Health Indicator Report of Obesity Among Adults

Obesity in the U.S. and in Utah continue to increase, although rates in Utah may be beginning to level off.

Notes

Obesity is defined as a BMI of 30 or more. BMI is calculated by dividing weight in kilograms by the square of height in meters. In 2016, Utah BRFSS modified its methodology for age adjustment to align with U.S. age adjustment. Data has been updated from 2011 onward in all chart views to reflect this modification.   [[br]] [[br]] Age-adjusted to U.S. 2000 standard population. [[br]] U.S. data does not include U.S. territories, but does include Dist. of Columbia.[[br]] [[br]] Beginning in 2011, BRFSS data include both landline and cell phone respondent data along with a new weighting methodology called iterative proportional fitting, or raking. Comparisons between 2011 and prior years should be made with caution. More details about these changes can be found at: [https://ibis.health.utah.gov/pdf/opha/resource/brfss/RakingImpact2011.pdf].

Data Interpretation Issues

Height and weight are self reported. Respondents may tend to misreport their height and weight. To reduce bias and more accurately represent population data, the BRFSS has changed survey methodology. In 2010, it began conducting surveys by cellular phone in addition to landline phones. It also adopted "iterative proportional fitting" (raking) as its weighting method. More details about these changes can be found at: [https://ibis.health.utah.gov/pdf/opha/resource/brfss/RakingImpact2011.pdf].

Definition

Percentage of respondents aged 18 years and older who have a body mass index (BMI) greater than or equal to 30.0 kg/m^2^ calculated from self-reported weight and height.

Numerator

Number of respondents aged 18 years and older who have a body mass index (BMI) greater than or equal to 30.0 kg/m^2^ calculated from self-reported weight and height.

Denominator

Number of respondents aged 18 years and older for whom BMI can be calculated from their self-reported weight and height (excludes unknowns or refusals for weight and height).

Healthy People Objective NWS-9:

Reduce the proportion of adults who are obese
U.S. Target: 30.5 percent
State Target: 24.0 percent

How Are We Doing?

According to a recent report from the Trust for America's Health and the Robert Wood Johnson Foundation, Utah ranks 47th among the 50 states and the District of Columbia.[[br]] [https://www.tfah.org/releases/stateofobesity/?state=utah] Over the past 17 years, the age-adjusted proportion of Utah adults who were obese has increased from 19.5% in 2000 to 26.0% in 2017. While the sampling method changed in 2011, this change was still similarly pronounced in the years immediately prior to 2011. The highest rates of obesity were seen for adults ages 50 to 64. Age-adjusted rates are used to compare rates for race and local health districts to account for the differences in ages. In 2017, Native Hawaiian/Pacific Islander adults and American Indian/Alaskan Native adults had much higher rates than the state, with rates of 45.5% and 34.3%, respectively. An estimated 27.7% of Hispanic/Latino adults were obese, compared to 25.5% of non-Hispanic/Latino adults.

How Do We Compare With the U.S.?

The age-adjusted prevalence of obesity in Utah adults is slightly lower than the U.S. In 2017, the obesity prevalence rate in Utah adults was 26.0%. The obesity prevalence for U.S. adults in 2016 was 30.1%.

What Is Being Done?

The Healthy Living through Environment, Policy, and Improved Clinical Care Program (EPICC) was established through funding from the Centers for Disease Control and Prevention (CDC). EPICC focuses on Environmental Approaches that Promote Health, specifically promoting policies around healthy eating and active living. EPICC works: In Schools:[[br]] 1) Schools are encouraged to adopt the Comprehensive School Physical Activity Program. This framework encourages students to be physically active for 60 minutes a day through school, home and community activities.[[br]] 2) Height and weight trends are being tracked in a sample of elementary students to monitor Utah students.[[br]] 3) Action for Healthy Kids brings partners together to improve nutrition and physical activity environments in Utah's schools by implementing the school-based state plan strategies, working with local school boards to improve or develop policies for nutritious foods in schools. This includes recommendations for healthy vending options. In Worksites:[[br]] 1) The Utah Health Improvement Plan--a public and private partnership--has selected worksites as their priority for the goal of Preventing Obesity and Related Chronic Conditions. A smaller workgroup, UHIP-O, works to create a Culture of Health within businesses in the state of Utah. 2) The Utah Council for Worksite Health Promotion recognizes businesses that offer employee fitness and health promotion programs.[[br]] 3) EPICC partners with local health departments to encourage worksites to complete the CDC Scorecard and participate in yearly health risk assessment for their employees. EPICC provides toolkits and other resources for employers interested in implementing wellness programs through the [http://choosehealth.utah.gov choosehealth.utah.gov] website: [http://choosehealth.utah.gov/worksites/why-worksite-wellness.php] -- In Communities:[[br]] 1) Local health departments (LHDs) receive federal funding to partner with schools, worksites, and other community based organizations to increase access to fresh fruits and vegetables through food service guidelines, farmers markets and retail stores. LHDs also work with cities within their jurisdictions to create a built environment that encourages physical activity. In Healthcare:[[br]] 1) EPICC works with health care systems to establish community clinical linkages to support individuals at risk for or diagnosed with diabetes or hypertension to engage in lifestyle change programs such as chronic disease self-management and diabetes prevention programs. In Childcare:[[br]] 1) Ten local health departments statewide have implemented the TOP Star program, which aims to improve the nutrition, physical activity, and breastfeeding environments and achieve best practice in child care centers and homes.[[br]] 2) EPICC works with state and local partners through the Childcare Obesity Prevention workgroup to implement policy and systems changes in early care and education across agencies statewide.

Evidence-based Practices

The EPICC program promotes evidence based practices collected by the Center for Training and Research Translation (Center TRT). Center TRT bridges the gap between research and practice and supports the efforts of public health practitioners working in nutrition, physical activity, and obesity prevention by: *Reviewing evidence of public health impact and disseminating population-level interventions; *Designing and providing practice-relevant training both in-person and web-based; *Addressing social determinants of health and health equity through training and translation efforts; and, *Providing guidance on evaluating policies and programs aimed at impacting healthy eating and physical activity. [[br]] Appropriate evidence based interventions can be found at: [http://www.centertrt.org/?p=interventions_interventions_overview]

Available Services

Action for Healthy Kids Local School Policy CD - for more information, call 801-538-6142 The Utah Department of Health houses the Healthy Living through Environment, Policy and Improved Clinical Care (EPICC). The EPICC website has information on healthy living, including prevention of diabetes, heart disease and stroke on [http://www.choosehealth.utah.gov]. Utah Worksite Wellness Council is a non-profit organization made up of volunteers from organizations across Utah. Information is available at [http://utahworksitewellness.org].