The State of America's Health as Obama Takes Office

Graphic: America's Checkup

Graphic: Chronic Killers

Graphic: Spread of Disease

Video: Family Health

Rather than leaving it up to individuals to make healthful decisions about diet and exercise, researchers are taking aim at our physical and social environments. "If we can start to shift our systems, it will go a lot farther than trying to reach 300 million people one-on-one," says Christina Economos, an assistant professor at the Friedman School of Nutrition Science and Policy at Tufts University.

Economos led the "Shape Up Somerville" study, a three-year CDC-funded childhood obesity intervention in which researchers worked with the city of Somerville, Mass., to make it easier for children to "eat right, play hard," as the study's slogan puts it. Over the course of two years, school cafeterias—and even local restaurants—changed menus to offer more fruits, grains, and veg-etables. Fatty snacks and sugary drinks were eliminated from lunchrooms. Parents were encouraged to take televisions out of kids' bedrooms. Bike racks were installed at the schools, and trees were planted to create leafy shade over the sidewalks. The changes worked: The city's first through third graders gained a pound less during each of the two years than their peers in two control communities.

But the changes didn't end when the study finished in 2005. Somerville has continued to alter its environment to encourage people to eat smart and play hard, including extending bike paths, creating new parks, and opening farmers' markets.

"This is not about going on a diet," says Somerville Mayor Joseph Curtatone. "This is about social change. We're changing the culture and behavior of people to get them to move in another direction." The reality is, getting Americans to move at all would be a good first step toward health improvement. The nation's new health coach in chief, clearly, has his work cut out for him.