This diary is long. If you want the short, abridged, easy to digest version, here it is:
Lack of sane public health policy is killing us and drying up our Medicare funds.
Check out the graphic at this CDC site. Watch the map of the U.S. change from pale blue (low obesity incidence) to dark red (high rate of obesity) over the last twenty years.
Right now, over half of American adults are obese or overweight.
Wanna see something even scarier? Check out the map of obesity rates of low income pre-school children.
Yeah, that’s right. Pre-school children. These are kids who are too young to make their own food choices. Their parents are the ones overfeeding them. Or feeding them high fat meals. If both parents have to work to pay the rent, no one is going to have time to prepare home cooked meal. The cheapest, most filling pre-cooked meals are all high in fat.
These are kids too young to have homework, so presumably they have all day to play outdoors. Except that they probably live in a polluted, crime ridden urban area where playing outdoors is now dangerous, and so they spend their time inside, playing their big siblings’ video games. So maybe the problem is not just food choices. Maybe part of it is no exercise. Here is a map of physical activity levels across the U.S.:
Did you know that back pain costs this country $100 billion a year in lost work, medical care and disability? And that was back in 2004. Did you know that low back pain is the second most common reason folks see a doctor---after allergies and respiratory infections? You can probably guess what common medical problem is associated with low back pain.
Do you know what other common---and potentially much more serious---medical problem is associated with obesity? Here is the diabetes map of the U.S. Note that the “red” states in the south are also “red” with diabetes. These folks stand to benefit a lot from universal health care. Too bad so many of them are convinced that they do not need it.
More scary trends: Bush Lite created the No Child Left Behind act. Schools are now required to do a better job teaching kids….how to take standardized tests. So, public schools---like the ones my son attended in Fort Worth, Texas---- cut out physical education goals and started drilling students in how to improve their chances on a multiple guess test. You know. “Never” is seldom correct but “sometimes” usually is. Too bad there is nobody in the U.S. hiring standardized test takers. Too bad our children are growing up too heavy and out of shape for many of the starter jobs that our society does offer.
Ready for some really scary stuff? Kids are getting diabetes. Yeah, I know. Kids have always gotten diabetes. Type 1, the kind where the pancreas stops working for who knows what reason and the children have to take insulin shots. I am not talking about that kind of diabetes. This is Type II, the adult type that you usually see in folks over 40 who are overweight. In the past, these kids would have been healthy young adults. They would not have developed their parents’ diabetes until they reached middle age. Now, they are getting sick in high school. In elementary school. At this rate, they will have their first myocardial infarction before their kids go to their prom.
This is a public health disaster. Where is the national fitness czar? Where is the office of Homeland Healthy Lifestyles? Why has so much public health money been spent of bioterrorism----which has not occurred in the U.S. unless you count swine flu from Mexico as a “terrorist” act---and so little on keeping America fit?
In Fort Worth, all the public pools are closed. They were closed last year, too. The city says it does not have the money to maintain them. They have arranged for the YMCA pools to be open to the public a few hours a week. Yeah, times are tough. We all have to make sacrifices. Too bad your children can’t get outdoors to exercise during the summer, when temperatures are typically over 100. But at least they can exercise their eyes on these public art projects that the city of Fort Worth was able to afford at the same time that it couldn’t afford to keep our kids fit.
The city has spent over $2 million on two public art projects, but it does not have the money to open its pools. The city recently spent almost $40,000 building a parking lot for a pool that is closed.
Last year, the city decided to save money by closing all its pools except one. That one---the landmark Forest Park Pool---had to close early because it had not been repaired in decades, despite that fact that it is enormously popular. Estimated cost to catch up on repairs at the Forest Park pool: $1.5 million.
Note the advertisement at the top of the webpage for a new housing subdivision in Fort Worth which does include a pool---a private, not a public one. The city has at least seven country clubs, so that the rich and their children can stay fit. Also note that the Forest Park Pool did not suddenly spring a leak at a bad time. The pool was way overdue for maintenance. During the flush decades, before the recession, the city could have invested in its outdoor recreation for children. But it had other priorities back then. It was saving its pennies, nickels and millions for a river walk project that would encourage tourists to come to the city for leisurely walks along our too-polluted-to-fish-in Trinity River. I am sure it would have been lovely. More exercise for the eyes instead of the body.
The city of Fort Worth knows that diabetes---including diabetes among children---is a problem. I quote from the Tarrant County Medical Society web page: (The City of Fort Worth public health department was shut down to save money):
Diabetes is a chronic disease that has no cure. According to the American Diabetes Association, it also is the fifth-deadliest disease in the United States (2005). A growing concern today is the number of children and adolescents who are developing type 2 diabetes - a form of diabetes that was formerly diagnosed only among adults. The Diabetes Awareness and Prevention Curriculum was developed for middle school-aged students to bring about awareness of the disease and impart strategies on how it can be prevented.
The Texas Institute of Hispanic Health knows that there is a problem
We will expand our groundbreaking work with the Fort Worth ISD, clinics and community groups to combat obesity and diabetes in school-aged children, particularly Hispanics.
In March of 2000 we screened more than 1,000 Fort Worth fifth-graders for type 2 diabetes, cardiovascular disease and obesity; identifying almost 300 who were at risk, and prompting changes in FWISD food services and health/physical education procedures. We're currently seeking funds from Bristol Meyers to further test these identified at-risk children and prove the value of targeted interventions.
Further funding will enable us to provide targeted education and guidance to these children and their families, as well as to teachers, school nurses and family physicians. We also hope to conduct more rounds of screenings and follow-ups in both Fort Worth and Dallas.
The CDC knows that diabetes is a particular problem among Hispanics, and it has recommended prevention.
Apparently, in Fort Worth, regular exercise for children is not part of the preventive strategy.
Like all municipalities, the city of Fort Worth makes investments that it thinks will help raise more tax revenue. Children who develop diabetes go on SCHIP or Medicaid. That makes them a state or federal government problem. Unfortunately, Texas has a long history of failure to provide even the services it can afford. In the past, it has had extremely low rates of enrollment of children who were qualified for SCHIP and Medicaid, even though the money came from the federal government. And its current governor, Rick Perry, has said that he wants to eliminate Medicaid.
That leaves the federal government. Can we dump No Child Left Behind and get a No Child Left Out to Die of Preventable Disease program instead? Can we make sure that all the private and charter schools that are so much in vogue provide good nutrition and exercise? Maybe the feds could allocate more money for recreational facilities for at risk children. Maybe WIC---Women, Infants and Children (up to age 5)---nutritional services need to continue until kids are out of high school.
You know what is driving Medicare bankrupt? Besides the price gouging by (mostly foreign) drug companies? Chronic, preventable diseases, like low back pain and diabetes and its many complications. Yes, I know that there is no money. It is all being spent on tax cuts for the rich. But the rich already have recreational facilities for their kids. And one day, when Medicare is bankrupt, they will have platinum plated health insurance that will buy them the best possible care while the rest of us are dying on the streets of preventable illness that has it roots in childhood.
So, did you figure out what has me so scared? It is not obesity or diabetes. It is the almost total lack of any sort of sane public health policy in this country.