Improving state childhood obesity surveillance: A review of current practice and recommendations for change

Introduction: Local-level childhood obesity surveillance is critical to galvanizing support for and informing interventions. Since national surveillance systems do not capture locally-representative objectively-measured child BMI data, states are increasingly attempting to fill the data gap. This is the first study to systematically document states' child BMI surveillance efforts, identify best practices for collecting and reporting child BMI data, and recommend feasible state-based surveillance systems.

Methods: In January 2014, we searched state health and education agency websites for relevant information and contacted both agencies in every state to confirm current surveillance practices.

Results: Eleven states (22%) collect population-representative BMI data for at least one grade level; ten collect data annually and five collect longitudinal data. Ten states report local-level data. Within select grades (ranging from one to 13 grade levels), nine states measure all students (three in conjunction with physical fitness assessments and six as a health screen), and two states assess students in a random sample of schools. Collectively, these states survey approximately 8.4 million children (6% of U.S. school children).

Conclusion: While local child BMI data is fundamental to understanding the forces driving obesity rates, few states administer ongoing surveillance systems. Eleven states demonstrate the feasibility of conducting school-based BMI surveillance and provide insight into the administrative costs. Although locally-representative longitudinal surveillance data are optimal for tracking trends and evaluating intervention efforts, the public health value must be weighed against the financial burden of collecting, analyzing and disseminating the data when making policy recommendations.