Together in the fight against obesity

Filed under: Health Quarterly | Tags:

Everyone from Michele Obama to the American Heart Association is worried about obesity.

While Colorado remains the thinnest state in the country, its obesity rates are growing faster than the rest of the nation. If current trends continue, it is estimated that 76 percent of the state’s population will be obese or overweight by 2020, according to the Colorado’s Children Campaign.

According to the Centers for Disease Control and Prevention, 17 percent of Colorado adults don’t get any physical activity whatsoever, which is especially startling in a state that prides itself on its hiking and biking trails, high-mountain vistas and Olympic training facilities.

The problem isn’t limited to adults. About 10 percent of high school students are overweight, and an additional 10 percent are obese. Only two in five of the kids in ninth through 12th grade are meeting physical activity levels as proscribed by the CDC, and only 19 percent eat the required amounts of fruits and vegetables daily. However, 27 percent watch three or more hours of television every day.

The CDC estimates that health care costs in Colorado associated with adult obesity amount to $874 million a year.

The government has stepped in to help out. The Colorado Physical Activity and Nutrition Program and the Colorado Department of Public Health and Environment both work to increase physical activity throughout the state.

A host of non-profit organizations, led by LiveWell Colorado, also are taking steps to fight obesity in both adults and children.

And the state’s insurance companies also are working on the problem. United Healthcare, the state’s largest insurance company, and Kaiser Permanente, an HMO company, both have grants and programs in place to fight adult and childhood obesity.

Here’s a closer look at what the various groups are doing.

LiveWell Colorado Springs

Colorado Springs is one of eight communities benefiting from the LiveWell program, a nonprofit organization launched in 2007.

In Colorado Springs, the group is working with Harrison School District 2, one of the most racially diverse sections of the city. It has put into place several programs aimed at increasing activity levels in the neighborhoods served by the school district.

“We’re working with the YMCA on after-school programs, to get kids moving after school,” said Mina Liebert, executive director. “We chose Harrison because we determined that section of the city would gain the most benefit.”

Enrollment is free to the children who enroll in the program, offering them an opportunity to take part in organized sports such as soccer, basketball and more.

The group is also working with the school district to raise money to provide more healthy choices for the children’s school lunches — more fruits and vegetables, more milk and water, fewer soft drinks, less fast-food types of meals and high-fat food.

Statewide, LiveWell reaches 87,000 residents, and plans to expand to 25 communities next year.

Kaiser Permanente

As an insurance company, Kaiser puts an emphasis on prevention.

“Exercise, eating right, getting the necessary preventive tests or immunizations when needed, work/home balance — all are a part of the overall picture,” said C.J. Moore, spokeswoman for Kaiser in Colorado Springs. “We believe that our communities need to think more about how they are structure. Are there bike lanes? Is public transportation available?”

Kaiser has committed to investing $20 million over a six-year period to LiveWell Colorado, in addition to providing in-kind support and physician advocacy in more than 25 communities across the state.

Kaiser also offers KP Health Workforce for its employer groups. “It involves great stuff, like classes at Whole Foods, partnering with REI to do hikes or learn snowshoeing,” she said.

“We also have a really great in-house employee wellness program called KP Be Well,” she continued. “And it came into existence in 2004 when we realized that our own employee group was the most expensive group we insured.

“By improving the health of our employees, we had an opportunity to help close the gap between direct health can and indirect costs. Kaiser has had an opportunity to improve operating budget margins and pass cost savings onto members.”

Kaiser is also well known for its “Thrive” campaign — getting people to think about healthy eating and active living.

The insurance company also sponsors the Colorado Art and Farm Market and provides grants that encourage healthy eating and active lifestyles.

United Healthcare

United is the largest insurer in the state of Colorado, and offers a more traditional approach to fighting obesity.

The company has agreed to fund the Colorado Rural Health Care Grant Council with $7.5 million for the next six years to strengthen delivery in rural parts to the state.

Rural health clinics, federally qualified health centers, public health departments and private health clinics all receive money from the council. Its grants support health information technology, construction and remodeling projects, equipment and staff training.

United also hopes to affect the state’s obesity rates directly by offering small grants to programs that can show results in reducing childhood obesity. Announced this summer, the grants of up to $1,000 will be awarded to programs that are easily implemented, scaled and measured.

The grants are available at www.ysa.org/heroes.

COPAN

The Colorado Physical Activity an Nutrition Program funds LiveWell Colorado, but also has been involved in other efforts to get people moving.

Get Fit Colorado is the nutrition and physical-activity equivalent to the tobacco-cessation Quitline. Available in rural areas of the state, the program has thus far reached 400 residents and resulted in an average weight loss of 6 percent.

The program targets rural areas because it’s more difficult for residents to find such services near their homes, said Eric Aakko, director of the COPAN program.

The strategy: residents call into the telephone service and receive a pedometer in the mail. They call in every week to a health counselor who assesses their progress and provides individual resources for increasing activity levels, preparing healthy meals and strategies for weight loss.

In its first three months, the 117 people enrolled in the program each lost between 2 to 10 pounds.

COPAN also created a “smart seal” program that highlights healthier choices for people when they eat out. Even McDonald’s is a member, offering apples instead of fries; milk instead of soda.

American Heart Association

Someone dies from cardiovascular disease in the U.S. every 38 seconds. Heart disease kills more women than every single form of cancer combined. Of course, preventing cardiovascular disease requires eating better and exercising more.

That’s where the American Heart Association comes in. The national nonprofit group is dedicated to eradicating heart disease by raising money for research through its annual Heart Walk. Last year, the Colorado Springs Heart Walk generated nearly $9,000. The goal was significantly higher: $130,000.

Beyond the walk, the AHA also offers classes on eating right. Its main message: staving off disease doesn’t have to be difficult. Switching out pizza for vegetables is a start. The other part of it — 30 minutes of exercise a day. Its advice isn’t anything most people haven’t heard: Take the stairs, not the elevator. Park father away from the store. Take a walk around the block.

Does it work?

Some nutritionists argue that all the grants in the world can’t really change behavior.

Health experts say eating too much and exercising too little are symptoms of a larger problem: a nation clogged with inexpensive fast-food meals, advertising for fatty, sugary products, lack of supermarkets, even in many urban areas, and high-stress workplaces.

Researchers are beginning to focuses on these bigger problems, hoping to push large-scale changes to food prices, advertising and available produce.

States are starting to tax soda and candy — Colorado just passed its own laws over the objections of business groups this year. Calorie information on fast-food menus is mandated as part of national health care reform laws.

But it isn’t enough, advocates say. Fast-food restaurants can charge lower prices for hamburgers and French fries because government subsidizes corn and soybeans used for animal feed and vegetable oil.

No government subsidies are available for fruits and vegetables, which is why salad is so expensive at many restaurants.

In contrast, the inflation-adjusted price of a McDonald’s quarter-pounder with cheese fell 5.4 percent from 1990 to 2007, according to a study in the journal Health Affairs. The inflation-adjusted price of fruit and vegetables rose 17 percent from 1997 to 2003.

“If we cut the subsidy on whole milk and made it cheaper only to drink low-fat milk,” said Dr. Barry Popkin, author of the report, “people would switch to it and it would save a lot of calories.”

Health experts want to encourage the private sector to do more, too. Replacing Snickers with fruit in the office-vending machine could save on health care costs, he said.

Many corporations already have discovered it’s less expensive for businesses to keep workers healthy than to cover medical costs of problems related to obesity.

At IBM, for example, the annual medical claim for an obese adult employee costs double that of a non-obese adult.