The prevalence of both diabetes and obesity has grown significantly in California. Six million adults are obese and an additional 9.3 million are overweight. Obesity is a significant risk factor for diabetes; more than two million adults have been diagnosed with diabetes in California. Obesity and diabetes disproportionately affect people of color, the poor and those with the least education in California. Policy and environmental changes that promote and encourage physical activity and healthy eating will likely prove most effective in combating obesity and related conditions.

SUMMARY: In California, more than 2 million adolescents (58%) drink soda or other sugar-sweetened beverages every day, and more than 1.6 million adolescents (46%) eat fast food at least twice a week. Adolescents who live and go to school in areas with more fast food restaurants and convenience stores than healthier food outlets such as grocery stores are more likely to consume soda and fast food than teens who live and go to school in areas with healthier food environments. State and local policy efforts to improve the retail food environment may be effective in improving adolescents’ dietary behaviors.

In California, more than 1.3 million adolescents (38%) do not participate in physical education (PE) at school, and this rate increases dramatically with age, from just 5% at age 12 to 77% at age 17. In addition, only 19% of teens meet current physical activity recommendations. Participation in PE at schoolis associated with more overall physical activity. Policies that promote more opportunities for physical activity, including those that help schools meet or exceed current PE requirements, can contribute to greater levels of physical activity for adolescents.

Only 27 percent of non-elderly adults in the United States have a "medical home" –- a place where they regularly receive medical care and advice. Shifting from more costly emergency care to the preventative and coordinated care provided by a medical home impacts costs, access, quality of care and the overall health status of low-income uninsured individuals. In this policy brief, the authors present interim findings on the efforts of ten California counties to explore the medical home model as part of the state's Health Care Coverage Initiative (HCCI), a three-year program to expand health care coverage for eligible low-income, uninsured individuals not otherwise covered by Medi-Cal. Among the innovations described are efforts to create electronic health and medical records, modify e-referrals to two-way communication between primary care physicians and other providers and standardize chronic disease registries. Support for this policy brief was provided by a grant from The California Endowment.

The prevalence of diabetes in California continues to rise. Over 1.8 million adults age 18 and over (7%) have been diagnosed with diabetes, up from 1.5 million (6.2%) in 2001. This policy brief examines the prevalence and management of diabetes in California based on data from the 2005 California Health Interview Survey (CHIS 2005). It also describes how the prevalence has changed since 2001 based on data from CHIS 2001. The brief concludes with public policy recommendations intended to reduce the risk of diabetes and its related complications.

This policy brief describes physical activity among California's adolescents based primarily on data from the 2003 California Health Interview Survey (CHIS 2003). The number of California adolescents who are physically inactive is increasing. Teenage girls, teens from low-income families, teens with no access to safe parks or open spaces, teens whose schools do not require physical education, and Latino, Asian, and African American teens are particularly at risk. The policy brief recommends that efforts to increase physical activity among California's youth should focus on assuring increased opportunities for activity at school and more safe environments for activity out of school.

People living in neighborhoods crowded with fast-food and convenience stores but relatively few grocery or produce outlets are at significantly higher risk of suffering from obesity and diabetes. The authors of this report correlated the responses of nearly 40,000 Californians surveyed in the 2005 California Health Interview Survey (CHIS) with the Retail Food Environment Index (RFEI) to determine the prevalence of obesity and diabetes. The Retail Food Environment Index (RFEI) is a ratio of the total number of fast-food restaurants and convenience stores compared to grocery stores and produce vendors near a person's home. The authors found that Californians living in communities with many fast food restaurants ­ rather than grocery stores and other outlets providing more nutritious choices ­ were more likely to have diabetes and/or be obese. The authors also found that although low-income communities are often hit hardest by this phenomenon, the health correlation is seen across all geographic regions, income levels and ethnicities. The report was authored by The UCLA Center for Health Policy Research, the California Center for Public Health Advocacy (CCPHA) and PolicyLink. The findings draw upon The UCLA Center for Health Policy Research's California Health Interview Survey (CHIS), a biennial statewide survey of more than 40,000 Californians used by legislators, policy makers, local health departments, state agencies, community organizations, advocacy groups, foundations, researchers, and many others.