The Elephant in the room

[Trek420]

Not to politicize the board and I don't care whether you're blue or red or Dem or Republican I think I have found something we all can agree or nearly agree on while different viewpoints will abound:

Question for the group: can bikes, running, exercise along with sensible healthy eating solve or at least help the US health care crisis?

http://www.nytimes.com/2009/09/10/op...0pollan&st=cse


quote from the article "We’re spending $147 billion to treat obesity, $116 billion to treat diabetes, and hundreds of billions more to treat cardiovascular disease and the many types of cancer that have been linked to the so-called Western diet. One recent study estimated that 30 percent of the increase in health care spending over the past 20 years could be attributed to the soaring rate of obesity, a condition that now accounts for nearly a tenth of all spending on health care."

[Tri Girl]

Yes, I think you are right. We should invest money in MUP's, bike lanes, and healthier cities (ie: not so spread out you need a car to reasonably get around). Maybe workplaces could offer benefit (insurance) discounts if you can provide documentation that you are active (or something like that).
I would LOVE to see us become healthier and have healthier cities. I live in one of the bottom 10 fattest states (last I checked) and we sure could use some "trimming down." We have hundreds of miles of proposed trails in our city, but very few have been built because of funding issues.

Honestly, tho, as much as I'd like to think that if you made it easy for people they'd become more active- in reality I think "we" are a lazy society and will always choose cars over healthier options. The fact that my co-workers are just flabbergasted and in awe that I ride 3 miles to work everyday (that's SO far- how do you do it?), and that they think that's so unattainable tells me most people are not ready/willing to make big changes. Change is hard.
In my heart of hearts I wish we could change, tho. Maybe one day...

[Trek420]

I have a theory, but no medical experience or training to bear it out.

I think we few, we happy few (active folk) are different. Stuff others think undoable, my 2 mile bike to work, walking the dog before and after work, any work out you do feels GOOD. We want to do this the way others want to sit and veg. Feel the burn, the burn feels good.

Part of my theory is that nearly all of my family does something in the way of a workout or just has an active lifestyle.

Where others strive to sit.

How many of the little things you do, not even the epic ride get a raised eyebrow from your peers? When I get off the elevator on the 2nd floor (no stairs from the 1st) to walk to the 6th and a coworker says "You do that on purpose? When the elevator works? "

[Jolt]

I definitely believe that healthier lifestyles would go a long way toward helping with our health-care problems. Given how much of the health care costs come from chronic diseases that seem to be fairly preventable, getting our society to be more active and eat a healthier diet should cut way down on those costs. The problem is motivating people to change their habits and making it easier for them to succeed. The way things are currently set up, there are some big obstacles: needing a car to get around many places because of the distance and/or road conditions, office jobs requiring one to sit at a desk all day, pressure to overschedule ourselves making it difficult to fit in exercise (since most of the physical activity has been taken out of our daily life) or the time to cook from scratch, the fact that processed junk foods tend to be significantly cheaper than a lot of healthier whole foods, safety issues in some neighborhoods making people afraid to get outside and walk/let their kids outside to play, and I'm sure some of you can think of others. To really solve the problem, there will have to be some major changes in the culture and that will take time. The ideas put forth so far about investing in cycling facilities and offering incentives for people to eat well/be active are good ones. In regards to encouraging cycling, I think an important part of that would be educating the public about sharing the road and following the same rules on a bike as in a car. I would also add community farms/gardens using a CSA model and offering discounts to people for putting in time helping out on the farm (and thereby getting some exercise to boot). Maybe those places could also offer cooking classes featuring whatever is in season and focusing on recipes that are quick and easy. I'm not sure what we can do about the office jobs so many people are stuck in...maybe there would be some way to get some physical activity into the job (and at least some people have the option to commute by bike or on foot).

[Selkie]

I agree with you 100%. It would be great for any sort of activity to be encouraged and I would LOVE to get discounts on insurance, a lower tax rate, etc., due to my active/healthy lifestyle. Maybe that would be a great incentive---lower your federal tax rate if you work out xxxx hours a week!

People are over-scheduled and stressed out. I think a lot more people would take the time to devote to fitness IF they had that luxury of time (which seems to get more precious with every passing year). The big house or even "affordable house" far from work and a 2 hour commute make it nearly impossible for a lot of people.

What is most worrisome is the large number of KIDS who are overweight. And young adults. I'm 46 and am in better shape/health than probably 97% of the females under 35 with whom I work. Of course, I don't have kids, so I ostensibly have more free time to devote to my athletics. [I do have a husband, 3 dogs, a full-time job, and a house, so it can be argued that I'm not completely unencumbered by obligations]. That said, I do so at personal sacrifice -- getting up at an ungodly hour to ride and swim so I can fit in work and home responsibilities.

[Crankin]

While I don't think this has anything to do with politics, I can already hear the people screaming that this would be "too much big government." Sorry, but I just saw the news tape of the protest in DC yesterday. I would like to ask those people what they would do if they lost their job and then got sick...
OK back on topic. This is something that is dear to my heart. But even my well educated, financially well off friends think I am weird for doing what I do. Perhaps some of us are hard wired to be active. My oldest son, while active in the sense of walking everywhere (up to 10 miles) and using public transportation a lot, has done nothing else for fitness. About a month ago, he started riding the old mountain bike we gave him, which is set up for commuting. He is now totally hooked, riding to work at least 3 days a week and once or twice on the weekends. Yesterday, we went to his place, to give him some lights, gloves, and a jacket (all of which we had "hanging around ,") and when I heard him say "I have to ride tomorrow," I thought we have created a monster. But, I think it's in his genes and he sees the writing on the wall in terms of fitness.
It is hard to plan time for fitness or walking/riding to work. I am faced with this now with my new schedule. My day now consists of sitting down all day, and I really hate it. Even though I supposedly live in the second skinniest state in the country, we have virtually no MUTs compared to other places. Unless you live in the city, you need a car...

[Reesha]

There would be a lot of potential for abuse of the incentives program, I think, but I do feel that the way to go is to push for more bike lines, more pedestrian access, and more education all around. In cities, bicycling can certainly be an answer but in the suburbs designed around the car, people have to be fairly hardcore to get themselves from point A to point B because it IS farther. My rural experience says that there is ample opportunity to be active simply by being in the sticks, but many choose not to take these opportunities and use their car for everything.

I don't think that this 'active desire' is genetic, but I do feel that it is an environmental thing. I grew up surrounded by both obesity and activity. My brother and sister became obese and I watched them (and my mother) gain weight and decided that would not be me. Since, then, I've watched my brother take up road biking and track racing and he is gradually starting to change shape and slim down. I'm really proud of him because I know that it requires a near-complete reprogramming of habits he's developed over a lifetime. Also, as the youngest, he was enabled a lot when it came to food and sedentary lifestyle. We're trying to encourage our sister gently, but she really needs to see the writing on the wall on her own.

I agree with you Crankin, that in many ways New England is a bit of a conundrum. It's generally a fairly 'thin' cluster of states, but man are the roads NOT fit for cycling. We made the best of it, but NE roads simply weren't designed for other travel besides car travel. I'd love to see Boston shift its eye toward complete streets now that the Big Dig and the bridge are essentially complete.

Another interesting thing is that some cities that have a large bicycling population still aren't as bicycle-friendly as they ought to be. Madison, WI is a good example of this. I don't think I've ever been to a city with more bicyclists, but there were only as many bike lanes as there are in St. Louis. You'd think with such a flourishing bike culture, the city would try to do more for these people.

All I can say is vote vote vote and lobby for yourselves. I wish there was a way to donate my tax money to specific causes, we all know that that's not how it works.

[Medianox]

Everyone has very valid points and I agree with what I have read here so far.
As someone with many years in health care (RN since 1991 and was LVN for 10 years prior to that) I have seen many programs and improvements come and go.
What never changes and what needs to change first before anything is the fact that most americans are very ignorant of how their bodies work and what good health is in the first place. Its a cart before the horse situation if you throw tons of info at people explaining why exercise is good, or why eating better can prevent or improve certain conditions and diseases but if they have no understanding of what those diseases and conditions are in the first place-its very hard to make it stick.
Education is a huge part of my job and I can't tell you how many times I've started to teach someone the basics of how to manange something like diabetes lets say, and when I begin with, "The body has a special organ, the pancreas, that makes insulin that regulates blood sugar..." so many people don't even know that they have a pancreas, let alone where it is or what it does. These are not illiterate people. Most have at least a high school education, if not more. That is just one example, I could go on but the point is, until this country gets serious about health education from elementary school forward, all the reforms in the world won't make much of a difference. Its a matter of getting people as a society to care from the ground up about their own health and I just don't see that happening any time soon.
There are so many facets to this arguement that it well could be endless but we have to look at why it is cheaper in this country to eat poorly and be obese than it is to eat in a healthy manner and be fit. Also, to touch on a very sensitive subject we need to have a mature outlook on end of life and have realistic expectations of what that means.
Sorry for the rant.

[roadie gal]

I completely agree with everyone that exercise and better eating would go a long way to cutting down on so many health issues. But it's not just Americans. I recently read an article that compared exercise to non-emergent angioplasty in stable angina. The article, from somewhere in Scandinavia (Norway I think), showed that they were equally effective. The interesting thing to me, though, is that they had to stop the study early because they couldn't recruit enough people into the exercise arm of the study. Most people wanted the quick fix of the angioplasty rather than the long term commitment of exercise. It's a problem in all of the first world countries.

[skhill]

More bikes and more/better bike infrastructure would help, sure, but...

One obvious thing that no one seems to be talking about (probably because it's even more politically dangerous to address) is changing agricultural policies, so that we're no longer producing mountains of cheap corn ready to be turned into cheap junk food. Might it not be better for our nations health if real food were cheaper than the junk? And if the crappy groceries in poor neighborhoods carried real food?

And it's so retro, but how about home-ec for all kids? If their parents don't cook, and their grandparents don't cook, they're not learning just how easy and cheap (if maybe time-consuming) it can be to put together a tasty, healthy meal... I recently took a loaf of home-made bread to a neighbor who's been having a rought time, and her 11 year old daughter had never even seen a loaf of home-made, not pre-sliced bread. Somehow, I don't think that's all that unique. There's something wrong with this situation...

Anyway, my 2 cents...

[Trek420]

.... we have to look at why it is cheaper in this country to eat poorly and be obese than it is to eat in a healthy manner and be fit.

I agree. You see ads for fast food billed as the friend of the busy and or working poor. "Got a buck, you're in luck". Don't get me started on subsidies to corn farmers so we can have cheap high fructose corn syrup (the first item in the label of most junk) while farms producing other produce struggle and many neighborhoods can't get fruits and vegies at all.

It's cheap now but there are long term costs of that Happy Meal are vast. I don't want to pay for for an entire nations angioplasty nor your long term care from the stroke.


People want good food. Read below where a Christian Community Group finds a way to bring fresh produce to the community with 26 liquor stores and only one grocery store:

http://www.madamethejourney.com/2009...uce-truck.html

And it's been proven over and over that where a safe option exists people prefer to bike or walk for work or errands.

This is why when asked "how much does your bike cost?" I say that I think of it as an investment in my health.

Support your local bike advocacy group, help solve the health care crisis.

[Jolt]

While I don't think this has anything to do with politics, I can already hear the people screaming that this would be "too much big government." Sorry, but I just saw the news tape of the protest in DC yesterday. I would like to ask those people what they would do if they lost their job and then got sick...

And the kicker is that a lot of the stuff being discussed here doesn't even have to (and often shouldn't) be done by the government! Sure, things like changing the infrastructure and agricultural policies will require government intervention, but incentives for healthy habits can be provided by employers and insurance companies. Education about exercise (including safe cycling), healthy eating and as Medianox said, about what good health is and how the body works can be carried out by other organizations and individual health workers (I happen to be a nurse as well, and working on becoming a nurse practitioner). For example, churches could (and some do) have parish nurses whose role includes educating and providing information about health topics; I am trying to work on getting something like that started in my church since we have a good number of nurses. Cyclists in a community could get together and do a presentation on utility cycling and road safety in a place like a YMCA or community center. Grassroots activities have a lot of potential to help this situation.

[Jolt]

I completely agree with everyone that exercise and better eating would go a long way to cutting down on so many health issues. But it's not just Americans. I recently read an article that compared exercise to non-emergent angioplasty in stable angina. The article, from somewhere in Scandinavia (Norway I think), showed that they were equally effective. The interesting thing to me, though, is that they had to stop the study early because they couldn't recruit enough people into the exercise arm of the study. Most people wanted the quick fix of the angioplasty rather than the long term commitment of exercise. It's a problem in all of the first world countries.

Would you mind posting a link or reference to that article? It sounds really interesting (speaking as a nurse with an interest in cardiology)!

[shootingstar]

And the kicker is that a lot of the stuff being discussed here doesn't even have to (and often shouldn't) be done by the government! Sure, things like changing the infrastructure and agricultural policies will require government intervention, but incentives for healthy habits can be provided by employers and insurance companies. Education about exercise (including safe cycling), healthy eating and as Medianox said, about what good health is and how the body works can be carried out by other organizations and individual health workers (I happen to be a nurse as well, and working on becoming a nurse practitioner).

Designing communities with neighbourhoods, transportation infrastructure and services that encourage more use of non-car transportation should be encouraged...as one piece of the whole big solution.

Nothing wrong with incentives by employers and other organizations to encourage healthy habits and lifestyles, but...real long lasting change also must begin early in life and at home, with parents/at home where eating habit, activities and diet have a profound influence on children's foundational health ...for their future.

It is hard work and patience here that demands serious dedication and consistency by parents and other adults to provide to children reasonably healthy food day after day, week after week, year after year and finds ways to encourage them to eat it.

[Crankin]

I read that article (the one about angioplasty), and while I really do agree that for the majority of people with these symptoms, lifestyle changes would probably eliminate the need for angioplasty, it doesn't apply to everyone. My DH was dealt the card of horrible genetics and despite the fact he was a already a fit cyclist who ate well, he still had 2 80% blockages. It's true that if he had started cycling 10 years earlier and had started medication before he did (about a year before the surgery), maybe they would not have developed. But, he was not inactive, was not overweight, and ate better than most people.
I guess I just don't want people to think that lifestyle changes is the whole thing...