The nation's more than 2,900 nonprofit hospitals are facing new requirements to qualify for federal tax-exempt status under the Affordable Care Act, including producing a Community Health Needs Assessment that identifies local health needs. With obesity affecting more than one-third of adults and 17 percent of children in the United States, the Strategies to Overcome and Prevent (STOP) Obesity Alliance released five research-based, consensus recommendations today to help guide nonprofit hospitals in developing programs that address obesity in their communities.
"The new federal community health benefit requirement presents a critical opportunity to address obesity at the local level, given the role nonprofit hospitals play in improving a community's health," said Scott Kahan, MD, MPH, Director of the Alliance. "With the federal value of the hospital tax benefit estimated to be in the billions of dollars, there is a lot at stake. The challenge will be to empower hospitals to build efficient and evidence-based programs for addressing obesity while avoiding common pitfalls, such as weight stigma and unrealistic expectations. "
The Alliance strongly encourages nonprofit hospitals to base programs designed to overcome and prevent obesity on the following core principles:
- Redefining Success: Promote the use of a sustained loss of five to ten percent of current weight as a key measure of health improvement to judge the effectiveness of weight reduction interventions.
- Encourage Innovation and Best Practices in Obesity Treatment: Identify and disseminate successful or promising practices for interventions.
- Address and Reduce Stigma as a Barrier to Improving Health Outcomes: Cultivate a positive environment by promoting awareness and open discussion among health professionals, opinion leaders, role models and the public of the harmful impact of stigmatizing people affected by obesity. Promote interventions that provide support for sustained weight loss and go beyond recognizing the role of personal responsibility.
- Broaden, Intensify and Coordinate the Research Agenda for Obesity: Encourage an interdisciplinary research environment that addresses the obesity epidemic as a result of a complex interplay of biological, genetic, behavioral, cultural, environmental, social, policy and economic factors.
- Encourage Physical Activity for Improved Health: Encourage interventions and create environments and systems that support active living as well as moderate-vigorous physical activity to improve health, independent of weight loss.
"These recommendations offer hospitals a research-based range of opportunities to invest in community health as part of their community benefit activities," said Sara Rosenbaum, Harold and Jane Hirsh Professor of Health Law and Policy at the George Washington University School of Public Health and Health Services. "Counseling and programs that create community healthy living options have been shown effective in controlling weight and improving patient health."
There are many ways that nonprofit hospitals can use these recommendations to tailor community interventions around obesity. For example, health care organizations may address obesity by using individual-based strategies with counseling techniques as well as system strategies that address community health needs around healthy living. A nonprofit hospital can build programs around the evidence showing that helping patients to lose five to ten percent of their body weight, or helping communities engage in more physical activity, can lead to significant health improvement.
In addition to this set of recommendations, the Alliance will conduct an expert roundtable to further explore issues around obesity program design and implementation as it pertains to the Community Health Needs Assessment reporting requirement and Implementation Strategy. From this roundtable, the Alliance will work to provide hospitals with a set of examples and best practices in community-based obesity programming and evidenced-based research in community building options targeted at healthy weight.
"It's our hope that the STOP Obesity Alliance recommendations encourage meaningful action to address obesity," said Kahan. "Certainly there is not a one-size-fits-all obesity program for every community across America. But if the programs adhere to the health-focused recommendations developed by STOP's cross-section of diverse stakeholders, that is a great place to start."
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