Arkansas School Student BMI Assessments

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Arkansas School StudentBMI Assessments

• Joseph W. Thompson, MD, MPH
• Director, Arkansas Center for Health Improvement

2005 3rd National Prevention SummitWashington,
DC 2005 Secretarys Innovation in Prevention
AwardsPublic SectorSchoolsObesity October 24,
2005
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Arkansas Center for Health Improvement

• Mission
• Be a catalyst for improving the health of
  Arkansans through evidence-based research, public
  issue advocacy, and collaborative program
  development

Health Promotion/ Disease Prevention
Health Care Financing
Scope of Work
Access to Quality Care
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ACHIs major achievements

• Tobacco Settlement Proceeds Act
• Optimization for Arkansas Medicaid
• Arkansas Health Insurance Roundtable strategic
  plan and safety-net benefits program
• Arkansas Southern Rural Access Program
• Arkansas Health Data Initiative
• Child and adolescent obesity initiative

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National data sources on child and adolescent
obesity

• National Health and Nutrition Examination Survey
  (19702001)
• Source of federal estimates for childhood obesity
• Actual measurements of
• Youth Risk Behavior Survey
• CDC/State survey of adolescents
• Self-reported data on height and weight

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BMI normalized percentile histograms from NHANES
19761980
19711974
0 20 40 60 80 100
0 20 40 60 80 100
19992001
19881994
0 20 40 60 80 100
0 20 40 60 80 100
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84th General Assembly Act 1220 of 2003
An act to create a Child Health Advisory
Committee to coordinate statewide efforts to
combat childhood obesity and related illnesses
to improve the health of the next generation of
Arkansans and for other purposes.

• Goals
• Change the environment within which children go
  to school and learn health habits everyday
• Engage the community to support parents and build
  a system that encourages health
• Enhance awareness of child and adolescent obesity
  to mobilize resources and establish support
  structures

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Act 1220 activities

• Elimination / restriction of all vending machines
  in schools statewide
• Requirement of professional education for all
  cafeteria workers
• Public disclosure of pouring contracts
• Establishment of local parent advisory committees
  for all schools
• Establishment of a state Child Health Advisory
  Committee to make recommendations to DOE
• Confidential child health report delivered
  annually to parents with body mass index (BMI)
  assessment

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BMI Taskforce
Developed Strategic Plan
School Nurses Local Clinical Resources
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Data from Arkansas public schools


Matched for 2-yr comparison 264,480
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Overall results by BMI classification
c26.3, df3, p .05
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Arkansas BMI standardized percentiles
20032004
0 10 20 30 40 50 60 70 80 90 100
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Percentage of students overweight or at risk for
overweight by Arkansas school districts
(20042005)
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Overall results by grade
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Child Health Report (2004)
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Overall results by gender and ethnicity
60
50.7
49.7
50
44.2
43.9
43.1
42.6
38.7
38.6
38.5
38.3
34.6
40
34.3
30
20
10
0
Year 1 2 1 2 1 2 1 2 1 2 1 2
Females Males Females Males Females Males
Caucasians African Americans Hispanics
Overweight At risk for overweight
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Spanish Child Health Report (2005)
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Child obesity initiative accomplishments

• Physician Continuing Medical Education
• BMI screening and treatment algorithm
• Year 3 of BMI assessments underway
• Community, school district, and school reports
  being developed for year 3
• Support for local Parent Advisory Committees
• Board of Education adopted Child Health Advisory
  Council recommendations
• Baseline established for evaluation of Acts
  impact

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Conclusions

• Arkansas population-based assessments exceed the
  national estimates for child and adolescent
  obesity rates
• US estimates 15 overweight / 15 at risk
• AR estimates 21 overweight / 17 at risk
• Parental reports incorporated to raise awareness
  school and health resources mobilized for support
• Longitudinal school-based assessments are
  possible and provide local information
• Establishing a baseline enables the state to
  evaluate progress in combating the child obesity
  epidemic

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