Adewale Troutman: The Case For Health Reform.
The case for health reform
By Adewale Troutman
Community Transformation Grants are perhaps one of the least discussed but most important aspects of the current health care reform legislation before the House. These grants will fund local initiatives to reduce chronic disease rates and increase health equity in communities across America.
Approximately 75 percent of current health care costs in America are the result of chronic diseases, many of which can be prevented if we give people the tools to eat healthier and to be more physically active. As a matter of fact, we only spend about 3 percent of medical care costs on prevention. Many of the chronic diseases faced by Americans, such as heart disease and diabetes, are brought on by obesity, lack of physical activity and poor diet.
Chronic disease is a growing epidemic across all segments of the American population. One in three Americans — 133 million — has some chronic condition. Our economy simply cannot afford to treat one-third of its population using expensive hospital-based interventions. Preventing these conditions in the first place is the answer.
Last July the Centers for Disease Control and Prevention (CDC) released a report indicating that the direct medical costs of obesity were about $147billion annually. The proportion of all annual medical costs that are due to obesity increased from 6.5 percent in 1998 to 9.1 percent in 2006, the study said. Obese people spent $1,429 (42 percent) more for medical care in 2006 than did normal weight people. As the study indicated, “Reversing this epidemic requires a multifaceted and coordinated approach that uses policy and environmental change to transform communities into places that support and promote healthy lifestyle choices for all people.”
While personal responsibility certainly plays a role in eating healthier and in engaging in more physical activity, it's not always that simple. People can only make healthy lifestyle choices from the choices available to them to make.
It is one thing to urge people to eat five to nine servings of fresh fruits and vegetables daily; it is quite another thing to actually do this when you don't have a car, when the nearest supermarket is miles away and when you live in a neighborhood riddled with fast food restaurants and convenience stores that carry only junk food. Low income communities and communities of color often bear a greater chronic disease burden because they more often have limited access to fresh produce and offer fewer opportunities for exercise. There also are the added effects of unemployment, poverty, lack of high educational attainment and other social determinants of health. But even middle class and non-minority communities have seen huge cutbacks in such resources as physical education in the schools. We need to focus on prevention in every community!
The Community Transformation Grants will fund local initiatives to make healthier food options and physical education activities available in our schools. The grants will create an infrastructure to support active living and will promote health equity by making fresh produce and opportunities to exercise in safety available in lower economic neighborhoods and communities of color.
This generation of Americans — our kids and grandkids — will be the first generation whose lifespan will be shorter than that of its parents if we don't reverse the path that we have put them on. It's not enough for us to make sure that our kids and grandkids can go to the doctor and to the hospital when they develop such chronic conditions as heart disease and diabetes. We must give them the tools and the resources to do everything in their power to prevent these conditions!
True health care reform must mean keeping people well! It must remove barriers to good health that make people sick in the first place by providing resources for prevention and insuring health equity for all. These investments in prevention will not only help us to lead longer healthier lives, they will save us money.
I urge support for the current health care reform legislation and I further urge that the Community Transformation Grants remain a part of the final bill signed by the president.
Adewale Troutman, M.D., M.P.H., M.A., is Louisville's director of public health.
By Adewale Troutman
Community Transformation Grants are perhaps one of the least discussed but most important aspects of the current health care reform legislation before the House. These grants will fund local initiatives to reduce chronic disease rates and increase health equity in communities across America.
Approximately 75 percent of current health care costs in America are the result of chronic diseases, many of which can be prevented if we give people the tools to eat healthier and to be more physically active. As a matter of fact, we only spend about 3 percent of medical care costs on prevention. Many of the chronic diseases faced by Americans, such as heart disease and diabetes, are brought on by obesity, lack of physical activity and poor diet.
Chronic disease is a growing epidemic across all segments of the American population. One in three Americans — 133 million — has some chronic condition. Our economy simply cannot afford to treat one-third of its population using expensive hospital-based interventions. Preventing these conditions in the first place is the answer.
Last July the Centers for Disease Control and Prevention (CDC) released a report indicating that the direct medical costs of obesity were about $147billion annually. The proportion of all annual medical costs that are due to obesity increased from 6.5 percent in 1998 to 9.1 percent in 2006, the study said. Obese people spent $1,429 (42 percent) more for medical care in 2006 than did normal weight people. As the study indicated, “Reversing this epidemic requires a multifaceted and coordinated approach that uses policy and environmental change to transform communities into places that support and promote healthy lifestyle choices for all people.”
While personal responsibility certainly plays a role in eating healthier and in engaging in more physical activity, it's not always that simple. People can only make healthy lifestyle choices from the choices available to them to make.
It is one thing to urge people to eat five to nine servings of fresh fruits and vegetables daily; it is quite another thing to actually do this when you don't have a car, when the nearest supermarket is miles away and when you live in a neighborhood riddled with fast food restaurants and convenience stores that carry only junk food. Low income communities and communities of color often bear a greater chronic disease burden because they more often have limited access to fresh produce and offer fewer opportunities for exercise. There also are the added effects of unemployment, poverty, lack of high educational attainment and other social determinants of health. But even middle class and non-minority communities have seen huge cutbacks in such resources as physical education in the schools. We need to focus on prevention in every community!
The Community Transformation Grants will fund local initiatives to make healthier food options and physical education activities available in our schools. The grants will create an infrastructure to support active living and will promote health equity by making fresh produce and opportunities to exercise in safety available in lower economic neighborhoods and communities of color.
This generation of Americans — our kids and grandkids — will be the first generation whose lifespan will be shorter than that of its parents if we don't reverse the path that we have put them on. It's not enough for us to make sure that our kids and grandkids can go to the doctor and to the hospital when they develop such chronic conditions as heart disease and diabetes. We must give them the tools and the resources to do everything in their power to prevent these conditions!
True health care reform must mean keeping people well! It must remove barriers to good health that make people sick in the first place by providing resources for prevention and insuring health equity for all. These investments in prevention will not only help us to lead longer healthier lives, they will save us money.
I urge support for the current health care reform legislation and I further urge that the Community Transformation Grants remain a part of the final bill signed by the president.
Adewale Troutman, M.D., M.P.H., M.A., is Louisville's director of public health.
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