wisconsin department of health services january 2014 p-00522m healthiest wisconsin 2020 baseline and...
TRANSCRIPT
Wisconsin Department of Health Services
January 2014 P-00522M
Healthiest Wisconsin 2020 Baseline and Health Disparities Report
Physical Activity
PHYSICAL ACTIVITY
Background• Overview of Healthiest Wisconsin 2020 Baseline and Health Disparities
Report • Healthiest Wisconsin 2020 objectives and indicators• Rationale• Key points
Data• Weight and physical activity among youth• Weight and physical activity among adults• Environmental factors and resources
References
Links to additional reports and resources
Contacts
Chapter Outline
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Chapter outline
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Report Overview
• This chapter is part of a larger report created by the Wisconsin Department of Health Services to track progress on the objectives of Healthiest Wisconsin 2020 (HW2020) and identify health disparities in the state. The full report is available at: http://www.dhs.wisconsin.gov/publications/P0/p00522.pdf
• The report is designed to address the Health Focus Areas in HW2020. Where direct measures exist, data are presented; where direct measures are not available, related information may be included.
• Information about populations experiencing health disparities is provided in the Health Focus Area chapters and is summarized in separate chapters devoted to specific populations.
• Technical notes are available at: http://www.dhs.wisconsin.gov/publications/P0/p00522y.pdf
Report overview
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Report Format
Full Report• Format: PDF • Intended use: reference document
Chapters• Format: Annotated PowerPoint slide set• Intended uses: presentations to
– Decision-makers– Service providers– Community leaders– The public
Sample annotated slide
Report overview
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Report Outline
Executive Summary
Section 1: Introduction
Section 2: Demographic overview
Section 3: Health focus areas
Section 4: Infrastructure focus areas
Section 5: Data summaries by population
Section 6: Technical notes
Report overview
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Report Outline: Detail
Section 3: Health focus areas
• Alcohol and other drug use• Chronic disease prevention and management• Communicable diseases• Environmental and occupational health• Healthy growth and development• Injury and violence• Mental health• Nutrition and healthy foods• Oral health• Physical activity• Reproductive and sexual health• Tobacco use and exposure
Section 4: Infrastructure focus areas• Access to health care
Report overview
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Report Outline: Detail
Section 5: Data summaries by population
Racial/ethnic minority populationso American Indianso Asianso Blackso Hispanics
People of lower socioeconomic status People with disabilities Lesbian, gay, bisexual, and transgender populations Geography
Report overview
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Data notes
• Please refer to the Technical Notes chapter for a more detailed description of limitations and methods: http://www.dhs.wisconsin.gov/publications/P0/p00522y.pdf
• The 95% confidence intervals are denoted by error bars. Where
confidence intervals do not overlap, as shown in the example on
the right, differences are statistically significant. Larger confidence
intervals may indicate less reliable estimates that should be
interpreted with caution.
• Population estimates that are considered unreliable are excluded.
• Misclassification of racial/ethnic groups may affect the accuracy of rates.
• Unless otherwise indicated, the Hispanic population may include people of various races; Whites, Blacks, Asians, and American Indians are non-Hispanic.
Report overview
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Factors that influence health
Social determinants
of health
Source: University of Wisconsin Population Health Institute. County Health Rankings 2013, http://www.countyhealthrankings.org/our-approach
Report overview
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Healthiest Wisconsin 2020 objectives and indicators
Objective 1
By 2020, increase physical activity for all through changes in facilities, community design, and policies.
Objective 1 Indicators
• Proportion of high school students who meet federal physical activity guidelines for aerobic physical activity and muscle-strengthening.
• Proportion of adults who meet federal physical activity guidelines for aerobic physical activity and muscle-strengthening.
Source: Wisconsin Department of Health Services, Healthiest Wisconsin 2020, Physical Activity Focus Area Profile.10
HW2020 objectives
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Objective 2
By 2020, every Wisconsin community will provide safe, affordable and culturally appropriate environments to promote increased physical activity.
Objective 2 Indicators
• Percent of children less than 18 years old living in a neighborhood with a nearby park or recreation center and sidewalks.
• Percent of Wisconsin communities with satisfactory scores as measured by the Wisconsin Assessment of the Social and Built Environment.
Source: Wisconsin Department of Health Services, Healthiest Wisconsin 2020, Physical Activity Focus Area Profile.11
HW2020 objectives
Healthiest Wisconsin 2020 objectives and indicators
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Objective 3
By 2020, every Wisconsin community will provide safe, affordable and culturally appropriate environments to promote increased physical activity for individuals among populations of differing races, ethnicities, sexual identities and orientations, gender identities, and educational or economic status.
Objective 3 Indicators
• Inventory of environments by community (including parks, facilities, workplace programs).
Source: Wisconsin Department of Health Services, Healthiest Wisconsin 2020, Physical Activity Focus Area Profile.12
HW2020 objectives
Healthiest Wisconsin 2020 objectives and indicators
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Rationale
• Physical activity means any bodily activity that enhances or maintains physical fitness and overall health.
• Regular physical activity can help to reduce the risk of certain chronic diseases, such as high blood pressure, stroke, coronary artery disease, type 2 diabetes, obesity, colon cancer, and osteoporosis.
• Physical activity recommendations include strategies to make physical activity an easy choice. This can be accomplished by creating opportunities for children, adults, and older adults to be active where they live, play, work and learn.
Source: Wisconsin Department of Health Services, Healthiest Wisconsin 2020, Physical Activity Focus Area Profile.13
Rationale
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Key points
Youth
• During 2007-2011, approximately 10% of high school students in Wisconsin were obese and 14% were overweight.
• In 2010, 14% of children (ages 2-4 years) enrolled in WIC were obese.
• Significant disparities exist in the prevalence of physical activity and sedentary behavior among youth in Wisconsin by race/ethnicity and sexual minority status. For example, compared to White youth, Black, Hispanic, and Asian youth were significantly less likely to exercise throughout the week, and were more likely to watch three or more hours of television a day.
• A greater percentage of Black children lived in neighborhoods with multiple resources for physical activity, but Black parents were less likely than White parents to feel that their neighborhoods were safe for their children.
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Key points
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Key points
Adults
• In 2009-2011, approximately two-thirds (65%) of Wisconsin adults were overweight or obese and 29% were obese. Significant disparities exist in the prevalence of adult obesity. For example:
o Black and American Indian adults were significantly more likely to be obese compared to White adults.
o Adults with the lowest household income were significantly more likely to be overweight or obese compared to middle- or high-income adults.
o Among Wisconsin adults ages 18-64, those with a disability were more likely to be overweight or obese than those without a disability.
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Key points
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Key points
Adults
• Physical inactivity is significantly more prevalent among:o Black, Hispanic, and American Indian adults, compared to White and
Asian adults.o Adults with lower household incomes, compared to adults with higher
incomes.o Adults living with a disability, compared to adults without a disability.
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Key points
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Weight and physical activity among youth
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Overweight, obesity, and weight loss attempts among Wisconsin high school students, by race/ethnicity, 2007-2011
Weight and physical activity among youth
Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.
Overweight Obese Trying to lose weight0%
10%
20%
30%
40%
50%
60%
70%
13% 10% 44%17% 12% 35%20% 14% 55%15% 15% 49%16% 44%
White Black
Hispanic Asian
American Indian
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Overweight, obesity, and weight loss attempts among Wisconsin high school students, by sexual minority status, 2007-2011
Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.
Overweight Obese Trying to lose weight0%
10%
20%
30%
40%
50%
60%
14% 8% 43%18% 12% 56%
Sexual majoritySexual minority
Weight and physical activity among youth
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Physical activity and sedentary behaviors among Wisconsin high school students by race/ethnicity, 2007-2011
Exercise 1+ hour, 5 out of 7 days
Attend physical educa-tion at least in once
past 7 days
Watch 3+ hours TV on average school day
Play 3+ hours video/computer
games on average school day
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
48% 55% 21% 19%35% 43% 49% 26%29% 46% 34% 25%37% 54% 28% 31%49% 54% 20% 24%
WhiteBlackHispanicAsianAmerican Indian
Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.
Weight and physical activity among youth
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PHYSICAL ACTIVITY
Physical activity and sedentary behaviors among Wisconsin high school students by sexual minority status, 2007-2011
Weight and physical activity among youth
Exercise 1+ hour, 5 out of 7 days
Attend physical edu-cation at least once in
past 7 days
Watch 3+ hours TV on average school
day
Play 3+ hours video/computer
games on average school day
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
47% 23% 19% 52%35% 26% 28% 48%
Sexual majoritySexual minority
Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.21
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Rate of physical inactivity among Wisconsin adults, by race/ethnicity, 2008-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 land-line only dataset.
Did not participate in any physical activity in past month, other than at job0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
19% 36%
No disabilityDisability
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Weight and physical activity among youth
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Obesity among children ages 10-17, by disability status, Wisconsin, 2011-2012
Obese0%
5%
10%
15%
20%
25%
30%
35%
40%
12% 18%
Children with no special health care needs
Children with special health care needs
Source: 2011-2012 National Survey of Children's Health
Weight and physical activity among youth
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Obesity among children (ages 2-4 years) enrolled in the Supplemental Nutrition Program for Women, Infants, and Children (WIC), by race/ethnicity, Wisconsin, 2001 and 2010
White Black Hispanic Asian American Indian0%
5%
10%
15%
20%
25%
30%
35%
40%
10% 8% 16% 18% 18%12% 11% 18% 17% 27%
2001 2010
Source: Centers for Disease Control and Prevention (CDC) Pediatric Nutrition Surveillance Survey 2010.Note: Based on >= 95th growth chart percentiles for Body Mass Index for age. WIC is the Supplemental Nutrition Program for Women, Infants, and Children.
Weight and physical activity among youth
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Weight and physical activity among adults
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Overweight and obesity among Wisconsin adults, by sex, 2009-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009-2011 landline-cellphone combined dataset.
Overweight or Obese Obese0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
65% 29%73% 29%58% 28%
Total Male
Female
Weight and physical activity among adults
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PHYSICAL ACTIVITY
Overweight and obesity among Wisconsin adults, by age, 2009-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009-2011 landline-cellphone combined dataset.
Overweight or Obese Obese0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
39% 14%65% 29%73% 35%68% 27%
18 - 2425 - 4445 - 6465+
Weight and physical activity among adults
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PHYSICAL ACTIVITY
Age-adjusted rates of overweight and obesity among Wisconsin adults by race/ethnicity, 2008-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.
Overweight or Obese Obese0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
63% 27%78% 44%67% 29%45% 71% 38%
WhiteBlackHispanicAsianAmerican Indian
Weight and physical activity among adults
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PHYSICAL ACTIVITY
Age-adjusted rates of overweight and obesity among Wisconsin adults, by household income, 2008-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.
Overweight or Obese Obese0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
70% 41%65% 29%60% 23%
Low income (<$20,000)
Middle income ($20,000-$74,999)
High income ($75,000+)
Weight and physical activity among adults
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PHYSICAL ACTIVITY
Age-adjusted rates of overweight and obesity among Wisconsin adults, by level of urbanization, 2008-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.
Overweight or Obese Obese0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
67% 31%63% 27%64% 29%
Milwaukee County
Smaller metropolitan counties
Non-metropolitan counties
Weight and physical activity among adults
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PHYSICAL ACTIVITY
Overweight and obesity among Wisconsin adults ages 18-64, by disability status, 2008-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline only dataset
Overweight or Obese Obese0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
61% 25%74% 43%
No disability
Disability
Weight and physical activity among adults
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PHYSICAL ACTIVITY
Overweight and obesity among Wisconsin adults, by sexual orientation and sex, 2008-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.
Overweight or obese, male
Overweight or obese, female
Obese, male Obese, female0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
72% 56% 30% 27%49% 61% 17% 30%
Sexual majority
Sexual minority
Weight and physical activity among adults
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PHYSICAL ACTIVITY
Physical inactivity among Wisconsin adults, by sex, 2009-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009-2011 combined landline-cell dataset.
Did not participate in any physical activity in past month, other than at job
-10%
0%
10%
20%
30%
40%
50%
60%
23% 21% 24%
Total
Male
Female
Weight and physical activity among adults
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PHYSICAL ACTIVITY
Physical inactivity among Wisconsin adults, by age, 2009-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009-2011 combined landline-cell dataset.
Did not participate in any physical activity in past month, other than at job
-10%
0%
10%
20%
30%
40%
50%
60%
14% 20% 24% 33%
18 - 2425 - 4445 - 6465+
Weight and physical activity among adults
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PHYSICAL ACTIVITY
Age-adjusted rate of physical inactivity among Wisconsin adults, by race/ethnicity, 2008-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset
Did not participate in any physical activity in past month, other than at job
-10%
0%
10%
20%
30%
40%
50%
60%
22% 37% 33% 28% 26%
WhiteBlackHispanicAsianAmerican Indian
Weight and physical activity among adults
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PHYSICAL ACTIVITY
Age-adjusted rate of physical inactivity among Wisconsin adults, by household income, 2008-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset
Did not participate in any physical activity in past month, other than at job
-10%
0%
10%
20%
30%
40%
50%
60%
37% 24% 16%
Low income (<$20,000)
Middle income ($20,000-$74,999)
High income ($75,000+)
Weight and physical activity among adults
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PHYSICAL ACTIVITY
Age-adjusted rate of physical inactivity among Wisconsin adults, by level of urbanization, 2008-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset
Did not participate in any physical activity in past month, other than at job
-10%
0%
10%
20%
30%
40%
50%
60%
28% 22% 26%
Milwaukee County
Smaller metropolitan counties
Non-metropolitan counties
Weight and physical activity among adults
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PHYSICAL ACTIVITY
Physical inactivity among Wisconsin adults ages 18-64, by disability status, 2008-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.
Did not participate in any physical activity in past month, other than at job
-10%
0%
10%
20%
30%
40%
50%
60%
19% 36%
No disability
Disability
Weight and physical activity among adults
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PHYSICAL ACTIVITY
Physical inactivity among Wisconsin adults, by sexual orientation, 2008-2011
Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset
Weight and physical activity among adults
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Did not participate in any physical activity in past month, other than at job0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
22% 23%
Heterosexual
Lesbian, gay, bisexual
PHYSICAL ACTIVITY
Environmental factors and resources
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Neighborhood environment of children less than 18 years of age, by race/ethnicity, Wisconsin, 2011-2012
Source: 2011-2012 National Survey of Children's Health. *Neighborhoods that include all four of these amenities. Data were not available for other races.
Environmental factors and resources
Children living in neighborhoods with sidewalks, libraries, recreation centers, and parks*
Children living in neighborhoods their parents feel are usually or always safe
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
55% 94%63% 61%55% 86%
WhiteBlackHispanic
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PHYSICAL ACTIVITY
Percentage of census blocks close to parks and fitness centers, Wisconsin and United States, 2007
Source: Centers for Disease Control and Prevention (CDC), State Indicator Report on Physical Activity, 2010.
Environmental factors and resources
0%
5%
10%
15%
20%
25%
23% 15%20% 17%
WisconsinUnited States
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PHYSICAL ACTIVITY
References
1. University of Wisconsin Population Health Institute. County Health Rankings, 2013. http://www.countyhealthrankings.org/our-approach
2. Center for Urban Population Health. Milwaukee Health Report, 2011. http://www.cuph.org/mhr/2011-milwaukee-health-report.pdf
3. LaVeist TA, Gaskin DA, Richard P (2009). The Economic Burden of Health Inequalities in the United States. Joint Center for Political and Economic Studies. http://www.jointcenter.org/sites/default/files/upload/research/files/The%20Economic%20Burden%20of%20Health%20Inequalities%20in%20the%20United%20States.pdf
4. Thomas JC, Sage M, Dillenberg J, Guillory VJ (2002). A Code of Ethics for Public Health. Am Journal of Public Health. 92(7):1057–1059. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447186/
5. Wisconsin Department of Health Services (DHS). Healthiest Wisconsin 2020. http://www.dhs.wisconsin.gov/publications/P0/P00187.pdf
6. Centers for Disease Control and Prevention (CDC). Adolescent and School Health: Childhood Obesity Facts. http://www.cdc.gov/healthyyouth/obesity/facts.htm
7. CDC. Adolescent Health in the United States. http://www.cdc.gov/nchs/data/misc/adolescent2007.pdf
8. CDC. Adolescent and School Health: Physical Activity. http://www.cdc.gov/healthyyouth/physicalactivity/facts.htm
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References
PHYSICAL ACTIVITY
9. CDC. Association Between Sedentary Behavior, Physical Activity, and Obesity: Inactivity Among Active Kids. http://www.cdc.gov/pcd/issues/2009/jan/07_0242.htm
10. U.S. Department of Health and Human Services. Physical Activity Guidelines. Chapter 7: Additional Considerations for Some Adults. http://www.health.gov/paguidelines/guidelines/chapter7.aspx
11. U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. Children with Special Health Care Needs in Context: A Portrait of States and the Nation, 2007. Rockville, MD: U.S. Department of Health and Human Services, 2011. http://www.mchb.hrsa.gov/nsch/07cshcn/
12. CDC. Obesity Prevalence Among Low-Income, Preschool-Aged Children - United States, 1998-2008. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5828a1.htm
13. CDC. About BMI for Adults. http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html#Definition
14. Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, Prevalence and Trends Data. http://apps.nccd.cdc.gov/brfss/
15. CDC. Disability and Obesity. http://www.cdc.gov/ncbddd/disabilityandhealth/obesity.html
16. Boehmer U, Bowen DJ, Bauer GR. Overweight and obesity in sexual minority women: evidence from population-based data. American Journal of Public Health. 2007; 97: 1134–1140. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1874217/
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References
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17. National Eating Disorders Association. Eating Disorders in LGBT Populations. http://www.nationaleatingdisorders.org/sites/default/files/ResourceHandouts/LGBTQ.pdf
18. CDC: Physical Activity. http://www.cdc.gov/physicalactivity/everyone/guidelines/index.html
19. CDC: Physical Activity. Older adults. http://www.cdc.gov/physicalactivity/everyone/guidelines/olderadults.html
20. CDC. State Indicator Report on Physical Activity, 2010. http://www.cdc.gov/physicalactivity/downloads/PA_State_Indicator_Report_2010.pdf
21. Kahn EB, Ramsey LT, Brownson RC, et al. The effectiveness of interventions to increase physical activity: A systematic review. Am J Prev Med. 2002;22(4 suppl):73–107. http://www.thecommunityguide.org/pa/pa-ajpm-evrev.pdf
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References
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Links to additional reports and resources
• The Epidemic of Chronic Disease in Wisconsin: Why it Matters to the Economy and What You Can Do to Help: http://www.dhs.wisconsin.gov/publications/P0/P00238.pdf
• Obesity, Nutrition, and Physical Activity in Wisconsin: http://www.dhs.wisconsin.gov/physical-activity/
• State Indicator Report on Physical Activity, 2010: http://www.cdc.gov/physicalactivity/downloads/PA_State_Indicator_Report_2010.pdf
• Wisconsin Nutrition, Physical Activity and Obesity Program: http://www.dhs.wisconsin.gov/physical-activity/
• Centers for Disease Control and Prevention (CDC). Physical Activity: http://www.cdc.gov/physicalactivity/
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Links
PHYSICAL ACTIVITY
Contact
Jon Morgan, MS
Physical Activity Coordinator
Nutrition, Physical Activity and Obesity Program
Bureau of Community Health Promotion
Division of Public Health
Wisconsin Department of Health Services
Email: [email protected]
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Contacts