Priority Area: Physical Activity and Nutrition

The Burden of Physical Inactivity and Poor Nutrition

Major causes of morbidity and mortality in the United States are related to poor diet and physical inactivity. By maintaining a healthy diet and being physically active, individuals can achieve a healthy weight and reduce their risk of chronic diseases such as diabetes, heart disease and some forms of cancer; strengthen bones and reduce the risk of osteoporosis. Cardiovascular diseases are the leading causes of death in New York State, killing almost 59,000 residents each year. Diabetes is the most rapidly growing chronic disease, affecting one out of every 12 adult New Yorkers.

Obesity, which may be addressed through proper nutrition and physical activity, is a major risk factor for many chronic diseases, and has reached epidemic proportions both in New York and across the nation. The percentage of obese adults in New York State more than doubled from 10% in 1997 to 25% in 2008 and, nationally, obesity among children and adolescents has tripled over the past three decades. In fact, obesity costs New York State more than $6 billion annually in direct medical expenditures for treatment of related diseases, as well as indirect costs such as lost productivity.1 Physical inactivity, poor nutrition, consumption of sugar-sweetened beverages and television viewing can contribute to excess weight gain in children and adults.

References

  1. Finkelstein EA, Fiebelkorn IC, Wang G. State-level estimates of annual medical expenditures attributable to obesity.Obesity Research. January 2004;12(1):18-24.

Objectives

  • By the year 2013, reduce the percentage of New York children who are overweight or obese so that:
    • The percentage of children (ages 2-4 years) enrolled in the Supplemental Nutirion Program for Women, Infants and Children Program (WIC) who are obese is no more than 11.6%.*
      (Baseline: 15.5%, WIC Program data, 2005)
    • The percentage of children ages 6-11 years who are obese is no more than 5%.*
      (Baseline: unavailable)
    • The percentage of children ages 12-19 years who are obese is no more than 5%.*
      (Baseline: unavailable)
  • By the year 2013, reduce the percentage of adult New Yorkers who are obese to no more than 15.0%.* (Baseline: 22.9%, BRFSS, 2006)
  • By the year 2013, increase the percentage of adult New Yorkers who engage in some type of leisure time physical activity to at least 80%.* (Baseline: 74.0%, BRFSS, 2006)
  • By the year 2013, increase the percentage of adult New Yorkers who consume fruits and vegetables five or more times per day to at least 33.0%.* (Baseline: 26.0%, BRFSS, 2005)
  • By the year 2013, increase the proportion of New York mothers who breastfeed their babies at 6 months to at least 50%.* (Baseline: 39.5% of WIC mothers, WIC Program data, 2005)

    * Healthy People 2010 Objective

Indicators for Tracking Public Health Priority Areas

Each community's progress towards reaching these Prevention Agenda Objectives is tracked so communities can see how close they are to meeting these objectives.

Data and Statistics

New York State Department of Health Programs

Healthy Heart Program

  • The Healthy Heart Program addresses cardiovascular disease by reducing associated risk factors and improving detection and treatment, especially for hypertension, hyperlipidemia and stroke. It supports or collaborates with many partners to implement public health strategies in four sectors: worksites, schools, health care settings and the community-at-large.
  • The environment in which people live, work, play and receive health care strongly influences physical activity, food habits and other health-related behaviors. Policy and environmental changes help people be physically active, eat healthy foods, and receive evidence-based health care. Sample interventions include making communities more walkable, opening schools after hours for community use, establishing community gardens, implementing health risk appraisals at worksites, making it safer for children to walk and bike to school, and improving care for people suffering from strokes.
  • The Healthy Heart Program, with a panel of experts, developed Cardiovascular Health in New York State: A Plan for 2004 - 2010, which details 19 objectives to promote healthier behaviors, quality health care and reduction of risks for heart disease and stroke.

Overweight and Obesity Prevention Program

  • The Overweight and Obesity Prevention Program aims to increase physical activity and improve nutrition among New York residents. The program’s current primary focus is the prevention of childhood obesity.
  • The New York State Strategic Plan for Overweight and Obesity Prevention identifies evidence-based strategies and promising approaches that can be replicated. Interventions that address the need for changing policies and environments to promote and provide options for healthy eating and more physical activity are highlighted.
  • Priority areas of the strategic plan are based on their potential for:
    • Increasing the perception of overweight and obesity as major public health threats.
    • Increasing early recognition of healthy weight, overweight, and/or excessive weight gain.
    • Promoting, supporting, and maintaining systemic and sustainable changes needed to make healthy eating and physical activity easy for everyone.
    • Expanding and improving surveillance and program evaluation.
    • Increasing initiation, exclusivity and duration of breastfeeding during infancy.
    • Increasing lifelong physical activity.
    • Improving lifelong healthy eating.
    • Decreasing exposure to television and other recreational screen time.
  • In addition to the tracking indicators, the Overweight and Obesity Prevention Program has established two indicators to monitor its impact on TV viewing:
    • Percentage of 9th - 12th grade students watching one hour or less per day of TV on an average school day (YRBSS 2007) for New York State and the U.S.
    • Percentage of 9th - 12th grade students watching two hours or less per day of TV on an average school day (YRBSS 2007) for New York State and the U.S.

Student Weight Status Initiative

  • A new approach to assess childhood obesity throughout the state is being implemented to:
    • Increase screening and early recognition of overweight and obesity by pediatric healthcare providers.
    • Collect, aggregate and report weight status data for public schools and school districts.
    • Provide local, county and statewide estimates of the prevalence of childhood obesity.
    • Target resources to populations most at risk for childhood obesity.
    • Identify what is working in schools and communities to help prevent and reduce childhood obesity.

Model Guidelines on Nutrition, Physical Activity and Media for After-School Settings

  • New York is one of 10 states selected to receive a grant from the National Governors Association to develop and disseminate model guidelines on nutrition, physical activity and media use in after-school care settings. Recognition will be given to after-school programs that adopt and implement the model childhood obesity prevention guidelines.

Diabetes Prevention and Control Program

  • The Diabetes Prevention and Control Program (DPCP) collaborates with local, state and national partners to reduce and eliminate the burden of diabetes in New York State. Since its inception, the DPCP has transitioned from a focus on the control of diabetes complications to a comprehensive public health approach including prevention of type 2 diabetes and the promotion of healthy lifestyles across the lifespan. The DPCP has identified three goals to align with CDC's and national diabetes program framework:
    • Prevent type 2 diabetes.
    • Prevent complications, disabilities and the disease burden associated with diabetes.
    • Eliminate diabetes-related health disparities.
  • In order to achieve these goals, the DPCP implements strategies within the following priority areas:
    • Public awareness and education.
    • Children and diabetes in schools and childcare settings.
    • Healthcare practice.
    • Access to care.
    • Sustainability and policy, systems and environmental change.
    • Public health tracking and evaluation.

Eat Well Play Hard Program

  • Eat Well Play Hard (EWPH) is a childhood obesity prevention initiative incorporated into large-scale public health food and nutrition programs that serve low-income preschool children and their families in targeted communities. EWPH strategies are integrated into each program’s food policies, nutrition education efforts, staff training, and marketing and outreach efforts. The core strategies for the EWPH intervention aim to:
    • Increase developmentally appropriate physical activity.
    • Increase consumption of 1% or fat-free milk and low-fat dairy products.
    • Increase consumption of fruits and vegetables.
    • Decrease TV and screen time.
    • Increase the initiation and duration of breastfeeding.
  • A total of 15 community projects cover 22 counties and involve a variety of settings including daycare centers, WIC clinics, schools, and after-school programs. The statewide goal for these projects is to establish sustainable, local collaborative partnerships that focus on creating environmental, policy and practice changes to increase healthy eating and physical activity at the community level.

Special Supplemental Nutrition Program for Women, Infants and Children (WIC)

  • The Women, Infants and Children (WIC) Program supports the EWPH objectives through state policies and resources provided to WIC local agency staff and participants, such as encouraging low-fat dairy products for participants over age two and incorporating physical activity into clinic education.

Child and Adult Care Food Program

  • Recognized as the gold standard for nutrition and food service in daycare centers, the Child and Adult Care Food Program currently serves more than half of all eligible daycare programs, including all Head Start centers in the state.

The Hunger Prevention and Nutrition Assistance Program

  • Hunger Prevention and Nutrition Assistance Program (HPNAP) ensures that the state’s emergency food system supports EWPH objectives by establishing policies and resources for emergency food relief organizations, such as food banks, food pantries, soup kitchens and shelters. Examples of these efforts include:
    • The HPNAP policies require that at least 10 percent of HPNAP food funds are spent on fresh produce and a minimum of two percent are spent on non-flavored low-fat or non-fat fluid milk.
    • Food recovery projects, food banks, and other contractors are increasing the availability of fresh produce, including locally grown produce, in food pantries, soup kitchens and emergency shelters by collecting leftover produce on farms, participating in Community Supported Agriculture, operating gardens and delivering fresh produce to low-income areas.
    • Just Say Yes to Fruits and Vegetables is a Food Stamp Nutrition Education Program designed to increase access to and consumption of fruits and vegetables by individuals and families receiving food stamps and WIC benefits.

Strategic Alliance for Health

  • The Strategic Alliance for Health program is working to create healthier communities through sustainable, innovative, evidence-based and practice-based community health promotion and chronic disease prevention efforts that promote policy, system, and environmental change. Albany, Broome, Orange, and Schenectady Counties are funded to work with schools and communities to encourage physical activity, healthy eating, and tobacco-free choices in order to reduce the burden of diabetes, cardiovascular disease, and obesity. Beginning in September 2009, interventions will target populations most in need with a special emphasis on reaching specific racial and ethnic groups, those with limited income and insurance coverage, those with high chronic disease rates, and individuals with disabilities.

Strategies - The Evidence Base for Effective Interventions

Reports

All Ages

  • Physical Activity Guidelines for Americans

    The Federal Government has issued its first-ever physical activities guidelines. They describe the types and amounts of physical activities that offer substantial health benefits.

  • U.S. Dietary Guidelines for Americans

    The guidelines are jointly issued by the Departments of Agriculture and Health and Human Services. They provide authoritative advice for people two years and older about how good dietary habits can promote health and reduce risk for major chronic diseases.

  • Rudd Center for Food Policy and Obesity - Yale University

    This report describes policy initiatives to increase the availability of healthy foods in low-income neighborhoods.

  • Robert Wood Johnson Reports on Physical Activity

    The environment in which people live can make it easier, or more challenging, to be physically active. Physical changes to communities can create safe, healthy environments that encourage and promote active living.

  • RWJF Toolkit Offers Resources to Prevent Childhood Obesity

    Leadership for Healthy Communities, a national program of the Robert Wood Johnson Foundation (RWJF), created an Action Strategies Toolkit, in close collaboration with 11 national policy-maker organizations. The toolkit offers practical examples of policy approaches and resources that can help state and local policy-makers prevent childhood obesity and improve children's health.

  • The Keystone Forum on Away-From-Home Foods: Opportunities for Preventing Weight Gain and Obesity - Final Report, May 2006

    This report describes current patterns in eating away from home and potential strategies to reduce calorie consumption in these settings. The report examines: 1) Understanding and influencing consumer behavior with regard to away-from-home foods; (2) increasing the availability of lower-calorie products, menu items, and meals at establishments that provide away-from-home foods; and (3) providing consumers with nutrition information regarding away-from-home foods.

  • Reversing Obesity in NYC

    This October 2008 report educates people about food policy choices for New York City. The target audience is health professionals, advocates, and policy makers.

Diabetes Prevention Program, National Institutes of Health

The Diabetes Prevention Program demonstrated that lifestyle change, such as weight loss and increased physical activity, among people with pre-diabetes reduces the risk of type 2 diabetes by 58 percent and may return blood glucose levels to normal. In adults over the age of 60, the risk was reduced by 71 percent.

Children

Resources

CDC Division of Nutrition, Physical Activity and Obesity

CDC provides information about public health approaches to address the role of nutrition and physical activity in improving the public's health and preventing and controlling chronic disease. It includes epidemiological and behavioral research, surveillance, training and education, intervention development, health promotion and leadership, policy and environmental change, communication and social marketing, and partnership development.

The Center for Science in the Public Interest

This organization provides information on a variety of nutrition issues including trans fat, menu labeling, sugar-sweetened beverages, school nutrition policies and more.

CDC Weight Management Research to Practice Guides

An overview of the science on different nutrition topics is summarized for public health professionals, including implications for practice. Topics to date include away-from-home food consumption, fruit and vegetable consumption, portion sizes, decreasing sugar-sweetened beverages consumption, breastfeeding and pediatric overweight risk reduction, and low-energy-dense foods.

Return on Investment

Worksite Wellness

This website provides examples of companies saving money in a variety of areas due to wellness programs at the worksite.

Healthy Workforce 2010: An Essential Health Promotion Sourcebook for Employers, Large and Small

This resource is a guide for large and small employers to plan effective health promotion programs for their employees, providing a positive return on investment.

Community-Based Physical Activity Interventions

Seven physical activity interventions to reduce disease incidence are cost-effective and offer good value for money spent.

American Journal of Health Promotion: Economic Return on Investment of Worksite Wellness

Economic Return on Investment of Worksite Wellness is a formal meta-evaluation of 56 economic return studies of worksite health promotion programs.

Partners

More Information

Bureau of Community Chronic Disease Prevention
Address: Riverview Center, Room 350. 150 Broadway, Albany, NY 12204
Email: hhp@health.state.ny.us
Voice: 518-408-5142
Fax: 518-474-3356

Division of Nutrition
Address: Riverview Center,6th Floor West, 150 Broadway, Albany, NY 12204
Email: ewph1@health.state.ny.us
Voice: 518-402-7090
Fax: 518-402-7220