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The Journal Gazette

Monday, April 08, 2019 1:00 am

Epidemic proportions

Reducing obesity rate will be healthy for us all

Claire Fiddian-Green

Claire Fiddian-Green is president and CEO of the Richard M. Fairbanks Foundation, whose mission is to advance the vitality of Indianapolis and the well-being of its people.

Indiana is on the front lines of some of the nation's most pressing health crises, with tobacco use and drug overdoses claiming 14,200 lives in 2017 and costing the state $12.6 billion annually. While these challenges generate significant attention, another health epidemic is growing – quietly – with devastating consequences on Hoosiers' physical and financial well-being.

Obesity has risen steadily in Indiana over the past two decades. Almost 34% of Hoosier adults were obese in 2017 – up from 20 percent in 1995. Fort Wayne's rate is even higher, with 35 percent of adults considered obese. Indiana's obesity rate is now the 12th highest in the U.S.

If we are to thrive as a state, we must address this challenge with urgency and work across sectors on promising solutions. Obesity's consequences – on health, the economy and national security – demand action.

Adults who are obese face increased risks of major diseases such as type 2 diabetes, heart disease, stroke, kidney disease and various types of cancer. Obesity carries significant mental health effects, too, and nearly one in four young people are deemed ineligible to serve in the military because they are overweight.

We all share in the economic cost, which totaled $8.5 billion in Indiana in 2017, and households and the private sector bear the majority. That toll includes increased health care costs paid by private insurance, employers and individuals, as well as lost productivity and lost potential earnings from absenteeism and premature death.

Diet and lack of physical activity are two major drivers that contribute to obesity, and we can address both. In Indiana, close to 90% of Hoosiers do not eat the recommended amounts of fruits and vegetables, and 83% do not meet minimum physical activity guidelines.

Social factors – such as income, education, employment and more – compound these effects.

Living without convenient access to a grocery store or in isolation from pedestrian-friendly infrastructure, for example, profoundly affects daily habits and routines.

And obesity has a disproportionate effect on Hoosiers of color. Black adults have a 31% higher prevalence of obesity, and multiracial adults have a nearly 15% higher chance of being obese than white adults in Indiana.

The environmental factors driving obesity are myriad and complex, but targeted solutions can help address them. It will take a coordinated effort from all sectors.

Health care systems are a natural setting for identifying obesity in children and adults and intervening with effective solutions. Health care professionals can support healthy weight in patients through a reduced-calorie diet approach, physical activity recommendations and behavioral therapy.

Employers can have a major effect on obesity by providing incentives to encourage employees to improve diet and increase physical activity.

This could include counseling on nutrition and physical activity delivered through one-on-one or group meetings.

K-12 schools can promote healthier eating by modifying the cafeteria environment; for example, by offering sliced fruit or using creative names to make healthier foods more appealing.

Community organizations can also play a role.

For example, there is promising evidence that increasing the availability of healthy items or making fruits and vegetables less expensive through discounts at grocery stores can improve diet.

Government can use a variety of policy mechanisms to support obesity prevention and treatment, including subsidies or regulation to improve health and safety.

Obesity is one of the greatest health challenges facing our state today. The good news is, it's a problem that can be addressed with multiple sectors working together to take aim at the environmental factors driving it.

By joining forces, we can target the root causes of one of our state's most pressing health challenges and help Hoosiers lead healthier lives.