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Tackling Childhood Obesity through the Communities Putting Prevention to Work (CPPW) Initiative

Nationally in 2013–14, almost 40% of the adult population 20 years and over was obese. Among children and adolescents aged 2–19 years, the prevalence of obesity in 2013–14 was almost 20%.1 Consequences of obesity include heart disease, stroke, type 2 diabetes, and cancer, which lead to premature and preventable deaths.2 Obesity impacts a large percentage of the population in King County, Washington, which includes the city of Seattle. In King County, 21% of adults were obese in 2006–2010, and 9% of youth (8th, 10th, and 12th grade students) were obese in 2010.3 Obesity rates are disproportionately high among certain populations in King County, including blacks, American Indians, and Alaska natives. For youth, this disparity is evident among high school students, as obesity rates among ethnic minorities in 2010 were at least double that of white students.4

Through the Communities Putting Prevention to Work (CPPW) initiative, the Centers for Disease Control and Prevention (CDC) provided support to 50 communities across the country for obesity and tobacco-use prevention activities, one of which was King County.5 Public Health-Seattle & King County (PHSKC) used funding from the CPPW initiative to address obesity and health inequality in their community through promoting healthy eating active living (HEAL), which included a school-based component only implemented in low-income school districts. During the 2-year initiative period (2010–2012), PHSKC funded 41 HEAL projects, focusing on neighborhoods with lower incomes and higher rates of physical inactivity, poor diet, and chronic disease.6 To support these efforts, the Community Coalition (“Healthy King County Coalition”) was created to engage stakeholder groups (or stakeholders), project partners, grantees, public health staff, and other community organizations in an effort to foster a network to create a broader impact in the community.7

The school-based interventions focused on improving nutrition and increasing physical activity among all students (grades K–12). For example, the Kent School District implemented a farm-to-school program, which connected farms with school cafeterias and classrooms. Program activities included highlighting locally produced foods in the cafeteria or classroom, hosting special event meals with local farmers or producers, developing a nutrition curriculum, coordinating field trips to farms, and training food service staff to prepare and promote fresh, local food.8 During the initiative period, $140,000 worth of local food was purchased in the Kent School District.9 Another 6 school districts implemented school menu changes and developed digital menu boards to provide nutritional information to students. Across these school districts, 432 food service staff were trained in whole foods preparation across the school districts. Other projects focused on physical education, such as an effort to implement new high-quality physical education curricula, which included training of teachers and purchasing equipment.10 Finally, students from one King County high school created a public awareness initiative, Commit to Fit, to empower students to make healthy choices. Through this initiative, students and staff could earn points by exercising or organizing healthy community events, and points were then redeemed for prizes and rewards. Within two weeks of the event launch at the end of 2010, more than 2,200 students and staff had registered.11

To assess the impact of CPPW, PHSKC analyzed childhood obesity in King County using Washington State Healthy Youth Survey data.12 In 2012, for the first time, the obesity prevalence among students in grades 8, 10, and 12 in King County youth showed a statistically significant decrease, while no change occurred in the remainder of the state. The odds of a student being obese in 2012 were 10% less than in 2004. When comparing CPPW and non-CPPW schools in King County before and after the initiative was implemented, there was a significant decline in CPPW schools. Among students in CPPW school districts, obesity prevalence decreased from 10.6% in 2010 to 8.8% in 2012. Between 2010 and 2012, the obesity prevalence among students in non-CPPW districts increased from 6.3% to 6.8%. These results show the potential impact of the CPPW initiative and HEAL activities on childhood obesity in King County, specifically on low-income populations. 

1 Centers for Disease Control and Prevention. Childhood Obesity Facts. Accessed November 2015. Available at:

2 CDC. Adult Obesity Facts. 

3 Centers for Disease Control and Prevention. Division of Community Health (DCH): Making Healthy Living Easier. Community Profile: King County, Washington. Accessed November 2015. Available at:

4 Ibid. 

5 Centers for Disease Control and Prevention. Division of Community Health (DCH): Making Healthy Living Easier. Communities Putting Prevention to Work (2010-2012). Accessed November 2015. Available at:

6 Cheadle A, Cromp D, Krieger JW, Chan N, McNees M, Ross-Viles S, Kellogg R, Rahimian A, MacDougall E. Promoting policy, systems, and environment change to prevent chronic disease: lessons learned from the King County Communities Putting Prevention to Work initiative. J Public Health Management Practice. 2015; 00(00)

7 Public Health – Seattle King County. Who’s involved in communities putting prevention to work? Accessed November 2015.

8 Kent School District. Nutrition Services: Farm to School. Accessed November 2015. Available at:

9 Cheadle A, et al. Promoting policy. 

10 Ibid. 

11 CDC. Community Profile: King County. 

12 Kern E, Chan NL, Fleming DW, Krieger JW. Declines in student obesity prevalence associated with a prevention initiative – King County, Washington, 2012. MMWR. 2014; 63(07); 155–157.


Date Posted:
Organization Name: Public Health-Seattle & King County
Program Name: 

Communities Putting Prevention to Work / Healthy Eating Active Living

401 5th Ave.
Suite 1300
Seattle, WA 98104
United States
Healthy People 2020 Topic Area(s) addressed: 
Healthy People 2020 Objective(s) addressed: 
Healthy People 2020 overarching goal addressed: 
Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death.
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