North Carolina

Overweight and obesity have tremendous consequences on our nation's health and economy. Both are linked to a number of chronic diseases, including coronary heart disease, stroke, diabetes, and some cancers. Most American communities are characterized by unhealthy options when it comes to diet and physical activity. We need public health approaches that make healthy options easy, affordable, and available for all Americans.

CDC's Division of Nutrition, Physical Activity, and Obesity (DNPAO) currently funds 25 states to address the problems of obesity and other chronic diseases through statewide efforts with multiple partners.  The program's primary focus is to create policy and environmental changes to increase: physical activity, consumption of fruits and vegetables, and breastfeeding; and to decrease: television viewing, consumption of sugar-sweetened beverages, and consumption of high-energy dense foods (high calorie/low nutrient foods). North Carolina has received funding for this program since 2000.

The Burden of Obesity in North Carolina

North Carolina's estimated 2007 total population is 9 million, roughly 7 million are adults. Of those adults, 36% are considered overweight and another 29% are considered obese, according to 2007 Behavioral Risk Factor Surveillance System data. Problems are also seen in factors related to obesity and other chronic diseases.

• Approximately one quarter of adults report no leisure time physical activity in the past month.
• Only 22% of North Carolinians report eating fruits and vegetables at least five times a day.

Also, the National Immunization Survey shows that North Carolina is not meeting any of the five Healthy People 2010 goals for breastfeeding based on children born in 2005.

The problem is not limited to adults alone. Thirty percent of North Carolina youth (9th–12th grades) are either overweight or obese, according to 2007 Youth Risk Behavior Survey data.

• Approximately two-in-five youth are meeting current physical activity recommendation levels.
• Only 15% eat fruits and vegetables five or more times a day.
• Thirty-seven percent drink at least one non-diet soda each day.
• Thirty-five percent watch three or more hours of television each day.

According to the 2006 Child Assessment and Monitoring Program survey, more than one-in-three children and youth under age 18 eat a fast food meal once a week; another 35% eat a fast food meal two or more times each week.

Obesity also affects the state's economy. In North Carolina, the medical costs associated with adult obesity were $2.1 billion in 2003 dollars. 

What is North Carolina Doing about Obesity?

North Carolina's Eat Smart, Move More movement encompasses the work of more than 60 organizations statewide. These organizations are involved in implementing Eat Smart, Move More: North Carolina's Plan to Prevent Overweight, Obesity and Related Chronic Diseases 2007-2012 using evidence-based and promising strategies.

Since 2000, 157 Eat Smart, Move More community grants totaling approximately $1.8 million have been awarded to local health departments and community partners. Each year, the ESMM Community Grants program provides up to $20,000 each to 10–20 local health departments through a competitive application process. The grants support multi-level interventions—projects that make changes to policies and environments (e.g., workplaces, schools) while also educating community members about healthy behavior. Projects funded through this program have included a walking trail with fitness stations (Graham County), changing physical activity and nutrition policies in schools (Iredell County), and implementing a healthy dining program in local restaurants (New Hanover County).

Out of the 20 community grant recipients in 2007–2008, the vast majority reported increases in physical activity among their target population, and half reported increases in fruit and vegetable consumption among the target population. Collectively, grantees implemented 47 new policies or practices (e.g., policies to improve physical activity promotion, nutrition education, and food/beverage choices) and 20 physical changes to facilities (e.g., the establishment or enhancement of parks, recreational equipment, greenways, trails, and paths for walking and biking). These 20 mini-grants reached over 13,000 people in North Carolina. Furthermore, 60% of grant-funded interventions enabled community coalitions to leverage additional funds.

The Eat Smart, Move More–Maintain, Don't Gain! Holiday Challenge is one of several strategies targeting mothers aged 25–54. The Challenge is designed to help participants maintain their weight over the holiday season. The 2008 Challenge reached well over 5,000 participants in all 100 North Carolina counties and 43 states with weekly electronic newsletters, tools, tips and recipes. The www.MyEatSmartMoveMore.com site hosted a blog and Ask the Expert features to support the campaign. In 2008, 79% of participants reported maintaining their weight, while another 12% reported losing weight over the course of the six-week campaign.

NC has played a key role in developing a worksite wellness infrastructure for state government agencies. Since 2004, NC has collaborated with state partners to develop the NC HealthSmart Worksite Wellness Toolkit and provide Toolkit training and technical assistance to over 200 worksite wellness committees across the state. In 2008, these efforts were enhanced by the passage of the Office of State Personnel Worksite Wellness Policy. This policy requires state agencies and public universities to develop a wellness infrastructure consisting of a Wellness Leader and Wellness Committees to develop and implement worksite wellness programs addressing healthy eating, physical activity, tobacco cessation, and stress management.

Through these activities, North Carolina and CDC are addressing obesity by creating places where North Carolinians can make healthy choices about nutrition and physical activity.

For more information:
Cathy Thomas
Project Manager/Head, Physical Activity and Nutrition Branch
North Carolina Department of Health and Human Services
Telephone: 919-707-5216
Fax: 919-870-4804
E-mail: cathy.thomas@ncmail.net
Web site: www.EatSmartMoveMoreNC.com

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