Friday, May 28, 2010

Guest Commentary: Obesity Trends - There is Hope

Laura Kimberly, MSW, MBE
Director of Special Projects
Jefferson School of Population Health

Recently at JSPH, two presenters at separate events referenced the CDC’s Behavioral Risk Factor Surveillance System obesity trend maps in their presentations. These maps track obesity rates over time and create a powerful visual demonstration of the sharp increases in states’ obesity rates since the 1980’s. The numbers are startling, and the associated costs, both fiscal and social, paint a grim picture.

Much has been written recently about the challenge of addressing rising rates of obesity in the United States, and the outlook tends to be gloomy. Well-intentioned interventions may enjoy isolated, short-term success, yet behavioral change with staying power seems elusive. However, at JSPH’s Health Policy Forum on May 12th, Karen Glanz, PhD, MPH, offered a note of hope. She discussed her work, which strives to make connections between academia and the community and to measure the impact of evidence-based interventions. She began by noting that the national vision for health, articulated in the Healthy People 2020 goals, includes an emphasis on creating social and physical environments that improve health for all, and she referenced T. R. Frieden’s health impact pyramid as a helpful framework for examining population health issues.

Dr. Glanz advocates for a social ecological approach to health promotion, and she pointed to several examples of interventions which have had a positive impact in the sphere of community and health system environmental interventions, and in legislation, regulation, and enforcement. In particular, Dr. Glanz discussed the success of tobacco control initiatives and was hopeful that our experiences with tobacco may help point us in the right direction as we develop strategies to address obesity.

She ended by cautioning that there is more work to be done and reminded us that we can’t assume causal relationships and shouldn’t always rely on randomized control trials as the gold standard when we do have access to natural experiments which can offer valuable insight. In addition, we need to reach disadvantaged populations and develop more practical tools.

All-in-all a sobering and immensely sensitive topic, but an area in which we can’t afford to throw up our hands. Do you think we can develop effective strategies to address rising rates of obesity? Please share your thoughts.