Saturday, April 10, 2010

The Skinny on Childhood Obesity

Yesterday, Michelle Obama led the White House Childhood Obesity Summit.  The meeting was a follow-up to her (much-needed) Let's Move Campaign she announced in February.  We all know childhood obesity is a problem and the first lady is getting some national discussions started on how to combat this public health epidemic within the next generation.  Both Health and Human Services (HHS) Secretary Kathleen Sebelius and Surgeon General Regina Benjamin have also stated their plans to help Americans stop the obesity epidemic.

One of the leading health policy journals, Health Affairs, released their special March 2010 issue (Vol 29, No 3), with the theme: Child Obesity: The Way Forward. In this issue, there are a number of great articles discussing implications of childhood obesity and potential next steps to combat it.

Regarding costs, John Cawley's article on "The Economics of Childhood Obesity," mentioned two interventions shown to be not just effective, but cost-effective in youth.  One is the Coordinated Approach to Child Health (CATCH) and the other is Planet Health (cost-effective for females).  He argues that we need to use policies and incentives to promote cost-effective interventions and to find other cost-effective measures to stop this problem costing us $14.1 billion in outpatient care and $237.6 billion in inpatient care each year (direct costs).  

So, what can we do and what's being done? Thomas Frieden, director of the Centers for Disease Control and Prevention (CDC) was the lead author on an action agenda, "Reducing Childhood Obesity Through Policy Change: Acting Now To Prevent Obesity," in the Health Affairs issue.  Recommendations include: food and beverage taxes, zoning policies, banning ads, counterads, increasing exposure to healthy foods, increasing physical activity, and decreasing sedentary behavior.  However, the food and beverage taxes would likely need to be pretty high as a study released last week in Health Affairs revealed soda taxes at 4% have no effect on consumption.  However, if the tax revenues are used to fund cost-effective interventions for childhood obesity, there is still potential benefit in these increased taxes, also noted by the authors.    The authors also called to duty: federal, state, and local governments, parents, the food industry, and businesses to act.

Additionally, issue and policy briefs were released in Washington DC.  The Senate Health, Education, Labor and Pensions (HELP) Committee started a series of hearings on child obesity and how to address the epidemic, with the first in the series being the Health Affairs hearing on March 2.  A number of stakeholders convened to begin discussions on what can be done, the built environment, and food policy. You can view the Health Affairs Issue Briefing here.  Aside:  One of the speakers was Debbie Chang, Vice President of Policy & Prevention for Nemours.  I consulted with Dr. Cynthia Minkovitz and the Johns Hopkins Women & Child Health Policy Center (WCHPC) on a policy scan last year regarding current policies practiced by youth-serving organizations to promote healthy eating and physical activity.  It's exciting to be a part of positive change for our nation.

What are your thoughts on the best way to fight childhood obesity?  What is the largest barrier to stopping the epidemic?

Health Affairs, 29, no. 3 (2010): 357-363
The theme issue for Health Affairs was supported by the Robert Wood Johnson Foundation.
Photo of Michelle Obama courtesy of Evan Vucci/Associated Press.

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