking water
• Limit access to sugar-sweetened beverages
• Decrease relative cost of healthy beverages
  through differential pricing and/or taxation of
  sugar-sweetened beverages
• To Increase Fruit and Vegetable Consumption
• Establish food policy councils
• Support farm-to-where-you-are programs
• Improve access to retail food stores that
  provide fruits and vegetables

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Story, M., K. M. Kaphingst, et al. (2008).
"Creating healthy food and eating environments
policy and environmental approaches." Annual Rev
Public Health 29 253-72, Figure 1.
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CDC Supports State-Based Nutrition, Physical
Activity, and Obesity Programs

• Currently funds 25 states, with a total of 16.1
  million a year average of 700,000 per state
  award
• CDC contributes to the development of state
  obesity programs by providing states with
• - program funding
• - training
• - technical assistance
• - program oversight
• For more information
• Claire Heiser
• Division of Nutrition, Physical Activity, and
  Obesity
• E-mail cheiser_at_cdc.gov
• Web site http//www.cdc.gov/obesity/stateprogram
  s/index.html

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Community Guide Promoting Physical Activity

• Environmental and policy approaches are designed
  to provide environmental opportunities, support,
  and cues to help people be more physically
  active.
• The physical environment
• Social networks
• Organizational norms and policies
• Laws
• Public health professionals, community
  organizations, legislators, departments of parks,
  recreation, transportation, and planning, and the
  media
• http//www.thecommunityguide.org/pa/environmental-
  policy/index.html

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CDC Recommended Community Strategies and
Measurements to Prevent Obesity in the US
http//www.cdc.gov/obesity/downloads/community_str
ategies_guide.pdf
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Promote the Availability of Affordable Health
Foods and Beverages

• Communities should
• Increase availability of healthier food and
  beverage choices in public service venues
• Improve availability of affordable healthier food
  and beverage choices in public service venues
• Improve geographic availability of supermarkets
  in underserved areas
• Provide incentives to food retailers to locate in
  and/or offer healthier food and beverage choices
  in underserved areas
• Improve availability of mechanisms for purchasing
  foods from farms
• Provide incentives for the production,
  distribution, and procurement of foods from local
  farms

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American Recovery and Reinvestment
ActPrevention and Wellness Initiative

• Emphasis on policy and environmental change at
  state and local levels
• - Increase levels of physical activity
• - Improve nutrition
• - Decrease obesity rates and
• - Decrease smoking prevalence, teen smoking
  initiation, and exposure to second-hand
  smoke.
• www.cdc.gov/chronicdisease/recovery

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Examples of Policies and Programs

• Improving access to healthy foods in schools
  through changes in school meal planning and
  purchasing across the state.
• Increasing physical activity among school
  children by implementing improvements to physical
  education programs and expanding the number of
  minutes students are physically active.
• Promoting breastfeeding through hospital and
  workplace policies to support initiation and
  continuation of breastfeeding.
• Reducing exposure to secondhand tobacco smoke
  through statewide policies limiting smoking in
  public and work places.

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MAPPS - Nutrition

• Media
• Access
• Point of Purchase/ Promotion
• Price
• Social Support and Services
• http//www.cdc.gov/chronicdisease/recovery/

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Media

• Media and advertising restrictions consistent
  with federal law
• Promote healthy food/drink choices
• Counter-advertising for unhealthy choices

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Access

• Healthy food/drink availability (e.g., incentives
  to food retailers to locate/offer healthier
  choices in underserved areas, healthier choices
  in child care, schools, worksites)
• Limit unhealthy food/drink availability (whole
  milk, sugar sweetened beverages, high-fat snacks)
• Reduce density of fast food establishments
• Eliminate transfat through purchasing actions,
  labeling initiatives, restaurant standards
• Reduce sodium through purchasing actions,
  labeling initiatives, restaurant standards
• Procurement policies and practices
• Farm to institution, including schools,
  worksites, hospitals and other community
  institutions

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• Point of Purchase/Promotion
• Signage for healthy vs. less healthy items
• Product placement attractiveness
• Menu labeling
• Price
• Changing relative prices of healthy vs. unhealthy
  items (e.g. through bulk purchase/procurement/comp
  etitive pricing).
• Social Support Services
• Support breastfeeding through policy change and
  maternity care practices

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Quality Control

• Project officer oversight, provide tools,
  guidance and TA
• Monitor performance and outcomes
• Ongoing feedback to maximize health impact of
  projects
• CDC and HHS will use the lessons learned from the
  initiative to improve the design and delivery of
  their state and local health promotion and
  disease prevention programs

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Final Award Amounts for State and Territory
Component

• CDC received 58 applicationsfrom all 50 states
• All applicants receive funding for efforts in
  nutrition, physical activity, and tobacco
  control.
• TOTAL AWARD AMOUNT 119,067,687
• http//www.cdc.gov/chronicdisease/recovery/docs/
  State_prevention_and_wellness_ARRA_awards_fact_she
  et.pdf

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CDC Resources

• Community Recommendations
• www.cdc.gov/obesity/downloads/community_strategie
  s_guide.pdf
• The State Indicator Report on Fruits and
  Vegetables, 2009 http//www.fruitsandveggiesmatte
  r.gov/indicatorreport
• DNPAO State Legislation Database
  http//apps.nccd.cdc.gov/DNPALeg/
• ARRA
• www.cdc.gov/chronicdisease/recovery
• State Programs
• www.cdc.gov/obesity/stateprograms/index.html
• http//www.cdc.gov/nccdphp/dnpao
• http//www.cdc.gov/healthyyouth/