Mass In Motion: Addressing Obesity and Overweight in the Commonwealth
BOSTON, January 26, 2009 -
BOSTON -- Last June, state Public Health Commissioner John Auerbach pledged that within a year Massachusetts would have a plan in place to reverse the steady incline in the state’s obese population. Commissioner Auerbach made that promise at a discussion on childhood obesity hosted by the Heller School at Brandeis University’s Massachusetts Health Policy Forum.
It took the commissioner less than a year to return to the Massachusetts Health Policy Forum to discuss the new state initiative to combat obesity, called, ‘Mass in Motion’, a comprehensive plan which addresses the public health crisis of overweight and obesity in Massachusetts. This week’s forum was co-sponsored by the Harvard Pilgrim Health Care Foundation’s ‘Growing Up Healthy’ initiative.
According to Dr. Auerbach, this state has witnessed a ‘dramatic’ increase in adult obesity rates since the 1970s. Currently, he said, nearly 60 percent of adults are overweight and 20 percent are considered obese, while 30 percent of Massachusetts children are overweight. There is significant medical evidence linking obesity to chronic health issues, including heart problems and diabetes. In fact, he said, over the last 10 years the number of people in this state diagnosed with diabetes has doubled. Another alarming statistic cited by Dr. Auerbach is that one in five Massachusetts adults are either diabetic or have been diagnosed as being pre-diabetic. ”Clearly, being obese or overweight has serious health consequences,” Dr. Auerbach said.
While some people may claim that the current economy cannot support additional programs and new services, Dr. Auerbach believes that because obesity tends to disproportionately affect the poorest people, “this is exactly the time to focus on the epidemic of obesity.” Years ago, he added, poor people were the least likely to be overweight. Now, he said, fast food chain restaurants that offer high-calorie menus have populated low income neighborhoods, so that trend has been reserved. In addition, there are fewer grocery stores in low-income communities and neighborhoods of color that offer a broad selection of fresh produce. These areas are less likely to have adequately maintained recreational facilities, or safe, walkable neighborhoods. “Based on that information, it makes sense to begin this statewide initiative during a time of financial crisis,” according to Dr. Auerbach.
Making good on last year’s pledge, Dr. Auerbach and the Patrick administration worked over the past several months to develop ‘Mass in Motion.’ One of the initiatives included in that plan is a proposed regulation requiring fast food chain restaurants to post the calorie content of all menu offerings at the point of sale.
New York City initiated mandatory calorie posting for its fast food chain restaurants in 2007. According to Maura Kennelly, special assistant to the New York City Dept. of Health and Mental Hygiene, the program has been highly successful. An evaluation undertaken before the regulation took effect showed that, on average, a person purchasing lunch at one of that city’s fast food restaurants would consume 827 calories. That’s a lot of calories, she explained, since it is recommended that the average person not consume more than 2,000 a day. The baseline study also showed that thirty-four percent of those purchasing lunch consumed 1,000 calories and only 15% consumed 1,200 calories or less.
Since the new regulation took effect, 60 percent of customers said they saw the posted information and 25 percent said they were motivated to purchase a healthier meal choice. A more complete evaluation will be done this spring, she said, but in the meantime, even some of the restaurant chains have been motivated to reduce their high calorie choices. One chain restaurant started using low-fat mayonnaise on their club sandwich, slicing the calories from 800 to a healthier 447.
Another ‘Mass in Motion’ proposal would require that schools confidentially provide parents with their child’s Body Mass Index calculation in four specific grade levels. For those students registering in the overweight or obese category, the schools would also provide parents with proven methods of improving their child’s eating and exercise habits. If the state’s public health council approves the proposals, the regulations will become law, Auerbach noted.
In order to ‘raise the public’s consciousness” of the new regulations, a marketing campaign has begun with billboards placed on public buses. There are plans to add radio and television advertising and Internet videos as part of the public awareness campaign. The state has also developed an interactive web site ( www.mass.gov/massinmotion ) designed to provide continually updated information and a calendar listing of healthy activities in specific communities.
During the initial data-gathering stage of this initiative, hundreds of employers were surveyed and an overwhelming number of companies indicated that they would like to offer employees some type of workplace wellness program. According to Dr. Auerbach, employers around the state are finding that healthy workers translate into less absentism and decreased insurance premiums. In response to the high level of interest by companies, the state developed a pilot program last spring, involving 11 companies and 6,000 employees. A curriculum was created and $2,000 grants were given to companies to develop their own workforce wellness programs, which have included organized lunchtime activities and the availability of healthier snacks in the workplace. The state plans to ‘dramatically’ expand this program, according to Dr. Auerbach.
In addition, there are a number of private/public partnerships underway in several communities, including Somerville, Cambridge, Boston, Holyoke, Springfield and Fitchburg, involving the schools, recreation, planning and transportation departments, in order to create an environment more conducive to healthy living and exercise.“Even in times of economic crisis, we need to make sure that we are paying attention to this problem of an overweight and obese population – but not by one single organization. This will take an incredible mobilization of organizations throughout the state,” Dr. Auerbach concluded.