The trouble is, of course, it’s sneaky about it. Instead of killing us outright, which would make the whole overeating/underexercising thing far easier to fix, obesity hides behind persistent, debilitating chronic conditions – coronary heart disease, stroke, high blood pressure, type 2 diabetes, liver and gallbladder disease, sleep apnea and respiratory conditions, mental illness, infertility, and cancers, such as endometrial, colon and breast cancer.
Obesity started really gaining ground in the mid- to late-1980’s; the many chronic conditions doctors treat each day grow out of that ever-trending obesity. Chronic disease accounts for more than 80% of health care spending. Here’s the trouble: life expectancy is just a tiny bit less for the obese than for those not overweight. Longer life expectancy doesn’t mean a good life expectancy, of course. This means that chronic illnesses – often the result of obesity – and the pain and suffering and diminished quality of life they entail, persist over a long time. A long and very, very costly time.
How can we help promote a better understanding of the connection between the two? It is reported that Medicare and Medicaid – not defense – is the biggest single fiscal issue confronting our nation today. These programs inherit the chronically ill, taking them on as patients long after their diabetes has forced an amputation, or heart disease has done its worst.
The National Association of Health Underwriters Capitol Hill conference discussion this week revolved around keeping health care costs affordable. Why do we care about this? Because – contrary to popular opinion – the talk did not center around death panels, limiting access to coverage or squeezing policies dry of all decent options. The biggest emphasis was on preventive care. There is also great awareness among physicians and health professionals of the need to support real health care reform without impeding access to innovative care and services. This means that we should prevent illness and disease at the same time that we are treating those already ill. It’s not either/or, it’s both.
So how does this work? Along with developing more efficient approaches to the care of those with chronic diseases, the coordination of that care and patient-focused support, it is agreed that we all need to get healthier and stay healthier, period. Government programs that concentrate on preventive services are a critical and indispensible part of that mandate.
Of course it’s not easy to legislate ways to stay healthy, but in a way, that’s what we need to do. We need to support health education and prevention with every breath we take. There are many factors driving up the cost of health care today. A good portion is driven by technology and medical advances. Still, the cost of treating just women for heart disease alone in 2008 was $43.6 billion, with cancer coming in second at $37.7 billion and mental disorders in third at $37.3 billion. These are staggering sums, and we all share – directly or indirectly – in their burden. State and federal regulatory requirements also contribute to skyrocketing costs. Where it stops, or levels off, is anyone’s guess. No one will be able to afford health care at this rate. Is there anything in this situation that we can control?
Yes. We need to commit to programs and activities that prevent and reduce obesity, for one thing. This will help reduce the cost of chronic illness care. These programs can be implemented in schools, child care centers, workplaces and other communities nationwide. There is nothing fancy here – the goals are simple and straightforward:
- Increase the consumption of fresh fruits and vegetables.
- Increase physical activity, particularly walking.
- Increase breastfeeding initiation duration and exclusivity.
- Decrease the consumption of sugar drinks.
- Decrease the consumption of high-energy-dense foods, which are very high in calories.
Essentially, we are replacing the ‘what’s good for business is good for America’ model with a ‘what’s good for our health and fitness is good for America’ model. And don’t misunderstand – the business model is fine, where it belongs. It’s just that corporate profits shouldn’t dictate what our little ones eat at snack time, what we serve for supper and whether or not recess or art class is necessary.
Good nutrition, respect for mental and physical fitness and following programs that support and maintain those goals – these are steps we can take today. These are steps that will also allow us to purchase and maintain health insurance coverage that actually does what it is designed to do: help us prevent disease and illness and give us access to the best care possible when we need it.