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Physicians for Healthy Communities Initiative: An obesity prevention project of the CMA Foundation

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Title: Physicians for Healthy Communities Initiative: An obesity prevention project of the CMA Foundation


1
Physicians for Healthy Communities InitiativeAn
obesity prevention project of the CMA Foundation
2
CMA Foundation Mission
  • The CMA Foundation champions improved individual
    and community health through a partnership of
    leaders in medicine, related health professions,
    and the community.
  • To fulfill our mission, the CMA Foundation acts
    as a bridge linking physicians to their
    communities. We work in collaboration with all of
    our many partners to achieve significant
    improvement in key health issues. We receive
    funding for our projects through physician,
    corporate, and foundation support.

3
The CMA Foundations Physicians for Healthy
Communities project will
  • Prevent obesity, focusing on youth, underserved
    communities and high-risk ethnic groups.
  • Train and support Physician Champions to
    educate, advocate, and shape policies on
    overweight and obesity.
  • Strengthen physicians impact on public health.

4
Obesity Timeline
  • 1980s screen time increases, physical activity
    decreases
  • 1985 NIH classifies obesity as disease
  • 1990s fast-food and computer use explodes
  • 1992 USDA creates Nutrition Facts and Food
    Pyramid
  • 2001 U.S. Surgeon General issues Call to
    Action
  • 2004 LA Unified Schools bans soft drinks
  • 2004 Institute of Medicine report Preventing
    Childhood Obesity
  • 2005 California passes the most strict school
    nutrition bills in the country

5
From the AAP
  • Prevalence of overweight and its significant
    co-morbidities in pediatric populations has
    rapidly increased and reached epidemic
    proportions. Advocacy is needed in the areas
    ofearly recognition and management of overweight
    and obesity Committee on Nutrition,
    Prevention of Pediatric Overweight and Obesity
    (2003)

6
From the American Academy of Family Physicians
(AAFP)
  • Family Physicians should offer assistance to
    patients that are obese or overweight or who
    request assistance to prevent obesity. Family
    physicians should also participate in local,
    state and national efforts to prevent obesity,
    and encourage physical activity for both children
    and adults. Policy and Advocacy (2004)

7
From the AMA
  • The war on obesity cannot be fought only on the
    clinical front. It requires a collaborative and
    coordinated effort by many groups, and
    physiciansare in the unique position of being
    able to negotiate many of those arenas.
    -Recommendations for Physician and Community
    Collaboration on the Management of Obesity (2005)

 
8
From the Institute of Medicine (IOM)
  • An epidemic of childhood obesityis occurring in
    boys and girls in all 50 states,across all
    socioeconomic strata, and African Americans,
    Hispanics, and American Indians are
    disproportionately affectedour children are
    gaining weight to a dangerous degree and at an
    alarming rate.
    Preventing Childhood
    Obesity (2005)

9
From the CMA
  • CMA encourages physicians to become
    knowledgeable about community resources and
    referral services that can assist with the
    management of diabetic, overweight and obese
    patientsCMA recognizes the many benefits of
    educating parents, children and physicians about
    obesity, its treatment and about healthy
    lifestyles. (2005)

10
National and State Efforts
  • National Government
  • Public education handbooks toolkits
  • Outreach campaigns
  • Focus Growing obesity issue adopting healthy
    lifestyles
  • Focus Shaping individual and family behaviors in
    home community
  • California
  • Changes in school environments vending machines,
    wellness policies, etc.
  • Several state programs promoting healthy, active
    lifestyles
  • Examples
  • California Nutrition Network
  • California 5 a Day
  • Project Lean
  • California Works Well Health Promotion Program
  • StayWell Program
  • California Obesity Initiative
  • California Diabetes Program

11
Governors 10-Point Vision for a Healthy
California
  • Emphasis on importance of physical activity and
    healthy eating.
  • Childrens daily participation in physical
    activities.
  • Adults will be physically active every day.
  • Only healthy foods and beverages in schools.
  • Market only healthy foods and beverages to
    children 12 years old and younger.
  • Affordable and readily available produce and
    healthy food.
  • Community and neighborhood support of physical
    activity.
  • Access, affordability and promotion of healthy
    foods and beverages in grocery stores,
    restaurants and entertainment venues.
  • Promotion of physical activity and healthy eating
    by insurers and health care providers.
  • Employee access to physical activity and healthy
    food options.

Governors Vision for a Healthy California.
Governors Summit on Health, Nutrition and
Obesity. Sept. 15, 2005.
12
Context for Action
  • The prevalence of adult obesity has doubled over
    the last 20 years. California has experienced
    the fastest increase in adult obesity of any
    state in the nation.
  • Nearly 2/3 of the U.S. adult population is
    overweight 32 of those are considered obese
  • Overweight adults have a
  • 60 increased risk for diabetes
  • 80 increased risk for high blood pressure
  • 50 higher chance for elevated cholesterol levels
  • 17 of children and adolescents are overweight
  • 15 of children and adolescents are at risk 70
    - 80 of obese adolescents will become obese
    adults.
  • The incidence of obesity is higher in
    African-American, Latino, and underserved,
    low-income populations.
  • Health Plans Emerging As Pragmatic Partners in
    Fight Against Obesity. National Institute for
    Health Care Management. April 2005.
    http//www.nihcm.org/finalweb/Obesity Report.pdf
  • Department of Health and Human Services. Healthy
    People 2010, 2nd ed. With understanding and
    improving health, and objectives for improving
    health. Washington, DC Government Printing
    Office, 2000.

13
Populations at Risk
  • Low-income
  • lt185 of Federal Poverty Level
  • 34,873 for a family of 4
  • African-Americans
  • Latinos
  • Youth
  • California Obesity Prevention Initiative. The
    Obesity Problem. Available at http//www.dhs.ca.g
    ov/ps/cdic/copi/html/problem.htm. Retrieved 9
    November 2005.
  • Department of Health and Human Services.
    Healthy People 2010, 2nd ed. With understanding
    and improving health, and objectives for
    improving health. Washington, DC Government
    Printing Office, 2000.

14
Obesity Rates by Race/Ethnicity
15
Rates of Overweight and Unfit Children in
California
California Center for Public Health Advocacy.
Rates of Childhood Overweight and Obesity in
California Cities and Counties.
16
California Neighborhoods Opportunities for
Children to Get Physical Activity
Nearly 4 in 10 Californians rated their
neighborhoods as fair, poor or very poor in
opportunities for children to get physical
activity. California Field Poll - Childhood
Obesity, November 2003
17
Who do patients want to hear from?
  • Physicians As Key Messengers to Spread the Word

This was highest among Latinos and African
Americans, at 90 and 96 respectively. California
Field Poll - Childhood Obesity, November 2003
18
Economic Consequences
  • Health care costs for obese individuals 36
    (average) higher compared to normal weight
    individuals.
  • Direct and indirect cost of obesity is currently
    100 billion/year nationally.
  • 28.1 Billion in California
  • Health Plans Emerging As Pragmatic Partners in
    Fight Against Obesity. National Institute for
    Health Care Management. April 2005.
    http//www.nihcm.org/finalweb/Obesity Report.pdf

19
Projected Cost for 2005 28
BILLION Source California Department of Health
Services, 2005
20
Why Clinicians need to talk to their patients
about overweight and obesity
  • In a 2003 Field Poll, nearly 90 percent of
    Californians surveyed wanted physicians to be
    their primary source of information about
    nutrition, physical activity, and other issues
    associated with obesity.
  • Physicians report identifying obesity in only
    8.6 of all patients seen in their offices and
    less than 30 of overweight patients report being
    counseled by their physician.
  • Studies have shown that for obese children,
    obesity is documented in the medical record for
    only 53 of these children.
  • Stafford et al. Archives of Family Medicine.
  • Galuska et al. JAMA 1999
  • OBrien et al. Pediatrics 2004.

21
Strategies for Combating Obesity
  • Multifaceted strategies involve the efforts of
    many stakeholders including
  • Individuals
  • Families
  • Employers
  • Health plans
  • Schools
  • Communities
  • Government
  • Policy Makers
  • Healthcare Providers
  • Health Plans Emerging As Pragmatic Partners in
    Fight Against Obesity. National Institute for
    Health Care Management. April 2005.
    http//www.nihcm.org/finalweb/Obesity Report.pdf
  • Preventing Childhood Obesity, Health In the
    Balance. Institute of Medicine. 2005

22
Strategies for Combating Obesity
  • Significant culture changes to
  • promote healthy lifestyles.
  • New model of care and significant
  • cultural change to address the non-
  • medical causes and management.
  • Leverage public and private
  • resources and expertise.
  • Focus on the community as well as lifestyle.
  • Education

Health Plans Emerging As Pragmatic Partners in
Fight Against Obesity. National Institute for
Health Care Management. April 2005.
http//www.nihcm.org/finalweb/Obesity Report.pdf
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