An ounce of prevention for health decline

July 13, 2013 

How do you live a long life? ‘Take a 2-mile walk every morning before breakfast.’

– Harry S. Truman

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Give ‘em Hell Harry died at 88. He didn’t linger. He went into a Kansas City hospital with pneumonia on Dec. 5, 1972, and died Dec. 26.

The late president’s life traced a near perfect arc from birth to demise. He lived long and well and passed away after a brief illness. It’s enough to inspire you take a two-mile walk every morning.

But Truman’s experience is less and less our own. Improved medical care is enabling Americans to live longer, but many are finding the extra years filled with chronic illness and infirmity.

An article published last week in the Journal of the American Medical Association reported the findings of one of the broadest assessments of U.S. health in more than a decade. Life expectancy for Americans rose from 75.2 in 1990 to 78.2 years in 2010. But that good news came with a gloomy side: The average period of later life during which Americans live with a chronic disability increased from 9.4 years in 1990 to 10.1 years in 2010.

In an editorial accompanying the JAMA article, Dr. Harvey V. Fineberg, president of the Institute of Medicine in Washington, wrote: “Despite a level of health expenditures that would have seemed unthinkable a generation ago, the health of the U.S. population has improved only gradually and has fallen behind the pace of progress in many other wealthy nations.”

So Americans are living longer but falling behind comparable nations in wellness. In a nation full of runners and busy gyms and with our media full of information about what’s best to eat, it’s puzzling why Americans are losing ground to other developed nations in terms of health. But it’s not a mystery to a North Carolina organization that’s trying to improve wellness by preventing – or at least holding off – disease and disabilities.

Meg Molloy is president and CEO of NC Prevention Partners, a nonprofit she and others founded 15 years ago. She said the cause of many health problems is obvious and fixable: Too many Americans smoke, and most eat too much of the wrong things and exercise too little. And while smoking has been reduced, obesity is hitting children with effects once generally limited to adults: diabetes and high blood pressure.

That trend is more pronounced in North Carolina, where rates of smoking and obesity exceed the national average.

As Molloy tactfully puts it, “Our state has more opportunities to change than others,” though North Carolina has improved some since she began to campaign for prevention in a state that ranked 50th in physical activity levels. “We were the couch potato state,” she says.

NC Prevention Partners, an organization with a $2 million budget, is supported largely by foundation grants, corporate and individual donations and some earned income. It is engaged with more than 500 organizations that include roughly 600,000 people in a program called WorkHealthy America, which is trying to get businesses to see the value of a healthier workforce.

It’s not a hard case to make. Sick employees cost their employers in terms of lost productivity and higher medical insurance bills. But it’s hard to get companies to change a culture. It’s more than adding healthy food to vending machines and opening an exercise room. Often those changes affect only people who are already eating well and inclined to exercise.

The company must reach those who eat poorly and have no experience with or desire for exercise. Committing to wellness doesn’t have to require a lot of work time – allowing small islands of free time will do – but the commitment does have to be universal and unambiguous.

“They can’t be saying, ‘You should do this,’ and then they look at you funny if you get up and take a 15-minute walk,” Molloy says.

Wellness is part of the culture in parts of the country and at many high-tech firms, but Molloy has been impressed by how many smaller and rural North Carolina companies with blue-collar workers and state and local government agencies are interested in making changes to improve the health of their employees.

“We’re seeing it starting to happen everywhere,” she says. “They understand there’s a problem on the (medical) cost side, and they are starting to look for solutions.”For North Carolinians and all Americans to become healthier in an era when people are living longer, our state and nation need to become more like the countries that are living better. People there consume less food and walk more. America is a land of sprawl that requires travel by car, of cheap calories and of jobs that park people in front of computers for eight hours.

“When people ask me how can someone lose 50 pounds, I say, ‘Send them to almost any other country in the world,’ ” she says. “What we see as normal doesn’t have to be the way it is.”

Rather than go abroad, it might be enough to simply go back to the days when Americans moved more and ate real food. “Our grandparents didn’t sit in front of a computer all day. They were up doing something else,” Molloy says. “We need to bring that back into our lives.”

It seems Harry Truman had it right. Take a long walk before a good breakfast.

Editorial page editor Ned Barnett can be reached at 919-829-4512, or nbarnett@newsobserver.com

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