Inter-Departmental Correspondence

Health Services Agency



May 20, 2004


June 8, 2004



Honorable Board of Supervisors


Charlene A. Silva, Director of Health Services

Brian Zamora, Director of Public Health and Environmental Protection



Agreement with State Department of Health Services for the California Nutrition Network



Adopt a resolution authorizing the President of the Board to execute an agreement with the State Department of Health Services for the California Nutrition Network



Obesity contributes greatly to the risk of chronic diseases such as cardiovascular disease, cancer and diabetes. In San Mateo County, 54% of residents are overweight or obese. The percent is even higher in low-income communities. Of middle and high school students in the county, 34% are overweight or obese compared to 32% nationally. The data on children in the Child Health and Disability Prevention Program places San Mateo County in the top 5 counties across California in percentage of children who are overweight (25% of children aged 5 to 11 and 23% of children 12 to19.)


The California Nutrition Network for Healthy, Active Families (CNN) represents one of the major County programs addressing the problem of obesity. Funded by the U.S. Department of Agriculture, CNN focuses on reducing the rates of poor nutrition and physical inactivity, which are both closely linked to the incidence of obesity and are the second-highest contributors to preventable death in the United States. The goal of the CNN Program is to assemble a network of organizations and design a persuasive, coordinated statewide campaign to achieve healthier eating and increased physical activity in households at or below 185% of the Federal Poverty Level.


Other County efforts to reduce risk of obesity and the incidence of chronic diseases such as cardiovascular disease, cancer, hypertension, and diabetes include the SHAPEDOWN Program, in Public Health's Child Health Services Unit, and Smoke-Free Start and the Active for Life programs, in Public Health's Health Education Unit. For nearly four years, the SHAPEDOWN has provided services to manage obesity and overweight in children, using a comprehensive model developed at UC San Francisco.



During FY 2004-05, the CNN Project will address both improving diet and increasing physical activity levels. Staff will focus on combining messages about healthy eating and increased activity within an enjoyable structure that is most relevant to target audiences, such as hiking along the many beautiful trails and recreation areas throughout the county. Program components also include promoting healthy eating in the overall context of taking care of one's body.


In addition, the CNN grant will include activities within schools, addressing policy changes in areas of standards for foods served and levels of physical activity promoted and guaranteed. Efforts will be made to involve the entire school community: principals and other administrative staff, school nurses (when available), teachers, food service employees, students, parents, businesses and various community groups.


Performance Indicator

FY 2002-03 Actual

FY 2003-04 Projected

FY 2004-05 Projected

FY 2005-06 Projected

Percent of CNN families who have increased daily consumption of fruits and vegetables at 4 weeks follow up






In FY 02-03, 23 percent of CNN families increased daily consumption of fruits and vegetables, which was almost triple the 8 percent average annual increase in consumption derived from the 1989-1999 California Dietary Pediatrics Survey. CNN will continue to improve this measure's performance, serving as a model county program for promoting nutrition and physical activity.


Additional objectives to address childhood obesity will be identified by your Board's Pediatric Obesity Initiative. It is expected that funding from this CNN agreement will be used to address those objectives.


Vision Alignment

This agreement with the State Department of Health Services keeps the commitment of ensuring basic health and safety for all and goal number 5: Residents have access to healthcare and preventive care. Participation in CNN contributes to this commitment and goal by promoting exercise and proper nutrition to reduce the risk of chronic disease.


Term and Fiscal Impact

The term of the agreement with the State Department of Health Services is from October 1, 2003 through September 30, 2006. The total dollar amount is $378,461: $120,983 for FY 2003-04, $125,648 for FY 2004-05, and $131,830 for FY 2005-06. The agreement requires a commitment of local funds at a 2:1 ratio in order to obtain the State funds. Grant funding covers $77,998 of the local match, and the remaining $42,985 is from County general funds. Revenues and expenditures in the amount of $108,565 have been included in Public Health's approved FY 2003-04 budget. Additional revenue of $12,418 and expenditures for the same amount will be included in the year-end ATR. There is no new net County cost. Revenues and expenditures will be included in the recommended budgets for FY 2004-05 and FY 2005-06.