1. Disparities Report Card Update Disparities Council June 28, 2010

2. Status of Data Obesity –Prevalence by race and ethnicity –Distribution of persons with obesity by race and ethnicity within income brackets within educational levels –Personal behaviors Consumption of fruits and vegetables Physical activity Smoking

3. Status of Data Obesity –Health consequences Health status, diabetes, heart disease, stroke, HBP, elevated cholesterol, asthma, disability status Heart Disease and Stroke –Prevalence by race and ethnicity –Mortality rate –Risk factors by race and ethnicity Elevated cholesterol, HBP, diabetes, smoking, physical activity, obesity, consumption of fruits and vegetables

4. Status of Data Heart Disease and Stroke –Health care utilization Hospitalizations –Quality of care BP checked, cholesterol checked Asthma Infant Mortality Diabetes

5. Framework for Addressing Health Disparities Societal/Policy Factors Access to Health Care Personal Health Behaviors Extent and Quality of Health Care and Outcomes Individual Factors Community Factors Institutional Transformation Version 3+: 6/18/09

6. Social Determinants Need consensus on factors to attribute to each condition –Safety –Violence –Housing status –Density of fast food restaurants, package stores, and outdoor advertising of high calorie, low nutrient food –Measures of segregation; discrimination

7. Policies to Mitigate, Correct Disparities Obesity –Local government Zoning policies, school siting policies, safe routes to school, incentives for supermarkets in low- income communities, –State Regional transportation policy, incentives for local planning to address obesity Workplace incentives School food policies Menu labeling

8. Sample Policies to Reduce Obesity Zoning laws require all new residential and commercial developments include sidewalks and other safe paths to encourage physical activity Require warning labels on foods with high sugar or fat content Require grocers add surcharge to high sugar, high fat foods and use the revenues to reduce prices for fresh fruits and vegetables Remove candy and sugared drinks from sales tax exemption Use land-use planning to limit or eliminate specific uses of real estate such as fast food restaurants Tax incentives to promote introduction of grocery stores in communities; to prevent fast food restaurants in communities

9. Recommendation Workgroup develop recommendations to present to Council in fall Deliverables –Identify social determinant measures –Assign to condition –Identify policies to support elimination of disparities Assign to condition Develop a grading system to describe where state and local governments are