State health officials use many strategies to fight obesity

Georgia health officials say they are using multiple strategies to fight obesity in the state, even as the recent Trust for America's Health report, “F as in Fat: How Obesity Policies are Failing in America, 2005,” presents a sobering picture of the obesity epidemic in the United States.

"When you know there is a health problem that is affecting over half, and almost two-thirds, of your population, you go to work on it," said Dr. Stuart Brown, director of the Division of Public Health. "And that's exactly what we've done."

Although the Trust for America's Health report makes a strong argument for broader policy change, especially in regard to urban and suburban community planning, Georgia officials say community-level interventions, in a variety of settings, are the focus of the state's efforts to reduce obesity and associated health risks.

The Division of Public Health received a CDC grant in 2003 to address obesity and physical activity in the state, and this summer published its own report and 10-year action plan, Georgia's Nutrition and Physical Activity Plan - To Prevent and Control Chronic Disease in Georgia, 2005-2015. In addition to considering the planning and policy changes championed in the national report, the Georgia plan calls for integrated efforts in communities, and through schools, health care providers, work sites, and faith-based organizations.

A Division of Public Health worksite wellness program - Healthy Solutions for Business Groups - has helped Georgia emerge as a leader in worksite wellness according to program officials. Over the past two years, program staff have provided over 85 workshops and presentations to business groups and chambers of commerce across the state, representing more than 800 employers with a combined workforce of over a million Georgians. Providing technical assistance and linkages to vendors and health insurers, the program focuses on reducing employers' health care costs and insurance premiums by reducing cardiovascular disease risk in their employee populations. Worksite risk reduction programs help employees increase physical activity and as a result help reduce obesity.

The Division of Public Health Chronic Disease Prevention branch has also partnered with school districts to implement the School Health Index, a school-based assessment of health and nutrition policy. Public health staff from the state or local health districts provide technical assistance and consultation on developing school health promotion policies that focus on physical education, nutrition (and vending machines), and how school staff can model health behaviors. DeKalb, Glynn, and McIntosh counties have all worked with the Department of Human Resources to implement the school health index in various schools in their counties.

In addition, health officials say the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), continues to provide nutrition education and coupons for nutritious foods to thousands of low-income Georgians.

"Being low-income is a risk factor for poor nutrition," said Brown. "The WIC program allows us to reach a population that is at risk for poor nutrition, provide healthy food and nutrition education, and help reduce poor health outcomes - including obesity - that are associated with poor nutrition."

Recognizing the burden of chronic disease generally, and obesity specifically, Georgia governor Sonny Perdue last year launched the Live Healthy Georgia campaign in collaboration with the Department of Human Resources. Live Healthy Georgia seeks to reduce chronic disease in the state, and is designed to remind Georgians of leading risk factors with five simple prevention messages: Be Active, Be Smoke Free, Eat Healthy, Get Checked, and Be Positive.

Using data from both the US Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), the Trust for America's Health report ranked US states by percentage of overweight and obese adults. According to the report, Georgia ranks 12th highest in the nation for the percentage of adults that are classified as obese, 24.5 percent — the same as the percentage of adult obesity in the US as a whole.

Because being overweight is a leading risk factor for becoming obese, the report also ranks states by the combined percentage of adults who are overweight or obese. The percentage of Georgia adults who are either overweight or obese, 59.6 percent, ranks 25th in US, and is lower than the national average of 64.5 percent.

The state with the highest combined percentage of overweight and obese adults is Mississippi with 65.5 percent, while Colorado has the lowest percentage, 52.9 percent. Although the rankings likely generated headlines in every state, health officials point out that the true headline should be how narrow the range of difference is, even from worst to best.

"When you look at the rankings, you're struck by the fact that in the state that ranked 'best,' over half - more than half - the adults are overweight or obese, and that's the best we've got," said Brown. "And when you look at the 'worst' state, you see that it is only one percentage point worse than the US as a whole. The bottom line is, we are a fat nation, and it is killing us."

Brown said that there are many factors that influence obesity levels in the state and across the nation including urban sprawl, super-sized portions at many restaurants, and a proliferation of entertainment choices in which participants are sedentary, such as video games. Because lifestyle choices are individual and personal, ideal health promotion programs teach individuals how to make healthy choices and foster community environments that support those choices.

"We know obesity is a problem, a serious problem, and we know that making progress will take time," he said. "And while we have got a good plan, it is something that everyone is going to have to make personal decisions about - how long do I want to live? What do I want the quality of my life to be?"