Wisconsin Department of Health Services January 2014 P-00522M Healthiest Wisconsin 2020 Baseline and...

Wisconsin Department of Health Services

January 2014 P-00522M

Healthiest Wisconsin 2020 Baseline and Health Disparities Report

Physical Activity

PHYSICAL ACTIVITY

Background• Overview of Healthiest Wisconsin 2020 Baseline and Health Disparities

Report • Healthiest Wisconsin 2020 objectives and indicators• Rationale• Key points

Data• Weight and physical activity among youth• Weight and physical activity among adults• Environmental factors and resources

References

Links to additional reports and resources

Contacts

Chapter Outline

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Chapter outline

PHYSICAL ACTIVITY

Report Overview

• This chapter is part of a larger report created by the Wisconsin Department of Health Services to track progress on the objectives of Healthiest Wisconsin 2020 (HW2020) and identify health disparities in the state. The full report is available at: http://www.dhs.wisconsin.gov/publications/P0/p00522.pdf

• The report is designed to address the Health Focus Areas in HW2020. Where direct measures exist, data are presented; where direct measures are not available, related information may be included.

• Information about populations experiencing health disparities is provided in the Health Focus Area chapters and is summarized in separate chapters devoted to specific populations.

• Technical notes are available at: http://www.dhs.wisconsin.gov/publications/P0/p00522y.pdf

Report overview

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http://www.dhs.wisconsin.gov/publications/P0/p00522.pdf

http://www.dhs.wisconsin.gov/publications/P0/p00522y.pdf


PHYSICAL ACTIVITY

Report Format

Full Report• Format: PDF • Intended use: reference document

Chapters• Format: Annotated PowerPoint slide set• Intended uses: presentations to

– Decision-makers– Service providers– Community leaders– The public

Sample annotated slide

Report overview

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PHYSICAL ACTIVITY

Report Outline

Executive Summary

Section 1: Introduction

Section 2: Demographic overview

Section 3: Health focus areas

Section 4: Infrastructure focus areas

Section 5: Data summaries by population

Section 6: Technical notes

Report overview

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PHYSICAL ACTIVITY

Report Outline: Detail

Section 3: Health focus areas

• Alcohol and other drug use• Chronic disease prevention and management• Communicable diseases• Environmental and occupational health• Healthy growth and development• Injury and violence• Mental health• Nutrition and healthy foods• Oral health• Physical activity• Reproductive and sexual health• Tobacco use and exposure

Section 4: Infrastructure focus areas• Access to health care

Report overview

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PHYSICAL ACTIVITY

Report Outline: Detail

Section 5: Data summaries by population

Racial/ethnic minority populationso American Indianso Asianso Blackso Hispanics

People of lower socioeconomic status People with disabilities Lesbian, gay, bisexual, and transgender populations Geography

Report overview

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PHYSICAL ACTIVITY

Data notes

• Please refer to the Technical Notes chapter for a more detailed description of limitations and methods: http://www.dhs.wisconsin.gov/publications/P0/p00522y.pdf

• The 95% confidence intervals are denoted by error bars. Where

confidence intervals do not overlap, as shown in the example on

the right, differences are statistically significant. Larger confidence

intervals may indicate less reliable estimates that should be

interpreted with caution.

• Population estimates that are considered unreliable are excluded.

• Misclassification of racial/ethnic groups may affect the accuracy of rates.

• Unless otherwise indicated, the Hispanic population may include people of various races; Whites, Blacks, Asians, and American Indians are non-Hispanic.

Report overview

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PHYSICAL ACTIVITY

Factors that influence health

Social determinants

of health

Source: University of Wisconsin Population Health Institute. County Health Rankings 2013, http://www.countyhealthrankings.org/our-approach

Report overview

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PHYSICAL ACTIVITY

Healthiest Wisconsin 2020 objectives and indicators

Objective 1

By 2020, increase physical activity for all through changes in facilities, community design, and policies.

Objective 1 Indicators

• Proportion of high school students who meet federal physical activity guidelines for aerobic physical activity and muscle-strengthening.

• Proportion of adults who meet federal physical activity guidelines for aerobic physical activity and muscle-strengthening.

Source: Wisconsin Department of Health Services, Healthiest Wisconsin 2020, Physical Activity Focus Area Profile.10

HW2020 objectives

PHYSICAL ACTIVITY

Objective 2

By 2020, every Wisconsin community will provide safe, affordable and culturally appropriate environments to promote increased physical activity.


• Percent of children less than 18 years old living in a neighborhood with a nearby park or recreation center and sidewalks.

• Percent of Wisconsin communities with satisfactory scores as measured by the Wisconsin Assessment of the Social and Built Environment.


HW2020 objectives


PHYSICAL ACTIVITY

Objective 3

By 2020, every Wisconsin community will provide safe, affordable and culturally appropriate environments to promote increased physical activity for individuals among populations of differing races, ethnicities, sexual identities and orientations, gender identities, and educational or economic status.


• Inventory of environments by community (including parks, facilities, workplace programs).


HW2020 objectives


PHYSICAL ACTIVITY

Rationale

• Physical activity means any bodily activity that enhances or maintains physical fitness and overall health.

• Regular physical activity can help to reduce the risk of certain chronic diseases, such as high blood pressure, stroke, coronary artery disease, type 2 diabetes, obesity, colon cancer, and osteoporosis.

• Physical activity recommendations include strategies to make physical activity an easy choice. This can be accomplished by creating opportunities for children, adults, and older adults to be active where they live, play, work and learn.


Rationale

PHYSICAL ACTIVITY

Key points

Youth

• During 2007-2011, approximately 10% of high school students in Wisconsin were obese and 14% were overweight.

• In 2010, 14% of children (ages 2-4 years) enrolled in WIC were obese.

• Significant disparities exist in the prevalence of physical activity and sedentary behavior among youth in Wisconsin by race/ethnicity and sexual minority status. For example, compared to White youth, Black, Hispanic, and Asian youth were significantly less likely to exercise throughout the week, and were more likely to watch three or more hours of television a day.

• A greater percentage of Black children lived in neighborhoods with multiple resources for physical activity, but Black parents were less likely than White parents to feel that their neighborhoods were safe for their children.

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Key points

PHYSICAL ACTIVITY

Key points

Adults

• In 2009-2011, approximately two-thirds (65%) of Wisconsin adults were overweight or obese and 29% were obese. Significant disparities exist in the prevalence of adult obesity. For example:

o Black and American Indian adults were significantly more likely to be obese compared to White adults.

o Adults with the lowest household income were significantly more likely to be overweight or obese compared to middle- or high-income adults.

o Among Wisconsin adults ages 18-64, those with a disability were more likely to be overweight or obese than those without a disability.

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Key points

PHYSICAL ACTIVITY

Key points

Adults

• Physical inactivity is significantly more prevalent among:o Black, Hispanic, and American Indian adults, compared to White and

Asian adults.o Adults with lower household incomes, compared to adults with higher

incomes.o Adults living with a disability, compared to adults without a disability.

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Key points

PHYSICAL ACTIVITY

Weight and physical activity among youth

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PHYSICAL ACTIVITY

Overweight, obesity, and weight loss attempts among Wisconsin high school students, by race/ethnicity, 2007-2011


Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

Overweight Obese Trying to lose weight0%

10%

20%

30%

40%

50%

60%

70%

13% 10% 44%17% 12% 35%20% 14% 55%15% 15% 49%16% 44%

White Black

Hispanic Asian

American Indian

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PHYSICAL ACTIVITY

Overweight, obesity, and weight loss attempts among Wisconsin high school students, by sexual minority status, 2007-2011

Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.

Overweight Obese Trying to lose weight0%

10%

20%

30%

40%

50%

60%

14% 8% 43%18% 12% 56%

Sexual majoritySexual minority


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PHYSICAL ACTIVITY

Physical activity and sedentary behaviors among Wisconsin high school students by race/ethnicity, 2007-2011

Exercise 1+ hour, 5 out of 7 days

Attend physical educa-tion at least in once

past 7 days

Watch 3+ hours TV on average school day

Play 3+ hours video/computer

games on average school day

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

48% 55% 21% 19%35% 43% 49% 26%29% 46% 34% 25%37% 54% 28% 31%49% 54% 20% 24%

WhiteBlackHispanicAsianAmerican Indian

Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.


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PHYSICAL ACTIVITY

Physical activity and sedentary behaviors among Wisconsin high school students by sexual minority status, 2007-2011


Exercise 1+ hour, 5 out of 7 days

Attend physical edu-cation at least once in

past 7 days

Watch 3+ hours TV on average school

day

Play 3+ hours video/computer

games on average school day

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

47% 23% 19% 52%35% 26% 28% 48%

Sexual majoritySexual minority

Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.21

PHYSICAL ACTIVITY

Rate of physical inactivity among Wisconsin adults, by race/ethnicity, 2008-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 land-line only dataset.

Did not participate in any physical activity in past month, other than at job0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

19% 36%

No disabilityDisability

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PHYSICAL ACTIVITY

Obesity among children ages 10-17, by disability status, Wisconsin, 2011-2012

Obese0%

5%

10%

15%

20%

25%

30%

35%

40%

12% 18%

Children with no special health care needs

Children with special health care needs

Source: 2011-2012 National Survey of Children's Health


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PHYSICAL ACTIVITY

Obesity among children (ages 2-4 years) enrolled in the Supplemental Nutrition Program for Women, Infants, and Children (WIC), by race/ethnicity, Wisconsin, 2001 and 2010

White Black Hispanic Asian American Indian0%

5%

10%

15%

20%

25%

30%

35%

40%

10% 8% 16% 18% 18%12% 11% 18% 17% 27%

2001 2010

Source: Centers for Disease Control and Prevention (CDC) Pediatric Nutrition Surveillance Survey 2010.Note: Based on >= 95th growth chart percentiles for Body Mass Index for age. WIC is the Supplemental Nutrition Program for Women, Infants, and Children.


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PHYSICAL ACTIVITY

Weight and physical activity among adults

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PHYSICAL ACTIVITY

Overweight and obesity among Wisconsin adults, by sex, 2009-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009-2011 landline-cellphone combined dataset.

Overweight or Obese Obese0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

65% 29%73% 29%58% 28%

Total Male

Female


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PHYSICAL ACTIVITY

Overweight and obesity among Wisconsin adults, by age, 2009-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009-2011 landline-cellphone combined dataset.


10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

39% 14%65% 29%73% 35%68% 27%

18 - 2425 - 4445 - 6465+


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PHYSICAL ACTIVITY

Age-adjusted rates of overweight and obesity among Wisconsin adults by race/ethnicity, 2008-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.


10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

63% 27%78% 44%67% 29%45% 71% 38%



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PHYSICAL ACTIVITY

Age-adjusted rates of overweight and obesity among Wisconsin adults, by household income, 2008-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.


10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

70% 41%65% 29%60% 23%

Low income (<$20,000)

Middle income ($20,000-$74,999)

High income ($75,000+)


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PHYSICAL ACTIVITY

Age-adjusted rates of overweight and obesity among Wisconsin adults, by level of urbanization, 2008-2011



10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

67% 31%63% 27%64% 29%

Milwaukee County

Smaller metropolitan counties

Non-metropolitan counties


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PHYSICAL ACTIVITY

Overweight and obesity among Wisconsin adults ages 18-64, by disability status, 2008-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline only dataset


10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

61% 25%74% 43%

No disability

Disability


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PHYSICAL ACTIVITY

Overweight and obesity among Wisconsin adults, by sexual orientation and sex, 2008-2011


Overweight or obese, male

Overweight or obese, female

Obese, male Obese, female0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

72% 56% 30% 27%49% 61% 17% 30%

Sexual majority

Sexual minority


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PHYSICAL ACTIVITY

Physical inactivity among Wisconsin adults, by sex, 2009-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009-2011 combined landline-cell dataset.

Did not participate in any physical activity in past month, other than at job

-10%

0%

10%

20%

30%

40%

50%

60%

23% 21% 24%

Total

Male

Female


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PHYSICAL ACTIVITY

Physical inactivity among Wisconsin adults, by age, 2009-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009-2011 combined landline-cell dataset.


-10%

0%

10%

20%

30%

40%

50%

60%

14% 20% 24% 33%

18 - 2425 - 4445 - 6465+


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PHYSICAL ACTIVITY

Age-adjusted rate of physical inactivity among Wisconsin adults, by race/ethnicity, 2008-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset


-10%

0%

10%

20%

30%

40%

50%

60%

22% 37% 33% 28% 26%



35

PHYSICAL ACTIVITY

Age-adjusted rate of physical inactivity among Wisconsin adults, by household income, 2008-2011



-10%

0%

10%

20%

30%

40%

50%

60%

37% 24% 16%

Low income (<$20,000)

Middle income ($20,000-$74,999)

High income ($75,000+)


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PHYSICAL ACTIVITY

Age-adjusted rate of physical inactivity among Wisconsin adults, by level of urbanization, 2008-2011



-10%

0%

10%

20%

30%

40%

50%

60%

28% 22% 26%

Milwaukee County

Smaller metropolitan counties

Non-metropolitan counties


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PHYSICAL ACTIVITY

Physical inactivity among Wisconsin adults ages 18-64, by disability status, 2008-2011



-10%

0%

10%

20%

30%

40%

50%

60%

19% 36%

No disability

Disability


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PHYSICAL ACTIVITY

Physical inactivity among Wisconsin adults, by sexual orientation, 2008-2011



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Did not participate in any physical activity in past month, other than at job0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

22% 23%

Heterosexual

Lesbian, gay, bisexual

PHYSICAL ACTIVITY

Environmental factors and resources

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PHYSICAL ACTIVITY

Neighborhood environment of children less than 18 years of age, by race/ethnicity, Wisconsin, 2011-2012

Source: 2011-2012 National Survey of Children's Health. *Neighborhoods that include all four of these amenities. Data were not available for other races.


Children living in neighborhoods with sidewalks, libraries, recreation centers, and parks*

Children living in neighborhoods their parents feel are usually or always safe

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

55% 94%63% 61%55% 86%

WhiteBlackHispanic

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PHYSICAL ACTIVITY

Percentage of census blocks close to parks and fitness centers, Wisconsin and United States, 2007

Source: Centers for Disease Control and Prevention (CDC), State Indicator Report on Physical Activity, 2010.


0%

5%

10%

15%

20%

25%

23% 15%20% 17%

WisconsinUnited States

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PHYSICAL ACTIVITY

References

1. University of Wisconsin Population Health Institute. County Health Rankings, 2013. http://www.countyhealthrankings.org/our-approach

2. Center for Urban Population Health. Milwaukee Health Report, 2011. http://www.cuph.org/mhr/2011-milwaukee-health-report.pdf

3. LaVeist TA, Gaskin DA, Richard P (2009). The Economic Burden of Health Inequalities in the United States. Joint Center for Political and Economic Studies. http://www.jointcenter.org/sites/default/files/upload/research/files/The%20Economic%20Burden%20of%20Health%20Inequalities%20in%20the%20United%20States.pdf

4. Thomas JC, Sage M, Dillenberg J, Guillory VJ (2002). A Code of Ethics for Public Health. Am Journal of Public Health. 92(7):1057–1059. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447186/

5. Wisconsin Department of Health Services (DHS). Healthiest Wisconsin 2020. http://www.dhs.wisconsin.gov/publications/P0/P00187.pdf

6. Centers for Disease Control and Prevention (CDC). Adolescent and School Health: Childhood Obesity Facts. http://www.cdc.gov/healthyyouth/obesity/facts.htm

7. CDC. Adolescent Health in the United States. http://www.cdc.gov/nchs/data/misc/adolescent2007.pdf

8. CDC. Adolescent and School Health: Physical Activity. http://www.cdc.gov/healthyyouth/physicalactivity/facts.htm

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References

http://www.countyhealthrankings.org/our-approach

http://www.cuph.org/mhr/2011-milwaukee-health-report.pdf

http://www.jointcenter.org/sites/default/files/upload/research/files/The%20Economic%20Burden%20of%20Health%20Inequalities%20in%20the%20United%20States.pdf

http://www.jointcenter.org/sites/default/files/upload/research/files/The%20Economic%20Burden%20of%20Health%20Inequalities%20in%20the%20United%20States.pdf

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447186/

http://www.dhs.wisconsin.gov/publications/P0/P00187.pdf

http://www.cdc.gov/healthyyouth/obesity/facts.htm

http://www.cdc.gov/nchs/data/misc/adolescent2007.pdf

http://www.cdc.gov/healthyyouth/physicalactivity/facts.htm

PHYSICAL ACTIVITY

9. CDC. Association Between Sedentary Behavior, Physical Activity, and Obesity: Inactivity Among Active Kids. http://www.cdc.gov/pcd/issues/2009/jan/07_0242.htm

10. U.S. Department of Health and Human Services. Physical Activity Guidelines. Chapter 7: Additional Considerations for Some Adults. http://www.health.gov/paguidelines/guidelines/chapter7.aspx

11. U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. Children with Special Health Care Needs in Context: A Portrait of States and the Nation, 2007. Rockville, MD: U.S. Department of Health and Human Services, 2011. http://www.mchb.hrsa.gov/nsch/07cshcn/

12. CDC. Obesity Prevalence Among Low-Income, Preschool-Aged Children - United States, 1998-2008. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5828a1.htm

13. CDC. About BMI for Adults. http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html#Definition

14. Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, Prevalence and Trends Data. http://apps.nccd.cdc.gov/brfss/

15. CDC. Disability and Obesity. http://www.cdc.gov/ncbddd/disabilityandhealth/obesity.html

16. Boehmer U, Bowen DJ, Bauer GR. Overweight and obesity in sexual minority women: evidence from population-based data. American Journal of Public Health. 2007; 97: 1134–1140. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1874217/

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References

http://www.cdc.gov/pcd/issues/2009/jan/07_0242.htm

http://www.health.gov/paguidelines/guidelines/chapter7.aspx

http://www.mchb.hrsa.gov/nsch/07cshcn/

http://www.mchb.hrsa.gov/nsch/07cshcn/

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5828a1.htm

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5828a1.htm

http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html

http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html

http://apps.nccd.cdc.gov/brfss/

http://apps.nccd.cdc.gov/brfss/

http://www.cdc.gov/ncbddd/disabilityandhealth/obesity.html



PHYSICAL ACTIVITY

17. National Eating Disorders Association. Eating Disorders in LGBT Populations. http://www.nationaleatingdisorders.org/sites/default/files/ResourceHandouts/LGBTQ.pdf

18. CDC: Physical Activity. http://www.cdc.gov/physicalactivity/everyone/guidelines/index.html

19. CDC: Physical Activity. Older adults. http://www.cdc.gov/physicalactivity/everyone/guidelines/olderadults.html

20. CDC. State Indicator Report on Physical Activity, 2010. http://www.cdc.gov/physicalactivity/downloads/PA_State_Indicator_Report_2010.pdf

21. Kahn EB, Ramsey LT, Brownson RC, et al. The effectiveness of interventions to increase physical activity: A systematic review. Am J Prev Med. 2002;22(4 suppl):73–107. http://www.thecommunityguide.org/pa/pa-ajpm-evrev.pdf

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References

http://www.nationaleatingdisorders.org/sites/default/files/ResourceHandouts/LGBTQ.pdf

http://www.nationaleatingdisorders.org/sites/default/files/ResourceHandouts/LGBTQ.pdf

http://www.cdc.gov/physicalactivity/everyone/guidelines/index.html

http://www.cdc.gov/physicalactivity/everyone/guidelines/index.html

http://www.cdc.gov/physicalactivity/everyone/guidelines/olderadults.html

http://www.cdc.gov/physicalactivity/downloads/PA_State_Indicator_Report_2010.pdf


http://www.thecommunityguide.org/pa/pa-ajpm-evrev.pdf

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Links to additional reports and resources

• The Epidemic of Chronic Disease in Wisconsin: Why it Matters to the Economy and What You Can Do to Help: http://www.dhs.wisconsin.gov/publications/P0/P00238.pdf

• Obesity, Nutrition, and Physical Activity in Wisconsin: http://www.dhs.wisconsin.gov/physical-activity/

• State Indicator Report on Physical Activity, 2010: http://www.cdc.gov/physicalactivity/downloads/PA_State_Indicator_Report_2010.pdf

• Wisconsin Nutrition, Physical Activity and Obesity Program: http://www.dhs.wisconsin.gov/physical-activity/

• Centers for Disease Control and Prevention (CDC). Physical Activity: http://www.cdc.gov/physicalactivity/

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Links

http://www.dhs.wisconsin.gov/publications/P0/P00238.pdf

http://www.dhs.wisconsin.gov/physical-activity/

http://www.dhs.wisconsin.gov/physical-activity/





PHYSICAL ACTIVITY

Contact

Jon Morgan, MS

Physical Activity Coordinator

Nutrition, Physical Activity and Obesity Program

Bureau of Community Health Promotion

Division of Public Health

Wisconsin Department of Health Services

Email: [email protected]

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Contacts

mailto:[email protected]

Wisconsin Department of Health Services January 2014 P-00522M Healthiest Wisconsin 2020 Baseline and...

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