By 2020 three-quarters of Americans will be overweight or obese. By 2035 obesity will result in 100,000 excess cases of coronary heart disease per year. By 2050 one-third of U.S. adults will have diabetes.
In response to the burgeoning crisis, a variety of antiobesity initiatives have arisen. One funded by the Patient Protection and Affordable Care Act was announced in September 2010: Collaborate for Healthy Weight (www.collaborateforhealthyweight.org), a joint venture of the Health Resources and Services Administration and the National Initiative for Children's Healthcare Quality. Making use of existing alliances and forging new ones among local clinicians, public health professionals, and community organizations, the project began in mid-2011 with 10 teams, and in March of this year it spread to 50 teams in 10 regions. Each team develops an action plan, provides services to targeted populations, and develops community programs that encourage healthful eating and physical activity. The primary goals are to compile a searchable database of guidelines, policy briefs, and other information and to identify and disseminate outcomes of the changes the 50 teams are implementing in their communities.
In Lincoln County, Washington, nearly a third of residents are officially “low income,” and that same percentage are obese. In 2010 Ed Dzedzy, the Lincoln County Health Department administrator, applied to participate in the collaborative and was accepted because of efforts to reduce obesity in the county's children that were already in place. A team was formed that included clinicians, an elementary school principal, and the director of the local farmer's market, among others. Area schools had been measuring children's height and weight but not always their body mass index (BMI), so the team established systems to measure BMI more routinely and use the information to set up counseling sessions with primary care providers when necessary. It's too soon to calculate outcomes related to weight loss, Dzedzy said, but the BMI measurements have resulted in an increase in the provision of preventive services to the county's at-risk two-to-17-year-olds. Many other examples from the first phase of the initiative are being reported (go to http://bit.ly/HIpacl to read about them).
Jolene Erickson, a public health nurse in Lincoln County, said that the initiative represents “public health in its best sense,” a sentiment Dzedzy concurred with. “But the health department, the school, and the clinic alone aren't going to make an impact,” he said. “If we want to make a long-term difference, we have got to involve the family in that community.”—Joy Jacobson