Experts Say Tackling Michigan's Obesity Issue Requires Broad Approach
Olga Dazzo stood before a crowd of a hundred or so under the Capitol dome last month and admitted something not normally heard at a press conference.
"I'm obese," said the newly appointed head of the Michigan Department of Community Health. "My BMI is over 30."
BMI stands for "body mass index," and it's one measurement of how much unhealthy fat a person is carrying around. Anything over 25 is considered overweight and over 30 is considered obese.
Dazzo's explanation for revealing such personal information at a public event was a single word.
"Transparency," she said.
Her boss, Gov. Rick Snyder, has made it one of Michigan's top priorities to not only trim the state's budget, but also its waistlines.
Snyder surprised some people in January when he mentioned obesity in his first State of the State Address alongside the state's budget crisis and unemployment.
"We will look to build a system that encourages all of us to have an annual physical, reduce obesity and encourage an active and healthier lifestyle in our state," Snyder said in his speech.
He has deemed the issue so important, in fact, that he is tracking the state's obesity rate on his Michigan Dashboard - a website where citizens can measure the state's progress on things such unemployment and the number of children living in poverty.
But is it realistic to think that a state government can actually change the obesity tide?
10th fattest state
The scales are clear: Michigan has a lot of work to do.
According to a 2010 report called "F as in Fat" by the Trust for America's Health and the Robert Wood Johnson Foundation Michigan tied with North Carolina as the 10th fattest state in the nation.
Nearly 30 percent of Michigan adults and 12 percent of children are considered obese.
Experts and officials say the consequences are vast and frightening.
Obese people are at greater risk of range of health problems, from Type 2 diabetes and heart disease to stroke and some cancers.
"We are facing the first generation to have shorter life spans than their parents," Dazzo said at the same press conference last month.
The heavy burden strains more than our bodies. It also weighs down our state pocketbook.
Obesity-related health care costs in Michigan now top $2.9 billion a year, according to a study by the National Conference of State Legislatures.
That's an issue of particular urgency to Michigan, where skyrocketing Medicaid costs have become one of the largest and most inflexible pieces of the state budget.
The state's Medicaid population has spiked 54 percent since 1999. Nearly 2 million Michiganians - almost 20 percent of the entire state population - now rely on the publicly funded program for their health care coverage.
At $2 billion of state dollars, it represents nearly 25 percent of the general fund.
The numbers are expected to grow even more after 2014, when a portion of the federal health care reform act goes into effect and will expand Medicaid eligibility.
"There is a huge financial component to this," said Geralyn Lasher, Snyder's communications director. "There is an impact even on jobs. We need a vibrant and healthy workforce. Increasing productivity through health and wellness are important to the success of a business."
Understanding the consequences, however, doesn't necessarily lead to solutions.
Obesity is a deep ocean of a problem with countless rivers of factors feeding it.
Finding solutions requires sensitive and at-times unpopular debates about the role of personal responsibility (get more exercise) versus public policy (build more bike lanes).
There are also disparities among ethnic groups, income levels and educational attainment.
According to the "F as in Fat" report:
• In Michigan, 38 percent of blacks are obese, compared to 33 percent of Latinos and 28 percent of whites.
• Nationally, 35 percent of people who earn less than $15,000 a year are obese compared to 25 percent of people earning more than $50,000, according to the same report.
• People without a high school diploma make up 34 percent of the obese adult population versus 22 percent for those with a college degree.
No one reason
Bottom line: People are fat for a lot of reasons.
So finding real, lasting solutions is neither easy nor quick, said Marilyn Lieber, president and CEO of the Michigan Fitness Foundation, a nonprofit created in 1994 to support the Governor's Council on Physical Fitness, Health and Sports.
"If every state agency looks at what they can do to support that, and if all the workplaces and schools do it, and if everyone has a goal to help the people in their lives improve their health, we can make a difference," Lieber said. "But that requires such a broad approach, and no state that has tried to do this has been successful yet."
That's not to say there haven't been some victories or individual success stories the state could build on, Lieber said.
Some companies, including Okemos-based Jackson National Life, have made healthy employees a corporate mission.
Jackson employees have an array of employer-sponsored wellness activities available to them both at their workplace and afterhours.
For example, fitness classes are offered during lunch breaks and after business hours at the insurance company's headquarters. The company will pay sign-up fees for employees who want to join a gym and offers flu shots on-site each year.
"If you have happy, healthy associates, you're going to have a healthy, happy, more productive work environment," spokeswoman Kristyn Ladd said.
"It goes back to the concept that we know our company is only as great as our associates."
The only way for Michigan to see broad change in its health is for groups like Jackson National Life to join others and take a comprehensive approach to the problem, said Emily Pols-rok, spokeswoman for the Healthy Kids Healthy Michigan coalition.
The coalition is made up of 120 organizations, including Blue Cross Blue Shield, the Michigan State Medical Society and the Michigan Soft Drink Association.
Last year, the group successfully lobbied the state Board of Education to approve a resolution encouraging school districts to adopt higher nutrition standards for school breakfast and lunch programs, Pols-rok said.
"In some areas of the state, the food that children are receiving at school could be their main source of nutrition for the day," Polsrok said. "It's so important that it be good for them."
The group's 2011 agenda includes strengthening school health and physical education programs and a requirement that safety and transportation issues be taken into effect in decisions about school closures.
Individually, each issue seems just a small drop in the obesity ocean, said Polsrok. But obesity cannot be tackled any other way.
"You bring in different groups, each with a specialty that is one piece of the whole who can affect policy change," she said. "There are changes our society can make and our state can make to help move that needle on the dashboard. It's not going to happen overnight. Not even in year or two. But the changes we can incorporate now will make a difference five to 10 to 15 years down the road."
In the meantime, Community Health Director Dazzo has been charged with coming up with a plan to whip the state into shape.
That makes her, in effect, the state's leading personal trainer.
She's trying to lead by example. "I've already lost 10 pounds," Dazzo said.
Source: Lansing State Journal