President Obama“So the only way that we can initiate true health care reform is if we control costs.  And one of thePresident Obama most important ways for us to control costs is to deal with the issue of prevention.  Which means making sure that we have proper nutrition programs in our schools; making sure that we've got effective physical education programs for our children. (Applause.)” - President Barack Obama, town hall meeting in Los Angeles March 19, 2009.

.

More Proof What We Do COUNTS!

This nation is facing a serious childhood obesity epidemic. Today 16.3 percent of children and adolescents ages 2 to 19 are obese, and 31.9 percent are obese or overweight.1 Th is translates into 12 million children and adolescents who are obese and more than 23 million who are either obese or overweight.2 During the past four decades, the obesity rate for children ages 6 to 11 has more than quadrupled (from 4.2 to 17 percent) and more than tripled for adolescents ages 12 to 19 (from 4.6 to 17.6 percent).3 Obese and overweight children are likely to suff er health consequences not only during childhood and adolescence, but also throughout their adult lives. Th ey are at greater risk as children and as adults for bone and joint problems, sleep apnea, social and psychological problems (e.g., stigmatization and poor self-esteem), heart disease, type 2 diabetes, stroke, cancer, and osteoarthritis.4

...more Preventing Childhood Obesity: A School Policy Guide (National School Boards' Association)

The Problem

“For the first time in more than 100 years, our children’s life expectancy is declining due to the increase in overweight.”
~New England Journal of Medicine

Do you know that 30 minutes of active physical activity during the school day can help control weight, build healthy bones, muscles and joints, reduce symptoms of anxiety and depression, enhance feelings of well-being and may even improve academic performance?

Yet only one in four U.S. children gets the recommended daily amount of physical activity: 30 minutes of moderate-intensity physical activity such as brisk  walking, or 20 minutes of vigorous activity. Daily participation in high school physical education classes dropped from 42 percent in 1991 to 28 percent in 2003.

Obesity in North Carolina

  • Nearly 2 in every 3 adults in NC is overweight or obese.1  More than 1 in every 3 children in NC is overweight or obese.2
  • Overweight adolescents have a 70% chance of becoming overweight and obese adults. This increases to 80% if at least one parent is overweight or obese. 3

Physical Activity and Nutrition – Our Unhealthy Habits

Sedentary lifestyles and poor eating habits are widely recognized contributors to the overweight epidemic in North Carolina.  Physical inactivity and unhealthy eating combined are the second leading preventable cause of death in North Carolina, and both increase the risk of heart disease, certain types of cancer, diabetes, high blood pressure, stroke, and obesity.4
  • More than 24% of North Carolina adults reported no physical activity within the previous month and nearly 24% of adults had not engaged in leisure-time physical activity within the previous week.5
  • 56% of NC adults do not get the recommended amount of physical activity, compared with 51.2% nationally.6   Nearly half of North Carolina students do not get the recommended amount of physical activity. 7
  • Nearly 80% of North Carolina adults and 85% of North Carolina high school students eat less than 5 servings of fruits and vegetables each day, the minimum recommended for good health. 8 9 
  • One-third of North Carolina children typically consume one serving or less of vegetables per day,10   and one in every three North Carolina children eats fast food two or more times per week.11  
  • 49.9% of North Carolina children watch more than two hours of television on a typical day. 12

Obesity, Physical Activity, and Academic Achievement

  • Overweight children were absent significantly more than normal-weight children.13 Studies have demonstrated a negative association between number of absences and academic performance.14 15
  • Studies suggest that overweight or obese children (grades K through Grade 12) have poorer academic outcomes.16

Physical Education and Academic Achievement

  • Students with higher grades are less likely to engage in physical inactivity than their classmates with lower grades. 17
  • “Despite devoting twice as many minutes per week to physical education, the health-related physical education program did not interfere with academic achievement.” 18
  • Providing quality physical education has been noted to decrease disruptive behavior in schools and improve students’ grades, concentration, test scores, and self-esteem.19 20 21 22

Obesity and Other Chronic Diseases

  • Overweight and obesity are significantly associated with diabetes, high blood pressure, high cholesterol, asthma, arthritis, and poor health status.  Heart disease, cancer, stroke, and chronic lung disease account for 58% of all deaths in North Carolina.23
  • Overweight individuals are nearly 40% more likely to develop heart disease and 50% more likely to develop diabetes than healthy weight individuals.  The risk is even greater for obese individuals.
  • Diabetes has more than doubled in North Carolina over the past decade.  Nearly 1 in 10 North Carolina adults have been diagnosed with diabetes, which is higher than the general US population. 24 
  • More than 1.2 million people in North Carolina have pre-diabetes or diabetes, and many are unaware of their condition.  87% of adults with diabetes in North Carolina are overweight or obese.  

Obesity and Chronic Diseases in Children and Youth – Kids with adult diseases!

  • An estimated 15-45% of all new diabetes case in North Carolina children are Type II – a disease previously found only in adults.25   North Carolina public schools reported that 4,437 students had diabetes in 2005-2006; 3,419 monitored blood glucose at school; 1,918 received insulin injections at school; and 1,414 had insulin pumps.26
  • In addition, nearly half of North Carolina students do not get the recommended amount of physical activity,27 which means they are 600 times more likely to develop heart disease as adults.28

Cost to North Carolina Employers

Overweight and obese workers cost their employers more.

  • Increasing BMI is associated with greater costs to employee health plans; obese workers have up to 21% higher health care costs compared with those of healthy weight.29 30 31 
  • An overweight or obese adult will accrue $250,000 in lost productivity over the course of his or her career.32   A Duke University study found that the number of lost workdays for obese adults was almost 13 times higher, compared with those of healthy weight.33

Obesity-related Medical Costs

Individuals who are obese have annual medical costs 37.4% higher than their healthy weight counterparts, representing an additional $732 per obese person, per year. 34 

     North Carolina Costs

    Costs in 2006 35

    Projected Costs for 2011

    Projected Costs for 2015

    Adults 18 +:
    Direct Medical & Indirect Costs

    $57.37 billion

    $75.64 billion

    $94.31 billion

    Youth Age 10-17:
    Direct Medical Costs
    related to overweight and obesity*

    $105.13 million

    $164.59 million

    $204.96 million

.

.

.

.

* North Carolina costs are calculated according to the prevalence of the following risk factors: poor nutrition, physical inactivity, overweight and obese, hypertension, high cholesterol, tobacco use, depression and type II diabetes.

Medicaid Expenditures – We all pay the price for obesity!

  • Nationally, nearly one half of overweight- and obesity-attributable medical spending becomes the responsibility of the public sector (Medicaid and Medicare).36
  • In 2003, an estimated 11.5% ($662 million) of North Carolina Medicaid expenditures for adults were attributed to obesity. 37  The direct and indirect Medicaid costs related to obesity in North Carolina youth is estimated at nearly $16 million per year (based on 2003 dollars). 38  


References

    1 Geier, A.B., Foster, G.D., Womble, L.G., et al. (2007). The Relationship Between Relative Weight and School Attendance Among Elementary Schoolchildren. Obesity. 15, 2157–2161.  Accessed on March 13, 2009 at  http://www.nature.com/oby/journal/v15/n8/full/oby2007256a.html#bib13

    2 North Carolina Behavioral Risk Factor Surveillance System Survey, NC State Center for Health Statistics, NC Department of Health and Human Services, (2007).

    3 35.5% of children and youth age 6-17 are overweight (18.6%) or obese (16.9%). Data Source: North Carolina State Center for Health Statistics. Child Health Assessment and Monitoring Program (CHAMP), 2007. Available at: www.schs.state.nc.us/SCHS/champ/index.html

    4   Telama, R., Yang, X., Laakso, L., and Vilkari, J. (1997). Physical activity in childhood and adolescence as predictor of physical activity in young adulthood.  American Journal of Preventive Medicine, 13, 317-323.

    5 Monk, D., Ibrahim, M. (1984) Patterns of absence and pupil achievement. Am Educ Res J. 21: 295–310.

    6 Dunn, M. C., Kadane, J. B., Garrow, J. R. (2003) Comparing harm done by mobility and class absence: missing students and missing data. J Educ Behav Statist. 28: 269–288.

    7 Taras, H., Potts-Datema, W. (2005) Obesity and student performance at school. J School Health. 75: 291–295.

    8 Data from the 2003 National Youth Risk Behavior Survey (YRBS), http://www.cdc.gov/HealthyYouth/health_and_academics/pdf/health_risk_behaviors.pdf

    9 Sallis, J.F., McKenzie, T.L., Kolody, B., Lewis, M., Marshall, S., and Rosengard, P. (1999). Effects of health-related physical education on academic achievement: Project SPARK. Research Quarterly for Exercise and Sport, 70, 127-136. Abstracted in "The Research File" newsletter of the Canadian Fitness and Lifestyle Research Institute. December 1999.

    10 Shepard RJ, et al. Required physical activity and academic grades. A controlled study. In J Ilmarinen and I
    Vaelimaeki, eds. Children and Sport. Pediatric work Physiology. Berlin, Germany. Springer-Verlag. 1984, 58-
    63.

    11Centers for Disease Control and Prevention. Guidelines for School and Community Programs: Promoting
    Lifelong Physical Activity. March 1977.

    12Dwyer, T, et al. Relation of academic performance to physical activity and fitness in children. Pediatric
    Exercise Science, 2001,13:225-237,1979,3:196-202.

    13 Sallis JF, et al. Effects of health-related physical education on academic achievement. Project
    SPARK, Research Quarterly for Exercise and Sport, 1999, 70(2), 127-134.

    14Centers for Disease Control and Prevention. Guidelines for School and Community Programs: Promoting Lifelong Physical Activity. March 1977.2007).

    15 NC 9.1% versus 8.1% nationally. Data Source: North Carolina Behavioral Risk Factor Surveillance System Survey, NC State Center for Health Statistics, NC Department of Health and Human Services, (2007).

    16 Tipping the Scales: How obesity and unhealthy lifestyles have become a weighty problem for the North Carolina economy.  Be Active North Carolina, Inc. June 2008.  (Chenoweth & Associates)

    17 NC Annual School Health Nursing Survey: Summary Report of School Nursing Services 2005-06 NC Division of Public Health, Department of Health and Human Services. Public Schools of North Carolina, Department of Public Instruction.  http://wch.dhhs.state.nc.us/2005_2006_EOY%20Report%2010-18-06.pdf  Accessed February 25, 2009.

    18 Reflects high school (56%) and middle school students (45%) who were not physically active for a total of at least 60 minutes per day on five or more of the past seven days. Data Source: North Carolina Youth Risk Behavior Surveillance System, North Carolina Department of Public Instruction and North Carolina Department of Health and Human Services. (2007)

    19 Tipping the Scales: How obesity and unhealthy lifestyles have become a weighty problem for the North Carolina economy.  Be Active North Carolina, Inc. p. 12. June 2008. / 2005 NC YRSS   (Chenoweth & Associates)

    20 Burton WN, Chen CY, Schultz AB, Edington DW. The economic costs associated with body mass index in a workplace. J Occup Environ Med. 1998;40:786-792.

    22 Wang F, Schultz AB, Musich S, McDonald T, Hirschland D, Edington DW. The relationship between National Heart, Lung, and Blood Institute Weight Guidelines and concurrent medical costs in a manufacturing population. Am J Health Promot. 2003;17:183-189.

    22 Anderson DR, Whitmer RW, Goetzel RZ, et al; Health Enhancement Research Organization (HERO) Research Committee. The relationship between modifiable health risks and group-level health care expenditures. Am J Health Promot. 2000;15:45-52.

    23 Tipping the Scales: How obesity and unhealthy lifestyles have become a weighty problem for the North Carolina economy.  Be Active North Carolina, Inc. p. 12. June 2008. (Chenoweth & Associates)

    24 Ostbye, T. et al. Obesity and Workers’ Compensation: Results from the Duke Health and Safety Surveillance System, Arch Intern Med. 2007; 167:766-773.

    25 Finkelstein EA., Fiebelkorn IC, Wang G. National medical spending attributable to overweight and obesity: how much, and who's paying? Health.Aff.  2003, Suppl Web Exclusives, W3-219-26.

    26 Be Active North Carolina, Inc. Tipping the Scales: How obesity and unhealthy lifestyles have become a weight problem for the North Carolina economy. June 2008.Available at www.beactivenc.org . Accessed on March 5, 2009.

    27 Finkelstein EA., Fiebelkorn IC, Wang G. National medical spending attributable to overweight and obesity: how much, and who's paying? Health.Aff.  2003, Suppl Web Exclusives, W3-219-26.

    28 Finkelstein EA., Fiebelkorn IC, Wang G. State-level estimates of annual medical expenditures attributable to obesity. Obes Res. 2004; 12: 18-24.

    29 Be Active North Carolina, Inc. The economic cost of unhealthy lifestyles in North Carolina. December 2005.Available at www.beactivenc.org. Accessed on November 12, 2007.

    30 North Carolina State Center for Health Statistics, 2002; NC Medical Journal, July/August 2002, Vol.63, #4, Makdad, 2004 & NC Mortality 2006.

    31 North Carolina Behavioral Risk Factor Surveillance System (BRFSS), State Center for Health Statistics. Available at: http://www.schs.state.nc.us/SCHS/brfss/results.html.
    Accessed on 4/3/2007

    32 North Carolina Behavioral Risk Factor Surveillance System Survey, NC State Center for Health Statistics, NC Department of Health and Human Services, (2007).

    33 Reflects high school (56%) and middle school students (45%) who were not physically active for a total of at least 60 minutes per day on five or more of the past seven days. Data Source: North Carolina Youth Risk Behavior Surveillance System, North Carolina Department of Public Instruction and North Carolina Department of Health and Human Services. (2007)

    34 21.6% of North Carolina adults consume five or more servings of fruits and vegetables per day. Data Source: North Carolina Behavioral Risk Factor Surveillance System (BRFSS), State Center for Health Statistics. (2007). Available at: http://www.schs.state.nc.us/SCHS/brfss/results.html.
    Accessed on 4/3/2007

    35 State Center for Health Statistics.  Department of Health and Human Resources, Division of Public Health. Services. Available at:  http://www.nchealthyschools.org/data/YRBSS/  Accessed on 6/27/2007

    36 North Carolina Child Health Assessment and Monitoring Program (CHAMP), State Center for Health Statistics. Available at: http://www.schs.state.nc.us/SCHS/champ/results.html. Accessed on 11/13/2007      

    37 North Carolina Department of Health and Human Services, Division of Public Health, State Center for Health Statistics. Health Profile of North Carolinians: 2007 Update-May 2007. Available at: http://www.schs.state.nc.us/SCHS/pdf/HealthProfile2007.pdf

    38 North Carolina Child Health Assessment and Monitoring Program (CHAMP), State Center for Health Statistics. (2007). Available at: http://www.schs.state.nc.us/SCHS/champ/results.html. Accessed on 11/13/2007      

Proposed North Carolina P.E. Laws

Why Do We Need a P.E. Bill?

Quality physical education programs, particularly for the   elementary school student, can enhance all aspects of development.  Areas of   specific contribution include:
1.  ACADEMIC PERFORMANCE:  Regular physical activity makes   children more alert and energetic, which improves their capacity to learn.  A   healthy  mind needs a healthy body to perform at its best!
2.  HEALTH:  A primary benefit of regular physical activity is   protection against heart disease.  Physical inactivity appears to contribute to   coronary risk factors like obesity, high blood pressure, and elevated blood   cholesterol.  In addition, physical activity appears to provide some protection   against several other chronic diseases like certain cancers, osteoporosis, and   depression.
3.  WEIGHT CONTROL:  Active participation in P.E. increases energy   expenditure and helps control body fat levels.
4.  PHYSICAL FITNESS:  By introducing children to developmentally   appropriate programs in P.E., students learn the principles and skills necessary   for implementing and maintaining a physical activity regime later in life.
5.  MOVEMENT KNOWLEDGE/MOTOR SKILL DEVELOPMENT:  Motor skill   development is one of the most efficient and sustainable ways to develop   physical fitness.
6.  SELF-ESTEEM:  Directed play and P.E. programs contribute to   the development of self-esteem in elementary students.
7.  STRESS MANAGEMENT:  Like adults, children experience stress in   their daily lives.  Physical activity is a positive method for coping with   stress.
8.  SOCIAL DEVELOPMENT:  Research has found that participation in   games, sports, and play seems to be related to children learning to fit into   their society by learning social expectations. Through participation and   appropriate instruction in physical activities, moral ideas and attitudes   concerning fair play are shaped.

What Are We Doing Now in NC?

With the generous support of the Health and Wellness Trust Fund, the Blue Cross Blue Shield of North Carolina Foundation, and the Kate B. Reynolds Charitable Trust, In-school Prevention of Obesity and Disease (IsPOD) is being implemented in each of the 1800 K-8 schools in the state.

What Are NC Standards for P.E.?

Yes, North Carolina's Standard Course of Study includes standards for K-12 Health and Physical Education (Healthful Living). (NC Standard Course of Study) In 2006-07, NCAAHPERD began a curriculum training program for K-8 schools in North Carolina as part of their In-school Prevention of Obesity and Disease (IsPOD) program. This research based proven curriculum is called SPARK (Sports, Play and Active Recreation for Kids). The SPARK curriculum aligns with the North Carolina Standard Course of Study. (SPARK & NC Standards). Both SPARK and NC Standards align with the national standards established by the National Association of Sports and Physical Education (NASPE). These standards are:
NASPE's standards of a physically educated person.

  • Demonstrates competency in many movement forms and proficiency in a few movement forms.
  • Applies movement concepts and principles to the learning and development of motor skills.
  • Exhibits a physically active lifestyle.
  • Achieves and maintains a health-enhancing level of physical fitness.
  • Demonstrates responsible personal and social behavior in physical activity settings.
  • Demonstrates understanding and respect for differences among people in physical activity settings.
  • Understands that physical activity provides opportunities for enjoyment, challenge, self-expression, and social interaction.