Southerners More Prone to Obesity
By Dr. James Palermo // August 28, 2012
(VIDEO by CDCStreamingHealth)
BREVARD COUNTY, FLORIDA–America is laser focused on what Wisconsin Representative and Republican Vice Presidential candidate Paul Ryan says is “the most important election in our lifetimes.” The controversial Patient Protection and Affordable Care Act (PPACA) is on the forefront of the pivotal campaign issues, with the key goal of health reform being what was coined by the former head of the Institute for Healthcare Improvement and administrator for the Centers for Medicare and Medicaid Services (CMS), Dr. Donald Berwick, to be the Triple Aim: better care for individuals, better health for populations, and lower per-capita costs.
American Obesity At Crisis Level
The one preventable condition that may have the most significant impact on our ability to address and meet the Triple Aim objectives is obesity. Over the past three decades, obesity in the United States has been on the rise, and rates are among the highest in the world.
According to a new report from the Robert Wood Johnson Foundation and the Trust for America’s Health, adult obesity rates exceed 30% in 12 states, with a “fat belt” across the South. The report is based on 2011 state-by-state obesity data from the Center for Disease Control (CDC), which include adults’ self-reported height and weight. However, the rate of obesity—defined by a body mass index of 30 or higher in adults—is likely higher than statistics indicate, given respondents’ tendency to under-report their weight.
Mississippi Highest, Colorado Lowest
The report shows that the South has the highest percentage of obese adults at 29.5%, followed by the Midwest at 29%, the Northeast at 25.3% and the West at 24.3%. The survey data identified 26.6% of adult Floridians as obese. Colorado earned bragging rights for the least obese at a rate of 20.7%, but no state even came close to meeting the U.S. Surgeon General’s Call to Action to Prevent and Decrease Overweight and Obesity prevalence among adults to 15%.
The states with the highest obesity rates are:
- Mississippi (34.9%);
- Louisiana (33.4%);
- West Virginia (32.4%);
- Alabama (32%); and
- Michigan (31.3%).
The states with the lowest obesity rates are:
- Colorado (20.7%);
- Hawaii (21.8%);
- Massachusetts (22.7%);
- The District of Columbia and New Jersey (23.7%); and
- California (23.8%).
The survey methodology used to determine the 2011 rates was slightly different than the methodology used in past years, so no direct comparisons were made. However, the CDC noted that no matter which measures are used, “the obesity epidemic is still a major health problem.”
Obesity Is Dominant Preventable Condition Influencing Healthcare Costs
Obesity is a costly condition that can reduce quality of life and increases the risk for many serious chronic diseases including heart disease, stroke, type 2 diabetes and certain types of cancer, some of the leading causes of premature and preventable death. In 2008 medical costs associated with obesity were estimated at $147 billion, and the medical costs for people who are obese were $1,429 higher than those of normal weight. John Cawley of Cornell University and Chad Meyerhoefer of Lehigh University reported in January in the Journal of Health Economics that the national price tag for medical spending as a result of obesity has ballooned to $190 billion, or 20.6% of the U.S. health care expenditures.
“Obesity has contributed to a stunning rise in chronic disease rates and healthcare costs. It is one of the biggest health crises the country has ever faced,” Jeffrey Levi, executive director of the nonprofit Trust for America’s Health, said in a statement. “The good news is that we have a growing body of evidence and approaches that we know can help reduce obesity, improve nutrition and increase physical activity based on making healthier choices easier for Americans. The bad news is we’re not investing anywhere near what we need to in order to bend the obesity curve and see the returns in terms of health and savings.”
The Trust for America’s Health and the Robert Wood Johnson Foundation are expected to release a report later this year analyzing the rates and the policy efforts to curb obesity. Earlier this year, the Institute of Medicine outlined ways to reverse obesity, including a commitment to making physical activity a more integrated part of life, creating food environments that encourage healthful choices and making schools a focus of the efforts.
Addressing Obesity Is Key To The Success Of Evolving New Healthcare Models
It is all about personal choices, which often need to be influenced by the “carrot or stick” concept. Based on the objective of reversing the trend toward an obese America, the PPACA provides the stick that allows employers to charge obese workers 30% to 50% more for health insurance if they decline to participate in a qualified wellness program. The law also includes carrots and celery sticks, so to speak, to incentivize Medicare and Medicaid beneficiaries to see a primary care physician about losing weight, and funds community demonstration programs for weight loss.
No matter what happens in November or ultimately with the healthcare reform bill, more focus and resources must be devoted to striving for a less obese, healthier and more active America if we are to move away from a “reactive” disease-based model of health to a “proactive” wellness-based model to reduce the risk of chronic disease, improve overall health and wellbeing and minimize medical costs.