Across the United States, more than 1 in 3 adults have obesity—making it a serious and costly health issue. In the state of Delaware, obesity rates rose from 13% in 1992 to 28% in 2007. Fortunately, the prevalence has been relatively level since 2007, staying close to 29% from 2007 through 2015. Although lower than the national obesity rate, the trend in Delaware is similar to the United States overall.
In response to these numbers, the state’s Division of Public Health (DPH), which is part of the Delaware Department of Health and Human Services, helped form the Delaware Coalition for Healthy Eating and Active Living (DE HEAL) in 2009. And in 2010, the coalition released a comprehensive plan for obesity prevention. The coalition provides statewide leadership and coordination of physical activity and healthy nutrition programs, and serves as a catalyst for developing obesity prevention efforts.
DPH’s Physical Activity, Nutrition, and Obesity Prevention (PANO) program is a member of the coalition—and provides technical assistance to support a range of obesity prevention initiatives in Delaware. “Involving individuals from a variety of disciplines, from health care to transportation, allows us to take an inclusive approach to improving Delawareans’ health,” says Dr. Karyl Rattay, Director of DPH.
“We follow a social-ecological model,” adds Laura Saperstein, who manages the PANO program. That means DPH supports efforts like building “complete communities” (communities with walking and biking options), increasing opportunities for physical activity at schools and work sites, and educating individuals on healthier habits, in an effort to decrease overweight and obesity in Delaware.
“And since we’re a small program,” Saperstein continues, “strategic partnerships are really important for increasing our impact.”
Funding Programs by Motivating Participants
One ongoing effort involves a dynamic and interdependent model for funding healthy weight activities in Delaware. Former Governor Jack Markell convened the Delaware Council on Health Promotion and Disease Prevention (CHPDP) in 2010 to help with the fight against obesity. CHPDP created an online “clubhouse”—a portal where residents can log their healthy activities.
When residents log miles (for walking, biking, or other activities), they earn points, or “kudos.” And thanks to donations from the private sector, these kudos then fund wellness programs at local nonprofit organizations. “It gets adults to exercise and it moves money to local organizations, which then offer related programs,” Saperstein explains.
“We used some of our federal CDC funding for the initial website build and marketing,” she says. “And there was a huge push to get local businesses to put money into the foundation side of it so that as people exercise more, more money gets donated.”
The name of the initiative? Motivate the First State. And it does!
One of the participating organizations is the YMCA of Delaware, which uses the funds to offer Healthy Weight and Your Child, an evidence-based program where families get active and learn healthy habits together. There are about 30 people in each 15-week session, and the YMCA has already completed several sessions.
Planning Physical Environments that Promote Health
The PANO program also works with other state departments, local governments, planners, and developers to increase the amount of walking and biking opportunities residents have close to home. “Using the social-ecological model means that we look at the social determinants of health,” Saperstein says. “We want to create healthier communities with more access to physical activity and healthy food.”
To advance this goal, DPH helped create Delaware’s Plan4Health initiative, which was led by the Delaware Chapter of the American Planning Association and the Delaware Public Health Association. “We focused first on Kent County because it has the highest obesity rate in the state,” Saperstein explains. “We developed a guiding document for the county to use so when it came time to redo their comprehensive plan, they had already identified the public health priorities to include in the plan.”
Members of the initiative are now reaching out to other counties and towns to communicate the importance of including health equity considerations in their comprehensive plans.
“We’re seeing improvements where developers have more understanding and bring better designs, like including bike lanes and not building in the middle of nowhere. They see how complete communities are more profitable—and they’re appealing to millennials.”
Sharing the Tools to Make Communities Healthier
In another effort, DPH partnered with the University of Delaware’s Institute for Public Administration to create the Toolkit for a Healthy Delaware. It offers resources for local governments to assess—and work to improve—their towns’ opportunities for physical activity and access to healthy foods and environments.
“It’s the counties and towns that ultimately make the decisions,” Saperstein points out. “But we’ve developed a relationship with the Department of Transportation so that now, when they see plans for a new development, they ask how it will impact health.”
It’s the partnerships that lead to positive steps that Saperstein finds most gratifying about the PANO program’s work. “When I see developers coming to the table with plans that show best practices for building communities with access to physical activity, it shows that they’re listening—and that they’re willing to change. That’s a success story in my mind.”
About Stories from the Field
Each month, this series highlights how communities across the Nation are addressing the Healthy People 2020 Leading Health Indicators (LHIs). LHIs are a subset of 26 Heathy People 2020 objectives that communicate high-priority health issues. Tackling the LHIs appropriately will dramatically reduce the leading causes of death and preventable illnesses.
This month’s story features a program that is addressing the Nutrition, Physical Activity, and Obesity LHI topic.