The epidemic of overweight and obesity has become one of the most critical public health threats for New Yorkers and Americans. This epidemic has affected all age groups, boys and girls, men and women, and reached across racial/ethnic and socioeconomic groups. Obesity rates increased slightly during the 1970's, but escalated for both children and adults during the 1980's and 1990's. While the rate of increase may be slowing among adults, there are no signs that the epidemic of childhood obesity is abating. In fact, overweight and obesity are increasing problems in young children, setting the stage for the obesity epidemic to continue far into the future. As a result, for the first time in history, children are predicted to have a shorter life expectancy than their parents.
By 2010, some have predicted that the root causes of the obesity epidemic-poor nutrition and physical inactivity-will become the leading underlying causes of preventable deaths in the U.S. The costs, both financial and personal, associated with obesity are also increasing, in part, because obesity leads to higher rates of many diseases, including heart disease, stroke, diabetes, cancer, asthma, arthritis, disability and a number of psychological conditions, including depression.
Stopping the obesity epidemic will not be easy, but there are precedents for success in other public health endeavors. It will require the input, hard work, skills, talents and perseverance of many people, a wide array of organizations and groups, including the medical, educational, non-profit and business communities, academia and government. While there is a role for individual behavior change, population-focused prevention efforts require both decreasing environmental barriers to and supporting healthy food choices and physically active lifestyles. A multi-faceted public health policy campaign is needed, with special attention to selected groups, including Hispanics, Blacks, and Native Americans, and communities experiencing health disparities and social and physical environments unsupportive of healthy eating and physical activity.
Beginning in January 2003, the New York State Department of Health embarked on a strategic planning process to address the problem of overweight and obesity in NYS. In February 2003, the Department summarized current efforts in nutrition, physical activity and obesity prevention and applied for and received funding from The Centers for Disease Control and Prevention (CDC) Division of Nutrition and Physical Activity in July 2003.
The following steps were undertaken to develop a strategic plan to prevent overweight and obesity in New York State.
- In August 2003, a Steering Committee (Appendix I) comprised of 33 experts from the medical, professional and business communities, governmental agencies, and advocates provided guidance to the Department in the planning process.
- An inventory of NYS resources to prevent or reduce overweight or obesity was completed in the fall of 2003. A Planning Team (Appendix II) guided the plan development process.
- Six workgroups were formed based on recommendations by the CDC Physical Activity and Nutrition Program that four key focus areas (breastfeeding, television viewing, physical activity and fruits and vegetables) be included.
Workgroup Focus Areas
- Critical periods (perinatal period, infancy and breastfeeding)
- Nutrition and dietary determinants (caloric balance, fruits and vegetables)
- Physical activity
- Television viewing and media
- Surveillance and program evaluation
- Public and provider awareness
Each workgroup developed goals, specific objectives and strategies guided by the research evidence. State and national data, surveillance and evaluation findings, published professional guidelines, previous NYS chronic disease prevention plans (cancer, cardiovascular disease, diabetes, arthritis and disability), obesity prevention plans from other states (such as Pennsylvania, Massachusetts, Colorado, Texas, and North Carolina), the New England Coalition for Health Promotion and Disease Prevention's (NECON) "Strategic Plan for the Prevention and Control of Overweight and Obesity in New England" (2003) and the Institute of Medicine's (IOM) draft report, "Preventing Childhood Obesity: Health in the Balance" (2004) were used to inform this process and the resultant goals and strategies.
- To elicit community input, 14 Community Forums were held across NYS between December 2003 and February 2004. Approximately 300 community members participated in these forums to identify gaps in the proposed plan goals and strategies, to provide comments and feedback, and to identify and recruit additional partners and stakeholders for plan implementation at the state and local levels. A community forum participant database was developed to assess the diversity of representation, recruit local and regional partners, and identify priority objectives and issues across different regions of the state.
- In October 2004, two site-specific workgroups were held to provide additional opportunities for stakeholders to review the draft plan goals, objectives and strategies and to offer continued involvement and participation in developing the plan and guidance in implementation priorities. One workgroup focused on school and childcare settings and included professionals from the educational community and related organizations. The second workgroup focused on the healthcare and worksite settings. Participants included NYS representatives of professional and medical organizations such as the Medical Society of the State of New York, healthcare representatives of NYS businesses and employer groups (including the NYS Business Council) and individual businesses, medical directors of managed care plans and university-based obesity researchers. Over 75 people participated in these two one-day meetings.
- This report, the New York State Strategic Plan for Overweight and Obesity Prevention, was published in early 2005. It is only the first step toward achieving the vision that all New Yorkers will achieve and maintain a healthy weight. Implementing the proposed strategies will require continued and sustained commitment from a wide array of stakeholders.