Fielding discussed five roles a health department can play in obesity efforts; Silver discussed New York City’s menu labeling law, the first such law in the nation; and Johnson addressed the role of a mayor in championing and encouraging the leveraging of resources to move people along the path toward better health.


Los Angeles County encompasses 10 million residents, with more than 100 different languages being spoken by significant numbers of people. There is no one majority racial or ethnic group. The ethnic breakdown is 47 percent Latino, 30 percent white, 13 percent Asian/Pacific Islander, 9 percent African American, and 0.3 percent American Indiana/Alaskan native. Sixteen percent live in poverty, including about one in four children.

Five Roles for the Health Department

Fielding described the health department’s five roles related to preventing childhood obesity:

  • surveillance, monitoring, and data collection;

  • coordination and collaboration with a wide range of public and private partners;

  • modeling of a healthy workplace;

  • funding for pilot projects; and

  • use of health impact assessments.

Surveillance, Monitoring, and Data Collection

Obesity among children and adults in the county, as elsewhere in the country, has become more prevalent in the last 10 years. Gestational diabetes, which has long-term effects on babies mothers are carrying, more than tripled in a 12-year period. Using a model developed for Healthy People 2020, Fielding described how the health department focuses on influencing better health outcomes across the life span for children and adults.

Communities in Los Angeles that face the greatest economic hardships are also those with higher rates of obesity. The average prevalence of obesity in the county’s 10 wealthiest communities is 8 percent; in the poorest 10 communities, it is 31.5 percent. Some factors that contribute to the obesity epidemic are related to this disparity, such as the availability of safe places to play and access to healthy, affordable food, while others are more generalized.

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