1. BOARD OF SUPERVISORS Gloria Molina First District Yvonne Brathwaite Burke Second District Zev Yaroslavsky Third District Don Knabe Fourth District Michael D. Antonovich Fifth District Los Angeles County Blue Ribbon Task Force “Children and Youth Physical Fitness” Paving the Way for Physically Fit and Healthy Children

2. History and Purpose of Task Force January 29, 2002 - The Board of Supervisors established the LA County Task Force The Task Force charge – Hold hearings – Research the status of physical fitness – Report recommendations to the Board to improve children’s fitness.

3. Obesity* Trends Among U.S. Adults BRFSS, 1991, 1995 and 2000 (*BMI  30, or ~ 30 lbs overweight for 5’4” person) 19911995 2000 Source: Mokdad A H, et al. JAMA 1999;282:16, 2001;286:10. No Data <10% 10%-14% 15-19%  20%

4. L.A. County Youth 9-12 th Graders 12.4% overweight – 10.5% U.S. 16.5% at risk for becoming overweight – 13.6% U.S. Source:Centers for Disease Control and Prevention., Youth Risk Behavior Surveillance System: 2001 Results.

5. Prevalence of Overweight* Among Children (2-17 years old) Receiving a CHDP Exam, Los Angeles County, March 2000 (n = 35,978) *  95 th percentile for age- and sex- specific BMI

6. Prevalence of Overweight* California Physical Fitness Testing, 2001 *Public school children, grades 5, 7, and 9, using standardized body mass index-for-age growth charts by CDC

7. Risk Behaviors Related to Diet and Physical Activity Los Angeles 2001 United States 2001 Percentage of students who described themselves as slightly or very overweight. 31.4%29.2% Percentage of students who were trying to lose weight49.7%46.0% Percentage of students who ate five or more servings of fruits and vegetables per day during the past seven days. 21.6%21.4% Percentage of students who attended physical education class daily. 25.1%32.2% Percentage of students who watched three or more hours of TV per day on an average school day. 44.6%38.3%

8. Comorbidities of Obesity Asthma Cancer Hypertension – ten times the rate in obese Hyperinsulinism – Syndrome X Type 2 Diabetes Dyslipidemias Orthopedic Abnormalities Sleep Apnea – 1/3 have it and it impairs learning Gall Bladder Problems – 1/3 from obesity Hyperandrogenism Eating Disorders, Depression, Psychological Disorders

9. The Cost 300,000 deaths/year (second to tobacco) $117 billion/year  $61 billion in direct costs, including healthcare  $56 billion in indirect costs, including lost of productivity and earning lost

10. Task Force Response Four workgroups were established – Individuals and families – Communities – Schools – Health care Community Forum was held to obtain public input Extensive Literature review

11. Contributing Factors Individuals and Families Communities Schools Healthcare Food Industry

12. Task Force Recommendations Overarching Strategies – Policy – Programs and Initiatives – Research and Evaluation – Public Awareness Campaigns

13. Formation of Recommendations 4 settings/ under overarching themes: – Community (includes individuals and families) - 31 action steps – Schools – 10 action steps – Healthcare – 8 action steps – Worksite – 4 action steps 53 total recommendations/ specific action steps to be taken within the 4 settings

14. 6 Key Recommendations  Secure funding for programs, research, public awareness and policies  Promote joint use facilities with schools, parks, libraries, health clinics, community organizations

15. 6 Key Recommendations  Support passage of legislation to increase Physical Education, Physical Education training, decrease class size, increase equipment  Schools adopt SB 19 nutritional standards for items outside federal meal program with 50% fruit juice sold

16. 6 Key Recommendations  Implement a model comprehensive worksite wellness program  Appoint accountable County department personnel to work in collaboration with community-based committees and agencies to develop an implementation plan of the recommendations and to monitor the plan’s progress.

17. Lessons Learned A comprehensive approach is required to combat physical inactivity and unhealthy eating Recommendations must be meaningful and achievable on a multitude of levels Recommendations need to include a means for accountability

18. Barriers to Implementation Finding funding for program development Convincing individuals who are not interested in physical activity or healthy eating that the consequences necessitate change requiring their interest

19. For Your Copy of the Report For persons interested in a copy of the full report detailing the Task Forces’ findings and recommendations, download the report from: www.lapublichealth.org/mch Paving the Way for Physically Fit and Healthy Children: Findings and Recommendations

20. To Contact the Presenters: Cynthia Harding: charding @dhs.co.la.ca.us Valerie Ruelas: vruelas@dhs.co.la.ca.us Tel: (213) 639-6400 Fax: (213) 639-1033 Maternal, Child and Adolescent Health Programs Los Angeles County - Department of Health Services 600 S. Commonwealth Avenue, Suite 800 Los Angeles, CA 90005