Taxation, education, the general defense. Government has its role in society. But what about protecting its citizens from common and pervasive enemies found closer to home? If obesity is a 'disease,' then what is the government's role in finding a solution to the economic as well as health care burden obesity brings?

There is no doubt that the United States is in the throes of a health crisis related to obesity.  Some of the contributing factors to obesity in the United States are the foods we eat, lack of daily activity, portion sizes and structured exercise.  One need only to look at photographs of groups of Americans taken in the 60’s and 70’s and compare them to today to see a vast difference in the size of the general population.  Sadly, the problem is not an esthetic one but one that is affecting our health seriously as well as our countries finances.  The problem is compounded when you consider that many of the people in our society live in poverty and do not have access to proper health care.

We typically think of government as being an entity which creates and governs laws for taxation, education, protection of the people and even conservation but given the seriousness of the current situation, state governments are being asked to step in and assist our society with the epidemic that is obesity and find solutions to the economic as well as health care burden resulting from obesity in adults in the United States.

States have been slow to pass legislation related to health and wellness issues but there have been eight different types of legislation introduced and passed, mainly aimed at controlling obesity at the school age.  They are:
 
o Nutrition Standards – This is geared towards our children and what they are being served in schools.
o Limiting Access to Vending Machines – Regulating food items sold in vending machines as well as limiting access to them in schools.
o Education Regarding Body Mass Index – There are many people who are not aware that at just a BMI of 30, they are clinically considered obese

o Physical Education in Schools – Schools have stopped prioritizing physical activity by reducing or eliminating physical education and/ or recess.  This is slowly being reversed.
o Obesity Education – Schools are beginning to establish classes geared towards understanding how to live a healthy lifestyle.
o Funding for Obesity Research – The government is releasing funds to facilitate research to study obesity.
o Obesity Treatment in health insurance – Many health insurance companies are beginning to cover obesity related treatments as part of the standard coverage. Fitness facility membership costs are even included as part of wellness maintenance on some policies.
o Obesity Commissions – Legislation established commissions designed to study obesity

So, which states in United States are experiencing higher rates of obesity?  California, New York and Tennessee are at the top of the list for states that are actively trying to control the problem.  California and New York rank 36th and 38th in terms of obesity prevalence. Tennessee has a more serious problem coming in at 8th in obesity in the country. Idaho, Utah and Wyoming come in at dead last as states taking no action whatsoever to control or legislate the issues facing them. These states ranked 24.5%, 21.2% and 24.2% obesity which landed them at ranking 24th, 42nd, and 28th most obese states.

Some states are going beyond the legislations being enacted and taking proactive steps to correct the billion dollar a year problem.  New York for example has banned restaurants from using trans-fats.  New Jersey’s school board is addressing childhood obesity issues.  Mississippi, Louisiana, West Virginia and South Carolina are the top ranked states with obesity problems.  

The battle against obesity at the government level is being fashioned after the tobacco crises we have been fighting for years now.  The most influential campaigns aimed at controlling the behaviors have been those aimed at children, thus the push at the school level to educate children on the risks or obesity.  The states leading the effort to control childhood obesity are California, Illinois, Oklahoma, Pennsylvania, South Carolina and Tennessee.  Nevada, Utah and Wyoming are at the bottom of the list.

Legislation aimed at establishing obesity commissions are the most frequently occurring classification followed by requirements for recess, physical education and nutritional guidance.  Only seven states currently require BMI data collection which although an important tool to assist in education and diagnosis, is considered to be an invasion of privacy. Seven states currently provide for obesity treatment as part of the health insurance programs and nine have obesity research support programs.

(The following data was collected from http://www2.cdc.gov/phlp/Federal_obesity.asp )

The CDC Public Health Law Program conducted a systematic search of both LexisNexis and Thomas (a legislative information service of the Library of Congress) to identify obesity-related legislation.    For the most recent legislative action, readers should refer to http://thomas.loc.gov/.  

• S.2558 Healthy Lifestyles and Prevention American Act or HeLP America Act:   The purpose of this bill is to improve the health of Americans and minimize health care costs by restructuring the Nation's health care system towards prevention, wellness, and self care. Sponsor: Sen. Harkin, [IA] (introduced 6/22/2004)
Summary:  S. 2558 (Web link) Full Text:  S. 2558 (Web link)
(Posted: 08/26/2004 3:00 PM)
 
• S.2399 Healthy Lifestyles Act of 2004:  This bill provides for the implementation of physical activity and nutrition in schools, worksites, and communities to help prevention efforts of obesity for all Americans. Sponsor: Sen. Fitzgerald [IL] (introduced 5/10/2004)

Summary:  S.2399 (Web link) Full Text:  S.2399 (Web link)
(Posted: 08/26/2004 3:00 PM)
 
• S. 18. Right Start Act of 2003:   A bill to improve early learning opportunities and promote preparedness by increasing the availability of Head Start programs, to increase the availability and affordability of quality child care, to reduce child hunger and encourage healthy eating habits, to facilitate parental involvement, and for other purposes. Sponsor: Sen. Daschle [SD] (introduced 1/7/2003) Related Bills: H.R.2363 Summary: (PDF file)  Full Text: (PDF file)
 
• S. 1172.  IMPACT Act (Improved Nutrition and Physical Activity Act):   A bill to establish grants to provide health services for improved nutrition, increased physical activity, obesity prevention, and for other purposes. Sponsor: Sen. Frist [TN] (introduced 6/3/2003).  Latest Major Action: 2/3/2004. Referred to House subcommittee. Status: Referred to the Subcommittee on Health   Summary: (PDF file) Full Text: (PDF file)
 
• S. 1392.  A bill to amend the Richard B. Russell National School Lunch Act to improve the nutrition of students served under child nutrition programs. Sponsor: Sen. Harkin [IA] (introduced 7/10/2003).  Summary: (PDF file)  Full Text:  (PDF file)
 
• S. 1428.   Commonsense Consumption Act of 2003:   A bill to prohibit civil liability actions from being brought or continued against food manufacturers, marketers, distributors, advertisers, sellers, and trade associations for damages or injunctive relief for claims of injury resulting from a person's weight gain, obesity, or any health condition related to weight gain or obesity. Sponsor: Sen. McConnell [KY] (introduced 7/17/2003).  Latest Major Action: 10/16/2003 Senate committee/subcommittee actions. Status: Committee on the Judiciary Subcommittee on Administrative Oversight and the Courts. Hearings held.  Summary: (PDF file)  Full Text: (PDF file) 
 
• H.CON. RES.76.  Recognizing the health risks associated with childhood obesity and encouraging parents to promote healthy weight and increased physical activity to their children. Sponsor: Rep. Tiberi [OH-12] (introduced 2/27/2003).  Latest Major Action: 3/10/2003 Referred to House subcommittee.  Status: Referred to the Subcommittee on Health  Summary: (PDF file)   Full Text: (PDF file) 
 
• H.R. 716.  To establish grants to provide health services for improved nutrition, increased physical activity, obesity prevention, and for other purposes. Sponsor: Rep. Bono [CA-45] (introduced 2/12/2003).  Latest Major Action: 2/26/2003.  Referred to the Subcommittee on Health.  Summary: (PDF file)  Full Text: (PDF file)
 
• H.R. 1022.  Urban and Rural Disease Prevention and Health Promotion Act of 2003. To provide assistance for the development of indoor disease prevention and health promotion centers in urban and rural areas throughout the United States. Sponsor: Rep. Sanders [VT] (introduced 2/27/2003).  Latest Major Action: 3/17/2003.  Referred to the Subcommittee on Workforce Protections.  Summary: (PDF file)  Full Text: (PDF file)
 
• H.R. 1470.  WISEWOMAN Expansion Act of 2003.   To reduce health care costs and promote improved health by providing supplemental grants for additional preventive health services for women. Sponsor: Rep. DeLauro [CT-3] (introduced 3/27/2003).  Latest Major Action: 4/10/2003.  Referred to House subcommittee.  Status: Referred to the Subcommittee on Health.   Summary: (PDF file)  Full Text: (PDF file) 
 
• H.R. 2227.  Obesity Prevention Act.  To encourage innovative school-based activities to help reduce and prevent obesity among children, and for other purposes. Sponsor: Rep. Castle [DE] (introduced 5/22/2003).  Latest Major Action: 6/30/2003.   Referred to House subcommittee.  Status: Referred to the Subcommittee on Education Reform.  Summary: (PDF file)  Full Text: (PDF file)

By Christina Leon, Staff  Writer