2000 and warned of a growing obesity epidemic in children and adults. These data, coupled with evidence that obesity is not merely a cosmetic issue but leads to an array of serious health problems and comorbidities (Williams et al., 2005) as well as increasing health care costs (DHHS, 2001; Finkelstein et al., 2003, 2004; Wang and Dietz, 2002), were sufficient to raise national concern about the urgency of the epidemic and to stimulate congressional action. In 2001, the U.S. Surgeon General issued the Surgeon General’s Call to Action to Prevent and Decrease Overweight and Obesity to stimulate the development of specific agendas and actions targeting this growing public health problem (DHHS, 2001).

In 2002, the Institute of Medicine (IOM) undertook a congressionally mandated study to develop a blueprint for a comprehensive action plan that is summarized in the report, Preventing Childhood Obesity: Health in the Balance (IOM, 2005a). The recommendations from that report focused on the actions needed by multiple stakeholders; the report called on government at all levels to take a leadership role and to bring resources to bear on this important health concern. The present IOM committee recommends increased efforts to address the government recommendations of the Health in the Balance report (Boxes 4-2 to 4-4) and to incorporate an evaluation component into all policies, programs, and initiatives.

To explore the breadth of childhood obesity prevention activities currently under way in the government sector—and whether and how they are being evaluated—the committee reviewed and drew information from a variety of sources, including those described in Chapter 1, as well as information and data from federal and state government surveillance and reporting systems, reports, and websites and from interviews conducted with selected state health officials; federal regulatory agencies; and federal representatives of the health, agriculture, and education sectors. A complete and systematic inventory of federal, state, and local government policies, programs, and activities relevant to childhood obesity prevention was beyond the charge of the committee and the scope of this progress report. However, a selected list of recent federal agency programs, initiatives, and surveillance systems relevant to childhood obesity prevention is compiled in Appendix D.

FEDERAL GOVERNMENT

The federal government has a responsibility to address public health crises including the childhood obesity epidemic through ensuring sufficient capacity to provide essential public health services; responding when a health threat is apparent across the entire country, region, or many states; providing assistance when the responses are beyond the jurisdictions of individual states; helping to formulate the public health goals of state and



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