BMI Report for Sampled CCSD Students: 2010‐2013BMI Report for Sampled CCSD Students: 2010 2013 Michael Tsai, MPHFebruary 21, 2014

Legislative History

• 2003 – Senate Concurrent Resolution No. 13 directed the Legislative C itt H lth C ’ S b itt t d t i t iCommittee on Health Care’s Subcommittee to conduct an interim study of the Medical and Societal Costs and Impacts of Obesity in Nevada.

• 2007 – Assembly Bill 354 required the collection of height and2007  Assembly Bill 354 required the collection of height and weight data in a representative sample of Nevada students in 4th, 7th, 10th grades until June 30, 2010.  

• 2009 – Assembly Bill 191 extended the period for data collection of height and weight data beyond the sunset date to June 30, 2015 and also authorized a school district to conduct the examinations in other grade levels.

• 2013 Senate Bill 442 limits height and weight data collection to• 2013 – Senate Bill 442 limits height and weight data collection to school districts in a county whose population is 100,000 or more (currently Clark and Washoe Counties) and ends requirement on June 30, 2015. 

Data Collection In Clark County

• Clark County School District (CCSD) chose to collect measurements l f it t d t ithi th d l l d t thon a sample of its students within these grade levels due to the 

large population size of its student body. • Data was collected from a convenience sample on the heights and 

weights of 4th 7th and 10th gradersweights of 4th, 7th, and 10th graders. • Using a sample methodology provided by Nevada State Health 

Division (NSHD), a total of 19 schools (12 elementary, 4 middle, and 3 high schools) were selected to participate.

• AB 354 was an unfunded mandate – school nurses were chosen to collect data on sampled students without financial support for additional staff, placing additional burden on existing responsibilities and resourcesresponsibilities and resources.

BMI PercentileThe following example demonstrates how sample BMI numbers would be interpreted for a 10‐The following example demonstrates how sample BMI numbers would be interpreted for a 10year‐old boy:

Weight Status, 2010‐2011 School Year

40.0%40 0%

45.0%

33.2%

30.0%

35.0%

40.0%

18.0%

22.9%

15 0%18.2%20.0%

25.0%

15.0%

5 0%

10.0%

15.0%

0.0%

5.0%

Overweight or Obese Overweight Obese

CCSD NHANES

Weight Status by gender, 2010‐2011 School Year

45.0%

50.0%

35.0%

40.0%

26.3%

19.8%

19.6%16.5%25.0%

30.0%

ObeseO i ht

10 0%

15.0%

20.0% Overweight

17.6%14.2%

18.4% 15.9%

0 0%

5.0%

10.0%

0.0%CCSD NHANES CCSD NHANES

Males Females

Communities Putting Prevention to Work (CPPW)

• Established a “Prevention First” position responsible for coordinating screenings with schools.

• Developed a more robust data collection protocol and conducted trainings for CCSD staff involved in dataconducted trainings for CCSD staff involved in data collection. 

• Secured standardized equipment for data collection: scales and stadiometersscales and stadiometers.

• Funding was used solely to improve data quality.  • No schools were added and the sampling strategy p g gyremained the same.

• CCSD nursing staff was still responsible for data collectioncollection.

CPPW Data, 2011‐2012 School Year

50.0%

40.0%43.0%

35.0%40.0%45.0%

18.0%22.9%

19.0%24.0%

20.0%25.0%30.0%

5.0%10.0%15.0%

0.0%5.0%

Overweight or Obese Overweight Obese

2010 11 2011 122010‐11 2011‐12

CPPW Data, 2011‐2012 School Year

45.0%

50.0%

%35.0%

40.0%

26.3% 28.1%19.6% 19.4%

25.0%

30.0%

ObeseO i ht

20 0%10 0%

15.0%

20.0% Overweight

17.6% 18.1% 18.4% 20.0%

0 0%

5.0%

10.0%

0.0%2010‐11 2011‐12 2010‐11 2011‐12

Males Females

Sampled CCSD Students 2010‐2013

30.0%

23.2%24.0% 23.7%25.0%

18.5% 19.0%17 5%

20.0% OverweightOb17.5%

15.0%

Obese

10 0%10.0%2010‐11 2011‐12 2012‐13

Sampled CCSD Students 2010‐2013

55.0%

48.0%49.7%

46.8%50.0%

41.9%

39 3%

45.0%White, NHBlack, NH

34.4% 34.7% 34.5%

39.3% 39.0%

35 0%

40.0% Hispanic

34.4%

30 0%

35.0%

30.0%2010‐11 2011‐12 2012‐13

Weight Status by gender, 2012‐2013 School Year

60.0%

40 0%

50.0%

20 3%

33.4%

14 0%

23.3%30.0%

40.0%

ObeseO i ht20.3% 14.0%

20.0%

Overweight

15.8% 17.4% 18.6% 19.4%

0 0%

10.0%

0.0%White, NH Hispanic White, NH Hispanic

Males Females

Self‐reported vs. Measured data, 2011‐2012

l ifi i hi l k f i i iBMI Classification White or Caucasian (NH)

Black or African American (NH)

Hispanic

CCSD YRBSS CCSD YRBSS CCSD YRBSS

h / bOverweight/Obese 32.9% 20.8% 41.0% 35.9% 48.3% 33.2%

Overweight 15.3% 12.9% 17.0% 18.7% 20.0% 19.4%g

Obese 17.6% 7.9% 24.0% 17.2% 28.3% 13.8%

Benefits of BMI Surveillance

• Measured data is generally more accurate and g yreliable compared to self‐reported data.

• School based BMI surveillance programs can increase parental awareness of weight risk inincrease parental awareness of weight risk in children.

• Identify demographic or geographic subgroups atIdentify demographic or geographic subgroups at greatest risk of obesity to target prevention and treatment programs.M i d l b i l d• Monitor and evaluate obesity related grant/funding objectives and school‐based programs.p g

Questions

Michael Tsai, MPHCh i i id i l iChronic Disease Epidemiologist

702‐759‐1387tsai@snhdmail.org