There’s so much focus on obesity in the news – why is it important?

Individuals who are obese are at greater risk of developing a number of chronic diseases, including heart disease, diabetes, and some types of cancer. From what you’ve read in different news articles, you’re probably well aware that rates of obesity are on the rise, but when you look at trends over time, I think those changes are really staggering. In 2010, about one-quarter of Minnesota residents were considered obese, which is slightly lower than the national average. However, the rate of obesity among adults has increased over time and we also know that obesity is becoming a problem for children at younger ages.

Research has also shown rates of obesity are higher within some cultural communities. These trends mean that a growing number of residents are at greater risk of developing largely preventable chronic diseases at earlier ages, and that has huge implications on the overall health of the population as well as our health care system and expenditures.

How do we reverse this trend?

Research has shown that although we each make individual decisions about the food we eat and how active or inactive we choose to be, key social and economic factors - such as employment, community safety, and household income - have a strong influence on health outcomes. In short, we make individual decisions about our behavior, but our choices are influenced by where we live and our level of access to various resources.

Our 2010 report, Unequal distribution of health in the Twin Cities, demonstrated that even though Minnesota is among the healthiest states, there are differences in health outcomes among populations, based on geographic location, race/ethnicity, educational status, and household income. These factors are referred to as “social determinants of health.” We’re currently working on an updated version of that report that looks deeper into these associations by exploring trends in the metro region during the last 10 years. I think this report, and research being done throughout the country, demonstrates that community-level solutions are needed to improve long-term health outcomes and reduce health inequities.

What do we know about effective neighborhood-level strategies that can be used to reduce obesity?

Earlier this year, we hosted an event to talk about strategies that can be used to increase access to healthy foods, particularly in communities where there is less access to fresh fruits and vegetables.

A number of promising approaches have been used in communities across the county, and in Minnesota, to improve access to healthy foods, such as:

  • Modifying school lunch programs
  • Establishing farmer’s markets
  • Incentivizing food retailers to locate stores in underserved neighborhoods
  • Realigning bus routes to ensure there are reliable transportation options to grocery stores
  • Changing zoning policies to support the development of community gardens

There isn’t a one-size-fits-all solution; the “right” approach is the one that addresses the needs of residents in a specific neighborhood or community.

How is this type of work being supported in Minnesota?

There are a lot of different things happening across the state to address obesity and reduce the prevalence of chronic disease, but I especially want to highlight the work Minnesota has been doing through the Statewide Health Improvement Program (SHIP) to work “upstream” to address the factors that ultimately influence healthy behaviors and make the healthy choice the easy choice.

Through SHIP, local community health boards and tribal governments received funding to make policy, systems, and environmental changes to increase access to healthy foods, create more opportunities for physical activity, and reduce exposure to tobacco smoke. Ultimately, the goal of this work is expected to lead to long-term reductions in obesity and tobacco use and related chronic health conditions.

Wilder Research worked with a number of SHIP grantees during the past two years to conduct local needs assessments and evaluate their implementation of specific interventions. We saw some good examples of communities establishing policies and implementing other changes that build a foundation to support healthy eating and physical activity. However, a challenge to working “upstream” is that the changes in obesity rates and reductions in health care costs don’t occur overnight. It will take time to achieve these long-term outcomes.

Melanie Ferris is a research scientist at Wilder Research. She works on a broad range of projects, including evaluations and research with programs and initiatives focused on children’s mental health, substance use, health inequities, and health promotion.  Prior to joining Wilder Research, Melanie worked for the National Alliance on Mental Illness informing legislators on mental health issues, and as a case coordinator for adults with developmental disabilities and mental illness.  Melanie has a Master of Public Health degree from the University of Minnesota, School of Public Health, and a B.A. in biology from Macalester College.