521: Territories Invisible in Many Databases, Strategies to Reduce Childhood Obesity

ROBERT JOHNSON: 

This is the award-winning Public Health Review Morning Edition for Wednesday, October 11, 2023. I'm Robert Johnson. Now today's news from the Association of State and Territorial Health Officials.

ANNA-MICHELLE MCSORELY: 

In the article, we point to a report published by ASTHO that demonstrates that the territories are largely missing from 32 of the most commonly used federal health data systems.

JOHNSON: 

Dr. Anna-Michelle McSorely is at the New York University School of Global Public Health. She's talking about an article she wrote with ASTHO's Alex Wheatley and others calling on federal data collectors to include stats on the health of people in the U.S. territories.

MCSORELY: 

So, thus far in my work, I've reviewed over 93 systems and identified that the territories are largely missing from many of these essential data sources. And in instances when they are representative. It's difficult to access public files and public sources of this information.

JOHNSON: 

McSorely says without the data, people in the territories are invisible. She wants more.

MCSORELY: 

We're hoping to address the ambiguity that currently exists surrounding territorial eligibility for these health data systems. In some cases, such as the Behavioral Risk Factor Surveillance System, territories can choose to opt-in to those programs of data collection. However, it's not always clear in which systems and in what cases territories are eligible.

JOHNSON: 

McSorely also urges more attention to local workforce capacity, and more flexible funding to address the shortfalls. You can read the article on the Journal of the American Medical Association's Health Forum using the link in the show notes.

Also today, ASTHO is looking for a contractor to build a toolkit for health equity performance indicators that can be used by leaders in the territories and freely associated states. You can get more information by clicking the link in the show notes.

Childhood obesity continues to be a problem in the United States. Dr. Steven Gortmaker, has spent a lifetime working on groundbreaking studies connecting obesity to television-viewing marketing of unhealthy foods and sugary beverages.

STEVEN GORTMAKER: 

You're reaching a point where excess weight is going to be producing more excess deaths than smoking. Because smoking rates have been declining, it's taking a long time. But obesity rates keep on increasing through every state in the United States. And among all different parts of the population.

JOHNSON: 

Gortmaker calls out to programs that he says continued to make an impact. The WIC program and another that was signed into law in 2010.

GORTMAKER: 

One example is the Healthy Hunger-Free Kids Act, you know, championed by Michelle Obama and many others that led to improved foods available in schools, school meals. And this was accompanied by actually the prevention of childhood obesity, particularly among children from low-income households.

JOHNSON: 

Gortmaker says public health can and should engage starting with a strong evidence base.

GORTMAKER: 

Make sure you're working with intervention strategies with a strong base and work with a broad coalition of decision makers and community partners so that you can develop a really realistic view of the likely impact of these strategies. Like what's it going to cost?

JOHNSON: 

Cost is a consideration. But Gortmaker says partnerships are equally vital.

GORTMAKER: 

I think the other part of this though, is if you're working with your community partners at the state level, or it could be the city or county level, it's probably helpful to have a number of these strategies lined up because at any particular moment in time, one may be more feasible than another and it's good to have a broader perspective of a broad range of these strategies.

JOHNSON: 

Gortmaker, from Harvard's T.H. Chan School of Public Health, is on a team of experts working on the Childhood Obesity Intervention Cost-Effectiveness Study, also known as CHOICES. You can visit the website by clicking the link in the show notes.

Finally, this morning, we'd like to remind you to follow this newscast on your podcast player and ASTHO on social media. We're on LinkedIn, Twitter, and Facebook.

That'll do it for today. We're back tomorrow morning with more ASTHO news and information. I'm Robert Johnson. You're listening to the award-winning Public Health Review Morning Edition. Have a great day.