Health Policy Commons^™

The U.S. Department Of Agriculture As A Public Health Agency? A "Health In All Policies" Case Study, Lindsay F. Wiley

Journal of Food Law & Policy

The "war on obesity" is now well into its second decade. What began as an effort to encourage medical doctors to screen and treat patients whose weight put them at risk for health problems has transformed into a much broader public health campaign to address the root causes of obesity. A growing number of state, territorial and local health departments are currently exploring new ways to promote healthy eating and physical activity. At the federal level, the U.S. Centers for Disease Control and Prevention (CDC) has made "nutrition, physical activity and obesity" a top priority.

The Forgotten Half Of Food System Reform: Using Food And Agricultural Law To Foster Healthy Food Production, Emily Broad Leib

Journal of Food Law & Policy

America is facing widespread problems with its food system, including environmental harms due to externalities from industrial farms; the increasing amount of "food _miles" traveled by the products that make up our daily meals; and the growing size and complexity of recent outbreaks of foodborne illnesses. Indeed, the entire system that covers the life cycle of food, through production, processing, distribution, consumption, and food waste management, is in crisis. One of the most disturbing of these well-documented problems with the industrial food system is the increase in rates of obesity and diet-related illnesses. Obesity rates in the U.S. have more …

A Healthy Diet Of Preemption: The Power Of The Fda And The Battle Over Restricting High Fructose Corn Syrup From Food And Beverages Labeled 'Natural', Adam C. Schlosser

Journal of Food Law & Policy

America is unhealthy. America faces an obesity epidemic. The food consumed by Americans is making them fat. Americans, bombarded every single day by negative headlines like these, are becoming more and more health conscious. This newfound commitment to health is reflected in the food and beverages Americans purchase.

Combating The High Prevalence Of Obesity Among Egyptian Households: A Pilot Study: Port-Said Households/ مكافحة السمنة في المجتمع المصري: دراسة تجريبية في بورسعيد, Asmaa Sedky, Marwa Gaber, Noha Magdy, Shaimaa El Safoury

Papers, Posters, and Presentations

Obesity is a major public health issue in Egypt and its repercussions are not only limited to the health dimension but also extend to affecting the productive capacity of the citizens. This adversely affects the overall fundamentals of the Egyptian economy. Moreover, there is a current political interest in promoting the health and well-being of the citizens which is reflected in the recent 100 Million Seha massive campaign that measured the weight and height of millions of Egyptians.

By applying the decision-making rule which has to do adhere to the equity, administrative, and political criteria, we recommend adjusting the Egyptian …

Politics Of The Obesity Epidemic, Jacob Lyle

CMC Senior Theses

American society has long been obsessed with the issue of obesity. The turn of the 20th century broadly marked the beginning of America's current collective understanding of obesity. Throughout the century, the salience of the issue waxed and waned due to various factors. Around 2000, obesity became a major political issue. Media coverage of the issue exploded, and it became a hot topic for political debate. This paper looks to conduct a complete reckoning of the obesity epidemic that includes contextualizing the economic, cultural, and political factors that have shaped the issue throughout the 20th and 21st centuries.

Preventing Obesity: A Social Ecological Exploration Of Centers For Disease Control Prevention Strategies And Guidance Toward Healthy Eating, Physical Activity, And Communities, Ryan Kelly

Theses and Dissertations

Abstract

Obesity has reached nearly 40% of the adult public in the United States, costing the citizen taxpayer over $200 billion annually in healthcare costs. Those suffering from obesity deal with multiple physical and mental repercussions. Through a content analysis of four Centers for Disease Control (CDC) documents and guided by the conceptual framework of the social ecological model, this research explores the federal approach to preventing obesity. The analysis finds that CDC solutions to obesity involve connecting people to each other and healthier choices, an orientation toward local public administration, and an emphasis on environmental and infrastructure improvements. The …

Aligning Food Environments With Institutional Values: A Mixed Methods Study Of Oregon Health Care Organizations, Elizaveta Walker

Dissertations and Theses

A major driver of the obesity epidemic is obesogenic food environments, characterized by nutrient-poor and energy-dense foods that saturate the collective physical, economic and sociocultural conditions that influence nutritional status. Food environments in organizations such as hospitals and public health agencies warrant special consideration given their health-focused mission. Improving food environments within health care settings has been highlighted by the Centers for Disease Control and Prevention (CDC) as one of seven key strategies to prevent obesity. However, most of the refereed literature examining healthy food environment policies (HFEPs) within hospitals focuses on the inpatient dietary environment, leaving a paucity of …

Socioeconomic Correlates Of Overweight And Obesity Among Ever-Married Urban Women In Bangladesh, Tania Sultana Tanwi, Sayan Chakrabarty, Syed Hasanuzzaman, Sue Saltmarsh, Stephen Winn

Research outputs 2014 to 2021

Background

The escalating prevalence of overweight and obesity globally is reflected amongst urban women in many low-to-middle income countries. Evidence also shows that overweight and obesity is an increasing trend in Bangladesh. The present study assessed the prevalence and socioeconomic determinants of overweight and obesity among urban women in Bangladesh.

Methods

Data were extracted from Bangladesh Demographic and Health Survey (BDHS) 2014. A two-stage stratified sampling technique has been used for data collection in this cross-sectional survey. A sample of 1701 ever-married non-pregnant urban women aged 15–49 years was selected for statistical analysis. Descriptive analysis, multiple binomial logistic regression analysis …

Eating Frequency And The Role Of Snacking On Body Weight Of Wic Preschool Children, Andrea Charvet

FIU Electronic Theses and Dissertations

The objective of this study was to understand the influence of eating episodes and snack quality on body weight of children ages 3-4.9 years participating in the Broward County Special Supplementation Nutrition Program for Women, Infants, and Children (WIC).Additional objectives were to evaluate obesity risk factors and to examine the effect of childcare arrangements on body weight. Data was collected from 7 Broward County Health Department WIC clinics over 4 months via a researcher-administered questionnaire. Additional data was extracted from the WIC data system. BMI-for-age percentiles were used to categorize children by weight according to Centers for Disease Control (CDC) …

Identifying Windows Of Opportunity For Active Living And Healthy Eating Policies In Connecticut, 2016, Anna E. Greer, Ann-Uriel Knausenberger

Public Health Faculty Publications

We examined the relative importance of 23 community issues among elected officials and health directors in Connecticut in 2016. For this cross-sectional study, 74 elected officials (40.7% response rate) and 47 health directors (62.7% response rate), who were purposively sampled, completed a questionnaire to rate their perceived importance of 23 community issues. Eight of these issues were related to active living, healthy eating, or obesity. We used χ2 tests to evaluate differences in responses. Compared with elected officials, health directors significantly more often perceived obesity, access to healthy groceries, poor nutrition, lack of pedestrian walkways, and pedestrian safety as important. …

Engaging Parents To Promote Children’S Nutrition And Health: Providers’ Barriers And Strategies In Head Start And Child Care Centers, Dipti A. Dev, Courtney Byrd-Williams, Samantha Ramsay, Brent A. Mcbride, Deepa Srivastava, Ashleigh L. Murriel, Chrisa Arcan, Anna M. Adachi-Mejia

Department of Child, Youth, and Family Studies: Faculty Publications

Purpose: Using the Academy of Nutrition and Dietetics benchmarks as a framework, this study examined childcare providers’ (Head Start [HS], Child and Adult Care Food Program [CACFP] funded, and non-CACFP) perspectives regarding communicating with parents about nutrition to promote children’s health.

Design: Qualitative.

Setting: State-licensed center-based childcare programs.

Participants: Full-time childcare providers (n ¼ 18) caring for children 2 to 5 years old from varying childcare contexts (HS, CACFP funded, and non-CACFP), race, education, and years of experience.

Methods: In-person interviews using semi-structured interview protocol until saturation were achieved. Thematic analysis was conducted.

Results: Two overarching themes were barriers and …

“Mexico, Public Policy And Obesity In A Global Context”, Daniela Carina Bermudez

Master's Theses

Mexico has one of the most obese populations in the world. A country known for its diversity of rich flavorful food is drowning in low nutritional food products. This thesis examines Mexico’s obesity epidemic within the larger global context of international economic trade policies, public policies and Mexico’s health policies. The key research questions are 1) why is there an obesity epidemic in Mexico? and 2) what remedies should Mexico implement to control it? This thesis contributes to a viable policy strategy for the Mexican government to control and prevent the further increase of this obesity epidemic. Reviewing both the …

A Clinical Score To Predict Dose Reductions Of Antidiabetes Medications With Intentional Weight Loss: A Retrospective Cohort Study., Ghanshyam Palamaner Subash Shantha, Anita Ashok Kumar, Vimal Ravi, Rohit C Khanna, Scott Kahan, Lawrence J Cheskin

Health Policy and Management Faculty Publications

Abstract

Background

We assessed the predictive accuracy of an empirically-derived score (weight loss, insulin resistance, and glycemic control: “WIG”) to predict patients who will be successful in reducing diabetes mellitus (DM) medication use with weight loss.

Methods

Case records of 121 overweight and obese patients with DM at two outpatient weight management centers were analyzed.

Results

Mean period of follow-up was 12.5 ± 3.5 months. To derive the “WIG” scoring algorithm, one point each was assigned to “W” (loss of 5% of initial body weight within the first 3 months of attempting weight loss), “I” (triglyceride [TGL]/highdensity lipoprotein ratio >3 …

American Obesity: Rooted In Uncertainty, Institutions And Public Policy, James Woodward

Theses and Dissertations--Public Policy and Administration

Despite the efforts of policymakers, medical professionals, and other stakeholders, obesity and related health problems show no signs of receding from their record-high rates. Public policy has largely taken the form of consumer advice, (e.g., USDA’s Dietary Guidelines). Since consumers bear most of the costs associated with their obesity, the goal of obesity prevention appears to be incentive-compatible, prima facie. That is, there is no a priori case for much further policy intervention unless existing advice is deficient or consumers’ exhibit systematically poor decision-making.

My review of the literature shows that scholars have long conveyed a consistent narrative regarding …

Competitive Food Policy Implementation In Kentucky Schools, Paula Gisler

Theses and Dissertations--Nursing

This study was designed to explore the literature on competitive food policy implementation (CFPI); examines demographic and school factors associated with CFPI; and explores the experiences of school leaders and staff in CFPI using a proposed theoretical framework to guide the research. Competitive foods are those sold in vending machines, a la carte settings, fundraisers, class parties and other venues which compete with foods offered through the national school lunch and breakfast programs. Competitive foods have traditionally been of low nutritional value and high energy density. CFPI may be effective in reducing student calorie intake and BMI. However, evaluation of …

The Word Outside And The Pictures In Our Heads: Contingent Framing Effects Of Labels On Health Policy Preferences By Political Ideology, Sungjong Roh, Jeff Niederdeppe

Research Collection Lee Kong Chian School Of Business

This study uses data from systematic Web image search results and two randomized survey experiments to analyze how frames commonly used in public debates about health issues, oper- ationalized here as alternative word choices, influence public support for health policy reforms. In Study 1, analyses of Bing (N = 1,719), Google (N = 1,872), and Yahoo Images (N = 1,657) search results suggest that the images returned from the search query “sugar-sweetened beverage” are more likely to evoke health-related concepts than images returned from a search query about “soda.” In contrast, “soda” search queries were more likely to incorporate brand-related …

Acknowledging Individual Responsibility While Emphasizing Social Determinants In Narratives To Promote Obesity-Reducing Public Policy: A Randomized Experiment, Jeff Niederdeppe, Sungjong Roh, Michael A. Shapiro

Research Collection Lee Kong Chian School Of Business

This study tests whether policy narratives designed to increase support for obesity-reducing public policies should explicitly acknowledge individual responsibility while emphasizing social, physical, and economic (social) determinants of obesity. We use a web-based, randomized experiment with a nationally representative sample of American adults (n = 718) to test hypotheses derived from theory and research on narrative persuasion. Respondents exposed to narratives that acknowledged individual responsibility while emphasizing obesity’s social determinants were less likely to engage in counterargument and felt more empathy for the story’s main character than those exposed to a message that did not acknowledge individual responsibility. Counterarguing and …

The Historic Role Of Boards Of Health In Local Innovation: New York City’S Soda Portion Case, Lawrence O. Gostin, Belinda H. Reeve, Marice Ashe

Georgetown Law Faculty Publications and Other Works

Childhood and adult obesity pose major risks for cancer, diabetes, and cardiovascular disease, with the poor and racial minorities suffering from disproportionately high burdens of obesity and chronic disease. With current policies failing, cities and states have moved forward with creative prevention measures–-with boards of health driving policy innovation in many local jurisdictions. The New York City Board of Board of Health’s (NYCBH) soda portion limit pushed the boundaries of innovation, but was struck down on June 26, 2014 by New York State’s highest court, which held that the Board trespassed on the City Council’s authority.

The Court’s decision ignored …

Limiting What We Can Eat: A Bridge Too Far?, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Innovative mayors across America are seeking to shape personal decisions about diet and physical activity, taking a page from tobacco control. But attempts to limit personal choices of what to eat have drawn the ire of vocal critics and sometimes the rebuke of judges, with former New York City mayor Michael Bloomberg’s limit on soda portions becoming a key flash point. The public broadly accepts state power to control infectious diseases, but often draws a line at limiting dietary choices. The author wants to dispel some of the well-worn arguments in the obesity wars.

Safe Routes For Portland: A Comparative Analysis Of The Walking School Bus Model For Maine Schools., Rebecca Spitko

Muskie School Capstones and Dissertations

This purpose of this paper is to identify the effects an increase in active transportation to and from school would have on both commuters and communities, and to examine how to create a successful environment for active transportation models in Maine.

Public Health Emergencies: What Counts?, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Vaccines and drugs to prevent and treat Ebola Virus Disease that have never been tested in humans, and in scarce supply raise profound ethical challenges. What if good evidence emerged demonstrating safety and efficacy of drugs? What would be an ethical method of allocating scarce beneficial resources? The apparent preference given to foreign aid workers over West Africans provoked a firestorm. In addition to discussing the ethical allocation of scarce drugs, this article also asks a more fundamental question: Why did it take nearly 40 years after the first Ebola outbreak in 1976 to launch clinical trials?

Accounting For Product Substitution In The Analysis Of Food Taxes Targeting Obesity, Zhen Miao, John C. Beghin, Helen H. Jensen

Department of Agricultural Economics: Faculty Publications

We extend the existing literature on food taxes targeting obesity. We systematically incorporate the implicit substitution between added sugars and solid fats into a comprehensive food demand system and evaluate the effect of taxes on sugars and fats. The approach conditions how food and obesity taxes affect total calorie intake. The proposed methodology accounts for the ability of consumers to substitute leaner low-fat and low-sugar items for rich food items within the same food group. This substitution is integrated into a calibrated demand system in addition to the substitution among food groups, using recent food intake data and existing demand …

Fitness Tax Credits: Costs, Benefits, And Viability, Daniel M. Reach

Northwestern Journal of Law & Social Policy

As the number of overweight and obese Americans rises, it becomes increasingly clear that Americans need further incentives to stimulate lasting lifestyle changes. Tax incentives focused on exercise, which have been largely unexplored to this point, are an effective response to the growing obesity problem in the United States that would largely avoid the political opposition that tax policies focused on diet have encountered. In addition, they would also provide a more palatable solution for the taxpayer beneficiaries with a relatively low impact on government revenues. Viable tax incentives to encourage greater fitness include tax credits and sales tax breaks, …

Nutrition Policy, Nonmarket Failure, And The Obesity Epidemic, James Woodward

MPA/MPP/MPFM Capstone Projects

The Dietary Guidelines for Americans, which are based on the Dietary Goals for the United States, represent the federal government’s first attempt to improve the nation’s health by recommending that Americans avoid certain foods. The Guidelines were based on what was perceived, by the government and nutritionists alike, to be solid scientific evidence that consumption of fat and saturated fat in particular, increase the risk of developing heart disease. They also emphasized, and continue to emphasize, the importance of exercise and calorie restriction as the primary means of maintaining a healthy weight. In short, the Guidelines sought to …

Gender And Race Wage Gaps Attributable To Obesity, Avi Dor, Christine Ferguson, Ellen Tan, Lucas Divine, Jo Palmer

Health Policy and Management Faculty Publications

Currently, two out of three Americans are overweight or obese. In less than 20 years, roughly half of the population will be obese. Furthermore, obesity costs $168.4 billion a year, a number which is projected to increase by $48-66 billion per year. The societal costs of obesity are clear and staggering and the individual costs are equally chilling for most of those who are obese – particularly for Hispanic men and Caucasian and Hispanic women.

Parks And Obesity In Rural And Urban Nebraska, Michaela S. Wolf

Department of Environmental Studies: Undergraduate Student Theses

In order to better understand the role community design plays in obesity rates, this project studies a potential relationship between distance of parks from homes and obesity rates in four Nebraska counties. Park use may contribute to important health benefits, such as reducing risk of obesity by increasing physical activity levels. There are limitations to park use, such as crime rates and facility upkeep that are important to understand so that they might be managed and communities can reap greater benefits from their parks, including better fitness. This study examines park distance from homes as a potential limiting factor to …

A Heavy Burden: The Individual Costs Of Being Overweight And Obese In The United States, Avi Dor, Christine Ferguson, Casey Langwith, Ellen Tan

Health Policy and Management Faculty Publications

More than 60% of the United States population is overweight or obese, and if the current trajectory continues, 50% of the population will be obese by 2030. There is no question that being obese or overweight, is more costly than being of normal weight. Using existing literature, we have detailed the costs incurred due to overweight and obesity that affect working-age adults at the individual level.

Among the items discussed in this review, overweight or obese individuals bear the full burden for some costs, such as the value of lost life, lost wages, gasoline costs, and, when applicable, life insurance. …

The Diabetes Primary Prevention Initiative Interventions Focus Area: A Case Study And Recommendations, Deborah S. Porterfield, Laurie Hinnant, David M. Stevens, Ernest Moy, Dppi-Ifa Case Study Group

Health Policy and Management Faculty Publications

Background: In 2005, CDC began the Diabetes Primary Prevention Initiative Interventions Focus Area (DPPI-IFA), which funded fıve state Diabetes Prevention and Control Programs (DPCPs) to translate diabetes primary prevention trials into real-world settings by developing and implementing a framework for state-level diabetes primary prevention.

Purpose: The purpose of this case study, conducted in 2007, was to describe DPPI-IFA implementation, including facilitators and challenges to the initiative. Methods: Case studies of the fıve DPCPs in the DPPI-IFA involving site visits with key informant interviews of state staff and partners and archival record collection.

Results: Partners recruited for DPPI-IFA activities included …

The Relationship Between Obesity And Skin And Soft Tissue Infections, Juliana Swiney

MPA/MPP/MPFM Capstone Projects

The Problem:

It is well known that our country is experiencing an obesity epidemic: 33.9% of all adults are obese (BMI>30) and 67% of adults are either overweight or obese (BMI>25). Obesity is a risk factor for several serious disease states such as, diabetes, stroke, hypertension, heart disease and some types of cancer. It also has a less well defined relationship with skin and soft tissue infections.

Although it is known that excessive weight increases the opportunity for harmful skin conditions, this relationship has not been as well studied. Some of the mechanisms that predispose obese people to …

Strategies For Improving Access To Comprehensive Obesity Prevention And Treatment Services For Medicaid-Enrolled Children, Sara E. Wilensky, Ramona Whittington, Sara J. Rosenbaum

Health Policy and Management Issue Briefs

This policy brief builds on our prior work for the Robert Wood Johnson Foundation. In 2005, The George Washington University School of Public Health and Health Services (GW) evaluated the role of public and private insurance in financing preventive care and treatment for at-risk and obese children. One of the key findings from that report was that Medicaid's existing Early and Periodic Screening Diagnostic and Treatment (EPSDT) coverage standards provide for comprehensive, obesity-related pediatric health care interventions. Using data drawn from state Medicaid programs, this report examines the extent to which state programs use the Medicaid EPSDT benefit to address …