W.Va. ranks first in heart attack, diabetes, eight other categories

West Virginia is among the top five on just about every national chronic disease list. The state leads the nation in diabetes and obesity, according to the Gallup Healthways poll.

Surveys show that many West Virginians do not realize obesity is a leading cause of many chronic diseases. Many also feel those diseases are hereditary, and there is nothing a person can do to prevent them.

The state's children raise major red flags for the future. West Virginia University screens thousands of schoolchildren every year. In 2010-11, they found that 24 percent of fifth-graders have high blood pressure, 26 percent have high cholesterol, and 29 percent are obese. Eighteen percent of kindergartners and 23 percent of second-graders are obese.

There has been little public discussion of this problem. "The Shape We're In" project aims to stir up that discussion. Written and photographed by Annenberg fellow Kate Long, it will be divided into three parts in The Charleston Gazette, the state's largest newspaper:

• Children at risk
• Programs that work
• Communities making a difference

Some segments will be accompanied by West Virginia Public Radio pieces.

Part 1: "This is a public health emergency"

Part 2: A growing problem

Part 3: Putting the pieces together

Part 4: Health officials say W.Va. can reverse its chronic disease numbers

Part 5: W.Va. man: diabetes programs work

Part 6: "Get kids moving"

Part 7: Daily activity affordable, Department of Education says

Part 8: Wood researchers: Active kids do better academically

Part 9: Rocking the gym at 7:30 a.m.

Part 10: Nebraska school district lowers obesity rate

Part 11: What happened?

Part 12: 'Everyday heroes' saving own lives

Part 13: W.Va. ranks first in heart attack, diabetes, eight other categories

Part 14: Success from scratch

Part 15: Great Kanawha food fight

Part 16: Better focus

Part 17: W. Va. slammed with sugar

Part 18: Glenda and Jill vs. diabetes

Part 19: This is how bad diabetes can be

Part 20: Recognize diabetes before it's too late

Part 21: Logan hardest hit by diabetes

Part 22: Even if your relatives had diabetes, you don't have to

Part 23: Body and spirit

Part 24: American Diabetes Association is MIA in W.Va.

Part 25: Young people contending with diabetes

CHARLESTON, W.Va. -- West Virginia has the nation's worst statistics in 10 of 12 categories in the new 2011 Gallup Healthways ranking.

Mountain State residents lead the nation in obesity, high blood pressure, high cholesterol, diabetes, depression, heart attack, cancer, neck or back condition, leg or knee condition and "other recurring pain."

More than one in three West Virginians -- 35.3 percent -- are now obese, according to Gallup Healthways.

"If West Virginia lowered its obesity rate, it would most likely lower its ranking in other categories," Healthways official Reggie Ramsey said. Obesity is at the root of most high chronic disease numbers, he said.

"I think someone is sending us a message that our approach to health care hasn't worked," said Dr. Rahul Gupta, director of the Kanawha-Charleston Health Department.

"Almost all these problems are preventable," Gupta said. "We should be trying to prevent diseases as effectively as we try to fix them after they happen." West Virginia is just starting down the prevention road, he said. "If we continue, you will see these numbers come down, but it's going to take time."

"It's time for West Virginians to stand up together and say, 'We've had enough, and we can't stand to have such bad outcomes any longer.'"

"We need a good statewide education campaign," said Pat White, who directs Charleston's West Virginia Health Right. "A lot of people don't even know they can prevent these diseases.

"At Health Right, we spend a lot of time teaching people things like, if you walk a half hour a day, it lowers your risk of heart attack or diabetes. Or if you drink two soda pops a day, you're going to gain 20 pounds a year, which increases your risk of heart disease and diabetes.

 "People aren't born knowing this stuff," she said. "Billboards, radio ads, and so on could have a big impact." What message would she put on a billboard? "Your grandma and sister may have sugar, but you don't have to," she said.

The health reform law will lower West Virginia's numbers, said Perry Bryant, director of West Virginians for Affordable Health Care.

 "If the Supreme Court doesn't strike down the individual mandate and Medicaid expansion, about 190,000 West Virginians will get health insurance. A lot of people will get earlier checkups and catch problems at a preventable stage.

"Even if the mandate is struck down, the law contains many helpful prevention provisions," Bryant said.

 "West Virginia has some effective programs, but they tend to be in urban areas. We need to find ways to spread them to rural areas," said Renate Pore, health policy director for the West Virginia Center on Budget and Policy.

"To do all this, we need strong health leadership," she said. In 2011, Pore surveyed 33 state health and political leaders, asking how the state could improve its numbers. "Every one of them said West Virginia needs effective health leadership from the Governor's Office," she said. "They all said we have lacked leadership from the top."

Oklahoma City Mayor Mike Cornette is a good example of inspirational leadership, she said. Confronted with high heart attack, diabetes and stroke rates in 2008, he challenged his city to lose a million pounds.

"He got people united behind a common goal," Pore said.

He announced a Web address -- www.thiscityisgoingonadiet.com. More than 45,000 city residents signed on and started reporting their weight loss. By the end of 2011, they had lost more than 760,000 pounds. They expect to shed a million pounds in 2012. Walkways and bike trails are being built all over the city.

Jorea Marple, state superintendent of schools, says West Virginia's high numbers require a cross-agency attack. "It can't be solved by the education system alone or health care alone," she said. "I would very much like to be part of a discussion across departments. This is a public health issue, and all departments can contribute to its solution."

 She hopes to improve school meals and add physical activity to the children's day, she said. "We need to teach children how to stay healthy," she said. "One in four obese fifth-graders and one in four children with high blood pressure is not acceptable."

Delegate Don Perdue, chairman of the House Health and Human Resources Committee, said he is frustrated to see potentially helpful laws not being implemented.

"We created the GOHELP office partly to inventory our most successful programs so we could try them in other areas," said Perdue, a Wayne County pharmacist, "but GOHELP didn't do that, for whatever reason."

The GOHELP director, Martha Walker, and most of the staff have left. Gov. Earl Ray Tomblin has not filled those positions.

Similarly, "most of the Healthy Lifestyles Act has not been implemented," Perdue said.

Pore praised the state's network of 28 community health centers. "They are strongly oriented toward prevention," she said. Gupta cited Kanawha County's plans to build 100 miles of walking and biking trails.

"West Virginia could definitely lower the numbers, but for us to get there, our top leaders will have to give health care a top statewide priority. That's not happening yet, but we hope for it in the future," Bryant said.

Gallup Healthways surveys 353,000 Americans, 2,400 in West Virginia. Gallup Healthways is releasing its data one condition at a time. They provided the Gazette-Mail with all 12 categories.

West Virginia's 2011 statistics, according to Gallup Healthways, include: obesity, 35.3 percent; high blood pressure, 38.9 percent; high cholesterol, 33.5 percent; diabetes, 15.7 percent; depression, 23.9 percent; heart attack, 7.6 percent; cancer, 8.8 percent; neck or back condition, 38.9 percent; leg or knee condition, 33.9 percent; other recurring pain, 23.9 percent.

At 26.8 percent, West Virginia was second to Kentucky in smoking. At 13.2 percent, the state was sixth in asthma.

To see the Gallup Healthways poll online, visit http://bit.ly/AbNAiI