State Actions on Overweight and Childhood Obesity

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• State Actions on Overweight and Childhood Obesity
  2005 Update
• By
• Amy P. Winterfeld, JD
• Program Principal
• Health Program
• National Conference of State Legislatures
• amy.winterfeld_at_ncsl.org
• [phone]

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Obesity Fast Facts

• Obesity is epidemic in the U.S. and cost 117
  billion in 2000.
• Obesity increased 60 percent among U.S. adults in
  the last 10 years.
• 59 million U.S. adults are obese.
• 16 percent of U.S. children and adolescents age
  6-19 are overweight (9 million children).
• Since 1980, obesity has doubled for children and
  tripled for adolescents.
• Obesity-associated chronic diseases heart
  disease, some cancers, stroke, diabetes are the
  1st, 2nd, 3rd, 6th leading U.S. causes of
  death.

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Obesity Factors Driving Policy

• Obesity-attributable U. S. medical expenses were
  estimated at 75 billion for 2003.
• Taxpayers fund about half of this through
  Medicare and Medicaid.
• Healthy eating and a physically active lifestyle
  can help children and adults achieve and maintain
  a healthy weight and may reduce or prevent
  obesity-related medical costs and chronic
  diseases.

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State Medical Obesity Costs in Millions of Dollars

• Source Obesity Research, Volume 12, No. 1,
  January 2004

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Obesity Legislative Responses

• Nutrition Topics
• Nutrition Standards in Schools
• Nutrition Education
• Measurement of Student Body Mass Index (Arkansas
  enacted in 2003)
• Nutrition Menu Information for School Foods
• Taxes on Foods or Beverages with Minimal
  Nutritional Value

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Obesity Legislative Responses

• Physical Activity Topics
• Physical Education or Physical Activity in
  Schools
• Walkable communities - city planning,
  transportation
• Safe routes to school
• Partnerships with businesses to increase physical
  activity and healthy eating at workplaces

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Obesity Legislative Responses

• General Obesity-Related Legislation
• Diabetes Screening and Management
• Insurance Coverage for Obesity Prevention and
  Treatment
• School Wellness Policies
• Obesity Task Forces, Commissions, or Studies
• Raising Awareness
• Limitations on Lawsuits Against the Food Industry

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Obesity Costs Another View
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Nutrition Standards in Schools

• 38 states considered or enacted school nutrition
  legislation in 2005. This includes
• 13 states that enacted school nutrition
  legislation in 2005 AZ, AR, CO, CT, KS, KY, MD,
  NM, OK, SC, TX (passed legislature, sent to
  Governor, 6-1-05), UT (resolution sent to the
  lieutenant governor), and WV.
• 25 states that are considering or have considered
  school nutrition legislation in 2005 AL, AK, CA,
  HI, IL, IN, IA, LA, ME, MA, MO, MS, MT, NE, NH,
  NJ, NY, NC, ND, OH, OR, PA, RI, TN and VA.

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Nutrition Standards Enacted- 2005

• Comprehensive food and beverage guidelines that
  require healthy choices or restrict sale of
  competitive foods
• AZ HB 2544, AR SB 965, CT SB1309, KS SB 154, KY
  SB 172, MD SB 473, NM HB 61, OK SB 265, SC HB
  3499, WV HB 2816
• Encouraging school districts to adopt nutrition
  wellness guidelines
• CO SB 81, WV HB 2816
• Evaluation of nutrition services celebrations
  allowed
• TX SB 42
• Regulatory action on school nutrition standards
• TX (2004), NJ (2005)

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Body Mass Index (BMI) Legislation

• 13 states considered or enacted BMI legislation
  in 2005
• Enacting BMI reporting Tennessee, West Virginia
• Legislation introduced - Alaska, Connecticut,
  Georgia, Iowa, Maine, New Jersey, New York, North
  Carolina, Oregon, South Carolina, and Texas
• Considered repeal Arkansas

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Diabetes Legislation

• School child screening
• Enacted CA and IL 2003
• Considered NY and PA - 2004
• Considered PA 2005
• At-school treatment and training of school
  personnel in diabetes management
• Passed both chambers of legislature HI 2005
• Considered TX 2005 CA, IL, MA, NJ, PA, TN, VT,
  VA 2004
• Diabetes awareness in schools
• Enacted - CA 2005 (SCR 4)

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Insurance Coverage Obesity Prevention and
Treatment

• Insurance coverage option required GA, IN, VA
• States considering insurance coverage
  requirements or strengthening coverage
  requirements in 2005 CA, CT, GA, IN, MD, MO,
  MS, TN
• Insurance coverage required Maryland

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Nutrition Content Information for School Foods
Legislation

• School nutrition information requirements
  considered 2005
• California, Illinois, Massachusetts, and New York
• School nutrition information requirements enacted
  2005
• Colorado, West Virginia

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Nutrition Education in School Curriculum

• School nutrition education requirements
  considered 2005
• Illinois, Maine, Minnesota, New York, New Mexico,
  Oklahoma, Pennsylvania, Vermont, Virginia
• School nutrition education requirements enacted
  2005
• Illinois (for food stamp, TANF recipients -
  passed both legislative chambers), South
  Carolina, Texas (passed both legislative
  chambers)

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Physical Activity Legislative Responses

• Physical Education or Physical Activity in
  Schools
• 48 states require P.E. in schools, but scope of
  requirement varies
• 60 of states require schools to follow national
  or state P.E. guidelines. 80 require adapted or
  mainstream P.E. for IEP students.
• IL requires daily P.E. for K-12, but exemptions
  allowed. AL requires daily P.E. for K-8.

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Physical Activity Legislative Responses

• Physical Education or Physical Activity in
  Schools
• 8 states enacted or strengthened P.E.
  requirements in 2005 AZ, CO, CT, KS, KY, MT,
  SC, TX
• 25 states introduced legislation to implement or
  strengthen P.E. requirements in 2005 AL, AK, DE,
  GA, HI, IL, IN, IA, MA, MI, MS, MO, NE, NH, NM,
  NY, OH, OK, OR, PA, RI, TN, UT, VA

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Physical Activity Legislative Responses

• Walkable communities through community planning
  and transportation projects that encourage
  walking.
• Safe routes to school - CA, DE, FL, OR, TX have
  state laws as of 2003.
• Legislative role models CO legislators
  participate in 10,000 Steps to Better Health and
  created Colorado Walking Wednesday urging parents
  and children to walk to school WI legislators
  resolved to Lose a Ton.

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Nutrition and Physical Education Food for
Thought
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School Wellness Policy Legislation

• Federal Child Nutrition and WIC Reauthorization
  Act of 2004 Requires local school districts
  participating in the National School Lunch or
  Breakfast Programs to establish local wellness
  policies by the beginning of the 2006-2007 school
  year.
• Statewide wellness policy legislation
  considered in 2005 in CA, OH, RI, TN.
• Statewide wellness policy legislation enacted
  in 2005 in CO, IL (passed both chambers of
  legislature).

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Task Forces, Commissions, or Studies

• Six states previously enacted obesity task
  forces, commissions, or studies Arkansas,
  Maine, New York, Texas, Rhode Island, Washington
• Legislation introduced for obesity task forces,
  commissions, or studies in 2005 Kansas, New
  Mexico, North Carolina, Virginia, and West
  Virginia

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Legislative Effort to Raise Awareness

• California A panoply of awareness raising
  efforts encouraged to increased physical activity
  and improve nutrition and wellness in all
  branches and levels of government, communities,
  schools, workplaces healthy food options in
  restaurants, markets, and homes and increased
  emphasis on health education and prevention of
  obesity and diabetes.
• Maryland Proposed November as Obesity
  Awareness Month

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Snack Tax Legislation

• Nebraska Proposed sales tax on snack foods to
  create a fund for school facilities.
• Texas Proposed snack and sweets tax to fund
  childhood obesity prevention programs.

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Additional Resources

• Links for NCSL and other resources on legislation
  and policy options to address childhood obesity
  are
• NCSL updated overview of childhood obesity policy
  options considered in 2005 at http//www.ncsl.org
  /programs/health/childhoodobesity-2005.htm
• NCSL overview of childhood obesity policy options
  considered in 2003-2004 at http//www.ncsl.org/pr
  ograms/health/childhoodobesity.htm
• NCSL information on access to healthy foods in
  communities at http//www.ncsl.org/programs/healt
  h/publicHealth/foodaccess/index.htm?CFID614822CF
  TOKEN54359522
• Information about federal wellness policy
  requirements on the U.S. Department of
  Agriculture web site at http//www.fns.usda.gov/t
  n/Healthy/wellnesspolicy.html

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Thank you!