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Brandon Walker December 10th, 2010 Intro Public Policy Dr. Gary Dymski A Battle for a Better uture Within the !ast three decades, !oor "uality and inaccessibility to healthier food o!tions has redefined the #American diet$ and led to the u!risin% of a ne& e!idemic that is s&ee!in% the nation' obesity. (his modern day disease has had an e)cruciatin% affect on *arious states+ health care s!endin%, economy, and e)!ected life s!an &ithin the ,-, but more s!ecifically .alifornia. Because of !oor dietary choices and a lack of !hysical acti*ity, .alifornia+s current health status is in dan%er, and sho&s no si%n of im!ro*ement. In a !eriod of ten years, !olicymakers, le%islatures, .on%ress, and other sectors of %o*ernment ha*e brainstormed methods and formulated !lans in effort to combat &hat has been labeled as #(he /besity 0!idemic$. 1o&e*er, due to fra%mented efforts and the com!le)ity of the situation, there has yet to be an effecti*e !lan to !ut obesity to an end. /ne mi%ht "uestion2 #&hy does obesity matter3 What information has been brou%ht forth about this issue to %ain the attention of !olicy analysts3$ or those indi*iduals &ho "uestion the se*erity of obesity, &hat they may fail to reali4e is the affect obesity has on health' indi*idually and collecti*ely. #(he real obesity toll comes &ith o*er half of all .alifornia at %reater risk for heart disease, ty!e 2 diabetes, hi%h blood !ressure, strokes, arthritis5related disabilities, de!ression, slee! disorders, and some cancers$ 6.alifornia /besity Pre*ention Plan7. /besity can !otentially !enetrate

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e*ery as!ect of our li*es, but most im!ortantly, it also affects our children and youth. #(he number of o*er&ei%ht 8children9 has tri!led since 1:;0$ 6<raft and urlon% 2=;7. #A third of our children, and one in four teens are already o*er&ei%ht or obese$ 6.alifornia /besity Pre*ention Plan7. (he de*elo!in% cases of children &ith obesity are ra!idly increasin%. /*er the !ast t&enty years, o*er&ei%ht le*els ha*e doubled in children and tri!led in teens nationally. -tudies sho& o*er&ei%ht and obesity is occurrin% earlier in life and is increasin%ly common %ro&th !attern in youn% children 6.hild 1ealth and Disability Pre*ention Pro%ram7. >ost alarmin% ?05;0@ of o*er&ei%ht children &ill become o*er&ei%ht adults 6.alifornia /besity Pre*ention Plan7. If &e do not !ut an end to this e!idemic, our children &ill !ay the !rice &ith their li*es. /besity has caused a decrease in life e)!ectancy. Aankin% ?: th amon% nations in 200;, the life e)!ectancy of Americans &as B;.1 years 6<raft and urlon% 2C07. 1o&e*er, if !eo!le took better care of themsel*es then the life e)!ectancy &ould be much %reater. /besity has be%un to affect our !hysical &ell5bein%, and is no& attackin% health care. Because .alifornia has such a lar%e and %ro&in% !o!ulation, the cost of health care e)!enditures related to obesity is %oin% to be si%nificantly lar%er than other states. #-tate5le*el estimates ran%e from D;B million 6Wyomin%7 to DB.B billion 6.alifornia7. /besity5attributable >edicare estimates ran%e from D1= million 6Wyomin%7 to D1.B billion 6.alifornia7, and obesity5attributable >edicaid e)!enditures ran%e from D2E million 6Wyomin%7 to DE.= billion 6Fe& Gork7. (he state differences in obesity5 attributable e)!enditures are !artly dri*en by the differences in the si4e of each stateHs !o!ulation$ 6#/*er&ei%ht and /besity$7. 1ealth care !ro%rams, such as >edicare and >edicaid, are becomin% more e)!ensi*e and difficult to fund each year. 1ealth care

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!rices continue to rise, &hile bud%ets be%in to fluctuate. A si%nificant !ercenta%e of the illnesses !hysicians and !ractitioners treat, &hich these !ro%rams !ay for, are com!lications cause by obesity. (herefore, if &e can !re*ent obesity, the %o*ernment can sa*e billions on health care cost. I ha*e chosen the arena of health care, more s!ecifically obesity, an im!ortant issue that deser*es attention and needs correction, for my !olicy analysis. I chose this to!ic because I belie*e it is an issue that does not recei*e enou%h attention. As o!!osed to other issues facin% !ublic !olicy, such as 0ducation and Defense, obesity is a !olicy arena that has the !otential to be erased from the health care a%enda. A 200E article in Health Affairs !ut the cost of obesity at =.B !ercent of health care s!endin% and treatin% illness related to obesity cost more than 100 billion dollars 6<raft and urlon% 2C07. What I &ant !eo!le to understand is that obesity is one of the fe& issues &e, the !eo!le, ha*e the !o&er to re*erse. /besity itself is not hereditary' it is somethin% that can be !re*ented if addressed tactfully and more a%%ressi*ely. I belie*e if &e are able to accom!lish this, then &e &ill notice a drastic chan%e in the health of .alifornians, youn% and old, and &e &ill also notice a chan%e in health care s!endin%. (hrou%hout this analysis, I &ill introduce !olicies created to combat this e!idemic, em!irical facts concernin% the issue, and the history of it, the conse"uences of obesity if it is not controlled, and !ro!osals for ne& methods to sol*e this !roblem. /besity, a relati*ely ne& !roblem facin% !olitical matters, has already taken its toll on the li*es of !eo!le in .alifornia. #.alifornia residents ha*e %ained EC0 million !ounds of e)cess &ei%ht in the !ast ten years, a rate that is amon% the hi%hest in the country$ 6.alifornia /besity Pre*ention Plan7. /bese children are more than t&ice as

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likely to ha*e ty!e 2 diabetes as children of normal &ei%ht. If current trends continue, de*astatin% conse"uences may arise. 0)!erts &arn that one in three American children born in 2000, and half of all children from ethnicIracially di*erse !o!ulations, &ill suffer ty!e 2 diabetes durin% hisIher lifetime. In a 200= San Francisco article, # A((0A (1AF 0J0A Des!ite alarms o*er childhood obesity, .aliforniaHs kids are !ackin% on the !ounds$, .arl (. 1all says2 # itness5test scores in the !ublic schools sho&ed that about 2; of e*ery 100 schoolchildren in .alifornia &ere o*er&ei%ht in 200?, u! C !ercent from 2001, &hen a similar study &as done$. -tudies ha*e also sho&n a connection bet&een obesity and minorities. (he same studies conducted in the 1all article sho&ed Pacific Islanders had the hi%hest !ercenta%e of children o*er&ei%ht, at E=.: !ercent, follo&ed by Katinos at E=.? !ercent, American IndiansIAlaskan Fati*es at E1.B !ercent and African Americans at 2;.B !ercent. /nly 1B.: !ercent of Asians and 20.C !ercent of &hite children &ere in the o*er&ei%ht cate%ory. (he Ke%islati*e Black .aucus of .alifornia and the Katino Ke%islati*e .aucus of .alifornia ha*e already be%un to take incenti*es to sol*e this !roblem that is ne%ati*ely affectin% their communities. .ontro*ersies o*er &ho should be held accountable for the cause of obesity be%an to rise in .on%ress and also %ained the attention of !ublic officials, such as Go*ernor of .alifornia Arnold -ch&ar4ene%%er. While some ar%ue the res!onsibility of obesity lies &ith the indi*idual, others belie*e them to be the *ictims of the ei%ht hundred billion dollar food industries &ho #undermine %ood nutrition by stron%ly !romotin% sales of unhealthy food$ 6<raft and urlon% 2=:7. It then becomes e)tremely difficult to !romote a healthier lifestyle &hen #o*er ;0 !ercent of food !roducts bein% 8!romoted by food industries9 aimed at children are of !oor nutritional *alue$ 6.alifornia

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/besity Pre*ention Plan7. Because of the food industry, the #American diet$ mainly consists of foods hi%h in calories, fat, and cholesterol. As a result of the obese !o!ulation !lacin% the blame of their !oor health on food industries, in /ctober of 200= .on%ress !assed a bill that &ould ban obesity related la&suits a%ainst restaurants and food manufacturers. -u!!orters said the bill &as intended to !rioriti4e !ersonal res!onsibility amon% an increasin%ly obese American !o!ulation 6#.heesebur%er Bill$, .B- Fe&s7' for they also feared these la&suits could !otentially bankru!t the food industry. I find their claims to be inaccurate and lack substance because they fail to take into account the actual number of la&suits filed a%ainst restaurants and food manufacturers for obesity, &hich aren+t that many. 1o&e*er, there &as one case in !articular that %ained attention. In 2002, t&o Bron) teena%ers accused >cDonaldHs of makin% them fat by ser*in% them hi%hly !rocessed food that affected their health. A Lud%e tossed out the case a year later, but an a!!eals court reinstated !art of the suit in early 200= 6.heesebur%er Bill, .FF Politics7. Passin% this bill has caused tension and a di*ision of ideolo%y in the 1ouse. -ome committee members ar%ued that fast5food com!anies need to be held accountable for their harmful !roducts. Ae!resentati*e of .alifornia Bob ilner says2 #.on%ress has allo&ed the need of bi% cor!orations before the need of our children$ 6#.heesebur%er Bill$, .FF Politics7, &hile Ae!resentati*e of (e)as Kamar -mith belie*es2 #We should not encoura%e la&suits that blame others for our o&n choices and could bankru!t an entire industry$ 6.heesebur%er Bill, .B- Fe&s7.

.ontro*ersies concernin% the res!onsibility and causes of obesity are %ainin% the attention of academic !rofessional as &ell. In 200?, <elly Bro&nell, >arion Festle, and

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Aadley Balko &ere three indi*iduals &ho entered the realm of health care and contributed their intellectual insi%ht on obesity and %o*ernmental re%ulation on food industries. In a Times Magazine article, #Fot if blamin% the *ictim is Lust an e)cuse to let industry off the hook$, &ritten by <elly Bro&nell, Director of the Audd .enter for ood Policy and /besity at Gale 6 #<elly Bro&nell$7, and >arion Festle, a !rofessor of !ublic health at Fe& Gork ,ni*ersity, are moderates &ho e)!ress their *ie&s on the food industries+ and %o*ernment+s res!onsibility for the health of consumers. (hese t&o res!ected officials belie*e the %o*ernment has a res!onsibility to re%ulate the food industry because they are able to mani!ulate !eo!le to choice unhealthy food !roducts throu%h media and ad*ertisement, and the notion of !ersonal res!onsibility does not &ork because com!anies like >cDonalds s!end =00 million dollars on cam!ai%ns to ensure that !eo!le buy their !roducts. #8 ood industries !romoted9 unhealthy foods, !articularly to children. 0ach year kids see more than 10,000 food ads on (J alone, almost all for items like soft drinks, fast foods and su%ared cereals$ 6Bro&nell M Festle 17. 1o& are indi*iduals su!!ose to take !ersonal res!onsibility and eat healthier &hen they are constantly bein% fed an ima%e that !romotes an unhealthy lifestyle3 It the obese and o*er&ei%ht !o!ulation &ho are the *ictims and the food industries that are the crooks' stealin% and de!ri*in% !eo!le of any chance to eat healthier. I a%ree &ith Bro&nell and Festle in sayin%2 #!ersonal res!onsibility is a tra!$ 6Bro&nell and Festle7. #(he ar%ument is startlin%ly similar to the tobacco industry efforts to sta*e off le%islati*e and re%ulatory inter*entions. (he nation tolerated !ersonal5res!onsibility ar%uments from Bi% (obacco for decades &ith disastrous results$ 6Bro&nell and Festle7. (hey !arallel the obesity crisis to the tobacco industry to ser*e as an e)am!le. /ne idea

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Bro&nell belie*ed in that &as not !resented in the article &as #fat ta)$. at ta) is a ta) or surchar%e that is !laced u!on fattenin% foods, be*era%es or indi*iduals aim8ed9 to discoura%e unhealthy diets and offset the economic costs of obesity 6#fat ta)$7. #81e9 !ro!osed that re*enue from Lunk5food ta)es be used to subsidi4e more healthful foods and fund nutrition cam!ai%ns$ 6#fat ta)$7. 1e also belie*ed that if the !rices of the fatty and unhealthy foods &ent u!, then &e &ould see a si%nificant shift in consum!tion. What Bro&nell and Festle &ants us to understand is #%o*ernment should be doin% e*erythin% it can to create conditions that lead to healthy eatin%, su!!ort !arents in raisin% healthy children and make decisions in the interests of !ublic health rather than !ri*ate !rofit$ 6Bro&nell and Festle7. >ean&hile Balko, a liberal !olicy analyst at the .ato Institute, ar%ues in his article, #Go*ernment 1as Fo Business Interferin% &ith What Gou 0at$, that !eo!le should take res!onsibility for their o&n health. /n the other hand, &e ha*e food industries, !ro5business %rou!s, and Aadley Balko &ho counter critici4e the o!inions and beliefs e)!ressed by Bro&nell and Festle. Balko, an American Kibertarian &riter and s!eaker for the .ato Institute, belie*es that #instead of inter*enin% in the array of food o!tions a*ailable to Americans, our %o*ernment ou%ht to be &orkin% to foster a !ersonal sense of res!onsibility for our health and &ell5bein%$ 6Balko7. Balko makes it clear that be belie*es the food industries should not be held res!onsible for the health of others because it is a !ersonal res!onsibility. Balko o!ens his ar%ument by listin% initiati*es taken by %o*ernment and !olitical fi%ures to sol*e the issue of unhealthy eatin% and obesity. #-e*eral state le%islators and /akland, .alif., >ayor Nerry Bro&n, amon% others, ha*e called for a #fat ta)$ on hi%h5calorie foods. .on%ress is considerin%

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menu5labelin% le%islation that &ould force chain restaurants to list fat, sodium and calories for each itemO (his is !recisely the &ron% &ay to fi%ht obesity$ 6Balko7. Accordin% to Balko, %o*ernment re%ulation is not the solution to combat unhealthy eatin% and obesity. (he best &ay to sol*e obesity and unhealthy eatin% is to !romote self res!onsibility. Balko belie*es that if one is held res!onsible for the health care cost of unhealthy eatin%, then that indi*idual &ould alter his or hers diet. #(he best &ay to combat the !ublic5health threat of obesity is to remo*e obesity from the realm of #!ublic health$ $6 Balko7. Fot only does Balko !resent us &ith a lo%ical fallacy, but this idea also !romotes discriminations a%ainst minorities, the !oor, and indi*iduals &ith disabilities or a biolo%ical link to obesity. (he notion that Balko belie*es only throu%h a certain method &ill this !roblem be sol*ed makes it a lo%ical fallacy. Because healthcare and obesity is a com!le) issue, there are multi!le &ays to address the issue. -ince studies ha*e sho&n that obesity is concentrated in a certain area, it is only natural to belie*e this !lan is tar%eted to&ards that s!ecific %rou!. #(his e!idemic affects *irtually all a%es, educational, ethnic, and disability %rou!s, althou%h rates are hi%hest amon% Katinos and African Americans &ith lo&er incomes and disabilities. Balko &ishes to cut obesity from healthcare. What he fails to reali4e is this sho&s discrimination to&ard certain %rou!s. What about the indi*iduals &ho ha*e disabilities3 What about the !eo!le &ho li*e in metro!olitan areas &here healthier o!tions are not a*ailable3 What about those &ho can+t afford to eat healthier3 Balko+s solution to cut obesity from healthcare sho&s !reLudice and discrimination to&ards those %rou!s. Balko also belie*es that health should be a !ri*ate issue and res!onsibility, not a !ublic one. #Gi*e Americans moral financial and !ersonal res!onsibility for their o&n health, and obesity is no lon%er a

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!ublic matter but a !ri*ate oneP&ith all the cost, concerns and &orries of bein% o*er&ei%ht borne only by those !eo!le &ho are actually o*er&ei%ht. Balko tries to create a se!aration bet&een those &ho are o*er&ei%ht and those &ho aren+t, &hich is also another form of discrimination. Because I am o*er&ei%ht, and you are thin, should that affect our healthcare cost3 What Balko &ants is for !eo!le #to take res!onsibility for 8their9 diet and lifestyle. 8(hey+re9 likely to make better decisions &hen someone else isn+t !ayin% for the conse"uences$ 6Balko7. Because the obesity crisis has sho&n minimal !ro%ress, in -e!tember of 200C, Go*ernor of .alifornia Arnold -ch&ar4ene%%er &orked collaborati*ely &ith -ecretary of the 1ealth and 1uman -er*ice A%ency <imberly Belshe and Director -andra -he&ry to create Get Healthy California- California Obesity Prevention Plan: A ision for Tomorro!" Strategic Action for Tomorro!# a !re*entati*e health care !lan to combat the obesity e!idemic facin% .alifornians. Pre*entati*e health care is # the !romotion of health and !re*ention of disease in indi*iduals throu%h such actions as routine screenin% for serious diseases' better treatment of chronic illnesses' im!ro*ed health care education' and more attention to the role of diet, e)ercise, smokin%, and other lifestyle choices$ 6<raft and urlon% ?=B7. (his California Obesity Prevention Plan is meant to ser*e as a s!rin%board for %o*ernment, businesses, *oluntary and !hilanthro!ic sectors to con*ert fra%mentation into collaboration and syner%y, to carefully ali%n and in*est resources, and create a shared res!onse to a societal crisis 6.alifornia /besity Pre*ention Plan7. (his !lan offers a thorou%h analysis and e)!lanation for the failure of !re*ious attem!ts to sol*e this !roblem. It also !ro!oses a !lan for action.

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The California Obesity Prevention Plan su%%ests that obesity and the the reasons for !re*ious failed attem!ts to sol*e obesity are based on three !rinci!le factors2 !oor nutrition and inacti*ity, com!etin% en*ironmental forces, and fra%mented, uncoordinated efforts. Poor nutrition and inacti*ity are causin% serious health !roblems, includin% ty!e 2 diabetes, stroke, heart disease, and no& comes cancers. If left unchecked, they habits can lead to &orsenin% conditions in the future. .om!etin% en*ironmental forces !lays a substantial role in contributin% to the de*elo!ment of obesity. While obesity results most directly from choices indi*iduals make re%ardin% !hysical acti*ity and diet, stron% en*ironmental forces influences those choices. A si%nificant factor as to &hy !eo!le make the choices they do &hen it comes to food is because of con*enience and !rice. It also because a matter of a*ailability and access. #(oo many lo&5income families must tra*el miles outside their communities to !urchase healthy foods at reasonable !rices' the hi%her the concentration of !o*erty &ithin the community, the fe&er the su!ermarkets. /ne study found that children &ho li*ed in metro!olitan areas &here fruits and *e%etable &ere relati*ely e)!ensi*e %ained si%nificantly more &ei%ht than children &ho li*ed &here fruits and *e%etables &ere chea!er$ 6.alifornia /besity Pre*ention Plan7. (ele*ision also influences &hat &e eat. (ele*ision ads, the Internet, %ames, and the strate%ic !roduct !lacement stron%ly influence children to !refer and re"uest hi%h5calorie, lo&5 nutrient foods and be*era%es. Fationally, EE billion dollars are s!ent on food marketin% each year 6.alifornia /besity Pre*ention Plan7. It also becomes difficult for children to %et the recommended thirty to si)ty minutes of daily !hysical acti*ity if nei%hborhoods lack safety and the lack of !ro!er facilities. #,nsafe streets and lack of safe !lay areas and !arks kee! children

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from bein% acti*e outside. (hose most at risk to be o*er&ei%ht, lo&5income, ethnicallyIracially di*erse communities, ha*e the least access to !arks, bike trials, and !ublic !ools. After analy4in% the causes of obesity, I disco*ered another !roblem, lack of access and sufficient "uality in under !ri*ile%ed communities. I disco*ered a linka%e bet&een obesity and lo&5income and ethnically and racially di*erse communities. urthermore, I belie*e it is e*en more crucial to find an actionable solution to this !roblem because if &e are able to sol*e the obesity crisis, &e &ill be able to sol*e other !roblems that affect that same %rou!. As time !rocesses and obesity becomes a bi%%er issue, %o*ernment, businesses, and other sectors be%in to reali4e their res!onsibilities and roles in findin% solutions. 1o&e*er, their efforts are not coordinated and therefore do not achie*e ma)imum im!act. #Aeal chan%e &ill occur &hen %o*ernment, business, a%riculture, schools, land use !lanners, de*elo!ers, trans!ortation, retailers, !ublic safety, health care, and media be%in to &ork to%ether !roacti*ely and collaborati*ely to create en*ironments that allo& !eo!le to safely inte%rate e*eryday !hysical acti*ity such as bicyclin% or &alkin% into their li*es and to easily access affordable, healthy foods. In reco%nition of .alifornia+s %ro&in% obesity e!idemic, com!etin% en*ironmental forces and fra%mented, uncoordinated efforts across !ri*ate and !ublic sectors, the Ke%islature mandated that .alifornia De!artment of 1ealth -er*ices create this strate%ic !lan to coordinate e)istin% resources and to %uide a state&ide res!onse to the obesity crisis. 6Bud%et Act of 200=, -B BB, Item Q ?2C0.001.0001, Pro*ision B.7. (he %oal in this !lan build on current !ro%rams, e)istin% infrastructure, and best !ractices throu%h en%a%ement of business, !hilanthro!ic, *oluntary, and %o*ernment sectors as e"ual !artners 6.alifornia /besity Pre*ention Plan7.

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(o start the mo*ement, in 200= Go*ernor of .alifornia Arnold -ch&ar4ene%%er, &ho is *ery !assionate about healthy eatin% and !uttin% an end to obesity, s!onsored and si%ned le%islation bannin% Lunk food from schools, e)tended to hi%h schools a la& bannin% sodas in elementary and middle schools, and !ro*ided fundin% for fresh fruits and *e%etables in school means. (his &as the first initiati*e taken in riddin% the school en*ironment of hi%h calorie, lo& nutrient foods and be*era%es that contribute to childhood obesity. (o further sho& his commitment, the Go*ernor si%ned a 200C bud%et that &ould s!onsor and !romote a healthier &ay of eatin% and li*in%2 D?0 million in on%oin% %rants to hire more credentialed !hysical education 6P07 teachers to hel! kids de*elo! healthy, life5lon% habits' D=00 million for the !urchase of P0, arts, andIor music su!!lies and e"ui!ment to im!ro*e and e)!and the infrastructure of school !ro%rams' DE million to meet an increased demand for the -chool Breakfast Pro%ram and the .alifornia resh -tart Pilot Pro%ram to increase the number of students recei*in% nutritious breakfast that include more fruit and *e%etable choices' and D1=million to re*itali4e the -chool Garden Pro%ram so that students can e)!erience the im!ortant educational benefits of %ro&in% fruit *e%etables, and !lants.

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(his !lan identifies !olicy strate%ies to make sustainable chan%es in the en*ironment that &ill result in !hysical acti*ity o!!ortunities and access to healthy affordable foods 6.alifornia /besity Pre*ention Plan7. (his !lan uses the strate%ic action taken &ith The Tobacco $%&erience used to !romote an en*ironmental chan%e in smokin% ' (obacco control efforts be%an at the federal le*el &ith reco%nition of the ad*erse health efforts of tobacco use, the first ste! in the en*ironmental chan%e model. A&areness and education efforts continued &ith the 1:CE ,.-. -ur%eon General+s re!ort that documented tobacco as harmful. ederal action re"uired &arnin% labels on ci%arettes follo&ed by a ban on tele*ision ads to break the association bet&een %lamorous lifestyle and smokin% 6.alifornia /besity Pre*ention Plan7. /fficials belie*e that because of the success of the tobacco !re*ention !lan, results of a !lan for obesity &ould be similar if they follo& the same structure. (he !roblem &ith tryin% to recreate a !lan such as the (obacco 0)!erience to sol*e this obesity crisis is you don+t need to smoke to li*e' it isn+t a necessity. It then creates contro*ersies' &ill a !lan that &as created for smokin% be Lust as successful for eatin% healthy3 It becomes a debate of #smokin% *s. eatin%$. I belie*e a !re*ention !lan similar the (obacco 0)!erience &ould not be successful because of the *ery different circumstances of each !roblem. -mokin% re"uires a le%al limit, &hile eatin% unhealthy food does not. 0atin% is a necessity to li*e, &hile smokin% is a social habit' it is an o!tion and is not re"uired for sur*i*al. #(he Plan2 Aecommendations for Action$, based on the best !ractice tobacco e)!erience, are deri*ed from a number of ad*isory %rou!s, forums, and meetin%s that re*ie&ed o!tions to create a healthier en*ironment. (he

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.alifornia De!artment of 1uman -er*ices has created a four ste! !lan they belie*e offers the most !romise to achie*e a healthier .alifornia. (he first %oal is to #ensure state le*el leadershi! and coordination that reaches into communities across the state$. .ommunication is key. .reatin% a central !oint of contact &ithin state %o*ernment &ould hel! coordinate local efforts at !romotin% com!rehensi*e and effecti*e a!!roaches to im!ro*e the nutrition and !hysical acti*ity of community members. Workin% &ith different sectors such as schools, entertainment, em!loyers, and health care, &ould hel! to !romote an acti*e li*in% and healthy eatin% en*ironments. (he !rimary function of the central !oint of contact &ould act as a catalyst to initiate !olicy and systems chan%e to create an inte%rated, consistent a!!roach to acti*e li*in% and healthy eatin% issues in .alifornia. (he second %oal is to #create a state&ide !ublic education cam!ai%n that frames healthy eatin% and acti*e li*in% as .alifornia li*in%$. .reatin% a state&ide media cam!ai%n &ould be an effecti*e &ay to reach the attention of both adults and youth. (he cam!ai%n &ould focus on counterin% the !romotion of unhealthy foods' !romotin% !hysical acti*ity in school, &ork, and !lay' reducin% the a!!eal and access of funk food to youth, and transformin% the #American diet$ and lifestyle to one that is healthy and encoura%es fun acti*ity. A &ay to broadcast this cam!ai%n &ould be throu%h radio, tele*ision, billboard, and !rint ad*ertisin%. (he third %oal &ould be to #su!!orts local assistance %rants and im!lements multi5sectoral !olicy strate%ies to create healthy eatin% and acti*e li*in% community en*ironments$. If healthier choices become more accessible, affordable, and socially

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acce!table, then .alifornia &ould see a shift to&ards healthier lifestyles. All it takes is im!ro*in% access, !romotion, and !artici!ation in a healthier diet and acti*e li*in% to create a chan%e in the !hysical and social en*ironments. Aecommendations for these actions ha*e been created for all sectors ran%in% from %o*ernment to restaurants. Go*ernment should make !re*ention a #to! !riority$ in state and local health de!artments. (he !roblem I ha*e disco*ered &ith that is !re*ention !ro%rams ma)imi4e the time, effort, and money of %o*ernment. rom the outside lookin% in, &e see little concern and effort bein% !ut into !re*ention !ro%rams for obesity, but they are *ery e)!ensi*e and time consumin%. Fot to discredit the se*erity of obesity, but I belie*e that if %o*ernment !laces too much attention and effort on obesity, it may take a&ay time and funds for !roblems that are more im!ortant. Go*ernment is also recommended to encoura%e full access to !ublic facilities, such as community centers, schools, and %o*ernment buildin%s, &hich !ro*ide !ro%rams and ser*ices that increase the amount of daily !hysical acti*ity. Also !olicies that !ro*ide access to o!tions for healthier eatin% and !hysical acti*ity, and ensure that food assistance !ro%rams !ro*ide healthy foods should be de*elo!ed. Businesses should consider offerin% !hysical acti*ity, healthier food o!tions, and lactation accommodations for their em!loyees. -tate and local %o*ernment should also identify sources to fund !roLects for maintenance, rehabilitation, and de*elo!ment of !arks, community %ardens, su!ermarkets, farmer+s markets, and recreational facilities in all nei%hborhoods. (his is a %ood &ay to combat obesity because it %i*es indi*iduals the o!!ortunity to en%a%e in !hysical acti*ity, and it is a &ay to build u! lo&5income, ethnically and racially di*erse communities. I belie*e if these communities ha*e the !ro!er facilities, then &e &ill notice a si%nificant decrease in

Walker 1C

obesity for them. -ection E.2b states em!loyers should offer healthy food at meetin%s and e*ents, and !ro*ide incenti*es to em!loyees &ho &alk, bike, or use !ublic trans!ortation to commute to and from &ork. 0m!loyers should encoura%e !hysical acti*ity by !romotin% stair&ay use, !ro*idin% bake racks, and offer fle) time or breaks for !hysical acti*ity. (he !roblem &ith this is em!loyees may abuse these break !ri*ile%es and use the desi%nated !hysical acti*ity time to en%a%e in other acti*ities. It may also be difficult to monitor &ho is actually usin% the time for !hysical acti*ity. (his could also cause a decrease in com!any !roducti*ity. 1ealth care insurers can contribute by !romotin% !re*ention as the first ste! in res!onse to obesity. (his could !re*ent bariatric sur%ery and !harmaceuticals that are *ery e)!ensi*e. 1ealth care !ro*iders should su!!ort ne& mothers in !rolon%in% breastfeedin% because it hel!s !rotect children a%ainst obesity. amilies can do their !art by eatin% at least one healthy meal a day as a family. Parents should monitor and reduce the *ie&in% time of tele*ision and com!uter %ames their children !artake in. amilies should encoura%e their children to !artici!ate in !hysical acti*ity by !artici!atin% in fun !hysical acti*ities as a family. Another recommendation is to monitor !ortions and reduce the consum!tion of soft drinks and foods &ith hi%h amounts of su%ar and fat. In section E.2e, schools are e)!ected ensure that children recei*e "uality !hysical education and !ro*ide healthy food and be*era%es for all meals a*ailable for k512 students and after5 school !ro%rams. -chools should ad*ertise healthy foods and be*era%es on school %rounds, and !ro*ide a nutritious breakfast usin% the federal -chool Breakfast Pro%ram. (hey should also make school recreational facilities a*ailable for after5hours by the community. (his &ould allo& the indi*iduals &ho li*e in communities that lack facilities

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to %et the !hysical acti*ity they need. ood and be*era%e industries should ad*ertise and !romote healthy foods and be*era%es to children and youth throu%h tele*ision, !rint, celebrity endorsements, and cartoon characters. Aestaurants should !ost calorie information on menus so costumers &ill kno& information on the meals they are consumin% and be encoura%ed to choose healthier o!tions on the menu. (he fourth and final %oal calls to #create and im!lement a state&ide trackin% and e*aluation system$. By creatin% a coordinated and systematic a!!roach to trackin% and e*aluatin% obesity, its risk factors, and health im!act then state %o*ernment has the ability to make the information a*ailable and accessible to the community, !ro%rams, and !olicymakers. After e*aluatin% the information, !ro!osals, and recommendations offered by *arious sectors of %o*ernment, I ha*e de*elo!ed a better understandin% of the !olicy concerns facin% obesity' &ith this ne& found kno&led%e, I ha*e created my o&n solutions to this !roblem. irst, to address the California Obesity Prevention Plan, I find it to be a *ery thorou%h and detailed !lan for action. 1o&e*er, I belie*e &ith cases such as obesity, more than a #!lan$ is in need. It becomes *ery difficult to do more and im!lement more la&s and re%ulation because it is not ille%al to be o*er&ei%ht or obese. (he !lan offers multi!le su%%estions and recommendations but it seems the element of reality are absent from some of these recommendations. (he !lan e)!ects for !eo!le to drastically alter their li*es, but the reality of the situation is much different. (oday+s society is molded and dri*en by the mass media, and the mass media is constantly feedin% us this ima%e of an unhealthy life style. And because businesses are !rotected from la&s that !re*ent !eo!le from filin% la&suits a%ainst them, they &ill continue to

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manufacture these !roducts. I belie*e to sol*e the obesity crisis &e must restrict and re%ulate freed. Pre*ious attem!ts to sol*e obesity %a*e !eo!le o!tions. (hese o!tions include the choice and access to healthier foods, but today !eo!le i%nore those o!tions and continue to choose the unhealthy foods and be*era%es. Althou%h it may be difficult or im!ossible to tell control &hat adults eat, it is not too late to restrict the o!tions of children. Instead of children ha*in% the o!tion to choice a sub or a !i44a, make the sub the only o!tion a*ailable. I belie*e if this action is carried out, children &ould be forced to choose healthier o!tions and e*entually start to choose them on their o&n. A &ay to reach the adults, I belie*e &e must force on an area that &ould %ain their attention and hit them the hardest' their &allets. If state health care !ro*iders &ere to alter their re"uirements for co*era%e, !eo!le &ould be forced to chan%e their lifestyle to fit those re"uirements. ,nlike >edicare, >edicaid is a !ro%ram &here there e)!enses are di*ided amon% the federal %o*ernment and the state. Because the state co*ers half of the medical e)!enses, they are able to set their o&n re"uirements for co*era%e. (he states are free to set the eli%ibility le*els 6<raft and urlon% 2?E7. -ince maLority of the obese !o!ulation in .alifornia are lo&5income indi*iduals, &e can assume they are co*ered by >edical. If &e alter the health re"uirements, that may encoura%e !eo!le to start makin% better choices so they &ill be able to recei*e those benefits. /besity has been !ro*en to be a *ery com!licated and difficult !roblem to sol*e. (here is no #ri%ht$ &ay or one s!ecific &ay to combat obesity. 1o&e*er, I belie*e the !olicy analysis I ha*e !resented &ould be a start and an effecti*e &ay to sol*e this crisis.

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Works .ited Balko, Aadley. #Go*ernment 1as Fo Business Interferin% With What Gou 0at.$ C Nune 200?. Print. Bro&nell, <elly and >arion Festle. #Fot if blamin% the *ictim is Lust an e)cuse to let industry off the hook.$ Time Magazine Nune 200? 152. Print. California Obesity Prevention Plan: A ision for Tomorro!" StrategicAction for To(ay . 200?. 152E. Print. #.heesebur%er Bill.$ C)S *e!s: Health +atch' Web>D, Inc. n.d. Web. ; Dec 2010. #.heesebur%er Bill.$ C** Politics' (urner Braodcastin% -ystem, Inc. n.d. Web. ; Dec 2010. #.hild 1ealth and Disability Pre*ention Pro%ram.$ American >edical Association 200B 0)!ert .ommittee Aecs.2 152. Aca(emic Search Premier. Web 10 Dec 2010. # at ta).$ +i,i&e(ia. Wiki!edia oundation ,Inc. ? Dec 2010. Web. 10 Dec 2010. urlon%, >ichael 0. <raft. P-blic Policy: Politics" Analysis" an( Alternatives . .R Press, 200:. Print.

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1all, .arl (. # A((0A (1AF 0J0A Des!ite alarms o*er childhood obesity, .aliforniaHs kids are !ackin% on the !ounds.$ San Francisco Chronicle 2= Au% 200=. Print. #<elly Bro&nell.$ +i,i&e(ia. Wiki!edia oundation, Inc. ? /ct. 2010. Web. ; Dec 2010. #/*er&ei%ht and /besity.$ Center of .isease Control an( Prevention' ; /ct. Web. ; Dec 2010.

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