CROSS-
SECTOR
RESPONSES
TO OBESITY:
MODELS
FOR
CHANGE
Steve Olson, Rapporteur
Roundtable on Obesity Solutions
Food and Nutrition Board
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
THE NATIONAL ACADEMIES PRESS
Washington, D.C.
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
NOTICE: The workshop that is the subject of this workshop summary was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
This activity was supported by Contracts between the National Academy of Sciences and The JPB Foundation (Contract No. 10001561); Kaiser Permanente (Contract No. 10001518); The Kresge Foundation (Contract No. 10001539); Robert Wood Johnson Foundation (Contract No. 10001565); Academy of Nutrition and Dietetics; Alliance for a Healthier Generation; American Academy of Pediatrics; American College of Sports Medicine; American Council on Exercise; American Heart Association; American Society for Nutrition; Bipartisan Policy Center; Blue Cross Blue Shield of North Carolina; Chartwells School Dining Services; ChildObesity180/Tufts University; Edelman; General Mills, Inc.; Greater Rochester Health Foundation; HealthPartners, Inc.; Healthy Weight Commitment Foundation; Highmark, Inc.; Kellogg Company; Mars, Inc.; Nemours Foundation; Nestlé Nutrition, North America; Nestlé USA; The Obesity Society; Partnership for a Healthier America; President’s Council on Fitness, Sports, and Nutrition; Reebok, International; Salud America!; Sesame Workshop; and YMCA of the USA. The views presented in this publication do not necessarily reflect the views of the organizations or agencies that provided support for the activity.
International Standard Book Number-13: 978-0-309-37105-6
International Standard Book Number-10: 0-309-37105-8
Additional copies of this workshop summary are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.
For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu.
Copyright 2015 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America
Cover credit: Design by Casey Weeks.
The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.
Suggested citation: IOM (Institute of Medicine). 2015. Cross-sector responses to obesity: Models for change. Workshop summary. Washington, DC: The National Academies Press.
“Knowing is not enough; we must apply.
Willing is not enough; we must do.”
—Goethe
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
Advising the Nation. Improving Health.
THE NATIONAL ACADEMIES
Advisers to the Nation on Science, Engineering, and Medicine
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.
The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. C. D. Mote, Jr., is president of the National Academy of Engineering.
The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Victor J. Dzau is president of the Institute of Medicine.
The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. C. D. Mote, Jr., are chair and vice chair, respectively, of the National Research Council.
PLANNING COMMITTEE ON CROSS-SECTOR WORK ON OBESITY PREVENTION, TREATMENT, AND WEIGHT MAINTENANCE: MODELS FOR CHANGE1
NICOLAS P. PRONK (Chair), HealthPartners, Inc., Minneapolis, Minnesota
DEBBIE I. CHANG, Nemours Foundation, Newark, Delaware
DAVID D. FUKUZAWA, The Kresge Foundation, Troy, Michigan
LISEL LOY, Bipartisan Policy Center, Washington, DC
AMELIE G. RAMIREZ, Salud America!, San Antonio, Texas
SYLVIA ROWE, SR Strategy, LLC, Washington, DC
IOM Staff
LYNN PARKER, Scholar
LESLIE J. SIM, Senior Program Officer
HEATHER DEL VALLE COOK, Program Officer
SARAH ZIEGENHORN, Research Associate
SARAH SIEGEL, Program Coordinator
Consultant
WILLIAM H. DIETZ, George Washington University, Washington, DC
____________________
1Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteur and the institution.
This page intentionally left blank.
ROUNDTABLE ON OBESITY SOLUTIONS1
BILL PURCELL III (Chair), Jones Hawkins & Farmer, PLC, Nashville, Tennessee
RUSSELL R. PATE (Vice Chair), University of South Carolina, Columbia
MARY T. STORY (Vice Chair), Duke University, Durham, North Carolina
SHARON ADAMS-TAYLOR, American Association of School Administrators, Alexandria, Virginia
NELSON G. ALMEIDA, Kellogg Company, Battle Creek, Michigan
SHAVON ARLINE-BRADLEY, National Association for the Advancement of Colored People, Baltimore, Maryland
JEANETTE BETANCOURT, Sesame Workshop, New York, New York
CAPT HEIDI MICHELS BLANCK, Centers for Disease Control and Prevention, Atlanta, Georgia
DON W. BRADLEY, Duke University, Durham, North Carolina
CEDRIC X. BRYANT, American Council on Exercise, San Diego, California
HEIDI F. BURKE, Greater Rochester Health Foundation, Rochester, New York
DEBBIE I. CHANG, Nemours, Newark, Delaware
YVONNE COOK, Highmark, Inc., Pittsburgh, Pennsylvania
EDWARD COONEY, Congressional Hunger Center, Washington, DC
KITTY HSU DANA, United Way Worldwide, Alexandria, Virginia
CHRISTINA ECONOMOS, Tufts University, Boston, Massachusetts
GINNY EHRLICH, Robert Wood Johnson Foundation, Princeton, New Jersey
IHOUMA ENELI, American Academy of Pediatrics, Columbus, Ohio
DAVID D. FUKUZAWA, The Kresge Foundation, Troy, Michigan
LISA GABLE, Healthy Weight Commitment Foundation, Washington, DC
PAUL GRIMWOOD, Nestlé USA, Glendale, California
SCOTT I. KAHAN, George Washington University, Washington, DC
SHIRIKI KUMANYIKA, University of Pennsylvania, Philadelphia
CATHERINE KWIK-URIBE, Mars, Inc., Germantown, Maryland
THEODORE KYLE, The Obesity Society, Pittsburgh, Pennsylvania
MATT LONGJOHN, YMCA of the USA, Chicago, Illinois
LISEL LOY, Bipartisan Policy Center, Washington, DC
MARY-JO MAKARCHUK, Canadian Institutes of Health Research/Instituts de researche en santé du Canada, Toronto, Ontario
LINDA D. MEYERS, American Society for Nutrition, Bethesda, Maryland
____________________
1Institute of Medicine forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published workshop summary rests with the workshop rapporteur and the institution.
SHELLIE PFOHL, President’s Council on Fitness, Sports, and Nutrition, Rockville, Maryland
BARBARA PICOWER, The JPB Foundation, New York, New York
NICOLAS P. PRONK, HealthPartners, Inc., Minneapolis, Minnesota
AMELIE G. RAMIREZ, Salud America!, San Antonio, Texas
OLIVIA ROANHORSE, Notah Begay III Foundation, Santa Ana Pueblo, New Mexico
SYLVIA ROWE, SR Strategy, LLC, Washington, DC
JOSE (PEPE) M. SAAVEDRA, Nestlé Nutrition, Switzerland
JAMES F. SALLIS, University of California, San Diego
EDUARDO J. SANCHEZ, American Heart Association, Dallas, Texas
BRIAN SMEDLEY, National Collaboration for Health Equity, Washington, DC
LAWRENCE SOLER, Partnership for a Healthier America, Washington, DC
LOEL S. SOLOMON, Kaiser Permanente, Oakland, California
MARION STANDISH, The California Endowment, Oakland
ALISON L. STEIBER, Academy of Nutrition and Dietetics, Chicago, Illinois
MAHA TAHIRI, General Mills, Inc., Minneapolis, Minnesota
KATHLEEN TULLIE, Reebok, International, Canton, Massachusetts
TISH VAN DYKE, Edelman, Washington, DC
HOWELL WECHSLER, Alliance for a Healthier Generation, New York, New York
JAMES R. WHITEHEAD, American College of Sports Medicine, Indianapolis, Indiana
TRACY WIEDT, National League of Cities, Washington, DC
IOM Staff
LYNN PARKER, Scholar
LESLIE J. SIM, Senior Program Officer
HEATHER DEL VALLE COOK, Program Officer
SARAH ZIEGENHORN, Research Associate
SARAH SIEGEL, Program Coordinator
RENEE GETHERS, Senior Program Assistant (from March 2015)
Consultant
WILLIAM H. DIETZ, George Washington University, Washington, DC
Reviewers
This workshop summary has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published workshop summary as sound as possible and to ensure that the workshop summary meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this workshop summary:
Adam B. Becker, Consortium to Lower Obesity in Chicago Children (CLOCC)
Kate McGrail, Institute for Public Health Innovation
M. Amalia Mendoza, Foundation for a Healthy Kentucky
Marion Standish, The California Endowment
Although the reviewers listed above provided many constructive comments and suggestions, they did not see the final draft of this workshop summary before its release. The review of this workshop summary was overseen by Hugh Tilson, University of North Carolina at Chapel Hill. Appointed by the Institute of Medicine, he was responsible for making certain that an independent examination of this workshop summary was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this workshop summary rests entirely with the rapporteur and the institution.
This page intentionally left blank.
Contents
The Need for Cross-Sector Approaches
Organization of the Workshop and This Summary
Reflections of the Workshop Discussions
Institutional Approaches to Creating Health Equity in a Changing U.S. Population
Providing Access to Healthy Food
A Roadmap to Approaching Evaluation
Considerations in Comparing Dose with Population-Level Changes
Development of the National Prevention Strategy
Obesity Prevention in the General Services Administration
7 A STATEWIDE STRATEGY IN THE BATTLE AGAINST CHILD OBESITY IN DELAWARE
An Integrated Community Health Model
Getting Started on Prevention in Early Childhood Programs at St. Michael’s School
Getting Kids Moving in the Christina School District
The NHPS Approach: Letting Community Partners Lead the Way
Getting Parents and Families on Board
The Pros and Cons of a Statewide Approach
The Connections Among Food, Neighborhoods, and Health Inequities in Cook County
Protecting Workers in the Food Service Sector
Fighting for Food Justice in Harvey, Illinois
9 POWERUP: MOBILIZING AGAINST OBESITY IN ST. CROIX VALLEY, MINNESOTA, AND WISCONSIN
A Community-Based Framework That Powers Up Partnerships
How Long-Term Funding Support and Social Capital Make a Difference
10 COMMUNITY TRANSFORMATION IN THE SAULT STE. MARIE TRIBE OF CHIPPEWA INDIANS IN MICHIGAN
Leveraging Grant Dollars Across Sectors for Healthier, Safer Communities
Building Trust with Tribal Leadership to Measure Community Health
Strategies for Talking About Health Equity
Means of Building Relationships in Communities and Across Sectors
Direct Versus Indirect Approaches to Addressing Obesity
Measurement and Evaluation Issues
Ways of Sustaining the Work of Initiatives with the Next Generation of Leadership
B NATIONAL PREVENTION COUNCIL CROSS-SECTOR CASE STUDY
C DELAWARE CROSS-SECTOR CASE STUDY
D COOK COUNTY PLACE MATTERS CASE STUDY
E POWERUP IN THE ST. CROIX VALLEY (MN/WI) CASE STUDY
F SAULT STE. MARIE TRIBE OF CHIPPEWA INDIANS CROSS-SECTOR CASE STUDY