UICC World Cancer Congress 2006

With over 36 million residents, trends in California are often a bellwether for the Nation. California has the largest agricultural production of any state and the 6th largest GDP in the world. But behind the mythic healthy California image, there is the same reality – an epidemic of overweight and obesity—that confronts the United States (U.S.) and world. Well over half of adults are overweight or obese, and rates among children continue to rise. The epidemic is also an economic one, costing health insurers, businesses and individuals an estimated $28 billion in 2005. Less well known, but of as great a concern, is the paradox of obesity and hunger/food insecurity. Almost 3 million Californians cannot always put food on the table, or they forego other basic needs in order to do so, yet many are overweight. People cannot eat healthy, and rates of obesity cannot be lowered, if they do not have enough and the right kinds of food to eat, along with safe, pleasant conditions for an active lifestyle.

It is not surprising that California, the home of Hollywood and the entertainment industry, has prolific advertising. The food industry is the second largest advertiser in the U.S., spending $33 billion each year on marketing each year. That amounts to at least $9 million every day in California! Yet, less than two percent of food advertising is spent promoting the healthiest choices—fruits and vegetables. A recent report showed that the marketing of unhealthy foods outspent California's 5 a Day Campaign by 50 to 1.

With comparisons to California's world renowned tobacco control program, this presentation will assess how California has begun to address the epidemic by building elements of a comprehensive obesity prevention program. The session will provide an overview of the statewide infrastructure being developed to deliver nutrition and physical activity programs, describe recent state and local efforts to change environments that influence food and physical activity decisions, and highlight recent policy achievements.

The discussion will showcase how a successful planning model for driving local tobacco control policy, Communities of Excellence, is being adapted and applied by the California Department of Health Services in its nutrition, physical activity, and obesity prevention programs. Finally, the presentation will also critically examine California's current challenges—fragmentation, restricted funding, and lack of coordination which hinder putting public health strategies into practice and creating healthier policies and environments—and make recommendations for achieving population-based change.