YOUNG AND OVERWEIGHT: One-on-one with Nebraska's chief medical officer

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June 21, 2012 - 7:00pm

Editor's note: As part of the NET News "Young and Overweight" project, Mike Tobias talked one-on-one with Dr. Joann Schaefer, Nebraska's chief medical officer and director of the Division of Public Health for Nebraska Health and Human Services about some of the efforts to lessen youth obesity, the scope of the problem in Nebraska and the impact of public policy solutions.

Schaefer is also featured on an NET News television special, "Young and Overweight: Fighting Obesity in Nebraska," which airs Friday, June 22 at 7 p.m. CT on NET1 and NET-HD. For more stories and information on this project go to

MIKE TOBIAS, NET News: Were you surprised at the recent Centers for Disease Control report which showed no improvement in childhood obesity levels?

DR. JOANN SCHAEFER, Nebraska chief medical officer: Sadly, I'm not surprised. I wish numbers were better but it wasn't a shock to me to see the numbers had not changed.

TOBIAS: Why is that?

SCHAEFER: We're having a hard time getting this on everyone's radar, still. It's better, but we haven't seen a lot of changes in habits out there for kids. I think the adults are getting engaged, but it's just going to take a little bit longer for the factors that are influencing children's obesity to become an issue for parents and an issue for the community to really start addressing.

TOBIAS: Is Nebraska any better or worse than other states? I know the Body Mass Index report that was released last year actually showed Nebraska's youth obesity rate a little higher than average.

SCHAEFER: We are a little bit higher than the national average, we believe, based on the data that we've gathered in our surveillance project. But we know there are areas of the country that are worse. But we have work to do.

TOBIAS: One challenge is that youth obesity is a multifaceted problem.

SCHAEFER: Yes. If you just look at our population as a whole, we've just gotten bigger. Adults and children, over years. Why is that? What's changed?

A lot has changed. We eat much bigger portions, we have a bigger component of our calories coming from processed foods and foods that just have more sugar content, more fat content, more calories per serving than it was 30 years ago. Just a huge change in how we eat.

Then, we are much more sedentary. Kids don't go out and play as often. When you and I were young, it was get home from school, do your homework, go outside until the streetlights come on, because we didn't have the television channels we have access to today, we didn't have cable TV, we didn't have satellite TV, we didn't have computers and all these things that increase our ability to sit and be still. Not that all that stuff isn't fun and wonderful, and even educational at times, but it's just a different lifestyle than we had.

So the increased calories, increased portion size, increased richness of the food, and then sitting and being sedentary, are huge factors in contributing to obesity in children.

TOBIAS: Does Nebraska lag behind other states in terms of how we're dealing with this from a public policy perspective?

SCHAEFER: I don't think so. I don't think so at all. I think there's a perception that you need to have laws to fix things. But I think you need to have an engaged population to fix things. I think where we've really excelled is in wellness and corporate wellness, and really getting folks engaged at work. Some recent data shows that we really have the adults engaged in what it takes to change your lifestyle and become healthier. So we know we're having an impact on the adults.

So now we think we're going to have a bigger impact on the children. Kids spend a lot of time in school, so that's where we're targeting our efforts, local policy and local things that can be done. So I think we have had an impact, and I don't think we've lagged behind there, because school wellness programs and some of the innovative programs we've done across the state have made an impact. It's just going to take a long time to change the data and still get more people engaged.

TOBIAS: Do we lag behind other states in our capacity to monitor youth obesity?

SCHAEFER: Sure, our data capacity could be better. That is something that we could do. A lot of states struggle with that. Folks just don't want to turn over data to the state. So we rely heavily on the ability to survey and do spot checks and surveillance on that. That's not unique to Nebraska.

TOBIAS: Are there ways that public policy can affect youth obesity?

SCHAEFER: Our take on this has always been that things can be done at the local level very effectively. We think that a school where children spend a majority of their time during the day is a logical place for things to occur. So local school boards and school administrators do have the capacity, and they're working really hard to change what's being served at the school in terms of food - what access kids have to certain items that may be less healthy than others. In other words, you make the healthy choice the default choice for kids when they're present at school; how much exercise they're getting at school. Those are complicated things for schools to figure out sometimes, and it's not always a one-size-fits-all approach.

So in other words, state laws to mandate certain things like this are not always effective. It sounds great, it sounds like a nice thing, just make a state law that you have to do this, this and this, but that's generally not the Nebraska way or the Nebraska approach to things. We like to let things be settled out at the local level, where local school and local districts can take action where they feel it best fits into their curriculum, their purchasing power for school lunches and what not, so that they can make the right decisions that work for their students.

So that's been our approach, and a lot of schools are taking that step, and we work with them and provide a lot of technical assistance to help them achieve the school health and wellness that they want.

TOBIAS: Right now, approximately one out of six young people are considered overweight. Is there a realistic goal for 10 or 20 years from now?

SCHAEFER: That's a really good question. For 10 or 20 years from now, I would hope that we could reverse the trend. Right now I think a realistic goal over the next five years is to plateau the surveillance data that we have. If we could just see a plateau so the obesity and overweight children, we don't increase in that number. I think that's realistic.

It takes a lot of time, and patience, and education, but we have to do it. It's our next generation, and they're going to be a really unhealthy generation with a lot of health care costs and not the same quality of living if we don't take it.




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