Childhood Obesity in Orange County: More Needs to be Done*

Lack of coordination: Orange County Health Care Agency currently is responsible for the coordination of all programs receiving grants to fight childhood obesity. OCHCA and groups of administrators attempt to coordinate the efforts of numerous programs. However, with limited personnel dedicated to childhood obesity prevention, OCHCA is unable to provide the required coordination to better use its limited funds. Response: Disagrees wholly with the finding. The OCHCA is responsible for coordination of programs provided directly by, or through contracts with, the County of Orange and has sufficient resources to do so effectively. OCHCA also supports coordination of county-wide programs and services by serving in leadership roles with groups such as the Nutrition and Physical Activity Collaborative (NuPAC) which exist to improve coordination. The OCHCA supported community-wide coordination through NuPAC by securing funding for a coordinator to expand the role of NuPAC as a central coordination point in Orange County.

Grant limitations: The County receives federal and state grants that support programs to fight childhood obesity which contain conditions that restrict how funds may be used, thus limiting the effectiveness of the programs' efforts. For example, some children may be excluded because they are not in a group targeted by grant criteria, such as food stamp eligibility or being below federal poverty level. Response: Disagrees partially with the finding. The OCHCA agrees that federal and state funds include restrictions regarding how the funding may be used and that provisions associated with those funds limit the number of people that can be reached. While OCHCA would appreciate increased flexibility in the use of these funds, we recognize that funding restrictions are intended to direct resources in the most effective way by targeting services to individuals and families that are at the highest risk for obesity.

Over-reliance on grant funds: There is an over-reliance by the County on state and federal grants to address the obesity epidemic in children. There is no assurance that any grants will be awarded. Response: Disagrees wholly with the finding. While there may be no formal assurance that grants will continue, state and federal funds are a common source of funding for local programs and many nutrition and physical activity programs have a long history of supporting obesity prevention efforts. The increase in obesity across the nation is a complex problem requiring private and public support at all levels. The OCHCA works with the community to identify resources that support both public and private efforts to address the problem.

Lack of parental involvement: Parental involvement is a crucial element in combating childhood obesity. Existing city and county programs, networks, workgroups and committees are composed of administrators from various public agencies, who meet periodically. Few, if any of these groups meet directly with parents; therefore, little information reaches the home. Response: Disagrees partially with the finding. The OCHCA agrees that parental involvement is a crucial element in combating childhood obesity. However, parents and families do receive information and services from many programs provided by the County, schools, and community- based organizations. Several OCHCA supported programs, including the NuPAC-sponsored Champions for Change and the four Orange County Women, Infants and Children (WIC) programs, include significant direct parental involvement components. These programs work with parents individually and in groups to provide nutrition education and information regarding the benefits of," and resources for, physical activity. Many programs also offer skill building opportunities to parents such as in-store shopping demonstrations that teach how to read nutrition labels, stretch available dollars to buy healthy food, and prepare healthy meals. The purpose of most networking committees and workgroups is to promote information sharing and coordination between service providers so that information can get to parents and the community through these organizations. As such, they are not geared toward education of the general public.

Lack of comprehensive plans: There is not a comprehensive plan which outlines all County efforts in place to address childhood obesity. Response: Disagrees wholly with the finding. The rise in obesity and associated health consequences is the result of complex social and individual factors. Because of the need for community-wide strategies that address that complexity, the OCHCA has focused on building the capacity of NuPAC, and implementation of the NuPAC-developed Orange County Obesity Prevention Plan. NuPAC is composed of over seventy groups in Orange County and the obesity prevention plan developed by NuPAC partners is modeled after the plan developed by the California Department of Public Health. The plan identifies community-wide priorities and strategies for addressing obesity focused on seven sectors: 1. State and Local Government Families Health Care Insurers and Providers 4. Schools 5. Employers and Worksites 6. Food and Beverage Industry 7. Entertainment and Professional Sports The County will continue to work in conjunction with NuPAC to support the county-wide Orange County Obesity Prevention Plan that identifies common goals and objectives to coalesce the community's efforts to create sustainable change. Responses to Recommendations: R.1 through R.5