The author is president and CEO of the Robert Wood Johnson Foundation.
The Robert Wood Johnson Foundation and the Trust for America’s Health recently released our annual report, “F as in Fat: How Obesity Threatens America’s Future.” Obesity rates in the United States remain unacceptably high, and the epidemic persists in affecting blacks and Hispanics disproportionately. For the first time, this year’s report examined how the obesity epidemic could impact our future 20 years from now. Ironically, this forecast has made me reflect on the past.
Thirty years ago, I lived in Philadelphia and was an instructor at Temple University. After a long day of teaching, I remember heading home with my daughter, who was a preschooler at the time. My office looked down North Broad Street, which ran through some of the worst urban blight of any American city in the past several decades. We wanted to pick up a few items for dinner, but couldn’t find a grocery store or supermarket with the fresh fruit, produce and other healthy foods we were accustomed to eating. About 20,000 people — mostly poor, mostly African American and Hispanic — lived in that neighborhood and had to cope with this type of disadvantage on a daily basis. What I didn’t know then was that Philadelphia was a microcosm of how policies and environments affect diets, obesity and health.
At that time, obesity was not on the radar as a major public health concern, and state obesity rates looked tame compared with what we see today. In 1995, Mississippi had an adult obesity rate of 19.4 percent, and Colorado had the lowest rate, 13.9 percent. According to the latest data, Colorado still has the lowest rate, but it has climbed to 20.7 percent. I don’t think we could have imagined it in 1995, but the lowest rate today is higher than the highest rate back then. That’s why it’s so important for us to look ahead to 2030 and try to chart a better course.
The new analysis in this year’s report shows that if obesity rates continue on their current trajectory, it’s estimated that by 2030 adult obesity rates could reach or exceed 44 percent in every state, and 32.6 percent of adult D.C. residents could be obese.
If so, new cases of type 2 diabetes, coronary heart disease and stroke, hypertension and arthritis could skyrocket. Obesity-related health-care costs could increase by more than 10 percent in 43 states and by more than 20 percent in nine states.
On the other hand, the analysis also shows that if the average adult body mass index (BMI) was decreased by only 5 percent in each state, we could spare millions of Americans from serious health problems and save billions of dollars in health-care spending — between 6.5 percent and 7.8 percent in costs in almost every state. The District of Columbia could save 6.7 percent in health-care costs, which would equate to savings of more than $1 billion by 2030.
We have made important progress toward preventing and reducing obesity around the country, especially among children. For instance, California, Mississippi and New York City are beginning to show decreases in overall rates of childhood obesity. The trends in those areas also have shown us that children who face the biggest obstacles to healthy choices and are at greatest risk for obesity do not always benefit when progress is made. I saw the evidence of this first hand when I lived in Philadelphia. That’s why a study released this fall tells the best story of all.
New data show Philadelphia has reduced its obesity rates in ways that also helped to close the disparities gap. While the city achieved an overall decline in obesity rates among public school students, the largest improvements came among black male and Hispanic female students. For black males, rates declined nearly 8 percent; rates for Hispanic females dropped 7 percent.
Although the decrease in childhood obesity rates in Philadelphia is a recent development, community-wide efforts started there more than a decade ago. We need to learn from the City of Brotherly Love and spread the actions and policies that work, so all children can enjoy the benefits of better health.
I am now a grandmother and want my grandkids, and their entire generation, to be healthy. If we take effective action, many Americans could be spared from type 2 diabetes, heart disease, cancer and other health problems, and the savings in health-care costs and increased productivity would have a real and positive impact on the economy. Investing in prevention today means a healthier, more productive and brighter future for our country.
The Robert Wood Johnson Foundation (RWJF) and Trust for America’s Health (TFAH) collaborated on the report, which was supported by a grant from RWJF. The full report with state rankings in all categories is available on RWJF's Web site.
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