America's 2005 obesity "report card" shows some progress among states but plenty of room for improvement.

Released by the University of Baltimore's Obesity Initiative, the report awarded only one "A." California took that honor for its attempt to control childhood obesity. However, California's overall grade for its efforts to address the obesity epidemic (not just among school children) was a "B."

About a quarter of states earned a failing grade for efforts to control childhood obesity, the report card states. "Given the importance of establishing healthy habits early in life, the results are very disappointing," write the researchers.

Overall Grades

Here are the grades for state overall efforts to control obesity (states listed in alphabetical order):

A: No states.

B: Arkansas, California, Connecticut, Hawaii, Maryland, New York, North Carolina, Oklahoma, Tennessee, Texas, Washington

C: Arizona, Colorado, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Mississippi, Missouri, New Hampshire, New Jersey, New Mexico, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Virginia, West Virginia

D: Alabama, Alaska, Delaware, Florida, Michigan, Minnesota, Montana, Nebraska, North Dakota, Vermont, Wisconsin

F: Idaho, Nevada, South Dakota, Utah, Wyoming


Grades for Childhood Obesity

The report card also gave grades for state efforts regarding childhood obesity:

A: California

B: Arkansas, Connecticut, Colorado, Hawaii, Kansas, Kentucky, Maine, New York, North Carolina, Oklahoma, Pennsylvania, Tennessee, Texas, Washington, West Virginia

C: Arizona, Delaware, Georgia, Illinois, Indiana, Iowa, Louisiana, Maryland, Massachusetts, Michigan, Missouri, Mississippi, New Hampshire, New Jersey, Nebraska, New Mexico, Ohio, Oregon, Rhode Island, South Carolina, Virginia

D: Alabama, Florida, Minnesota, Montana, North Dakota, Wisconsin, Vermont

F: Alaska, Idaho, Nevada, South Dakota, Utah, Wyoming


Making the Grade, Or Not

The report card comes from the University of Baltimore's Obesity Initiative. Grades were based on legislation introduced and/or passed by the states on eight topics: nutrition standards; vending machine usage; body mass index (BMI) measured in school; recess and physical education; obesity programs and education; obesity research; obesity treatment in health insurance; and obesity commissions. The researchers looked at each state's most recent legislative session.

To receive an "A," states had to successfully pass a law related to obesity. Points were awarded if legislation was introduced but not passed. "Introducing legislation at least indicates some awareness and the presence of a will directed to controlling obesity," notes the report card.

Researchers working on the report card included Kenneth R. Stanton, PhD, MBA, an assistant professor of finance at the University of Baltimore's business school.

'Disturbing' Shortfall for Stopping Obesity

"Many states made progress in enacting legislation," write researchers. But they say some states with high obesity rates "are lagging in taking corrective steps."

For instance, the report card states that according to the CDC, Mississippi had the nation's highest obesity rate in 2001. Mississippi earned points for passing legislation on recess/physical education requirements and establishing an obesity commission. But only the recess/physical education law is likely to have any near-term impact, according to the report card.

West Virginiaand Michigan were the No. 2 and No. 3 states for obesity prevalence in 2001 according to the CDC, says the report card. The researchers say both states have proposed obesity legislation but no laws were successfully passed.

"Overall, states have been slow to recognize the need for prompt actions that may have a more immediate effect," write researchers. "The absence of significant state efforts to address the epidemic is disturbing."

Hot Topics

The top three areas of proposed legislation among the states were:

—Recess/physical education requirements (27 states)

—Nutrition standards (23 states)

—Vending machine restrictions (21 states)

Fourteen states tried to pass laws regarding BMI assessment of school children, and 13 attempted to pass laws mandating curricula to address nutrition education and obesity awareness. Less than five states had proposed legislation for obesity research.

State Obesity Rates

The CDC's 2003 Behavioral Risk Surveillance Survey lists adult obesity rates for each state. States in each category are listed alphabetically.

Adult obesity rate of 15 to 19 percent: Arizona, Colorado, Connecticut, Florida, Hawaii, Maine, Massachusetts, Montana, New Hampshire, New Jersey, New Mexico, Rhode Island, Utah, Vermont, Wyoming

Adult obesity rate of 20 to 24 percent: Alaska, Arkansas, California, Delaware, Georgia, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Missouri, Nebraska, Nevada, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Oregon, South Carolina, South Dakota, Tennessee, Texas, Virginia, Washington, Wisconsin

Adult obesity rate of at least 25 percent:Alabama, Indiana, Mississippi, West Virginia

By Miranda Hitti, reviewed by Brunilda Nazario, MD


SOURCES: The University of Baltimore Obesity Initiative: "The U.S. Obesity Report Card." CDC.