Obesity affects as many as 30% of the population and associated with a variety of comorbid conditions. It remains a contributing factor to hypertension, diabetes, mellitus, cardiovascular disease, arthritis, and sleep disorders, (Weintraub et al, 2011). This causes increased concern for public health. It attributes to high medical costs in a number of fields and areas. Studies suggest that by the year 2030 medical costs related to obesity will rise above $1 trillion, (Weigntraub et al, 2011). However, the dynamics of obesity is complex and multi-layered. It is related to many facets of society including nutrition, environment, education, and community. This can be observed in low costs of high calorie foods, limited access to recreation, and reduced options in underserved areas. For this reason, there is a growing concern to reduce obesity. Help from the state and district representatives are required to ensure the good health of the communities they serve. The most effective way to attack this problem is to apply government policy and community partnership. Enacting, the Community Health Initiative for Promoting Exercise and Nutrition (CHIPEN), will provide policies and programs, education, taxation, and environmental infrastructure to improve public health and reduce obesity.
Strategy, Message, Recommendations
To ensure long term success, assistance from local and state government is needed for community action. This can only be accomplished through change in policy to provide incentive programs and improve community infrastructure. The suggested policy is called, Community Health Initiative for Promoting Exercise and Nutrition, CHIPEN. The initiative is created to improve health, one community at a time. It is multi-layered to work in coordination and partnership with nongovernment institutions. The message and recommendation is to use a variety of environments in collaboration to improve public health. The aim is to reduce the rate of obesity from 30% to 20% by the year 2020.
To promote nutrition, policies must be created under CHIPEN to discourage unhealthy foods and encourage the consumption of healthy foods. This can be done by, “food policies to reduce obesity: altering relative food prices, shifting our exposure to food, and improving the image of healthy food while making unhealthy food unattractive”, (Frieden, Dietz, & Collins, 2010). There are many ways to achieve this. This includes increased taxes on sugary drinks which accounts for the significant rise in obesity. Policies like this are currently in place in various cities across the state including San Francisco and Berkeley. Additional avenues are to promote fruits and vegetables through community based programs and incentives. Vouchers will be provided to Women Infants and Children’s, Special Supplemental Nutrition programs and Food Stamps. To ensure these families have access to healthy foods, grocers and corner stores must be improved. This includes creating community gardens, incentive programs for health food stores to build in underserved communities, and farmers markets.
However, stimulating health through improved nutrition is also aimed at high calorie food. CHIPEN involves community zoning. Zoning restrictions will be applied to fast food establishments that can distance locations from high risk communities, schools, and residential areas. Zoning will also be applied to public schools to restrict high calorie foods from the cafeteria. In conjunction with counter advertisement, the image of unhealthy foods will educate the public of its harmful agents. The public will be less tempted to consume foods that encourage obesity. In this way, these “polices improve market competitive and promote more consumption of fruits and vegetables”, (Frieden, Dietz, & Collins, 2010).
There is significant supporting evidence by researchers and organizations to reduce obesity and improve public health. Representatives of the American Heart Association developed a policy statement for recommendations to prevent cardiovascular disease often related to obesity. They indicate the “primary prevention is an environmental model that maintains that an individual’s behavior is influenced by his or her surrounding physical, social, and cultural environments… workplaces, schools, homes, and communities”, (Weintraub et al, 2011). Other associations to combat obesity include city and county programs. Thus, by providing policy that incorporates various influences associated with obesity it improves the objective of policy initiatives.
Taxation on unhealthy foods and beverages is proven to raise billions per year for the state (Salis et al, 2012). A study conducted by the Journal of Health Affairs found that, “taxes would reduce average per capita consumption by 8,000 calories annually, potentially preventing about 2.3 pounds per year of weight gain” (Frieden, Dietz, & Collins, 2010). Pennsylvania was one of the first states to create a program improving access to healthy food options in underserved communities. This community created 5000 new jobs and $190 million annually in revenue by building health food stores in these areas, (Weintraub et al, 2011). They further renovated existing stores and developed a partnership with businesses to market and promote reduced priced produce. It more than quadrupled the initial government investment of $30 million. Reducing prices of low-fat items has proven to increase the purchase and consumption of healthy goods. This was seen even when reducing produce price by 10%, (Chan & Woo, 2010).
Improving community infrastructure has also shown to promote physical activity and recreation, thus curbing the rate of obesity. “A study … found that for every $1 invested in building (walking) trails, nearly $3 in medical cost savings may be achieved”, (Weintraub et al, 2011). Additional studies conducted by the Urban Institute found that investing $10 per person in community based prevention programs saves the country $16 billion annually for 5 years, (Weintraub et al, 2011). Suggested examples include improving current parks and recreation facilities to promote activity. This is seen as many underserved communities have limited access or desire to use parks and recreation centers due to distance, safety, and infrastructure. From creating bike trails to updating and innovating community parks, individuals will have access and resources to move. Other programs have shown positive results to improve physical activity. Federal funded program, Safe Routes to School, promoted safe and active commuting to school improving walking by 64% and biking by 114%, (Foltz et al, 2012).
Impact and Importance
Various organizations in health have shown interest in this problem and addressed ways to curb the obesity epidemic. This has the potential to reduce healthcare costs and improve the overall health of communities across the nation. Organizations including, “the US Preventive Health Services Task Force and the Task Force on Community Preventive Services, sponsored by the Agency for Healthcare Research and Quality and the Centers for Disease Control and Prevention, respectively have evaluated the evidence for the effectiveness of preventive services”, (Weintraub et al, 2011). These organizations have conducted researched and collected evidence for recommendation. The American Heart Association recommends this be addressed as a policy strategy to make obesity prevention a priority. Organizations such as the Centers for Disease Control and the American Heart Association recommend targeting the context of daily lives. It includes recreation, transportation, built environments, schools, and worksites to improve physical activity, (Sallis, Floyd, Rodriguez, & Saelens, 2012).
Policy provides laws to regulate government, corporate, health, and educational practices. Thus, it is the responsibility of government representatives to hear, process, and generate legislature to maintain the health of society. Obesity continues to be a growing problem of concern. It has generated attention from high profile people such as former First Lady Michelle Obama, physicians, health organizations, and the general public. To sustain public health and the security of future generations, policies must be enacted. This includes to improve the health of individuals and families, social equality, and the American economy. Obesity and the health complications associated with it are preventable and reversible. Its enactment will reduce health care costs and improve the overall quality of life. Not only does it improve health it is also cost effective. AHA policy statement “suggest that public policy, community efforts, and pharmacological interventions are likely to be cost-effective and often cost saving compared with common bench marks”, (Weintraub et al, 2011). This only substantiates the need and effectiveness of combination intervention strategies as observed in CHIPEN. With the involvement of school, community, government, health, and organizational institutions, it can substantially slow the epidemic of obesity in the United States to 20% by 2020.
- Chan, R., & Woo, J. (2010). Prevention of overweight and obesity: How effective is the current public health approach. International Journal of Environmental Research and Public Health, 7(3), 765-83. Retrieved from http://www.mdpi.com/1660-4601/7/3/765/htm
- Foltz, J., May, A., Belay, B., Nihiser, A., Dooyema, C., & Blanck, H. (2012). Publication-level intervention strategies and examples for obesity prevention in children. The Annual Review of Nutrition, 3(2), 391-415. Retrieved from http://www.genhkids.org/Downloads/Obesity Prevention Strategies – Peer Reviewed.pdf
- Frieden, T., Dietz, W., & Collins, J. (2010). Reducing childhood obesity through policy change: Acting now to prevent obesity. Journal of Health Affiars, 29(3), 357-63. Retrieved from http://w.banpac.org/pdfs/sfs/2010/reduc_child_obes_11_04_10.pdf
- Sallis, J., Floyd, M., Rodriguez, D., & Saelens, B. (2012). Recent advances in preventive cardiology and lifestyle medicine. Circulation, 12(5), 729-37. Retrieved from http://circ.ahajournals.org/content/125/5/729.full
- Weintraub, W., Daniels, S., Burke, L., Franklin, B., Goff, D., Hayman, L., Lloyd-Jones, D., & Pandey, D. (2011). American heart association policy statement. Circulation, 12(4), 967-90. Retrieved from http://circ.ahajournals.org/content/124/8/967.long