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NWS-10.4 Data Details

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NWS-10.4 Reduce the proportion of children and adolescents aged 2 to 19 years who are considered obese

Leading Health Indicators are a subset of Healthy People 2020 objectives selected to communicate high-priority health issues.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

Data Source: 
National Health and Nutrition Examination Survey
Changed Since the Healthy People 2020 Launch: 
Baseline (Year): 
16.1 (2005–08)
Target-Setting Method: 
10 percent improvement

Number of persons aged 2 to 19 years with a body mass index (BMI) at or above the sex-and age-specific 95th percentile from the CDC Growth Charts; United States


Number of persons aged 2 to 19 years

Comparable Healthy People 2010 Objective: 
Adapted from HP2010 objective
Data Collection Frequency: 
Leading Health Indicator:
Methodology Notes: 

    The NHANES obtains measured weights in an examination gown and heights without shoes. BMI is calculated by dividing weight in kilograms by the square of height in meters. Children and adolescents with a BMI at or above the sex-and age-specific 95th percentile based on the 2000 CDC growth charts are considered obese.

Caveats and Limitations: 
Obesity is generally defined as excess body fat. However, since excess body fat is difficult to measure directly, obesity is often defined as excess body weight adjusted for height as measured by BMI or age and sex specific BMI percentiles for children and adolescents. BMI will be used as a proxy for obesity in children and adolescents until a better measure is developed. Clinical assessment and other markers should be considered when determining a child’s overall health and development. Among children, the marked BMI changes that occur with growth and development make it necessary to specify a high BMI relative to children of the same sex and age.
Trend Issues: 
Two-year data are used as a placeholder to provide the latest data available and will be replaced with four-year data when available. Two-year and four-year data are not comparable. Two-year estimates are generally less stable and reliable than four-year estimates.
Changes Between HP2010 and HP2020: 
This objective differs from Healthy People 2010 objective 19-3c in that the age group tracked for obesity in children was expanded from 6–19 years to 2–19 years.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch: 
In 2012, the original baseline was revised from 16.2 to 16.1 percent due to a change in the methodology. Obesity was originally coded based on the calculated BMI variable which is rounded in NHANES and had an error in the 2007-08 dataset. To be consistent with NHANES reports, instead of using the calculated BMI variable, BMI is now computed directly from the weight and height variables. The method for computing the CI's was revised from the standard Wald method to the Wald method on the log scale. The target was proportionately adjusted from 14.6 to 14.5 percent based on the original target-setting method.


Additional resources about the objective

  1. CDC Growth Charts

  2. Troiano RP and Flegal KM. Overweight children and adolescents: Description, epidemiology, and demographics. Pediatrics 101:497-504, 1998.
  3. U.S. Department of Health and Human Services. The Surgeon General’s Vision for Health and Fit Nation, Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General, January 2010.