Healthy eating and active living in Missouri: A state-wide policy assessment

Background: Missouri has the 15th highest rate of overweight youth in the US and the 12th highest rate of adult obesity. Recognizing that preventing obesity is critical to the overall health of Missourians, Missouri Foundation for Health (MFH) developed the Healthy & Active Communities Initiative (H&AC), a comprehensive program to support community-based obesity prevention efforts with an emphasis on environmental and policy change.

Methodology: In 2008, H&AC contracted with a team from Washington University in St Louis to conduct a statewide assessment of existing local policies specific to healthy eating and active living. A stratified nested cluster design was applied to identify a geographically representative sample across seven environments: schools, health care, government, afterschool, child care, neighborhoods, and workplaces. Key informant interviews and review of public documents were utilized to identify policies.

Evaluation: The policy team will assess 2,322 policies total from 89 counties. To date 1,759 contacts for key informant interviews have been completed. Policies are categorized into three phases: 1) resolution, steering committees, and councils; 2) enacted but unfunded (N=220 policies); and 3) enacted and funded (N=41 policies).

Discussion: Findings from this policy assessment will be used: to populate the ENACT local policy dataset; to better define the seven target environments; to clarify key policy components, and; to identify a local “model policy.” This partnership between philanthropy and academia illustrates a model consistent with the call from leaders in obesity prevention to employ multi-faceted approaches and collaborations targeting environmental and policy changes to effectively curb obesity rates.