State Actions on Childhood Overweight and Obesity–

Update for 2005

By Amy Winterfeld, JDProgram PrincipalHealth Program

National Conference of State Legislaturesamy.winterfeld@ncsl.org

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Obesity – Fast Facts Obesity is epidemic in the U.S.

and cost $117 billion in 2000. Obesity increased 60 percent among

U.S. adults in the last 10 years. 59 million U.S. adults are obese. Obesity-associated chronic diseases –

heart disease, some cancers, stroke, diabetes – are the 1st, 2nd, 3rd, & 6th leading U.S. causes of death.

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Obesity & Children’s Health 16 percent of U.S. children and

adolescents age 6-19 are overweight (9 million children).

Since 1980, obesity has doubled for children and tripled for adolescents.

The number of children diagnosed with type 2 diabetes (formerly “adult onset diabetes”) has increased.

Other health consequences of obesity for children may include:

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Obesity – Factors Driving Policy Obesity-attributable U. S. medical

expenses were estimated at $75 billion for 2003.

Taxpayers fund about half of this through Medicare and Medicaid.

Healthy eating and a physically active lifestyle can help children and adults achieve and maintain a healthy weight and may reduce or prevent obesity-related medical costs and chronic diseases.

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State Medical Obesity Costs in Millions of Dollars

Source: Obesity Research, Volume 12, No. 1, January 2004

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Obesity – Legislative Responses

Nutrition Topics Nutrition Standards in Schools Nutrition Education Measurement of Student Body Mass

Index (Arkansas enacted in 2003) Nutrition Menu Information for School

Foods Taxes on Foods or Beverages with

Minimal Nutritional Value

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Obesity – Legislative Responses

Physical Activity TopicsPhysical Education or Physical

Activity in SchoolsWalkable communities - city

planning, transportationSafe routes to school Partnerships with businesses to

increase physical activity and healthy eating at workplaces

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Obesity – Legislative Responses

General Obesity-Related LegislationDiabetes Screening and

Management Insurance Coverage for Obesity

Prevention and TreatmentSchool Wellness PoliciesObesity Task Forces, Commissions,

or StudiesRaising AwarenessLimitations on Lawsuits Against the

Food Industry

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Obesity Costs – Another View

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Nutrition Standards in Schools 38 states considered or enacted school

nutrition legislation in 2005. This includes:

15 states that enacted school nutrition legislation in 2005: AZ, AR, CO, IL, KS, KY, LA, ME, MD, NM, OK, RI, SC, TX and WV. In UT a resolution encouraging passed the legislature and was sent to the lieutenant governor.

21 states that are considering or have considered school nutrition legislation in 2005: AL, AK, CA, HI, IN, IA, MA, MO, MS, MT, NE, NH, NJ, NY, NC, ND, OH, OR, PA,TN and VA.

Information is updated periodically on the NCSL web site at:http://www.ncsl.org/programs/health/ChildhoodObesity-2005.htm

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Nutrition Standards Enacted- 2005 Comprehensive food and beverage guidelines

that require healthy choices or restrict sale of competitive foods AZ HB 2544, AR SB 965, CT SB1309, KS SB 154, KY

SB 172, MD SB 473, NM HB 61, OK SB 265, SC HB 3499, WV HB 2816

Encouraging school districts to adopt nutrition & wellness guidelines CO SB 81, WV HB 2816

Evaluation of nutrition services; celebrations allowed TX SB 42

Regulatory action on school nutrition standards TX (2004), NJ (2005)

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Body Mass Index (BMI) Legislation

13 states considered or enacted BMI legislation in 2005

Enacting BMI reporting – Tennessee, West Virginia

Legislation introduced - Alaska, Connecticut, Georgia, Iowa, Maine, New Jersey, New York, North Carolina, Oregon, South Carolina, and Texas

Considered repeal – Arkansas

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Diabetes Legislation School child screening

Enacted CA and IL – 2003 Considered NY and PA - 2004 Considered PA – 2005

At-school treatment and training of school personnel in diabetes management Passed both chambers of legislature – HI – 2005 Considered TX – 2005; CA, IL, MA, NJ, PA, TN, VT, VA – 2004

Diabetes awareness in schools Enacted resolution - CA – 2005 (SCR 4)

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Insurance Coverage – Obesity Prevention and Treatment

Insurance coverage option required – GA, IN, VA

States considering insurance coverage requirements or strengthening coverage requirements in 2005 – CA, CT, GA, IN, MD, MO, MS, TN

Insurance coverage required – Maryland

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Nutrition Content Information for School Foods Legislation

School nutrition information requirements considered 2005 California, Illinois, Massachusetts, and New

York

School nutrition information requirements enacted 2005 Colorado, Kentucky, Maine, West Virginia

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Nutrition Education in School Curriculum

School nutrition education requirements considered 2005 Minnesota, New Mexico, New York, Oklahoma,

Pennsylvania, Vermont, Virginia

School nutrition education requirements enacted 2005 Colorado, Kansas, Illinois (for food stamp, TANF

recipients - passed both legislative chambers), Maine, South Carolina, Texas and West Virginia

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Physical Activity – Legislative Responses

Physical Education or Physical Activity in Schools 48 states require P.E. in schools, but scope

of requirement varies 60% of states require schools to follow

national or state P.E. guidelines. 80% require adapted or mainstream P.E. for IEP students.

IL requires daily P.E. for K-12, but exemptions allowed. AL requires daily P.E. for K-8.

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Physical Activity – Legislative Responses

Physical Education or Physical Activity in Schools 8 states enacted or strengthened P.E. or

physical activity requirements in 2005: AZ, CO, CT, KS, KY, MT, SC, TX

25 states introduced legislation to implement or strengthen P.E. or physical activity requirements in 2005: AL, AK, DE, GA, HI, IL, IN, IA, MA, MI, MS, MO, NE, NH, NM, NY, OH, OK, OR, PA, RI, TN, UT, VA.

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Physical Activity – Legislative Responses

Walkable communities – through community planning and transportation projects that encourage walking.

Safe routes to school - CA, DE, FL, OR, TX have state laws as of 2003.

Legislative role models – CO legislators participate in 10,000 Steps to Better Health and created Colorado Walking Wednesday urging parents and children to walk to school; WI legislators resolved to Lose a Ton.

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Nutrition and Physical Education – Food for Thought

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School Wellness Policy Legislation Federal Child Nutrition and WIC

Reauthorization Act of 2004 – Requires local school districts participating in the National School Lunch or Breakfast Programs to establish local wellness policies by the beginning of the 2006-2007 school year.

Statewide wellness policy legislation – considered in 2005 in CA, OH, TN.

Statewide wellness policy legislation – enacted in 2005 in CO, IL, RI.

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Task Forces, Commissions, or Studies

Six states previously enacted obesity task forces, commissions, or studies – Arkansas, Maine, New York, Texas, Rhode Island, Washington

Legislation introduced for obesity task forces, commissions, or studies in 2005 – Kansas, New Mexico, North Carolina, Virginia, and West Virginia

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Legislative Effort to Raise Awareness California – A panoply of awareness raising

efforts encouraged to increased physical activity and improve nutrition and wellness in all branches and levels of government, communities, schools, workplaces; healthy food options in restaurants, markets, and homes; and increased emphasis on health education and prevention of obesity and diabetes.

Maryland – Proposed November as “Obesity Awareness Month”

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Snack Tax Legislation Nebraska – Proposed sales tax on

snack foods to create a fund for school facilities.

Texas – Proposed snack and sweets tax to fund childhood obesity prevention programs.

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Additional ResourcesLinks for NCSL and other resources on legislation and policy

options to address childhood obesity are:

NCSL updated overview of childhood obesity policy options considered in 2005 at: http://www.ncsl.org/programs/health/childhoodobesity-2005.htm

NCSL overview of childhood obesity policy options considered in 2003-2004 at: http://www.ncsl.org/programs/health/childhoodobesity.htm

NCSL information on access to healthy foods in communities at: http://www.ncsl.org/programs/health/publicHealth/foodaccess/index.htm?CFID=614822&CFTOKEN=54359522

Information about federal wellness policy requirements on the U.S. Department of Agriculture web site at: http://www.fns.usda.gov/tn/Healthy/wellnesspolicy.html

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Thank you!

NCSL Contact for Additional Childhood Obesity Policy Information:

Amy WinterfeldProgram PrincipalHealth ProgramNational Conference of State Legislatures7700 East First PlaceDenver, Colorado 80230amy.winterfeld@ncsl.org303-364-7700, ext. 1544