Georgia Making Strides Against Childhood Obesity
Georgia has made great strides in addressing childhood obesity over the last 15 years. Many of these efforts are highlighted in the November/December supplemental issue of Public Health Reports. Georgia’s work to address physical activity, nutrition, and weight status, using a multidisciplinary approach, has implications for public health practitioners nationally. The Georgia Health Policy Center (GHPC) contributed to two articles published in this special issue.
In 2011, Governor Nathan Deal included reducing childhood obesity as one of his strategic goals for the state. The resulting multidisciplinary effort, known as Georgia Shape, serves as an umbrella initiative, allowing diverse stakeholders — including those in education, public health, and agriculture — to work together to achieve strategic childhood obesity-related goals using a collective impact framework that promotes population-level change.
“States and their local partners have the opportunity to make real changes in the policies, systems, and environments that influence what foods and opportunities for physical activity are regularly available to children,” says Debbie Kibbe, GHPC senior researcher associate and coauthor of an invited commentary in Public Health Reports. “We believe that multipronged and multilayered approaches, such as those of the Georgia Shape initiative, are needed to control childhood obesity. Examining these approaches will help us understand effective mechanisms by which healthier weight, better quality dietary intake, increased fitness, improved health status, and reduced disease risk can be obtained.”
Improving the quality and/or quantity of daily physical education (kindergarten through grade 12) and integrating moderate to vigorous physical activity into elementary classrooms are the two policies that would have the largest potential impact on reducing the prevalence of childhood obesity in Georgia, according to results of a systems simulation model published in the special issue. While these two strategies would yield the largest impact, GHPC researchers found that a variety of policy interventions will be necessary to significantly reduce the burden of childhood obesity.
The systems model, originally launched in 2008 and updated in 2014, simulates the impact of education, health care, and transportation policy interventions on the prevalence of childhood obesity in Georgia through 2034. The model is informed by data from peer-reviewed literature and quantitative estimates by experts in childhood obesity, physical activity, nutrition, health economics, and health policy. The model was built in partnership with a group of state legislators as part of the Legislative Health Policy Certificate Program, offered by GHPC at Georgia State University’s Andrew Young School of Policy Studies.With no policy change, the updated model projects that the prevalence of obesity among children and adolescents in Georgia would hold steady at 18% from 2014 through 2034. Most policy interventions, if enacted individually, could reduce the prevalence slightly to 16% to 17%. Mandating daily school physical education would cut childhood obesity to 12%, while and integrating moderate to vigorous physical activity into elementary classrooms would reduce childhood obesity to 10%. Enacting all nine policies simultaneously would lower the prevalence of childhood obesity from 18% to 3%.
“Systems thinking, especially with simulation models, facilitates an understanding of complex health policy problems,” says Karen Minyard, Ph.D., GHPC’s CEO and coauthor of the study. “Building and using models is a great way to synthesize the evidence for policymakers and make the impact of various policy options quickly visible. Model use also facilitates conversation about how and why different policies influence outcomes because policymakers are able to look at the system together. These conversations can include the benefits of strategies beyond the reduction of childhood obesity, such as improved classroom behavior and higher test scores after moderate to vigorous physical activity.”
The systems simulation model study coauthors include consultants Kenneth Powell, M.D., and Chris Soderquist; Debra Kibbe and Karen Minyard, Ph.D., from the Georgia Health Policy Center; Rachel Ferencik and Mary Ann Phillips, both formerly with GHPC; and Emily Anne Vall, Ph.D., from the Georgia Department of Public Health.