Magazine article Policy & Practice

On Child Obesity

Magazine article Policy & Practice

On Child Obesity

Article excerpt

I recently had the pleasure of attending the White House meeting on childhood obesity, hosted by First Lady Michelle Obama. Participating, too, were three Cabinet secretaries, the Surgeon General, the OMB director, and the President's chief domestic policy adviser. The First Lady made it clear that the time for action to address the growing epidemic of overweight children in this country is now. The working session was held to collect ideas to incorporate into recommendations to the president from his Task Force on Childhood Obesity.


Mrs. Obama's "Let's Move" campaign has made childhood obesity a national concern, even beyond the usual health quarters. The challenge has been taken up by the Department of Education, the National Parks System, and even the military as a national security issue due to its inability to recruit healthy young Americans for service. I applaud the administration's "systems thinking" that connects the dots across disparate agencies with laser-like focus on the outcome we seek: healthier kids who will grow into healthier adults.

We made it clear to the task force that APHSA can be a significant resource in this conversation. APHSA members interact daily with millions of Americans across the country who access federal and state public health and human services, in large cities, small towns, the most rural and remote locations, and on native tribal lands. We deliver the nation's federal health and human service programs on the state and local levels, including Medicaid, Temporary Assistance for Needy Families, the Supplemental Nutrition Assistance Program, child welfare, child care, and other critical human service programs, that can present an unprecedented opportunity for alignment to achieve better outcomes for millions of American children.

Through the lens of childhood obesity prevention, we can see many places across our various service programs where the lines intersect and opportunities exist to improve federal and state policies and programs to support positive, healthy actions that will redound significant benefit in terms of child health and future success, not only for the child but for the state as well. Collectively, we can work to integrate the often disjointed, fragmented and categorically disparate federal and state policies, programs and funding streams and can use our work to promote good public policy.

Consider this: about half of all costs associated with obesity in the United States today are paid for through Medicaid and Medicare. Our state Medicaid directors are seriously concerned about the growing costs associated with obesity. We know, for instance, that obese children and teenagers are at risk for developing serious chronic diseases and psychosocial effects that will diminish their quality of life long term and will continue to drive up costs in the public health and human service systems. What if there were more flexible reimbursement methods in Medicaid programs that would allow comprehensive obesity prevention coverage, including medically monitored exercise and diet, dietary counseling and home nurse visits, as well as proven effective programs that can improve health and reduce cost?

Some states have already initiated innovative comprehensive programming to address this issue, either through Medicaid waivers, state-only funded programs or public-private partnerships. …

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