In bad health

The state must step up efforts to curb obesity, a major problem in most areas.

December 25, 2012 

North Carolina’s “state toast” proclaims it to be a place “where the weak grow strong and the strong grow great.” But a national survey of overall health in the United States ranks North Carolina 33rd, anything but great and in fact a number showing more weakness than strength. This must change, and the state needs to begin a measurable effort to improve that ranking year by year.

One estimated figure in the report from the Minnesota-based United Health Foundation is particularly alarming: The state has a 29 percent obesity rate. Obesity, measured by a formula determining body mass index (BMI), carries with it the potential for serious health problems, from diabetes to heart disease to asthma to some types of cancer to osteoarthritis. The childhood obesity rate nationwide has been growing in alarming proportions.

The foundation also found that the state has poor rankings, near the bottom, in infant mortality, low-birth-weight babies and funding for public health.

Will these findings ring the proper alarms on the part of government, which has a role in addressing the problems, and for parents and for that matter, citizens who suffer from maladies related to a neglect of health? Or will this report merely sit on the desks of policymakers and state and community leaders until it takes is place in a dust bin? Let’s hope the answers are yes, and no.

How to improve

The N.C. Institute of Medicine, which describes itself as an “independent, quasi-state agency,” was created by the General Assembly almost 30 years ago to be a sort of nurse-practitioner monitoring the state’s vital signs when it comes to public health. Pam Silberman, its CEO, recently presented some ideas to lawmakers, and said that some states have improved on the things in this report where North Carolina has weakness.

She suggested, for example, that doctors and day-care centers and schools could help monitor obesity. Indeed, parents have to be in that mix. Doctors, who are more aggressive in addressing obesity these days, certainly take this seriously. But the state, through the legislature, could use this report as a launch for a coordinated, and monitored, effort. This type of thing worked well when focused on teen smoking, rates of which have dropped substantially.

Some bad individual habits must be changed, of course, from kids eating far too much sugar (dramatically raising the rate of Type II diabetes while the age at which it is acquired goes down) to young and older adults not exercising to many people with bad family histories avoiding a doctor’s office. But there are societal habits as well, from kids sitting for hours in front of video games to parents using televisions as baby sitters to dining out all the time for portions that are gargantuan, with the diner sure to follow one day.

Jump starting

No, the government, for example, can’t send someone to every living room. But part of doing the duty of public safety is tracking public health, and toward that end, lawmakers could invigorate an initiative on obesity that would raise awareness through advertising, send more public health nurses and doctors to schools more often, host family meetings at YMCAs, seek doctors to visit communities where obesity tends to be a greater problem (those in poverty seem to be more vulnerable) and perhaps boost physical education in schools.

Nelson Dollar, a Republican representative from Cary, is chairman of an oversight committee on health and human services. While he doesn’t dispute the need for the state to improve its efforts, he seems skeptical of the need to spend more. He needs to remain open-minded (the report found public health funding low, after all). Investment in prevention, in lowering the rate of Type II diabetes for one, saves the state countless health care dollars in the not-so-long run because the illnesses diabetes leads to will be curbed.

The state can set clear goals, measure the rate of achievement and live up to its toast. But it must begin, and this credible report is a good place to start.

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