What is the State of Obesity in America?

The following is a letter from Risa Lavizzo-Mourey, MD, MBA, president and CEO of the Robert Wood Johnson Foundation (RWJF), and Richard Hamburg, Interim President and CEO Trust for America's Health (TFAH)

Risa Lavizzo-Mourey and Richard Hamburg

The Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) believe that all adults should have access to affordable, healthy foods and beverages and the opportunity to live healthy, active lives. We also believe all children in the United States — no matter who they are or where they live — should have the chance to grow up at a healthy weight. Since this report was first issued more than a decade ago, we've seen progress toward achieving this vision.

Take, for example, CentraCare Health, a nonprofit healthcare system in central Minnesota that, in the early 2000s, set out to help children in the region reach a healthy weight. With support from Stearns County Public Health and a grant from Minnesota's Statewide Health Improvement Program, CentraCare Health brought together a coalition of medical professionals, policymakers, educators and other local organizations committed to making healthy foods and physical activity a regular part of children's lives. The result?

  • New, safer routes to school.
  • Grocery stores and local schools adopted a nutrition scoring system to make it easier for families to make healthy choices.
  • School districts updated their wellness policies
  • And between 2008 and 2015, the obesity rate among 12-year-olds in St. Cloud dropped from 17 percent to 13 percent, a 24 percent relative decline.

Stories like this illustrate the progress we have seen in recent years. The obesity rate is declining among our nation's youngest children and has held steady among older children and teens for ten years but is still increasing among younger teens. In addition to St. Cloud, a number of cities, counties and states, Cherokee County, South Carolina, Seminole County, Florida, Southern California, Philadelphia, Colorado, and New Mexico, have reported declines in their childhood obesity rates in the last year alone, joining a list of many others from coast to coast.

Growth in adult rates have slowed over time. We used to see dozens of states reporting increases in their adult obesity rates each year. This year, just two did. But rates overall are still far too high. Twenty-five states have adult obesity rates over 30 percent, putting millions of people at increased risk for heart disease, cancer and diabetes. Rates are even higher among Black, Latino and Native American families, as well as families living in poverty.

The Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) believe that all adults should have access to affordable, healthy foods and beverages and the opportunity to live healthy, active lives. We also believe all children in the United States — no matter who they are or where they live — should have the chance to grow up at a healthy weight. Since this report was first issued more than a decade ago, we've seen progress toward achieving this vision.

Fortunately, we have also seen significant progress on the policy front this year that will benefit millions of families and neighborhoods across America:

  • The U.S. Department of Agriculture (USDA) issued updated nutrition standards for the foods and beverages served in the Child and Adult Care Food Program (CACFP). More than four million young children from low-income families, as well as more than 120,000 adults, will benefit from the updated standards.
  • The U.S. Department of Agriculture also released updated requirements for local school wellness policies that will ensure any food or beverage marketed in schools meets Smart Snacks nutrition standards.
  • The U.S. Food and Drug Administration issued final updates to the Nutrition Facts panel found on packaged foods and beverages and put the finishing touches on new menu labeling requirements that cover chain restaurants and other food retail establishments. These changes will provide important nutrition information to consumers when they shop at the grocery store or go out to eat. With more information, families will be able to make healthier choices.
  • Thanks to the enactment of the landmark Every Student Succeeds Act (ESSA), physical education is included for the first time among the "well-rounded" subjects eligible for federal funding for schools with a high percentage of students from lower-income families.

These changes will take time to be fully implemented, but we are confident that they will ultimately result in healthier schools and communities for families across the country. States and cities are continuing to show a lot of forward momentum too. Some examples over the past year include:

  • Ohio enacted a budget that includes $2 million in seed capital to create a Healthy Food Financing Initiative (HFFI), which will be a flexible grant and loan fund; Mississippi enacted a bill setting snack nutrition standards that goes beyond Smart Snacks requirements;
  • Virginia enacted a bill setting minimum time requirements for physical activity in elementary schools; and,
  • Los Angeles approved requirements for all farmers' markets to accept SNAP Electronic Benefit Transfer (EBT) cards.

This year's report has a renewed focus on what states already are doing to help all children grow up at a healthy weight, and has implications for leaders across sectors.

This progress makes us hopeful about the future. We need that hope. Because there's still no question that obesity is a bigger threat to our health and our country now than it was when we were children.

This year's State of Obesity report is an urgent call to action for government, industry, healthcare, foundations, schools, child care and families around the country to redouble efforts to provide a brighter, healthier future for our children. Together we can build an inclusive Culture of Health in this country and ensure that all children and families live healthy lives.