The document discusses obesity rates and causes in the Bronx county of New York. It finds that nearly 1 in 3 children and 1 in 4 adults in the South Bronx are obese. Obesity is linked to increased risk of diseases like diabetes and hypertension. Prevention strategies discussed include improving access to physical activity, nutrition education programs in schools and for parents, and making healthy foods like salad more available to children.

1. Obesity
in Bronx County
 The slide shows that the overall BMI trend in
United States is going down since 2009.
 On the other hand, the trend of obesity is
going up in Bronx county without any
interruption.
 Obesity is not just being extra weight, but
also a precursor of many other adverse
health conditions.
 By preventing obesity, we can prevent
Diabetes, Hypertension, High Cholesterol,
Heart diseases effectively.

2. Obesity and overweight are common in
residents of all ages in the
South Bronx.
• Nearly 1 in 3 children in Head Start programs is obese,
and almost half are overweight or obese.
• Nearly 1 in 4 children in public elementary schools is
obese, and nearly 4 in 10 are overweight or obese.
• About 1 in 6 public high school students is obese, and
more than 1 in 3 is overweight or obese.
• One in 4 adults is obese, and 2 in 3 are overweight or
obese.
https://www.monroecollege.edu/uploadedFiles/_Site_Assets/PDF
/dpho-bronx-obesity.pdf

3. In comparison to NYC overall

4. Causes of
Obesity
• Lack of physical
activities
• Low fiber food
• High intake of
sugary drinks and
fast foods
• High salt
consumption
• Family
predisposition
• Lack of self care and
motivation.

5. Burden of Obesity
 Obesity is related to Prediabetes which greatly increases the risk of having
cardiovascular and cerebrovascular diseases.
 Obesity is directly related to hypertension. Losing weight greatly improves
Hypertension.
 Obesity makes Hypertension and diabetes management difficult.
 Several investigators have evaluated the cost of obesity on an individual
level. Finkelstein and colleagues found that in 2006, per capita medical
spending for obese individuals was an additional $1,429 (42 percent
higher) compared to individuals of normal weight. (7) Cawley and
Meyerhoefer, meanwhile, found that per capita medical spending was
$2,741 higher for obese individuals than for individuals who were not
obese-a 150 percent increase.
 https://www.hsph.harvard.edu/obesity-prevention-source/obesity-
consequences/economic/

6. Percent of NYC Residents with Diagnosed
Diabetes, by Borough, 2003

7. Management of Obesity
BMI 30-40 kg/m2 with
obesity-related
complications or
BMI >40 kg/m2 without
obesity-related
complications
Management flow
diagramhttps://diabetessociety.com.au/documents/ObesityM
anagementAlgorithm18.10.2016FINAL.pdf

8. Rates and ranking of cardiovascular
diseases in Bronx

9. Obesity Prevention Programs and Activities
Regional Nutrition Education and Obesity Prevention Centers of Excellence (RNECE)
Build the evidence-base for nutrition education and obesity prevention strategies and interventions that produce
measurable improvements in health, obesity, nutrition (food behavior), and physical activity-related outcomes of
interest to USDA; and develop effective education/extension, environmental, systems, and policy translational
activities that promote health and prevent/reduce obesity in disadvantaged low-income families and children
 Designing a Strong and Healthy New York (DASH-NY)
DASH-NY leads a statewide coalition and works with partners from such sectors as transportation, agriculture,
economic development, planning, education, academia, and health care, to develop sustainable policy, systems
and environmental changes and strategies for reducing the burden of obesity and chronic disease. DASH-NY
provides policy analysis, training, technical assistance, and support for sustainable changes that increase access
to healthy food and safe places to be physically active for communities, schools, child care and health care.
 Local IMPACT
The Local Initiatives for Multi-Sector Public Health Action (Local IMPACT) project aims to implement intensive,
location-specific strategies in community and health system settings through Local IMPACT partnerships to prevent
obesity and diabetes, and prevent and control heart disease and stroke, with a focus on reducing health disparities
among adults. Implementation of these strategies will be tracked through a number of specific performance
measures.
https://nifa.usda.gov/program/obesity-prevention-healthy-weight-programs
https://www.health.ny.gov/prevention/obesity/prevention_activities/

10. Relevant Health
Theory
 Obesity in Bronx is a
multidimensional problem
 We must improve health education,
opportunities for physical activities,
recreation, socio economic condition,
standard of living, availability of
healthy foods at an affordable cost
and vision of the society to fight
against this problem.
 We should promote organizations
that work on obesity and other
related health issues.

11. Ensure healthy
diet to children
 As of December 2014, the Salad
Bars to School program has
delivered nearly 4,000 salad bars
to school across the nation.
 Successful Outcomes of Salad
Bar: Implementation Increased
students’ access to fresh fruits
and vegetables
 Most schools reported increased
student participation in school
lunch (57%)
 A majority of schools reported
purchasing more fruits and
vegetables (78%) Schools used
fresh, pre-cut fruits and
vegetables for salad bars (81%)
http://www.saladbars2schools.org/wp-
content/uploads/2014/01/Exec_Summary_Eval_Infographic.pdf

12. Removing Environmental Barriers to
Activity
 A pilot study found that opening an after-hours supervised schoolyard increased the outdoor
activity levels of inner-city children by 84 percent compared with a matched control community.
(1)
 Programs that combine nutrition and physical activity seem to be more effective at reducing
children’s body weight than those that focus on physical activity alone. (2)
 Risks to safety can run the gamut from reckless drivers and “stranger danger” to bullies in the
playground. (3) And there’s evidence that if people believe their neighborhoods are unsafe,
children are less likely to play outside, and adults are more wary about walking or taking part in
other physical activities. A recent report found that Los Angeles residents who perceived their
neighborhoods as dangerous had significantly higher BMIs than those who considered their
communities safe. (4)
 Centers for Disease Control and Prevention recommends that communities improve access to
public transportation as an obesity prevention strategy, since better access to public
transportation may encourage people to use it.

13. Educating about
obesity
 Reinforce messages about healthy eating outside
of school by conducting workshops for parents.
 Workshops will cover different topics in nutrition
and physical activity, including how sugary drinks
affect health, the value of home cooked meals, the
importance of fruits and vegetables, and where to
find opportunities for physical activity.
 Implement Eat Well Play Hard and the SPARK
curricula to incorporate nutrition education and
physical activity into their preschool and after
school programs. Classroom nutrition education
will frequently involve hands on opportunities for
children to taste and prepare new foods and the
center involves families in healthy eating through
nutrition workshops where parents learn tips for
preparing and serving healthy foods at home.

14. References:
 (1). Farley TA, Meriwether RA, Baker ET, Watkins LT, Johnson CC, Webber
LS. Safe play spaces to promote physical activity in inner-city children:
results from a pilot study of an environmental intervention. Am J Public
Health. 2007;97:1625-31.
 (2) Katz DL, O’Connell M, Njike VY, Yeh MC, Nawaz H. Strategies for the
prevention and control of obesity in the school setting: systematic review
and meta-analysis. Int J Obes (Lond). 2008;32:1780-9.
 (3) Carver A, Timperio A, Crawford D. Playing it safe: the influence of
neighbourhood safety on children’s physical activity. A review. Health
Place. 2008;14:217-27
 (4) 47. Fish JS, Ettner S, Ang A, Brown AF. Association of perceived
neighborhood safety on body mass index. Am J Public Health.
2010;100:2296-303.