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CCHPA Part 1

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Wonderful presentation given by Dr. Harold Goldstein from CCHPA on Aug 12th at UCDMC.

Wonderful presentation given by Dr. Harold Goldstein from CCHPA on Aug 12th at UCDMC.

Published in: Health & Medicine
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  • Introduction
  • We have created a culture where obesity is inevitable
  • 19553,597
    19644,345
    19703,985
    19803,849
    19902,826
    20021,979
  • 1980 46%
    199056%
    200064.5%
  • Transcript

    • 1. Harold Goldstein, DrPH Executive Director California Center for Public Health Advocacy The Critical Role of Public Policy in Keeping People Healthy Lessons from Obesity Prevention
    • 2. Promote the establishment of public health policy at both the State and local levels
    • 3. OVERVIEW 1. Public Health Perspective 2. Key Role of Public Policy 3. Lessons from Obesity Prevention 4. Soda as Examplary
    • 4. Medicine historically focuses on individuals
    • 5. PUBLIC HEALTH:
    • 6. PUBLIC HEALTH: Healthy people in healthy communities
    • 7. Obesity Trends* Among U.S. Adults BRFSS, 1985 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
    • 8. Obesity Trends* Among U.S. Adults BRFSS, 1990 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%
    • 9. Obesity Trends* Among U.S. Adults BRFSS, 1995 No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
    • 10. Obesity Trends* Among U.S. Adults BRFSS, 2000 No Data <10% 10%–14% 15%–19% ≥20% (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
    • 11. Obesity Trends* Among U.S. Adults BRFSS, 2005 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
    • 12. Obesity Trends* Among U.S. Adults BRFSS, 2008 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
    • 13. Obesity Rates in California 1985 - 2009 ObesityPrevalence 8.9% CDC, 2010
    • 14. Obesity Rates in California 1985 - 2009 ObesityPrevalence 8.9% 24.8% CDC, 2010
    • 15. Childhood Obesity Overweight among children aged 6-19 increased nearly 4-fold from 1963 – 2000.
    • 16. So What’s Happening? Genetic change? Less will power? Less informed? or Have we built a toxic environment?
    • 17. Junk Food is EVERYWHEREJunk Food is EVERYWHERE
    • 18. Portion sizes
    • 19. Limited Food Access
    • 20. Fast Food Restaurants
    • 21. Fast Food Restaurants + Convenience Stores
    • 22. Fast Food Restaurants + Convenience Stores
    • 23. Fast Food Restaurants + Convenience Stores Grocery Stores
    • 24. Fast Food Restaurants + Convenience Stores Grocery Stores + Produce Vendors
    • 25. Fast Food Restaurants + Convenience Stores Grocery Stores + Produce Vendors California: 4.18 Retail Food Environment Index
    • 26. $10 BILLION IS SPENT ANNUALLY ADVERTISING FOOD AND BEVERAGES TO CHILDREN IOM, 2005
    • 27. Human beings are biologically hard- wired to crave fat, sugar and salt
    • 28. Cities are Designed for Cars, Not People Cities are Designed for Cars, Not People
    • 29. Physical Education?
    • 30. Safe Parks?
    • 31. 9.4 20.0 0.0 5.0 10.0 15.0 20.0 25.0 30.0 0 to 4 5 to 9 10 to 14 15 or more All U.S. AdultsYears of U.S. Residence %Obese(BMIof30ormore) Kaplan et al. AJPM. 2004:27(4):323-6. Adult Obesity Among Latino Immigrants, 1998
    • 32. Adult Obesity Among Latino Immigrants, 1998 9.4 14.5 20.0 0.0 5.0 10.0 15.0 20.0 25.0 30.0 0 to 4 5 to 9 10 to 14 15 or more All U.S. AdultsYears of U.S. Residence %Obese(BMIof30ormore) Kaplan et al. AJPM. 2004:27(4):323-6.
    • 33. Adult Obesity Among Latino Immigrants, 1998 9.4 14.5 21.0 20.0 0.0 5.0 10.0 15.0 20.0 25.0 30.0 0 to 4 5 to 9 10 to 14 15 or more All U.S. AdultsYears of U.S. Residence %Obese(BMIof30ormore) Kaplan et al. AJPM. 2004:27(4):323-6.
    • 34. Adult Obesity Among Latino Immigrants, 1998 9.4 14.5 21.0 24.2 20.0 0.0 5.0 10.0 15.0 20.0 25.0 30.0 0 to 4 5 to 9 10 to 14 15 or more All U.S. AdultsYears of U.S. Residence %Obese(BMIof30ormore) Kaplan et al. AJPM. 2004:27(4):323-6.
    • 35. “It is unreasonable to expect that people will change their behavior easily when so many forces in the social, cultural, and physical environment conspire against such change.”
    • 36. Personal Responsibility OR Collective Responsibility
    • 37. Personal Responsibility AND Collective Responsibility
    • 38. Individual Behavior or The Environment
    • 39. Individual Behavior WITHIN Public Policy The Environment The social, economic, and political context in which we make our food and activity choices Public Policy
    • 40. Major Public Health Movements  Sanitation  Worker Safety  Clear Air / Clean Water  Auto Safety  Drunk Driving  Lead Poisoning  Violence Prevention  Tobacco Control  Obesity / Chronic Disease
    • 41. Universal Lessons  NOT only a matter of personal responsibility and “more education”  Social, cultural, and economic norms must be changed so personal responsibility can be more easily exercised  Federal, state, and local policies play crucial role
    • 42. Major Public Health Movements  Worker Safety: OSHA laws  Clear Air / Clean Water: pollution stds  Auto Safety: seat belts, airbags  Drunk Driving: blood alcohol limits  Lead Poisoning: lead out of gas/paint  Violence Prevention: gun safety  Tobacco Control: age limits, taxes, etc  Obesity / Chronic Disease
    • 43. CA School Food Reforms (1999–2005)
    • 44. SB 12 (K-12 Food Standards) SB 965 (High School Beverages) SB 19 (Nutrition Standards, 2001) LAUSD (Soda, Junk Food, 2002-3) SB 677 (Soda Ban, 2003) All schools K-12 K-8 Pilot Test Standards CA School Food Reforms (1999–2005)
    • 45. 2007 - 2008 Give consumers the information they need so they CAN make healthy choices MENU LABELING
    • 46. FOOD AWAY FROM HOME AS SHARE OF TOTAL FOOD EXPENDITURES United States (1929 - 2006) 1929 1956 1961 1966 1971 1976 1981 1986 1991 1996 2001 2006 20% 30% 40% 50%
    • 47. Test your fast-food IQ
    • 48. Which Denny’s option has the least calories? Ham & Cheddar Omelet 595 cal 36% Country Fried Steak & Eggs 464 cal 11% French Toast w/ Syrup & Marg 1,003 cal 15% Pancakes w/ Syrup & Marg 650 cal 29% Field Poll, 523 registered voters, April 2007
    • 49. Which Denny’s option has the least calories? Ham & Cheddar Omelet 595 cal 36% Country Fried Steak & Eggs 464 cal 11% French Toast w/ Syrup & Marg 1,003 cal 15% Pancakes w/ Syrup & Marg 650 cal 29% Field Poll, 523 registered voters, April 2007
    • 50. Which Denny’s option has the least calories? Ham & Cheddar Omelet 595 cal 36% Country Fried Steak & Eggs 464 cal 11% French Toast w/ Syrup & Marg 1,003 cal 15% Pancakes w/ Syrup & Marg 650 cal 29% Field Poll, 523 registered voters, April 2007
    • 51. Which Denny’s option has the least calories? Ham & Cheddar Omelet 595 cal 36% Country Fried Steak & Eggs 464 cal 11% French Toast w/ Syrup & Marg 1,003 cal 15% Pancakes w/ Syrup & Marg 650 cal 29% Field Poll, 523 registered voters, April 2007
    • 52.  Research to support the policy  Extensive media coverage  Powerful coalition of supporters  Extraordinary legislative champion  Tipping point of local efforts Classic Public Health Advocacy Campaign
    • 53. Surgeon General on Smoking: 1964 “…cigarette smoking contributes substantially to mortality from certain specific diseases and to the overall death rate.”
    • 54. Per Capita Cigarette Consumption 1955-2002 Numberofcigarettes 1964 5,000 4,000 3,000 2,000 1,000 1955 1970 1980 1990 2002 US adults (18+ years)
    • 55. Tobacco Policies  Smoke-free schools, workplaces  Extensive K-12 education  Health care sector participation  Advertising restrictions  Warning labels  Tobacco taxes (CA Prop 99) - funding state/local programs - anti-tobacco ads
    • 56. Surgeon General on Diet: 1988 “…over consumption of certain dietary compo- nents is now a major concern for Americans.”
    • 57. “Overweight and obesity have reached epidemic proportions nationwide.” Surgeon General on Obesity: 2001
    • 58. Overweight Prevalence* 1980-2000 * US adults (18+ years) 1980 1990 2000 PercentOverweight 20% 40% 60% 80% 1988
    • 59. If these problems go unchecked: The long term consequences will be staggering
    • 60. “ We need very big PUBLIC POLICY CHANGES to stop diabetes and obesity from ruining our young people.” Newt Gingrich Tavis Smiley Program, NPR June 11, 2004

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