Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
Harold Goldstein, DrPH
Executive Director
California Center for Public Health Advocacy
The Critical Role of Public Policy
...
Promote the establishment of
public health policy at both the
State and local levels
OVERVIEW
1. Public Health Perspective
2. Key Role of Public Policy
3. Lessons from Obesity Prevention
4. Soda as Examplary
Medicine
historically
focuses on
individuals
PUBLIC HEALTH:
PUBLIC HEALTH:
Healthy people
in healthy communities
Obesity Trends* Among U.S. Adults
BRFSS, 1985
No Data <10% 10%–14%
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. Adults
BRFSS, 1990
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
Obesity Trends* Among U.S. Adults
BRFSS, 1995
No Data <10% 10%–14% 15%–19%
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” pe...
Obesity Trends* Among U.S. Adults
BRFSS, 2000
No Data <10% 10%–14% 15%–19% ≥20%
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ ...
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. ov...
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. ov...
Obesity Rates in California
1985 - 2009
ObesityPrevalence
8.9%
CDC, 2010
Obesity Rates in California
1985 - 2009
ObesityPrevalence
8.9%
24.8%
CDC, 2010
Childhood Obesity
Overweight among children
aged 6-19 increased nearly
4-fold from 1963 – 2000.
So What’s Happening?
Genetic change?
Less will power?
Less informed?
or
Have we built a toxic environment?
Junk Food is EVERYWHEREJunk Food is EVERYWHERE
Portion sizes
Limited Food Access
Fast Food Restaurants
Fast Food Restaurants
+ Convenience Stores
Fast Food Restaurants
+ Convenience Stores
Fast Food Restaurants
+ Convenience Stores
Grocery Stores
Fast Food Restaurants
+ Convenience Stores
Grocery Stores + Produce Vendors
Fast Food Restaurants
+ Convenience Stores
Grocery Stores + Produce Vendors
California: 4.18
Retail Food Environment Index
$10 BILLION IS SPENT ANNUALLY ADVERTISING
FOOD AND BEVERAGES TO CHILDREN IOM, 2005
Human beings are biologically hard-
wired to crave fat, sugar and salt
Cities are Designed for Cars,
Not People
Cities are Designed for Cars,
Not People
Physical Education?
Safe Parks?
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(...
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 mo...
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 ...
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 1...
“It is unreasonable to expect that people
will change their behavior easily when
so many forces in the social, cultural,
a...
Personal
Responsibility
OR
Collective
Responsibility
Personal
Responsibility
AND
Collective
Responsibility
Individual Behavior
or
The Environment
Individual Behavior
WITHIN
Public Policy
The Environment
The social, economic, and political
context in which we make our ...
Major Public Health Movements
 Sanitation
 Worker Safety
 Clear Air / Clean Water
 Auto Safety
 Drunk Driving
 Lead ...
Universal Lessons
 NOT only a matter of personal responsibility
and “more education”
 Social, cultural, and economic nor...
Major Public Health Movements
 Worker Safety: OSHA laws
 Clear Air / Clean Water: pollution stds
 Auto Safety: seat bel...
CA School Food Reforms
(1999–2005)
SB 12
(K-12 Food Standards)
SB 965
(High School Beverages)
SB 19 (Nutrition Standards, 2001)
LAUSD (Soda, Junk Food, 2002-...
2007 - 2008
Give consumers the information
they need so they CAN make
healthy choices
MENU
LABELING
FOOD AWAY FROM HOME AS SHARE
OF TOTAL FOOD EXPENDITURES
United States (1929 - 2006)
1929 1956 1961 1966 1971 1976 1981 198...
Test your
fast-food
IQ
Which Denny’s option has the least
calories?
Ham & Cheddar Omelet 595 cal 36%
Country Fried Steak & Eggs 464 cal 11%
Frenc...
Which Denny’s option has the least
calories?
Ham & Cheddar Omelet 595 cal 36%
Country Fried Steak & Eggs 464 cal 11%
Frenc...
Which Denny’s option has the least
calories?
Ham & Cheddar Omelet 595 cal 36%
Country Fried Steak & Eggs 464 cal 11%
Frenc...
Which Denny’s option has the least
calories?
Ham & Cheddar Omelet 595 cal 36%
Country Fried Steak & Eggs 464 cal 11%
Frenc...
 Research to support the policy
 Extensive media coverage
 Powerful coalition of supporters
 Extraordinary legislative...
Surgeon General on Smoking: 1964
“…cigarette smoking contributes substantially
to mortality from certain specific diseases...
Per Capita Cigarette Consumption
1955-2002
Numberofcigarettes
1964
5,000
4,000
3,000
2,000
1,000
1955 1970 1980 1990
2002
...
Tobacco Policies
 Smoke-free schools, workplaces
 Extensive K-12 education
 Health care sector participation
 Advertis...
Surgeon General on Diet: 1988
“…over consumption of
certain dietary compo-
nents is now a major
concern for Americans.”
“Overweight and
obesity have reached
epidemic proportions
nationwide.”
Surgeon General on Obesity: 2001
Overweight Prevalence*
1980-2000
* US adults (18+ years)
1980 1990 2000
PercentOverweight
20%
40%
60%
80%
1988
If these problems go unchecked:
The long term consequences
will be staggering
“ We need very big
PUBLIC POLICY CHANGES
to stop diabetes and obesity from
ruining our young people.”
Newt Gingrich
Tavis ...
CCHPA Part 1
CCHPA Part 1
CCHPA Part 1
CCHPA Part 1
CCHPA Part 1
CCHPA Part 1
CCHPA Part 1
CCHPA Part 1
CCHPA Part 1
Upcoming SlideShare
Loading in …5
×

CCHPA Part 1

546 views

Published on

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

Published in: Health & Medicine
  • Be the first to comment

  • Be the first to like this

CCHPA Part 1

  1. 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. 2. Promote the establishment of public health policy at both the State and local levels
  3. 3. OVERVIEW 1. Public Health Perspective 2. Key Role of Public Policy 3. Lessons from Obesity Prevention 4. Soda as Examplary
  4. 4. Medicine historically focuses on individuals
  5. 5. PUBLIC HEALTH:
  6. 6. PUBLIC HEALTH: Healthy people in healthy communities
  7. 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. 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. 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. 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. 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. 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. 13. Obesity Rates in California 1985 - 2009 ObesityPrevalence 8.9% CDC, 2010
  14. 14. Obesity Rates in California 1985 - 2009 ObesityPrevalence 8.9% 24.8% CDC, 2010
  15. 15. Childhood Obesity Overweight among children aged 6-19 increased nearly 4-fold from 1963 – 2000.
  16. 16. So What’s Happening? Genetic change? Less will power? Less informed? or Have we built a toxic environment?
  17. 17. Junk Food is EVERYWHEREJunk Food is EVERYWHERE
  18. 18. Portion sizes
  19. 19. Limited Food Access
  20. 20. Fast Food Restaurants
  21. 21. Fast Food Restaurants + Convenience Stores
  22. 22. Fast Food Restaurants + Convenience Stores
  23. 23. Fast Food Restaurants + Convenience Stores Grocery Stores
  24. 24. Fast Food Restaurants + Convenience Stores Grocery Stores + Produce Vendors
  25. 25. Fast Food Restaurants + Convenience Stores Grocery Stores + Produce Vendors California: 4.18 Retail Food Environment Index
  26. 26. $10 BILLION IS SPENT ANNUALLY ADVERTISING FOOD AND BEVERAGES TO CHILDREN IOM, 2005
  27. 27. Human beings are biologically hard- wired to crave fat, sugar and salt
  28. 28. Cities are Designed for Cars, Not People Cities are Designed for Cars, Not People
  29. 29. Physical Education?
  30. 30. Safe Parks?
  31. 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. 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. 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. 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. 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. 36. Personal Responsibility OR Collective Responsibility
  37. 37. Personal Responsibility AND Collective Responsibility
  38. 38. Individual Behavior or The Environment
  39. 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. 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. 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. 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. 43. CA School Food Reforms (1999–2005)
  44. 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. 45. 2007 - 2008 Give consumers the information they need so they CAN make healthy choices MENU LABELING
  46. 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. 47. Test your fast-food IQ
  48. 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. 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. 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. 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. 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. 53. Surgeon General on Smoking: 1964 “…cigarette smoking contributes substantially to mortality from certain specific diseases and to the overall death rate.”
  54. 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. 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. 56. Surgeon General on Diet: 1988 “…over consumption of certain dietary compo- nents is now a major concern for Americans.”
  57. 57. “Overweight and obesity have reached epidemic proportions nationwide.” Surgeon General on Obesity: 2001
  58. 58. Overweight Prevalence* 1980-2000 * US adults (18+ years) 1980 1990 2000 PercentOverweight 20% 40% 60% 80% 1988
  59. 59. If these problems go unchecked: The long term consequences will be staggering
  60. 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

×