A Health Equity Approach to Obesity Efforts Proceedings of a Workshop—in Brief (2019) / Chapter Skim
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A Health Equity Approach to Obesity Efforts: Proceedings of a Workshop - in Brief
A Health Equity Approach to Obesity Efforts: Proceedings of a Workshop - in Brief
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Speaker presentations addressed three areas: current policies and practices that either perpetuate health inequities or advance health equity; mechanisms to support community-driven solutions that can influence the social determinants of health; and approaches for fostering multisector collaboration to address disparities by exploring the issues related to the creation, implementation, and evaluation of equity-oriented programs, policies, and systems changes. Participants also discussed research needs to inform and mobilize equity-centered obesity prevention and treatment actions.
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and the Behavioral Risk Factor Surveillance System (BRFSS) -- and one using physical examination data, NHANES.
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Asians reside, Araneta said that the highest prevalence exists among Pacific Islanders, Filipinos, and South Asians, an observation that would be masked if all Asians and Pacific Islanders are grouped together because their overall prevalence is lower when reported collectively. Based on these and other data, Araneta explained that the American Diabetes Association revised its BMI cut points for diabetes screening in Asian Americans to "Screen at 23" based on data that a cut point of 23 kg/m2 would lead to a diabetes diagnosis for 300,000 of the approximately 510,000 Asian Americans with undiagnosed diabetes (Araneta et al., 2015; Hsu et al., 2015)
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. Turning back to the Healthy People social determinants of health framework, McGowan delved into two of its five domains -- health and health care and education -- by sharing several examples of relevant civil rights laws and protections dating from the Civil War to present day.
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Valarie Blue Bird Jernigan, professor of rural health and director of the Center for Indigenous Health Research and Policy at Oklahoma State University, spoke about social determinants of inequities in AI/AN populations. The federal government recognizes native people as citizens of sovereign nations, Jernigan explained, and this government-to-government relationship affords tribes the ability to deal directly with the federal government.
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. Haire-Joshu described two examples of partnerships between academia and home visiting organizations that aimed to translate the National Diabetes Prevention Program for women of childbearing age and compensate for the disparities in social determinants that they experience.
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‘Ohana lifestyle program, which was adapted from the National Diabetes Prevention Program and tailored to NHPIs. Through qualitative research, he said, contributing factors such as cultural stereotypes and access to culturally relevant activities and affordable healthy foods became apparent (Kaholokula et al., 2018)
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The available data have not yielded clear strategies for modifying the delivery of perinatal care to affect gestational weight gain and maternal morbidity, Simon said, but additional trials are under way. Health inequities do not just happen, she said in conclusion, and the architecture and design of policies, clinical care settings, and provider training play a role.
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Kumanyika returned to close the meeting, appealing to participants that something different should come out of the workshop. The next step for the obesity community, she suggested, might be to combine solutions that target behaviors with those that address social determinants and engage communities to change environments and policies.
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2013. Sociodemographic, behavioral, and biological variables related to weight loss in Native Hawaiians and other Pacific Islanders.
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2019. Healthy People 2020 social determinants of health.
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SPONSORS: This workshop was partially supported by the Academy of Nutrition and Dietetics; Alliance for a Healthier Generation; American Academy of Pediatrics; American College of Sports Medicine; American Council on Exercise; American Society for Nutrition; Bipartisan Policy Center; Blue Cross and Blue Shield of North Carolina Foundation; The California Endowment; ChildObesity180/Tufts University; Edelman; General Mills, Inc.; Greater Rochester Health Foundation; Health Partners, Inc.; The JPB Foundation; Kaiser Permanente; The Kresge Foundation; Mars, Inc.; National Recreation and Park Association; Nemours Foundation; Nestlé Nutrition Institute; Novo Nordisk; Obesity Action Coalition; The Obesity Society; Partnership for a Healthier America; Reebok, International; Reinvestment Fund; Robert Wood Johnson Foundation; Weight Watchers International, Inc.; and YMCA of the USA. For additional information regarding the workshop, visit nationalacademies.org/obesitysolutions.
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