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Unhealthy Shopping Difference:

2. First, let ’ s set the stage with a tale of two Texas shopping trips and an experiment that shows why we are all fighting an uphill battle. 3. BUDGET: $56.75, the national average weekly SNAP benefit in 2011 for a family of four – one mom and three school-aged children. 4.

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Unhealthy Shopping Difference:

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  1. 2 First, let’s set the stage with a tale of two Texas shopping trips and an experiment that shows why we are all fighting an uphill battle.

  2. 3 BUDGET: $56.75, the national average weekly SNAP benefit in 2011 for a family of four – one mom and three school-aged children.

  3. 4 BUDGET: $56.75, the national average weekly SNAP benefit in 2011 for a family of four – one mom and three school-aged children.

  4. 5 Unhealthy Shopping Difference:

  5. Putting Obesity in Perspective: A Growing Problem 6 OBESITY AND OVERWEIGHT PREVALENCE AMONG CHILDREN AGED 10 TO 17, 2003 vs. 2011 Source: National Survey of Children’s Health, 2003 and 2011

  6. Texas Is Not The Largest State In The Union, But… 7 PERCENT OF ADULTS CLINICALLY OBESE, 2012 TEXAS: 29.2% ALASKA: 25.7%

  7. Legacy For Our Children? 8 PERCENT OF HIGH SCHOOL STUDENTS OBESE, 2011

  8. Legacy For Our Children? 9 PERCENT OF OVERWEIGHT/OBESECHILDREN, 10–17, 2011 ⅓

  9. Schools Have an Obligation 10 Why Focus on Schools? That’s Where the Kids Are… TEXAS Children 6-18 mustattend school. ALASKA Children 7-16 mustattend school. Education Code, Sec. 25.085. | Compulsory School Attendance. (a) A child who is required to attend school under this section shall attend school each school dayfor the entire period the program of instruction is provided. (b)  Unless specifically exempted by Section 25.086, a child who is at least six years of age, or who is younger than six years of age and has previously been enrolled in first grade, and who has not yet reached the child's 18th birthday shall attend school. Chapter 14.30 Pupils and Educational Programs for Pupils | Article 01. | Compulsory Education | Sec. 14.30.010. (a) Every child between seven and 16 years of age shall attend schoolat the public school in the district in which the child resides during each school term. Every parent, guardian or other person having the responsibility for or control of a child between seven and 16 years of age shall maintain the child in attendanceat a public school in the district in which the child resides during the entire school term, except as provided in (b) of this section.

  10. Must Change the Culture of Food at School 11 OPPORTUNITIES: • Better food choices • Fresher food choices • Portion sizes • Active fun • Non-food rewards CHALLENGES: • Too much “screen time” • Convenience food • Public engagement

  11. What We Did In Texas 12

  12. Major Policy Provisions 13 • Took competitive foods out of elementary schools and replaced fried foods with baked. • Restricted fried, minimallynutritious food, and candy from middle schools until after last class period. • Lowered permissible fat and sugar content of foods. • Cut portion sizes. • For example, limited servings of fried potato products to no more than 3 oz. • Disallowed soda in containers larger than 12 oz. (for high schools).

  13. Food Providers Making an Effort 14 • These companies took responsible steps in the wake of policy changes: • Pizza Hut reconfigured its school pizza to meet fat requirements. • Aramark offers popular dishes like penne Alfredo made with less fat. • Frito-Lay brought in baked chips and cut portion sizes. • Coca-Cola, Pepsi and Nestle hustled in healthier new offerings as well. • Process hasn’t been painless for all: • One high school in Dallas had to shutter its student store that sold candy to pay for classroom VCRs and choir music.

  14. But We Also Did More To Educate & Inspire 15 Posters to school cafeterias to encourage kids to eat healthy and exercise.

  15. Educating Families to Change Perceptions of Portion 16 Showproper portions in everyday ways; distributed to more than a million students in 1st through 4th grade in Texas public schools.

  16. Engaging Kids and Their Parents 17 Engagedkids with hands-on activities such as recipe contests, which were featured statewide on book covers, in magazines and at school events.

  17. Engaging Educators and Families 18 Communicatedpolicies and best practices to schools and families via every channel: print materials (sent home to parents), Web, broadcast. As of 2010, nearly 30% of Texans spoke Spanish as their primary language.

  18. Making the Most of One-Time Federal Funding 19 Promoting specialty crops to introduce Texas kids to fresh produce at school tasting events. Tasting is believing. In 2001, Texas was allocated $2.6 million to promote specialty crops, and Alaska received $20,000 (based on production).

  19. As the State’s Chief Fiscal Officer 20 In 2007, issued the Counting Costs and Calories special report outlining the staggering cost of obesity to business in Texas. • We reported that everything is bigger in Texas — nearly two-thirds, 64.1 percent, of the state’s population was overweight or obese in 2007. • Obesity cost Texas businesses $3.3 billion in 2005 (absenteeism, presenteeism, disability and healthcare costs).

  20. Investing State Funds 21 As Comptroller: Allocated $40 million in grants in 2007–2011 to support in-school PE and nutrition programs for grades 6-8. • Texas Fitness Now for middle school students in economically disadvantaged schools • Base grant of $1,500, plus additional funds added to total per student served. (E.g., in 2007–08, $1,500 + $32 per student.) • Funds used for PE equipment, fitness measurement, curriculum, teacher training and nutrition education.

  21. The Impact of Texas Fitness Now 22 “We cannot say enough about the TFN grant. It let us get equipment our students needed for a long time.” “TFN is a godsend to help attack our childhood obesity problem.” Comments from the 2009–10 Texas Fitness Now End-of-Year Progress Report The Texas Legislature did not fund Texas Fitness Now beyond 2011.

  22. An Update on Obesity Issues in Texas 23 In 2011, issued Gaining Costs, Losing Time special report updating projections of obesity’s cost to individuals, businesses and the state. • From 1980 to 2011, the prevalence of obesity among children and adolescents tripled. • Obesity cost Texas businesses $9.5 billion in 2009.

  23. Added Annual Health Care Cost Per Person U.S., 2009 24

  24. Cost to Texas Businesses, 2009 25 With current trends: cost projected to be $32.5 billion by 2030.

  25. Keeping The Issue On The Front Burner 26 Launched ReshapingTexas.org in 2012, a Web portal designed to be a one-stop spot for obesity informationand resources in Texas, including the following: • Data on the costs/economic impact of obesity,•Grant opportunities for treatment and prevention,•Ongoing initiatives to prevent and treat obesity,•Success stories from across the state,•The latest obesity research and news, and •Feedback mechanisms to include social media, email.

  26. And Provide Tools Needed 27 Integrated searchable GIS mapping with statewide FITNESSGRAMBMI data to identify school districts at highest risk.

  27. Pinpointing the Issue 28 Students with scores that fall in the Healthy Fitness Zone (HFZ) are considered to have a body composition sufficient for good health. MIAMI ISD Percent BMI achieving HFZ: 60 Percent BMI at Some Risk: 19 Percent BMI at High Risk: 21 SAN DIEGO ISD Percent BMI achieving HFZ: 34 Percent BMI at Some Risk: 14 Percent BMI at High Risk: 52

  28. Feast Or Famine: School Health Legislation 29 • Texas Legislation has alternately bolstered and weakened health standards for students. • Contentious points between schools and health advocates: • Physical education requirements (e.g., duration, frequency). PE and arts curricula often conflict. • Time and expense can limit reporting of student physical fitness to the state, parents and ISDs. • Empowerment of School Health Advisory Councils (SHACs): What is the appropriate level of their purview? • SHACs expanded in scope in 2013. Now they make specific recommendations to ISDs to increase physical activity and improve student fitness. They also seek opportunities to share community facilities for the sake of exercise/fitness.

  29. The Battle Never Ends 30 One Step Forward, Two Steps Back HB 1781, passed by Texas Legislature in May 2013: Allows high schools to have junk food fundraisers, disallowing fines. And in Mexico, the WSJ tracks the health battle over sodas:Ad campaigns to reduce consumption of sodas countered by soda company campaigns. Yet, seven out of 10 Mexican adults over the age of 20 are either overweight or obese, and an estimated 10million Mexicans have diabetes. Mexico recently overtook the U.S. as the world’s fattest nation. Breaking News: WSJ recently reported on efforts to tax Mexican junk food:The lower house of Congress passed a “special tax on junk food” on Oct. 17. The measure “is seen as potentially the broadest of its kind, part of an ambitious Mexican government effort to contain runaway rates of obesity and diabetes.”

  30. Continuing to Meet the Challenge & Raising an Alarm 31 • Partnered with Texas elementary school libraries in economically disadvantaged areas and public libraries to provide 25,000 books/DVDs on healthy eating and exercise. • Boxes contained 7 to 10 books/DVDs selected from 17 titles. • 900+ public libraries and 1,100+ school libraries received boxes of books. • Those school libraries serve more than 600,000 students, and the public libraries serve 23.6 million Texans. • Provided sports equipment to 3,500+ schools with 5-8 graders at the highest risk of obesity. Those schools serve more than 2 million students.

  31. Feedback Shows Challenges, Opportunities 32 • Perception Problem — More than one third of Texas children, age 10-17, are obese or overweight. BUT, public librarians, principals and school librarians said the following when surveyed. • Public libraries: 73% of respondents say their communities have only an average or normal prevalence of obesity. • School principals: 75% said the same about their schools. • School librarians: 68% said the same about their schools. • Are they really aware of the extent of the problem? • However, we also were heartened to receive this feedback regarding Reshaping Texas outreach. • “I plan to put together a prominent display of these books and DVDs in the children’s area and to tell the parents about the ReshapingTexas.org website.” • “With your donation, we will be able to educate our students on the importance of maintaining a healthy lifestyle.” • “We will do all that we can to encourage the local families to use the books and make decisions based on what they learn.”

  32. So, What Does This Mean? 33 • Even in the face of facts, people aren’t facing facts. We must keep messaging the scope and implications of the problem. • Fighting this battle will never be easy. There’s a reason proponents of healthy eating feel outnumbered, outgunned and outmuscled — $1.8 billion spent on food advertising directed at youths in 2009. • This is an entire culture change. We must convey the dire need to shape a new vision on health and take the steps necessary to realize that vision.

  33. Some Rays of Hope as Texas Businesses Step Up 34 • HEB’s Slim-Down Contest (public, statewide 2013 and 2014): • Fifteen people will be chosen from applicant pool to attend a “fit camp.” Then they return home to apply what they know and receive a pantry makeover with help from dietician. • Grand prize winner will receive $10,000 award. • HEB used to sponsor Slim-Down contest internally, but has now opened campaign to the public. • USAA Take Care of Your Health program (internal): • Addresses employee health issues through 20 initiatives such as healthy points which could be earned by participating in wellness activities and could be spent to reduce health plan premiums. • Reduced absences and saved $105 million over three years.

  34. Working Together 35 • The magnitude of the challenge requires an equally bold response. • Must facilitate engagement at all levels: policy makers, schools, businesses and individuals. • We have a moral obligation to our children and their future. • Make bold policy choices — even though they may not receive a 100% positive reception. • Working together, we can help each other reshape the future. • Create forums like Reshaping Texas to identify challenges and highlight proven strategies.

  35. Let’s Cut Obesity Down to Size 36 Susan Combs Texas Comptroller of Public Accounts www.ReshapingTexas.org susan.combs@cpa.state.tx.us To download this presentation, please visitwww.ReshapingTexas.org/docs/alaska.ppt

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