Border Obesity Prevention (BOP):
Development of a binational strategic framework
Prevención de la Obesidad en la
Frontera (POF):
Desarrollo de un marco estratégico binacional
Ronald J. Dutton, PhD
and Allison Banicki, PhD
Obesity among adults (2012)
Source: Organization for Economic Cooperation and Development (OECD)
USA No. 1
Mexico No. 2
Childhood obesity in the U.S. (2011-12)
• Children and adolescents aged 2-19 years,
the prevalence of obesity has remained fairly
stable at about 17%.
• The prevalence among children and
adolescents was higher among Hispanics
(22.4%) and non-Hispanic blacks (20.2%)
than among non-Hispanic whites (14.1%).
• Ref: www.cdc/obesity/data/childhood.html
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Prevalence of obesity in
Mexican adults, 2012
• The epidemic of overweight and obesity in Mexico is
affecting men and women of all ages, regions, urban
and rural areas, SES and levels of educational
attainment.
• The prevalence of abdominal obesity was:
• higher in northern Mexico than in less developed areas (central and
southern regions, not including Mexico city).
• higher in urban areas than in rural areas.
• higher among those of higher SES
• higher among those with lower educational attainment
• Simón Barquera, et. al., Salud Pública Méx 2013; Vol. 55(supl.
2):S151-S160 ENSANUT 2012 (Encuesta Nacional de Salud y
Nutrición)
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Burden of Obesity in Adults
(Texas 2014)
Area
Prevalence
Texas – non-border
counties
32.0%
Texas – border counties
39.1%
US (2013)
29.4%
From Behavioral Risk Factor Surveillance System (BRFSS). Data are age
adjusted to the 2000 standard population using age groups 18-44, 45-64 and
65 years and over.
5
Ground zero – Cameron, County, Texas?
(the southern most US-Mexico Border county)
Ref: Susan Fisher-Hoch, et. al., PLOS One 10(7), 2015
• 10 year Cameron County Cohort (2004-2014)
• Cohort of 2,838 adults
• Average Age (46 years)
• Overweight (33.3%)
• Obesity (50.9%)
• Diabetes (27.6%)
(16.4% diagnosed +
11.2% undiagnosed)
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Border Obesity Prevention (BOP):
activities sponsored by the Commission
• BOP Summit held July 16-18, 2013, in McAllen,
Texas.
• About 240 attendees from all 10 US-Mexico border states and both
federal governments (U.S. DHHS, CDC, Mexico SSA, Mexico
INSP).
• Recommendations from BOP Summit included:
• Continue binational sharing of best practices, information and
materials for obesity prevention programs.
• Work to achieve border obesity prevention through public, private,
non-profit and governmental partnerships on both sides of the
border.
• Establish a Border Obesity Prevention (BOP) Technical Work
Group to develop a strategic action plan.
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BOP Workshop
August 4-6, 2015, Laredo, Texas
• Decided to focus on the strategic map´s Strategic Objective D1:
Influence Public Policies Relevant to Obesity Prevention and
used the Social Ecological Model below as a conceptual
framework for organizing needs & potential interventions.
• Formed 4 work groups:
1)
2)
3)
4)
Healthy eating
Physical activity and active living
Breastfeeding and
Communication
• Workshop participants identified specific recommendations
within each of those four priority areas.
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Healthy Eating Recommendations
(and selected objectives and tasks)
• Promote healthy foods.
• Increase access to healthier food choices that are
consistent with national dietary guidelines.
• Obtain baseline nutritional data for the border
region.
• Promote healthy beverages.
• Improve access to clean water.
• Reduce the consumption of sugary beverages.
• Encourage soda taxes (as have been demonstrated to
reduce consumption of sugary beverages in Mexico).
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Physical Activity and Active Living
Recommendations
• Create a border physical activity plan to inform
and support community leaders to take action and
make changes to increase physical activity and
active living in their communities.
• Develop a surveillance system to assess, evaluate
and monitor physical activity levels.
• Incorporate physical activity into the US-Mexico
Border Health Commission policies and activities
(“walk the walk…”).
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Breastfeeding Recommendations
(and selected objectives and tasks)
• Promote laws and policies supporting
breastfeeding by working mothers.
• Develop programs that recognize employers with
worksite policies and practices that are supportive
of breastfeeding.
• Ensure a minimum 4 months maternity leave
• Improve Hospital Practices
• Ensure that maternity care practices are fully
supported for breastfeeding.
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Communication Recommendations contd.
(and selected objectives and tasks)
• Promote effective BOP communication messages
through multiple channels, audiences and time
• Create health communication workshops across sister cities
and states annually where entities can come together to ID
messages for release that year.
• Work with broadcast organizations and other communication
entities that already promote health related topics.
• Use the different channels (e.g. social media, website,
radio, TV, newspaper, newsletters, texting, consumer
health technologies).
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Border Obesity Prevention (BOP):
Development of a binational strategic framework
2012 Regional
Planning
Meetings held
with border
communities
2013 BOP
Summit in
McAllen,
Texas
Established BOP
Technical Workgroup
(binational SMEs) define
vision, mission, goals and a
Strategic Map
Identified 4 Priority Areas:
1) Healthy eating;
2) Physical activity;
3) Breastfeeding;
4) Communication
BOP Workshop (August,
2015) focus on Objective
(D1): Influence public
policies
The initial audience is USMexico Border Health
Commission with goal to
implement recommendations
into organizations strategic
planning border wide.
Policy white paper is being drafted
with recommendations (objectives,
tasks and evaluation framework)
for each of the 4 Priority Areas
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Thank You!!
Ronald J. Dutton, Ph.D.
Director, Office of Border Health
www.dshs.state.tx.us/borderhealth/
www.borderhealth.org