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Prevention Must-Reads, February 2016

The highlights below come from recent publications, speeches, and testimony focused on the intersection of health and healthcare. Please let us know if you have comments or suggestions we should consider.

Compiled by Caitlin Krutsick and Hannah Martin

An Integrated Framework for the Prevention and Treatment of Obesity and Its Related Chronic Diseases
By William H. Dietz, Loel S. Solomon, Nico Pronk, Sarah K. Ziegenhorn, Marion Standish, Matt M. Longjohn, David D. Fukuzawa, Ihouma U. Eneli, Lisel Loy, Natalie D. Muth, Eduardo J. Sanchez, Jenny Bogard, and Don. W. Bradley

“Improved patient experience, population health, and reduced cost of care for patients with obesity and other chronic diseases will not be achieved by clinical interventions alone. We offer here a new iteration of the Chronic Care Model that integrates clinical and community systems to address chronic diseases … Dietary and physical activity interventions will prevent, mitigate, and treat obesity and its related diseases. Challenges with the implementation of this model include provider training, the need to provide incentives for health systems to move beyond clinical care to link with community systems, and addressing the multiple elements necessary for integration within clinical care and with social systems.” Read the full article.

Three Interventions That Reduce Childhood Obesity Are Projected To Save More Than They Cost To Implement
By Steven L. Gortmaker, Y. Claire Wang, Michael W. Long, Catherine M. Giles, Zachary J. Ward, Jessica L. Barrett, Erica L. Kenney, Kendrin R. Sonneville, Amna Sadaf Afzal, Stephen C. Resch, and Angie L. Cradock

“Policy makers seeking to reduce childhood obesity must prioritize investment in treatment and primary prevention. We estimated the cost-effectiveness of seven interventions high on the obesity policy agenda: a sugar-sweetened beverage excise tax; elimination of the tax subsidy for advertising unhealthy food to children; restaurant menu calorie labeling; nutrition standards for school meals; nutrition standards for all other food and beverages sold in schools; improved early care and education; and increased access to adolescent bariatric surgery … In our model, three of the seven interventions—excise tax, elimination of the tax deduction, and nutrition standards for food and beverages sold in schools outside of meals—saved more in health care costs than they cost to implement. Each of the three interventions prevented 129,000–576,000 cases of childhood obesity in 2025. Adolescent bariatric surgery had a negligible impact on obesity prevalence. Our results highlight the importance of primary prevention for policy makers aiming to reduce childhood obesity.” Read the full article.

Estimating the Effects of Federal Policies Targeting Obesity: Challenges and Research Needs
By Noelia Duchovny, Eamon Molloy, Lori Housman, and Ellen Werble, CBO

“Because obesity is associated with numerous diseases and higher average health care spending, lawmakers have expressed interest in developing policies that would reduce the prevalence of obesity. Determining the likely effects of such policy proposals is difficult, however. Despite a rapidly growing body of literature that explores the effects of obesity on health and health care spending, research on the effects that policy interventions aimed at weight loss would have on the federal budget is largely lacking. The Congressional Budget Office has determined that the available evidence does not support the conclusion that certain policies to stem obesity … would generate significant savings for the federal government. Given the limitations of current research, some of which are outlined in this blog post, further well-designed studies and systematic reviews of the literature on the effects of obesity interventions and their budgetary consequences would enhance CBO’s analytic capabilities in this area and could change the agency’s conclusions.” Read the full article.

Targeted policy actions could help discourage obesity, Stanford expert says
By Clifton B. Parker, Stanford News

“In a new journal article, Deborah Rhode, a legal ethics scholar, said if society is serious about curbing obesity, especially in children, then it must adopt policies that confront obesity rates, which are a growing public health concern … In her analysis, she examined the track record of government intervention on obesity and evaluated a range of policy options such as caloric disclosure requirements, taxes, sugary drink bans, food stamp modifications, zoning regulations, marketing to children, physical education, litigation and education.” Read the article.

How One of America’s Most Overweight Cities Lost a Million Pounds
By Ian Birrell, The Atlantic

“Oklahoma City has declared war on fat. First the mayor—realizing he had become clinically obese just as his hometown was identified by a magazine as one of America’s most overweight cities—challenged his citizens to collectively lose a million pounds. But hitting that target was just the start: This veteran Republican politician then took on the car culture that shaped his nation and asked citizens to back a tax rise to fund a redesign of the state capital around people.” Read the article.

The CEO of Bolthouse Farms on Making Carrots Cool
By Jeffrey Dunn, Harvard Business Review

“How do you make carrots cool? In 2008, when I became the CEO of Bolthouse Farms, that was the question we needed to answer. Like most agricultural businesses, the company had been preoccupied for much of its 93-year history with supply: getting its products—primarily carrots but also juices and dressings—from the field and the factory to the family dinner table. We liked steady, predictable demand, of course, but no one was seeking step-change growth. As a 20-year veteran of the soft drinks industry, I wasn’t satisfied with that.” Read the post.

Severe Obesity Costs Medicaid $8 Billion Annually, Study Finds
By Alan Mozes, Health Day

“Severe obesity is putting a huge financial strain on both the U.S. Medicaid system and severely obese patients themselves, new research suggests. The study pegs the national bill for providing obesity-related health services for the severely obese at $69 billion a year … Medicaid pays just over 10 percent of the annual cost of treating the severely obese. That works out to about $8 billion a year, the researchers said.” Read the article.

Combating obesity as a market failure
By Terry Kosdrosky, Medical Xpress

“How to best combat obesity—and the proper role of the markets and government in that mission—is far from settled. That’s why a new study by Aneel Karnani, professor of strategy at the University of Michigan’s Ross School of Business, and colleagues looks at obesity as a market failure. They identified a problem with many causes and politically unpopular solutions. Unlike the causes of other preventable ills—such as tobacco and alcohol—food is a necessity with sometimes subjective views of what’s unhealthy. The hope is that evidence-based study sparks public discussion about taking steps that work.” Read the article.

Too Fat, Too Frail to Serve, Report Warns
By Beatriz Alvarado,

“Retired Army Brigadier General Joe E. Ramirez Jr. recently went on a statewide speaking tour in Texas to discuss obesity’s impact on the military and to share the recent report from the nonprofit Mission: Readiness titled “Too Fat, Frail, and Out-of-Breath to Fight.” “In Texas, 73 percent of young adults can’t serve. The national average is about 30 percent.

“It’s been a problem for a while,” he said. “Our country is getting bigger and that concerns a lot of us.” Read the article.

Hospital Community Benefit: How Partnerships Can Support Healthy Communities
By C.J. Eisenbarth Hager, Health Affairs

“With the increased focus on broader determinants of health, health foundations are asked to think and act more expansively and creatively about how to support health. In many ways, public health is getting back to its roots in doing so: the idea that the basic building blocks of our neighborhoods and communities greatly influence our health. If we want healthy people, we must ensure that these fundamental community elements, such as housing, transportation, public recreation opportunities, job opportunities, and food, are engineered to encourage and support health.” Read the full article.

Opinion: C-Stores Aren’t Health Food Stores
By Hank Armour and Lawrence Soler, CSP

“Make no mistake: convenience stores are not health food stores, and they don’t aspire to be. They sell speed of service to busy consumers who want to get in and out quickly. But what they sell—and how they sell it—continues to evolve as people expect to get fresh, healthy items on the go. Stores don’t need to look to eliminate less healthy choices, but rather continue to increase the healthier options to meet shifting demands.” Read the full article.

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