Making Prevention a Priority

Preventing obesity-associated chronic diseases and improving our nation's public health requires policy, systems and environmental change. Where we live, eat, sleep, work, learn, and play all impact our health.
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Prevention and wellness across the lifespan: That's the theme for this week's American Public Health Association annual meeting in San Francisco. In a time when the U.S. is facing an obesity epidemic -- 35.7 percent of adults and 16.9 percent of children age 2 to 19 are obese -- this couldn't be a more perfect theme. As a 30-year public health veteran, this has also become my personal mantra.

When the Trust for America's Health and the Robert Wood Johnson Foundation released the "F as in Fat" report last month, I was blown away by the alarming findings. Based on the report, if Americans do not change their eating and exercise habits now, then half of U.S. adults will be obese by 2030. This is frightening.

Another recently released report by the University of Michigan, the first to measure the health of Pacific Islanders living in the United States, found that nearly half of Pacific Islanders reported being smokers. This rate was three to four times higher than that for other Californians. Again, frightening.

Even more frightening is that we know obesity is a harbinger for so many other chronic conditions and illnesses -- ranging from cancer to Type 2 diabetes. These chronic diseases take an enormous toll on the nation, both in terms of lives lost and monetary resources. An estimated 7 in 10 deaths are due to chronic diseases, and costs for obesity-related preventable diseases could approach $66 billion per year by 2030.

Preventing obesity associated chronic diseases and improving our nation's public health requires policy, systems and environmental change. Where we live, eat, sleep, work, learn, and play all impact our health. That's why we must address the underlying factors behind these diseases, which include the lack of access to affordable healthy food, food insecurity, lack of education, and our structural environment. Essentially, we need creative solutions at all levels of government and across all sectors of society.

President Obama's Affordable Care Act (ACA) is part of the solution. The law has already expanded access to critical preventive care for millions of individuals, and starting in 2014, millions more will have access to affordable health insurance. In addition, the ACA makes a number of investments and reforms to improve public health and eliminate racial and ethnic health disparities and inequities. Given the numerous socioeconomic factors that influence health and present barriers to care, communities of color need strategies that are responsive to their particular needs.

Being attuned to these needs is where the federal government has made major headway. The Centers for Disease Control and Prevention's Racial and Ethnic Approachs to Community Heath (REACH) program strives to do just that, by focusing on changes in weight, proper nutrition, physical activity, tobacco use, and emotional and mental wellness. The Asian and Pacific Islander American Health Forum (APIAHF) recently received one of only six national REACH grants to implement a new project known as STRIVE. STRIVE -- Strategies to Reach and Implement the Vision of Health Equity -- aims to eliminate chronic disease disparities and improve the health of Asian Americans, Native Hawaiians and Pacific Islanders by working with community-based organizations across the country to implement evidence- and practice-based programs that improve physical activity levels and nutrition.

Why is this important? Over time, we have learned that with a concerted effort we can change a community's culture and lifestyle (e.g., eating habits and physical activity) through the types of foods being offered in grocery stores and schools. But communities, especially those that are low-income and that face a number of other barriers to good health, cannot do it alone. And that's where the need for innovative and new collaborations becomes imperative.

Some creative solutions to expanding access to healthy food and positive lifestyle changes have come from both corporate and government sectors. Corporations like Walmart have joined the cause by providing affordable, healthy food options to their customers. The first lady Michelle Obama's Let's Move campaign brings together communities and families to promote healthy lifestyles. In addition, federally-supported Community Transformation Grants are funding initiatives across a number of sectors, from health to business, to produce real change. These programs are just a few examples of the kinds of investment, collaboration and leadership we need to move public health forward.

So, if we all band together -- local, corporate and government -- we can teach each other about making healthy choices. If we collectively do our part, our efforts will add up to prevention and wellness across the lifespan.

For more by Kathy Lim Ko, click here.

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