Obesity and Overweight Data

• In 2000, the Santa Clara County Behavioral Risk Factor Survey (BRFS) identified that 51.6% of the county’s adult population was overweight or obese. 
• The 2004 BRFS reported a slight rise with 52.5% overweight or obese.
• Rates improved slightly for Whites from 2000 to 2004, but disparately worsened for African Americans and Latinos.
• The 2004 California Healthy Kids Survey revealed that 1 in 3 African American and Latino students age 6-19 were overweight or at risk of overweight compared to 1 in 5 for other ethnic groups. 
• The 2004-2005, California Physical Fitness Report revealed that slightly more than one-quarter of the County’s 5th graders were able to meet 6 out of 6 fitness standards.  Just 32.5 percent in grade seven, and 34.7% in grade nine achieved the fitness standards for all six areas of the test.
• While global environmental changes are important for the whole community, priority efforts must be undertaken in the large Latino population, which is currently at highest risk. 
• At current rates, it is predicted that as many as 1 in 2 Latino children will develop diabetes. 

Treatment or Prevention for Obesity
Our current system of health care is focused on downstream solutions for disease processes. However, health care financing mechanisms provide payment to treatment providers, but rarely support primary prevention activities.  There is research and financial modeling that is beginning to demonstrate the significant impact on health outcomes from weight loss through moderate physical activity and healthy nutrition, but current incentives and the health care system continue to favor expensive treatments and technology over prevention.

Environmental and Institutional Influences on Obesity
Changes in the environment and our institutions have affected the way we live in the past 20 years and have played a major role in the upward obesity trend:

• Emphasis on academic test scores leave some children with very little or no time for physical education, in some cases not even recess, even though physical education is mandated. 
• Parents’ concern about safety (whether from violence, traffic/street crossing and bicycle safety) mean children do not walk or bike to school.
• Environmentally, schools have been offering sugary sodas, calorie-dense snack foods, and fewer healthy options.  Only recently has the State legislature passed laws to implement food standards in schools.  Even then, these standards will only be implemented fully in many districts years from now.
• Education on nutrition and physical health is limited in the curriculum.
• More restaurant and fast food meals with large portions and high calories are being eaten by individuals and families, with an estimated at 46% of food dollars spent on away-from-home foods. 
• Technology has brought us more reasons to stay at home for entertainment options, including cable and satellite television (with choices of hundreds of channels,) the internet and video gaming. A recent Stanford University study found that 3rd graders’ screen time exceeded 3 hours per day and cites the 40,000 television commercials the average child in the US sees every year.
• For many low-income families, access and affordability of fruits, vegetables and other healthy foods are difficult.  Many supermarkets are moving out of the cities’ downtown core in favor of the more profitable neighborhoods and suburbs. 
• While an exception may be made with integrated health systems, our health care system and insurers have little incentive to provide prevention.  The health system behaves as if complications of overweight are often so far into the future that many people will have already switched jobs or insurers, or have even died, by the time the consequences occur.  The reality is payors are already bearing the burden of health consequences of obesity with over $28 billion, in California alone, in direct medical expenses, workers compensation and lost productivity.
• Our built environment (the physical structures and infrastructure of communities), involving access to safe walkways, bike paths and recreation areas, has changed.  The built environment includes transportation, businesses, housing, access to supermarkets with fresh fruits and vegetables and the presence of fast food restaurants and their proximity to schools.