On the morning of my talk to the Northfield Rotary, the StarTribune published a story on a recent report by Blue Cross and Blue Shield of Minnesota and the Minnesota Department of Health: “Obesity and Future Health Care Costs: A Portrait of Two Minnesotas.” (Executive summary also available.) The report is a collaboration between Blue Cross and Blue Shield of Minnesota, the Minnesota Department of Health, and the Minnesota State Demographer. It is based on research by Kenneth E. Thorpe, Ph.D., of Emory University.

According to the StarTribune article, these are the key findings of the report:

• If Minnesotans pack on the pounds at current rates, fewer than one fourth will be a healthy weight by 2020, according to projections in the study prepared by Kenneth Thorpe, chairman of health policy and management at Emory University in Atlanta.

• Treatment costs for overweight or obese people will be 61 percent more by 2020 than for people of healthy weight.

• Unless rates go down, health problems related to overweight and obesity will account for 31 percent of the increase in health care costs projected to occur by 2020.

• That would add $900 million a year to the health care tab for Minnesota by 2010 and $3.7 billion a year by 2020.

I was particularly struck by this question and the answer from the StarTribune article.

What could reduce obesity rates?

[Dr. Sanne] Magnan[, commissioner of health,] recommended that communities provide more sidewalks, bike paths and parks to facilitate 30 minutes of moderate physical activity a day. Employers can have sidewalks nearby and can allow employees breaks for walks. “That’s probably the most powerful step we can take right now to have an immediate impact on people’s behavior,” [Dr. Marc] Manley[, vice president and medical director for population health at Blue Cross Blue Shield.] said.

I also dug into the report itself. Here is a choice quote from the executive summary:

Reframing the obesity epidemic

Tackling Minnesota’s obesity epidemic requires a clear understanding of the root causes. Although obesity has multiple causes, including genetics, biological factors cannot explain the rapid increase in U.S. obesity rates, which has occurred among all socioeconomic groups.

Being overweight is commonly considered an issue of personal responsibility, even a failure of personal willpower. However, the choices individuals make are always influenced by the social and physical environments in which they live.

The obesity epidemic may best be understood as an epidemic of inadequate physical activity and unhealthy eating. Our social and physical environments consistently promote poor eating
choices and less activity—that is “what’s normal” right now in Minnesota.

Changing “what’s normal” can be done. It will take creativity and persistence, and concerted action by community leaders. This report focuses on the economic payoff. But the payoff in human terms is equally compelling. [p. 3]

Changing “what’s normal.” That’s exactly what we need to do!

Here are two more important quotes from the full report:

The Root Causes of Obesity

…Additional environmental factors make it difficult for many individuals to incorporate regular physical activity into their lives:

• “Auto-centric” communities that often lack safe places to walk or bike for errands, commuting or recreation

• “Sprawl” that increases the distance between residences and common destinations (schools,
worksites, and shopping areas), thus heightening dependence on automobiles

To the extent that these factors contribute to more sedentary lifestyles, they also are associated with increased risk of overweight and obesity….

A Call to Action

[B]usiness, policy, and community leaders need to take collective action now to create environments and conditions that make healthier eating and regular physical activity the normal, easy choices for Minnesota’s residents. How can this be accomplished?

• Elected officials can guide community design through zoning and other policy mechanisms to create communities that are more amenable to walking and biking, and that increase access to fresh fruits and vegetables.

• Employers can create environments and policies where employees are encouraged to be active and offer low-cost, healthier options in the cafeteria and vending machines.

• Individuals also have a role, by taking increased responsibility for their decisions concerning use of leisure time and their food choices.

A major implication of this report is that even modest success at curbing the rise in obesity rates would substantially decrease the projected cost burden—with concomitant improvements in health and productivity. [p. 15]

This entry was posted on Monday, February 4th, 2008 at 2:38 pm and is filed under Biking/Walking, Health, Minnesota.