Obesity Prevention: A look at the legislative landscape

Andrew Wapner, DO, FACOP, FAAP2012 Public Policy Institute

Preliminary Program

Learning Objectives

The learner will be able to:•discuss the importance of addressing obesity prevention through evidence-based strategies to improve health through environmental change.•discuss the role of public health practitioners in improving opportunities for healthy living. •discuss current legislation to improve nutrition and increase physical activity in Ohio.

What Influences Our Behavior?

Swinburn, Lancet, 2011

“Global Drivers & Local Environments”

Where Does Public Health Fit?

Legislation: What’s Out There?

• Nutritional Standards• BMI & Student Fitness• Chronic disease management• Insurance coverage for CD prevention and management• Joint use agreements• Nutritional and physical education• Physical activity & Recess• School wellness Policies• Taxes & tax credits

2010 US Childhood Obesity Legislation• 12 states and DC: school nutrition legislation

• California and North Carolina included legislation to improve nutrition in early childhood or day care programs

• 3 states: student fitness assessment/BMI screening

• North Carolina also requires development of fitness assessment

• At least 10 states and DC: Physical education or PA at school

www.NCSL.org

• Required insurance coverage for obesity evaluation and management as a child wellness service

• Maryland

• Joint use authorization and/or funding• Arkansas, California, North Carolina, Washington

• Existing or newly enacted nutritional education schools requirements

• California, Colorado, Indiana, Louisiana, Maine, Massachusetts, New Hampshire, Oklahoma, South Carolina, Texas, Vermont, West Virginia, Illinois, Minnesota and Mississippi

• Tax exemption changes & new taxes/fees on specific foods• Colorado, DC, Mississippi, Tennessee and Washington

www.NCSL.org

2010 US Childhood Obesity Legislation

Ohio in 2010: Healthy Choices for Healthy Children• More than 70 partners from health care, public

health, public and private sector• Bipartisan, bicameral• Focus on three main areas

• Nutrition• Physical Activity• Body Mass Index Screening

HCHC—Nutrition

• Limits sale of certain foods/beverages to students during school and at before- and after-school programs

• Districts to adopt standards for beverage sales on school premises and report on compliance

• Prohibits placement of vending machines in classrooms

• Permits federal school breakfast program to be offered in the classroom

HCHC—Physical Activity (PA)

• ODE administration of a PA pilot program for students to participate in at least 30 minutes of moderate to rigorous physical activity daily

• Specifies new hires be licensed in physical education

• Requires the one-half unit in health education to provide instruction in nutrition and the benefits of physical activity

HCHC—Body Mass Index Screening

• Body mass index (BMI) screening programs for K, 3rd, 5th and 9th grades

• Any school may request a waiver of BMI screening requirements stating an inability to comply

HCHC—Reporting & Administration

• ODE annual compliance report with the BMI screening requirements

• ODE report cards to include:• Student success in meeting physical education

standards• Compliance with federal requirements for local

wellness policies• Compliance with BMI requirements• Participation in PA pilot program

Take Home Points:

• Healthy eating and active living requires consistent positive influences from multiple levels in our social networks, communities, organizations and environments

• Policy is a critical tool that can help turn influences into opportunities for whole populations to lead healthful lives

• Many options exist and Ohio is moving forward!

Andrew Wapner, DO

Chronic Disease Medical DirectorBureau of Healthy OhioOhio Department of Health614-466-1337Andrew.Wapner@odh.ohio.gov