Obesity and Diabetes: Two programs are taking a new approach to preventing chronic disease
From the opening keynote of this week's National Health Journalism Fellowship seminar, prevention and health beyond just health care have been common themes. Today's afternoon panelists gave examples of programs that take simple, novel approaches to integrating physical activity into people's daily lives.
Take a Walk
Dr. Glenn A. Lopez, a family physician and public health expert, revealed some startling facts: Two out of three Latinos in Los Angeles who have diabetes are not being treated. Of those who are untreated, half are not being treated for economic reasons or because they wait until they feel the symptoms of diabetes to seek treatment. The other half do not know that they have the diesase. The Department of Health does not do mass screenings for diabetes and other chronic diseases. "They don't want to go near it with a ten-foot pole," he said, largely because they do not have the capacity for treating people they diagnose.
The problem is not just one of health -- it is a cost issue. The average per year health care costs of someone without diabetes is $2,500. Diabetes patients' costs are an average of $12,500 per year. Part of the reason for this huge gap is that so many diabetics go untreated and end up in emergency rooms with complications, where they receive care that is much more expensive than prevention would have been.
Lopez, an assistant professor at UCLA, created community walking groups in Sun Valley to help prevent chronic disease and make it easy for people to exercise. The idea took off, and now the program is run by a nonprofit called "Walking in Community ... A Project of Community Partners." The groups, now led by local community members, have been given $50,000 by Los Angeles County and the City of Los Angeles to continue and expand. Lopez created a company, OnSite Health Solutions, to integrate mobile primary care into these neighborhoods as well as corporate settings.
Instant Recess
Dr. Antronette K. Yancey, M.D., M.P.H., is fighting a war against prolonged sitting. Yancey, a UCLA professor and co-director of the UCLA Kaiser Center for Health Equity (formerly the Center to Eliminate Health Disparities), aims to make inactivity as unacceptable as smoking or drinking and driving.
"Our genes have not changed much over the last 40 years," she said. "What has changed is our environment."
Among African Americans, Latinos and whites in Los Angeles county, one-third of adults are obese. Many Asians and Pacific Islanders may look as though they have escaped this epidemic, but measurements of their body mass indexes show that they are still at high risk for chronic disease. Also, the statistics do not differentiate between recent immigrants and Asians who have grown up in America. Disparities have much to do with socio-economic status. Low-income families have less leisure time, less park space, longer commutes and generally less healthy lifestyles. Advertising for unhealthy lifestyles -- sodas and fast-food for example-- is concentrated in poor neighborhoods and communities of color.
"For most of human history on the planet, exercise was something to minimize," Yancey said. "That was a survival advantage."
To change that mindset, Yancey is creating programs to make fitness a part of life. FriarFit is a resource developed with the San Diego Padres, and Sparking Motion is a collaboration with the Los Angeles Sparks. The programs and Yancey's work promote "instant recess," in which organizations integrate short bouts of physical activity into the workplace.
"Our health care system is really a medical care system," said Yancey. Medical care, however, only makes up a small part of health. "If we spend a little more on the prevention side, we might get a lot more health bang for our buck."