Philanthropies also play a major role in obesity prevention in the United States. As a notable example, RWJF is allocating $500 million over 5 years to efforts to reduce childhood obesity by 2015.

Finally, as noted earlier, the United Kingdom has a more vertically integrated system than that of the United States, with more national-level programs, while the United States is characterized by more state and local control. This difference implies different structures for the development of policies and programs to combat obesity. In the United States, top-down policy is more difficult to implement, but the country’s decentralized system also fosters innovation at the local level. At least 100 communities have initiated interventions directed at childhood obesity (three of these are discussed more fully in Chapter 7). However, good evaluation criteria are needed to determine what does and does not work.

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