California Obesity
Prevention Initiative

California is experiencing an unparalleled obesity epidemic that represents a public health challenge of equal magnitude to that of tobacco. Poor diet and physical inactivity are the second leading causes of death and disability, resulting in nearly 30,000 deaths each year in California. The prevalence of overweight in Californians has increased from 38 percent in 1984 to 57 percent in 2003. All gender, age, and race/ethnic groups have shown an increase during the past decade.  Californians below the poverty level are disproportionately affected.

With obesity comes associated health risks, including heart disease, type 2 diabetes, high blood pressure, stroke, arthritis-related disabilities, sleep disorders, cancers of the breast, prostate, and colon, depression, and other mental health problems. California’s children are suffering unnecessarily from long-term health and emotional impacts of obesity due to experiencing adult-like medical problems at astonishingly younger ages. The economic burden of physical inactivity, overweight, and obesity in adults exceeded $21.7 billion for California in 2000, and is expected to rise exponentially to $28 billion by 2005 for medical care, lost productivity, and workers’ compensation.

Available data indicate that overweight and obesity affect virtually all age, income, educational, and ethnic groups. Especially high rates are found among California’s African American, Latino, and American Indian/Alaska Native adult populations. Such high rates of obesity may contribute to other health issues experienced by these groups, such as type 2 diabetes.

California youth are also impacted by the obesity epidemic. Currently, about one in three children and one in four teens is at risk or already overweight (Source: California Department of Public Health, Cancer Prevention and Nutrition Services).  Overweight and At Risk for Overweight disproportionately affect California's Latino and African American adolescents (Source: California Health Interview Survey, 2003).

Data from the 2003 California Department of Education FITNESSGRAM reveals the following about children in grades five, seven, and nine:

• Only 23 percent of the students tested in grade five, 27.1 percent in grade seven, and 24.1 percent in grade nine met the minimum fitness standards.

Over 1.3 million students participated in the 2003 FITNESSGRAM which assesses six major fitness areas, including aerobic capacity, body composition, abdominal strength and endurance, trunk strength and flexibility, upper body strength and endurance, and overall flexibility (Source: California Department of Education FITNESSGRAM 2003).

According to a 2002 study, An Epidemic: Overweight and Unfit Children in California Assembly Districts, produced by the California Center for Public Health Advocacy:

• 26.5 percent of the state’s students are overweight.
• 39.6 percent of the state’s students are considered unfit.
• Urban Los Angeles County and the rural Central Valley have the highest rates of overweight.
• African-American and Latino youth face higher rates of overweight and poor fitness than White and Asian youth.

The California Center for Public Health Advocacy analyzed data from the 2001 FITNESSGRAM for their study.  In addition to the findings stated above, the study shows that there are high rates of overweight and unfit children in all 80 Assembly Districts in California (Source: California Center for Public Health Advocacy, 2002).

National and state surveys indicate that rates of overweight and obesity began to rise in the late 1980’s, accelerated in the 1990’s, and as yet in this decade show no signs of slowing. Of the nation’s ten Leading Health Indicators for Healthy People 2010, only overweight and obesity are moving strongly in the wrong direction.

A recent study focused on the state-level estimates of total obesity-attributable medical expenditures, including Medicare and Medicaid costs.  California’s obesity-attributable costs were approximately $7.7 billion, the largest state-level expenditure in the United States (Source: Obesity Research; Finkelstein, Fiebelkorn, and Wang, 2004).

Proposed Causes

The worldwide spread of obesity has been attributed to complex, powerful societal forces that encourage eating too many high calorie foods, getting too little physical activity, and acquiring too much body weight over time. The pressure to eat more food has become increasingly pervasive. Large portions of high calorie foods with little nutritional value are mass produced, heavily advertised, and made widely available throughout the day, while the opposite is generally true for healthier foods like fruits and vegetables. Increased marketing of high calorie, low nutrient foods to children; lack of access to healthier foods in workplaces, schools, and many lower-income communities; and food insecurity—in addition to a host of other barriers—make it difficult for individuals to maintain a healthy diet.

Technology has decreased the extent of physical activity in most workplaces, in daily living, for transportation, and during leisure. Renewed emphasis on academic achievement in the educational system has reduced the time and space available for active play as well as for structured physical education. Long workdays and single parent households limit time for physical activity. Safety concerns, poor community design, and urban sprawl discourage walking, bicycling, and recreation in many neighborhoods. Time spent watching television plays an important role in adult, adolescent, and childhood obesity. However, the impact of television viewing on the adolescent and childhood obesity epidemic is a significant concern.  Children who watch four hours or more of television per day weigh significantly more than children watching fewer than two hours per day.  A national survey of adolescents found that overweight increased by 2% for each additional hour of TV viewing. According to the UC Berkeley's Center for Weight and Health, television viewing not only displaces physical activity time, but it also provides opportunities for snacking and exposure to junk food advertising.

Even factors occurring very early or for brief periods in life contribute to obesity later in life. These include high birth weight from uncontrolled diabetes, low birth weight, and lack of breastfeeding.  Children breastfed at any time are 15% to 25% less likely to become overweight, while children breastfed 6 months or longer are 20% to 40% less likely (Source: US Dept. of Health and Human Services, CDC, Preventing chronic diseases: Investing wisely in health: Preventing obesity and chronic disease through good nutrition and physical activity).