Hospitals are community cornerstones. We rely on them in times of emergencies and when a loved one is in need of care. In addition, nonprofit hospitals have long been charged with providing programs and services that provide "community benefit" and improve community health.  Now, the Affordable Care Act (ACA) includes a Community Health Needs Assessment (CHNA) provision, which codifies and creates new reporting standards for nonprofit hospitals seeking to maintain their federal tax-exempt status.  Every three years, nonprofit hospitals must conduct and report on community health needs via a formal CHNA process. Additionally, nonprofit hospitals must submit an implementation strategy, which specifically describes what community benefit programming the hospital will undertake to address the health needs identified in their CHNA.

At STOP, we're taking a closer look at what these changes mean and how they may benefit communities around the country when it comes to addressing obesity. During this time of change, the new requirements could serve as an opportunity for nonprofit hospitals to assess and address their community's needs related to overweight and obesity and may create new opportunities for community-hospital partnerships.    

Earlier this month, the Alliance convened a group of experts from nonprofit hospitals, health-focused associations, government and academic institutions to explore issues around obesity program design and implementation as it pertains to the CHNA reporting requirement and implementation strategy. We discussed some of the excellent work nonprofit hospitals already have underway to address a host of community health needs, including obesity and other chronic diseases. We also discussed the high likelihood that when conducting their CHNA, many of the nation's more than 2,900 nonprofit hospitals will identify obesity as a community health need that they choose to address, including many hospitals that are not currently focused on the problem.

While this is all good news, hospitals may also meet some roadblocks along the way should they choose to address obesity. For one, opinions vary on which programs are effective and which provide the most return on investment. There is even back and forth on how to define such returns on investment and what sorts of returns are most valuable - be it reductions in health care costs for the hospital, improved quality of life for people in the community or something else entirely. While opinions vary, we learned from the experts gathered that there are programs in operation today that are showing positive results and could serve as models for others.

To help nonprofit hospitals learn from these successful examples, the STOP Obesity Alliance's obesity research team at George Washington University is developing a paper based on this discussion that will provide examples of lessons learned and suggestions for nonprofit hospitals seeking to develop similar programs. To be released in the coming months, the paper also will help nonprofit hospitals communicate the case for community-building activities that support healthy weight efforts, by describing options and evidence for structural investments in the built environment, such as parks, sidewalks and bike lanes.

This paper advances STOP's work on this issue that also includes research-based recommendations  for nonprofit hospitals seeking to develop obesity-related programs to address their community health benefit requirements. Additionally, the Alliance released earlier this month its most recent "Weight and the States" bulletin, which focused on how states, particularly state public health agencies, can support nonprofit hospitals in conducting CHNAs and community-based obesity programming. Ensuring that local obesity efforts align with state efforts may help increase the efficacy and reach of public health efforts. You can click here to download the bulletin.

I'm optimistic that our nation's nonprofit hospitals will see the need to address obesity in their community benefit work, and I'm excited about the positive impact this activity will have at the local level. I look forward to sharing these innovative ideas and concepts for addressing obesity at the community-level. If you have questions, suggestions or comments, or are interested in learning more about this work, I encourage you to contact me.

Best,

Several Alliance Steering Committee and Associate Members were featured in news stories this month including:

•  Alliance Director Scott Kahan, MD, MPH in HealthDay, "Focus on Health, Not Fat, in Food Talks With Kids," and in Medical Daily, "Talking To Kids About Their Weight: Push For Healthy Eating, Not Weight Loss, Study Says."
• STOP Obesity Alliance in Greatist.com Blog, "Why the Workplace Will Be the Future of Health and Fitness."
• American College of Sports Medicine in Reuters, "Fittest Cities Take Exercise Publicly and Personally."  
• American Heart Association in The Hill, "Health Groups Tell Michelle Obama: Conserve Land to Prevent Obesity."   
• Rebecca Puhl, PhD in NPR, "The Fat-Shaming Professor: A Twitter-Fueled Firestorm."

Obesity Community Supports the Treat and Reduce Obesity Act of 2013

Academy of Nutrition and Dietetics, Obesity Action Coalition, The Obesity Society, American Society for Metabolic & Bariatric Surgery and American Society of Bariatric Physicians all announced their support of the Treat and Reduce Obesity Act, introduced on June 19 by U.S. Senators Tom Carper (D-DE) and Lisa Murkowski (R-AK), and U.S. Representatives Bill Cassidy (R-LA) and Ron Kind (D-WI). The legislation would provide Medicare recipients and their healthcare providers with meaningful tools to treat and reduce obesity by improving access to obesity screening and counseling services and new prescription drugs for chronic weight management. Read more here.

Latest "Weight and the States" Bulletin Now Available

STOP Obesity Alliance released the latest installment of the "Weight and the States" bulletin, which focuses on things states con consider doing to aid nonprofit hospitals. In this issue, STOP's George Washington University research team explores ideas state public health departments could consider to ensure that local obesity efforts align with state efforts to increase the efficacy and reach of public health efforts. Click here to view the bulletin.

5th Annual NEWM Draws More Support 

Nearly 70,000 employees from more than 175 organizations participated in the fifth annual National Employee Wellness Month (NEWM). This year's NEWM was sponsored by Virgin HealthMiles in partnership with STOP, the Partnership to Fight Chronic Disease and WorldatWork. Participating organizations included STOP's founding sponsor Sanofi U.S. as well as STOP members American College of Preventive Medicine, American Diabetes Association, American Institute of Cancer Research, American Society of Bariatric Physicians, Canyon Ranch Institute, Care Continuum Alliance, Healthcare Leadership Council, National Association of Chronic Disease Directors, Obesity Action Coalition, and OWL - The Voice of Midlife and Older Women.

WIG Launches New Childhood Obesity Policy Resource Center

Women In Government (WIG) launched the Childhood Obesity Policy Resource Center, which is designed to provide information and resources regarding issues surrounding childhood obesity. The center is funded by a grant from Robert Wood Johnson Foundation. WIG will work to collaborate with women state legislators to increase opportunities for healthy eating and active living with the goal of reducing childhood obesity in their communities. Click here to view the resource center.

AADE to Host Annual Meeting

American Association of Diabetes Educators (AADE) will hold its annual meeting August 7-10 in Philadelphia, PA. Presentation topics will include the ways to use social media to reach diabetics and the potential impact of diabetes educators. The event will also feature an exhibit with the newest tools and technologies for patients with diabetes. Click here to register.

Joslin Diabetes Centers Names New Chief Medical Officer

Joslin Diabetes Center named Dr. Robert Gabbay as its chief medical officer who will assist in clinical improvements and programs that will contribute to Joslin's ongoing efforts to address and impact the global diabetes epidemic. Dr. Gabbay was the former director of the Penn State Institute for Diabetes and Obesity. Read more about Dr. Gabbay here.

More Than Disease Management Needed to Control Costs, JAMA Study Says 

June 24, 2013

Modern Healthcare

By Melanie Evans

The U.S. will have to do more to prevent chronic illness than simply managing it better in order to save significantly on costs for Medicare's most expensive patients, according to a study published in JAMA. The costliest 10 percent of patients accounted for 70 percent of Medicare spending analyzed by the Harvard University researcher team. The results suggest that hospitals and policymakers must look beyond disease management to population health and hospital efficiency to slow U.S. health spending.

June 19, 2013

Modern Healthcare

By Rich Daly

Obesity rates are still rising, but at a slower pace, which some experts say may be a sign people are finally responding to a smattering of policy initiatives and an outpouring of national concern about its long-term impact on healthcare spending. The CDC reported that the adult obesity rate increased slightly to nearly 29 percent in 2012. According to the report, it is a .2 percent increase from the 2011 rate and was the slowest rise in adult obesity since 2003.

AMA Backs Disease Classification For Obesity  

June 18, 2013

Forbes

The American Medical Association (AMA) officially endorsed recognizing obesity as a disease at its annual meeting in Chicago. By an overwhelming vote of the AMA's policy-making House of Delegates, the group voted in favor of a resolution to "recognize obesity as a disease state with multiple pathophysiology aspects requiring a range of interventions to advance obesity treatment and prevention."

June 11, 2013

Health Affairs Blog

By Sara Rosenbaum, Amber Rieke and Maureen Byrnes

An article written by members of a George Washington University research team discusses community benefit investments that have been an obligation of nonprofit hospitals as a condition of their federal tax-exempt status for decades. However, in the wake of increasing scrutiny by Congress, the IRS established a nationwide reporting system that enables a deeper dive into the question of nonprofit hospital community investment.

10 Ways to Talk to Your Child About Weight 

June 7, 2013

BBC News Magazine

By Kathryn Westcott

The article highlights how parents can discuss the subject of weight with their children in a healthy and productive way. The article discusses situations a parent may face like when a child is bullied at school or being asked directly "Am I fat?" Some parents think that the less said the better, yet many expert argue that discussing the topic of weight in a "common sense" way will help the relationship and the child's health. 

Heavy Patients Trust Diet Advice From Overweight Docs Most: Study 

June 7, 2013

HealthDay

By Kathleen Doheny

Overweight and obese patients prefer getting advice about weight loss from doctors who are also overweight or obese, according to a study published in Preventative Medicine. Although 77 percent of those seeing a normal-weight doctor trusted the diet advice, 87 percent of those seeing an overweight doctor trusted the advice, as did 82 percent of those seeing an obese doctor. Study researchers suggest that obese patients may feel a "shared identity" with overweight or obese doctors.