North Carolina Nutrition and Physical Activity Surveillance System (NC-NPASS)

The purpose of the NC-NPASS is to provide accurate, timely information relevant to child health indicators of nutritional status such as overweight, underweight and anemia. Local public health departments and WIC programs routinely submit data on clients to the NC Health Services Information System (HSIS). NC-NPASS is a subset of this larger HSIS database and includes height, weight, a few lab measures and limited behavioral data. In the future, NC-NPASS will have the capacity to monitor trends in key nutrition and physical activity behaviors such as soft drink consumption, fruit and vegetable consumption, levels of physical activity and television viewing.

The data set used to generate NC-NPASS reports may not be representative of the population as a whole since it is comprised of data collected on children seen in NC Public Health sponsored Women, Infants and Children (WIC) and child health clinics and some school-based health centers.

2003 NC-NPASS Data on Childhood Overweight (Published March 2004)

Trends in Overweight
Tables showing Overweight by age, Hispanicity, and gender
NC Map Showing the geographic distribution of the prevalence of overweight children 2-4, 5-11, 12-18
County-specific BMI for Ages 2 to 18
County-specific BMI for Ages 2 to 4
County-specific BMI for Ages 5 to 11
County-specific BMI for Ages 12 to 18

2002 NC-NPASS Data on Childhood Overweight

Trends in Overweight in Children by Age Group (1995-2002)
Tables showing Overweight by age, Hispanicity, and gender
NC Map Showing the geographic distribution of the prevalence of overweight children 2-4, 5-11, 12-18
County-specific Data that shows the prevalence of underweight, healthy weight, at-risk for overweight, and overweight for NC counties. Counties that do not submit data are noted on the data tables.


Data & Statistics

Physical Activity and Nutrition (PAN) Behavior Monitoring Form and HSIS Guidance Manual now available online!

In 2002, the North Carolina Task Force on Healthy Weight in Children and Youth recommended that a “comprehensive, continuous, reliable system for monitoring Body Mass Index (BMI), weight-related chronic disease, and nutrition and physical activity behaviors,” be developed and implemented in our state. With Centers for Disease Control funding, the NC Healthy Weight Initiative developed and piloted the Physical Activity and Nutrition Behavior Monitoring Form . It is now available for North Carolina public health agency use on the Health Services Information System.

The PAN Monitoring Form helps local health departments collect data for conducting community assessments, planning and evaluating programs, and applying for grants.

The North Carolina Physical Activity and Nutrition Behavior Data Collection and Reporting Guidance Manual provides technical information to staff in public health agencies on tools for collecting and reporting information on physical activity and nutrition behaviors. This Adobe Reader formatted document will open with a left bar which lists the Table of Contents for ease of navigation. Simply move your cursor over the page number or appendix you wish to see and click.

Schools, community groups and other providers who would like to collect PAN behavior data on their clients may also use the PAN Monitoring Form. Contact us ( to learn how you can begin using the form and the data set.

PAN Guidance Manual for NC HSIS Users
PAN Guidance Monitoring Form

General Facts on Childhood Overweight

The percentage of children who are overweight in the United States doubled during the past two decades and the percentage among adolescents tripled. Data from the 2003 North Carolina Nutrition and Physical Activity Surveillance System (NC-NPASS) show an even greater increase in our state; however, there are early signs that the rate of increase may be slowing. Still, childhood overweight remains an epidemic in North Carolina affecting:

  • More than one in four (26.5%) youth 12 to 18 years of age,
  • More than one in five (22.8%) children 5 to 11 years, and
  • One in eight (14.4%) preschool children 2 to 4 years of age.

Are certain groups at higher risk?

It is clear from NC-NPASS data that substantial proportions of children and youth of all races, ethnicities, and both genders are overweight and at-risk for overweight, but there are some differences among groups in North Carolina:

  • Among 2 to 4 year-olds and 5 to 11 year olds, Asian/Pacific Islanders have the highest prevalence of overweight.
  • Young Hispanic children have a higher prevalence of overweight than non-Hispanic children of the same age; however, by adolescence, the rates are higher among non-Hispanic than Hispanic teens.
  • More adolescent African American girls are overweight than boys; however in Whites, American Indian and Asian/Pacific Islanders, adolescent boys are more likely to be overweight than girls.

    In Young Black Girls, Safety Concerns, Lack of Recreation Options Contribute to Weight Problems: Read a recent article about an overweight issue African-American girls are facing.

Why should we be concerned?

Most of us recognize that obesity in adults is a serious risk to health and well being. However, most of us do not realize that:

  • Sixty percent of overweight children, 5 to 10 years of age, have at least one cardiovascular risk factor such as high cholesterol, elevated blood pressure or increased insulin level.
  • Type 2 diabetes, formerly called adult-onset diabetes and seen primarily in middle age, is increasingly being diagnosed in children and young adults.
  • Overweight adolescents have a 70% chance of becoming overweight or obese adults, with all of the associated health risks.
  • Early maturation, orthopedic problems, and sleep apnea also occur with increased frequency in overweight youth.
  • Children and youth that are overweight or at-risk for overweight increasingly suffer from depression, anxiety and social angst.

While it is important to reduce the increased health risk placed on children by excessive weight, we must do so without jeopardizing their physical and emotional well being. Strategies to prevent or reduce overweight must be based on an understanding of and sensitivity to weight discrimination, social pressure for excessive slenderness, and unsafe weight loss practices.

Data Sources

CDC Breastfeeding National Immunization Data
This nationwide survey provides the nation’s public health community with current national, state, and selected urban-area estimates of vaccination coverage rates for U.S. children aged 19 to 35 months.

CDC Wonder
WONDER provides a single point of access to a wide variety of reports and numeric public health data. Some of Wonder’s Databases include:

  • Chronic Disease Prevention Database
    The Chronic Disease Prevention (CDP) databases were developed to provide access to information on chronic disease prevention and health promotion to health professionals responsible for supporting, planning, developing, implementing, and evaluating chronic disease prevention and risk reduction efforts. The databases provide bibliographic citations and abstracts of various types of materials including journal articles, monographs, book chapters, reports, curricular materials, fact sheets, and proceedings.
  • Data 2010…the Healthy People 2010 Database
    DATA2010 is an interactive database system developed by staff of the Division of Health Promotion Statistics at the National Center for Health Statistics, and contains the most recent monitoring data for tracking Healthy People 2010. Data are included for all the objectives and subgroups identified in the Healthy People 2010: Objectives for Improving Health. DATA2010 contains primarily national data. However, state-based data are provided as available.
  • Morbidity and Mortality Weekly Report (MMWR)
    The MMWR weekly contains data on specific diseases as reported by state and territorial health departments and reports on infectious and chronic diseases, environmental hazards, natural or human-generated disasters, occupational diseases and injuries, and intentional and unintentional injuries. Also included are reports on topics of international interest and notices of events of interest to the public health community.
  • YRBSS 2003 Data
    Monitors behaviors that contribute to unintentional injuries and violence; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection; unhealthy dietary behaviors; and physical inactivity --- plus overweight
  • Behavioral Risk Factor Surveillance System (BRFSS)
    The BRFSS, the world’s largest telephone survey, tracks health risks in the United States. Information from the survey is used to improve the health of the American people.

Kids Count 2004 Data Book Online
Ten key measures comprise an index of child well-being used to rank states and supplemental data on education, health, and economic conditions for each state.

Kids Health Poll
This poll, sponsored by the National Association of Health Education Centers summarizes the attitudes, opinions and feelings of 1,100 kids ages 9 to 13 on weight related issues. February 20, 2004.

National Health and Nutrition Examination Survey (NHANES)
The National Health and Nutrition Examination Survey is a population-based survey designed to collect information on the health and nutrition of the U.S. household population.

NC Center for Health Statistics
Monitors the health conditions of North Carolinians. Accurate and timely information for use in setting health policy, planning prevention programs, directing resources, and evaluating the effect of health programs and services.

Parents Speak Out on Health and Health Care in Schools
Results of a parent survey on the role of health and health care in schools.

Partners in Information Access for the Public Health Workforce
A listing of links to health statistics and data sets as well as resources to support data collection.

National Library of Medicine - Your link to searches of the medical literature.

U.S. National Library of Medicine, National Institutes of Health
A comprehensive link to health services research Web sites.

CDC New Searchable Inventory of Qualitative Research
The site provides basic information about qualitative studies that have been conducted in the fields of nutrition, physical activity, and other related fields. The inventory allows users to search for information using search fields, entering keywords, or searching the entire database. No registration or password is required.

North Carolina Healthy Weight Initiative, in support of Eat Smart, Move More...North Carolina

NC Dept. of Health and Human Services, | NC Division of Public Health


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