Fat Seen As More Than Health Issue
Graham Clyne, director of the Canadian Institute for Economic Evaluation, frames obesity and other public health problems in economic terms. Speaking recently at Spectrum Health, he said that high incidence rates of obesity further burden the health-care system by driving up costs, and take an economic toll on communities as well.
"Nobody in their right mind" would make a major business investment in a community with high incidence rates for obesity and overweight persons, Clyne said. Focusing on obesity in terms of economics, rather than only as a public health issue, can help bring a greater number of players together to address the problem.
"When you put dollars and cents figures with it, you're able to interest a lot more groups in health and well-being," said Clyne, who provides training to care providers and organizations on addressing obesity from a broad-based perspective. "There will be all sorts of impacts that will appeal to people's self-interests."
Clyne's appearance in Grand Rapids, sponsored by Spectrum Health's Healthier Communities Department, came on the heels of the launch of Project Takeoff, a new initiative in Kent County that was formed by a coalition of parties to reduce the local incident rates of obese and overweight people. A similar initiative, Stay Active Muskegon, was launched early this year in Muskegon County.
Reversing the current trend requires a broad cross-section of players from far beyond the heath-care sector, rather than focusing on individual risk factors and how medical care is provided, Clyne said. The effort also requires participation of governmental, educational, nonprofit and business sectors in order to identify and address the root causes that have led to the overeating and sedentary lifestyles that have driven up obesity rates during the last two decades, he said.
Without that kind of collaborative push, "I don't care how much money you put into it," Clyne said. Solutions have to come from a variety of sources in order to change societal behaviors and to improve the public health, he said.
"If you come at it as a community, then you've got a far better chance," Clyne said. "It's about freeing resources so they can be more effectively deployed."
Beyond the medical, social and financial implications for people who are overweight or obese, there's a cost to all of society through indirect costs and higher health insurance premiums resulting from treating people with ailments related to their weight — diabetes, high blood pressure, heart disease, some forms of cancer and sleep apnea among them.
A study released last spring by Michigan Economic Development Corp. concluded that overweight and obese persons could expect to incur $1,500 in additional medical costs annually because of heath problems associated with their conditions — costs that are a contributor to ever-rising health insurance premiums.
The state study showed that 61 percent of Michigan's population is overweight and 24.7 percent is obese, putting those individuals at greater risk for chronic illnesses.
In Kent County, 37.3 percent of adults answering a 2002 behavioral risk survey reported they were overweight. Another 19.6 percent of adults said they were obese, according to Kent County Healthy Department survey, up from 17 percent in 1993. The obesity incidence rate was higher for African Americans in Kent County: 28.3 percent.
Nationally, medical expenditures alone directly related to obesity and being overweight are as high as $93 billion, or 9.1 percent of all health-care expenses in the U.S. — a figure that nearly rivals the cost of smoking, according to researchers whose findings were published in the May 2003 issue of Health Affairs, a national health-care journal.
That kind of data has begun to galvanize communities and lead to the formation of local coalitions to address rising obesity rates.
"Obesity has finally attained a profile where it's getting the kind of attention it deserves," Clyne said.
He cites numerous areas where communities can address the root causes.
In the health-care arena, physicians need to do more to work with obese and overweight patients and health plans need to re-tool to provide incentives for people to improve and maintain their health.
Communities need to examine how much public money is invested in parks and recreation and look at their land-use plans and development policies to see if they encourage "walkable communities" with bike paths and hiking trails that allow people to walk more and ride bikes to stay fit.
Schools should review their curriculum on nutrition and health and look at removing soda and snack machines, Clyne said.
"We can talk about obesity all day long," he said, "and if there's pop for sale in the schools, we're wasting our breath."