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Childhood Obesity Prevention in Texas: Workshop Summary (2009)

Chapter: 5 Texas State Government: What the Future Holds

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Suggested Citation:"5 Texas State Government: What the Future Holds." Institute of Medicine. 2009. Childhood Obesity Prevention in Texas: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12746.
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5
Texas State Government: What the Future Holds

Recognizing that ongoing efforts are essential for controlling the growing obesity epidemic, Texas state agency officials support the reduction and prevention of childhood obesity through a collaborative effort among the Texas Department of State Health Services, the Texas Education Agency, and the Texas Department of Agriculture to develop strategies that contribute to and enhance student education, nutrition, and health. These agencies seek to work with a broad array of partners, including legislative leadership, other state agencies, and stakeholders, to accomplish their goals.

According to Todd Staples, Commissioner, Texas Department of Agriculture, the consequences of the obesity problem among both children and adults in Texas are three-fold:

  • Exorbitant costs imposed on Texas taxpayers and businesses

  • Decreased economic competitiveness of the state due to an increasing burden of health care costs on the state’s employers

  • An increased burden on the health care system

Staples stated that Texas ranks sixth among all states in rates of childhood obesity. This point is underscored by recent data gleaned from Fitnessgram (described in Chapter 3) revealing that only 8 percent of 12th-grade girls and 9 percent of 12th-grade boys in Texas fall within the healthy zone for all six Fitnessgram tests used in Texas (Table 5-1). Conversely, this means that 91 to 92 percent of these youths fail to meet Fitnessgram health standards.

Despite these unsettling data, Staples remarked that Texas is doing one thing right: “We have a strong Texas Public School Nutrition Policy.

Suggested Citation:"5 Texas State Government: What the Future Holds." Institute of Medicine. 2009. Childhood Obesity Prevention in Texas: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12746.
×

TABLE 5-1 Overall Fitness of Texas Schoolchildren According to Fitnessgram, as presented by Staples

Grade

Students Assessed (n)

% Achieving Healthy Fitness Zone on All Six Fitnessgram Tests

Girls

Boys

3

102,342

33.25

28.6

7

55,441

21.32

17.26

9

39,456

13.9

15.04

12

13,040

8.18

8.96

It exceeds the standards required by the U.S. Department of Agriculture. We offer fruits and vegetables on all points of service, we restrict fat and sugar content, and we offer dairy and whole grains” (see also Chapter 4). These higher standards have increased participation in the National School Lunch Program, which is driving additional dollars to more Texas schools to enable them to offer healthy meals.

To further advance the progress made in schools, Staples is spearheading an initiative in partnership with the Texas Education Agency and the Department of State Health Services that focuses on the three E’s of healthy living: education, exercise, and eating right. To bolster the eating right component of this initiative, the Texas Department of Agriculture is seeking a $50 million investment from the state legislature to fund healthy food programs in schools, nutrition education curricula, after-school and summer camps, and mentoring programs. The Texas Department of Agriculture is also working with farmers and ranchers at the local level to supply school cafeterias with fresh fruits and vegetables. In addition, Staples has created an advisory committee, Healthy Students = Healthy Families, that brings together educators, food service managers, purchasing agents, and health professionals to serve as a conduit for school districts to communicate on policy.

Commissioner Lakey, speaking on behalf of the Department of State Health Services, emphasized that Texas is at the leading edge of efforts to address the obesity epidemic in the nation. He began by presenting some sobering statistics: the proportion of obese Texans increased from 13 percent in 1990 to 29 percent in 2007 (Figure 5-1), while the proportion of individuals of normal weight decreased from roughly 58 percent in 1990 to only 34 percent in 2007.

The approach adopted by the Department of State Health Services to combat obesity is to (1) serve as a catalyst and a resource for other organizations that can harness the support offered to them to implement policies throughout the state, (2) focus on community wellness, and (3) coordinate

Suggested Citation:"5 Texas State Government: What the Future Holds." Institute of Medicine. 2009. Childhood Obesity Prevention in Texas: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12746.
×
FIGURE 5-1 Obesity prevalence trends in Texas adults, 1990–2007

FIGURE 5-1 Obesity prevalence trends in Texas adults, 1990–2007

SOURCE: Information from Texas Comptroller: www.window.state.tx.us/specialrpt/obesitycost/summary/.

activities with other state agencies. The many partners that the Department of State Health Services seeks to engage in realizing community-based solutions to the childhood obesity epidemic are shown in Figure 5-2.

The agency has organized its approach to obesity prevention throughout the state by devising and refining a Strategic Plan for the Prevention of Obesity in Texas that has gone through two iterations since its creation in 2003. The purpose of this plan is to make healthy foods and active lifestyles the easy choice for all Texans. To this end, the plan outlines 19 target objectives that are specific, measurable, attainable, and time based. More than half of these key targets relate to childhood obesity. They include increasing physical activity, increasing the consumption of fruits and vegetables, expanding worksite support for breastfeeding, decreasing television viewing time, instituting a freeze on exclusive vending contracts in school districts, ensuring wellness policies for all Texas school districts, and preventing an increase in childhood obesity rates (Table 5-2).

An Interagency Council on Obesity, created by Senate Bill 556, brings together the Department of State Health Services, the Texas Education Agency, and the Department of Agriculture to enhance communication and coordination of obesity issues among state leaders and guide planning around obesity prevention, health promotion, and improved nutrition. Over the past year since the Interagency Council was formed, it has for-

Suggested Citation:"5 Texas State Government: What the Future Holds." Institute of Medicine. 2009. Childhood Obesity Prevention in Texas: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12746.
×
FIGURE 5-2 Partnerships needed to implement childhood obesity prevention, as presented by Lakey.

FIGURE 5-2 Partnerships needed to implement childhood obesity prevention, as presented by Lakey.

NOTE: DSHS = Department of State Health Services.

mulated a number of recommendations for moving forward to achieve a healthy Texas:

  • Continue collaboration among the three agencies.

  • Support social interventions.

  • Strengthen K–12 nutrition education

  • Strengthen nutrition education and physical activities in early childhood and after-school programs.

  • Place continued emphasis on worksite wellness.

  • Offer tax incentives for Texas employers.

  • Examine ways to increase the availability of fresh produce for disadvantaged and/or low-income populations.

  • Develop mechanisms or strategies to use the results of Fitnessgram data.

  • Involve parents and community members in school-based and/or youth-focused physical activity and nutrition programming, especially through local School Health Advisory Councils.

  • Increase the availability of resources, technical assistance, training, and support for schools and community-based organizations to

Suggested Citation:"5 Texas State Government: What the Future Holds." Institute of Medicine. 2009. Childhood Obesity Prevention in Texas: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12746.
×

enhance the implementation of evidence-based programs to prevent obesity.

  • Identify effective programming throughout the state as a means for referrals and modeling, and establish criteria and measurement systems to identify such programs.

TABLE 5-2 Key Child-Specific Targets from the Strategic Plan for the Prevention of Obesity in Texas, as presented by Lakey

Target

Description

2

Between 2007 and 2012, the prevalence of BMI ≥ 85th percentile among schoolchildren in Texas will not increase from 42% among 4th graders, 39% among 8th graders, 36% among 11th graders, and 31.5% among high school students

4

By 2012, 80% of mothers will initiate breastfeeding, 30% will exclusively breastfeed at 3 months, 10% will exclusively breastfeed through 6 months, and 25% will be breastfeeding (not necessarily exclusively) at 1 year

5

By 2012, 15% of school-age children will eat three or more servings of vegetables daily and 65% will eat two or more servings of fruit daily; at least 25% of high school students will eat fruits and vegetables at least five times daily

6

By 2012, 80% of all eligible school-age children will participate in the National School Lunch Program

8

Between 2007 and 2012, the percentage of Texas school districts with exclusive vending contracts will not increase

9

By 2012, increase the number of hospitals that have officially initiated policies and practices to support breastfeeding initiation to at least three Baby-Friendly Hospitals and at least 65 Texas Ten Steps Facilities

10

By 2012, increase the number of worksites that have initiated policies and practices to support breastfeeding and lactation by at least 25% of baseline

13

By 2012, 50% of high school children in Texas will accumulate 60 minutes or more of physical activity per day on 5 or more days of the week

17

By 2012, the percentage of school-age children who view 3 or more hours of television per day will decrease by 5% from 32% among 4th graders, 52% among 8th graders, and 44% among 11th graders

19

By 2012, 100% of all public school districts will have implemented an approved school wellness policy consistent with the Federal Child Nutrition Act, 100% will have established a School Health Advisory Council, and 100% will have adopted an approved coordinated school health program consistent with state mandates

Suggested Citation:"5 Texas State Government: What the Future Holds." Institute of Medicine. 2009. Childhood Obesity Prevention in Texas: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12746.
×

Being a large agency, the Department of State Health Services has numerous divisions and programs focused on the prevention of childhood obesity. These include the Health Promotion and Chronic Disease Prevention Section, the Division of Family and Community Health, and the Texas School Health Advisory Council, among many others. Lakey commented that, just as the agency must partner and work with other state agencies, it is critical to ensure that the different divisions within the agency are working together in a coordinated manner.

Suggested Citation:"5 Texas State Government: What the Future Holds." Institute of Medicine. 2009. Childhood Obesity Prevention in Texas: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12746.
×
Page 25
Suggested Citation:"5 Texas State Government: What the Future Holds." Institute of Medicine. 2009. Childhood Obesity Prevention in Texas: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12746.
×
Page 26
Suggested Citation:"5 Texas State Government: What the Future Holds." Institute of Medicine. 2009. Childhood Obesity Prevention in Texas: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12746.
×
Page 27
Suggested Citation:"5 Texas State Government: What the Future Holds." Institute of Medicine. 2009. Childhood Obesity Prevention in Texas: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12746.
×
Page 28
Suggested Citation:"5 Texas State Government: What the Future Holds." Institute of Medicine. 2009. Childhood Obesity Prevention in Texas: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12746.
×
Page 29
Suggested Citation:"5 Texas State Government: What the Future Holds." Institute of Medicine. 2009. Childhood Obesity Prevention in Texas: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12746.
×
Page 30
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Childhood Obesity Prevention in Texas summarizes the information gathered at a workshop held February 5-6, 2009, in Austin, Texas. At this workshop, committee members met with Texas lawmakers, public officials, and community leaders to exchange ideas and to view first-hand strategies that are being implemented effectively at the state and local levels to prevent and reverse childhood obesity.

Texas leaders at the workshop expressed the strong belief that the state's economic vitality and security depend on the health of its population. Accordingly, the state is no longer simply describing the personal, community, and financial costs of its obesity crisis; it is taking proactive steps to address the problem through strategic initiatives. An overarching strategy is to address obesity by targeting the state's youth, in whom it may be possible to instill healthy behaviors and lifestyles to last a lifetime. A guiding principle of these efforts is that they should be evidence based, community specific, sustainable, cost-effective, and supported by effective partnerships. Moreover, the goal is for the responsibility to be broadly shared by individuals, families, communities, and the public and private sectors.

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