Spring 2012 Vol. 4, No. 3
Eating Well For Healthy Results
Chronic diseases are among the most common, costly and preventable health problems in the United States. Eating a diet high in saturated fat, sodium and trans fat, and low in fiber-rich foods such as whole grains, vegetables and fruits, and calcium from low-fat dairy products, increases the risk for chronic diseases such as heart disease, cancer, stroke, diabetes, high blood pressure, overweight and osteoporosis. More than a decade ago, the U.S. Department of Agriculture (USDA) estimated that healthier eating may prevent $71 billion a year in medical costs, lost productivity and premature deaths. Today, more than 75 percent of health care costs spring from chronic conditions, and more than 130 million Americans, nearly half the population, are affected by chronic diseases. But a healthy diet can prevent many of these conditions and their serious, costly effects.
The 2010 Dietary Guidelines for Americans issued by the U.S. Departments of Agriculture and Health and Human Services recommend that Americans improve their diet by, among other things, filling half their meal plates with fruits and vegetables and reducing their sodium intake. Produce can be affordable and low in sodium; a recent USDA survey found that 50 of 94 vegetables studied cost less than 60 cents a cup. However, according to a 2009 CDC report, fewer than 22 percent of high school students and 24 percent of adults eat three or more daily servings of vegetables and two or more of fruit.
For many, that’s because fruits and vegetables may not be conveniently available, says the CDC report. More than a quarter of all U.S. census tracts don’t have the type of food retailers that are likely to offer healthy food such as fruits and vegetables within ½ mile of their borders. In 24 states, these retailers aren’t located nearby for almost a third of census tracts (Alaska, Alabama, Arkansas, Indiana, Iowa, Kansas, Maine, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Mexico, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Vermont, Wisconsin and Wyoming).
People living in neighborhoods with adequate access to fruits and vegetables through supermarkets, grocery stores, local grocers who stock these items or farmers’ markets have a higher produce consumption rate than those who don’t.
State policy options that may help citizens eat healthier by eating more fruits, vegetables, whole grains and low-fat dairy products include:
- Grants, loans or tax credits or exemptions to support grocery development;
- Nutrition education in schools and communities;
- Programs that bring healthier choices from “Farm-to-School, Plate, Table or Cafeteria;” or
- Nutrition standards for foods served throughout school campuses or government facilities.
State policymakers can choose the options best suited to the communities they represent to increase the availability and consumption of healthier foods and to provide new markets for farmers and local food producers.
Healthy Eating Resources
2010 Dietary Guidelines for Americans
CDC: State Indicator Report on Fruits and Vegetables, 2009
USDA: High Costs of Poor Eating Patterns in the United States
USDA Economic Research Service: How Much Do Vegetables Cost?
NCSL Healthy Eating Resources
NCSL Publication: State Actions to Promote Healthy Communities and Prevent Childhood Obesity
NCSL Webinar Archive: "Charting a Course toward Good Food and Good Business: State Options"
Upcoming Events and NCSL Resources
The 2012 NCSL Legislative Summit in Chicago, August 6-9, will bring together some 6,000 men and women from all 50 states and around the world. This meeting will feature 160 sessions on every major issue being debated in state legislatures today. Legislators, legislative staff members, corporate representatives, unions, government officials, foundation members and others will discuss critical state issues, innovations, cost-saving measures and share ideas that shape the country.
NCSL Webinar: “Cost-Effective Investments in Children's Oral Health” on Friday, May 18, 2012 at 2 p.m. ET. According to the Pew Children’s Dental Campaign, in 2009, more than 800,000 ER visits across the country related to preventable dental conditions, a 16 percent increase from 2006. Driven by access issues, these ER visits impose significant costs on already troubled state budgets. Listen to the Pew Children’s Dental Campaign and your state legislative colleagues discuss examples of investments in children’s oral health and areas for significant cost savings.
National Women’s Health Week
Mark your calendars: May 13 – 19 is National Women’s Health Week! For additional information on women’s health please visit NCSL’s Women’s Health Across the Lifespan Overview webpage. Also, for some insight on women’s health and the Affordable Care Act take a look at the NCSL February 2012 issue brief Improving Women’s Health: Opportunities and Challenges in Health Reform.
NCSL can provide testimony to legislatures on chronic disease prevention; health promotion; preventing injuries and violence; reducing health disparities; access to health care; community health centers; and other health policy topics. Contact Alise Garcia at Healthfirstname.lastname@example.org.
NCSL Health Reform Database
NCSL continues updating its Federal Health Reform: State Legislative Tracking Database tracking the actions of state legislatures related to some of the major provisions in the Affordable Care Act. This database has been used by state legislators, legislative staff, the media and the public since it was launched in 2011. It includes both carry-over measures from 2011 legislative sessions and legislation introduced in 2012.
In the News
On April 3, 2012, the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation released the 2012 County Health Rankings that assess the overall health of nearly all U.S. counties. The rankings are based on key factors that influence health, such as education rates, income levels, and access to healthy foods and medical care. Also announced was availability of the 2012 Roadmaps to Health Community Grants, to support two-year state and local efforts among policymakers, business, education, health care, public health and community organizations to create policies or systems to address the social and economic factors that impact health.
Research from Leadership for Healthy Communities, a national program of the Robert Wood Johnson Foundation, shows that people with unreliable access to food are also more likely to be obese. The research brief, Making the Connection: Linking Policies that Prevent Hunger and Childhood Obesity provides policymakers seeking to address hunger in their communities with policy options that can also contribute significantly to reversing the childhood obesity epidemic. –March 2012
According to a new CDC report, State Cigarette Excise Taxes—United States, 2010-2011, eight states increased their cigarette excise taxes (and one state decreased its cigarette excise tax) during 2010-2011. The national average cigarette excise tax increased from $1.34 per pack in 2009 to $1.46 per pack in 2011. At the end of 2011, excise tax rates ranged from $0.17 per pack to $4.35 per pack. –March 2012
On March 27, 2012, the Trust for America’s Health and the Robert Wood Johnson Foundation released a new report, Investing in America’s Health, examining key disease rates in combination with health spending in states around the country. The report concludes that a sustained and sufficient investment in public health and disease prevention is important to improving health and driving down the nation’s health care costs.
On March 21, 2012, the Institute of Medicine released the report, Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Responses, indicating that the infrastructure and systems to deliver health care during or after catastrophic disasters such as major earthquakes or widespread disease outbreaks are underdeveloped.
Schools often keep facilities like gyms, fields, basketball courts, and playgrounds locked after hours because they’re concerned about security, liability, maintenance, and other costs. But cities and towns around the country are resolving these issues through joint use agreements – written contracts spelling out terms that allow public agencies and nonprofits to share the costs and responsibilities. KaBOOM! and the National Policy & Legal Analysis Network to Prevent Childhood Obesity produced, Playing Smart, a new guide to opening school property to the public through joint use agreements. –March 2012
On February 22, 2012, President Obama signed legislation that cuts the Prevention and Public Health Fund by $5 billion—from $15 to $10 billion—over the next 10 years. A policy brief from Health Affairs and the Robert Wood Johnson Foundation discusses the creation of the fund, reviews its spending to date, and presents the debate over preserving, cutting, or eliminating it altogether.
The Surgeon General’s report, Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General, discusses the consequences of tobacco use for our nation’s youth and suggests that every level of government be involved in implementing proven strategies to keep kids off tobacco. The report also indicates that young people are highly susceptible to tobacco advertising and marketing activities leading many youth to a lifetime of addiction coupled with serious health consequences. –February 2012
A study published in the Archives of Pediatrics and Adolescent Medicine shows that despite industry efforts and those of others, snacking behavior among children remains unchanged. One reason is that healthier snacks are being offered alongside less nutritious snacks. The study found that between 2006 and 2010, about half of the schools had vending machines, stores and cafeterias that offered unhealthy foods. Availability of high-fat foods in schools followed regional patterns as well. –February 2012
Funded by the Robert Wood Johnson Foundation and the Kresge Institute, The Hilltop Institute’s Hospital Community Benefit Program published a brief, Hospital Community Benefits after the ACA: Partnerships for Community Health Improvement. It illustrates that partnerships between hospitals, local communities and public health agencies can help leverage limited public health and health care dollars, while addressing specific social, economic and environmental factors that affect community health. –February 2012
Research from the Partnership for Prevention shows that a company saves an average of $3.50 in health care costs for every $1 spent on employee wellness. To help lower health care costs a growing number of small business owners are following corporate counterparts and implementing employee wellness programs that include incentives for participation. –February 2012
Chronic diseases affect more than 133 million Americans, costing nearly $2 trillion annually in health care spending. The Institute of Medicine released a report, Living Well with Chronic Illness, that determines little attention has been given to improving the quality of life for Americans who live with one or more chronic conditions. The report identifies nine conditions that are diverse yet have many factors in common, including significant effect on the nation’s health and economy. – January 2012
The Robert Wood Johnson Foundation has funded a series of new public health services and systems research (PHSSR) projects. The 11 grants, totaling $2.7 million, will support two-year studies examining the impact of budget reductions and program cuts on population health. Studies will examine key areas such as the recruitment and retention of staff, structure of health departments and delivery of public health services. –February 2012
Public Health Project Partner News
NCSL collaborates with the Centers for Disease Control and Prevention and other national organizations—including the National Governors Association, the Association of State and Territorial Health Officials and the Society for Public Health Education—on public health projects. Recent resources available from partner organizations on public health topics include the following.
ASTHO Website Showcases Public Health Policy Resources
ASTHO has taken the lead on several efforts to increase the capacity for using evidence‐based resources to inform public health policy, particularly through adoption of the Task Force recommendations in The Guide to Community Preventive Services (The Community Guide) .
CDC Releases Disability and Health Disparity Data
CDC’s Office for State, Tribal, Local and Territorial Support released data on disabilities and health disparities, linking diabetes with a lack of access to preventive health services, obesity, and an increased likelihood of smoking. The data was compiled from the Disability and Health Data System, an online, interactive tool used to identify trends across the country and compare up to 70 health measures on disabilities, psychological distress, and related health care expenditures.
CDC Funds Prevention Research Centers
The CDC’s Prevention Research Program is a national network of 37 academic research centers that partner with public health agencies to conduct prevention research and translate results into public health policy and practice. The program also provides training to nearly 2,900 health employees each year.
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