Mar 6, 2014 - Forest Lake) and Rep. Kim Norton (DFL-Rochester). Current members of the working group are: Rep. Yvonne Se
Minnesota Childhood Obesity Legislative Working Group A bipartisan and bicameral working group with a goal to reverse Minnesota’s childhood obesity trend
2014 LEGISLATIVE RECOMMENDATIONS
OVERVIEW Obesity is one of the most serious public-health crises facing the United States today. According to researchers at the U.S. Centers for Disease Control and Prevention (CDC), rates of childhood obesity have remained statistically the same for the past 10 years, with the exception of the prevalence of obesity among boys (2 to 19 years old) increasing from 14 percent in 1999 to 2000 to 18.6 percent in 2009-2010.i However, rates of obesity among children ages 2 to 19 are still far too high—more than triple what they were in 1980. According to the most recent National Health and Nutrition Examination Survey (NHANES), 16.9 percent of children ages 2 to 19 are obese, and 31.7 percent are overweight or obese. This translates to more than 12 million children and adolescents who are obese and more than 23 million who are either obese or overweight.ii Minnesota is no exception to this public-health crisis. According to the Minnesota Department of Health (MDH), as of 2010 obesity stood at 24.5 percent, up from 15.3 percent in 1995.iii The rates of obesity among Minnesota youth are equally troubling, especially when one considers that behavior established in childhood can follow an adolescent as they grow into adulthood. According to the Minnesota Department of Education’s 2007 student survey, childhood obesity and overweight statistics stood at:
Graphic from Minnesota Department of Health
For 9th grade students, 15 percent of males and 11 percent of females are overweight For 9th grade students, 12 percent of males and 6 percent of females are obese Among 12th grade students, 12 percent of males and 11 percent of females are overweight Among 12th grade students, 13 percent of males and 6 percent of females are obeseiv
The public health impacts of obesity are staggering. Children and adolescents who are overweight or obese have a greater risk for development and early onset of a wide variety of chronic diseases and health conditions during adulthood. Overweight children and adolescents are at a higher risk of experiencing risk factors such as hypertension, high cholesterol and type 2 diabetes. Being obese or overweight as a child or adolescent can place that individual at higher risk for serious, even life-threatening health problems such as heart disease, stroke, diabetes, some cancers, depression and osteoarthritis.v The economic costs of obesity are equally staggering. In addition to its serious health consequences, childhood obesity has real economic costs that affect all of us. The cost of adult obesity nationally is estimated to be as high as $147 billion each year, and childhood obesity costs an estimated $14 billion per year in medical care alone.vi A study by Blue Cross and Blue Shield of Minnesota and the MDH found that if Minnesota's obesity rate continues to rise at current levels, Minnesotans will pay an addition $3.7 billion a year in health care costs by 2020.viiThe epidemic is also a leading cause of worker sick days and school absenteeism — trends that jeopardize our nation’s economic strength. And military leaders have warned that childhood obesity threatens our national security, because fewer young people are fit for military service.
Graphic from Minnesota Department of Health
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REDUCING OBESITY AMONG CHILDREN AND ADOLESCENTS The causes of obesity are well known — unhealthy eating and a lack of physical activity.viii According to the CDC, to reverse the obesity epidemic, places and practices need to support healthy eating and active living in many settings. States like Minnesota have the ability to help reduce the incidence of obesity by working with organizations and communities to implement broad-based strategies designed to make healthier choices easier for children and adolescents and their families. When children have safe places to walk, bike and play in their communities — like parks, playgrounds and after-school programs, they’re more likely to be active and less likely to be obese. It’s the same with healthy food: When communities have access to healthy, affordable foods, families eat better. Even the best efforts to educate families to exercise more and eat better will be unsuccessful if they don’t have the resources or tools to make those choices.
CHILDHOOD OBESITY LEGISLATIVE WORKING GROUP BACKGROUND Recognizing the seriousness of the public-health crisis associated with obesity and its impacts on all Minnesotans, the COLWG was formed in 2009 to bring both Minnesota legislative bodies and both parties together to look at state policy solutions to help reduce the childhood obesity problem. Members of the Legislature recognized that if steps could be taken to reduce obesity among children and adolescents, the positive impacts of those actions would help to reduce obesity among all Minnesotans. As an informal group, membership of the working group has been fluid as it has looked at different issues, but has consistently brought Republicans and Democrats of both legislative bodies together with a solution-oriented focus. Throughout its tenure, much of its work has been informed by a cadre of childhood obesity researchers at the University of Minnesota led by Dr. Susie Nanney. Co-chairs of the working group are Rep. Bob Dettmer (RForest Lake) and Rep. Kim Norton (DFL-Rochester). Current members of the working group are: Rep. Yvonne Selcer (DFL-Minnetonka), Rep. JoAnn Ward (DFL-Woodbury), Rep. Laurie Halverson (DFL-Eagan), Rep. Karen Clark (DFL-Minneapolis), Sen. Alice Johnson (DFL-Spring Lake Park), Rep. Tim Faust (DFL-Hinckley) and Sen. Chuck Wiger (DFL-Maplewood). A wide variety of stakeholders have been involved in the work of the COLWG, including the University of Minnesota, the American Heart Association, the Minnesotans for Healthy Kids Coalition, the Minnesota Academy of Nutrition and Dietetics, Blue Cross and Blue Shield of Minnesota, among others. State agency staff from Minnesota Department of Health and Minnesota Department of Education have provided information throughout the group’s work.
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2014 LEGISLATIVE SESSION RECOMMENDATIONS The COLWG is endorsing the following pieces of legislation because of their potential to reduce obesity among Minnesota’s children and adolescents: Safe Routes to School (Franzen SF687/Hortman HF797) The COLWG supports providing $6 million in bonding dollars for infrastructure funding for the Minnesota Safe Routes to School program. The funding would be used to help build infrastructure throughout Minnesota, including sidewalks and improved pedestrian crossings, to make it easier and safer for Minnesota students to walk or bike to school. Current funding levels under the federal SRTS program fall far short of Minnesota’s needs. In the last federal funding cycle, the Minnesota Department of Transportation received 63 applications from localities requesting $15 million for SRTS infrastructure but only $6.7 million was available through the federal program. In addition, federal funding for the program has now been exhausted. The benefits of walking or biking to school are well known. Studies have found a strong correlation between physical activity and students’ academic performance. Pediatric physicians have linked the obesity epidemic to unhealthy eating and a lack of physical fitness. Walking one mile to and from school each day equals two‐thirds of the recommended level of physical activity per day. Require that Minnesota Department of Education prepare a report on the status of physical education in Minnesota schools, including quality and quantity of physical education (Sen. Kent SF2207/Rep. Norton HF 2672) In 2010, the Minnesota Legislature passed and Governor Pawlenty signed into law a requirement that all school districts include a physical education minimum standards component in their curriculum. This law has been in place for nearly four years, and has been implemented by all school districts and charter schools since the beginning of the 2012-2013 school year. This specific proposal asks MDE to provide the Legislature with a summary detailing how much time Minnesota students spend in physical education, how schools are measuring and assessing students’ fitness levels, how much of that time is being taught by a certified fitness instructor and how much physical activity kids are getting through the course of the day. The U.S. CDC recommends that children receive 150 minutes per week of physical education in elementary school and 225 minutes per week in middle school and high school.ix This legislation is designed to determine if Minnesota’s schools are achieving those recommended levels of physical education. Provide $65,000 for an Amateur Sports Commission Childhood Obesity Pilot program (Sen. Johnson SF 2511/Rep. Hortman HF1573) This pilot program is designed to develop a model childhood obesity intervention program. The after-school program will be targeted for children who don’t traditionally participate in athletic activities. The program is designed to maintain and enhance fitness, nutrition and health with a special emphasis for at-risk children. The multidisciplinary intervention techniques will be rigorously evaluated by a team from the University of Minnesota. The funds will be used to reduce program costs to make it more affordable for participants. Expand access to free school lunch by eliminating the 40 cent fee currently paid by working class poor families for a reduced-price lunch (Rep. Selcer HF2480/ Sen. Hayden SF146) The health benefits of free and reduced-price school breakfasts and lunches are well known. Children and adolescents who eat healthy meals are less likely to be obese or overweight. So too, their academic performance in school is better. Free and reduced-price school lunches are designed to provide healthy, nutritious meals for children who may not otherwise have access to a proper diet. These meals often feed children and adolescents who live in food-insecure households or who may have inadequate access to the necessary calories and nutrients for good health and school performance. Eliminating the 40 cent fee currently paid by working class poor families will help to increase the number of students from those families who will eat the lunches, thereby gaining nutritional and educational benefits they may not be receiving now. 4
PAST LEGISLATIVE ENDORSEMENTS Some of the past Minnesota legislative successes that the COLWG has been involved in include:
Legislation to enact statewide physical education standards to create a standard for quality PE across the state and a report recommending active recess guidelines for schools (guidelines may be found at: http://education.state.mn.us/MDE/StuSuc/Nutr/PhyActiv/053514) (2010)
Statewide Complete Streets legislation (2010)
Legislation to clarify the limits of liability when schools open their doors to community members for physical activity (2011)
Legislation to establish a state-level Safe Routes to School Program, and securing non-infrastructure funding of $250,000 per year (2012-2013)
Legislation to fund the Statewide Health Improvement Program (SHIP)—a state-based grant program that supports local strategies to reduce obesity through evidence-based strategies. Many of the strategies considered by the working group have been pursued at the local level through support from SHIP, such as Farm to School initiatives, daycare practices that focus on healthy food and physical activity, and a long list of local initiatives to reduce obesity. (2009-2013)
2010 Legislative Session: Primary legislation was the Healthy Kids Act COLWG Recommendation 1. Physical Education Adopt statewide physical education standards based on current national standards or statelevel benchmarks, which allows school districts flexibility of implementation and access to federal grant funding. As part of regular, annual data collection, require the Department of Education to collect annual data from school districts on PE classes, physical education standards, and graduation requirements. 2. Physical Activity Integrate physical activity into non-physical education classes, recess and extra-curricular activities throughout the school day using PE teachers as a resource. Encourage at least 60 minutes of quality physical activity be available daily in a school environment. When appropriate, incorporate physical activity or outdoor education into environmental and natural resource services and programs.
Result: Passed and standards must be adopted by 2012-13 school year. (Ch. 396)
Passed and was signed by Governor. (Ch. 396)
Healthy Kids Awards program will reward schools for integrating physical education. (Ch. 396)
Healthy Kids Awards program will reward schools for promoting 60 minutes/day if adopted in criteria. (Ch. 396) Funded as part of LCCMR bill: $300,000 to MDE for integration of outdoor education in curriculum standards for grades 7-12. (Ch. 362 Sec. 2 Subd. 8) 5
3. Recess Promote quality recess guidelines that engage all students, increase their activity levels, build social skills, and decrease behavioral issues. Allow SHIP funds to be used to assure quality physical activity during recess as well as in before and after school opportunities. Discourage recess from being taken away from students as a form of punishment. 4. Transportation Ensure children can safely walk and bike to school and throughout the community by authorizing the Complete Streets proposal. Complete Streets policy creates safer roadways for bicyclists and pedestrians and encourages physical activity as well as promoting safe routes to school. 5. Nutrition Support a resolution declaring Farm to School week in September 2010. Allow SHIP funds to be used to implement policies that require nutritious food and beverage options in schools and Farm to School programs 6. Misc. School districts post school wellness policies on local school district website when available. Maintain the Legislature’s commitment of funds to the Statewide Health Improvement Program (SHIP) to implement effective population-based strategies to prevent chronic disease and contain health care costs.
2011 Legislative Session: COLWG Recommendation Support the clarification of school liability protection for shared recreational use of school resources—promote school facilities to be used as a resource for physical activity by the community Fund the Statewide Health Improvement Program (SHIP)—continue program that is promoting healthy activity and eating at school and community level
MDE was encouraged to develop recess guidelines as part of Healthy Kids legislation that passed. (Ch. 396)
SHIP program allows this activity for grantees.
Could be incorporated in guidelines above. (Ch. 396) Legislation passed and was signed by Governor. (Ch. 351)
Governor’s Proclamation was secured. SHIP program allows this activity for grantees.
Part of Healthy Kids legislation that passed. (Ch. 396)
Funding for SHIP was preserved despite proposed budget cuts (funded for the biennium at $47 million).
Result: Passed into law and signed by Governor Dayton
Program was funded at $15 million for the biennium.
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2012 Legislative Session: COLWG Recommendation Establish and support funding for the Safe Routes to School program to fund infrastructure that will enable children to more safely walk or bicycle to school Fund SHIP to return to a statewide scope and ensure sustainable ongoing funding. 2013 Legislative Session: COLWG Recommendation Fund the Safe Routes to School program to fund both program costs and infrastructure that will enable children to more safely walk or bicycle to school Fund SHIP to return to a statewide scope and ensure sustainable ongoing funding.
Support funding for Farm to School programs
School meal reimbursement rate increase (2 cents per meal) to support the improved federal school meal standards
Result: Minnesota Safe Routes to School program was established in state law. No funding was attached to the program. Funding for SHIP was preserved.
Result: Minnesota Safe Routes to School program received $250,000 per year in base funding through MnDOT. This is the first-ever investment in SRTS by the state. SHIP was funded at $35 million per biennium in the base funding for MN Dept. of Health. This will ensure the program returns to statewide scope and the ongoing funding in the base will allow these strategies to demonstrate results. Funded at $3 million for the biennium in the MN Dept. of Ag. budget Reimbursement rate for school meals was increased by 1/2 cent per meal
Endnotes i
F as in Fat: How Obesity is Threatening America's Future, Trust for America's Health and the Robert Wood Johnson Foundation, http://fasinfat.org/methodology/ (March 6, 2014) ii U.S. Centers for Disease Control and Prevention, Prevalence of Obesity Among Children and Adolescents: United States, Trends 1963-1965 Through 2007-2008, http://www.cdc.gov/nchs/data/hestat/obesity_child_07_08/obesity_child_07_08.htm (March 6, 2014) iii Minnesota Department of Health, Overweight and Obesity Prevention, http://www.health.state.mn.us/cdrr/obesity/ (March 6, 2014) iv Minnesota Department of Health, Overweight and Obesity Prevention: Childhood Obesity, http://www.health.state.mn.us/divs/hpcd/chp/cdrr/obesity/pdfdocs/childrenoverwightfactsheet.pdf (March 6, 2014) v U.S. Centers for Disease Control and Prevention, Adolescent and School Health: Childhood Obesity Facts http://www.cdc.gov/healthyyouth/obesity/facts.htm, (March 6, 2014) vi U.S. Centers for Disease Control and Prevention, Overweight and Obesity: Adult Obesity Facts, http://www.cdc.gov/obesity/adult/causes/index.html (March 6, 2014) vii Obesity and Future Health Care Costs: A Portrait of Two Minnesotas, Minnesota Department of Health and Blue Cross and Blue Shield of Minnesota, January 2008, http://www.preventionminnesota.com/objects/pdfs/TwoMNsExecSum_spreads.pdf (March 6, 2014) viii U.S. Centers for Disease Control and Prevention, Overweight and Obesity: Adult Obesity Facts, http://www.cdc.gov/obesity/adult/causes/index.html (March 6, 2014) ix U.S. Centers for Disease Control and Prevention, Physical Activity, http://www.cdc.gov/physicalactivity/everyone/guidelines/children.html
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