Obesity rates may have leveled off in the United States, but don't expect a sigh of relief from Shiriki Kumanyika.
"You don't want to say it's good news, because it's leveling off at high rates," said Kumanyika, a pioneering obesity researcher who is visiting the University of Washington this week.
About one-third of American adults continue to be obese, according to the Centers for Disease Control and Prevention, while more than half of African-American women are obese. Kumanyika noted the rates for all men and boys in the U.S. continues to rise and is now more than 35 percent.
About two-thirds of all adults in America are overweight or obese, putting them at increased risk for heart attack, stroke, diabetes and other diseases.
Kumanyika is a professor emeritus of epidemiology at the University of Pennsylvania, president of the American Public Health Association, a consultant for the World Health Organization (WHO), and a long-time expert on obesity rates in African Americans. She is meeting with SPH researchers this week and delivered the Mangels campus-wide lecture on Tuesday as part of the UW's Weight and Wellness series.
The United States has much to learn from other countries, Kumanyika said. She cited Mexico's year-old tax on soft drinks and snacks, which has "already seen some promising results."
Obesity rates recently reached nearly 33 percent in Mexico. Other countries that have tried taxing high-calorie foods include France, Samoa and Hungary.
Kumanyika said public health advocates also need to partner with the business sector and to "think out of the box" to come up with new strategies.
"I'm interested in working with businesses because they control the work day, and they often affect the food in the daily environment," she said. Many firms offer incentives to keep people healthy, which lowers company health insurance costs, she said. They can also can create environments conducive to physical activity and can arrange for farmer's markets to promote the idea of buying healthier food.
Kumanyika cited the importance of partnerships with non-profit organizations such as the National Gardening Association. "They're very interested in getting kids to be active outside, but also learning about foods," she said.
Another example is Mission: Readiness, a group of retired military leaders promoting physical education, early childhood education programs and increased access to healthier food at school. The military is "disadvantaged by the lack of fitness in the general population," Kumanyika added, as many youth are not physically fit to join the armed forces.
These overall strategies apply even more to disadvantaged populations, Kumanyika added, because they have less latitude in their options. "When you do things that change society, you're going to increase the options for people who are less likely to have them," she said.
A working mother in a single-parent household, for example, may not have time or access to resources for her children. If there are no recreation centers in the neighborhood, or they're not child-friendly, what's done in school – recess, stretching exercises in the classroom – becomes all that more important, she said.
A wide range of advocacy is needed to bring down our national weight, she said, much as forces joined to reduce tobacco use, promote recycling and reduce traffic fatalities.
"It's an all-hands activity," Kumanyika said. "It's not just a few obesity experts going out and giving you advice on how to manage your weight."
In her role as president of the American Public Health Association (APHA), Kumanyika said the central challenge is to make America "the healthiest nation in a generation."
"We're raising awareness that America is not the healthiest nation among its peers; in fact, it's low ranked," she said. The latest rankings from the WHO show the US at number 33 among the high-income countries, she said.
She again stressed the role of businesses.
"Whether businesses should fund public health is controversial," she said. "It might not be related to public health, but it's community give-back and enhances their reputation."
In a recent column for the APHA newspaper, the Nation's Health, she mentioned an IBM program to help improve the high school graduation rate.
"Education is one of the leading public health indicators," she said. "Education has predictable relationships to good health. We don't always know the mechanism, but it's a ringer for opportunity and advancement and ability to take advantage of the health opportunities and things in the environment."