Is the message that the nation is getting too fat beginning to sink in?
The answer is, “Yes, but,” says the Trust for America’s Health, a nonprofit, non-partisan group that aims to protect the health of communities and make disease prevention a national priority. And a study of health care quality and quantity across the nation suggests some reasons why things are not improving uniformly.
Obesity is a disease, and for the past 13 years the Trust and the Robert Wood Johnson Foundation have monitored obesity rates in the country, focusing on the proportion of a state’s population that is obese. The study designates someone as obese whose body mass index (a measure based on height and weight) is 30 or higher.
This year’s results show that after a decade in which every state’s obese population rose, a few states have finally experienced a decrease.
“We’re seeing the rates plateau albeit at a very high level,” says Richard Hamburg, the interim president of the Trust.
Although rates have dropped in Montana, Minnesota, New York and Ohio, even those decreased rates are still high. Twenty-six percent of adults in Minnesota were still considered obese, and nearly 30 percent were in Ohio. Even in the states with the lowest rates — Colorado, California, Utah, Montana, Hawaii and Massachusetts — rates remain between 20 and 25 percent.
Twenty-two of the 25 states with the highest adult obesity rates are in the South and Midwest, including Kansas and Kentucky, both of which experienced an increase.
To put this in perspective, Hamburg told me that in 1980 no state had a rate above 15 percent; in 1990 no rate was above 20 percent. “Colorado is the healthiest state but exceeded the 20 percent rate years ago,” he said.
What happened? Hamburg explained that many societal changes have conspired to increase obesity rates. Children have less opportunity for physical activities; parents are no longer comfortable sending their kids out to play and telling them to come home by dark.
- Sedentary activities such as computer games have replaced physical activity.
- Many schools no longer offer physical education and are not always open for physical activity after the school day ends.
- More kids arrive at school via car or bus. In 1969, 89 percent of kids walked or rode their bikes to school. By 2009, the number had dropped to 35 percent.
Eating habits are different, too, with families eating more often in restaurants, including fast-food establishments, and consuming more added sugars and fats. Many families eat at McDonald’s or Burger King a few times a week, but even if they cooked at home, they might not be eating “healthy” because they don’t have access to fresh fruits and vegetables.
Hamburg told me 30 million people don’t have easy access to a supermarket; many residents in dense urban areas have to walk or take public transportation more than a mile to get more than a “convenience store” selection. Many in rural areas must drive 10 miles or more.
Powerful marketing from the food industry is also a culprit, beckoning consumers to eat pizza, overstuffed tacos and sodas without regard for the effect on their weight or health.
I usually don’t pay much attention to state rankings from various groups. Most people aren’t going to move to another state just because it ranks better on whatever is being measured. But this time I did because as the obesity report came out, a personal finance website, WalletHub, announced its latest report, “2016’s States with the Best & Worst Health Care.” And I was struck by a possible connection.
What did WalletHub have to say about those states in the South and Midwest with high numbers of people who are obese? Were they getting routine examinations, and dental care? Were physicians accepting Medicare? Were there adequate hospital beds, particularly in rural areas where many hospitals have closed?
Now, I didn’t attempt to do a scientific correlation, and there may be many reasons why a state’s health care system ranks high or low on the WalletHub site. But for me, the take-away from these studies is that communities must offer not only treatment for health problems relating to obesity but also ways to prevent the underlying cause in the first place.
Communities must have not just enough and appropriate medical facilities and personnel but also programs to encourage better eating habits and more physical activity.
The Trust report offers suggestions that point in that direction. To learn more about how your state ranks on both these studies, go to stateofobesity.org and wallethub.com.
The states with the highest and lowest obesity rates (in percentage of population), and how Indiana ranks, according to Trust for America’s Health. (Rankings include the District of Columbia)
1. Louisiana, 36.2
2. Alabama, 35.6
2. West Virginia, 35.6
2. Mississippi, 35.6
5. Kentucky, 34.6
15. Indiana, 31.3
47. California, 24.2
48. Montana, 23.6
49. Hawaii, 23.7
50. District of Columbia, 22.1
51. Colorado, 20.2
The states with the best and worst health care (scores listed), and how Indiana ranks, according to Wallethub. (Rankings include the District of Columbia)
1. Minnesota, 67.37
2. Maryland, 64.36
3. South Dakota, 63.98
4. Iowa, 63.89
5. Utah, 63.85
30. Indiana, 53.77
47. Arkansas, 46.20
48. Nevada, 45.86
49. Mississippi, 43.98
50. Louisiana, 42.05
51. Alaska, 39.56
Trudy Lieberman, a journalist for more than 40 years, is a contributing editor to the Columbia Journalism Review, where she blogs about health care and retirement at cjr.org. She can be reached at email@example.com. This column was distributed by The Rural Health News Service.