Often the result of poor nutrition and misinformation, obesity brings with it a host of debilitating health problems and a hefty economic price tag. Virginia is committed to promoting a healthy lifestyle, starting in childhood, to help citizens avoid obesity and live long, productive lives.
Why is This Important?
A healthy community is one in which individuals adopt healthy behaviors such as eating nutritious foods and being physically active, both of which can prevent or control the devastating effects of obesity. Obesity often results in lost workdays, lower productivity, and negative health outcomes, including diabetes and depression; it also strains private and government health care programs.
Unfortunately, obesity rates in the United States are still generally rising, with few exceptions. Virginia continues to be committed to healthcare programs that help residents avoid or at least reduce the health and economic consequences of obesity.
How is Virginia Doing?
Consistent with trends nationwide, obesity rates in Virginia have been steadily rising for the last decade and more. The state's current (2011) 29.2 percent obesity rate is higher than the national average (27.8%). Virginia's peer states are also all higher than the national average: Maryland (28.3%), North Carolina (29.1%), and Tennessee (29.2%). Colorado, which has led the nation in lowest obesity rates since 2000, again led in 2011 with 20.7 percent.
Among Virginia's regions, the Southside region had the highest obesity rate at 38.0 percent in 2011. It was followed by the Southwest (35.6%) and West Central (31.8%) regions. The Northern region had the lowest rate of obesity at 23.4 percent.
The 2007 National Survey of Children's Health found that 31 percent of Virginia's 10-to-17-year-olds were overweight or obese, an increase since 2003 of 1 percent. This figure puts Virginia just under the national average of 31.6 percent and ranks the state 23rd highest in the country for percentage of overweight or obese children. Virginia's rate was lower than North Carolina (33.5 percent) or Tennessee (36.5 percent), but higher than Maryland (28.8 percent). Utah was lowest in the U.S. at 23.1 percent. Of the states tracked here, only Maryland and North Carolina showed a decrease in percent of overweight or obese children in 2007. [A new survey is now underway (from February 2011-March 2012); look here for an update in 2013.]
F as in FAT. A September 2012 report published by the Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation warns that -- if nothing is done to alter the average American's diet and exercise habits -- the adult obesity rate in the United States would soar from an average 35.7 percent today to nearly 50 percent by 2030; in no state would the rate fall below 44 percent, while over a fifth would see rates above 60 percent.
However, this same study found that losing just a small amount of weight could significantly alter outcomes. An adult is considered obese if his or her body mass index (a measurement of fatty to lean tissue) is 30 or above. If Virginia could reduce the average body mass index (BMI) of its residents by just 5 percent, for example, the state could help prevent thousands of cases of type-2 diabetes, coronary heart disease and stroke, hypertension, cancer, and arthritis. Virginia would also save thousands in health care dollars per resident. For a 6-foot-tall person weighing 200 pounds, a 5 percent reduction in BMI would be the equivalent of losing approximately 10 pounds.
Using data from the National Heart Forum, the TFAH analysis makes detailed projections about the obesity-related incidence of disease. For instance, if average BMI is reduced by 5 percent by 2020 in the Commonwealth, over 345,000 cases of obesity-related disease could be avoided, for a potential cost savings of nearly $6.3 billion.
Failing Standards. All 50 states are engaged in at least a few standardized practices in their public schools to combat obesity. Every state, for example, has a physical education requirement and most have a health education requirement; about two-thirds have adopted Nutritional Standards for Competitive Foods (vending machines and other non-school-provided meals), while not quite half have also adopted the federal Nutritional Standards for School Meals.
Of the nine widely accepted Obesity-Related Standards in School, Trust for America's Health's 2011 study found that Virginia met only four (after having added standards in 2009 and 2010):
- nutritional standards for competing foods (added in 2010)
- physical education
- health education
- farm-to-school programs (programs which encourage the supply of fresh local produce to schools; added in 2009)
It did not meet the standards for:
- school meals meeting the latest nutritional standards
- limited access to competitive foods (e.g., vending machines)
- physical activity
- collection of BMI or health information
- diabetes screening
Peer states North Carolina and Tennessee met 7 of the 9 standards, while Maryland met five; Virginia was in a group of 20 states -- among them Alaska, Idaho, Georgia, Kansas, Missouri, Washington, and Wyoming -- meeting 4 or fewer standards.
What Influences Obesity?
Body weight is the result of genes, metabolism, behavior, environment, culture and socioeconomic status. Being overweight or obese typically results from an energy imbalance that involves eating too many calories and not getting enough physical activity to use those calories up. Misinformation, as well as personal behaviors -- including poor nutritional, environmental, or exercise choices -- play a large role in causing people to be overweight and obese.
What is the State's Role?
The state's primary role in obesity prevention and control is to ensure the development of an aggressive, coordinated strategic plan. Through its CHAMPION program (Commonwealth's Healthy Approach and Mobilization Plan for Inactivity, Obesity and Nutrition), the Virginia Department of Health conducted lengthy public surveys in every region of the state to both educate local populations on the obesity problem and to garner their feedback on common obstacles and suggestions for overcoming them.
The project identified recommendations for actions for communities and effective interventions targeting behavioral, environmental and policy change strategies in the following four areas: media intervention, nutritional education and physical activity, community involvement, and public policy. Between 2009 and 2011, CHAMPION awarded $336,412 in funding to local health districts, hospitals, schools, and community organizations to implement 31 obesity prevention programs recommended in the CHAMPION Obesity Prevention Plan.
State rankings are ordered so that #1 is understood to be the best.
Data and Definitions
State and Regional Obesity Data: Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey (BRFSSS) Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2011.
NOTE: 2011 BRFSS results cannot be compared to earlier years because of changes in the sampling methodology.
Childhood Obesity Action Network. State Obesity Profiles, 2008. National Initiative for Children's Healthcare Quality, Child Policy Research Center, and Child and Adolescent Health Measurement Initiative, accessed on July 21, 2009.
Trust for America's Health and the Robert Wood Johnson Foundation. F as in Fat: How Obesity Threatens America's Future, 2012.
Trust for America's Health. Legislative Supplement: Obesity-related Legislative Action in States (Update). (PDF)
Finkelstein, E. A., I.C. Fiebelkorn, and G. Wang. 2004. State-level estimates of annual medical expenditures attributable to obesity (PDF). Obesity Research 12, 1: 18-24.
Virginia Department of Health, Virginia's CHAMPION Summary Report (PDF).
Information on the cost of obesity is available at the Centers for Disease Control and Prevention. (Accessed July 20, 2009)
See the Data Sources and Updates Calendar for a detailed list of the data resources used for indicator measures on Virginia Performs.