Federal Funding for Obesity Prevention
Division of Nutrition, Physical Activity and Obesity
Fiscal Year 2013 to 2014 Funding
|DNPAO Total||$47.5 million||$49.5 million|
|DNPAO Total||$2.5 million||$8 million|
|DNPAO Total||$4 million||$4 million|
|- High-risk obesity||n/a||$5 million|
|Total unrestricted for core activities||$41 million||$32.5 million|
|*21 percent decrease in unrestricted funds from FY 2013 to 2014|
CDC Chronic Disease Funding from FY 2003 to FY 2014 ($ in millions)
Prevention and Public Health Fund Allocations (FY 2010 to 2022)
Actual Current Funding (Under P.L. 112-96)
vs. Intended Funding Established by ACA ($ in billions)
The Prevention and Public Health Fund was created to supplement, not supplant, support for prevention programs. The Prevention Fund supports many measures aimed at obesity prevention, including the CDC's Division of Nutrition, Physical Activity and Obesity Prevention. However, discretionary funding for chronic disease prevention experienced cuts between Fiscal Year (FY) 2009 and 2013. In addition, the Fund also experienced cuts from the originally intended allocation levels. The ACA originally allocated $21 billion for the Prevention Fund from FY 2010 to FY 2022. The Fund has experienced cuts or reallocations of nearly one-third, dropping it to $14.5 billion, nearly a 32.3 percent cut.
Public health programs are funded through a combination of federal, state and local dollars. Analyses from a number of organizations, including the Institute of Medicine (IOM), New York Academy of Medicine (NYAM), Centers for Disease Control and Prevention (CDC) and a range of other experts have found that public health has been severely underfunded for decades and does not receive sufficient support to carry out many core functions, including programs to prevent disease and obesity.1
Much of the federal support for obesity prevention is through grants to states distributed through CDC's National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).
Federal funding for chronic disease prevention reached an all-time high of $1.16 billion in FY 2012, but then experienced a 17 percent cut in FY 2013. The FY 2014 Omnibus Appropriations Bill restored $185 million to chronic disease programs, largely as part of Prevention and Public Health Fund dollars — to reach a total of $1.15 billion.
Despite the increase, the overall limited nature of funding for prevention has meant decreased and inconsistent support for the various categorical disease-prevention and health-promotion programs.
For example, while the Division of Nutrition, Physical Activity and Obesity (DNPAO) — a division that specifically focuses on the obesity epidemic, improving nutrition, and increasing activity within NCCDPHP — received total amounts of ($47.5 million) in FY 2013 and ($49.5 million) in FY 2014, the division experienced a 21 percent cut to its core activities. Instead of adding to the funding base to be able to focus on high-priority initiatives, including breastfeeding, early child care education and a new "high-risk" obesity initiative that provides $5 million in competitive grants to communities where obesity rates are above 40 percent, the funds to support these efforts have been carved out from DNPAO's overall budget, leaving significantly less money for grants to states and core program activities.
Although the State Public Health Actions funding opportunity announcement (FOA) provides funding to all 50 states and D.C. to conduct public health functions related to obesity prevention such as epidemiology and surveillance activities, DNPAO funding for state level obesity prevention strategies with expanded reach and impact related to nutrition and physical activity has decreased and are funded at lower levels that those related to diabetes and heart disease. For example, in FY 2013 DNPAO provided $16.7 million to states for obesity prevention, while diabetes and heart disease received $20.7 million and $23.3 million, respectively. Currently, CDC does not have sufficient or sustained funds to maintain obesity prevention activities or to build upon or scale effective programs.
In FY 2013, NCCDPHP released a FOA that brings together four programs that were previously standalone programs: heart disease and stroke; nutrition, physical activity and obesity; school health; and diabetes. The FOA, entitled State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors and Promote School Health, aims to efficiently implement cross-cutting strategies in a variety of settings that improve multiple chronic diseases and conditions, while maintaining categorical appropriation funding levels and performance targets. Coordination is intended to improve the impact of efforts to prevent obesity and conditions related to obesity, such as diabetes and heart disease.
Division of Nutrition, Physical Activity and Obesity (DNPAO)
DNPAO supports healthy eating, active living and obesity prevention by creating healthy options in our nation's child care centers, schools, worksites, cities and communities. Partnerships with state, local, territorial and tribal health departments, private enterprise, nonprofit organizations and healthcare professionals and coordination with other agencies extend their work and reinforce consistent public health recommendations with promising practice.
The division focuses on improving dietary quality to support healthy child development and reduce chronic disease; increasing physical activity for people of all ages; and decreasing prevalence of obesity through prevention of weight gain and maintenance of healthy weight.
Division of Population Health (DPH), School Health Branch
CDC's Division of Population Health (DPH), School Health Branch addresses nutrition, physical activity and obesity in schools. In addition to research and evaluation activities, the School Health Branch in DPH supports the school specific activities in the CDC Funding Opportunity Announcement, State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors and Promote School Health. With this funding, the division supports all 50 states by funding state health departments to address nutrition and physical activity in schools. It also provides additional enhanced funding to 32 of the 50 states to support even more work around policies and practices around school physical activity, nutrition and managing chronic conditions in schools, including obesity.
1 Institute of Medicine. The Future of the Public's Health in the 21st Century. Washington, D.C, 2003. U.S. Centers for Disease Control and Prevention. Public Health's Infrastructure – A Status Report. Atlanta, Georgia, 2001 and Trust for America's Health. Blueprint for a Healthier America: Modernizing the Federal Public Health System to Focus on Prevention and Preparedness, 2008.