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PSD Supervisors’ Meeting
      Dec. 6, 2011
   Strategic Partners – LiveWell Colorado,
    Colorado Health Foundation, Kaiser
   Funders – Centers for Disease Control and
    Prevention, Colorado Health Foundation, MCH
   Elevating Obesity as a Priority – Division Plan,
    A35 Funding, Chronic Disease State Plan,
    Local Public Health
   Data and Surveillance Reports – The Weight of
    the State
Access to and
                                                                     Chronic disease
                                                Marketing of
                                                                     management
                                                primary care                                                     Sales/marketing
                                                                                                    Tobacco
                         Quality of primary                                                                      regulation
                                                                                Anti-smoking        taxes
                         care provision                  Screening for                                                      Access to and marketing
                                                                                social marketing
                                                         chronic disease                                                    of smoking quit products
                Sources of
                                                                                                                                  and services
                stress

  Access to and                                                                                                                    Smoking bans at work
  marketing of mental                                                                                                              and public places
                               Psychosocial                Utilization of
  health services                                         quality primary
                                   stress                                                   Smoking
                                                                care

                                                                                                                      Secondhand
                                                                          Diagnosis                                      smoke
 Access to healthy                                                                                                                      Particulate air
                                                                         and control
 food options                                                                                                                           pollution
                                                                                                                                                           Downward
Marketing & educ’n                                                                                                                                         trend in CV
around healthy                                                                                                                                            event fatality
food options
                                     Healthiness                                                    High BP
 Junk food taxes                       of diet
                                                                                                     High                               CV events &
                                                                                                   cholesterol
    Sales/marketing
                                                                                                                                        lung cancers
                                                           Obesity                                  Diabetes            COPD
    regulations
                                                                                                    Oral diseases
                                                                                                                 Colorectal
 Access to physical
                                   Extent of                                                                     cancers                                     Deaths
 activity options
                                physical activity                                                                                        Morbidity
                                                                Access to and
                                                                marketing of weight
       Marketing of physical                                                                                                       Breast
                                                                loss services
       activity options                                                                                                            cancers
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)




No Data   <10%   10%–14%
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)




No Data   <10%   10%–14%   15%–19%   ≥20%
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)




No Data   <10%   10%–14%   15%–19%   20%–24%   ≥25%
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%
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)




 No Data   <10%   10%–14   15%–19%   20%–24%   ≥25%
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)




No Data   <10%   10%–14%   15%–19%   20%–24%   ≥25%
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)




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




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




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




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




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




No Data   <10%   10%–14%   15%–19%   20%–24%   25%–29%   ≥30%
Not Moving
Moving
Sleep
Leisure
Occupational
Transportation
Household
   Public health improvement plans
   PA portfolio project
   Youth intern project
   Joint use agreements
   Built environment and land use
    planning
   Worksite Wellness
   PA in schools and day care
Greeley Tribune, Nov 18, 2011
   FDA menu labeling
   Smart Meal promotion
   Land use planning for local
    agriculture, including school and
    community gardens
   School wellness and healthy eating
   Nutrition portfolio project
   Cultural ―climate‖ of Colorado—what we’ve
    learned from Shaping Policy for Health

   ―We can’t do that!‖ ―That will never fly in
    Colorado.‖ Assumptions or facts?

   How do we prepare and respond?
     -50 state surveys, review of municipal ordinances
     -Litigation challenges and court decisions

   Building a public health law focus
 Sugar Sweetened Beverage
  Research Team
 Farm to School Task Force
 Joint Degree Program JD/MPH
  development with the University
  of Colorado
   Before weight begins to track upward
      Before co-morbidities emerge
      $$ Before the high price tag $$

How Early is Early?
    Prior to pregnancy
    During pregnancy
    During the first few years of a child’s life
Preconception
                        Healthy                       Health MIT

            Self-
                         Baby             WIC
         Management    Campaign
           Services
          Program

                        ECOP MCH                            CACFP

    Home
   Visitor            Implementation
  Programs

                           Team                             Other
                                                           External
                                                           Partners
   Early
Childhood             Kaiser      Local Public
                                                 Healthy
                                     Health
 Systems                            Partners      Living
                                                 Branch
What?
 • Appropriate gestational weight    • Breastfeeding
 gain                                • Physical activity (screen time &
 • Healthy parenting behaviors       marketing)
 (sleep & infant feeding)            • ECOP integration into systems
 • Healthy weight between            and policy
 pregnancies
Where?
 • WIC & LPHAs & Other Programs
 • Health Care Settings
 • Child Care Settings
How? A Multi-sector approach.
  Implement state and          • Promote consistent messaging
  local strategies that are:   • Form strategic external partnerships
  • evidence-based             • Disseminate evidence-based practices
  • systemic                   and ECOP data
  • population-based
PSD Obesity Presentation 2011
PSD Obesity Presentation 2011

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PSD Obesity Presentation 2011

  • 2.  Strategic Partners – LiveWell Colorado, Colorado Health Foundation, Kaiser  Funders – Centers for Disease Control and Prevention, Colorado Health Foundation, MCH  Elevating Obesity as a Priority – Division Plan, A35 Funding, Chronic Disease State Plan, Local Public Health  Data and Surveillance Reports – The Weight of the State
  • 3. Access to and Chronic disease Marketing of management primary care Sales/marketing Tobacco Quality of primary regulation Anti-smoking taxes care provision Screening for Access to and marketing social marketing chronic disease of smoking quit products Sources of and services stress Access to and Smoking bans at work marketing of mental and public places Psychosocial Utilization of health services quality primary stress Smoking care Secondhand Diagnosis smoke Access to healthy Particulate air and control food options pollution Downward Marketing & educ’n trend in CV around healthy event fatality food options Healthiness High BP Junk food taxes of diet High CV events & cholesterol Sales/marketing lung cancers Obesity Diabetes COPD regulations Oral diseases Colorectal Access to physical Extent of cancers Deaths activity options physical activity Morbidity Access to and marketing of weight Marketing of physical Breast loss services activity options cancers
  • 4. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%
  • 5. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%
  • 6. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
  • 7. 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%
  • 8. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14 15%–19% 20%–24% ≥25%
  • 9. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
  • 10. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
  • 11. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
  • 12. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
  • 13. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
  • 14. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
  • 15. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
  • 18.  Public health improvement plans  PA portfolio project  Youth intern project  Joint use agreements  Built environment and land use planning  Worksite Wellness  PA in schools and day care
  • 19.
  • 21.  FDA menu labeling  Smart Meal promotion  Land use planning for local agriculture, including school and community gardens  School wellness and healthy eating  Nutrition portfolio project
  • 22.  Cultural ―climate‖ of Colorado—what we’ve learned from Shaping Policy for Health  ―We can’t do that!‖ ―That will never fly in Colorado.‖ Assumptions or facts?  How do we prepare and respond? -50 state surveys, review of municipal ordinances -Litigation challenges and court decisions  Building a public health law focus
  • 23.  Sugar Sweetened Beverage Research Team  Farm to School Task Force  Joint Degree Program JD/MPH development with the University of Colorado
  • 24.  Before weight begins to track upward  Before co-morbidities emerge  $$ Before the high price tag $$ How Early is Early?  Prior to pregnancy  During pregnancy  During the first few years of a child’s life
  • 25. Preconception Healthy Health MIT Self- Baby WIC Management Campaign Services Program ECOP MCH CACFP Home Visitor Implementation Programs Team Other External Partners Early Childhood Kaiser Local Public Healthy Health Systems Partners Living Branch
  • 26. What? • Appropriate gestational weight • Breastfeeding gain • Physical activity (screen time & • Healthy parenting behaviors marketing) (sleep & infant feeding) • ECOP integration into systems • Healthy weight between and policy pregnancies Where? • WIC & LPHAs & Other Programs • Health Care Settings • Child Care Settings How? A Multi-sector approach. Implement state and • Promote consistent messaging local strategies that are: • Form strategic external partnerships • evidence-based • Disseminate evidence-based practices • systemic and ECOP data • population-based