Fruit and Vegetable Consumption Colorado...supercenter, large(r) grocery store, warehouse club, or fruit/vegetable specialty store in the tract or within 1/2 mile of the tract boundary.
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1Facts for Action: Chronic Diseases and Related Risk Factors in Colorado Fruit and Vegetable Consumption in Colorado
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10
20
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Children
Per
cent
High school* Adults
Ate fruit less than once a day Ate vegetables less than once a day
Fruit and Vegetable Consumption
in Colorado
November 2014
• 16%ofchildren,55%ofhighschoolstudentsand36%ofadultColoradansdidnoteatfruitatleastonceaday.
• Fruitjuicesubstantiallycontributestochildren’stotalfruitconsumption.Thepercentofchildrenwhodidnoteatfruitatleastonceadayjumpedfrom16%to24%whenfruitjuicewasexcludedfromconsideration.
• 29%ofchildren,55%ofhighschoolstudentsand19%ofadultColoradansdidnoteatvegetablesatleastonceaday.
Obesity and healthy eating
Percent of children (ages 1-14), high school students (grades 9-12), and adults (ages 18+) who did not eat fruits and vegetables at least once a day, Colorado, 2013.
Many Coloradans do not eat fruits and vegetables every day.
*Highschooldatadonotincludefruitjuice.
56% were overweight or obese.In 2013, 21% of adult Coloradans were obese..
F A acts for ction: Chronic Diseases and Related Risk Factors in Colorado
Colorado data sources: BehavioralRiskFactorSurveillanceSystem,ColoradoChildHealthSurvey,HealthyKidsColoradoSurvey1.CDC.2012.AdultOverweightandObesity:CausesandConsequences.[ONLINE]Availableat:http://www.cdc.gov/obesity/adult/causes/index.html.[Accessed24November14].2.CDC.2012.AdultOverweightandObesity:BasicsAboutChildhoodObesity.[ONLINE]Availableat:http://www.cdc.gov/obesity/childhood/basics.html.[Accessed24November14].3.FinkelsteinEA,TrogdonJG,CohenJW,DietzW.AnnualMedicalSpendingAttributabletoObesity:Payer-andService-SpecificEstimates.HealthAffairs2009;5:w822-w831.4.CDC.2013StateIndicatorReportonFruitsandVegetables.[ONLINE]Availableat:http://www.cdc.gov/nutrition/downloads/State-Indicator-Report-Fruits-Vegetables-2013.pdf.[Accessed24November14].5.USDA.MyPlateFoodGroups[ONLINE]Availableat:http://www.choosemyplate.gov/food-groups/.[Accessed24November14].
• ThedoublingoftheadultobesityprevalenceintheUnitedStates in the past 18 years has multiple causes including genet-ic, behavioral (e.g., diet, physical activity), and environmental factors (e.g., food retail and transportation infrastructure).
• Obesity has been shown to increase the risk of numerous ad-verse health conditions including coronary heart disease, type 2 diabetes, high blood pressure, stroke, and various cancers.1
• Obese children are more likely to become obese adults; If chil-dren are overweight, obesity in adulthood is likely to be more severe.2
• TheestimatedannualmedicalcostofobesityintheU.S.was$147billionin2008U.S.dollars;themedicalcostsforpeoplewho are obese were $1,429 higher than those of normal weight.3
• While no single-factor strategy can solve this complex problem alone, promotion of healthy eating patterns, especially the regular consumption of fresh fruits and vegetables, can help to reduce obesity and alleviate associated health burdens.4
>80%
Overall, 86% of adult Coloradans did not meet recommendations for fruit and vegetable consumption in 2013. Depending upon the age of adults, 4-5 cups of fruits and vegetables is the recommended daily amount for men and 3.5-4.5 cups for women.5
More than 80% of adult Coloradans (ages 18+) who have been diagnosed with a chronic condition did NOTmeetage/sex-specificrecommendationsforfruitandvegetableconsumptionin2013.
Percentage not meeting recommendations relative to other adverse health outcomes:90% of adults with diabetes90% of adults who had a heart attack, angina,
coronary heart disease or stroke89% of adults with high blood pressure
87% of adults with high blood cholesterol86% of adults with a depressive disorder82% of adults who have or had cancer (excluding
skin cancer)
2 Facts for Action: Chronic Diseases and Related Risk Factors in Colorado Fruit and Vegetable Consumption in Colorado
86% of adult Coloradans did not meet recommendations for fruit and vegetable consumption.
• Womenweresignificantlymorelikelytomeetrecommendationscomparedtomen.
• WhitesweresignificantlymorelikelytomeetrecommendationscomparedtoHispanicsandBlacks.
• Adultswithhouseholdincomesabove$50,000weresignificantlymorelikelytomeetrecommendationsthanthoseearning<$35,000.
• Adultswithhighereducationlevelsweresignificantlymorelikelytomeetrecommendations.
• Adultswithahealthyweightweresignificantlymorelikelytomeetrecommendationsthanoverweightandobeseadults.
• BlackandHispanicchildrenwere 1.8 and 2.0 times more likely not to eat vegetables every day compared with White children, respectively.
• 35%ofBlackchildrenand43%ofHispanicchildrendidnoteatvegetables at least once a day.
Data sources:BehavioralRiskFactorSurveillanceSystem,ColoradoChildHealthSurvey.
Terminologyforracial/ethnicgroupsmatchesthatusedduringdatacollection.
Disparities exist in the frequency of fruit and vegetable consumption.
Percent of adults (ages 18+) notmeetingage-andsex-specificrecommendationsforfruitandvegetable consumption, Colorado, 2013.
Percent of children (ages 1-14) who who did not eat fruits and vegetables at least once a day by race/ethnicity, Colorado, 2011-2013.
Byrace/ethnicity Byhouseholdincome
White
Black
Hispanic
Asian
50 60 70 80 90 100Percent
Rac
e/et
hnic
ity
<$15,000
$15-24,999
$25-34,999
$35- 49,999
$50,000+
50 60 70 80 90 100Percent
Inco
me
<High school
High school graduate
Some college
College graduate
50 60 70 80 90 100Percent
Edu
catio
n
Underweight
Healthy weight
Overweight
Obese
50 60 70 80 90 100Percent
Wei
ght s
tatu
s
Byeducation Byweightstatus
Fruit and vegetable consumption by household income and body mass index.• Children from households earning less than $25,000 per year were 1.8 times more likely not to eat vegetables
at least once a day compared with children from households earning $50,000 or more per year.• Consumption of fruits and vegetables did not differ based on children’s body mass index.
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White BlackRace/ethnicity
Hispanic
Per
cent
Ate fruit less than once a day Ate vegetables less than once a day
3Facts for Action: Chronic Diseases and Related Risk Factors in Colorado Fruit and Vegetable Consumption in Colorado
Access to healthy food in Colorado.Increasing access to quality and affordable fruits and vegetables is an important step to increase fruit and vegetable consumption.1
Policies and programs that promote or enhance access to fruits and vegetables in communities, schools and child care facilities represent an important step to increase fruit and vegetable consumption.1
Increasing access
Percent of Colorado’s census tracts without healthy food retail. DefinitionsByrace/ethnicity Byhouseholdincome
�• CensusTracts are small, relatively permanent statistical
subdivisions that provide a stable set of geographic unitsforthepresentationofCensusdata.Theygenerally have a population size between 1,200 and 8,000 people.
• Tractswithnohealthyfoodretaillackasupermarket,supercenter, large(r) grocery store, warehouse club, or fruit/vegetable specialty store in the tract or within 1/2 mile of the tract boundary.
• Nationally,30%ofCensustractsdonothavehealthyfoodretail(statevaluesvaryfrom17%-56%oftracts).2
• WithinColorado,29%oftracts(367of1,242)donothaveaccesstohealthyfoodretail.2
• Thepercentageofruraltracts(>50%ofresidentsclassifiedasruralbythe2010U.S.Census)thatdonothaveaccesstohealthyfoodretailis2.5 times higherthaninurbantracts(61%vs.24%,respectively).
• Affordability:Roughly1in8Coloradanslivebelowthepovertylineandmaybeunabletoregularlyaffordfruitsandvegetables.3• Public assistance programs: ProgramswithinSNAPthatsupporthealthyfoodpurchasing,suchastheHealthy
IncentivesPilot,canpromotefruitandvegetableconsumption.Overall,7.3%ofColoradohouseholdsparticipateinSNAP;thepercentagevariedfrom0%to21.2%amongthestate’s64counties.3,4
• Distance to healthy food retail:Nearly1in3Coloradansdoesnotlivenearahealthyfoodretailer,andthegreatertraveltimeand/ordistancetoreachtheseretailerslimitstheirabilitytopurchaseandconsumefruitsandvegetables.Onaverage,30%ofColoradansmusttravelrelativelylongdistancestoreachthenearestgrocerystore(>1mileinurbanareas,>10milesinruralareas).5
• Vehicle access:InsomeColoradocounties,over12%ofhouseholdsdonothaveaccesstoavehiclethatcouldbeusedforshopping,highlightingtheimportanceofproximitytoretailandpublictransportation.3
• Farmers markets:Farmer’smarketscanimproveaccesstofruitandvegetableretailandsupportlocalagriculturalproduction.Thereare3.2farmersmarketsper100,000residentsinColoradocomparedwith2.5per100,000nationally.1Farmer’smarketsthatacceptSNAPbenefitscanfurtherpromotefruitandvegetableconsumption.Currently,21.7%offarmersmarketsinColoradoacceptSNAPbenefits,comparedwith21.0%nationally.1
• School-based programs:InColorado,morethan560,000studentsbenefitfromfarm-to-schoolactivities.Associatedprograms,includingschoolgardens,encouragestudentstotrynewfruitsandvegetables,thuspromotinghealthyeatinghabitsthroughincreasedconsumptionoffruitsandvegetables.Agreaterpercentageofschools(6.1%)inColoradoalwaysofferfruitsornon-friedvegetablesinvendingmachines,schoolstores,canteensorsnackbarsandduringcelebrationswherefoodandbeveragesareofferedcomparedtothenationalaverage(2.1%).6
29%
71%
61%39%
24%
76%
All tracts
Percent of Colorado’s Census tracts without healthy food retail.
Urban tracts Rural tracts
Byeducation Byweightstatus
Datasources:1. CDC.2013StateIndicatorReportonFruitsandVegetables.[ONLINE]Availableat:http://www.cdc.gov/nutrition/downloads/
State-Indicator-Report-Fruits-Vegetables-2013.pdf.[Accessed24November14].2. GrimmKA,MooreLV,ScanlonKS.Accesstohealthierfoodretailers-UnitedStates,2011.MMWR2013;62(03):20-26.3. USCensus.2012AmericanCommunitySurvey5-yearestimates.[ONLINE]Availableat:http://factfinder2.census.gov.[Accessed
24November14].4. PersonalcommunicationwithJenniferFern.ColoradoHealthInstitute.September18,20145. USDA.FoodEnvironmentAtlas.[ONLINE]Availableat:http://www.ers.usda.gov/data-products/food-environment-atlas.aspx.
[Accessed24November14].6. CDC,DivisionofAdolescentandSchoolHealth.2012ChronicDiseasePreventionProfiles–ColoradoSecondarySchools[ONLINE]
Availableat:http://www.cdc.gov/healthyyouth/profiles/pdf/facts/co_chronic_profiles.pdf.[Accessed24November14].
4 Facts for Action: Chronic Diseases and Related Risk Factors in Colorado Fruit and Vegetable Consumption in Colorado
*Users(blue):numberofhouseholdsusingfreshfruitsandvegetablesinpastmonthper100householdsinthatCensustract.*Consumption(red):poundsoffreshfruitsandvegetablesusedinpastmonthperhouseholdusingfreshfruitsandvegetablesinthepastmonthinthatCensustract.
Data sources: NielsenHomescandata(2013)linkedtopovertydatafromU.S.Census2012AmericanCommunitySurvey5-yearestimates(availablefromhttp://factfinder2.census.gov/).
AccessdatafromUSDAFoodEnvironmentalAtlas(availablefromhttp://www.ers.usda.gov/data-products/food-environment-atlas.aspx).
Census tracts that have low fresh fruit and vegetable consumption and/or do not have healthy food retail represent potential areas to enhance access to quality and affordable fruits and vegetables.
Householdsusingfreshfruitsandvegetablesinpastmonth(per100households).
Consumption of fresh fruits and vegetables by Census tract poverty, access to healthy food retail, and access to vehicles.
• Asthepercentageoftractresidentslivingbelowpovertyincreased,thereweredecreasesinboththenumberofusersandconsumptionoffreshfruitsandvegetables.
• Boththenumberofusersandconsumptionoffreshfruitsandvegetablesdecreasedasaccesstovehiclesdecreased.
• Intractswithagreaternumberofindividualslivingamileormorefromfoodretailers,therewasanincreaseinboththenumberofusersandconsumptionoffreshfruitsandvegetables.
27
28
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64
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72
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78
80
<10% 10% -19.9% 20%- 29.9% 30%+
Consum
ption (lb per month)
Use
rs (
# pe
r 10
0 ho
useh
olds
)
Percent of residents per tract living below the poverty line
Users*Consumption*
27
28
29
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31
32
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64
66
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70
72
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76
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80
0% .1% - 4.9% 5%-9.9% 10%+
Consum
ption (lb per month)
Use
rs (
# pe
r 10
0 ho
useh
olds
)
Percent of workers (aged 16+) per tract in households with no vehicle access
Users*Consumption*
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64
66
68
70
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80
<10% 10 -39.9% 40-79.9% 80%+
Consum
ption (lb per month)
Use
rs (
# pe
r 10
0 ho
useh
olds
)
Percent of individuals per tract living at least 1 mile from the nearest supermarket, supercenter, or large grocery store
Users*Consumption*
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