CCLDPHN Presentation June 2017 California chronic disease Prevention Leadership Project Wendel Brunner MD wendel.brunner@gmail.com

Obesity Trends* Among U.S. Adults BRFSS, 1985 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

Obesity Trends* Among U.S. Adults BRFSS, 1995 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. Adults BRFSS, 2005 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends* Among U.S. Adults BRFSS, 2008 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Source: National Center for Health Statistics, Health, United States, 2006. Notes: Data include the civilian non-institutionalized population and are from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Examination Survey and National Health and Nutrition Examination Survey. Estimates are age-adjusted to the 2000 standard population using five age groups: 20-34 years; 35-44 years; 45-54 years; 55-64 years; and 65-74 years. Obese is defined as a BMI greater than or equal to 30. Pregnant women 20 years of age and over were excluded in all years.

Without changing the social, economic and physical environment, behavior change is difficult to sustain and risk factors are hard to control. Improve healthy nutrition through individual and community nutrition education and social marketing that is reinforced by policy, systems, and environmental change that increase access to and consumption of healthy foods and decrease access to and consumption of unhealthy foods and beverages. Increase daily physical activity rates by expanding activity opportunities in community, workplace, school and other settings, Create healthy, safe physical/built environments that promote active transportation Reduce tobacco exposure through policy, systems, and environmental changes that protect against tobacco where people live, work, play and study.

Social Determinants of Health (SDOH) SDOH are the social, economic, policy, environmental, and infrastructure conditions that overwhelmingly impact community health These conditions must be explicitly addressed in order to attain health equity

Integrated Spectrum of Prevention Influencing policy and legislation Fostering coalitions and networks Changing organizational practices Educating providers Promoting community education Strengthening individual knowledge and skills Mobilizing neighborhoods and communities Assuring access to quality health care

CCDPLP Recommendations CDPH, CCLHO & CHEAC work together to address chronic disease & obesity prevention in coordinated, integrated way Recommendation 4 State & LHDs collaborate to identify priorities, goals, outcomes and indicators Recommendation 5 Designate future taxes/funds for chronic disease prevention Recommendation 6 Leverage existing funding streams to better coordinate a broad chronic disease agenda Continue to apply Spectrum of Prevention model add a Healthy Equity Framework (BARHII) Work in mutual partnership with CDPH Strengthen statutory requirements to do this work Integrate Framework into CDPH programs Develop outcomes/indicators that are achievable and measurable Designate future taxes/funds directly to chronic disease prevention

SSB Environment in San Pablo 215 SSB vendors 90% of population lives within walking distance of SSB retailer. Average of 9.55 SSB vendors w/in .25 mile of schools. SHOULD THIS SLIDE JUST BE THE MAP? There are 215 retail food outlets in the city of San Pablo, including mobile food prep vehicles (n=12), ice-cream pushcarts (n=14), retail food vehicles (n=8), restaurants (n=64), convenience stores (n=36), and grocery stores (n=28) with the rest being miscellaneous food retail outlets. Using population estimates from the 2010 Census, it was estimated that 90% of the population resides within walking distance (.25 mile) of a retailer or vendor (26,403 of a total population of 29,139). Additionally, 81 of 215 outlets are within 0.25 mile of a school. The average number of outlets within 0.25 mile of a school is 9.55 (minimum = 1, maximum = 30)

Richmond and San Pablo CA