Joanna Cosgrove06.01.07
New Jersey Leverages State-Wide Assault on Obesity
The 'Garden State' takes another step forward with its progressive Obesity Action Plan.
By
Joanna Cosgrove
Online Editor
With a sobering obesity rate that’s on the rise, New Jersey (NJ) is trying to get back to its "Garden State" roots by implementing a comprehensive Obesity Action Plan designed to spur healthier lifestyles. The groundwork began in January 2005 when the state’s Governor appointed a 27-member task force that came face to face with overwhelming statistics reflecting the toll obesity is taking on the state, both fiscally and in the health of its residents.
For instance, NJ spent $2.3 billion in 2003 for medical expenses resulting from the treatment of obesity-related diseases. Half of that cost was borne by taxpayers in the form of Medicare and Medicaid expenditures. Inpatient and outpatient healthcare costs due to obesity are increasing at the rate of 36% every year, while prescription costs for obesity-related illnesses are climbing annually at a rate of 77%.
In addition, more than half of all NJ adults are obese or overweight. The crux of the problem is that less than 40% of NJ adults participate or engage in frequent physical activity and less than 30% of NJ adults eat five daily servings of fruits and vegetables (including legumes). NJ also has the highest incidence of obesity in low-income children aged two to five years in the nation.
Armed with those statistics, the task force crafted the "New Jersey Obesity Action Plan," which has seven goals at its foundation:
• Improve state and local capacity and support initiatives that address physical activity and healthy eating across the lifespan in NJ.
• Develop an intergenerational, culturally sensitive public awareness campaign on preventing obesity through healthy choices and physical activity.
• Mobilize and empower municipalities and counties to partner with local organizations and neighborhoods to help families raise healthier children and to motivate citizens to increase their physical activity and improve their diets.
• Mobilize and empower public and non-public schools to take local action steps to help families raise healthier children and increase the number of schools that view obesity as a public health issue.
• Increase workplace awareness of the obesity issue and increase the number of worksites that have environments that support wellness, including weight management, healthy food choices, physical activity and lactation support.
• Increase support for the promotion of healthy eating and physical activity within NJ’s healthcare systems and among healthcare professionals.
• Decrease disparities in obesity and increase healthy eating and physical activity across the lifespan among high risk groups in NJ, such as African-Americans, Hispanics, and persons of low socioeconomic status.
The Action Plan broadly addresses all NJ residents as unique individuals—children, adolescents, parents, working-age adults and older adults—and takes into account all major aspects of their lives—their home and family; childcare, if it is outside the home; their schools; their workplaces and employers; their communities as a whole and the organizations in them; their healthcare, both the individual providers and the systems; and their state and local government.
According to Fred Jacobs, MD, JD, commissioner of the state Department of Health and Senior Services, the sooner the state can realize the goals of the Action Plan, the better. “We must find more effective ways to counter our steadily rising rates of overweight and obesity, especially among children,” he said. “Overweight can lead to serious health problems, such as high blood pressure, type 2 diabetes and early heart disease. And it is costly both to individuals and to society.”
Dr. Jacobs added that many private and public groups, including public health, have been working on this issue. “Because the general public’s awareness of the obesity epidemic is rising, too, this is a good time to build on what's already been accomplished.” he said. “The new office can do that by collaborating with other concerned groups and by taking a leadership role in the state.”
The new office referred to by Dr. Jacobs is the state’s newly created Office of Nutrition and Fitness, which is slated to open later this summer. “We are combining a number of programs into one new Office of Nutrition and Fitness, and are still finalizing the organizational structure,” said Dr. Jacobs, noting that although no one has been tapped to helm the new office, the first order of business is already known. “The office’s first move will be to reconvene the Task Force, which will then set the office’s priorities based on the recommendations of the Task Force’s Action Plan,” he said.
As outlined by the Task Force, the new office will emphasize healthy eating habits—eating more fruits and vegetables, eating less processed food—and controlling portion sizes. The Task Force report, however, did not address the issue of supplements or functional foods.
The Ripple Effect
NJ may be the nation’s first state to enact such a comprehensive plan against obesity, but it is also a microcosm of the obesity problem that’s endangering the American public on a national scale. In fact, the rising rate of obesity in the U.S. has many in the industry wondering how long it will be before other states consider taking a similar course of action. “As with New Jersey, which has one of the highest childhood obesity problems, government has a duty to address health epidemics,” commented George Blackburn, MD, PhD, associate professor of surgery, Beth Israel Deaconess Medical Center, Boston, MA, and member of the Silver Spring, MD-based Obesity Society, adding that other states can learn a lot by mirroring how NJ established local, regional and statewide programs to coordinate all the statewide programs, and also how the state maximized the resources and funding gained from the federal government, local employers and others who want better health, particularly for the children.
The tenets of the Action Plan have also won favor with the American Dietetic Association. “The New Jersey plan is very proactive and takes a positive, preventive approach to encouraging healthful food and fitness habits,” said Elisa Zied, MS, RD, CDN, a NY-based registered dietitian, spokesperson for the American Dietetic Association and author of Feed Your Family Right! and So What Can I Eat?!.
“It also includes a variety of efforts that can indirectly support healthful weight management. Besides specific obesity prevention programs, it will oversee programs that encourage increased physical activity, promote breastfeeding and provide fresh fruits and vegetables,” she continued. “A positive, proactive approach such as this is likely to help many Americans, including children, eat more healthfully and move their bodies more. This can certainly help reverse the obesity trend or, at the very least, help adults stop gaining weight and help children achieve a healthful body weight.”
The NJ plan is still its infancy, but Ms. Zeid is hopeful more states will follow the Garden State’s lead to create a coordinated effort to tackle the nation’s obesity problem head-on. “We need to take action now, not just as a country, but state-wide and locally if we are to reverse the current trends in overweight and the rise in type 2 diabetes and other adverse health conditions related to overweight,” she stressed. “We also need to find a clear and organized way to help raise a healthier generation of children.
“Only time will tell how well the NJ program will work; if it is able to find ways to quantify and demonstrates how successful the various programs it coordinates are, other states are likely to follow their lead and create similar plans,” she said. “Of course, at first NJ may suffer from some growing pains and setbacks initially … it will take perseverance and a concerted effort by everyone to reverse the tides and fight the obesity effort head on to improve everyone’s health and well being.”