How To Combat Our Obesity Epidemic?
Neal Peirce
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WASHINGTON--The noose of evidence is tightening: this country is into a nationwide obesity epidemic. The epidemic is hurting us now. But the worst is yet to come.
For evidence, check the rather scary set of maps that the Centers for Disease Control have produced identifying the states in which 15 percent or more of adults are outright obese--and that means really fat: 30 percent or more over ideal body weight.
The 1991 map showed only four states--Michigan, West Virginia, Mississippi, Louisiana--in the dark blue selected to indicate obesity affecting more than 15 percent of adults. But by 1995 the dark blue of serious overweight had spread across most of the country east of the Rockies. By 2000, all 50 states except Colorado (at 13.8 percent) were engulfed. Today, one in five adults are reported at obese weight levels in 21 states.
Call this, if you will, a medical problem. On that count, it's clearly serious. Obese people have significantly more chronic health problems than daily smokers or heavy drinkers, according to a Robert Wood Johnson Foundation-funded national survey by the RAND institution in Santa Monica, Calif.
Overall, some 300,000 of us are dying each year from cases of diabetes, breast and colon cancer and hypertension that medical researchers attribute to obesity--more than our casualties from motor vehicle accidents, pneumonia and airline crashes combined. Weight issues are driving up U.S. health care costs by roughly $100 million a year.
"Americans are the fattest of the major nations on earth and growing fatter by the day," says Kelly Brownell, director of the Yale Center for Eating and Weight Disorders.
"Left unabated," U.S. Surgeon General David Satcher warns, "overweight and obesity may soon cause as much preventable disease and death as cigarette smoking."
And the damage is building. An estimated 54 percent of U.S. military personnel are overweight (as are 60 percent of all this country's adults). Obesity is skyrocketing among children, the military's next wave of prospective recruits.
To expect a nation of flabbies to be combat-ready, prepared to engage in 21st century struggles--whether the enemy is terrorism, organized military force or environmental hazards--is simply foolhardy.
So where's the cure?
Not just in a set of dire warnings by the Surgeon General, the CDC and other medical authorities, says Robert McNulty, president of the Washington-based Partners for Livable Communities. "This challenge needs civic engines, not just the health side." Among the candidates he suggests: schools and local governments, transportation agencies, faith-based organizations and the civil rights, community development, amateur and professional sports communities.
Among foundations, Robert Wood Johnson, premier funder of U.S. health research, is taking a lead with a new program "to promote healthy communities and lifestyles."
McNulty's organization is teaming with the National Coalition for Promoting Physical Activity--members including the National Parks and Recreation Association, the American Heart Association and the American Diabetes Association--to mount a nationwide awareness campaign on the same issues.
It won't be easy.
If one is arguing for lean, low-cholesterol meals, one runs straight up against the fast food industry and its proclivity for fat-dripping burgers, french fries and fried chicken. Plus the industry's advertising budget of billions of dollars a year to promote its foodstuffs.
If the case is made to get people out of their cars, walking and biking a great deal more, the natural adversary is the auto industry's romanticization of car riding as sexy, exhilarating, luxurious. The automakers make their case with vast resources for television and other advertising.
Or talk about smart growth--more compact, walkable and bikable communities, with parks, neighborhood shops, smaller community schools within easy reach. Then the adversaries range from builders of standard spread-out subdivisions to regional mall owners, from the asphalt lobbies to advocates of region-wide mega-schools.
Suggest all sorts of new greenways, bike paths, sidewalks where they're lacking, connections to get people from 8 to 80 out on their own two feet in the fresh air. Now the likely opponents will be budget guardians saying we can't afford such "frills"--especially in a time of economic recession.
Urge employers, as the surgeon general does, to include weight management and physical activity counseling as part of health insurance coverage, and the potential added costs will be thrown up as an obstacle.
Try to persuade schools to reinstate many of the physical exercise programs they've cut back in recent years, and the affordability issue will be raised again. Ditto any suggestion to build gyms in poor communities, where sports facilities are in chronic short supply.
OK--exercise programs and gyms may cost some money. But there's another thing we can't afford: a fat, unfit America in a demanding new century.
Neal Peirce's e-mail address is nrp@citistates.com.
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