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Rob Horowitz: National Attention to Obesity Starting to Pay Off

Tuesday, March 25, 2014


It's time to build on the positive results, expand on what we now know works and bring more resources and attention to solving the obesity epidemic, believes Rob Horowitz.

While the national debate over Obamacare is likely to continue at a high pitch at least through the mid-term elections in November, it is important to remember that health outcomes and costs are not only dependent on our approach to health insurance. No matter what kind of health care system we build, increasing life expectancy and containing costs is in large measure a function of whether or not we succeed in instilling better personal health habits including reducing smoking, drug abuse and obesity.

And on the obesity front there is some good news to report. Americans are no longer getting fatter. Perhaps more importantly, where comprehensive programs to prevent obesity in children have been put in place significant reductions in obesity rates are beginning to be seen.

The obesity epidemic

Stopping the precipitous increases in obesity in adults is an important first step. The average American is 24 pounds heavier today than in 1960, according to F as in Fat: How Obesity Threatens America's Future 2013, a report from the Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF). In the past 30 years, adult obesity rates have more than doubled; more than 1-in-3 adults are now obese. If this rate of increase continued it was projected that the “obesity rate would reach 50% by 2030 and the medical costs associated with treating preventable obesity related diseases would have increased by between $48 billion and $68 billion a year.” Also projected were hundreds of billions of dollars in lost economic activity each year.

Obesity is a major cause of type 2 diabetes, coronary heart disease and stroke, hypertension, arthritis and cancer, among other maladies. As the report asserts, “More than 75 percent of hypertension cases can be attributed to obesity. And approximately one-third of cancer deaths are linked to obesity or lack of physical activity.”

Encouraging news

If we can take the next step and begin to reduce adult obesity, not only we will get much better health outcomes, but major savings are possible. Just a 5% reduction in Body Mass Index (BMI) could yield cost-reductions of about $160 billion in the next ten years, according to the report.

There is even better news on child obesity. According to the Centers for Disease Control and Prevention (CDC) there are 18 states in which obesity rates for pre-school children from low income families declined. These declines are being seen in ‘’cities and states that were among the first to adopt a comprehensive approach to obesity prevention,” said Risa Lavizzo-Mourey, MD, RWJF president and CEO”. A nationally representative sample of 11 to 16 year olds conducted by the Eunice Kennedy Shriver National Institute of Child Health and Human Development demonstrates similar results.

Combating obesity

While there is not one silver bullet, we now know what works in this area. It’s the basics: encouraging and providing opportunities for more exercise and hammering home the importance of healthy foods as well as ensuring that all school meals are healthy.

Taken together, involving all community stakeholders, ensuring safe routes to school so children can walk and bike as well as making communities over-all more pedestrian and bike friendly, requiring physical education in school, increasing after-school recreation programs, continually stressing healthy eating with parents and children, and facilitating easier access to healthier foods, produce real results. Michelle Obama’s ‘Let’s Move’ campaign has been particularly helpful in spreading the word and getting communities to form childhood obesity prevention task forces.

Rhode Island and Massachusetts are doing better than most other states on combating obesity with Rhode Island currently ranked as the 14th least obese state and Massachusetts as the 3rd. But, with more than 1-in-4 Rhode Island residents and more than 1-in-5 Massachusetts residents remaining obese, there is still along way to go. It is time, both here in New England and throughout the nation, to build on the positive results, expand on what we now know works and bring more resources and attention to truly solving this persistent public health problem.


Rob Horowitz is a strategic and communications consultant who provides general consulting, public relations, direct mail services and polling for national and state issue organizations, various non-profits and elected officials and candidates. He is an Adjunct Professor of Political Science at the University of Rhode Island.


Related Slideshow: New England’s Healthiest States 2013

The United Health Foundation recently released its 2013 annual reoprt: America's Health Rankings, which provides a comparative state by state analysis of several health measures to provide a comprehensive perspective of our nation's health issues. See how the New England states rank in the slides below.



All Outcomes Rank: Outcomes represent what has already occurred, either through death, disease or missed days due to illness. In America's Health Rankings, outcomes include prevalence of diabetes, number of poor mental or physical health days in last 30 days, health disparity, infant mortality rate, cardiovascular death rate, cancer death rate and premature death. Outcomes account for 25% of the final ranking.

Determinants Rank: Determinants represent those actions that can affect the future health of the population. For clarity, determinants are divided into four groups: Behaviors, Community and Environment, Public and Health Policies, and Clinical Care. These four groups of measures influence the health outcomes of the population in a state, and improving these inputs will improve outcomes over time. Most measures are actually a combination of activities in all four groups. 

Diabetes Rank: Based on percent of adults who responded yes to the question "Have you ever been told by a doctor that you have diabetes?" Does not include pre-diabetes or diabetes during pregnancy.

Smoking Rank: Based on percentage of adults who are current smokers (self-report smoking at least 100 cigarettes in their lifetime and currently smoke).

Obesity Rank: Based on percentage of adults who are obese, with a body mass index (BMI) of 30.0 or higher.

Source: http://www.americashealthrankings.org/

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6. Rhode Island

Overall Rank: 19

Outcomes Rank: 30

Determinants Rank: 13

Diabetes Rank: 26

Smoking Rank: 14

Obesity Rank: 13



1. Low prevalence of obesity

2. High immunization coverage among adolescents

3. Ready availability of primary care physicians  


1.High rate of drug deaths

2. High rate of preventable hospitalizations

3. Large disparity in heath status by educational attainment

Source: http://www.americashealthrankings.org/RI

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5. Maine

Overall Rank: 16

Outcomes Rank: 25

Determinants Rank: 12

Diabetes Rank: 23

Smoking Rank: 29

Obesity Rank: 28



1. Low violent crime rate

2. Low percentage of uninsured population

3. Low prevalence of low birthweight  


1. High prevalence of binge drinking

2.High rate of cancer deaths

3. Limited availability of dentists

Source: http://www.americashealthrankings.org/ME

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4. Connecticut

Overall Rank: 7

Outcomes Rank: 15

Determinants Rank: 4

Diabetes Rank: 16

Smoking Rank: 4

Obesity Rank: 12



1. Low prevalence of smoking

2. Low incidence of infectious diseases

3. High immunization coverage among children & adolescents  


1. Moderate prevalence of binge drinking

2. Low high school graduation rate

3. Large disparity in health status by educational attainment

Source: http://www.americashealthrankings.org/CT

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3. New Hampshire

Overall Rank: 5

Outcomes Rank: 7

Determinants Rank: 5

Diabetes Rank: 16

Smoking Rank: 11

Obesity Rank: 22



1. Low percentage of children in poverty

2. High immunization coverage among children

3. Low infant mortality rate  


1. High prevalence of binge drinking

2.High incidence of pertussis infections

3. Low per capita public health funding

Source: http://www.americashealthrankings.org/NH

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2. Massachusetts

Overall Rank: 4

Outcomes Rank: 14

Determinants Rank: 3

Diabetes Rank: 10

Smoking Rank: 7

Obesity Rank: 2



1. Low prevalence of obesity

2. Low percentage of uninsured population

3. Ready availability of primary care physicians & dentists  


1. High prevalence of binge drinking

2. High rate of preventable hospitalizations

3. Large disparity in health status by educational attainment

Source: http://www.americashealthrankings.org/MA

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1. Vermont

Overall Rank: 2

Outcomes Rank: 12

Determinants Rank: 1

Diabetes Rank: 4

Smoking Rank: 9

Obesity Rank: 5



1. High rate of high school graduation

2. Low violent crime rate

3. Low percentage of uninsured population  


1. High prevalence of binge drinking

2. Low immunization coverage among children

3. High incidence of pertussis infections

Source: http://www.americashealthrankings.org/VT


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